Glycaemia is associated with cognitive impairment in older adults: the Guangzhou Biobank Cohort Study

Jagielski, Alison; Jiang, Chao Qiang; Xu, Lijuan; Taheri, Shahrad; Zhang, W. S.; Cheng, Kar Keung; Lam, Tai Hing; Thomas, G. Neil

doi:10.1093/ageing/afu088

Cited by 11 publications

(7 citation statements)

References 30 publications

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“…Third, this study utilized the MMSE rather than gold standard measures 50 (e.g., DSM-111, NINCDS-ADRDA, and clinical record) to evaluate cognitive function, and thus we were unable to diagnose dementia. Also, there might be more measurement bias comparing the MMSE with gold standard measures, but the reliability and validity of the MMSE have been well assessed among different populations including elderly Chinese 14 , 15 , 20 , 21 , 51 . Finally, blood samples were not collected in this study and therefore laboratory indicators such as blood glucose and lipid could not be measured.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China

Ren

Zheng

et al. 2018

Sci Rep

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To investigate the prevalence of cognitive impairment and its risk factors among Chinese elders aged over 80 years, a community-based, cross-sectional study was conducted from May to June 2016 in Shanghai, China. Cognitive function was measured by using Mini-Mental Status Examination. Multiple logistic regression assessed associations between risk factors and cognitive impairment. Of 480 participants, 30% were diagnosed with cognitive impairment. Women [adjusted odds ratio (AOR): 1.71, 95% confidence interval (CI): 1.03–2.83], solitary life (AOR: 3.15, 1.89–5.26), monthly income less than 2000 Chinese yuan (AOR: 3.47, 1.18–10.23) were significantly associated with increased risk of cognitive impairment, compared with men, non-solitary life, and monthly income greater than 4000 Chinese yuan, respectively. Overweight (AOR: 0.59, 0.36–0.97), being physically active at least 60 minutes per day (AOR: 0.59, 0.35–0.95), antihypertensive drugs users (AOR: 0.45, 0.28–0.72), and lipid lowering drugs users (AOR: 0.21, 0.06–0.76) significantly lowered the risk of cognitive impairment, compared with normal weight, inadequate outdoor activity, and non-medication users, respectively. Accordingly, this study found that women, solitary life, lower income was associated with increased risk of cognitive impairment, while overweight, being physically active, and antihypertensive and lipid lowering drugs usage might lower the risk.

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Section: Discussionmentioning

confidence: 99%

Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China

Ren

Zheng

et al. 2018

Sci Rep

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“…The mechanisms responsible may involve the hypothalamic-pituitary-adrenal axis, circadian pacemakers, sympathetic nervous system activation, oxidative stress, and systemic inflammation (Drager et al, 2010;Reutrakul and Van Cauter, 2014;Briançon-Marjollet et al, 2015). A recent Guangzhou Biobank cohort study that included 27,971 individuals concluded that cognitive impairment among older adults is associated with increasing glucose levels, even in the normoglycemic range (Jagielski et al, 2014). Brain-derived neurotrophic factor (BDNF) has antidiabetic properties, and reduced circulating BDNF is linked to dementia (Passaro et al, 2015).…”

Section: Osa Upregulates Glucosementioning

confidence: 99%

Evidence of neurodegeneration in obstructive sleep apnea: Relationship between obstructive sleep apnea and cognitive dysfunction in the elderly

Daulatzai

2015

J of Neuroscience Research

167

133

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The incidence of dementia and obstructive sleep apnea (OSA) increases with age. Late-onset Alzheimer's disease (AD) is an irreversible neurodegenerative disease of the elderly characterized by amyloid β (Aβ) plaques and neurofibrillary tangles. The disease involves widespread synaptic loss in the neocortex and the hippocampus. Rodent and clinical studies suggest that OSA impairs the structural integrity of several brain regions, including the medial temporal lobe. Indeed, hypoxia, hypertension, hypoperfusion, endothelial dysfunction, inflammation, and oxidative stress noted in OSA patients also occur in AD patients. This Review highlights pathological commonality, showing that OSA upregulates Aβ, tau hyperphosphorylation, and synaptic dysfunction. Indeed, OSA and hypertension trigger hypoperfusion and hypometabolism of brain regions, including cortex and hippocampus. Several studies show that hypertension-driven brain damage and pathogenic mechanisms lead to an Aβ increase. The pathophysiological mechanism by which OSA enhances hypertension may be linked to sympathoexcitation, oxidative stress, and endothelial dysfunction. Strong pathophysiological similarities that exist between OSA and AD are underscored here. For example, the hippocampus is negatively impacted in both OSA and AD. OSA promotes hippocampal atrophy, which is associated with memory impairment. Cognitive impairment, even in the absence of manifest dementia, is an important independent predictor of mortality. However, several pathophysiological mechanisms in OSA are reversible with appropriate therapy. OSA, therefore, is a modifiable risk factor of cognitive dysfunction, and treating OSA prior to mild cognitive impairment may be an effective prevention strategy to reduce risk for cognitive decline and AD in middle-aged persons and the elderly.

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“…After carefully analysis, the biomarkers or risk factors of cognitive decline in diabetic patients could be classified into the following three aspects: serum molecules or relevant complications, functional or metabolic changes by neuroimaging tools, and genetic variants (Figure 1 ). More concretely, parameters related to glucose metabolism, inflammation, comorbid depression and vascular diseases, as well as adipokines have shown significant alterations at the early stage of cognitive decline in diabetes [ 9 – 11 ]. Modern brain imaging technology provides a good platform to detect slight changes in cerebral metabolism and brain structures, such as functional magnetic resonance imaging (fMRI) and magnetic resonance spectroscopy (MRS) [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Biomarkers for cognitive decline in patients with diabetes mellitus: evidence from clinical studies

Zhao

Han

et al. 2017

Oncotarget

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Diabetes mellitus is considered as an important factor for cognitive decline and dementia in recent years. However, cognitive impairment in diabetic patients is often underestimated and kept undiagnosed, leading to thousands of diabetic patients suffering from worsening memory. Available reviews in this field were limited and not comprehensive enough. Thus, the present review aimed to summarize all available clinical studies on diabetic patients with cognitive decline, and to find valuable biomarkers that might be applied as diagnostic and therapeutic targets of cognitive impairment in diabetes. The biomarkers or risk factors of cognitive decline in diabetic patients could be classified into the following three aspects: serum molecules or relevant complications, functional or metabolic changes by neuroimaging tools, and genetic variants. Specifically, factors related to poor glucose metabolism, insulin resistance, inflammation, comorbid depression, micro-/macrovascular complications, adipokines, neurotrophic molecules and Tau protein presented significant changes in diabetic patients with cognitive decline. Besides, neuroimaging platform could provide more clues on the structural, functional and metabolic changes during the cognitive decline progression of diabetic patients. Genetic factors related to cognitive decline showed inconsistency based on the limited studies. Future studies might apply above biomarkers as diagnostic and treatment targets in a large population, and regulation of these parameters might shed light on a more valuable, sensitive and specific strategy for the diagnosis and treatment of cognitive decline in diabetic patients.

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Glycaemia is associated with cognitive impairment in older adults: the Guangzhou Biobank Cohort Study

Cited by 11 publications

References 30 publications

Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China

Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China

Evidence of neurodegeneration in obstructive sleep apnea: Relationship between obstructive sleep apnea and cognitive dysfunction in the elderly

Biomarkers for cognitive decline in patients with diabetes mellitus: evidence from clinical studies

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