- Email: [email protected]
The mediterranean diet and preservation of brain connectivity in older subjects
P454
Poster Presentations: P1
Background: A close link between bone fracture and cognitive function in elderly people is suggested, but there are few reports about bone density and the association with the cognitive function. In this study, we examined relationship between bone density and cognitive functions in healthy elderly Japanese. Methods: For 114 independently living community dwellers in Shimane prefecture in Japan aged 57 years or over, a brief dietary history questionnaire (BDHQ), cognitive function tests (the revised Hasegawa’s Dementia Scale: HDS-R, Mini-Mental State Examination: MMSE, and Frontal Assessment Battery: FAB), medical examinations with anthropometric, blood biochemical, fatty acid profiles of plasma and erythrocyte plasma membrane, bone density and plasma levels of bone metabolic markers were examined. Results: The mean MMSE score of volunteers was 27, indicating very mild cognitive impairment. “Age and Gender” were used as a confounding factor since it is associated with bone density. Plasma levels of TRAP-5b, a bone sorption marker, had a significantly negative relationship with HDS-R score and bone density. Bone density had a positive correlation with eicosapentaenoic acid and docosahexaenoic acid levels in erythrocyte plasma membrane and exercise-oriented score. When volunteers were divided into two groups (a higher score group, 29.0 6 0.1; a lower score group, 23.4 6 0.8) according to cutoff value of HDS-R score 27, plasma TRAP-5b level was higher in the lower score group than in the higher score group. Conclusions: A decrease in bone density may affect age-related cognitive decline in elderly Japanese. It was suggested that fish intake and exercise were effective for the prevention of the dementia due to the bone fracture.
ment. However, their findings were inconsistent. Methods: Six hundred and four participants aged 65 years or older were recruited from the annual Elderly Health Checkup at National Taiwan University Hospital from March 2011 to December 2013. Montreal cognitive assessment (MoCA) was used to assess cognition with a score<24 indicates cognitive impairment. Blood sample was collected to determine serum anti- Helicobacter pylori IgG level. Multivariable logistic regression analysis was performed to explore the relationship between serum anti- Helicobacter pylori IgG level and cognitive impairment adjusting for age, sex, educational level, APOE ε4 status, renal function, stroke, and depressive symptoms. Results: Helicobacter pylori seropositivity was 46.6 and 44.0% for cognitive impaired and normal elders, respectively (p < 0.61). Serum anti- Helicobacter pylori IgG level was significantly associated with cognitive impairment in the elders (adjusted odds ratio ¼ 1.09, 95% confidence interval ¼ 1.01-1.18, p ¼ 0.04). As compared with the model including Helicobacter pylori alone (c-statistic of receiver operating curve ¼ 0.54), multivariable regression model adjusting for potential confounders above showed ideal prediction ability (c-statistic¼ 0.78). Conclusions: This study found that previous Helicobacter pylori infection was associated with the risk of cognitive impairment probably via the enhancement of systemic inflammation and neurodegeneration.
P1-261
WITHDRAWN
P1-262
THE MEDITERRANEAN DIET AND PRESERVATION OF BRAIN CONNECTIVITY IN OLDER SUBJECTS
Cecilia Samieri1, Amandine Pelletier1, Christine Barul1, Catherine Feart2, Catherine Helmer1, Charlotte Bernard3, Olivier Periot3, Bixente Dilharreguy3, Jean-Franc¸ois Dartigues4, Michele Allard3, Pascale Barberger-Gateau1, Gwena€elle Catheline3, 1INSERM U897 and Universite de Bordeaux, Bordeaux, France; 2INSERM U897, Bordeaux, France; 3CNRS UMR 5287 - INCIA, CHU and Universite de Bordeaux, Bordeaux, France; 4Bordeaux University, Bordeaux, France. Contact e-mail: [email protected]
P1-260
RELATIONSHIP BETWEEN HELICOBACTER PYLORI INFECTION AND COGNITIVE PERFORMANCE IN ELDERS
Ming-Lun Han1, Jen-Hau Chen2, Jyh-Ming Liou3, Ta-Fu Chen4, YenChing Chen5, 1Min-Sheng General Hospital, Taoyan, Taiwan; 2Department of Geriatrics and Gerontology, National Taiwan University, Taipei, Taiwan; 3 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 4Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; 5Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Contact e-mail: [email protected] Background: Dementia ranked the 6th leading cause of death in the
elders in USA, which has become an important health issue around the world. Mild cognitive impairment (MCI) is a prodromal phase of Alzheimer’s disease (AD), which is the leading subtype of dementia. Chronic infection caused by pathogens, e.g., herpes simplex virus and Chlamydia pneumonia, have known to induce neuroinflammation and the following cognitive impairment, including AD and MCI. Recently, some studies explored the association between Helicobacter pylori infection and cognitive impair-
Background: The Mediterranean diet (MeDi) has been related to a lower risk of Alzheimer’s disease (AD), yet the underlying mechanisms are unknown. We hypothesized that protection against neurodegeneration would translate into higher grey matter volumes, while vascular pathways would be more specifically reflected by preserved white matter microstructure. Methods: We included 146 participants from the Bordeaux Three-City study not demented when they completed a dietary questionnaire, who underwent a 3-Tesla MRI examination an average 9 years later, including diffusion tensor imaging. Adherence to the Meditteranean diet was reflected by a 9-point score based on higher intakes of vegetables, fruits, legumes, cereals, fish; lower intakes of meats and dairies, moderate alcohol consumption and a higher ratio of monounsaturated:saturated fat. Results: In voxel-by-voxel analyses adjusted for age, gender, education and APOEε4 allele carrier status, and controlled for multiple comparisons, adherence to the Mediterranean diet was significantly associated with preserved white matter microstructure (ie, lower diffusivities and higher fractional anisotropy) in extensive brain areas (P<0.05 familywise-error corrected for multiple comparisons, see Figure); the relation of the Mediterranean diet to lower diffusivity values remained virtually
Poster Presentations: P1
unchanged after further adjustment for a large set of lifestyle, vascular and cognitive factors. In contrast, we found no relation with grey matter volumes. Conclusions: The MeDi appears to benefit brain health through preservation of structural connectivity. The strong relation of the MeDi with white matter microstructure in extensive areas with no substantial association with grey matter volumes suggests that the MeDi may benefit the brain through a favorable impact on cerebral vasculature; mediation by early vascular mechanisms deserves further research.
P455
hallucinations, depression, anxiety, and aberrant motor behavior) for the risk of incident dementia. The same results were obtained even if the association was controlled by other variables such as sociodemographic, clinical and cognitive reserve. Moreover the neurophysiopathological understanding of the damage associated to NPS is important for knowing and identifying the limits between healthy and pathological aging and recognize the utility of NPS as a risk factor for dementia.
P1-264
THE ROLE OF SEX IN POSTOPERATIVE COGNITIVE AND FUNCTIONAL DECLINE
Katie J. Schenning, Charles F. Murchison, Nora Mattek, Jeffrey Kaye, Joseph F. Quinn, Oregon Health & Science University, Portland, OR, USA. Contact e-mail: [email protected]
Figure 1. Association between higher Mediterranean score, lower diffusivity values (mean, axial and radial diffusivities) and higher fractional anisotropy in older subjects from the Bordeaux sample of the Three-City study (N¼146). The figure represents areas of the WM skeleton where each 1-point increase of the MeDi score was significantly associated with lower diffusivity (i.e. mean, axial and radial diffusivities) and higher fractional anisotropy values, after adjustment for age, gender, education and APOE4 allele carrier status. TBSS results were displayed at p<0.05, TFCE-corrected and overlaid on the MNI template. R ¼ right side.
P1-263
THE ROLE OF NEUROPSYCHIATRIC SYMPTOMS AS PREDICTORS OF DEMENTIA
Gilberto Isaac Acosta-Castillo1,2, Guilherme L. Borges3, Ana Luisa SosaOrtiz1, 1Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 2National Autonomous University of Mexico, Mexico City, Mexico; 3National Institute of Psychiatry, Mexico City, Mexico. Contact e-mail: [email protected] Background: Dementia manifestations are localized in three areas:
cognition, functionality and neuropsychiatric symptoms (NPS). The main interest for the study of NPS is related to its impact; identification and management in patients with dementia and in those who are at risk for the future development of dementia. Methods: This study explores the correlation between NPS and incident dementia in a three years follow-up general population study. We included 1,355 subjects, aged 65 years and older. Several instruments were used for having all the elements for operationalize dementia clinical diagnoses. Results: A total follow-up time of 4,168.6 person years was achieved. The average follow-up was 3.1 years with a median of 3.1 and an interquartile range of 3.0 to 3.2 years. Different strategies were explored to identify NPS related to increased risk for dementia. The associated risk to the develop dementia was estimated by modeling the cumulative incidence with Poisson’s model, socio-demographic, clinical and cognitive variables were adjusted in order to conduct a multivariate model analyses to test the effect of NPS.in the develop of dementia. Conclusions: The results showed a positive correlation between some of the NPS studied (delusions,
Background: Older adults receive >1/3 of the over 40 million anesthetics delivered yearly in the US, and these individuals are at the highest risk for deleterious postoperative neurocognitive outcomes. While women have an increased risk of developing AD, the role of sex in postoperative cognitive decline is unknown. We hypothesized that exposure to general anesthesia (GA) and surgery in older adults is associated with an accelerated deterioration of cognition, function, and brain volumes, and that this decline is more pronounced in women. Methods: We performed a retrospective, cohort analysis in two natural history studies of cognitive aging, the Oregon Brain Aging Study (n¼304) and the Intelligent Systems for Assessing Aging Changes (n¼223). After controlling for age, years of education, and Cumulative Illness Rating Scale, we used mixed-effects models to assess the relationship between exposure to GA/surgery and longitudinal change in measures of cognition, function, and brain volumes (Table 1). Exposure to GA/surgery was modeled as both a dichotomous categorical factor as well as a continuous variable indicating the number of exposure events to evaluate the Table 1 Outcome Measures Dementia
Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), CDR sum of boxes (CDR-SB) Cognitive Consortium to Establish a Registry for AD Word List Delayed Recall (CERAD) Delayed Word List, Animal Category Fluency, Trail Making Test B, Digit Symbol Test, Logical Memory Delayed Recall Functional Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Functional Activities Questionnaire (FAQ) Neuroimaging Total brain volume, Intracranial volume, Hippocampal volume, White matter hyperintensity volume, Ventricular volume Table 2 Participant Characteristics
Mean Age (years) Female (%) Mean Education (years) Cumulative Illness Rating Scale Presence of an APOE4 allele (%)*
Exposed (n¼182 )
Unexposed (n¼345)
p-value
80.0 (SD¼7.4) 61% 15.1 (SD¼2.7) 20.2 (SD¼3.3)
83.9 (SD¼7.0) 68% 14.8 (SD¼2.7) 20.5 (SD¼3.5)
<0.0001 0.10 0.33 0.56
23%
22%
*29 ISAAC participants are missing APOE genotype data.
0.68
Poster Presentations: P1
Background: A close link between bone fracture and cognitive function in elderly people is suggested, but there are few reports about bone density and the association with the cognitive function. In this study, we examined relationship between bone density and cognitive functions in healthy elderly Japanese. Methods: For 114 independently living community dwellers in Shimane prefecture in Japan aged 57 years or over, a brief dietary history questionnaire (BDHQ), cognitive function tests (the revised Hasegawa’s Dementia Scale: HDS-R, Mini-Mental State Examination: MMSE, and Frontal Assessment Battery: FAB), medical examinations with anthropometric, blood biochemical, fatty acid profiles of plasma and erythrocyte plasma membrane, bone density and plasma levels of bone metabolic markers were examined. Results: The mean MMSE score of volunteers was 27, indicating very mild cognitive impairment. “Age and Gender” were used as a confounding factor since it is associated with bone density. Plasma levels of TRAP-5b, a bone sorption marker, had a significantly negative relationship with HDS-R score and bone density. Bone density had a positive correlation with eicosapentaenoic acid and docosahexaenoic acid levels in erythrocyte plasma membrane and exercise-oriented score. When volunteers were divided into two groups (a higher score group, 29.0 6 0.1; a lower score group, 23.4 6 0.8) according to cutoff value of HDS-R score 27, plasma TRAP-5b level was higher in the lower score group than in the higher score group. Conclusions: A decrease in bone density may affect age-related cognitive decline in elderly Japanese. It was suggested that fish intake and exercise were effective for the prevention of the dementia due to the bone fracture.
ment. However, their findings were inconsistent. Methods: Six hundred and four participants aged 65 years or older were recruited from the annual Elderly Health Checkup at National Taiwan University Hospital from March 2011 to December 2013. Montreal cognitive assessment (MoCA) was used to assess cognition with a score<24 indicates cognitive impairment. Blood sample was collected to determine serum anti- Helicobacter pylori IgG level. Multivariable logistic regression analysis was performed to explore the relationship between serum anti- Helicobacter pylori IgG level and cognitive impairment adjusting for age, sex, educational level, APOE ε4 status, renal function, stroke, and depressive symptoms. Results: Helicobacter pylori seropositivity was 46.6 and 44.0% for cognitive impaired and normal elders, respectively (p < 0.61). Serum anti- Helicobacter pylori IgG level was significantly associated with cognitive impairment in the elders (adjusted odds ratio ¼ 1.09, 95% confidence interval ¼ 1.01-1.18, p ¼ 0.04). As compared with the model including Helicobacter pylori alone (c-statistic of receiver operating curve ¼ 0.54), multivariable regression model adjusting for potential confounders above showed ideal prediction ability (c-statistic¼ 0.78). Conclusions: This study found that previous Helicobacter pylori infection was associated with the risk of cognitive impairment probably via the enhancement of systemic inflammation and neurodegeneration.
P1-261
WITHDRAWN
P1-262
THE MEDITERRANEAN DIET AND PRESERVATION OF BRAIN CONNECTIVITY IN OLDER SUBJECTS
Cecilia Samieri1, Amandine Pelletier1, Christine Barul1, Catherine Feart2, Catherine Helmer1, Charlotte Bernard3, Olivier Periot3, Bixente Dilharreguy3, Jean-Franc¸ois Dartigues4, Michele Allard3, Pascale Barberger-Gateau1, Gwena€elle Catheline3, 1INSERM U897 and Universite de Bordeaux, Bordeaux, France; 2INSERM U897, Bordeaux, France; 3CNRS UMR 5287 - INCIA, CHU and Universite de Bordeaux, Bordeaux, France; 4Bordeaux University, Bordeaux, France. Contact e-mail: [email protected]
P1-260
RELATIONSHIP BETWEEN HELICOBACTER PYLORI INFECTION AND COGNITIVE PERFORMANCE IN ELDERS
Ming-Lun Han1, Jen-Hau Chen2, Jyh-Ming Liou3, Ta-Fu Chen4, YenChing Chen5, 1Min-Sheng General Hospital, Taoyan, Taiwan; 2Department of Geriatrics and Gerontology, National Taiwan University, Taipei, Taiwan; 3 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 4Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; 5Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Contact e-mail: [email protected] Background: Dementia ranked the 6th leading cause of death in the
elders in USA, which has become an important health issue around the world. Mild cognitive impairment (MCI) is a prodromal phase of Alzheimer’s disease (AD), which is the leading subtype of dementia. Chronic infection caused by pathogens, e.g., herpes simplex virus and Chlamydia pneumonia, have known to induce neuroinflammation and the following cognitive impairment, including AD and MCI. Recently, some studies explored the association between Helicobacter pylori infection and cognitive impair-
Background: The Mediterranean diet (MeDi) has been related to a lower risk of Alzheimer’s disease (AD), yet the underlying mechanisms are unknown. We hypothesized that protection against neurodegeneration would translate into higher grey matter volumes, while vascular pathways would be more specifically reflected by preserved white matter microstructure. Methods: We included 146 participants from the Bordeaux Three-City study not demented when they completed a dietary questionnaire, who underwent a 3-Tesla MRI examination an average 9 years later, including diffusion tensor imaging. Adherence to the Meditteranean diet was reflected by a 9-point score based on higher intakes of vegetables, fruits, legumes, cereals, fish; lower intakes of meats and dairies, moderate alcohol consumption and a higher ratio of monounsaturated:saturated fat. Results: In voxel-by-voxel analyses adjusted for age, gender, education and APOEε4 allele carrier status, and controlled for multiple comparisons, adherence to the Mediterranean diet was significantly associated with preserved white matter microstructure (ie, lower diffusivities and higher fractional anisotropy) in extensive brain areas (P<0.05 familywise-error corrected for multiple comparisons, see Figure); the relation of the Mediterranean diet to lower diffusivity values remained virtually
Poster Presentations: P1
unchanged after further adjustment for a large set of lifestyle, vascular and cognitive factors. In contrast, we found no relation with grey matter volumes. Conclusions: The MeDi appears to benefit brain health through preservation of structural connectivity. The strong relation of the MeDi with white matter microstructure in extensive areas with no substantial association with grey matter volumes suggests that the MeDi may benefit the brain through a favorable impact on cerebral vasculature; mediation by early vascular mechanisms deserves further research.
P455
hallucinations, depression, anxiety, and aberrant motor behavior) for the risk of incident dementia. The same results were obtained even if the association was controlled by other variables such as sociodemographic, clinical and cognitive reserve. Moreover the neurophysiopathological understanding of the damage associated to NPS is important for knowing and identifying the limits between healthy and pathological aging and recognize the utility of NPS as a risk factor for dementia.
P1-264
THE ROLE OF SEX IN POSTOPERATIVE COGNITIVE AND FUNCTIONAL DECLINE
Katie J. Schenning, Charles F. Murchison, Nora Mattek, Jeffrey Kaye, Joseph F. Quinn, Oregon Health & Science University, Portland, OR, USA. Contact e-mail: [email protected]
Figure 1. Association between higher Mediterranean score, lower diffusivity values (mean, axial and radial diffusivities) and higher fractional anisotropy in older subjects from the Bordeaux sample of the Three-City study (N¼146). The figure represents areas of the WM skeleton where each 1-point increase of the MeDi score was significantly associated with lower diffusivity (i.e. mean, axial and radial diffusivities) and higher fractional anisotropy values, after adjustment for age, gender, education and APOE4 allele carrier status. TBSS results were displayed at p<0.05, TFCE-corrected and overlaid on the MNI template. R ¼ right side.
P1-263
THE ROLE OF NEUROPSYCHIATRIC SYMPTOMS AS PREDICTORS OF DEMENTIA
Gilberto Isaac Acosta-Castillo1,2, Guilherme L. Borges3, Ana Luisa SosaOrtiz1, 1Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 2National Autonomous University of Mexico, Mexico City, Mexico; 3National Institute of Psychiatry, Mexico City, Mexico. Contact e-mail: [email protected] Background: Dementia manifestations are localized in three areas:
cognition, functionality and neuropsychiatric symptoms (NPS). The main interest for the study of NPS is related to its impact; identification and management in patients with dementia and in those who are at risk for the future development of dementia. Methods: This study explores the correlation between NPS and incident dementia in a three years follow-up general population study. We included 1,355 subjects, aged 65 years and older. Several instruments were used for having all the elements for operationalize dementia clinical diagnoses. Results: A total follow-up time of 4,168.6 person years was achieved. The average follow-up was 3.1 years with a median of 3.1 and an interquartile range of 3.0 to 3.2 years. Different strategies were explored to identify NPS related to increased risk for dementia. The associated risk to the develop dementia was estimated by modeling the cumulative incidence with Poisson’s model, socio-demographic, clinical and cognitive variables were adjusted in order to conduct a multivariate model analyses to test the effect of NPS.in the develop of dementia. Conclusions: The results showed a positive correlation between some of the NPS studied (delusions,
Background: Older adults receive >1/3 of the over 40 million anesthetics delivered yearly in the US, and these individuals are at the highest risk for deleterious postoperative neurocognitive outcomes. While women have an increased risk of developing AD, the role of sex in postoperative cognitive decline is unknown. We hypothesized that exposure to general anesthesia (GA) and surgery in older adults is associated with an accelerated deterioration of cognition, function, and brain volumes, and that this decline is more pronounced in women. Methods: We performed a retrospective, cohort analysis in two natural history studies of cognitive aging, the Oregon Brain Aging Study (n¼304) and the Intelligent Systems for Assessing Aging Changes (n¼223). After controlling for age, years of education, and Cumulative Illness Rating Scale, we used mixed-effects models to assess the relationship between exposure to GA/surgery and longitudinal change in measures of cognition, function, and brain volumes (Table 1). Exposure to GA/surgery was modeled as both a dichotomous categorical factor as well as a continuous variable indicating the number of exposure events to evaluate the Table 1 Outcome Measures Dementia
Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), CDR sum of boxes (CDR-SB) Cognitive Consortium to Establish a Registry for AD Word List Delayed Recall (CERAD) Delayed Word List, Animal Category Fluency, Trail Making Test B, Digit Symbol Test, Logical Memory Delayed Recall Functional Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Functional Activities Questionnaire (FAQ) Neuroimaging Total brain volume, Intracranial volume, Hippocampal volume, White matter hyperintensity volume, Ventricular volume Table 2 Participant Characteristics
Mean Age (years) Female (%) Mean Education (years) Cumulative Illness Rating Scale Presence of an APOE4 allele (%)*
Exposed (n¼182 )
Unexposed (n¼345)
p-value
80.0 (SD¼7.4) 61% 15.1 (SD¼2.7) 20.2 (SD¼3.3)
83.9 (SD¼7.0) 68% 14.8 (SD¼2.7) 20.5 (SD¼3.5)
<0.0001 0.10 0.33 0.56
23%
22%
*29 ISAAC participants are missing APOE genotype data.
0.68