Publications by authors named "Mary Yannakoulia"

140 Publications

Foods, Nutrients and Dietary Patterns in Relation to Irrational Beliefs and Related Psychological Disorders: The ATTICA Epidemiological Study.

Nutrients 2021 Apr 27;13(5). Epub 2021 Apr 27.

Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 176 71 Athens, Greece.

We explored the differences in dietary habits and dietary patterns between individuals characterized by irrational beliefs with no or low anxiety and depressive symptoms and individuals characterized by irrational beliefs with high anxiety and depressive symptomatology. Within the context of the ATTICA cohort study (2002-2012), 853 participants without evidence of cardiovascular disease (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent mental health assessment through the irrational beliefs inventory (IBI), the Zung self-rating depression scale (ZDRS) and the state-trait anxiety inventory (STAI). Demographic characteristics, a thorough medical history, dietary behaviour and other lifestyle behaviours were also evaluated and analysed using factor analysis. Five main factors related to dietary patterns were extracted for the high-IBI/low-STAI group of participants (explaining the 63% of the total variation in consumption), whereas four factors were extracted for the high-IBI/high-STAI participants, the high-IBI/low-ZDRS participants and the high-IBI/high-ZDRS participants, explaining 53%, 54% and 54% of the total variation, respectively. A Western-type dietary pattern was the most dominant factor for individuals reporting irrational beliefs and anxiety or depressive symptomatology. The high refined carbohydrates and fats dietary pattern was the most dominant factor for individuals with irrational beliefs but without psychopathology. Linear regression analysis showed that irrational beliefs, in combination with anxiety or depression, age, sex and BMI, were important predictors of adherence to the Mediterranean diet. Dietary habits interact with irrational beliefs and, in association with the consequent psychological disorders, are associated with overall diet, and presumably may affect the health status of individuals.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13051472DOI Listing
April 2021

Effects of fungal beta-glucans on health - a systematic review of randomized controlled trials.

Food Funct 2021 Apr;12(8):3366-3380

Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Str., Kallithea 176 76, Greece.

Introduction: Beta-glucans are polysaccharides that exhibit a wide range of biological properties as a result of their varying chemical composition. Like all dietary fibers, they avoid catabolism in the upper gastrointestinal tract, and they reach the large intestine undigested. There, they undergo fermentation by the gut microbiota, a process that has potential beneficial effects for the host. The aim of this systematic review is to assess the effects of consumption of beta-(1 → 3,1 → 6)-d-glucans, naturally found in the cell walls of fungi, on health outcomes.

Methods: A comprehensive literature search was performed on PubMed, Cochrane Library and Web of Science to retrieve studies that applied randomized controlled trials (RCTs) to investigate the impact of exclusive oral administration of fungal beta-glucans in any form and at any dosage to healthy subjects or patients.

Results: Thirty-four RCTs, of the 917 records retrieved in total, met the eligibility criteria and are included in the present review. The sources of fungal beta-glucans were Saccharomyces cerevisiae, Aureobasidium pullulans, Pleurotus ostreatus, Lentinula edodes and Ganoderma lucidum, and the dosage of supplementation ranged from 2.5 to 1000 mg daily for up to 6.5 months. The primary physiological outcome of the majority of the interventions was immunomodulation, which resulted in (a) strengthened immune defense that reduces the incidence and symptoms of cold, flu and other respiratory infections and (b) improvement of allergic symptoms. However, the findings on the induction of immune response alterations were inconsistent at the cellular and molecular levels. Another aspect is psychological wellbeing, as the cohorts that received the polysaccharides of interest reported improvement in their mood states as well as amelioration of overall wellbeing. At the same time, it might also be useful as a complementary agent to patients undergoing cancer therapies. Furthermore, supplements containing beta-(1 → 3,1 → 6)-d-glucan administered to overweight/obese adults might have the potential to decrease comorbid conditions associated with obesity. Notably, no adverse event causally related to glucans was recorded.

Conclusions: Supplementation with beta-(1 → 3,1 → 6)-d-glucans is well-tolerated, and health-promoting properties are manifested primarily through the potentiation of the immune system. More studies are required to confirm their additional beneficial effects, to establish the optimal dose, and to reveal the underlying molecular mechanisms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1039/d1fo00122aDOI Listing
April 2021

Late life psychotic features in prodromal Parkinson's disease.

Parkinsonism Relat Disord 2021 Apr 7;86:67-73. Epub 2021 Apr 7.

1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece. Electronic address:

Introduction: Some case series have suggested that psychotic features could occur even before the onset of motor symptoms of Parkinson's Disease (PD). Our aim was to investigate a possible association between psychotic symptoms and prodromal Parkinson's disease in a population-based cohort, the Hellenic Longitudinal Investigation of Aging and Diet study.

Methods: This cross-sectional study included participants aged ≥65 years without dementia or PD. We defined psychotic symptoms as the presence of at least one new hallucinatory or delusional feature, assessed with the Neuropsychiatric Inventory scale and the Columbia University Scale for Psychopathology in Alzheimer's Disease, exhibited only at follow-up and not present at baseline visit. We calculated the probability of prodromal PD (pPD) for every participant, according to the 2019 International Parkinson and Movement Disorders Society research criteria for prodromal PD.

Results: Participants who developed psychotic manifestations over a three-year follow up (20 of 914) had 1.3 times higher probability of pPD score (β [95%CI]: 1.3 [0.9-1.5], p=0.006) compared to non-psychotic subjects. This association was driven mostly by depressive symptoms, constipation and subthreshold parkinsonism (p<0.05).

Conclusion: Our data indicate that emerging psychotic features evolve in parallel with the probability of pPD. This is the first study that provides evidence for the presence of psychotic experiences in pPD. The association detected needs to be confirmed in longitudinal studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.parkreldis.2021.04.001DOI Listing
April 2021

Mediterranean diet and risk for dementia and cognitive decline in a Mediterranean population.

J Am Geriatr Soc 2021 Mar 16. Epub 2021 Mar 16.

1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.

Background: Current evidence suggests that nutrition in general and specific dietary patterns in particular, such as the Mediterranean type diet (MeDi), can be employed as potential preventive strategies against the development of dementia and cognitive decline. However, longitudinal data exploring the applicability of these findings in populations of Mediterranean origin are limited. The aim of the present study was to explore the potential relationships of MeDi adherence with dementia incidence rates and cognitive change over time in a traditional Mediterranean population, characterized by a lifelong exposure to Mediterranean eating habits and lifestyle.

Methods: The sample consisted of 1046 non-demented individuals over the age of 64 (mean age = 73.1; SD = 5.0), with available baseline dietary information and longitudinal follow-up. Diagnosis of dementia was made by a full clinical and neuropsychological evaluation, while cognitive performance was assessed according to five cognitive domains (memory, language, attention-speed, executive functioning, visuospatial perception) and a global cognitive score. Adherence to MeDi was evaluated by an a priori score (range 0-55), derived from a detailed food frequency questionnaire.

Results: A total of 62 incident dementia cases occurred during a mean (SD) of 3.1 (0.9) years of follow-up. Individuals in the highest MeDi quartile (highest adherence to MeDi) had a 72% lower risk for development of dementia, compared to those in the lowest one (p = 0.013). In addition, analysis of cognitive performance as a function of MeDi score revealed that the biennial cognitive benefit of a 10-unit increase in MeDi score offsets the cognitive decline associated with 1 year of cognitive aging.

Conclusion: In the present study, higher adherence to MeDi was associated with a reduced risk for dementia and cognitive decline in a traditional Mediterranean population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jgs.17072DOI Listing
March 2021

Incidence of mild cognitive impairment in the elderly population in Greece: results from the HELIAD study.

Aging Clin Exp Res 2021 Mar 8. Epub 2021 Mar 8.

1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece.

Background: There are no published data on Mild Cognitive Impairment (MCI) incidence in people over 65 years of age in Greece, relevant literature is scarce for Southern Europe, and reported rates worldwide show great variability.

Aims: To investigate the incidence and risk factors of MCI and its subtypes in the elderly population in Greece.

Methods: The incidence cohort of the HELIAD study (Hellenic Epidemiological Longitudinal Investigation of Aging and Diet) comprised 955 individuals who received full neurological and neuropsychological evaluation on two separate occasions about three years apart.

Results: The MCI incidence rate in our cohort is 54.07 new cases per 1000 person-years, standardized by age and sex to 59.99. Each additional year of age over 65 raises the probability of novel MCI by 6.2%, while lower educational attainment more than doubles the risk for incident MCI. Apolipoprotein E-ε4 (APOE-ε4) carriage results in increased risk for MCI by more than 1.7 times. Incidence rates for amnestic MCI are slightly higher than for the non-amnestic subtype, and AD is the most common potential underlying etiology.

Discussion: The MCI incidence rate in the Greek population over 65 years of age is 54/1000 person-years. Advanced age and APOE-ε4 carriage are predisposing factors, while higher educational attainment was found to exert a protective effect.

Conclusions: MCI incidence in people over 65 years-old in Greece is consistent with reported rates around the world. Larger studies encompassing neuroimaging and cerebrospinal fluid biomarkers will hopefully shed more light on MCI epidemiology in Greece in the future.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40520-021-01819-wDOI Listing
March 2021

Sleeping patterns and childhood obesity: an epidemiological study in 1,728 children in Greece.

J Clin Sleep Med 2021 May;17(5):1093-1101

Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece.

Study Objectives: Sleep is an essential normal function for children's growth and development, but over the years, lifestyle changes have resulted in insufficient sleep, a factor that may be associated with increased childhood obesity. The aim of this study was to evaluate the association between sleep duration and sleep patterns separately on weekdays and weekends regarding children's weight status.

Methods: This study was conducted among Greek students (55.1% girls) in 2014-2016. Children's weight status was classified according to the International Obesity Task Force tables and guidelines. Sleep duration was determined based on the sleep and wake time that children reported, separately for weekdays and weekends. Classification and regression tree analysis was used to derive sleep patterns and evaluate their relation to children's weight status.

Results: Multiadjusted analysis revealed an inverse association between average duration of sleep on weekdays and weekends with the likelihood of being overweight/obese (odds ratio per 1 hour 0.82; 95% confidence interval, 0.73-0.92). This was more prominent on weekends than on weekdays. Children who had lower duration on weekdays, but catch-up sleep duration on weekends, were 2% (95% confidence interval, 0.97-0.99) less likely to be overweight/obese compared to those children having both less or increased sleep duration on weekdays and weekends.

Conclusions: Sleep duration and sleep patterns seem to be associated with childhood weight status. Interventions should be developed to educate parents on the importance of an adequate sleep duration and healthy sleep patterns for their children's healthy development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5664/jcsm.9160DOI Listing
May 2021

Motives for weight loss and weight loss maintenance: results from the MedWeight study.

J Hum Nutr Diet 2021 Jan 25. Epub 2021 Jan 25.

Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.

Background: The relationship of weight loss motives with long-term outcomes is equivocal. We aimed to examine differences in weight loss motives of maintainers and regainers, as well as explore associations between motives and successful maintenance.

Methods: The study sample includes 607 adults, with a history of overweight/obesity and self-reported ≥10% voluntary weight loss, 12 months before study entry. Participants were classified as maintainers (weighing ≤90% maximum weight) or regainers. Volunteers identified possible motives for weight loss and maintenance (maintainers only), from a specific list.

Results: Both maintainers and regainers were predominantly motivated by physical appearance (38.6% versus 39.9%, P > 0.05) and self-esteem (26.8% versus 32.0%, P > 0.05) for weight loss. Compared to regainers, more maintainers reported weight reduction driven by social purposes (16.6% versus 9.4%, P = 0.022) and less were prompted by friends/family to lose weight (21.1% versus 31.7%, P = 0.005). In maintainers, shifts in motives from weight loss to maintenance phase were found, including an increased prevalence of health motives (6.4% versus 9.6%, P < 0.001) and decreased physical appearance motives (38.6% versus 30.3%, P < 0.001). Reporting physical appearance as main maintenance motive was inversely associated with maintained weight loss, after adjusting for age, sex and years of education (B = -3.49 [1.07], P = 0.001); maintainers reporting physical appearance as the main motive maintained 3.5% less weight loss compared to those who did not (P = 0.001).

Conclusions: The present study has highlighted motivational influences associated with weight loss outcomes. Future studies should explore the ability of people with overweight/obesity to act upon motives for long-term weight management, as well as the impact of shifting through motives on the magnitude of maintenance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jhn.12856DOI Listing
January 2021

The factors associated with the presence of psychotic symptoms in the HELIAD Greek community study of older adults.

Aging Ment Health 2021 Jan 20:1-10. Epub 2021 Jan 20.

Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece.

Background: The prevalence and associated factors related to psychotic symptoms in older adults are understudied. The objectives were to assess the prevalence, incidence and factors associated with psychotic symptoms in a representative Greek sample of community living older adults.

Methods: The sample includes  = 1,904 residents of the cities of Larissa and Maroussi in Greece participating in the Hellenic Longitudinal Investigation of Aging and Diet study with available data at baseline and  = 947 individuals at the 3-year follow-up. Past-month presence of delusions and hallucinations was assessed on the grounds of the 17 symptoms of the Columbia University Scale for Psychopathology in Alzheimer's Disease and 14 symptoms of the Neuropsychiatric Inventory Questionnaire. A comprehensive neuropsychological assessment for probable diagnosis of dementia and physical comorbidity was carried out by neurologists. Penalized logistic regression analyses were used to assess the socio-economic and clinical factors associated with psychotic symptoms.

Results: Past-month prevalence of psychotic symptoms was 1.9% and 1.0% when excluding cases of dementia. The prevalence of any delusion and hallucination was 0.8% and 0.3% when excluding dementia. The incidence of psychotic symptoms without dementia was 1.3%. Recent widows and farmers/breeders/craftsmen, versus public servants/teachers/executives, had both six times the odds of experiencing psychotic symptoms without dementia. Hearing impairment and the number of health conditions also increased the odds while increased age was protective.

Conclusion: Psychotic symptoms unrelated to dementia constitute a considerable mental health problem in old age. Paranoid delusions were the most prevalent. Socio-economic and health status factors are significant predictors of psychotic symptoms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13607863.2021.1871882DOI Listing
January 2021

Weight loss through lifestyle changes: impact in the primary prevention of cardiovascular diseases.

Heart 2020 Nov 20. Epub 2020 Nov 20.

School of Health Science and Education, Harokopio University, Attica, Greece

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/heartjnl-2019-316376DOI Listing
November 2020

Cardiovascular Diseases in Women: Policies and Practices Around the Globe to Achieve Gender Equity in Cardiac Health.

Risk Manag Healthc Policy 2020 12;13:2079-2094. Epub 2020 Oct 12.

Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.

The women's global health agenda has recently been reformulated to address more accurately cardiovascular disease (CVD) prevention, diagnosis, and treatment. The aim of the present work was to review the global and national policies and practices that address sex equality in health with a focus on CVDs in women. Scientific databases and health organizations' websites that presented/discussed policies and initiative targeting to enhance a sex-centered approach regarding general health and/or specifically cardiac health care were reviewed in a systematic way. In total, 61 relevant documents were selected. The selected policies and initiatives included position statements, national action plans, evidence-based guidelines, guidance/recommendations, awareness campaigns, regulations/legislation, and state-of-the art reports by national/international projects and conferences. The target audiences of large stakeholders (eg, American Heart Association, European Society of Cardiology, Centers for Disease Control and Prevention) were female citizens, health professionals, and researchers. Much as policy-makers have recognized the sex/gender gap in the CVD field, there is still much to be done. Thereby, tailor-made strategies should be designed, evaluated, and delivered on a global and most importantly a national basis to achieve gender equity with regard to CVDs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/RMHP.S264672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567535PMC
October 2020

Dementia Incidence in the Elderly Population of Greece: Results From the HELIAD Study.

Alzheimer Dis Assoc Disord 2021 Jan-Mar 01;35(1):48-54

1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School.

Objectives: Recently a declining trend in dementia incidence rates has been reported in high-income countries. We investigated dementia incidence in a representative sample of the Greek population in the age group of 65 years and above.

Methods: This research is part of the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (HELIAD). The incidence cohort consisted of 1072 participants who were reevaluated after a mean period of 3.09 years.

Results: The incidence rate of dementia was 19.0 cases per 1000 person-years (age-standardized and sex-standardized incidence: 25.4/1000 person-years), of which 16.3 per 1000 person-years were attributable to Alzheimer disease. Each additional year of age increased dementia risk by 19.3% and each additional year of education decreased dementia risk by 12.1%. Apolipoprotein E (APOE)-ε4 homozygous participants were 18 times more likely to be diagnosed with dementia. A baseline diagnosis of mild cognitive decline (MCI) resulted in a risk for dementia increased by 3.7 times compared with the cognitively normal; in participants with MCI at baseline, APOE-ε4 carriage increased dementia risk by 4.5 times.

Conclusions: The incidence rate of dementia in people 65 years and above in Greece is generally consistent with recently published rates in Europe and North America. Advancing age, baseline MCI, and APOE-ε4 homozygosity are risk factors, while higher educational attainment seems protective.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/WAD.0000000000000407DOI Listing
April 2020

Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study.

J Am Med Dir Assoc 2021 Mar 25;22(3):551-558.e1. Epub 2020 Sep 25.

1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY.

Objective: To explore the association between both self-reported quality and quantity sleep characteristics and frailty status in a large non-sex-specific population of older individuals in Greece.

Design: Cross-sectional study.

Setting And Participants: In total, 1984 older individuals (≥65 years old) were drawn from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD).

Measures: Frailty was assessed using 3 different definitions, the Frailty Index (FI), the Tilburg Frailty Indicator (TFI), and the Groningen Frailty Indicator (GFI). Sleep quality was evaluated through the Sleep Index II, which includes 9 of the 12 self-reported items of the Medical Outcomes Study-Sleep Scale. To examine sleep duration, participants were asked to report on how many hours they slept each night during the past 4 weeks. Logistic regression models adjusted for multiple covariates were explored. Additional analyses, stratified by gender, adjusting for sleep-related medications and excluding participants diagnosed with dementia, were also performed.

Results: In total, 389 (20%), 619 (31.9%), and 608 (31.3%) participants were categorized as frail according to the FI, the TFI, and the GFI respectively. Sleep quality was significantly associated with frailty in all models. Even after adjusting for subjective sleep duration, compared with participants who subjectively reported high sleep quality, those with low sleep quality had 3.7, 2.6, and 2.5 more times to be frail as measured with FI, TFI, and GFI respectively. Regarding the associations between frailty and self-reported sleep duration, sex-specific associations were observed: prolonged sleep duration was associated with frailty in the subsample of male participants.

Conclusions And Implications: The present study shows a strong correlation between subjective sleep quality and frailty status, contributing substantial information to the growing literature demonstrating that sleep is associated with older people's overall health. Sleep complaints should not be underestimated, and older individuals who self-report sleep disorders should be further assessed for frailty.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamda.2020.08.012DOI Listing
March 2021

Dairy products, surrogate markers, and cardiovascular disease; a sex-specific analysis from the ATTICA prospective study.

Nutr Metab Cardiovasc Dis 2020 11 31;30(12):2194-2206. Epub 2020 Jul 31.

First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.

Background And Aims: Dairy products are a very diverse food group with multiple effects on the cardiac health of men and women. The aim of this work was to evaluate the sex-specific association between dairy products (total and subtypes) and 10-year first fatal/nonfatal cardiovascular disease (CVD) incidence.

Methods And Results: In 2001-2002, n = 1514 men and n = 1528 women (>18 years old) from greater Athens area, Greece, were enrolled. Dietary assessment was based on a validated semi-quantitative food frequency questionnaire. Dairy product consumption was examined in relation to 10-year CVD incidence. Follow-up (2011-2012) was achieved in n = 2020 participants (n = 317 CVD cases). Ranking from lowest (<1 serving/day) to highest (>2 servings/day) total dairy intake, CVD incidence in men was 17.8%, 15.0%, and 10.9% (p = 0.41), while in women it was 14%, 6.0%, and 5.7% (p = 0.02). Multiadjusted analysis revealed that total dairy intake protected against CVD only in women [Hazard Ratio (HR) = 0.48 and 95% Confidence Interval (95% CI) (0.23, 0.90)], irrespective of the fat content. Further analysis revealed that only fermented products (yogurt and cheese), protected against CVD. For per 200 g/day yogurt consumption, CVD risk was 20%-30% lower with this claim being more evident in women, while for per 30 g/day cheese intake, about 5% lower risk was observed particularly in men. As for butter, nonsignificant associations were highlighted. These associations were mainly retained in the case of hepatic steatosis, insulin resistance, and systemic inflammation.

Conclusions: This work provides incentives for researchers to elucidate the diversity of ingredients and mechanisms through which dairy products exert their effect on cardiac health separately for men and women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.numecd.2020.07.037DOI Listing
November 2020

Frailty and Prodromal Parkinson's Disease: Results From the HELIAD Study.

J Gerontol A Biol Sci Med Sci 2021 Mar;76(4):622-629

1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece.

Background: To investigate the association between frailty, Parkinson's disease (PD), and the probability of prodromal Parkinson's disease (prodromal PD) in Greek community-dwelling older individuals.

Methods: Parkinson's disease diagnosis was reached through standard clinical research procedures. Probability of prodromal PD was calculated according to the International Parkinson and Movement Disorder Society's research criteria for PD-free participants. Frailty was evaluated according to definitions of the phenotypic and multidomain approach. Logistic and linear regression models were performed to investigate associations between frailty (predictor) and the probability of prodromal PD, either continuous or dichotomous (≥30% probability score), or PD (outcome).

Results: Data from 1765 participants aged 65 and older were included in the present analysis. Parkinson's disease and prodromal PD prevalence were 1.9% and 3.0%, respectively. Compared to nonfrail participants, those who were frail, as identified with either the Fried frailty phenotype or Frailty Index had approximately 4 (odds ratio [OR] 4.09, 95% confidence interval [CI] 1.54-10.89) and 12 times (OR 12.16, 95% CI 5.46-27.09) higher odds of having a PD diagnosis, respectively. Moreover, compared to the nonfrail, frail participants as identified with either the Fried frailty phenotype or Frailty Index had 2.8 (OR 2.83, 95% CI 1.09-7.37) and 8.3 times (OR 8.39, 95% CI 4.56-15.42) higher odds of having possible/probable prodromal PD, respectively.

Conclusions: Frailty status was associated with prodromal PD and PD, suggesting common characteristics or underlying mechanisms of these conditions. Although prospective studies are warranted, acknowledging the possible association of frailty, PD, and prodromal PD may improve their clinical management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/gerona/glaa191DOI Listing
March 2021

Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study.

BMC Med 2020 08 5;18(1):210. Epub 2020 Aug 5.

Neurology Department, University Hospital of Larissa, University of Thessaly, Larissa, Greece.

Background: Dementia shows sex difference in its epidemiology. Childbirth, a distinctive experience of women, is associated with the risk for various diseases. However, its association with the risk of dementia in women has rarely been studied.

Methods: We harmonized and pooled baseline data from 11 population-based cohorts from 11 countries over 3 continents, including 14,792 women aged 60 years or older. We investigated the association between parity and the risk of dementia using logistic regression models that adjusted for age, educational level, hypertension, diabetes mellitus, and cohort, with additional analyses by region and dementia subtype.

Results: Across all cohorts, grand multiparous (5 or more childbirths) women had a 47% greater risk of dementia than primiparous (1 childbirth) women (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.10-1.94), while nulliparous (no childbirth) women and women with 2 to 4 childbirths showed a comparable dementia risk to primiparous women. However, there were differences associated with region and dementia subtype. Compared to women with 1 to 4 childbirths, grand multiparous women showed a higher risk of dementia in Europe (OR = 2.99, 95% CI = 1.38-6.47) and Latin America (OR = 1.49, 95% CI = 1.04-2.12), while nulliparous women showed a higher dementia risk in Asia (OR = 2.15, 95% CI = 1.33-3.47). Grand multiparity was associated with 6.9-fold higher risk of vascular dementia in Europe (OR = 6.86, 95% CI = 1.81-26.08), whereas nulliparity was associated with a higher risk of Alzheimer disease (OR = 1.91, 95% CI 1.07-3.39) and non-Alzheimer non-vascular dementia (OR = 3.47, 95% CI = 1.44-8.35) in Asia.

Conclusion: Parity is associated with women's risk of dementia, though this is not uniform across regions and dementia subtypes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12916-020-01671-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406389PMC
August 2020

Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment.

Arch Gerontol Geriatr 2020 Nov/Dec;91:104112. Epub 2020 Jul 13.

Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.

Background: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).

Methods: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School.

Results: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.

Conclusion: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.archger.2020.104112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724926PMC
December 2020

A Prospective Validation of the Updated Movement Disorders Society Research Criteria for Prodromal Parkinson's Disease.

Mov Disord 2020 10 22;35(10):1802-1809. Epub 2020 Jun 22.

Parkinson's Disease and Movement Disorders Department, Hygeia Hospital, Athens, Greece.

Objective: The objective of this study was to validate the recently updated research criteria for prodromal Parkinson's disease (pPD) proposed by the International Parkinson's Disease and Movement Disorders Society.

Methods: A total of 16 of 21 markers of pPD were ascertained in the Hellenic Longitudinal Investigation of Aging and Diet cohort composed of community-dwelling individuals aged ≥65 years. The probability of pPD was calculated for 961 individuals without Parkinson's disease (PD) or dementia with Lewy bodies at baseline who were followed-up for a median of 3 years. The ability of the criteria to predict conversion to PD/dementia with Lewy bodies was assessed by estimating their sensitivity and specificity, plotting receiver operating characteristics curves, and using logistic regression. These analyses were repeated using the original criteria.

Results: No incident PD/dementia with Lewy bodies case had probable pPD at baseline (ie, ≥80% pPD probability). At cut-offs of 10%, 30%, and 50% probability of pPD, the sensitivity and specificity of the criteria ranged from 4.5% to 27.3%, and 85.7% to 98.3% respectively. The area under the receiver operating characteristics curve was 0.691 (95% confidence intervals, 0.605-0.777). In logistic regression models, the criteria-derived posttest odds of pPD were a significant predictor of conversion at follow-up. The updated criteria performed similarly to the original but showed a slight increase in sensitivity.

Conclusions: The new criteria demonstrated suboptimal sensitivity in our random sample of community-dwelling individuals. The absence of specialized assessments with high likelihood ratios in our cohort could be hindering the demonstration of higher sensitivities. Such assessments should be a part of future validation attempts. © 2020 International Parkinson and Movement Disorder Society.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/mds.28145DOI Listing
October 2020

Nutrition and the ageing brain: Moving towards clinical applications.

Ageing Res Rev 2020 09 24;62:101079. Epub 2020 May 24.

Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK. Electronic address:

The global increases in life expectancy and population have resulted in a growing ageing population and with it a growing number of people living with age-related neurodegenerative conditions and dementia, shifting focus towards methods of prevention, with lifestyle approaches such as nutrition representing a promising avenue for further development. This overview summarises the main themes discussed during the 3 Symposium on "Nutrition for the Ageing Brain: Moving Towards Clinical Applications" held in Madrid in August 2018, enlarged with the current state of knowledge on how nutrition influences healthy ageing and gives recommendations regarding how the critical field of nutrition and neurodegeneration research should move forward into the future. Specific nutrients are discussed as well as the impact of multi-nutrient and whole diet approaches, showing particular promise to combatting the growing burden of age-related cognitive decline. The emergence of new avenues for exploring the role of diet in healthy ageing, such as the impact of the gut microbiome and development of new techniques (imaging measures of brain metabolism, metabolomics, biomarkers) are enabling researchers to approach finding answers to these questions. But the translation of these findings into clinical and public health contexts remains an obstacle due to significant shortcomings in nutrition research or pressure on the scientific community to communicate recommendations to the general public in a convincing and accessible way. Some promising programs exist but further investigation to improve our understanding of the mechanisms by which nutrition can improve brain health across the human lifespan is still required.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.arr.2020.101079DOI Listing
September 2020

Exploring the relationship between the Mediterranean diet and weight loss maintenance: the MedWeight study.

Br J Nutr 2020 10 21;124(8):874-880. Epub 2020 May 21.

Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, GR 17671 Athens, Greece.

Weight loss maintenance is crucial for obesity management, yet optimal dietary patterns for this period are not established. We aimed to explore the relationship between adherence to the Mediterranean diet and weight loss maintenance. Sample includes 565 adults (62 % women) of the MedWeight study. Eligible volunteers were those reporting intentional weight loss of ≥10 %, starting from a BMI ≥ 25 kg/m2, over 12 months prior to enrolment. Based on current weight, participants were characterised as maintainers (≤90 % maximum weight) or regainers (>95 % maximum weight). Socio-demographics and weight history were recorded. Dietary intake was assessed by two non-consecutive 24-h recalls within 10 d and analysed in energy, macronutrient and food group intakes. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Score (MedDietScore) (range 0-55, greater scores showing higher adherence). Protein intake was higher in maintainers than in regainers (P < 0·001). When MedDietScore quartiles were considered, a linear trend for weight loss maintenance was revealed (P < 0·05). After adjustment for basic demographic characteristics, being in the third or fourth quartile of the MedDietScore (v. first) was associated with 2·30 (95 % CI 1·29, 4·09) and 1·88 (95 % CI 1·10, 3·22) increased odds of maintenance. Regarding individual MedDietScore components, only fruit intake is associated with increased odds for maintenance (1·03 (95 % CI 1·01, 1·06)). The leave-one-out approach revealed that at least six MedDietScore components were essential for the observed relationship. Higher adherence to the Mediterranean diet was associated with 2-fold increased likelihood of weight loss maintenance. Future studies should replicate these findings in non-Mediterranean populations as well.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S0007114520001798DOI Listing
October 2020

APOE ε4 and the Influence of Sex, Age, Vascular Risk Factors, and Ethnicity on Cognitive Decline.

J Gerontol A Biol Sci Med Sci 2020 09;75(10):1863-1873

Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.

We aimed to examine the relationship between Apolipoprotein E ε4 (APOE*4) carriage on cognitive decline, and whether these associations were moderated by sex, baseline age, ethnicity, and vascular risk factors. Participants were 19,225 individuals aged 54-103 years from 15 longitudinal cohort studies with a mean follow-up duration ranging between 1.2 and 10.7 years. Two-step individual participant data meta-analysis was used to pool results of study-wise analyses predicting memory and general cognitive decline from carriage of one or two APOE*4 alleles, and moderation of these associations by age, sex, vascular risk factors, and ethnicity. Separate pooled estimates were calculated in both men and women who were younger (ie, 62 years) and older (ie, 80 years) at baseline. Results showed that APOE*4 carriage was related to faster general cognitive decline in women, and faster memory decline in men. A stronger dose-dependent effect was observed in older men, with faster general cognitive and memory decline in those carrying two versus one APOE*4 allele. Vascular risk factors were related to an increased effect of APOE*4 on memory decline in younger women, but a weaker effect of APOE*4 on general cognitive decline in older men. The relationship between APOE*4 carriage and memory decline was larger in older-aged Asians than Whites. In sum, APOE*4 is related to cognitive decline in men and women, although these effects are enhanced by age and carriage of two APOE*4 alleles in men, a higher numbers of vascular risk factors during the early stages of late adulthood in women, and Asian ethnicity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/gerona/glaa116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7518559PMC
September 2020

Feeding the preterm infant: an overview of the evidence.

Int J Food Sci Nutr 2021 Feb 27;72(1):4-13. Epub 2020 Apr 27.

Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.

Feeding from own mother's milk is not always an option for preterm infants, and choosing between alternative means of feeding should be made in light of their effect on infants' health. In this work, we aimed to present evidence regarding feeding pre-term infants with human milk, either own mother's or donor milk (DM), and the potential effects on growth and other health related outcomes. Exclusive breastfeeding (BF) remains the optimal option, whereas feeding with DM as a sole diet or supplemental to maternal milk confers immunological advantages and fewer rates of necrotising enterocolitis against preterm formula feeding, yet the latter results in greater growth velocity. Literature gaps in the use of DM, practical suggestions for choosing suitable feeding means (i.e. continuous support of BF, adequate education regarding feeding preterm infants, including DM), and future perspectives on the potential effects of dietary manipulations of the maternal diet, are also discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09637486.2020.1754352DOI Listing
February 2021

The validity of technology-based dietary assessment methods in childhood and adolescence: a systematic review.

Crit Rev Food Sci Nutr 2021 20;61(7):1065-1080. Epub 2020 Apr 20.

Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.

Technology-based dietary assessment has promising benefits on improving accuracy and reducing cost of dietary data collection. The validity of technology-based tools in children/adolescents was examined. A systematic literature search was performed to identify studies published till September 2019. In total, 26 studies with 29 validation-related estimations were selected; 13 web-based 24-hdietary recalls (image assisted;  = 12, drop-down food list;  = 13), 4 mobile applications and 3 web-based dietary records (image based;  = 2 and image assisted;  = 1, drop-down food list;  = 3) and 6 web-based food frequency questionnaires (FFQs) (image assisted;  = 3). Fourteen studies were addressed to adolescents, ten studies to children (principally 9-11 years old) and two studies to mixed study samples. Validation was mostly performed through 24-h dietary recalls and dietary records while in some cases objective methods were used. Image-assisted 24-h dietary recalls presented good level of agreement with paper-based methods, yet principally in adolescents. Mobile-application dietary records with image-based facilities and drop-down food lists were found to accurately record dietary intake even when compared with objective methods. FFQs, mainly examined in adolescents, had good level of agreement with the "gold standard" dietary records method. The validity of technology-based methods could be supported yet various technical/methodological issues need better clarification.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/10408398.2020.1753166DOI Listing
March 2021

Meat consumption, depressive symptomatology and cardiovascular disease incidence in apparently healthy men and women: highlights from the ATTICA cohort study (2002-2012).

Nutr Neurosci 2020 Apr 11:1-10. Epub 2020 Apr 11.

First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.

To evaluate the association of meat consumption with prevalent depressive symptomatology and cardiovascular disease (CVD) incidence in apparently healthy individuals. ATTICA study was conducted during 2001-2012 including = 1514 men and = 1528 women (aged >18 years old) from the greater Athens area, Greece. At baseline, depressive symptomatology through Zung Self-Rating Depression Scale (range 20-80) and meat consumption (total meat, red, white and processed meat) through validated semi-quantitative food frequency questionnaire were assessed. Follow-up (2011-2012) was achieved in = 2020 participants (= 317 cases); = 845 participants with complete psychological metrics were used for the primary analysis. Ranking from 1st to 3 total meat consumption (low to high) tertiles, participants assigned in 2 tertile had the lowest depressive-symptomatology scoring (). This trend was retained in multiadjusted logistic regression analysis; participants reporting moderate total and red meat consumption had ∼20% lower likelihood to be depressed (i.e. Zung scale<45) compared with their 1st tertile counterparts (Odds Ratio (OR) 0.82, 95% Confidence Interval (95%CI) (0.60, 0.97) and OR 0.79 95%CI (0.45, 0.96)). Non-linear associations were revealed; 2-3 serving/week total meat and 1-2 servings/week red meat presented the lowest odds of depressive symptomatology (all ). These U-shape trends seemed to attenuate the aggravating effect of depressive symptomatology on CVD hard endpoints. All aforementioned associations were more evident in women (all ). The present findings generate the hypothesis that moderate total meat consumption and notably, red meat may be more beneficial to prevent depressed mood and in turn hard CVD endpoints.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/1028415X.2020.1750169DOI Listing
April 2020

Association between the adherence to the Mediterranean dietary pattern and common mental disorders among community-dwelling elders: 2015 Health Survey of São Paulo, SP, Brazil.

J Affect Disord 2020 03 22;265:389-394. Epub 2020 Jan 22.

University of Sao Paulo, School of Public Health, Av. Dr. Arnaldo, 715, São Paulo, CEP 01246-904 SP, Brazil; University of Sao Paulo, School of Arts, Science and Humanities, São Paulo, SP, Brazil.

Background: Some questions regarding the benefits of the Mediterranean Dietary Pattern (MDP) are still unanswered, especially in non-Mediterranean areas. As such, this study intends to evaluate the association between the adherence to the MDP with the presence of Common Mental Disorders (CMD) in Brazilian older adults, adopting two different concepts of MDP.

Methods: The sample included 545 elders from 2015 Health Survey of São Paulo City (cross-sectional population-based study). CMD were identified through the Self Reporting Questionnaire-20 (SRQ-20). Data from two 24-hour dietary recall were used to construct two concepts of MDP according to the Mediterranean-diet score (MDS): Traditional MDP (included only foods with characteristics of the original MDP) and Brazilian-MDP (included foods with non-Mediterranean characteristics). The analyses included two different models (crude model and adjusted model for potential confounders) of logistic regression.

Results: Moderate and high adherence to Traditional MDP were associated with a lower prevalence of CMD (OR: 0.59; 95% CI: 0.35-0.98 and OR: 0.42, 95% CI: 0.18-0.96, respectively), after adjustment for sociodemographic, lifestyle and health status variables. In turn, the presence of CMD was not significantly associated with any level of adherence to the Brazilian-MDP.

Limitations: due to the cross-sectional feature of the study, we cannot determine a cause-effect relationship; some covariates were self-reported; the results cannot apply to the elderly from other regions.

Conclusion: Moderate and high adherence to the traditional MDP was found to reduce the risk of mental disorders in Brazilian elderly. Nevertheless, an increased intake of non-Mediterranean food components can limit this effect.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jad.2020.01.100DOI Listing
March 2020

Successful weight loss maintenance: A systematic review of weight control registries.

Obes Rev 2020 05 12;21(5):e13003. Epub 2020 Feb 12.

Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal.

Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long-term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer-reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty-two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/obr.13003DOI Listing
May 2020

Dietary anti-inflammatory index, metabolic syndrome and transition in metabolic status; a gender-specific analysis of ATTICA prospective study.

Diabetes Res Clin Pract 2020 Mar 28;161:108031. Epub 2020 Jan 28.

First Cardiology Clinic, School of Medicine, University of Athens, Greece.

Aims: To examine the association between dietary anti-inflammatory index (D-AII) and metabolic syndrome (MetS)prevalence, 10-year (2002-2012) diabetes, hypertension, hypercholesterolaemia incidence and 10-year transition from healthy (absence of all MetS traits, excluding waist circumference) to unhealthy metabolic status.

Methods: In 2001-2002, n = 1514 men and n = 1528 women (>18 years old) in Athens, Greece, free of cardiovascular disease were recruited. MetS was defined according to the revised NCEP ATP III (2005) or the IDF criteria or the harmonized criteria. The validated D-AII was calculated using a standardized procedure (range 10-77).

Results: Inverse associations were observed between D-AII and transition from healthy to unhealthy metabolic status (Odds Ratio (OR) = 0.88 95% Confidence Interval (95%CI)(0.73, 0.98)) and diabetes (OR = 0.55, 95%CI(0.29, 0.77)). In women, D-AII was inversely associated with transition from healthy to unhealthy metabolic status (OR = 0.55, 95%CI(0.26, 0.90), diabetes (OR = 0.41, 95%CI(0.18, 0.64) and hypertension (OR = 0.75, 95%CI(0.20, 0.95), yet only with diabetes incidence in men (OR = 0.62, 95%CI(0.38, 0.93).

Conclusions: Diet with high anti-inflammatory load seems an effective preventive measure to retain a metabolically benign status, principally in terms of glycemic control.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.diabres.2020.108031DOI Listing
March 2020

Sex-Specific Physical Activity Patterns Differentiate Weight Loss Maintainers From Regainers: The MedWeight Study.

J Phys Act Health 2020 02 1;17(2):225-229. Epub 2020 Feb 1.

Background: Although plenty of evidence indicates that weight loss maintainers are highly physically active, studies focusing on the sex-specific differences in activity levels between maintainers and regainers are scarce. The authors aimed to investigate sex-specific differences in activity patterns in a cohort of Mediterranean maintainers and regainers.

Methods: Sample includes 756 participants of the MedWeight registry (60.5% women), aged 18-65 years, who lost ≥10% of their initial weight, and either maintained their loss for ≥12 months or regained it. Participants completed a series of questionnaires, including demographics and weight history. Activity levels were evaluated with the International Physical Activity Questionnaire-short version.

Results: Maintainers of both sexes were, in total, more active than their same-sex regainers. When specific activities were considered, women maintainers spent more time walking than regainers (Padjusted = .02), whereas men maintainers spent more time in vigorous activities (Padjusted = .001) and walking than regainers (Padjusted = .001). Modest increments in activity of sex-relevant intensity were associated with increased odds for maintenance.

Conclusions: Maintainers attained a more active lifestyle than their same-sex regainers, involving more walking for both sexes and more vigorous activities for men. The detected differences, according to activity intensity, support that activity patterns associated with successful weight loss are distinguishable between sexes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/jpah.2019-0407DOI Listing
February 2020

Prevalence of Mild Cognitive Impairment in the Elderly Population in Greece: Results From the HELIAD Study.

Alzheimer Dis Assoc Disord 2020 Apr-Jun;34(2):156-162

1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School.

Introduction: Timely recognition of mild cognitive impairment (MCI) is essential in optimizing prevention and treatment for Alzheimer disease. Because of the paucity of data on MCI epidemiology in Greece and the variability of worldwide published results, we investigated the prevalence and determinants of MCI in the elderly population in Greece.

Methods: As part of the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (HELIAD), we randomly selected 1960 individuals 65 years and older to undergo full neurological and neuropsychological assessment by a multidisciplinary team. MCI was diagnosed according to the Petersen criteria.

Results: The age-standardized and gender-standardized prevalence of MCI in people aged 65 years and older in Greece is 13.11%. The amnestic and multidomain MCI subtypes are more common than their nonamnestic and single-domain counterparts, respectively. Almost two thirds of cases are because of suspected Alzheimer disease. Every additional year of age increases the odds of prevalent MCI by 7.4%, every additional year of education decreases the odds of MCI by 6.3%, and apolipoprotein E (APOE-ε4) carriage increases the odds of MCI by 57.9%.

Conclusions: MCI prevalence in the elderly population in Greece is on par with previously reported rates. Prospective studies with robust methodology will enhance our understanding of the dementia continuum.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/WAD.0000000000000361DOI Listing
January 2020

Validation of cutoffs for skeletal muscle mass index based on computed tomography analysis against dual energy X-ray absorptiometry in patients with cirrhosis: the KIRRHOS study.

Ann Gastroenterol 2020 Jan-Feb;33(1):80-86. Epub 2019 Nov 21.

Department of Dietetics Nutrition and School of Health Education Sciences and Harokopio University (Georgiou Alexandra Yannakoulia Mary Meropi D. Kontogianni) Gastroenterology.

Background: Accurate assessments of muscle mass in patients with cirrhosis are necessary in clinical practice. Computed tomography (CT) of the upper abdomen has been proposed as a useful method for quantifying muscle mass. Recently, Carey et al developed specific cutoffs for muscle wasting based on the skeletal muscle index at the L3 vertebra (L3-SMI) for cirrhotic patients. The aim of the present study was to assess the concurrent validity of the newly proposed cutoffs of Carey et al, along with others widely used in several clinical contexts, using dual energy X-ray absorptiometry (DXA) as the reference method.

Methods: Data were evaluated from 97 Caucasian patients (59.8% male, 59.1±11.6 years old, 45.4% decompensated) with cirrhosis of various etiologies. Muscle mass was assessed using the appendicular lean mass index (ALMI) by DXA and the L3-SMI by CT. Low L3-SMI was defined in relation to 5 different cutoffs.

Results: Low muscle mass prevalence was 13.4% according to ALMI and 26.8-45.4% according to the different cutoffs applied for L3-SMI. The Carey et al, Prado et al and Montano-Loza et al cutoffs showed similar sensitivity (all 69.2%) and specificity (79.8%, 76.2% and 75.0%, respectively) and high accuracy (78.4%, 75.3% and 74.2%). The Carey et al cutoffs showed the highest diagnostic validity against DXA the multivariate odds ratio adjusted for age, sex, body mass index category, disease etiology and model for end-stage liver disease score (95% confidence interval) was 5.88 (1.36-25.4), P=0.018.

Conclusion: Compared to DXA, the cutoffs for identifying muscle wasting proposed by Carey et al were proven to be the most accurate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.20524/aog.2019.0432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928470PMC
November 2019

Malnutrition in older adults: Correlations with social, diet-related, and neuropsychological factors.

Nutrition 2020 03 9;71:110640. Epub 2019 Nov 9.

Department of Nutrition and Dietetics, Harokopio University, Athens, Greece. Electronic address:

Background: The number of older adults is increasing rapidly. Malnutrition is a major problem in this age group, which may adversely affect health and quality of life. Several physiological, socioeconomic, and neuropsychological factors can lead to malnutrition.

Objectives: The aim of this study was to evaluate the nutritional status of community-dwelling older adults, and explore the associations of malnutrition risk with physiological, socioeconomic, and neuropsychological characteristics.

Methods: This study is part of the Hellenic Longitudinal Investigation of Aging and Diet study, a cross-sectional observational study in Greece, and study participants were 1831 urban-dwelling elderly individuals (mean age: 73.1 ± 5.9 y; 40.8% men). Risk for malnutrition was assessed with the Determine Your Nutritional Health checklist. Data on age, sex, level of education, marital status, depression, cognitive performance, body mass index, total energy intake, and adherence to the Mediterranean diet were recorded. Correlations and multivariate analyses were performed between these variables and risk for malnutrition.

Results: The estimated prevalence of moderate and high nutritional risks was 34.8% and 29.4%, respectively. Risk for malnutrition was associated with marital status (unmarried), increased body mass index, male sex, lower level of education, lower cognitive performance, and lower adherence to the Mediterranean diet (P < 0.05).

Conclusions: Nutritional screening should be performed frequently in all community-dwelling older adults. Health experts should perform nutritional screening in all community-dwelling older adults as part of secondary prevention, and nutrition counselling and support should be offered in those at risk for malnutrition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nut.2019.110640DOI Listing
March 2020