Authors: Agarwal, Puja | Holland, Thomas M. | James, Bryan D. | Cherian, Laurel J. | Aggarwal, Neelum T. | Leurgans, Sue E. | Bennett, David A. | Schneider, Julie A.
Article Type: Research Article
Abstract: Background: An anthocyanidin, pelargonidin, primarily found in berries, has antioxidant and anti-inflammatory properties, and is associated with better cognition and reduced Alzheimer’s dementia risk. Objective: This study investigated if pelargonidin or berry intake is associated with Alzheimer’s disease (AD) neuropathology in human brains. Methods: The study was conducted among 575 deceased participants (age at death = 91.3±6.1 years; 70% females) of the Rush Memory and Aging Project, with dietary data (assessed using a food frequency questionnaire) and neuropathological evaluations. Calorie-adjusted pelargonidin intake was modeled in quartiles and berry intake as continuous (servings/week). Mean amyloid-beta load and phosphorylated tau neuronal neurofibrillary tangle density …across multiple cortical regions were assessed using immunohistochemistry. Global AD pathology burden, a quantitative summary score of neurofibrillary tangles, and diffuse and neuritic plaques using Bielschowsky silver stains in multiple brain regions, was also assessed. Results: In a linear regression model adjusted for age at death, sex, education, APOE ɛ4 status, vitamin E, and vitamin C, participants in the highest quartile of pelargonidin intake when compared to those in the lowest quartile, had less amyloid-β load (β (SE) = –0.293 (0.14), p = 0.038), and fewer phosphorylated tau tangles (β (SE) = –0.310, p = 0.051). Among APOE ɛ4 non-carriers, higher strawberry (β (SE) = –0.227 (0.11), p = 0.037) and pelargonidin (Q4 versus Q1: β (SE) = –0.401 (0.16), p = 0.011; p trend = 0.010) intake was associated with less phosphorylated tau tangles, no association was observed in APOE ɛ4 carriers. Berry intake was not associated with AD pathology. However, excluding participants with dementia or mild cognitive impairment at baseline, strawberry (p = 0.004) and pelargonidin (ptrend = 0.007) intake were associated with fewer phosphorylated tau tangles. Conclusion: Higher intake of pelargonidin, a bioactive present in strawberries, is associated with less AD neuropathology, primarily phosphorylated tau tangles. Show more
Keywords: Alzheimer’s disease pathology, anthocyanidin, berries, pelargonidin
DOI: 10.3233/JAD-215600
Citation: Journal of Alzheimer's Disease, vol. 88, no. 2, pp. 653-661, 2022
Authors: Dhana, Klodian | Aggarwal, Neelum T. | Beck, Todd | Holland, Thomas M. | Dhana, Anisa | Cherian, Laurel J. | Desai, Pankaja | Evans, Denis A. | Rajan, Kumar B.
Article Type: Research Article
Abstract: Background: Patients with stroke are at a higher risk of cognitive impairment and Alzheimer’s disease dementia. Objective: To quantify the role of lifestyle pre-stroke, post-stroke, and changes in lifestyle before and after stroke with cognitive decline in community-dwelling stroke survivors. Methods: Utilizing data from the Chicago Health and Aging Project, a population-based cohort study, we studied 1,078 individuals with stroke (662 incident and 416 prevalent) who underwent cognitive testing during the study period. A healthy lifestyle score was defined by scoring four behaviors: non-smoking, exercising, being cognitively active, and having a high-quality diet. The global cognitive score was derived from …a comprehensive battery of 4 standardized tests. Results: The mean age at incident stroke was 78.2 years, and 60.1% were women. A healthy lifestyle pre-incident stroke was associated with a slower rate of cognitive decline after stroke. Participants with 3–4 healthy lifestyle factors pre-incident stroke had a slower cognitive decline after stroke by 0.046 units/year (95% CI 0.010, 0.083), or 47.7% slower, than participants with 0–1 healthy lifestyle factor. Lifestyle score post-prevalent stroke was not associated with cognitive decline. Changes in lifestyle behaviors from pre- to post-incident stroke were related to cognitive decline after stroke. Individuals who deteriorated their lifestyle quality after stroke had a faster cognitive decline by 0.051 units/year (β –0.051, 95% CI –0.090, –0.012) than participants with no change in lifestyle score. Conclusion: A healthy lifestyle pre-stroke was associated with a slower rate of cognitive decline in stroke survivors, highlighting the importance of primary prevention. After the stroke, changes in lifestyle behaviors may influence the cognitive abilities of older adults as they age. Show more
Keywords: Cognition, cognitive decline, cohort study, healthy lifestyle, stroke patients
DOI: 10.3233/JAD-220305
Citation: Journal of Alzheimer's Disease, vol. 89, no. 2, pp. 745-754, 2022
Authors: Agarwal, Puja | Ford, Christopher N. | Leurgans, Sue E. | Beck, Todd | Desai, Pankaja | Dhana, Klodian | Evans, Denis A. | Halloway, Shannon | Holland, Thomas M. | Krueger, Kristin R. | Liu, Xiaoran | Rajan, Kumar Bharat | Bennett, David A.
Article Type: Research Article
Abstract: Background: We have limited evidence for the relationship of high sugar intake with dementia risk. Objective: To determine whether high sugar intake is associated with an increased risk of dementia in community-dwelling older adults Methods: This study included 789 participants of the Rush Memory and Aging Project (community-based longitudinal cohort study of older adults free of known dementia at enrollment), with annual clinical assessments and complete nutrient data (obtained by validated food frequency questionnaire). Clinical diagnosis of dementia is based on the criteria of the joint working group of the National Institute of Neurological and Communicative Disorders and Stroke and …the Alzheimer’s Disease and Related Disorders Association. We used Cox proportional hazard models. Results: 118 participants developed dementia during 7.3±3.8 years of follow-up. Those in the highest quintile of total sugar intake were twice as likely to develop dementia than those in the lowest quintile (Q5 versus Q1:HR=2.10 (95% CI: 1.05, 4.19) when adjusted for age, sex, education, APOE ɛ 4 allele, calories from sources other than sugar, physical activity, and diet score. Higher percent calories from sugar were positively associated with dementia risk (β=0.042, p = 0.0009). In exploratory analyses, the highest versus lowest quintile of fructose and sucrose in the diet had higher dementia risk by 2.8 (95% CI: 1.38, 5.67) and 1.93 (95% CI: 1.05, 3.54) times, respectively. Conclusions: A higher intake of total sugar or total calories from sugar is associated with increased dementia risk in older adults. Among simple sugars, fructose (e.g., sweetened beverages, snacks, packaged desserts) and sucrose (table sugar in juices, desserts, candies, and commercial cereals) are associated with higher dementia risk. Show more
Keywords: Alzheimer’s disease, dementia, longitudinal, total sugar intake
DOI: 10.3233/JAD-230013
Citation: Journal of Alzheimer's Disease, vol. 95, no. 4, pp. 1417-1425, 2023
