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1.
  • de Rojas, I., et al. (författare)
  • Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores
  • 2021
  • Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer’s disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer’s disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer’s disease. © 2021, The Author(s).
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  • Bellenguez, C, et al. (författare)
  • New insights into the genetic etiology of Alzheimer's disease and related dementias
  • 2022
  • Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 54:4, s. 412-436
  • Tidskriftsartikel (refereegranskat)abstract
    • Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele.
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  • Hausner, Helene, et al. (författare)
  • Effects of repeated exposure on acceptance of initially disliked and liked Nordic snack bars in 9-11 year-old children
  • 2012
  • Ingår i: Clinical Nutrition. - 0261-5614 .- 1532-1983. ; 31:1, s. 137-143
  • Tidskriftsartikel (refereegranskat)abstract
    • Background & aims: Children's food choices are guided by their preferences. It is established, however, that repeated exposure to a novel food increases children's acceptance. This study investigated how acceptance of an initially liked and disliked snack bar develops in 9-11 year-old children. Methods: 315 children were randomised into three groups: A control group (n = 111) and two groups exposed to an initially liked kamut bar (n = 94) and an initially disliked sea buckthorn bar (n = 110). Acceptance of both bars was tested before and after the exposure period, and on the 9th exposure. Results: Intake of both bars increased significantly in the exposure groups. There was no difference in the control groups' intake or liking of the bars between pre and post-testing. Liking rose significantly for children exposed to the disliked sea buckthorn bar, while this was not observed in children exposed to the liked kamut bar. In a post-test children exposed to kamut bars had higher intake of that bar than non-exposed children. This was also observed for the sea buckthorn bar that was also given significantly higher liking scores by the exposure group. Conclusions: The majority of children exposed to an initially disliked bar increase acceptance after nine exposures to the same level as an initially liked bar. Children repeatedly exposed to a liked bar show stable acceptance.
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  • Jansen, Willemijn J, et al. (författare)
  • Prevalence Estimates of Amyloid Abnormality Across the Alzheimer Disease Clinical Spectrum.
  • 2022
  • Ingår i: JAMA neurology. - : American Medical Association (AMA). - 2168-6157 .- 2168-6149. ; 79:3, s. 228-243
  • Tidskriftsartikel (refereegranskat)abstract
    • One characteristic histopathological event in Alzheimer disease (AD) is cerebral amyloid aggregation, which can be detected by biomarkers in cerebrospinal fluid (CSF) and on positron emission tomography (PET) scans. Prevalence estimates of amyloid pathology are important for health care planning and clinical trial design.To estimate the prevalence of amyloid abnormality in persons with normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia and to examine the potential implications of cutoff methods, biomarker modality (CSF or PET), age, sex, APOE genotype, educational level, geographical region, and dementia severity for these estimates.This cross-sectional, individual-participant pooled study included participants from 85 Amyloid Biomarker Study cohorts. Data collection was performed from January 1, 2013, to December 31, 2020. Participants had normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia. Normal cognition and subjective cognitive decline were defined by normal scores on cognitive tests, with the presence of cognitive complaints defining subjective cognitive decline. Mild cognitive impairment and clinical AD dementia were diagnosed according to published criteria.Alzheimer disease biomarkers detected on PET or in CSF.Amyloid measurements were dichotomized as normal or abnormal using cohort-provided cutoffs for CSF or PET or by visual reading for PET. Adjusted data-driven cutoffs for abnormal amyloid were calculated using gaussian mixture modeling. Prevalence of amyloid abnormality was estimated according to age, sex, cognitive status, biomarker modality, APOE carrier status, educational level, geographical location, and dementia severity using generalized estimating equations.Among the 19097 participants (mean [SD] age, 69.1 [9.8] years; 10148 women [53.1%]) included, 10139 (53.1%) underwent an amyloid PET scan and 8958 (46.9%) had an amyloid CSF measurement. Using cohort-provided cutoffs, amyloid abnormality prevalences were similar to 2015 estimates for individuals without dementia and were similar across PET- and CSF-based estimates (24%; 95% CI, 21%-28%) in participants with normal cognition, 27% (95% CI, 21%-33%) in participants with subjective cognitive decline, and 51% (95% CI, 46%-56%) in participants with mild cognitive impairment, whereas for clinical AD dementia the estimates were higher for PET than CSF (87% vs 79%; mean difference, 8%; 95% CI, 0%-16%; P=.04). Gaussian mixture modeling-based cutoffs for amyloid measures on PET scans were similar to cohort-provided cutoffs and were not adjusted. Adjusted CSF cutoffs resulted in a 10% higher amyloid abnormality prevalence than PET-based estimates in persons with normal cognition (mean difference, 9%; 95% CI, 3%-15%; P=.004), subjective cognitive decline (9%; 95% CI, 3%-15%; P=.005), and mild cognitive impairment (10%; 95% CI, 3%-17%; P=.004), whereas the estimates were comparable in persons with clinical AD dementia (mean difference, 4%; 95% CI, -2% to 9%; P=.18).This study found that CSF-based estimates using adjusted data-driven cutoffs were up to 10% higher than PET-based estimates in people without dementia, whereas the results were similar among people with dementia. This finding suggests that preclinical and prodromal AD may be more prevalent than previously estimated, which has important implications for clinical trial recruitment strategies and health care planning policies.
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  • Jansen, Willemijn J, et al. (författare)
  • Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis.
  • 2015
  • Ingår i: JAMA. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 313:19, s. 1924-38
  • Tidskriftsartikel (refereegranskat)abstract
    • Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies.
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  • Hartvig, Ditte L., et al. (författare)
  • Initial liking influences the development of acceptance learning across repeated exposure to fruit juices in 9–11 year-old children
  • 2015
  • Ingår i: Food Quality and Preference. - : Elsevier BV. - 0950-3293 .- 1873-6343. ; 39, s. 228-235
  • Tidskriftsartikel (refereegranskat)abstract
    • In several studies, it has been found that repeated exposure to a novel food increases children’s acceptance of the exposure food. The present study, investigated how repeated exposure influences the acceptance of two Nordic berry juices, and whether the development depends on initial liking of the product, in 9–11 year-old children. The study had 317 participants. Two groups of children were exposed to either sea-buckthorn (n = 92) or aronia (n = 105) juice eight times, and performed two follow-up sessions 3 and 6 months after the 8th exposure. A third group (n = 120) served as controls. During pre and post-test sessions all participating children evaluated acceptance of both juices.Intake of sea-buckthorn juice increased significantly over the eight exposures (55.1 ± 7.3 till 108.8 ± 12.3) and remained high after 6 months (131.1 ± 13.2). Intake of aronia juice was only increased at follow-up sessions. Liking did not develop significantly for any of the juices across exposures. When children were grouped by their initial liking increased intake across exposures was observed regardless of initial liking of sea-buckthorn. Liking developed similarly for both juices. A significant increase was found for the ‘initial dislikers’ only. This study demonstrates how exposure effects are influenced by initial liking; it appears that changes in familiarity explain the changes seen for sea-buckthorn among ‘dislikers’. ‘Initial dislikers’ had the most benefit from repeated exposures, but did not reach ‘initial likers’ across eight exposures; more exposures in the group of ‘initial dislikers’ had possibly led to even higher liking and intake. The increased intake observed for ‘neutral likers’ and ‘initial likers’ of sea-buckthorn was not explained by increased familiarity or increased liking.
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12.
  • Hausner, H., et al. (författare)
  • Effects of repeated exposure on acceptance of initially disliked and liked Nordic snack bars in 9-11 year-old children
  • 2012
  • Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 31:1, s. 137-143
  • Tidskriftsartikel (refereegranskat)abstract
    • Background & aims: Children's food choices are guided by their preferences. It is established, however, that repeated exposure to a novel food increases children's acceptance. This study investigated how acceptance of an initially liked and disliked snack bar develops in 9-11 year-old children. Methods: 315 children were randomised into three groups: A control group (n=111) and two groups exposed to an initially liked kamut bar (n=94) and an initially disliked sea buckthorn bar (n=110). Acceptance of both bars was tested before and after the exposure period, and on the 9th exposure. Results: Intake of both bars increased significantly in the exposure groups. There was no difference in the control groups' intake or liking of the bars between pre and post-testing. Liking rose significantly for children exposed to the disliked sea buckthorn bar, while this was not observed in children exposed to the liked kamut bar. In a post-test children exposed to kamut bars had higher intake of that bar than non-exposed children. This was also observed for the sea buckthorn bar that was also given significantly higher liking scores by the exposure group. Conclusions: The majority of children exposed to an initially disliked bar increase acceptance after nine exposures to the same level as an initially liked bar. Children repeatedly exposed to a liked bar show stable acceptance. © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.
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13.
  • Holmer, A, et al. (författare)
  • Acceptance of Nordic snack bars in children aged 8-11 years
  • 2012
  • Ingår i: Food & Nutrition Research. - 1654-6628 .- 1654-661X. ; 56:10484
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A health promoting diet is suggested to be tailored to regional circumstances to preserve the cultural diversity in eating habits, as well as contribute to more environmentally friendly eating. It may influence consumer acceptance, however, if the components of the diet differs considerably from their habitual food. Objective: This study aimed to investigate whether snack bars composed of Nordic ingredients were accepted by 8-11 year-old Danish (n=134) and Swedish (n=109) children. Design: A seven-point hedonic scale was used to measure the children’s acceptance of five snack bars that varied in their composition of whole grains, berries and nuts. A preference rank ordering of the five bars was also performed. Results: The results showed that samples that were rated highest in liking and were most preferred in both countries were a kamut/pumpkin bar and an oat/cranberry bar. The sample with the lowest rating that was also least preferred was a pumpernickel/sea buckthorn bar. Flavour was the most important determinant of overall liking followed by texture, odour and appearance. Conclusions: Children’s acceptances and preferences were highly influenced by the sensory characteristics of the bars, mainly flavour. In agreement with earlier studies, the novel food ingredients seemed to influence children’s preferences. The Nordic snack bars may have a potential to be a snack option for Danish and Swedish school children, but repeated exposures to the products are recommended to increase children’s acceptance.
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  • Jansen, Willemijn J, et al. (författare)
  • Association of Cerebral Amyloid-β Aggregation With Cognitive Functioning in Persons Without Dementia.
  • 2018
  • Ingår i: JAMA psychiatry. - : American Medical Association (AMA). - 2168-6238 .- 2168-622X. ; 75:1, s. 84-95
  • Tidskriftsartikel (refereegranskat)abstract
    • Cerebral amyloid-β aggregation is an early event in Alzheimer disease (AD). Understanding the association between amyloid aggregation and cognitive manifestation in persons without dementia is important for a better understanding of the course of AD and for the design of prevention trials.To investigate whether amyloid-β aggregation is associated with cognitive functioning in persons without dementia.This cross-sectional study included 2908 participants with normal cognition and 4133 with mild cognitive impairment (MCI) from 53 studies in the multicenter Amyloid Biomarker Study. Normal cognition was defined as having no cognitive concerns for which medical help was sought and scores within the normal range on cognitive tests. Mild cognitive impairment was diagnosed according to published criteria. Study inclusion began in 2013 and is ongoing. Data analysis was performed in January 2017.Global cognitive performance as assessed by the Mini-Mental State Examination (MMSE) and episodic memory performance as assessed by a verbal word learning test. Amyloid aggregation was measured with positron emission tomography or cerebrospinal fluid biomarkers and dichotomized as negative (normal) or positive (abnormal) according to study-specific cutoffs. Generalized estimating equations were used to examine the association between amyloid aggregation and low cognitive scores (MMSE score ≤27 or memory z score≤-1.28) and to assess whether this association was moderated by age, sex, educational level, or apolipoprotein E genotype.Among 2908 persons with normal cognition (mean [SD] age, 67.4 [12.8] years), amyloid positivity was associated with low memory scores after age 70 years (mean difference in amyloid positive vs negative, 4% [95% CI, 0%-7%] at 72 years and 21% [95% CI, 10%-33%] at 90 years) but was not associated with low MMSE scores (mean difference, 3% [95% CI, -1% to 6%], P=.16). Among 4133 patients with MCI (mean [SD] age, 70.2 [8.5] years), amyloid positivity was associated with low memory (mean difference, 16% [95% CI, 12%-20%], P<.001) and low MMSE (mean difference, 14% [95% CI, 12%-17%], P<.001) scores, and this association decreased with age. Low cognitive scores had limited utility for screening of amyloid positivity in persons with normal cognition and those with MCI. In persons with normal cognition, the age-related increase in low memory score paralleled the age-related increase in amyloid positivity with an intervening period of 10 to 15 years.Although low memory scores are an early marker of amyloid positivity, their value as a screening measure for early AD among persons without dementia is limited.
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  • Hartvig, Ditte, et al. (författare)
  • Quinine sensitivity influences the acceptance of sea-buckthorn and grapefruit juices in 9- to 11-year-old children
  • 2014
  • Ingår i: Appetite. - : Academic Press Inc.. - 0195-6663 .- 1095-8304. ; 74:1, s. 70-78
  • Tidskriftsartikel (refereegranskat)abstract
    • The acceptance of novel foods by children is related to a number of factors, and differences in taste sensitivity may form some specific challenges. High sensitivity might be a barrier to the acceptance of sour/bitter products by children. This study investigated the effect of sensitivity to bitter, sour, sweet, and salty tastes on the acceptance of Nordic juices in 9- to 11-year-old children. A total of 328 children were subjected to two taste sensitivity tests for quinine, citric acid, sucrose, and NaCl. Their acceptance of six juices (carrot, rosehip, sea-buckthorn, lingonberry, grapefruit, and aronia) was measured. Bitter sensitivity was found to be significantly correlated to the intake of the sweet sea-buckthorn and lingonberry juices; the most bitter-sensitive children exhibited the highest intake of these juices. The opposite relationship was found for bitter sensitivity and the intake of the bitter grapefruit juice. Sour, sweet, and salt sensitivities did not affect the intake of any of the juices. Liking scores were not affected by sensitivity. In conclusion, bitter sensitivity appears to influence food intake in children to a greater extent than sour, sweet, or salt sensitivity. Bitter-sensitive children exhibited a reduced intake of grapefruit juice and a higher intake of sucrose-sweetened juices. Thus, bitter sensitivity might be a challenge in the acceptance of certain bitter foods.
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  • Holmer, A., et al. (författare)
  • Acceptance of Nordic snack bars in children aged 8-11 years
  • 2012
  • Ingår i: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 56
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A health promoting diet is suggested to be tailored to regional circumstances to preserve the cultural diversity in eating habits, as well as contribute to more environmentally friendly eating. It may influence consumer acceptance, however, if the components of the diet differs considerably from their habitual food. Objective: This study aimed to investigate whether snack bars composed of Nordic ingredients were accepted by 8-11 year-old Danish (n = 134) and Swedish (n = 109) children. Design: A seven-point hedonic scale was used to measure the children's acceptance of five snack bars that varied in their composition of whole grains, berries and nuts. A preference rank ordering of the five bars was also performed. Results: The results showed that samples that were rated highest in liking and were most preferred in both countries were a kamut/pumpkin bar and an oat/cranberry bar. The sample with the lowest rating that was also least preferred was a pumpernickel/sea buckthorn bar. Flavour was the most important determinant of overall liking followed by texture, odour and appearance. Conclusions: Children's acceptances and preferences were highly influenced by the sensory characteristics of the bars, mainly flavour. In agreement with earlier studies, the novel food ingredients seemed to influence children's preferences. The Nordic snack bars may have a potential to be a snack option for Danish and Swedish school children, but repeated exposures to the products are recommended to increase children's acceptance. © 2012 Anna Holmer et al.
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  • Jansen, Iris E, et al. (författare)
  • Genome-wide meta-analysis for Alzheimer's disease cerebrospinal fluid biomarkers.
  • 2022
  • Ingår i: Acta neuropathologica. - : Springer Science and Business Media LLC. - 1432-0533 .- 0001-6322. ; 144:5, s. 821-842
  • Tidskriftsartikel (refereegranskat)abstract
    • Amyloid-beta 42 (Aβ42) and phosphorylated tau (pTau) levels in cerebrospinal fluid (CSF) reflect core features of the pathogenesis of Alzheimer's disease (AD) more directly than clinical diagnosis. Initiated by the European Alzheimer & Dementia Biobank (EADB), the largest collaborative effort on genetics underlying CSF biomarkers was established, including 31 cohorts with a total of 13,116 individuals (discovery n=8074; replication n=5042 individuals). Besides the APOE locus, novel associations with two other well-established AD risk loci were observed; CR1 was shown a locus for Aβ42 and BIN1 for pTau. GMNC and C16orf95 were further identified as loci for pTau, of which the latter is novel. Clustering methods exploring the influence of all known AD risk loci on the CSF protein levels, revealed 4 biological categories suggesting multiple Aβ42 and pTau related biological pathways involved in the etiology of AD. In functional follow-up analyses, GMNC and C16orf95 both associated with lateral ventricular volume, implying an overlap in genetic etiology for tau levels and brain ventricular volume.
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  • Jekel, Katrin, et al. (författare)
  • Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review.
  • 2015
  • Ingår i: Alzheimer's Research & Therapy. - : Springer Science and Business Media LLC. - 1758-9193. ; 7:1
  • Forskningsöversikt (refereegranskat)abstract
    • Introduction: There is a growing body of evidence that subtle deficits in instrumental activities of daily living (IADL) may be present in mild cognitive impairment (MCI). However, it is not clear if there are IADL domains that are consistently affected across patients with MCI. In this systematic review, therefore, we aimed to summarize research results regarding the performance of MCI patients in specific IADL (sub)domains compared with persons who are cognitively normal and/or patients with dementia. Methods: The databases PsycINFO, PubMed and Web of Science were searched for relevant literature in December 2013. Publications from 1999 onward were considered for inclusion. Altogether, 497 articles were retrieved. Reference lists of selected articles were searched for potentially relevant articles. After screening the abstracts of these 497 articles, 37 articles were included in this review. Results: In 35 studies, IADL deficits (such as problems with medication intake, telephone use, keeping appointments, finding things at home and using everyday technology) were documented in patients with MCI. Financial capacity in patients with MCI was affected in the majority of studies. Effect sizes for group differences between patients with MCI and healthy controls were predominantly moderate to large. Performance-based instruments showed slight advantages (in terms of effect sizes) in detecting group differences in IADL functioning between patients with MCI, patients with Alzheimer’s disease and healthy controls. Conclusion: IADL requiring higher neuropsychological functioning seem to be most severely affected in patients with MCI. A reliable identification of such deficits is necessary, as patients with MCI with IADL deficits seem to have a higher risk of converting to dementia than patients with MCI without IADL deficits. The use of assessment tools specifically designed and validated for patients with MCI is therefore strongly recommended. Furthermore, the development of performance-based assessment instruments should be intensified, as they allow a valid and reliable assessment of subtle IADL deficits in MCI, even if a proxy is not available. Another important point to consider when designing new scales is the inclusion of technology-associated IADL. Novel instruments for clinical practice should be time-efficient and easy to administer.
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21.
  • Le Guen, Yann, et al. (författare)
  • Multiancestry analysis of the HLA locus in Alzheimer's and Parkinson's diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes.
  • 2023
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences (PNAS). - 1091-6490 .- 0027-8424. ; 120:36
  • Tidskriftsartikel (refereegranskat)abstract
    • Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson's disease (PD) and Alzheimer's disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues.
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