Dementia In Men Research Articles

A population-based study on dementia and stroke in 97 year olds

the number of nonagenarians increases dramatically worldwide. to examine the prevalence of stroke/transient ischaemic attack (TIA) and dementia, their inter-relationship and their relation to 2-year mortality and institutionalisation in 97 year olds. a population-based sample of 97 year olds (n=591) was examined. Information on stroke/TIA was obtained from self-reports, key informants and hospital discharge registers. Dementia was diagnosed according to DSM-III-R criteria. the response rate was 65%. The prevalence of dementia was 32.7% in men and 59.3% in women (P<0.001). The prevalence of stroke/TIA was 21.5% (17.8% in men, 22.3% in women). Stroke/TIA was related to dementia in women (odds ratio=1.9, 95% CI: 1.2-3.0), but not in men. Dementia, but not stroke/TIA, was related to 2-year mortality and institutionalisation in logistic regression models. dementia was very common in this age group, and related to mortality and institutionalisation. Stroke/TIA in 97 year olds showed less association with dementia, mortality and institutionalisation than reported in studies of younger elderly populations. The finding that stroke was not associated with dementia in men needs to be taken cautiously due to the small number of men. The findings also emphasise that more studies are needed to scrutinise the aetiology of dementia in nonagenarians.

Behavioral Improvement after Chronic Administration of Coenzyme Q10 in P301S Transgenic Mice

Coenzyme Q10 is a key component of the electron transport chain which plays an essential role in ATP production and also has antioxidant effects. Neuroprotective effects of coenzyme Q10 have been reported in both in vitro and in vivo models of neurodegenerative diseases. However, its effects have not been studied in cells or in animals with tau induced pathology. In this report, we administered coenzyme Q10 to transgenic mice with the P301S tau mutation, which causes fronto-temporal dementia in man. These mice develop tau hyperphosphorylation and neurofibrillary tangles in the brain. Coenzyme Q10 improved survival and behavioral deficits in the P301S mice. There was a modest reduction in phosphorylated tau in the cortex of P301S mice. We also examined the effects of coenzyme Q10 treatment on the electron transport chain enzymes, the mitochondrial antioxidant enzymes, and the tricarboxylic acid cycle. There was a significant increase in complex I activity and protein levels, and a reduction in lipid peroxidation. Our data show that coenzyme Q10 significantly improved behavioral deficits and survival in transgenic mice with the P301S tau mutation, upregulated key enzymes of the electron transport chain, and reduced oxidative stress.

Younger Age at Crisis Following Parental Death in Male Children and Adolescents Is Associated With Higher Risk for Dementia at Old Age

To examine the association of midlife report of crisis following parental death (CFPD) during childhood and adolescence, with dementia at old age. In 1965, 9362 male participants of the Israel Ischemic Heart Disease study were asked whether they have experienced CFPD (paternal or maternal) during the following ages: 0 to 6, 7 to 12, 13 to 18, or >18 years. Dementia was assessed over 3 decades later in 1889 survivors of the original cohort, 1652 of whom were assessed for CFPD in 1965. Controlling for age, the estimated odds ratios for dementia relative to individuals who reported crisis following paternal parental death (CFPD-P) at the age of 18 years and above were 3.06 (95% CI: 1.42-6.61), 2.15 (95% CI: 0.87-5.31), and 2.35 (95% CI: 1.05-5.28) for those who reported CFPD-P at the ages of 0 to 6, 7 to 12, and 13 to 18 years, respectively. Odds ratios for dementia were 0.60 (95% CI: 0.32-1.11) for participants who reported CFPD-P at ages of 18 and above compared with participants who did not report such a crisis. Similar results were obtained for the association of crisis reported following maternal parental death (CFPD-M) at different age groups and dementia. CFPD during childhood is associated with an increased risk for dementia in men who survived until old age.

Relationship between changes in body weight and cognitive function in middle‐aged and older women

Although several longitudinal studies indicate that weight loss precedes dementia in men and women, the relationship between weight changes and cognitive performance is unclear. This study investigated the relationship between changes in adiposity and cognitive function in community-dwelling women. Data were derived from the Longitudinal Assessment of Women Study, a population-based study of 511 urban women initially aged 40-79 years. We analyzed data from 334 women who had complete information on demographics, cardiovascular risk factors, medical status, weight, height, and waist-to-hip ratio and cognitive scores at baseline and after a mean of 7.45 years of follow-up. Cognition was assessed at baseline and follow-up using the Mini Mental State Examination; the Auditory Delayed Index, Visual Delayed Index, and Working Memory Index from the Wechsler Memory Scale, Third Edition; and the Processing Speed Index from the Wechsler Adult Intelligence Scale, Third Edition. Associations were adjusted for age, education, baseline cognitive performance, cardiovascular risk factors, menopausal status, and apolipoprotein E-4 status. In multivariate analysis, both weight gain and loss were associated with poor Visual Delayed Index performance at follow-up compared with stable weight (β = -4.02 ± 1.57, p = 0.011; β = -6.50 ± 2.39, p = 0.007, respectively). No significant associations were found between body mass index, waist circumference, or waist-to-hip ratio and any cognitive domains at follow-up. Changes in cognitive performance were not associated with changes in adiposity measures. Weight loss and weight gain were associated with poor cognitive performance in middle-aged and older women compared with women with stable weight.

Mid-life and late-life vascular risk factors and dementia in Korean men and women

Dementia is one of the most important neurological disorders in the elderly population. The significance of vascular risk factors for dementia remains controversial. This study aimed to determine the effects of vascular risk factors, such as blood pressure, diabetes and smoking in the mid-life or the late-life on dementia risk. The data in this prospective cohort study came from 3252 dementia events occurring over 14 years among 848,505 Koreans aged 40–95 years insured by the National Health Insurance Corporation who had a biennial medical evaluation during 1992–1995. Data on clinical dementia during the period 1993–2006 were examined in relation to vascular risk factors. The age adjusted incidence per 100,000 was 31.9 for men and 45.0 for women, respectively. In multivariate Cox proportional hazard models, diabetes increased the risk of either dementia in Alzheimer's disease or vascular dementia in men and women, controlling for age, hypertension, total cholesterol, alcohol drinking, and smoking. Hypertension also increased vascular dementia in both men [Hazard ratio (HR) = 2.6, 95% confidence interval (CI) = 1.7–3.8] and women (HR = 2.3, 95%CI = 1.6–3.3). The association of hypertension or diabetes on risk of vascular dementia, however, among the group aged older than 65 was attenuated but remained as significant in men. There was no interaction between hypertension and diabetes on the risk of dementia. This study demonstrates that diabetes and hypertension increased the risk of vascular dementia. Treatment for these risk factors may reduce the risk of vascular dementia.

World War II Vets Study Still Providing MH Data

World War II Vets Study Still Providing MH Data

Handgrip strength and future dementia in elderly men: The Honolulu–Asia Ageing Study

Introduction: Handgrip strength is a predictor of disability, mortality, and cognitive decline. We examined the association of mid-life and late-life grip strength, and change between mid-life and late-life, with future risk of dementia in men participating in the Honolulu–Asia Ageing Study (HAAS). Methods: Late-life handgrip strength was assessed in 2323 men aged 71–92 years without dementia at the baseline exam of the HAAS in 1991–1993. Follow-up for incident dementia occurred at repeat examinations.

Apolipoprotein E ε4 Allele Genotype and the Effect of Depressive Symptoms on the Risk of Dementia in Men: The Honolulu-Asia Aging Study

Apolipoprotein E ε4 Allele Genotype and the Effect of Depressive Symptoms on the Risk of Dementia in Men: The Honolulu-Asia Aging Study

Apolipoprotein E ε4 Allele Genotype and the Effect of Depressive Symptoms on the Risk of Dementia in Men

The apolipoprotein E epsilon4 (APOE epsilon4) allele is a genetic risk factor for Alzheimer disease. Recently, depression has also become recognized as a risk factor for dementia. However, the possible effect of the APOE genotype on the association between depression and dementia is unexamined. To examine the independent and combined effects of depression and APOE epsilon4 on the risk of dementia and its subtypes. The Honolulu-Asia Aging Study, a population-based prospective cohort study of Japanese American men. Depressive symptoms and presence of the APOE epsilon4 allele were assessed between March 1991 and October 1993 in 1932 cognitively healthy men aged 71 to 90 years. Incident cases of dementia were diagnosed during approximately 6 years of follow-up based on neurologic assessment at 2 repeated examinations (April 1994-April 1996 and October 1997-February 1999). Overall dementia, Alzheimer disease, and vascular dementia. The interaction of depression and APOE epsilon4 was statistically significant in the analytical models. Compared with men with neither APOE epsilon4 nor depression, the risk of dementia in nondepressed men with APOE epsilon4 was not significant (hazard ratio, 1.1; 95% confidence interval [CI], 0.6-1.8); however, depressed men without APOE epsilon4 had a 1.6-fold greater risk (95% CI, 0.8-3.0), whereas depressed men with APOE epsilon4 had a 7.1-fold greater risk (95% CI, 3.0-16.7) of dementia. For subtypes, we found similar increased risks of Alzheimer disease. The APOE epsilon4 status modifies the association between depressive symptoms and dementia in elderly men. Because individuals with depressive symptoms and the APOE epsilon4 allele had a markedly increased risk of dementia, one might be especially watchful for early signs of dementia in the older person with depression who is also positive for the APOE epsilon4 allele. Because this cohort includes only men, further investigation in women is required.

Aspectos de comorbilidad en pacientes ancianos con demencia. Diferencias por edad y género

Prevalence of dementia in elderly patients is high. The goal of the study was to assess some aspects of comorbidity in the patients with dementia. We also analyzed comorbidity differences according to age and gender. A total of 311 patients older than 64 years old with dementia were prospectively evaluated. Data were collected on sociodemographic endpoints, type of dementia, Barthel Index (BI), Lawton Index (LO), Mini-Mental State Examination (MMSE), Charlson Index, total number of drugs, history of high blood pressure (HT), diabetes (DM), dyslipidemia (DL), heart failure (HF), chronic obstructive pulmonary disease (COPD) and cancer. The sample consisted of 222 women (71.4%) and 89 men. Mean age (standard deviation [SD]) was 80.6 (6) years. Patients were taking an average of 5.8 (2.6) drugs. The mean of Charlson Index was of 2.1 (1.3). Fifty-one percent had HT, 24% DM, 24% DL, 13% HF, 11% COPD and 8% cancer. We found better scores in the MMSE, higher comorbidity and percentage of married people and prevalence of vascular dementia in men with respect to women, who had higher percentage of Alzheimer disease, and widowers. When differences were analyzed according to age, we found a higher percentage of widowers and HF diagnosis, a lower LI values and DL percentage in the patients older than 84 years with respect to younger subjects. Our results showed the presence of high comorbidity and chronic drugs prescription in elderly people with dementia. There are some differences in comorbidity according to age and gender that must be taken into account.

Delaying Dementia and Nursing Home Placement

In order to capture the "longevity dividend," modifiable risk factors for a diagnosis of dementia and nursing home placement were examined in a longitudinal study of an elderly cohort living in Dubbo, New South Wales, Australia. One thousand two-hundred thirty-three men and 1572 women 60 years and older living in the community were examined in 1988 and followed to 2002 for diagnosis of dementia and nursing home placement. There were 244 (8.7%) nursing home placements and 44% of these placements were primarily due to dementia, but dementia was a secondary diagnosis in another 20% of cases. In a proportional hazards model for dementia, any intake of alcohol predicted a 34% lower risk, and daily gardening a 36% lower risk. Daily walking predicted a 38% lower risk of dementia in men, but there was no significant prediction in women. The lowest tertile of peak expiratory flow predicted an 84% higher risk of dementia, the upper tertile of depression score predicted a 50% higher risk. The Cox proportional hazards model for nursing home placement, showed placement increased significantly with age, urinary incontinence, impaired peak expiratory flow, physical disability, and depression. The hazard of placement was significantly reduced by alcohol intake and female gender. Socioeconomic factors were not significant. Similar risk factors for dementia and nursing home placement indicate that the continuation of moderate alcohol intake, the maintenance of physical activity, especially daily gardening, and improvement of respiratory function, and the treatment of depression are recommended targets for interventions to delay or prevent major negative late-life experiences.

P1-201: Testosterone and risk of dementia in men and women: The Rotterdam Study

P1-201: Testosterone and risk of dementia in men and women: The Rotterdam Study

Lifestyle factors and risk of dementia: Dubbo Study of the elderly

To identify risk factors for dementia in an elderly Australian cohort. A longitudinal cohort study conducted in Dubbo, NSW. 2805 men and women aged 60 years and older living in the community and initially free of cognitive impairment, first assessed in 1988 and followed for 16 years. Admission to hospital or nursing home with any kind of dementia. There were 115 cases of dementia in 1233 men (9.3/100) and 170 cases in 1572 women (10.8/100). In a proportional hazards model for dementia, any intake of alcohol predicted a 34% lower risk, and daily gardening a 36% lower risk. Daily walking predicted a 38% lower risk of dementia in men, but there was no significant prediction in women. The lowest tertile of peak expiratory flow predicted an 84% higher risk of dementia, the upper tertile of depression score predicted a 50% higher risk. While excess alcohol intake is to be avoided, it appears safe and reasonable to recommend the continuation of moderate alcohol intake in those already imbibing, as well as the maintenance of physical activity, especially daily gardening, in the hope of reducing the incidence of dementia in future years.

Dementia and Testosterone Levels in Men

To the Editor: The study by Ms Rosario and colleagues reports a relationship between low postmortem brain testosterone levels and preceding dementia in men. To be able to interpret these data it would have been valuable to know the potential impact on their results of body mass index, the intensity of care over the interval immediately preceding death, and recent opioid use. Obesity is associated with diminished serum testosterone and elevated serum estradiol. Expectant care, with no therapeutic interventions for several days immediately preceding death, may have modified tissue hormone levels in comparison with the levels of patients dying while undergoing active therapy. Opioid-induced androgen deficiency usually develops within a few hours of administration of relatively small doses of opioid medications, with plasma testosterone levels occasionally reaching near-castrate range within 24 hours. These low levels are maintained during continued opioid administration. Although tissue concentrations of sex hormones have not been measured during opioid use, the frequent use of these medications during end-of-life patient managementsuggests that theiradministrationshouldbeconsidered in interpreting postmortem tissue sex hormone levels. In contrast to levelsof testosterone,opioid-induced loweringofserum estradiol develops much more slowly, a difference that could have contributed to the observations reported.

Occupational exposure to electromagnetic fields and risk of Alzheimer's disease.

Extremely-low-frequency magnetic field (ELF-MF) exposure is suspected to increase the risk of Alzheimer's disease. Such fields are present in the vicinity of electrical motors and other electric appliances containing coils. We investigated lifetime occupational ELF-MF exposure in relation to Alzheimer's disease and dementia among a community dementia-free cohort (n = 931) age 75 years and older in Stockholm, Sweden. This cohort was followed from 1987-1989 until 1994-1996 to detect dementia cases (Diagnostic and Statistical Manual of Mental Disorders, revised 3rd edition criteria). Information on lifetime job history was obtained by interview, usually of next of kin. ELF-MF exposure was assessed using a job-exposure matrix, measurement on historical equipment, and expert estimation. We analyzed the data with Cox models controlling for potential confounders. Dementia was diagnosed in 265 subjects, including 202 with Alzheimer's disease. Among men, ELF-MF exposure > or=0.2 microT in lifetime principal job was related to multivariate-adjusted relative risks of 2.3 (95% CI = 1.0-5.1) for Alzheimer's disease and 2.0 (1.1-3.7) for dementia. We found no association among women. A similar sex-specific pattern was seen for the associations with average ELF-MF exposure throughout the work life. A dose-response relation was suggested in men, with multivariate-adjusted relative risks of 2.4 (0.8-6.8) for Alzheimer's disease and 2.5 (1.1-5.6) for dementia for the upper tertile of lifetime average exposure. Long-term occupational exposure to a higher ELF-MF level may increase the risk of Alzheimer's disease and dementia in men. Similar patterns were not seen in women, which may in part be the result of a greater exposure misclassification in women than in men.

Exploring sex differences in the relationship between depressive symptoms and dementia incidence: prospective results from the PAQUID Study.

To estimate the predictive relationship between depressive symptoms and 8-year dementia incidence in a large prospective community sample of French older adults and to compare the effect magnitude for men and women. Prospective population-based cohort with four interview waves and complete vital status ascertainment. Urban and rural communities in the Aquitaine Region (Gironde and Dordogne), southwest France. Three thousand seven hundred seventy-seven adults aged 65 and older residing in noninstitutional settings at study baseline. Each participant was interviewed by a neuropsychologist and screened for dementia with the Mini-Mental State Examination, a cognitive test battery, and a standardized questionnaire designed to ascertain the presence of the criteria for dementia according to the Diagnostic and Statistical Manual for Mental Disorders, Third Edition, Revised (DSM-III-R). Dementia status and subtype were confirmed using neurological examination and categorized according to DSM-III-R criteria for dementia and the National Institute of Neurological Disorders and Stroke/Alzheimer's and Related Disorders Association criteria. The Hachinski score was calculated to specify the etiology: possible or probable Alzheimer's disease, vascular dementia, and other types of dementia. Depressive symptomatology was evaluated using the Center for Epidemiologic Studies-Depression scale. Statistical analyses were weighted to correct for attrition not due to mortality. Ninety-seven men (incidence rate: 14.4/1,000) and 183 women (Incidence rate: 19.0/1,000) developed dementia during 8 years of follow-up. Baseline prevalence of depressive symptomatology was 12.9% for men and 14.7% for women. Depressive symptoms increased risk of dementia at subsequent interview wave, but only for men (odds ratio (OR) (men) = 3.5, 95% confidence interval (CI) = 1.9-6.5; OR (women) = 1.2, 95% CI = 0.7-2.0, P-value for sex difference = 0.03). The hypothesis that vascular depression might explain the observed sex difference was studied, and it was found that risk was 50% higher for men with hypertension who were depressed than for normotensive men. For women, hypertension status did not modify the absence of an association. This study supports the hypothesis of a relationship between proximal depressive symptomatology and dementia in men, but distant depression did not increase dementia risk in this sample. The results suggest that depression in older men might reflect a form of vascular depression associated with cerebral vascular pathology or multiinfarct disease that may amplify the dementing or declining process, hence accelerating the onset of manifest symptoms of dementia.

Association of vitamin E and C supplement use with cognitive function and dementia in elderly men.

To determine whether use of vitamin E and C supplements protects against subsequent development of dementia and poor cognitive functioning. The Honolulu-Asia Aging Study is a longitudinal study of Japanese-American men living in Hawaii. Data for this study were obtained from a subsample of the cohort interviewed in 1982, and from the entire cohort from a mailed questionnaire in 1988 and the dementia prevalence survey in 1991 to 1993. The subjects included 3,385 men, age 71 to 93 years, whose use of vitamin E and C supplements had been ascertained previously. Cognitive performance was assessed with the Cognitive Abilities Screening Instrument, and subjects were stratified into four groups: low, low normal, mid normal, and high normal. For the dementia analyses, subjects were divided into five mutually exclusive groups: AD (n = 47), vascular dementia (n = 35), mixed/other types of dementia (n = 50), low cognitive test scorers without diagnosed dementia (n = 254), and cognitively intact (n = 2,999; reference). In a multivariate model controlling for other factors, a significant protective effect was found for vascular dementia in men who had reported taking both vitamin E and C supplements in 1988 (odds ratio [OR], 0.12; 95% CI, 0.02 to 0.88). They were also protected against mixed/other dementia (OR, 0.31; 95% CI, 0.11 to 0.89). No protective effect was found for Alzheimer's dementia (OR, 1.81; 95% CI, 0.91 to 3.62). Among those without dementia, use of either vitamin E or C supplements alone in 1988 was associated significantly with better cognitive test performance at the 1991 to 1993 examination (OR, 1.25; 95% CI, 1.04 to 1.50), and use of both vitamin E and C together had borderline significance (OR, 1.18; 95% CI, 0.995 to 1.39). These results suggest that vitamin E and C supplements may protect against vascular dementia and may improve cognitive function in late life.

Midlife blood pressure and dementia: the Honolulu–Asia aging study ☆

We studied the association of mid-life blood pressure to late age dementia, specifically Alzheimer’s disease and vascular dementia. Data are from the cohort of 3703 Japanese–American men who were followed in the Honolulu Heart Program (HHP;1965–1971), and subsequently re-examined in 1991 for dementia. We assessed the risk (odds ratio (95% CI)) for dementia associated with categories of systolic (SBP) and diastolic blood pressure (DBP), stratified by never/ever treatment with anti-hypertensive medications, and adjusting for age, education, apolipoprotein ϵ allele, smoking and alcohol intake. Among those never treated (57% sample), the risk for dementia was OR 95%CI 3.8 (1.6–8.7) for DBP of 90–94 mmHg, and 4.3 (1.7–10.8) for DBP of 95 mmHg and over compared to those with DBP of 80 to 89 mmHg. Compared to those with SBP of 110 to 139 mmHg, the risk for dementia was 4.8 (2.0–11.0) in those with SBP 160 mmHg and higher. Blood pressure was not associated with the risk for dementia in treated men. These results were consistent for Alzheimer’s disease and vascular dementia. This study suggests elevated levels of blood pressure in middle age can increase the risk for late age dementia in men never treated with anti-hypertensive medication.

Incidence and distribution of parkinsonism in Olmsted County, Minnesota, 1976-1990.

Limited information is available on the frequency and distribution of parkinsonism as a syndrome. We studied the incidence of parkinsonism and its specific types among residents of Olmsted County, MN, for the period from 1976 through 1990. We used the medical records linkage-system of the Rochester Epidemiology Project to identify all individuals whose records contained documentation of any form of parkinsonism, related neurodegenerative diseases, or tremor of any type. A nurse abstractor screened the records, and, when applicable, a neurologist reviewed them to determine the presence of parkinsonism using specified diagnostic criteria and to define the year of onset. We found 364 incident cases of parkinsonism: 154 with PD (42%), 72 with drug-induced parkinsonism (20%), 61 unspecified (17%), 51 with parkinsonism in dementia (14%), and 26 with other causes (7%). The average annual incidence rate of parkinsonism (per 100,000 person-years) in the age group 50 to 99 years was 114.7; incidence increased steeply with age from 0.8 in the age group 0 to 29 years to 304.8 in the age group 80 to 99 years. The cumulative incidence of parkinsonism assuming no competing causes of death was 7.5% to age 90 years. PD was the most common type of parkinsonism, followed by parkinsonism in dementia in men and drug-induced parkinsonism in women. Men had higher incidence than women at all ages for all types of parkinsonism except drug-induced. Parkinsonism is a common disease among the elderly; its incidence increases steeply with advancing age and is consistently higher in men. The distribution by type changes with age and gender.

Amelioration of cholinergic neuron atrophy and spatial memory impairment in aged rats by nerve growth factor

In aged rodents, impairments in learning and memory have been associated with an age-dependent decline in forebrain of cholinergic function, and recent evidence indicates that the cholinergic neurons in the nucleus basalis magnocellularis, the septal-diagonal band area and the striatum undergo age-dependent atrophy. Thus, as in Alzheimer-type dementia in man, degenerative changes in the forebrain cholinergic system may contribute to age-related cognitive impairments in rodents. The cause of these degenerative changes is not known. Recent studies have shown that the central cholinergic neurons in the septal-diagonal band area, nucleus basalis and striatum are sensitive to the neurotrophic protein nerve growth factor (NGF). In particular, intraventricular injections or infusions of NGF in young adult rats have been shown to prevent retrograde neuronal cell death and promote behavioural recovery after damage to the septo-hippocampal connections. It is so far not known, however, whether the atrophic cholinergic neurons in aged animals are responsive to NGF treatment. We report here that continuous intracerebral infusion of NGF over a period of four weeks can partly reverse the cholinergic cell body atrophy and improve retention of a spatial memory task in behaviourally impaired aged rats.