Lower Risk Of Dementia Research Articles

Accelerometer-measured physical activity timing with incident dementia.

Moderate to vigorous physical activity (MVPA) is linked to lower dementia risk, though the optimal timing remains unclear. Using accelerometer-measured MVPA data from 90,329 dementia-free UK Biobank participants with at least 2 years of follow-up, we assessed associations between MVPA patterns (morning, afternoon, evening, mixed, inactive) and dementia risk via multivariable-adjusted Cox proportional hazards models. Compared to the inactive group, participants with a tendency of morning MVPA had a lower risk of all-cause dementia (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.40-0.90) and Alzheimer's disease (AD) risk (HR: 0.44, 95% CI: 0.22-0.86). No association of the other time point with all-cause dementia was observed. Additionally, the incidence of vascular dementia (VD) did not exhibit a significant relationship among all timing groups. Morning MVPA was associated with a lower risk of all-cause dementia and AD, while MVPA at any time point showed no association with VD. Few studies have examined accelerometer-measured moderate to vigorous physical activity (MVPA) timing with incident dementia. Participants with a tendency of morning MVPA had a lower risk of all-cause dementia and Alzheimer's disease. No significant association was found between all MVPA timing and vascular dementia (VD) risk. Findings suggest timing-specific physical activityinterventions for dementia prevention.

Attitudes of German General Practitioners Toward eHealth Apps for Dementia Risk Reduction: Qualitative Interview Study.

eHealth interventions constitute a promising approach to disease prevention, particularly because of their ability to facilitate lifestyle changes. Although a rather recent development, eHealth interventions might be able to promote brain health and reduce dementia risk in older adults. This study aimed to explore the perspective of general practitioners (GPs) on the potentials and barriers of eHealth interventions for brain health. Understanding the perspective of GPs allows us to identify chances and challenges for implementing eHealth apps for dementia risk reduction. We conducted semistructured expert interviews with 9 GPs working in an outpatient setting in and near Leipzig, Germany. Data were fully transcribed and analyzed using a process model of qualitative content analysis with codes and categories being constructed inductively and deductively. We found generally favorable but balanced views of eHealth apps for brain health. Eight themes were identified and elaborated on in the data as follows: "addressing dementia," "knowledge about dementia," "need for information," "potential for prevention," "chances for apps for prevention," "development of apps for prevention," and "barriers of apps for prevention." GPs talked mostly about how and when to address dementia and the requirements for their use of eHealth apps for dementia prevention. GPs stated that they only addressed dementia once abnormalities were already present or less frequently when a patient or relative expressed a direct wish, while individual dementia risk or standardized diagnostic during routine check-ups were mentioned much less frequently. According to GPs, knowledge about dementia in patients was low; therefore, patients expressed little need for information on dementia risk factors and prevention in GP practices. Most patients wished for quick information regarding diagnostics, treatment options, and progression of the disease. GPs mentioned a lack of overview of the available eHealth apps and their content. They also expressed a fear of inducing health anxiety when talking to patients about risk factors and prevention. GPs want patients to receive relevant and individualized information. Prerequisites for the use of eHealth apps for dementia prevention were app characteristics related to design and content. GPs need to address dementia more routinely, assess relevant risk factors, and aid patients in a preventive role. Concerns were expressed over limited effectiveness, overwhelming patients, limited use in clinical practice, and only targeting patients with an already low risk of dementia.

Risk of Dementia After Uterus or Prostate Resection: 17-Year Follow-Up of a Population-Based Retrospective Cohort Study.

The purpose of this retrospective study was to determine the effect of surgical operation, age at surgery, sex hormones, and anesthesia modality on the risk of dementia in both sexes. Data of females aged between 30 and 70 years old who were diagnosed with dysmenorrhea and underwent hysterectomy/myomectomy or without surgery, and males with benign prostate hyperplasia (BPH) with or without transurethral resection of the prostate (TURP) were identified from the National Health Insurance Research Database 2000-2016. The effect of age at surgery, surgery type, and anesthesia modality on dementia risk was assessed using Cox regression analyses. Among the 855,893 subjects, 10,242 developed dementia. Surgery at older age increased dementia risk in both sexes. Among females, hysterectomy/myomectomy was not significantly associated with dementia risk, although myomectomy was associated with a lower risk for dementia than hysterectomy. In males, TURP significantly increased the risk of dementia. Men with BPH and women with dysmenorrhea who were older at surgery have a higher risk of dementia. Regardless of the anesthetic method, surgery increased the risk of dementia in men. Among the data of women, although the surgery factor was not significantly associated with dementia risk, women with myomectomy had a lower risk of dementia than the ones with hysterectomy. These findings together contributed to risk stratification for each sex in such surgical settings.

New Horizons in Menopause, Menopausal Hormone Therapy, and Alzheimer's Disease: Current Insights and Future Directions.

Accumulating evidence suggests that the effects of menopausal hormone therapy (MHT) on risk of Alzheimer's disease (AD) and all-cause dementia are influenced by timing of initiation relative to age and time-since-menopause and the type of formulation. Randomized clinical trials (RCTs) of MHT conducted in older postmenopausal women indicate an increased risk of dementia. While RCTs conducted in midlife are lacking, observational research has provided evidence for associations between midlife estrogen-only therapy (ET) use and a reduced risk of AD dementia, whereas estrogen-progestogen therapy (EPT) is associated with more variable outcomes. However, existing studies are heterogenous, and conventional endpoints might not adequately assess MHT's potential for AD prevention. Herein, several approaches are being discussed, and the case is being made for utilizing AD biomarkers for assessment of early, AD-specific outcomes in relation to MHT use. From a clinical standpoint, findings that MHT may lower dementia risk warrant consideration as existing therapies like acetylcholinesterase inhibitors and memantine lack preventative efficacy, and vaccines for primary or secondary prevention are not yet available. MHT-associated risks, including breast cancer, stroke and venous thromboembolism, are generally considered rare (<10 events/10,000 women). Overall, the literature supports renewed interest in evaluating MHT as a sex-specific, time-sensitive approach for AD risk reduction, which is key to applying cumulated data in clinical decision making concerning AD prevention.

Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts.

This study aims to assess the relationship between modifiable dementia risk factors and both dementia and cognitive decline. Data were obtained from the Health and Retirement Study (HRS) [2008-2020], the China Health and Retirement Longitudinal Study (CHARLS) [2011-2020], and the English Longitudinal Study of Ageing (ELSA) [2010-2020]. After adjusting for confounding factors, multivariable logistic regression was utilized to analyze the relationship between modifiable dementia risk factors and dementia, while multivariable linear regression was employed to examine the relationship between these risk factors and cognitive decline. Additionally, the Cox proportional hazards model was used to assess the relationship between the number of risk factor events, clusters, and dementia risk. A total of 30,113 participants from HRS, CHARLS, and ELSA were included (44.6% male, mean age 66.04 years), with an average follow-up period of 7.29 years. A low education level was significantly associated with an increased risk of dementia and accelerated cognitive decline (Overall, OR = 2.93, 95% CI: 2.70-3.18; Overall, β = -0.25, 95% CI: -0.60 to-0.55). The presence of multiple dementia risk factors correlated with a higher dementia risk; Specifically, compared with more than 5 risk factor events, both having no dementia risk factors and having only one dementia risk factor were associated with a significantly lower risk of dementia (Overall, HR = 0.15, 95% CI: 0.11-0.22, HR = 0.22, 95% CI: 0.18-0.25). Compared to the group with no coexistence of risk factors, the clusters of excessive alcohol, diabetes, vision loss, and hearing loss (HR = 4.11; 95% CI = 3.42-4.95; p < 0.001); excessive alcohol, vision loss, smoking, and hearing loss (HR = 5.18; 95% CI = 4.30-6.23; p < 0.001); and excessive alcohol, obesity, diabetes, and smoking (HR = 5.96; 95% CI = 5.11-6.95; p < 0.001) were most strongly associated with dementia risk. Among the 11 risk factors, educational attainment has the greatest impact on dementia risk and cognitive decline. A dose-response relationship exists between the number of modifiable risk factor events and dementia risk. The coexistence of multiple risk factors is associated with dementia risk, and these associations vary by risk factor cluster.

Unraveling the bidirectional link between cancer and dementia and the impact of cancer therapies on dementia risk: A systematic review and meta-analysis.

Observational studies on the cancer-dementia relationship have yielded controversial results. This study systematically reviews the evidence to clarify this association. We searched Embase, Global Health, Ovid Medline, and APA PsycInfo. Colorectal and lung cancers showed the greatest risk reduction for all-cause dementia (ACD) and Alzheimer's disease (AD), respectively, while melanoma and colorectal cancers had the largest reduction in vascular dementia (VaD). Prostate cancer survivors on androgen deprivation therapy (ADT) had a higher risk of ACD/AD, while breast cancer patients on tamoxifen had a lower AD risk. Chemotherapy was linked to a reduced AD risk. ACD patients saw a 30% risk reduction for bladder, colorectal, and lung cancers, while AD patients had a ≈ 35% reduction for bladder and lung cancers. Our study urges clinicians to monitor cognitive function in cancer patients, especially those on ADT, tamoxifen, or chemotherapy and highlights the need for research into cancer-dementia mechanisms. HIGHLIGHTS: Cancer survivors have an 8% to 14% lower risk of dementia, while those with dementia have a 25% lower cancer risk. Colorectal and non-melanoma skin cancers were associated with reduced risks of all-cause dementia (ACD; 16%/9%), Alzheimer's disease (AD; 13%/5%), and vascular dementia (VaD; 24%/9%). Lung cancer reduced AD risk by 17%, and melanoma reduced VaD risk by 27%. ACD and AD patients had lower risks of lung (30%/36%), bladder (32%/34%), breast (26%/20%), and colorectal (31%/28%) cancers. Tamoxifen and chemotherapy reduced AD risk, while androgen deprivation therapy increased ACD risk.

The impact of SGLT2 inhibitors on dementia onset in patients with type 2 diabetes - A meta-analysis of cohort studies.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated neuroprotective effects and hold potential advantages in enhancing cognitive function. This study aims to clarify the association between SGLT2 inhibitors and the risk of dementia among individuals diagnosed with type 2 diabetes (T2D). All cohort studies concerning the impact of SGLT2 inhibitors on dementia onset in patients with T2D were identified. The literature search encompassed PubMed, Embase, Cochrane Library, and Web of Science from establishment to Mar 2024, with no language restriction. The quality of the literature was evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was conducted using RevMan5.4 software, calculating pooled risk ratios (RRs) with 95% confidence intervals (CI) for dichotomous outcomes. Five cohort studies encompassing a total of 331908 patients were included in the analysis. The findings showed that individuals receiving SGLT2 inhibitors had a lower risk of dementia (I2 = 42%, P = 0.14; RR: 0.77; 95% CI: 0.71-0.84) compared to the control group. Subgroup analyses confirmed the consistent beneficial effects of SGLT2 inhibitors across different study regions (I2=0%, P=0.60) and genders (I2=0%, P=0.50). SGLT2 inhibitors may reduce the dementia risk in T2D patients. Given the limitations of the study, further investigations were warranted to confirm the benefits.

Cardiovascular health, genetic predisposition, and dementia risk among atherosclerotic cardiovascular disease patients.

While optimal cardiovascular health (CVH) has been linked to a lower risk of dementia, few studies considered individuals' genetic background. We aimed to examine the interaction between CVH and genetic predisposition on dementia risk among individuals with atherosclerotic cardiovascular disease (ASCVD). We included 30,818 ASCVD patients from the UK Biobank. CVH was assessed using Life's Essential 8, and genetic predisposition determined by a genetic risk score (GRS) incorporating 85 genetic variants. Cox proportional hazard models were used to estimate hazard ratios (HRs) for all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). Over a median follow-up of 13.5 years, 1,360 cases of all-cause dementia were identified, including 489 AD and 440 VaD cases. Higher CVH levels were associated with a reduced risk of all-cause dementia (HR for high vs. low CVH: 0.60; 95 % CI: 0.47-0.77) and VaD (HR for high vs. low CVH: 0.32; 95 % CI: 0.19-0.54), with a stronger association in individuals with lower GRS. Although the overall CVH score was not associated with the risk of dementia in individuals with high GRS, higher levels of sleep and glucose control were associated with a lower risk of VaD. CVH levels showed no association with the risk of AD. Higher CVH levels were associated with a lower risk of VaD, not AD, with a stronger association in individuals with low GRS. Improvements in specific LE8 components, particularly sleep health and blood glucose management, were associated with reduced VaD risk across various genetic risk strata.

Robust, fully-automated assessment of cerebral perivascular spaces and white matter lesions: a multicentre MRI longitudinal study of their evolution and association with risk of dementia and accelerated brain atrophy.

Perivascular spaces (PVS) on brain MRI are surrogates for small parenchymal blood vessels and their perivascular compartment, and may relate to brain health. However, it is unknown whether PVS can predict dementia risk and brain atrophy trajectories in participants without dementia, as longitudinal studies on PVS are scarce and current methods for PVS assessment lack robustness and inter-scanner reproducibility. We developed a robust algorithm to automatically assess PVS count and size on clinical MRI, and investigated 1) their relationship with dementia risk and brain atrophy in participants without dementia, 2) their longitudinal evolution, and 3) their potential use as a screening tool in simulated clinical trials. We analysed 46,478 clinical measurements of cognitive functioning and 20,845 brain MRI scans from 10,004 participants (71.1±9.7 years-old, 56.6% women) from three publicly available observational studies on ageing and dementia (the Alzheimer's Disease Neuroimaging Initiative, the National Alzheimer's Coordinating Centre database, and the Open Access Series of Imaging Studies). Clinical and MRI data collected between 2004 and 2022 were analysed with consistent methods, controlling for confounding factors, and combined using mixed-effects models. Our fully-automated method for PVS assessment showed excellent inter-scanner reproducibility (intraclass correlation coefficients >0.8). Fewer PVS and larger PVS diameter at baseline predicted higher dementia risk and accelerated brain atrophy. Longitudinal trajectories of PVS markers differed significantly in participants without dementia who converted to dementia compared with non-converters. In simulated placebo-controlled trials for treatments targeting cognitive decline, screening out participants at low risk of dementia based on our PVS markers enhanced the power of the trial independently of Alzheimer's disease biomarkers. These robust cerebrovascular markers predict dementia risk and brain atrophy and may improve risk-stratification of patients, potentially reducing cost and increasing throughput of clinical trials to combat dementia. US National Institutes of Health.

Comparison of visit-to-visit blood pressure variability and time in target range in predicting risk for cognitive outcomes in the SPRINT trial.

Blood pressure (BP) variability (BPV) and time in target range (TTR) are emerging vascular risk factors for dementia, independent of traditionally targeted mean BP. Determine whether BPV or TTR is most strongly associated with cognitive risk. In this post hoc analysis of the SPRINT trial, 8034 participants underwent repeated BP measurement and cognitive testing at baseline and follow-up. Visit-to-visit BPV was calculated as average real variability. TTR was the percent of time in desired treatment arm target range (standard: 120-140 mmHg systolic BP; intensive: 110-130 mmHg systolic BP). Adjudicated clinical outcomes were no cognitive impairment, mild cognitive impairment (MCI), and probable dementia. We investigated a direct comparison of BPV and TTR in predicting cognitive risk, stratified by BP treatment group. Elevated BPV was associated with increased risk for MCI (adjusted HR: 1.21 [95% CI 1.10, 1.33], p < 0.001) and MCI/dementia (HR: 1.17 [95% CI 1.07, 1.27], p < 0.001) in the standard group, and dementia (HR: 1.17 [95% CI 1.01, 1.36], p = 0.039) in the intensive group. Higher TTR was related to lower dementia risk (HR: 0.72 [95% CI 0.60, 0.86], p < 0.001) in the intensive group only. Visit-to-visit BPV outperformed TTR in predicting risk for MCI and MCI/dementia. TTR was more strongly associated with dementia risk under intensive treatment. Findings were independent of mean BP in a cohort with rigorously controlled BP and suggest newer aspects of BP control may be harnessed to further reduce cognitive risk. ClinicalTrials.gov; NCT01206062.

Hearing Aids May Lower Risk of Dementia: Age-related hearing loss is linked to mental and physical problems.

Hearing Aids May Lower Risk of Dementia: Age-related hearing loss is linked to mental and physical problems.

Regardless of genetic susceptibility to Alzheimer's disease, a better lifestyle is associated with a lower risk of dementia and less cognitive decline

Regardless of genetic susceptibility to Alzheimer's disease, a better lifestyle is associated with a lower risk of dementia and less cognitive decline

Fatigue predicts 10‐year risk of incident dementia in a population representative cohort of United States Medicare beneficiaries

AbstractBackgroundFatigue is prevalent in later life and may increase dementia risk independent of health conditions. Yet, existing epidemiologic studies include samples that are not nationally representative of U.S. older adults. These studies have also not examined fatigue in combination with current physical activity level, which is important because higher fatigue ratings may also stem from a more active lifestyle that could lower dementia risk. We examined whether self‐reported fatigue, both independently and jointly with self‐reported physical activity, was associated with 10‐year risk of incident dementia in U.S. older adults.MethodParticipants were from the National Health and Aging Trends Study (2011‐2021, N = 5,167), a population representative cohort of U.S. Medicare beneficiaries. Fatigue was self‐reported as having low energy in the past month that interfered with activities (yes/no). Participants also reported past‐month engagement in any vigorous activity that increased their heart rate (e.g., working out; yes/no). Probable dementia cases were ascertained using cognitive testing and proxy reporting. Analyses included discrete‐time proportional hazards models with sample weighting to account for survey design and adjusted for baseline age, sex, race/ethnicity, education, BMI, number of health conditions, smoking status, social isolation, and depressive symptoms.ResultTwenty‐nine percent of participants reported fatigue. Frequencies of combined fatigue and activity groups included: “active/no fatigue” (31%), “active/fatigued” (8%), “inactive/no fatigue” (40%), “inactive/fatigued” (21%). There were 1,089 incident cases of probable dementia for up to 10 years of follow‐up (M±SD = 5.4±3.6 years). Individuals reporting fatigue (vs. no fatigue) had a 16% greater risk of incident dementia after full covariate adjustment (HR = 1.16, 95% CI: 1.01, 1.34, p = .041). Compared to the “active/no fatigue” group, the “inactive/fatigued” group had a 40% greater risk of incident dementia after adjustment (HR = 1.40, 95% CI: 1.16, 1.69, p = .001), but risk did not significantly differ for “active/fatigued” and “inactive/no fatigue” groups (p’s&gt;.05).ConclusionFatigue may be a signal of increased risk of incident dementia in U.S. older adults, independent of depressive symptoms and other health characteristics. Individuals reporting both fatigue and inactivity had the highest risk of dementia, suggesting that fatigue may be a symptom of underlying pathological processes, especially among those with low activity levels.

Network‐based Plasma Proteomics Reveals Molecular Overlap Between Physical Activity and Dementia Risk

AbstractBackgroundPhysical activity (PA) is associated with lower dementia risk; however, underlying molecular pathways are poorly understood. We leveraged large‐scale plasma proteomics to identify biological signatures of objectively‐monitored PA in cognitively unimpaired (CU) older adults and cross‐validated signatures in independent exercise intervention and Alzheimer’s disease (AD) cohorts.MethodDiscovery cohort included 65 CU adults (meanage = 76.6; 60% female; 34% PET Ab+) from the UCSF Memory and Aging Center with plasma assayed on SomaScan v4.1 (7,288 proteins). 30‐days of observational FitbitTM monitoring quantified PA (average daily steps). Generalized linear models (GLMs) examined individual protein correlates of PA, adjusting for age and sex. Weighted gene network analysis assembled proteins into unbiased modules of protein co‐expression, which were annotated for gene ontology and cell‐type enrichment. Modules were tested for overrepresentation of PA‐related proteins using Fisher’s exact tests with false discovery rate (FDR) correction. To validate PA pathways, modules were cross‐referenced with published plasma exercise intervention data (Robbins et al., 2023) of proteins that changed following a 20‐week endurance training intervention. To establish clinical relevance, PA‐related proteins from discovery analyses were compared between CU (N=189) and AD patients (N=55) from an independent cohort with plasma SomaScan (Stanford ADRC).ResultDiscovery: PA related to 568 proteins in GLMs. Of 32 protein modules identified from network analyses, six showed overrepresentation of PA‐related proteins. Module 12 (M12) positively associated with PA and harbored the largest proportion of PA‐related proteins. M12 was enriched for extracellular matrix (ECM) and nervous system development pathways with endothelial, neuronal, and oligodendrocyte cell type markers. Validation: M12 was significantly enriched for ECM‐related proteins that increased in the exercise intervention. Four proteins from M12 were significantly decreased in AD plasma compared to CU after FDR correction, including highly‐connected ‘hub’ proteins anthrax toxin receptor cell adhesion molecules 1 and 2 (ANTXR1, ANTXR2) and matrix remodeling associated 8 (MXRA8).ConclusionLarge‐scale analysis of the plasma proteome highlights ECM and neurodevelopmental pathways that increase with PA and decrease in AD. Cross‐validation with independent cohorts identified a biological link between PA and dementia risk. PA‐related ‘hub’ proteins, such as ANTXR1, ANTXR2, and MXRA8, may represent key molecular targets for dementia prevention.

Association between education and multimodal neuroimaging in men and women across the lifespan

AbstractBackgroundEducation has been associated with reserve mechanisms and lower dementia risk, but the literature shows inconsistent results on the association between education and brain outcomes across the lifespan. Considering that both dementia risk and education are likely to differ between sexes, our study aims at understanding the association between education and brain outcomes across the lifespan and whether it differs by sex.MethodIn 207 healthy individuals (110women) aged 19‐84 years old (47.98±18.75), we investigated the association between years of education and multimodal neuroimaging (structural‐MRI, FDG‐PET, Florbetapir‐PET) and how this association was modulated by age and sex. Analyses were restricted to regions involved in Alzheimer’s disease and/or reserve mechanisms (hippocampal volume, temporoparietal metabolism, neocortical amyloid, anterior and posterior cingulate cortices [ACC/PCC] for each modality).ResultThere was no main effect of years of education on neuroimaging (ps&gt;.09) nor interaction between education and the other variables. However, exploratory interactions conducted within young (18‐40), middle‐aged (40‐60) and older (60+yo) groups separately showed that, only in the older group, sex interacted with education on ACC volume, revealing that education was associated with greater volume only in older women (Figure; pinteraction=.006). Complementary analyses conducted in an independent and larger sample of older adults (n=135, 83women, &gt;65yo) in whom lifestyle was assessed retrospectively, suggest that midlife and late‐late‐life mental engagement, more than early‐life engagement (reflecting mainly education), are related to greater brain outcomes in late‐life (ACC volume, PCC amyloid burden, ACC metabolism). We assessed the moderative effect of sex on these associations and found that the association between grey matter volume and occupation (midlife engagement) was mainly driven by women (pinteraction=.02). The interaction between early‐life engagement and sex on ACC volume highlighted in the main cohort was replicated, yet at a trend‐level (pinteraction=.08).ConclusionOur study suggests that education is not strongly associated with age‐related differences in structure, metabolism or amyloid burden. Older women with higher levels of education, however, showed higher ACC volumes. These results suggest that education could promote brain reserve in late life in a sex‐dependent manner. Future studies should investigate the mechanisms behind these differences in brain reserve.

Formal education, household size and cognitive outcomes among Latino individuals: Data from the Skills‐Based Educational strategies for Reduction of Vascular Events in Orange County, Ca (SERVE OC) Trial

AbstractBackgroundIn the United States, Latino communities are disproportionately impacted by Alzheimer’s disease and related dementias (ADRDs)1 with 11.1% and 5.3% living with mild cognitive impairment and mild dementia due to ADRDs, respectively.2 Education is known to be associated with adults’ cognitive function; greater amounts of formal education predict lower risk of dementia in late‐life.3 The Montreal Cognitive Assessment (MoCA) is dependent on the educational level of participants, recommending a 1‐point correction for ≤12 years of education when scoring the assessment. However, additional adjustments may be necessary for minority populations with average education levels ≤12 years. Less is known about household size, as a proxy of social support, and cognition. In this study we aim to evaluate education and household size with cognitive outcomes of Hispanic/Latino self‐identifying individuals residing in Southern California.MethodsBaseline data from the Skills‐Based Educational strategies for Reduction of Vascular Events in Orange County (SERVE OC) Trial were used (Grant Number P50MD017366). Study participants (n = 254) were restricted to individuals ≥18 years who self‐identified as Hispanic/Latino and completed the MoCA 8.3 in English or Spanish at baseline. MoCA scores were adjusted for education, per instrument protocol. Multivariable linear regressions estimated associations between number of household residents, education, and MoCA score, overall and by age (&lt;50 and ≥50 years), controlling for gender and preferred language.ResultsParticipants were an average of 46.8 years (SD = 13.99) with 49.2%≥50 years; 67.2% of participants were female and 64.5% had ≤8 years of formal education. Average MoCA scores were 22.20 (SD = 3.71) and 20.67 (SD = 4.62) for individuals &lt;50 and ≥50years respectively. For individuals ≥50 years, having ≤8 years of formal education was significantly associated with lower MoCA scores (B = ‐3.22; p&lt;0.05) and with number of household residents trending towards intact cognition (B = 0.578, p = 0.063). For individuals &lt;50 years, number of household residents is a significant predictor of MoCA score (B = ‐0.618, p&lt;0.05).ConclusionUnderstanding the impact of education and household size is important when assessing memory/cognitive outcomes of Latino individuals. Research is needed to better understand if/how the MoCA should be further adjusted in underrepresented populations and the impact of household composition and dynamics on cognitive impairment.

Correlation between the utilization of sodium-glucose cotransporter-2 (SGLT2) inhibitors and the risk of dementia: a nationwide population-based study in Taiwan.

The impact of sodium-glucose cotransporter 2 inhibitors (SLGT2i) usage on reducing the risk of dementia remains uncertain. Our research seeks to establish the association between dementia risk and SLGT2 inhibitors among individuals with diabetes.This study relied on data from the Taiwan National Health Insurance Database (NHIRD), which was established in 1995 coinciding with the launch of the National Health Insurance (NHI) program by the Taiwanese government. The NHI program was implemented to enhance the healthcare system and public health in Taiwan. Patients with type 2 diabetes mellitus (T2DM) administered SGLT2i between 2016 and 2019 were included in the SGLT2i cohort. The comparison cohort consisted of patients who did not receive SGLT2i, propensity score matching by sex, age (in 5-y intervals), index date year, insurance fee, urbanization, comorbidities, and medications, with a 1:1 ratio of the exposure group.SGLT2i users had a significantly lower risk of dementia than non-SGLT2i users after adjusting for age, sex, insurance fees, urbanization, comorbidities, and medications (adjusted HR = 0.53, 95%CI: 0.50-0.57).The results revealed that patients treated with SGLT2i have a lower risk of dementia in Taiwan.

Life satisfaction and risk of dementia over 18years: an analysis of the National Alzheimer's Coordinating Center dataset.

Life satisfaction predicts lower risk of adverse health outcomes, including morbidity and mortality. Research on life satisfaction and risk of dementia has been limited by a lack of comprehensive clinical assessments of dementia. This study builds on previous research examining life satisfaction and clinically ascertained cognitive impairment and dementia. Participants (N = 23070; Meanage = 71.83, SD = 8.80) from the National Alzheimer's Coordinating Center reported their satisfaction with life at baseline. Incident dementia was ascertained through clinical assessment over up to 18years. Life satisfaction was associated with about 72% lower risk of all-cause of dementia, an association that remained significant accounting for demographic (age, sex, race, ethnicity, education, marital and living status), psychological (depression), clinical (obesity, diabetes, hypertension), behavioral (current and formersmoking), and genetic risk (APOEϵ4) factors. The association was not moderated by demographics, depression, andAPOEε4 status groups. The association was similar when cases occurring in the first five years were excluded, reducing the likelihood of reverse causality. Life satisfaction was also linked to specific causes of dementia, with a reduced risk ranging from about 60% to 90% for Alzheimer's disease and vascular dementia to > 2-fold lower risk of Lewy Body and frontotemporal dementia. Older adults who were satisfied with their lives were also at 61% lower risk of incident mild cognitive impairment and at 22% lower risk of converting from mild cognitive impairment to dementia. Being satisfied with one's life is associated with a lower risk of dementia. Improving life satisfaction could promote better cognitive health and protect against dementia.

Differences in dementia prevention knowledge by educational attainment: an analysis of a household survey from Great Britain

BackgroundHigher levels of education are associated with slower cognitive decline and a lower risk of dementia, with some evidence of a causal relationship. However, the mechanisms explaining these associations are...

Use of common cardiovascular disease drugs and risk of dementia: A case-control study in Swedish national register data.

Cardiovascular drug use may help prevent dementia; however, current evidence is mixed. Using a case-control design, we investigated the association between duration and combination of multiple cardiovascular drug classes and incident dementia. From the Swedish national registers, we included 88,065 incident dementia cases aged ≥70 at diagnosis between 2011 and 2016 and 880,650 age- and sex-matched controls. Cardiovascular drug use was ascertained from the Prescribed Drug Register. Long-term users (≥ 5years) of antihypertensives, diuretics, lipid-lowering drugs (LLDs), and oral anticoagulants (OACs) had statistically significantly fewer dementia diagnoses (odds ratio [OR] 0.75-0.91) than non-users. Antiplatelets use was associated with more dementia diagnoses (OR 1.13-1.25). Use of antihypertensives in combination with diuretics, LLDs, and OACs for ≥5 years was associated with fewer dementia diagnoses (OR 0.66-0.84). Preventing dementia via cardiovascular drug pathways may be possible. It is however important to consider the potential long-term negative cognitive effect of antiplatelets. Use ≥5 years of common cardiovascular drugs was associated with lower dementia risk. Common cardiovascular drug combination use was associated with lower dementia risk. Anti-platelet use of any duration was associated with higher dementia risk.