Objective:
This study aimed to investigate the association between dietary prebiotic intake
and risk for Alzheimer’s disease (AD).
Methods:
This longitudinal study includes 1,837 elderly (≥65 years) participants of a multi-ethnic
community-based cohort study who were dementia-free at baseline and had provided dietary information
from food frequency questionnaires. Total daily intake of fructan, one of the best-known
prebiotics, was calculated based on consumption frequency and fructan content per serving of 8
food items. The associations of daily fructan intake with AD risk were examined using a Cox proportional
hazards model, adjusted for cohort recruitment wave, age, gender, race/ethnicity, education,
daily caloric intake, and APOE genotype. Effect modification by race/ethnicity, APOE genotype,
and gender was tested by including an interaction term into the Cox models, as well as by
stratified analyses.
Results:
Among 1,837 participants (1,263 women [69%]; mean [SD] age = 76 [6.3] years), there
were 391 incident AD cases during a mean follow-up of 7.5 years (13736 person-years). Each additional
gram of fructan intake was associated with 24% lower risk for AD ((95% CI)=0.60-0.97; P
=0.03). Additional adjusting for smoking, alcohol consumption, and comorbidity index did not
change results materially. The associations were not modified by race/ethnicity, gender, and APOE
genotype, although stratified analyses showed that fructan intake was significantly associated with
reduced AD risk in Hispanics but not in non-Hispanic Blacks or Whites.
Conclusion:
Higher dietary fructan intake is associated with a reduced risk of clinical Alzheimer’s
disease among older adults.
OBJECTIVES:
The utility and risks to providers of performing cardiopulmonary resuscitation after in-hospital cardiac arrest in COVID-19 patients have been questioned. Additionally, there are discrepancies in reported COVID-19 in-hospital cardiac arrest survival rates. We describe outcomes after cardiopulmonary resuscitation for in-hospital cardiac arrest in two COVID-19 patient cohorts.
DESIGN:
Retrospective cohort study.
SETTING:
New York-Presbyterian Hospital/Columbia University Irving Medical Center in New York, NY.
PATIENTS:
Those admitted with COVID-19 between March 1, 2020, and May 31, 2020, as well as between March 1, 2021, and May 31, 2021, who received resuscitation after in-hospital cardiac arrest.
INTERVENTIONS:
None.
MEASUREMENT AND MAIN RESULTS:
Among 103 patients with coronavirus disease 2019 who were resuscitated after in-hospital cardiac arrest in spring 2020, most self-identified as Hispanic/Latino or African American, 35 (34.0%) had return of spontaneous circulation for at least 20 minutes, and 15 (14.6%) survived to 30 days post-arrest. Compared with nonsurvivors, 30-day survivors experienced in-hospital cardiac arrest later (day 22 vs day 7; p = 0.008) and were more likely to have had an acute respiratory event preceding in-hospital cardiac arrest (93.3% vs 27.3%; p < 0.001). Among 30-day survivors, 11 (73.3%) survived to hospital discharge, at which point 8 (72.7%) had Cerebral Performance Category scores of 1 or 2. Among 26 COVID-19 patients resuscitated after in-hospital cardiac arrest in spring 2021, 15 (57.7%) had return of spontaneous circulation for at least 20 minutes, 3 (11.5%) survived to 30 days post in-hospital cardiac arrest, and 2 (7.7%) survived to hospital discharge, both with Cerebral Performance Category scores of 2 or less. Those who survived to 30 days post in-hospital cardiac arrest were younger (46.3 vs 67.8; p = 0.03), but otherwise there were no significant differences between groups.
CONCLUSIONS:
Patients with COVID-19 who received cardiopulmonary resuscitation after in-hospital cardiac arrest had low survival rates. Our findings additionally show return of spontaneous circulation rates in these patients may be impacted by hospital strain and that patients with in-hospital cardiac arrest preceded by acute respiratory events might be more likely to survive to 30 days, suggesting Advanced Cardiac Life Support efforts may be more successful in this subpopulation.
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