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Associations of lifestyle and vascular risk factors with Alzheimer's brain biomarker changes during middle age: a 3-year longitudinal study in the broader New York City area.
BMJ Open. 2018 11 25; 8(11):e023664.BO

Abstract

OBJECTIVE

To investigate the associations between lifestyle and vascular risk factors and changes in Alzheimer's disease (AD) biomarkers (beta-amyloid load via 11C-PiB PET, glucose metabolism via 18F-FDG PET and neurodegeneration via structural MRI) and global cognition in middle-aged asymptomatic participants at risk for AD.

DESIGN

Prospective, longitudinal.

SETTING

The study was conducted at New York University Langone/Weill Cornell Medical Centres in New York City.

PARTICIPANTS

Seventy cognitively normal participants from multiple community sources, aged 30-60 years with lifestyle measures (diet, intellectual activity and physical activity), vascular risk measures and two imaging biomarkers visits over at least 2 years, were included in the study.

OUTCOME MEASURES

We examined MRI-based cortical thickness, fluoro-deoxy-glucose (FDG) glucose metabolism and PiB beta-amyloid in AD-vulnerable regions. A global cognitive z-score served as our summary cognition measure. We used regression change models to investigate the associations of clinical, lifestyle and vascular risk measures with changes in AD biomarkers and global cognition.

RESULTS

Diet influenced changes in glucose metabolism, but not amyloid or cortical thickness changes. With and without accounting for demographic measures, vascular risk and baseline FDG measures, lower adherence to a Mediterranean-style diet was associated with faster rates of FDG decline in the posterior cingulate cortex (p≤0.05) and marginally in the frontal cortex (p=0.07). None of the other lifestyle variables or vascular measures showed associations with AD biomarker changes. Higher baseline plasma homocysteine was associated with faster rates of decline in global cognition, with and without accounting for lifestyle and biomarker measures (p=0.048). None of the lifestyle variables were associated with cognition.

CONCLUSIONS

Diet influenced brain glucose metabolism in middle-aged participants, while plasma homocysteine explained variability in cognitive performance. These findings suggest that these modifiable risk factors affect AD risk through different pathways and support further investigation of risk reduction strategies in midlife.

Links

PMC Free PDF

Authors+Show Affiliations

Walters MJ
Department of Neurology, Weill Cornell Medical College, New York, USA.
Sterling J
Department of Psychology, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, New Jersey, USA.
Quinn C
Department of Psychiatry, New York University School of Medicine, New York, USA. The Graduate Center, City University of New York, New York, USA.
Ganzer C
Hunter-Bellevue School of Nursing, Hunter College, New York, USA.
Osorio RS
Department of Psychiatry, New York University School of Medicine, New York, USA.
Andrews RD
ADM Diagnostics, Northbrook, Illinois, USA.
Matthews DC
ADM Diagnostics, Northbrook, Illinois, USA.
Vallabhajosula S
Department of Radiology, Weill Cornell Medical College, New York, USA.
de Leon MJ
Department of Psychiatry, New York University School of Medicine, New York, USA.
Isaacson RS
Department of Neurology, Weill Cornell Medical College, New York, USA.
Mosconi L
Department of Neurology, Weill Cornell Medical College, New York, USA. Department of Psychiatry, New York University School of Medicine, New York, USA. Department of Nutrition and Food Studies, New York University Steinhardt School of Culture, Education, and Human Development, New York, USA.

MeSH

AdultAlzheimer DiseaseAmyloid beta-PeptidesBiomarkersBrainBrain ChemistryDietGlucoseHomocysteineHumansLife StyleLongitudinal StudiesMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingNew York CityPositron-Emission TomographyProspective StudiesRisk FactorsVascular Diseases

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30478117

Citation

Walters, Michelle J., et al. "Associations of Lifestyle and Vascular Risk Factors With Alzheimer's Brain Biomarker Changes During Middle Age: a 3-year Longitudinal Study in the Broader New York City Area." BMJ Open, vol. 8, no. 11, 2018, pp. e023664.
Walters MJ, Sterling J, Quinn C, et al. Associations of lifestyle and vascular risk factors with Alzheimer's brain biomarker changes during middle age: a 3-year longitudinal study in the broader New York City area. BMJ Open. 2018;8(11):e023664.
Walters, M. J., Sterling, J., Quinn, C., Ganzer, C., Osorio, R. S., Andrews, R. D., Matthews, D. C., Vallabhajosula, S., de Leon, M. J., Isaacson, R. S., & Mosconi, L. (2018). Associations of lifestyle and vascular risk factors with Alzheimer's brain biomarker changes during middle age: a 3-year longitudinal study in the broader New York City area. BMJ Open, 8(11), e023664. https://doi.org/10.1136/bmjopen-2018-023664
Walters MJ, et al. Associations of Lifestyle and Vascular Risk Factors With Alzheimer's Brain Biomarker Changes During Middle Age: a 3-year Longitudinal Study in the Broader New York City Area. BMJ Open. 2018 11 25;8(11):e023664. PubMed PMID: 30478117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of lifestyle and vascular risk factors with Alzheimer's brain biomarker changes during middle age: a 3-year longitudinal study in the broader New York City area. AU - Walters,Michelle J, AU - Sterling,Joanna, AU - Quinn,Crystal, AU - Ganzer,Christine, AU - Osorio,Ricardo S, AU - Andrews,Randolph D, AU - Matthews,Dawn C, AU - Vallabhajosula,Shankar, AU - de Leon,Mony J, AU - Isaacson,Richard S, AU - Mosconi,Lisa, Y1 - 2018/11/25/ PY - 2018/11/28/entrez PY - 2018/11/28/pubmed PY - 2019/10/28/medline KW - alzheimer’s disease KW - brain imaging KW - dementia KW - lifestyle KW - magnetic resonance imaging SP - e023664 EP - e023664 JF - BMJ open JO - BMJ Open VL - 8 IS - 11 N2 - OBJECTIVE: To investigate the associations between lifestyle and vascular risk factors and changes in Alzheimer's disease (AD) biomarkers (beta-amyloid load via 11C-PiB PET, glucose metabolism via 18F-FDG PET and neurodegeneration via structural MRI) and global cognition in middle-aged asymptomatic participants at risk for AD. DESIGN: Prospective, longitudinal. SETTING: The study was conducted at New York University Langone/Weill Cornell Medical Centres in New York City. PARTICIPANTS: Seventy cognitively normal participants from multiple community sources, aged 30-60 years with lifestyle measures (diet, intellectual activity and physical activity), vascular risk measures and two imaging biomarkers visits over at least 2 years, were included in the study. OUTCOME MEASURES: We examined MRI-based cortical thickness, fluoro-deoxy-glucose (FDG) glucose metabolism and PiB beta-amyloid in AD-vulnerable regions. A global cognitive z-score served as our summary cognition measure. We used regression change models to investigate the associations of clinical, lifestyle and vascular risk measures with changes in AD biomarkers and global cognition. RESULTS: Diet influenced changes in glucose metabolism, but not amyloid or cortical thickness changes. With and without accounting for demographic measures, vascular risk and baseline FDG measures, lower adherence to a Mediterranean-style diet was associated with faster rates of FDG decline in the posterior cingulate cortex (p≤0.05) and marginally in the frontal cortex (p=0.07). None of the other lifestyle variables or vascular measures showed associations with AD biomarker changes. Higher baseline plasma homocysteine was associated with faster rates of decline in global cognition, with and without accounting for lifestyle and biomarker measures (p=0.048). None of the lifestyle variables were associated with cognition. CONCLUSIONS: Diet influenced brain glucose metabolism in middle-aged participants, while plasma homocysteine explained variability in cognitive performance. These findings suggest that these modifiable risk factors affect AD risk through different pathways and support further investigation of risk reduction strategies in midlife. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/30478117/Associations_of_lifestyle_and_vascular_risk_factors_with_Alzheimer's_brain_biomarker_changes_during_middle_age:_a_3_year_longitudinal_study_in_the_broader_New_York_City_area_ DB - PRIME DP - Unbound Medicine ER -