| 1. |
- Ding, Ding, et al.
(författare)
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Can dementia be predicted using olfactory identification test in the elderly? A Bayesian network analysis
- 2020
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Ingår i: Brain and Behavior. - : John Wiley & Sons. - 2162-3279 .- 2162-3279. ; 10:11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: 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.
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| 2. |
- Ding, Ding, et al.
(författare)
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Cholesterol profiles and incident cognitive decline among older adults : the Shanghai Aging Study
- 2021
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Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:2, s. 472-479
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: the association between cholesterol profiles and risk of cognitive decline among older adults was inconclusive.OBJECTIVE: to examine the association between cholesterol profiles and risk of cognitive decline in older adults with or without vascular risk factors (VRFs) in the prospective phase of the Shanghai Aging Study.DESIGN: a prospective community-based cohort study.SETTING: Shanghai, China.PARTICIPANTS: we prospectively followed 1,556 dementia-free participants aged ≥60 years with a baseline cholesterol profile for 5.2 years on average. Participants with at least one of obesity, diabetes, hypertension, stroke, and coronary artery disease were categorised to the VRFs group, and those free of any VRFs were categorised to the non-VRFs group.METHODS: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol in serum were measured at baseline. At follow-up, consensus diagnosis of incident dementia and Alzheimer's disease (AD) were established based on medical, neurological, and neuropsychological examinations. Cox regression was used to assess the association between cholesterol and incident dementia/AD; multivariate linear regression was used to examine the relationship between cholesterol and an annual rate of Mini Mental State Examination (MMSE) score decline in participants with or without VRFs.RESULTS: among VRFs-free participants, TC (HR 0.62, 95%CI 0.40-0.95) and LDL-C (HR 0.47, 95%CI 0.28-0.80) were inversely associated with incident dementia, LDL-C was inversely associated with incident AD (HR 0.50, 95%CI 0.28-0.90). A significant correlation was found between incremental TC (β = 0.08), LDL-C (β = 0.09), and a slower annual decline of MMSE score.CONCLUSIONS: effect of cholesterol on cognitive decline may be modified by VRFs.
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| 3. |
- Ding, Ding, et al.
(författare)
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Predictive Value of Odor Identification for Incident Dementia : The Shanghai Aging Study
- 2020
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Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media S.A.. - 1663-4365 .- 1663-4365. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to evaluate the value of odors in the olfactory identification (OI) test and other known risk factors for predicting incident dementia in the prospective Shanghai Aging Study.Methods: At baseline, OI was assessed using the Sniffin' Sticks Screening Test 12, which contains 12 different odors. Cognition assessment and consensus diagnosis were conducted at both baseline and follow-up to identify incident dementia. Four different multivariable logistic regression (MLR) models were used for predicting incident dementia. In the no-odor model, only demographics, lifestyle, and medical history variables were included. In the single-odor model, we further added one single odor to the first model. In the full model, all 12 odors were included. In the stepwise model, the variables were selected using a bidirectional stepwise selection method. The predictive abilities of these models were evaluated by the area under the receiver operating characteristic curve (AUC). The permutation importance method was used to evaluate the relative importance of different odors and other known risk factors.Results: Seventy-five (8%) incident dementia cases were diagnosed during 4.9 years of follow-up among 947 participants. The full and the stepwise MLR model (AUC = 0.916 and 0.914, respectively) have better predictive abilities compared with those of the no- or single-odor models. The five most important variables are Mini-Mental State Examination (MMSE) score, age, peppermint detection, coronary artery disease, and height in the full model, and MMSE, age, peppermint detection, stroke, and education in the stepwise model. The combination of only the top five variables in the stepwise model (AUC = 0.901 and sensitivity = 0.880) has as a good a predictive ability as other models.Conclusion: The ability to smell peppermint might be one of the useful indicators for predicting dementia. Combining peppermint detection with MMSE, age, education, and history of stroke may have sensitive and robust predictive value for dementia in older adults.
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| 4. |
- Wu, Jie, et al.
(författare)
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The impact of kidney function on plasma neurofilament light and phospho-tau 181 in a community-based cohort : the Shanghai Aging Study
- 2024
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Ingår i: Alzheimer's Research & Therapy. - : BioMed Central (BMC). - 1758-9193. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The blood-based biomarkers are approaching the clinical practice of Alzheimer's disease (AD). Chronic kidney disease (CKD) has a potential confounding effect on peripheral protein levels. It is essential to characterize the impact of renal function on AD markers.METHODS: Plasma phospho-tau181 (P-tau181), and neurofilament light (NfL) were assayed via the Simoa HD-X platform in 1189 dementia-free participants from the Shanghai Aging Study (SAS). The estimated glomerular filter rate (eGFR) was calculated. The association between renal function and blood NfL, P-tau181 was analyzed. An analysis of interactions between various demographic and comorbid factors and eGFR was conducted.RESULTS: The eGFR levels were negatively associated with plasma concentrations of NfL and P-tau181 (B = - 0.19, 95% CI - 0.224 to - 0.156, P < 0.001; B = - 0.009, 95% CI - 0.013 to -0.005, P < 0.001, respectively). After adjusting for demographic characteristics and comorbid diseases, eGFR remained significantly correlated with plasma NfL (B = - 0.010, 95% CI - 0.133 to - 0.068, P < 0.001), but not with P-tau181 (B = - 0.003, 95% CI - 0.007 to 0.001, P = 0.194). A significant interaction between age and eGFR was found for plasma NfL (Pinteraction < 0.001). In participants ≥ 70 years and with eGFR < 60 ml/min/1.73 m2, the correlation between eGFR and plasma NfL was significantly remarkable (B = - 0.790, 95% CI - 1.026 to - 0,554, P < 0.001).CONCLUSIONS: Considering renal function and age is crucial when interpreting AD biomarkers in the general aging population.
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| 5. |
- Xiao, Zhenxu, et al.
(författare)
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Olfactory function, neurofilament light chain, and cognitive trajectory : A 12-year follow-up of the Shanghai Aging Study
- 2023
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Ingår i: Alzheimer's and Dementia. - : John Wiley & Sons. - 2352-8729. ; 15:4
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to determine whether blood neurofilament light chain (NfL) modifies the association of olfactory dysfunction (OD) with long-term cognitive decline. A total of 1125 non-demented older adults in the Shanghai Aging Study were evaluated for baseline olfaction (12-item Sniffin' Sticks Smell Test) and cognitive trajectory by a 12-year follow-up. Baseline blood NfL was quantified using Single Molecular Array assay, and dichotomized into low and high levels based on the median value of concentration. The Mini-Mental State Examination (MMSE) and Telephone Interview for Cognitive Status-40 were used to assess participants' cognitive function. Cognitive decline was ascertained when dementia was diagnosed or documented in the medical record during follow-up, or the MMSE declining rate (slope) was 1.0 SD larger than the group mean. OD participants presented a steeper trajectory of MMSE score (p interaction = 0.004) and a high risk of cognitive decline (adjusted HR [95% CI], 1.82 [1.11, 2.98]) only in those with high NfL. Participants with combined OD and high NfL showed the highest risk of cognitive decline (adjusted HR, 2.43 [1.20, 4.92]). OD, especially in combination with high blood NfL concentration, may be able to identify individuals who later incur cognitive deterioration.
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| 6. |
- Xiao, Zhenxu, et al.
(författare)
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Plasma p-tau217, p-tau181, and NfL as early indicators of dementia risk in a community cohort : The Shanghai Aging Study
- 2023
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Ingår i: Alzheimer's and Dementia. - : John Wiley & Sons. - 2352-8729. ; 15:4
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Blood biomarkers showed values for predicting future cognitive impairment. Evidence from the community-based cohort was limited only in high-income countries.METHODS: This study included 1857 dementia-free community residents recruited in 2009-2011 and followed up in waves 2014-2016 and 2019-2023 in the Shanghai Aging Study. We intended to explore the relationships of baseline plasma ALZpath phosphorylated tau 217 (p-tau217), p-tau181, neurofilament light chain (NfL) with follow-up incident dementia, Alzheimer's disease (AD), and amyloidosis.RESULTS: Higher concentrations of plasma p-tau217, p-tau181, and NfL were correlated to higher decline speed of Mini-Mental State Examination score, and higher risk of incident dementia and AD. The p-tau217 demonstrated a significant correlation with longitudinal neocortical amyloid-beta (Aβ) deposition (r = 0.57 [0.30, 0.76]) and a high accuracy differentiating Aβ+ from Aβ- at follow-ups (area under the receiver operating characteristic curve = 0.821 [0.703, 0.940]).DISCUSSION: Plasma p-tau217 may be an early predictive marker of AD and Aβ pathology in older community-dwelling individuals.Highlights: Plasma p-tau217, p-tau181, and NfL were positively associated with long-term cognitive decline and risk of incident dementia.Plasma p-tau217 showed a better performance distinguishing Aβ+ individuals from Aβ- individuals at follow-ups.Plasma NfL may be a suitable predictor of general cognitive decline in older community-dwelling individuals.
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| 7. |
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| 8. |
- Zhu, Zheng, et al.
(författare)
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TOMM40 and APOE variants synergistically increase the risk of Alzheimer's disease in a Chinese population
- 2021
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33:6, s. 1667-1675
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Tidskriftsartikel (refereegranskat)abstract
- Background: The apolipoprotein E (APOE) epsilon 4 allele is a strong risk factor for Alzheimer's disease (AD) in Caucasian and African American populations. It suggests that other genetic factors may modulate AD pathogenesis in Chinese populations, among which the frequency of this allele is reduced but the AD prevalence is maintained. The translocase of outer mitochondrial membrane 40 (TOMM40), which is located adjacent to APOE,may play an APOE-dependent role in modulating AD pathogenesis.Aims: This work aimed to investigate whether TOMM40 polymorphisms modulate AD risk independently of, or in conjunction with APOE polymorphisms in Chinese populations.Methods: We conducted a case-control study including 834 patients with AD recruited from the Memory Clinic and 643 cognitively normal participants recruited from the community. The Taqman SNP method was used for APOE genotyping, while TOMM40 polymorphism genotyping was conducted via a polymerase chain reaction-ligase detection reaction.Results: TheTOMM40 rs10119 and rs71352238 alleles were associated with AD independently of the patient APO status. The rs10119 AA genotype and rs71352238 CC genotype were risk genotypes of AD. Individuals carrying a TOMM40 rs10119 GG/APOE epsilon 4+ (OR, 3.73; 95% CI 1.49-9.37;P = 0.005), TOMM40 rs10119 AG/APOE epsilon 4+ (OR, 4.16; 95% CI 3.30-5.24;P < 0.001), or TOMM40 rs10119 AA/APOE epsilon 4+ (OR, 14.78; 95% CI 8.56-25.54;P < 0.001) genotype exhibited a significantly higher AD risk. Those carrying a TOMM40 rs71352238 TT/APOE epsilon 4+ (OR, 3.82; 95% CI 2.32-6.29;P < 0.001), TOMM40 rs71352238 CT/APOE epsilon 4+ (OR, 4.40; 95% CI 3.46-5.56;P < 0.001), or TOMM40 rs71352238 CC/APOE epsilon 4+ (OR, 14.02; 95% CI 7.81-25.17;P < 0.001) genotype also exhibited a significantly increased AD risk.Discussion and conclusions: This study provides invaluable insights into the mechanisms underlying the prevalence of AD in Chinese populations, and supports that simultaneous TOMM40 and APOE genotyping in the clinical setting may identify individuals at high risk of developing AD.
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