PMID- 29574441
OWN - NLM
STAT- MEDLINE
DCOM- 20180913
LR  - 20190220
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 8
IP  - 3
DP  - 2018 Mar 23
TI  - Lifestyle and vascular risk effects on MRI-based biomarkers of Alzheimer's 
      disease: a cross-sectional study of middle-aged adults from the broader New York 
      City area.
PG  - e019362
LID - 10.1136/bmjopen-2017-019362 [doi]
LID - e019362
AB  - OBJECTIVE: To investigate the effects of lifestyle and vascular-related risk 
      factors for Alzheimer's disease (AD) on in vivo MRI-based brain atrophy in 
      asymptomatic young to middle-aged adults. DESIGN: Cross-sectional, observational. 
      SETTING: Broader New York City area. Two research centres affiliated with the 
      Alzheimer's disease Core Center at New York University School of Medicine. 
      PARTICIPANTS: We studied 116 cognitively normal healthy research participants 
      aged 30-60 years, who completed a three-dimensional T1-weighted volumetric MRI 
      and had lifestyle (diet, physical activity and intellectual enrichment), vascular 
      risk (overweight, hypertension, insulin resistance, elevated cholesterol and 
      homocysteine) and cognition (memory, executive function, language) data. 
      Estimates of cortical thickness for entorhinal (EC), posterior cingulate, 
      orbitofrontal, inferior and middle temporal cortex were obtained by use of 
      automated segmentation tools. We applied confirmatory factor analysis and 
      structural equation modelling to evaluate the associations between lifestyle, 
      vascular risk, brain and cognition. RESULTS: Adherence to a Mediterranean-style 
      diet (MeDi) and insulin sensitivity were both positively associated with 
      MRI-based cortical thickness (diet: beta(s)>/=0.26, insulin sensitivity beta(s)>/=0.58, 
      P</=0.008). After accounting for vascular risk, EC in turn explained variance in 
      memory (P</=0.001). None of the other lifestyle and vascular risk variables were 
      associated with brain thickness. In addition, the path associations between 
      intellectual enrichment and better cognition were significant (beta(s)>/=0.25 
      P</=0.001), as were those between overweight and lower cognition (beta(s)>/=-0.22, 
      P</=0.01). CONCLUSIONS: In cognitively normal middle-aged adults, MeDi and insulin 
      sensitivity explained cortical thickness in key brain regions for AD, and EC 
      thickness predicted memory performance in turn. Intellectual activity and 
      overweight were associated with cognitive performance through different pathways. 
      Our findings support further investigation of lifestyle and vascular risk factor 
      modification against brain ageing and AD. More studies with larger samples are 
      needed to replicate these research findings in more diverse, community-based 
      settings.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Mosconi, Lisa
AU  - Mosconi L
AD  - Department of Neurology, Weill Cornell Medical College, New York City, New York, 
      USA.
AD  - Department of Psychiatry, New York University School of Medicine, New York City, 
      New York, USA.
AD  - Department of Nutrition and Food Studies, New York University Steinhardt School 
      of Public Health, New York City, New York, USA.
FAU - Walters, Michelle
AU  - Walters M
AD  - Department of Nutrition and Food Studies, New York University Steinhardt School 
      of Public Health, New York City, New York, USA.
FAU - Sterling, Joanna
AU  - Sterling J
AD  - Department of Psychology, New York University, New York City, New York, USA.
FAU - Quinn, Crystal
AU  - Quinn C
AD  - Department of Psychiatry, New York University School of Medicine, New York City, 
      New York, USA.
FAU - McHugh, Pauline
AU  - McHugh P
AD  - Department of Psychiatry, New York University School of Medicine, New York City, 
      New York, USA.
FAU - Andrews, Randolph E
AU  - Andrews RE
AD  - ADM Diagnostics, Chicago, Illinois, USA.
FAU - Matthews, Dawn C
AU  - Matthews DC
AD  - ADM Diagnostics, Chicago, Illinois, USA.
FAU - Ganzer, Christine
AU  - Ganzer C
AD  - Hunter-Bellevue School of Nursing, Hunter College, The City University of New 
      York, New York City, New York, USA.
FAU - Osorio, Ricardo S
AU  - Osorio RS
AD  - Department of Psychiatry, New York University School of Medicine, New York City, 
      New York, USA.
FAU - Isaacson, Richard S
AU  - Isaacson RS
AD  - Department of Neurology, Weill Cornell Medical College, New York City, New York, 
      USA.
FAU - De Leon, Mony J
AU  - De Leon MJ
AD  - Department of Psychiatry, New York University School of Medicine, New York City, 
      New York, USA.
FAU - Convit, Antonio
AU  - Convit A
AD  - Department of Psychiatry, New York University School of Medicine, New York City, 
      New York, USA.
LA  - eng
GR  - R01 AG022374/AG/NIA NIH HHS/United States
GR  - R01 AG035137/AG/NIA NIH HHS/United States
GR  - R01 AG013616/AG/NIA NIH HHS/United States
GR  - P30 AG008051/AG/NIA NIH HHS/United States
GR  - R01 DK083537/DK/NIDDK NIH HHS/United States
GR  - P01 AG026572/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20180323
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Biomarkers)
SB  - IM
MH  - Adult
MH  - Alzheimer Disease/*diagnostic imaging/pathology/prevention & control
MH  - Atrophy
MH  - *Biomarkers
MH  - Brain/diagnostic imaging/*pathology
MH  - Cognition
MH  - Cross-Sectional Studies
MH  - *Diet, Mediterranean
MH  - Female
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - *Life Style
MH  - Linear Models
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - New York City
MH  - Risk Factors
PMC - PMC5875649
OTO - NOTNLM
OT  - alzheimer's disease
OT  - brain Imaging
OT  - brain aging
OT  - lifestyle
OT  - vascular risk
COIS- Competing interests: None declared.
EDAT- 2018/03/27 06:00
MHDA- 2018/09/14 06:00
PMCR- 2018/03/23
CRDT- 2018/03/26 06:00
PHST- 2018/03/26 06:00 [entrez]
PHST- 2018/03/27 06:00 [pubmed]
PHST- 2018/09/14 06:00 [medline]
PHST- 2018/03/23 00:00 [pmc-release]
AID - bmjopen-2017-019362 [pii]
AID - 10.1136/bmjopen-2017-019362 [doi]
PST - epublish
SO  - BMJ Open. 2018 Mar 23;8(3):e019362. doi: 10.1136/bmjopen-2017-019362.