| Author | Zhao, Xuhao | |
| Author | Costa, Maria Fernanda Furtado de Lima e | |
| Author | Castro-Costa, Erico | |
| Author | Yan, Yifan | |
| Author | Lipnicki, Darren M. | |
| Author | Pang, Ting | |
| Author | Crawford, John D. | |
| Author | Chen, Christopher | |
| Author | Cheng, Ching-Yu | |
| Author | Venketasubramanian, Narayanaswamy | |
| Author | Chong, Eddie | |
| Author | Blay, Sergio Luis | |
| Author | Lipton, Richard B. | |
| Author | Katz, Mindy J. | |
| Author | Ritchie, Karen | |
| Author | Carriere, Isabelle | |
| Author | Scarmeas, Nikolaos | |
| Author | Yannakoulia, Mary | |
| Author | Kosmidis, Mary H. | |
| Author | Gureje, Oye | |
| Author | Ojagbemi, Akin | |
| Author | Bello, Toyin | |
| Author | Hendrie, Hugh C. | |
| Author | Gao, Sujuan | |
| Author | Guerra, Ricardo Oliveira | |
| Author | Auais, Mohammad | |
| Author | Gomez, José Fernando | |
| Author | Rolandi, Elena | |
| Author | Davin, Annalisa | |
| Author | Rossi, Michele | |
| Author | Riedel-Heller, Steffi | |
| Author | Löbner, Margit | |
| Author | Roehr, Susanne | |
| Author | Ganguli, Mary | |
| Author | Jacobsen, Erin P. | |
| Author | Chang, Chung-Chou H. | |
| Author | Aiello, Allison | |
| Author | Ho, Roger | |
| Author | Sanchez-Juan, Pascual | |
| Author | Valentí-Soler, Meritxell | |
| Author | del Ser, Teodoro | |
| Author | Lobo, Antonio | |
| Author | De-la-Cámara, Concepción | |
| Author | Lobo, Elena | |
| Author | Sachdev, Perminder S. | |
| Author | Xu, Xiaolin | |
| Author | Xu, Xin | |
| Author | Cohort Studies of Memory in an International Consortium (COSMIC) | |
| Access date | 2024-06-26T14:10:07Z | |
| Available date | 2024-06-26T14:10:07Z | |
| Document date | 2024 | |
| Citation | ZHAO, Xuhao et al. Additive Impact of Cardiometabolic Multimorbidity and Depression on Cognitive Decline: Findings from Multi-Regional Cohorts and Generalization from Community to Clinic. 2024. Available at: < https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4752614 >. | |
| URI | https://www.arca.fiocruz.br/handle/icict/64673 | |
| Language | eng | en_US |
| Publisher | Lancet | |
| Rights | restricted access | |
| Subject in Portuguese | Multimorbidade cardiobolica | pt_BR |
| Subject in Portuguese | Depressão | pt_BR |
| Subject in Portuguese | Declinio cognitivo | pt_BR |
| Subject in Portuguese | Estudo multiregional | pt_BR |
| Title | Additive Impact of Cardiometabolic Multimorbidity and Depression on Cognitive Decline: Findings from Multi-Regional Cohorts and Generalization from Community to Clinic | en_US |
| Type | Preprint | |
| Abstract | Background: Cardiometabolic multimorbidity (CMM) and depression are often co-occurring in older adults and independently associated with neurodegenerative outcomes. The present study aimed to estimate the additive associations of CMM and depression on long-term cognitive trajectory in multi-regional cohorts, and to validate the generalizability of the findings in additional settings, including clinical. Methods: Data harmonization was performed across 14 longitudinal cohort studies within the Cohort Studies of Memory in an International Consortium (COSMIC) group, spanning North America, South America, Europe, Africa, Asia, and Australia. Three external validation studies with distinct settings were employed for generalization. CMM was defined as: 1) CMM 5, ≥ 2 among hypertension, hyperlipidemia, diabetes mellitus, stroke, and heart disease and 2) CMM 3 (aligned with previous studies), ≥ 2 among diabetes mellitus, stroke, and heart disease. Depression was identified using the Geriatric Depression Scale, Center for Epidemiological Studies-Depression scale, or medical history. Cognition was assessed by neuropsychological testings and standardized as z-scores. Longitudinal cognition was calculated as changes in z-scores. A pooled individual participant data analysis was utilized to estimate the main and combined effects of CMM and depression and cognitive outcomes in COSMIC studies cross-sectionally and longitudinally. Stratified analyses were conducted based on baseline dementia status, demographics, and APOE genotype. Repeated analyses were performed in three external validation studies. Findings: Of the 32,450 older adults in the 14 COSMIC cohorts, we included 31,720 participants with complete data on CMM, depression and cognitive assessments for cross-sectional analyses. Among them, 23,242 who had at least 1 follow-up cognitive assessment were included in the longitudinal analyses. The three external studies for validation had 1964 participants from 3 multi-ethnic Asian elderly cohorts (community, memory, and stroke). In COSMIC, we found no interaction between CMM and depression on cognition (all Ps > 0.05). Each of CMM and depression was independently associated with cross-sectional cognitive performance and rate of change decline. Participants with both CMM and depression had lower cross-sectional cognitive performance (e.g. β=-0·20, 95%CI=(-0·25,-0·16) for CMM5(+)/depression(+)) and a faster rate of cognitive decline (e.g. β=-0·038, 95%CI=(-0·045,-0·032) for CMM5(+)/depression(+)) , compared with those without both conditions or with either alone. This combined effect remained consistent across different subgroups but was specifically evident in participants without dementia. These findings were reproduced in the three external validation studies. Interpretation: Our study demonstrated that CMM and depression each had an additive effect on cognitive decline. Targeting both cardiometabolic and psychological conditions in preventing cognitive decline could lead to greater effectiveness. | en_US |
| Affilliation | Zhejiang University. School of Public Health. Zhejiang, China | |
| Affilliation | Center of Studies in Public Health and Aging. Rene Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brasil | |
| Affilliation | Center of Studies in Public Health and Aging. Rene Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brasil | |
| Affilliation | Zhejiang University. School of Public Health. Zhejiang, China | |
| Affilliation | University of New South Wales. Sydney, Austrália | |
| Affilliation | Zhejiang University. School of Public Health. Zhejiang, China | |
| Affilliation | University of New South Wales. Sydney, Australia | |
| Affilliation | National University of Singapore. Department of Pharmacology. Singapura | |
| Affilliation | Singapore National Eye Centre. Singapore Eye Research Institute. Singapura | |
| Affilliation | National University of Singapore. Department of Pharmacology. Singapura | |
| Affilliation | National University Health System. Singapura | |
| Affilliation | Center for Studies in Public Health and Aging | |
| Affilliation | Yeshiva University. Albert Einstein College of Medicine. New York, NY, Estados Unidos | |
| Affilliation | Albert Einstein College of Medicine. New York, NY, Estados Unidos | |
| Affilliation | University of Montpellier. The Neuroscience Institute of Montpellier. Montpelllier, França | |
| Affilliation | University of Montpellier. The Neuroscience Institute of Montpellier. Montpelllier, França | |
| Affilliation | National and Kapodistrian University of Athens. Zografou, Grécia | |
| Affilliation | Harokopio University. Department of Nutrition and Dietetics. Travos, Grécia. | |
| Affilliation | Aristotle University of Thessaloniki. Lab of Neuropsychology & Behavioral Neuroscience. Thessaloniki, Grécia | |
| Affilliation | University of Ibadan. Department of Psychiatry. Ibadan, Oyo, Nigéria | |
| Affilliation | University of Ibadan. Ibadan, Oyo, Nigéria | |
| Affilliation | University of Ibadan. Ibadan, Oyo, Nigéria | |
| Affilliation | Indiana University Purdue University Indianapolis. Indiana University School of Medicine. Indianapolis, IN, Estados Unidos | |
| Affilliation | Indiana University Purdue University Indianapolis. Indiana University School of Medicine. Indianapolis, IN, Estados Unidos | |
| Affilliation | Universidade do Estado do Rio Grande do Norte. Natal, RN, Brasil | |
| Affilliation | School of Rehabilitation Therapy. Kingston, Ontario, Canada | |
| Affilliation | Universidad de Caldas. Caldas, Colômbia | |
| Affilliation | Golgi Cenci Foundation. Abbiategrasso, Itália | |
| Affilliation | Golgi Cenci Foundation. Abbiategrasso, Itália | |
| Affilliation | Golgi Cenci Foundation. Abbiategrasso, Itália | |
| Affilliation | Leipzig University. Leipzig, Alemanha | |
| Affilliation | Leipzig University. Leipzig, Alemanha | |
| Affilliation | Leipzig University. Leipzig, Alemanha | |
| Affilliation | University of Pittsburgh - Department of Epidemiology. Pittsburgh, PA, Estados Unidos | |
| Affilliation | University of Pittsburgh School of Medicine. Pittsburgh, PA, Estados Unidos | |
| Affilliation | Columbia University. Department of Epidemiology. New York, NY, Estados Unidos | |
| Affilliation | Columbia University. Department of Epidemiology. New York, NY, Estados Unidos | |
| Affilliation | National University of Singapore (NUS). Institute of Health Innovation and Technology (iHealthtech). Singapura | |
| Affilliation | Alzheimer’s Centre Reina Sofia-CIEN Foundation-ISCIII. Madri, Espanha | |
| Affilliation | Alzheimer’s Centre Reina Sofia-CIEN Foundation-ISCIII. Madri, Espanha | |
| Affilliation | Alzheimer’s Centre Reina Sofia-CIEN Foundation-ISCIII. Madri, Espanha | |
| Affilliation | Universidad de Zaragoza. Zaragoza, Espanha | |
| Affilliation | Universidad de Zaragoza. Zaragoza, Espanha | |
| Affilliation | Zaragoza CIBERSAM. Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza, Espanha | |
| Affilliation | University of New South Wales. Sydney, Austrália | |
| Affilliation | Zhejiang University. Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province. Zhejiang, China | |
| Affilliation | Zhejiang University. School of Public Health. Zhejiang, China | |
| Affilliation | Independent | |
| Subject | Cardiometabolic Multimorbidity | en_US |
| Subject | Depression | en_US |
| Subject | Cognitive Decline | en_US |
| Subject | Multi-Regional Study | en_US |
| Embargo date | 2150-12-31 | |
