Biomedical subjects

Amy R Borenstein

Publications and source records attributed to Amy R Borenstein.

13 recordsLinked to original sources

PubMed2006

Use of nutritional supplements in Parkinson's disease patients.

The use of nutritional supplements has almost doubled in the elderly population in the United States (US) in the past decade. We evaluated the use of nutritional supplements in Parkinson's disease (PD) patients to determine the prevalence of their use and whether patients were aware of possible side effects and drug interactions in the supplements they were taking. Consecutively selected PD patients from an academic movement disorders center completed a 33-item questionnaire regarding their use of nutritional supplements. A total of 120 PD patients completed the questionnaire and were included in the data analysis (mean age +/- SD = 68.2 +/- 11.65 years, 67 [55.8%] men and 53 women). Seventy-six patients (63%) took nutritional supplements at the time of data collection. Vitamins were the most common nutritional supplements used, and vitamin E was the most commonly used vitamin. Thirty-six patients (47%) who took nutritional supplements consulted with their doctor before taking them, and only 4% of patients who took nutritional supplements were aware of possible side effects from their use. Twenty patients (16.7%) reported that they were currently taking nutritional supplements because of symptoms related to their Parkinson's disease. The vast majority of PD patients surveyed were not aware that nutritional supplements could cause adverse side effects. Less than half of the patients who took nutritional supplements consulted their physician before starting them. Greater awareness of nutritional supplement use in PD patients is warranted to avoid potentially harmful effects and drug interactions.

Aged↗

PubMed2006

Fruit and vegetable juices and Alzheimer's disease: the Kame Project.

BACKGROUND: Growing evidence suggests that oxidative damage caused by the beta-amyloid peptide in the pathogenesis of Alzheimer's disease may be hydrogen peroxide mediated. Many polyphenols, the most abundant dietary antioxidants, possess stronger neuroprotection against hydrogen peroxide than antioxidant vitamins. METHODS: We tested whether consumption of fruit and vegetable juices, containing a high concentration of polyphenols, decreases the risk of incident probable Alzheimer's disease in the Kame Project cohort, a population-based prospective study of 1836 Japanese Americans in King County, Washington, who were dementia-free at baseline (1992-1994) and were followed through 2001. RESULTS: After adjustment for potential confounders, the hazard ratio for probable Alzheimer's disease was 0.24 (95% confidence interval [CI], 0.09-0.61) comparing subjects who drank juices at least 3 times per week with those who drank less often than once per week with a hazard ratio of 0.84 (95% CI, 0.31-2.29) for those drinking juices 1 to 2 times per week (P for trend < .01). This inverse association tended to be more pronounced among those with an apolipoprotein Eepsilon-4 allele and those who were not physically active. Conversely, no association was observed for dietary intake of vitamins E, C, or beta-carotene or tea consumption. CONCLUSIONS: Fruit and vegetable juices may play an important role in delaying the onset of Alzheimer's disease, particularly among those who are at high risk for the disease. These results may lead to a new avenue of inquiry in the prevention of Alzheimer's disease.

Aged↗

PubMed2006

Five-factor personality dimensions, mood states, and cognitive performance in older adults.

In this study we examined the impact of personality traits and negative mood state on performance in several cognitive domains in a sample of 398 elderly community-dwelling individuals. Multiple linear regression analyses were used to examine the variance in cognitive measures explained by state depression and anxiety after controlling for the effects of demographic characteristics and five-factor model personality traits. Personality traits were found to contribute significantly to cognitive function, explaining 2-7% of the variance in ability across domains. Examination of the contributions of individual five-factor traits showed that Openness had a significant relationship with all indexes of verbal memory and with general cognitive ability. State anxiety and depression variables were found to play a very small part, however, in contributing to cognitive function.

Affect↗

PubMed2006

Apolipoprotein E and cognition in community-based samples of African Americans and Caucasians.

To compare relative frequencies of apolipo-protein E (APOE) alleles in African-American and Caucasian populations and test associations with cognition, we studied two community-based samples: one of 253 African Americans and another of 466 Caucasians age 60-84 years. Logistic regression, adjusting for age, sex, education, and history of hypertension and diabetes was used to associate APOE with five cognitive measures. The APOE-epsilon4 allele frequency was 29.5% in African Americans and 12.1% in Caucasians. In the African Americans, no association was found between the presence of the APOE-epsilon4 allele and any of the cognitive measures. Among Caucasians, APOE-epsilon4 carriers performed more poorly on three of the five tests. We also report a considerably higher frequency of the APOE-epsilon4 allele in our African-American sample compared to other US-based studies.

Black or African American↗

PubMed2005

Alcohol and cognitive performance: a longitudinal study of older Japanese Americans. The Kame Project.

BACKGROUND: Recent data demonstrate that moderate consumption of alcohol (13-52 grams of ethanol per day) may be beneficial to cognitive functioning among older adults. METHODS: Longitudinal growth curve analyses controlling for baseline age, body mass index (BMI), education/income, migrant status, smoking, history of diagnosed stroke, hypertension, coronary heart disease (CHD), depression, diabetes and stroke (time-varying) were used to examine the relationship between alcohol consumption, gender and cognitive performance over an 8-year follow-up period. The sample included 1624 Japanese American community-dwelling adults aged 65 and older who were cognitively intact at baseline and participated in at least one follow-up examination. Cognitive performance was measured using the Cognitive Abilities Screening Instrument (CASI; 0-100 point scale), a global test of cognitive function. RESULTS: Current consumers (n = 480) scored significantly (p < 0.05) higher on CASI (mean rate of change-1.22 CASI units) over the 8-year follow-up period than past consumers or abstainers (n = 1144; mean rate of change-3.77 CASI units). There was no significant main effect for gender, or an alcohol and gender interaction. CONCLUSIONS: This study provides further support regarding the beneficial effects of moderate alcohol consumption on cognitive performance over time. Observed benefits were not modified by gender. Future studies need to determine whether alcohol preserves cognition directly or whether other factors such as physiology or cultural drinking practices are driving the observed association.

Aged↗

PubMed2005

Developmental and vascular risk factors for Alzheimer's disease.

To investigate developmental and vascular risk factors for Alzheimer's disease (AD), we examined 90 incident cases of probable AD in a cohort of 1859 individuals followed prospectively for six years. The presence of the APOE-epsilon4 allele was the strongest risk factor, and with increasing survival age, the effect of epsilon4 diminished. Among epsilon4 positives, developmental risk factors such as smaller head circumference (< or =54.4 cm) and having more than four children in the household at age 2-3 were independently associated with incident AD (hazard ratio (HR)=2.6 (95% CI 1.04-6.3) and 3.3 (1.2-9.2), respectively). Among epsilon4 negatives, vascular risk factors were related to AD risk (self-reported diagnoses of transient ischemic attack and diabetes (HR=5.1, 95% CI 1.7-15.5; HR 3.3, 95% CI 1.4-8.1)). These findings indicate that clinical AD is a result of early life as well as later life risk factors, and that genetic predisposition to the disease may modify the constellation of predictors.

Age Factors↗

PubMed2005

Florida Cognitive Activities Scale: initial development and validation.

We used a rational-empirical approach in the construction and validation of a cognitive activity scale for use with elderly populations. The scale development effort produced a 25-item scale with a reasonably high level of internal consistency in a sample of 200 elderly individuals. Scale scores were positively correlated with years of education and measures of various domains of cognitive ability. In a separate cross-validation sample, a similar pattern of reliability and validity coefficients was obtained. The full scale score was found to contribute significantly to the prediction of cognitive ability after controlling for the effects of age, education, and gender. Two subscales (Higher Cognitive Abilities and Frequent Cognitive Abilities) and a measure of self-reported maintenance of cognitive activity were also developed. In a separate study, the maintenance score was found to differ significantly between the validation sample and a sample of individuals with a history of neurological disorder, with a moderate effect size (d approximately = .7). Further cross-validation studies in minority groups and groups of varying socioeconomic status will be critical in establishing the research and clinical value of the scale and subscales.

Aged↗

PubMed2005

Performance on the CERAD neuropsychology battery of two samples of Japanese-American elders: norms for persons with and without dementia.

Norms for cognitive measures used to assess dementia are scant for minority groups, in particular for older Japanese Americans. Using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychology Battery, we compared the baseline performance of demented and nondemented Japanese Americans. Participants came from two harmonized epidemiological studies of dementia which were examined separately: the Kame Project, Seattle (350 men and women; 201 nondemented), age 65 and older; Honolulu-Asia Aging Study (HAAS), Hawaii (418 men; 120 nondemented), age 71 and older. The measures examined were Verbal Fluency; abbreviated Boston Naming; constructional praxis; and Word List Learning, Recall, and Recognition. Within each study, the CERAD measures distinguished between nondemented participants and those with mild cognitive impairment. Among persons with dementia, average level of performance decreased as severity of dementia increased. Determinants of score (age, education, language of administration, stage of dementia) varied between the two studies. Among Japanese Americans, the CERAD Neuropsychology Battery distinguished nondemented persons from those with dementia, but was less consistent in distinguishing levels of severity of dementia. This battery is useful for comparative epidemiological studies of dementia in minority populations.

Aged↗

PubMed2005

Depressive symptoms among African American and white older adults.

Guided by a stress and coping model, we explored determinants of depressive symptoms among community samples of older African Americans (n=255) and older Whites (n=452). We gave focus to the effects of demographic variables, physical health constraints (chronic conditions and functional disability), and psychosocial attributes (sense of mastery, religiosity, social support, and satisfaction with support), along with their interactive roles. We identified lower education, greater functional disability, lower sense of mastery, and poorer satisfaction with support as common risk factors for depressive symptoms in both groups; in contrast, the effects of age, gender, and religiosity were race specific. In addition, we obtained significant interactions among predictor variables in each group, identifying risk-reducing and risk-enhancing factors within each group.

Activities of Daily Living↗

PubMed2005

Very early detection of Alzheimer neuropathology and the role of brain reserve in modifying its clinical expression.

Numerous studies show that the pathology of Alzheimer's disease is present decades before a clinical diagnosis of dementia can be made. Given the likelihood that agents will become available that reliably delay onset and/or slow progression of Alzheimer's disease, it will be important to detect preclinical Alzheimer's disease as early as possible for maximal treatment effect. Detection of individuals by sensitive cognitive measures provides one way to identify people who are at high risk of developing clinical Alzheimer's disease. However, it is likely that those with considerable brain or cognitive reserve will be able to mask cognitive deficits until very close to the onset of the dementia, rendering such cognitive measures insensitive. Optimum biomarkers for Alzheimer's disease therefore need to target the severity of underlying brain pathology independently of brain reserve. Findings are presented showing the importance of higher education and larger brain size in masking the underlying disease pathology.

Aged↗

PubMed2004

Alcohol, gender, and cognitive performance: a longitudinal study comparing older Japanese and non-Hispanic white Americans.

BACKGROUND: Recent data demonstrate that moderate consumption of alcohol may be beneficial to cognition. DESIGN: Longitudinal growth curve analyses controlling for variables related to cognition were used to examine the relationship between alcohol consumption, ethnic differences, gender, and cognition over a 4-year-follow-up period. SAMPLE: The sample included 1,836 Japanese American and 2,581 Non-Hispanic White American community-dwelling adults age 65 and older who were cognitively intact at baseline and participated in at least one follow-up examination. MEASUREMENT: Cognitive performance was measured using the Cognitive Abilities Screening Instrument (CASI) and reaction time. RESULTS: Current drinkers scored significantly higher on CASI over time than past drinkers or abstainers. The same association between alcohol and CASI was observed in both genders and both ethnic groups. CONCLUSION: This study provides support regarding the potential beneficial outcomes associated with alcohol consumption and cognition and that these benefits were not modified by gender or ethnicity.

Acculturation↗

PubMedDate not supplied

Tools of the epidemiologist.

This review provides a summary of epidemiologic tools to facilitate understanding of the design and analysis of studies of Alzheimer disease (AD) and related disorders. Proportions, ratios, rates, prevalence, incidence, study designs, bias, confounding, effect modification, odds and risk ratios, statistical power, and confidence intervals are defined and discussed. Descriptive epidemiology is concerned with describing the distribution of disease by person, place, and time. It is useful for hypothesis generation, but not generally for hypothesis testing. Observational analytic epidemiology focuses on identifying putative causes for an illness. Although its primary mission is hypothesis testing, it can lead to new hypotheses as well. Finally, experimental analytic epidemiology or clinical trials can provide rigorous tests of presumed causal associations. The strengths and limitations of various designs as they apply to determining causal associations in studies of AD and dementia are reviewed. Over the past 60 years, the epidemiologic study of dementia has evolved from basic descriptive studies of prevalence and incidence to case-control and cohort studies and finally to the first clinical trials to prevent AD.

Alzheimer Disease↗

PubMedDate not supplied

Early-life risk factors for Alzheimer disease.

Research findings obtained over the past 20 years suggest that Alzheimer disease (AD) may have its origins in early life. In this review, we consider the evidence for early-life risk factors for this illness. We propose that risk factors that predict neuropathology are largely distinct from those related to the clinical expression of Alzheimer disease. Early-life risk factors for pathology include genes, chromosomal abnormalities, head injury, insulin resistance, and inflammation. With regard to risk factors for clinical expression of Alzheimer disease, six general groups of childhood exposures are reviewed: (1) perinatal conditions, (2) early-life brain development, (3) early-life body growth, (4) early-life socioeconomic conditions, (5) environmental enrichment, and (6) cognitive reserve. The literature reviewed suggests that risk of Alzheimer disease is probably not determined in any single time period but results from the complex interplay between genetic and environmental exposures throughout the life course. Enhancement or preservation of brain or cognitive reserve could delay the onset of Alzheimer disease and in some cases prevent the disease from occurring altogether.

Alzheimer Disease↗