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- Håkansson, Krister, 1952-, et al.
(författare)
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Association between mid-life marital status and cognitive function in later life : population based cohort study
- 2009
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Ingår i: The BMJ. - : BMJ. - 1756-1833 .- 0959-8138 .- 1468-5833. ; 339:July, s. Article number: b2462-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate whether mid-life marital status is related to cognitive function in later life. Design Prospective population based study with an average follow-up of 21 years. Setting Kuopio and Joensuu regions in eastern Finland. Participants Participants were derived from random, population based samples previously investigated in 1972, 1977, 1982, or 1987; 1449 individuals (73%), aged 65-79, underwent re-examination in 1998. Main outcome measures Alzheimer's disease and mild cognitive impairment. Results People cohabiting with a partner in mid-life (mean age 50.4) were less likely than all other categories (single, separated, or widowed) to show cognitive impairment later in life at ages 65-79. Those widowed or divorced in mid-life and still so at follow-up had three times the risk compared with married or cohabiting people. Those widowed both at mid-life and later life had an odds ratio of 7.67 (1.6 to 40.0) for Alzheimer's disease compared with married or cohabiting people. The highest increased risk for Alzheimer's disease was in carriers of the apolipoprotein E e4 allele who lost their partner before mid-life and were still widowed or divorced at follow-up. The progressive entering of several adjustment variables from mid-life did not alter these associations. Conclusions Living in a relationship with a partner might imply cognitive and social challenges that have a protective effect against cognitive impairment later in life, consistent with the brain reserve hypothesis. The specific increased risk for widowed and divorced people compared with single people indicates that other factors are needed to explain parts of the results. A sociogenetic disease model might explain the dramatic increase in risk of Alzheimer's disease for widowed apolipoprotein E e4 carriers.
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| 2. |
- Kivipelto, Miia, et al.
(författare)
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Apolipoprotein E epsilon 4 magnifies lifestyle risks for dementia : a population-based study
- 2008
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Ingår i: Journal of Cellular and Molecular Medicine (Print). - : Wiley. - 1582-1838 .- 1582-4934. ; 12:6B, s. 2762-2771
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Tidskriftsartikel (refereegranskat)abstract
- The risk of dementia and Alzheimer's disease (AD) probably results from an interaction between genetic and environmental factors. The aim of this study was to investigate the effects and putative interactions between the apoE epsilon 4 allele and lifestyle related risk factors for dementia and AD. Participants of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study were derived from random, population-based samples previously studied in 1972, 1977, 1982 or 1987. After an average follow-up of 21 years, 1449 individuals (72.5%) aged 65-79 years were re-examined in 1998. The apoE epsilon 4 allele was an independent risk factor for dementia/AD even after adjustments for sociodemographic, lifestyle and vascular factors (odds ratio [OR] = 2.83, 95% confidence interval [CI] epsilon 1.61-4.97). Physical inactivity, alcohol drinking and smoking increased the risk of dementia/AD particularly among the apoE epsilon 4 carriers. Furthermore, low-moderate intake of polyunsaturated, and moderate-high intake of saturated fats were associated with an increased risk of dementia/AD more pronouncedly among apoE epsilon 4 carriers. Composite effect of the lifestyle factors was particularly seen among the epsilon 4 carriers (OR = 11.42, 95% CI = 1.94-67.07 in the 4(th) quartile). Physical inactivity, dietary fat intake, alcohol drinking and smoking at midlife are associated with the risk of dementia and AD, especially among the apoE epsilon 4 carriers. The apoE epsilon 4 carriers may be more vulnerable to environmental factors, and thus, lifestyle interventions may greatly modify dementia risk particularly among the genetically susceptible individuals.
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| 3. |
- Maddock, Jane, et al.
(författare)
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Vitamin D and cognitive function : A Mendelian randomisation study.
- 2017
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The causal nature of the association between hypovitaminosis D and poor cognitive function in mid- to later-life is uncertain. Using a Mendelian randomisation(MR) approach, we examined the causal relationship between 25(OH)D and cognitive function. Data came from 172,349 participants from 17 cohorts. DHCR7(rs12785878), CYP2R1 rs12794714) and their combined synthesis score were chosen to proxy 25(OH)D. Cognitive tests were standardised into global and memory scores. Analyses were stratified by 25(OH)D tertiles, sex and age. Random effects meta-analyses assessed associations between 25(OH)D and cognitive function. Associations of serum 25(OH)D with global and memory-related cognitive function were non-linear (lower cognitive scores for both low and high 25(OH)D, p curvature ≤ 0.006), with much of the curvature attributed to a single study. DHCR7, CYP2R1, and the synthesis score were associated with small reductions in 25(OH)D per vitamin D-decreasing allele. However, coefficients for associations with global or memory-related cognitive function were non-significant and in opposing directions for DHCR7 and CYP2R1, with no overall association observed for the synthesis score. Coefficients for the synthesis score and global and memory cognition were similar when stratified by 25(OH)D tertiles, sex and age. We found no evidence for serum 25(OH)D concentration as a causal factor for cognitive performance in mid- to later life.
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| 4. |
- Rovio, Suvi
(författare)
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The effect of physical activity and other lifestyle factors on dementia, Alzheimer’s disease and structural brain changes
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Dementia is one of the major public health concerns and its impact is increasing rapidly in aging populations. Recent research has suggested that the origin of dementia and Alzheimer´s disease (AD), which is the most common form of dementia, is multifactorial including both genetic and environmental factors. Several vascular and lifestyle related factors have been associated with the risk of dementia but the results remain conflicting, especially concerning physical activity and other lifestyle factors. The present thesis project aimed at obtaining a comprehensive understanding about the role of physical activity in the development of dementia and AD, taking into account other lifestyle related and vascular factors and possible gene-environment interactions. More specifically, the effects of different types of midlife physical activity (i.e. leisure time, commuting and occupational), and also the possible interactions and combined effects of physical activity, other lifestyle factors (dietary fat intake, alcohol drinking and smoking) and the apolipoprotein E (apoE) epsilon4 allele for dementia and AD were examined. Finally, the associations between midlife leisure time physical activity and structural brain changes including brain volumes and white matter lesions (WML) detected on magnetic resonance imaging (MRI) later in life were studied. This thesis project was based on the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study. The participants of the CAIDE study were derived from four separate independent population based random samples previously studied in midlife in 1972, 1977, 1982 or 1987. Approximately 21 years later a random sample of 2000 persons, aged 65-79 years and living in two geographical areas in Kuopio and Joensuu in Eastern Finland, were invited to participate in the re-examination. Altogether 1449 persons (73 %) participated. A subpopulation (n=91) of the CAIDE participants was also MRI scanned. Study I. Persons who participated in leisure time physical activity at least two times a week in midlife were found to have an approximately 50% lower risk for dementia and 60% lower risk for AD than the more sedentary persons. The associations remained unchanged after adjustments for a wide range of vascular and lifestyle related factors, and were more pronounced among the apoE epsilon4 carriers. Study II. Neither occupational nor commuting physical activity at midlife was associated with the risk of dementia or AD later in life. Sociodemographic and vascular factors or the apoE epsilon4 allele did not modify the effects. Study III. The effects of the lifestyle related factors assessed in midlife (i.e. physical inactivity, dietary fat intake, alcohol drinking, and smoking), and the composite effect of them were all found to be more pronounced among the apoE epsilon4 allele carriers. Study IV. Midlife leisure time physical activity was found to be associated with larger cerebral grey matter and thereby total brain volume later in life, while it was not found to influence either subsequent white matter volume or WML. In summary, regular leisure time physical activity and other healthy lifestyle choices in midlife may be protective against dementia and AD later in life, and the benefits may be more pronounced for the apoE epsilon4 carriers. Work-related physical activity was not found to be sufficient to protect against dementia. Duration and intensity of physical activity may play a role, but the lack of the effect may also be partly due to residual confounding. The putative protective effects of leisure time physical activity may not be totally conferred through vascular factors as midlife leisure time physical activity was also found to be associated with larger total brain and grey matter volumes. Thus, this study adds evidence that a healthy and moderate lifestyle already in midlife may increase the possibilities of enjoying both cognitively and physically vital years later in life.
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| 5. |
- Vuorinen, Miika, et al.
(författare)
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Changes in vascular risk factors from midlife to late life and white matter lesions : a 20-year follow-up study
- 2011
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 31:2, s. 119-25
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: This study investigated the relation of midlife blood pressure, total cholesterol, body mass index (BMI), their changes over time, apolipoprotein E, and white matter lesions (WML). Methods: Participants of the Cardiovascular Risk Factors, Aging and Incidence of Dementia study were derived from random, population-based samples previously surveyed in 1972, 1977, 1982 or 1987. In 1998, 1,449 (73%) individuals aged 65-79 years were re-examined (average follow-up 21 years). A subpopulation (n = 112) was scanned with a 1.5-tesla MRI scanner in 1998, and WML were assessed from fluid-attenuated inversion recovery images using a semi-quantitative visual rating scale. Results: Risk of late-life WML was related to midlife overweight (relative risk = 2.53; 95% CI = 1.70-2.89), obesity (2.94; 2.44-3.03), and hypertension (2.73; 1.81-3.08), even after adjustments for several confounding factors. Elevated BMI (>25) (2.26; 1.42-2.62) and hypertension (3.14; 1.83-3.40) from midlife to late life also increased the risk of WML. In addition, an association with WML was seen for decreasing blood pressure (hypertension at midlife but not at late life) (3.25; 2.46-3.41), even after controlling for antihypertensive treatment. Lipid-lowering drugs had a protective effect against WML (0.13; 0.020.59). Conclusions: These results indicate that early and sustained vascular risk factor control is associated with a lower likelihood of having more severe WML in late life.
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