| 1. |
- Dintica, Christina S., et al.
(author)
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Tooth loss is associated with accelerated cognitive decline and volumetric brain differences : a population-based study
- 2018
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In: Neurobiology of Aging. - : Elsevier BV. - 0197-4580 .- 1558-1497. ; 67, s. 23-30
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Journal article (peer-reviewed)abstract
- Tooth loss has been related to cognitive impairment; however, its relation to structural brain differences in humans is unknown. Dementia-free participants (n = 2715) of age >= 60 years were followed up for up to 9 years. A subsample (n = 394) underwent magnetic resonance imaging at baseline. Information on tooth loss was collected at baseline, and cognitive function was assessed using the Mini-Mental State Examination at baseline and at follow-ups. Data were analyzed using linear mixed effects models and linear regression models. At baseline, 404 (14.9%) participants had partial tooth loss, and 206 (7.6%) had complete tooth loss. Tooth loss was significantly associated with a steeper cognitive decline (beta: -0.18, 95% confidence interval [CI]: -0.24 to -0.11) and remained significant after adjusting for or stratifying by potential confounders. In cross-sectional analyses, persons with complete or partial tooth loss had significantly lower total brain volume (beta: -28.89, 95% CI: -49.33 to -8.45) and gray matter volume (beta: -22.60, 95% CI: -38.26 to -6.94). Thus, tooth loss may be a risk factor for accelerated cognitive aging.
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| 2. |
- Jeruszka-Bielak, Marta, et al.
(author)
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Are Nutrition-Related Knowledge and Attitudes Reflected in Lifestyle and Health Among Elderly People? A Study Across Five European Countries
- 2018
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In: Frontiers in Physiology. - : Frontiers Media SA. - 1664-042X. ; 9
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Journal article (peer-reviewed)abstract
- Background: Nutrition-related knowledge (NRK) and nutrition-related attitudes (NRAs) are necessary for dietary changes toward healthier dietary patterns. In turn, healthier dietary patterns can be beneficial in maintaining health of older adults. Therefore, the aim of this cross-sectional study was to investigate whether NRK and NRAs were associated with lifestyle and health features among older adults (65+ years) from five European countries (France, Italy, Poland, the Netherlands and United Kingdom). Methods: Within the European project NU-AGE, 1,144 healthy elderly volunteers (65-79 years) were randomly assigned to two groups: intervention (NU-AGE diet) or control. After 1-year of follow-up, both NRK and NRAs were assessed during exit interviews, in combination with a number of lifestyle and health variables (e.g., physical activity, smoking, alcohol use, BMI, self-assessed health status). Multivariable linear regression models were used in data analysis. Results: In the NU-AGE study sample, good NRK was associated with lower BMI and higher physical activity. More positive NRAs were related to lower BMI and self-reported very good or good appetite. Moreover, both NRK and NRAs were associated with some socio-economic determinants, like financial situation, age, education, living area (for NRK), and country (for NRAs). Participants in the intervention group showed a better NRK (beta = 0 367 [95% CI 0.117; 0.617], p = 0.004) and more positive NRAs beta = 0.838 [95% CI 0.318, 1.358], p = 0.002) than those in the control group. Higher self-evaluated knowledge was also significantly related to more positive NRAs (p < 0.001). The most popular sources of nutrition information were food labels, books and magazines on health, the dietitian and the doctor's office, although their importance varied significantly among countries, and, to a lesser extent, between women and men and between intervention and control group. Conclusion: Higher NRK and NRA scores were associated with lower BMI and higher physical activity level. Therefore, a good nutrition-related knowledge and positive nutrition-related attitudes can strongly and positively influence the health status and quality of life among the older population. These results offer a great opportunity for policy makers to implement educational programs in order to counteract the epidemic of obesity and to improve the health span of European population.
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| 3. |
- Marseglia, Anna, et al.
(author)
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Cognitive Trajectories of Older Adults With Prediabetes and Diabetes : A Population-Based Cohort Study
- 2018
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In: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press. - 1079-5006 .- 1758-535X. ; 73:3, s. 400-406
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Journal article (peer-reviewed)abstract
- Background Diabetes has been linked to dementia risk; however, the cognitive trajectories in older adults with diabetes remain unclear. We aimed to investigate the effect of prediabetes and diabetes on cognitive trajectories among cognitively intact older adults in a long-term follow-up study.Methods Within the Swedish Adoption/Twin Study of Aging, 793 cognitively intact older adults aged ≥50 were identified at baseline and followed for up to 23 years. Based on standardized scores from 11 cognitive tests, administered at baseline and up to seven follow-ups, four cognitive domains (verbal abilities, spatial/fluid, memory, perceptual speed) were identified by principal-component analysis. Prediabetes was defined according to blood glucose levels in diabetes-free participants. Diabetes was ascertained based on self-report, hypoglycemic medication use and blood glucose levels. Data were analyzed with linear mixed-effect models adjusting for potential confounders.Results At baseline, 68 participants (8.6%) had prediabetes and 45 (5.7%) had diabetes. Compared to diabetes-free individuals, people with diabetes had a steeper decline over time in perceptual speed and verbal abilities. The annual declines in these domains were greater than the annual decline in memory. Prediabetes was associated with lower performance in memory in middle-age, but also associated with a less steep memory decline over the follow-up.Conclusions Diabetes is associated with a faster decline in perceptual speed and verbal abilities, while prediabetes is associated with lower memory performance in middle-age. However, the detrimental effects of hyperglycemia seem to not affect memory over time.
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| 4. |
- Bao, Cuiping, et al.
(author)
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Diabetes in midlife and risk of cancer in late life : A nationwide Swedish twin study
- 2018
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In: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 143:4, s. 793-800
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Journal article (peer-reviewed)abstract
- The association between diabetes and cancer risk remains controversial. Hence, we examined whether midlife diabetes is related to the risk of cancer in late-life, and whether genetic and early-life environmental factors play a role in this association. This study included 25,154 twin individuals born in 1958 or earlier from the Swedish Twin Registry. Information on cancer diagnosis in late life (aged >= 65) during 1998-2014, was derived from the National Patient and Cancer Registries. Diabetes was ascertained based on self- or informant-reported history, patient registry and antidiabetic medication use. Midlife diabetes was defined when diabetes was diagnosed before 65 years. Data were analyzed following two strategies: (i) unmatched case-control analysis for all participants using generalized estimating equation (GEE) models, and (ii) co-twin control analysis for cancer-discordant twin pairs using conditional logistic regression. Overall, 1,766 (7.0%) had midlife diabetes and 5,293 (21.0%) had cancer in late-life. In multiadjusted GEE models, the odds ratios (95% CIs) of diabetes were 10.55 (2.95-37.67) for pharynx cancer, 5.78 (1.72-19.40) for small intestine cancer, 2.37 (1.14-4.91) for liver cancer and 0.48 (0.35-0.67) for prostate cancer. In people with diabetes, diabetes duration was dose-dependently associated with cancer risk. In conditional logistic regression analysis of 176 prostate cancer-discordant twin pairs, the association between midlife diabetes and prostate cancer in later life became stronger. Midlife diabetes increases the risk of pharynx, small intestine and liver cancers, but reduces prostate cancer risk in late life. Genetic and early-life environmental factors may partially contribute to the diabetes-prostate cancer association.
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| 5. |
- Boccardi, Virginia, et al.
(author)
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Consensus paper on the executive summary of the international conference on Mediterranean diet and health : a lifelong approach an Italian initiative supported by the Mediterranean Diet Foundation and the Menarini Foundation
- 2018
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In: Nutrition. - : Elsevier BV. - 0899-9007 .- 1873-1244. ; 51-52, s. 38-45
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Journal article (peer-reviewed)abstract
- The Mediterranean Diet Foundation, in collaboration with the International Menarini Foundation, organized the International Conference on Mediterranean Diet and Health: A Lifelong Approach. The Conference was held in Ostuni (Puglia, Italy) from March 30 to April 1, 2017. The event received the endorsement of the American Federation for Aging Research, the Research Consortium Luigi Amaducci, the European Nutrition for Health Alliance, the European Union Geriatric Medicine Society, the Clinical Section of the International Association of Gerontology and Geriatrics European Region, the National Research Council Research Project on Aging, the Italian Society of Gerontology and Geriatrics, and the Italian Society of Clinical Nutrition and Metabolism.During the conference, results were presented from major studies on dietary interventions aiming to assess the efficacy of the Mediterranean diet in the prevention of chronic diseases and the potential underlying mechanisms. Twenty-six international speakers, in seven different sessions, discussed the biological basis, clinical impact, health policy, and behavioral implications of the Mediterranean diet, and its use in potential interventions for health promotion.
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| 6. |
- Marseglia, Anna, et al.
(author)
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Effect of the NU-AGE Diet on Cognitive Functioning in Older Adults : A Randomized Controlled Trial
- 2018
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In: Frontiers in Physiology. - : Frontiers Media SA. - 1664-042X. ; 9
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Journal article (peer-reviewed)abstract
- Background: Findings from animal and epidemiological research support the potential neuroprotective benefits from healthy diets. However, to establish diet neuroprotective causal relations, evidence from dietary intervention studies is needed. NU-AGE is the first multicenter intervention assessing whether a diet targeting health in aging can counteract the age-related physiological changes in different organs, including the brain. In this study, we specifically investigated the effects of NU-AGE's dietary intervention on age related cognitive decline.Materials and Methods: NU-AGE randomized trial (NCT01754012, clinicaltrials.gov) included 1279 relatively healthy older-adults, aged 65-79 years, from five European centers. Participants were randomly allocated into two groups: control (n = 638), following a habitual diet; and, intervention (n = 641), given individually tailored dietary advice (NU-AGE diet). Adherence to the NU-AGE diet was measured over follow-up, and categorized into tertiles (low, moderate, high). Cognitive function was ascertained at baseline and at 1-year follow-up with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD)-Neuropsychological Battery and five additional domain-specific single cognitive tests. The raw scores from the CERAD subtests [excluding the Mini-Mental State Examination (MMSE)] and the single tests were standardized into Z-scores. Global cognition (measured with MMSE and CERAD total score), and five cognitive domains (perceptual speed, executive function, episodic memory, verbal abilities, and constructional praxis) were created. Cognitive changes as a function of the intervention were analyzed with multivariable mixed effects models.Results: After the 1-year follow-up, 571 (89.1%) controls and 573 (89.8%) from the intervention group participated in the post-intervention assessment. Both control and intervention groups showed improvements in global cognition and in all cognitive domains after 1 year, but differences in cognitive changes between the two groups were not statistically significant. However, participants with higher adherence to the NU-AGE diet showed statistically significant improvements in global cognition [beta 0.20 (95%CI 0.004, 0.39), p-value = 0.046] and episodic memory [beta 0.15 (95%Cl 0.02, 0.28), p-value = 0.025] after 1 year, compared to those adults with lower adherence.Discussion: High adherence to the culturally adapted, individually tailored, NU-AGE diet could slow down age-related cognitive decline, helping to prevent cognitive impairment and dementia.
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| 7. |
- Marseglia, Anna
(author)
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The impact of diabetes on cognitive aging and dementia
- 2018
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Doctoral thesis (other academic/artistic)abstract
- The impact of prediabetes and diabetes on different stages of cognitive function during aging remains unclear. This thesis aimed to investigate the impact of prediabetes and of diabetes on cognitive aging—from cognitive deficits, through cognitive decline, to dementia—, explore underlying cerebral mechanisms and identify factors that may protect older adults with diabetes from dementia. The four studies in this thesis were based on data from the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K), the SNAC-K brain magnetic resonance imaging (MRI) study, and the Swedish Adoption/Twin Study of Aging (SATSA). Study I. This study used SNAC-K data to identify the cognitive domains sensitive to the detrimental impact of diabetes. In cognitively intact older adults, diabetes was associated with lower performance in perceptual speed (β -1.10; 95% CI -1.98, -0.23), category fluency (β -1.27; 95% CI -2.52, -0.03), and digit span forward (β -0.35; 95% CI -0.54, -0.17). These results suggest that domains of fluid abilities are more sensitive to diabetes than are other cognitive domains. Study II. This study used 23 years of follow-up data from SATSA to investigate the effect of prediabetes and of diabetes on trajectories of cognitive decline in different domains. Diabetes accelerated cognitive decline in perceptual speed (β -0.25; 95% CI -0.44, -0.05) and verbal abilities (β -0.19; 95% CI -0.33, -0.04). Prediabetes was associated with poor memory performance at baseline but with a less steep memory decline over time. Study III. The relationship of prediabetes and of diabetes with global cognitive decline and structural brain changes was assessed with data from SNAC-K and the SNAC-K MRI study. Both accelerated global cognitive decline. Prediabetes was associated with smaller global brain volume, particularly smaller white matter volume at baseline, and diabetes with accumulation of white matter hyperintensities (β 0.56, 95% CI 0.07–1.05) over time. Study IV. The compensatory effect of an active and socially integrated lifestyle on dementia risk in older adults with diabetes was examined with data from SNAC-K. Participants with diabetes and an inactive lifestyle had a higher risk of dementia (HR 6.0, 95% CI 3.0–12.3) than diabetes-free participants with an active lifestyle (high engagement in leisure activities or/and rich social network). In participants with diabetes, an active lifestyle was associated with less of a raised risk (HR 1.9, 95% CI 1.1–3.4). Conclusions. In the initial phase of cognitive deterioration, the domains primarily affected by diabetes may be processing speed, executive function, and attention/primary memory. Over time, having either prediabetes or diabetes accelerates the decline in fluid abilities (i.e., perceptual speed and verbal abilities) and global cognitive decline. At the structural brain level, diabetes is associated with the accumulation of cerebral microvascular lesions, which might start already during prediabetes. Finally, diabetes is associated with an increased risk of dementia. However, an active and socially integrated lifestyle may significantly counteract the detrimental effect of diabetes on brain aging.
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