Neurology最新文献

{"title":"Quantitative Assessment of the Effect of Chronic Kidney Disease on Plasma P-Tau217 Concentrations.","authors":"Joshua A Bornhorst,Carly S Lundgreen,Stephen D Weigand,Daniel J Figdore,Heather Wiste,Michael Griswold,Prashanthi Vemuri,Jonathan Graff-Radford,David S Knopman,Petrice Cogswell,Clifford R Jack,Ronald C Petersen,Alicia Algeciras-Schimnich","doi":"10.1212/wnl.0000000000210287","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210287","url":null,"abstract":"BACKGROUND AND OBJECTIVESChronic kidney disease (CKD) is known to be associated with increased plasma phosphorylated tau217 (p-tau217) concentrations, potentially confounding the utility of plasma p-tau217 measurements as a marker of amyloid pathology in individuals with suspected Alzheimer disease (AD). In this study, we quantitatively investigate the relationship of plasma p-tau217 concentrations vs estimated glomerular filtration rate (eGFR) in individuals with CKD with and without amyloid pathology.METHODSThis was a retrospective examination of data from 2 observational cohorts from either the Mayo Clinic Study of Aging or the Alzheimer's Disease Research Center cohorts. p-Tau217 was determined using the ALZpath Simoa p-tau217 immunoassay and an immunoprecipitation mass spectrometry assay that simultaneously measures p-tau217 and nonphosphorylated-tau217 (np-tau217) to determine %p-tau217 ([p-tau217/nonphosphorylated-tau217]) × 100%) (C2N Diagnostics). Amyloid positivity was defined by amyloid-PET and a centiloid of ≥25. Log-log linear regression fits were used to quantitatively predict increases in plasma p-tau217 associated with decreasing eGFR.RESULTSParticipants (n = 202, mean age of 78 years, 38% female) with diagnoses of cognitive unimpairment (n = 109), mild cognitive impairment (n = 71), and dementia (n = 22) were included. In all, 114 (56%) of all participants were amyloid-PET positive (A+). In addition, 86 (43%) of all participants were classified as having CKD (CKD stages 3-4). p-Tau217 concentrations were significantly higher in A- participants with an eGFR of <60 (mL/min/1.73 m2), as compared with those with eGFR >60 A- participants. For an eGFR of 45 vs 60 in the A- cohort, the calculated percentage changes were +31%, +55%, and +19%, for ALZpath p-tau217, C2N p-tau217, and C2N %p-tau217, respectively. For the A+ cohort, the corresponding calculated percentage changes were +17%, +15%, and -5%, respectively.DISCUSSIONCKD was associated with increased p-tau217 concentrations when measuring p-tau217 by ALZpath and C2N methodologies, but the effect was mitigated by the use of %p-tau217. These results indicate limitations for the utility of plasma p-tau217 measurements in individuals with significant renal impairment (eGFR <45 or CKD stage 3b or greater). Determination of eGFR should be considered to avoid inaccurate classification of the presence of AD-related pathology by plasma p-tau217 in individuals with CKD.CLASSIFICATION OF EVIDENCEThis study provides Class II evidence that in individuals with CKD stage 3 (especially stage 3b) or higher, p-tau217 concentrations are increased, with a greater increase in amyloid-PET-negative individuals.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"99 1","pages":"e210287"},"PeriodicalIF":9.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebound Growth Following Temporary Discontinuation of BRAFi and MEKi in a Patient With Multifocal BRAFV600E-Mutant Primary Brain Tumor.","authors":"Antonio Pisano,Samanta Cupini,Orazio Santo Santonocito,Bianca Pollo,Rosina Paterra,Giacomo Allegrini,Chiara Finale,Francesca Vannozzi,Claudia Scudieri,Vita Maria Montemurro,Elena Anghileri,Anna Luisa Di Stefano","doi":"10.1212/wnl.0000000000213336","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213336","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"27 1","pages":"e213336"},"PeriodicalIF":9.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Changes of Late-Onset Cystic Brain Radionecrosis.","authors":"Ammar T Abdulaziz,Lizhang Chen,Li He,Dong Zhou","doi":"10.1212/wnl.0000000000210118","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210118","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"40 1","pages":"e210118"},"PeriodicalIF":9.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching Video NeuroImage: Minipolymyoclonus: A Clinical Clue to Spinal Muscular Atrophy.","authors":"José Marcos Vieira Albuquerque Filho,Pedro Fraiman,Orlando G P Barsottini,José Luiz Pedroso,Alulin Tácio Quadros Santos Monteiro Fonseca","doi":"10.1212/wnl.0000000000213364","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213364","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"45 1","pages":"e213364"},"PeriodicalIF":9.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of Amyloid Accumulation in Late Adulthood Among People With Childhood-Onset Epilepsy.","authors":"Juho Joutsa,Juha O Rinne,Kalle J Niemi,Mira Karrasch,Riitta K Parkkola,Jani Saunavaara,Semi P Helin,Bruce P Hermann,Matti Sillanpää","doi":"10.1212/wnl.0000000000210303","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210303","url":null,"abstract":"BACKGROUND AND OBJECTIVESPrevious research has demonstrated increased brain amyloid plaque load in individuals with childhood-onset epilepsy in late middle age. However, the trajectory of this process is not yet known. The aim of this study was to determine whether individuals with a history of childhood-onset epilepsy show progressive brain aging in amyloid accumulation in late adulthood (Turku Adult Childhood-Onset Epilepsy study, TACOE).METHODSAdults from a prospective population-based cohort of individuals with childhood-onset epilepsy, originally recruited 1961-1964, together with matched controls, were scanned with [11C]PIB PET twice: after at least 50 years (TACOE-50) and again after at least 55 years (TACOE-55) from the diagnosis.RESULTSAt TACOE-55, 31.4% (11/36, mean age 63.3 years, 52.8% female) of individuals from the epilepsy group and 11.4% (4/35, 63.1 year, 54.3%) of controls had a visually abnormal [11C]PIB scan (p = 0.039). At TACOE-55, cortical brain [11C]PIB uptakes were higher and increased more from TACOE-50 in the epilepsy compared with the control group (p < 0.05). In voxelwise whole-brain analyses, the epilepsy group showed significantly higher and more widespread brain amyloid accumulation (pFWE < 0.05).DISCUSSIONThe results demonstrate that childhood-onset epilepsy is associated with an earlier age at onset of amyloidosis and greater progressive amyloid accumulation in late adulthood.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"23 1","pages":"e210303"},"PeriodicalIF":9.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effect of Intensive vs Standard Blood Pressure Control on Mild Cognitive Impairment and Probable Dementia in SPRINT.","authors":"David M Reboussin,Sarah A Gaussoin,Nicholas M Pajewski,Byron C Jaeger,Bonnie Sachs,Stephen R Rapp,Mark A Supiano,Maryjo L Cleveland,Valerie Hunter,Jamehl L Demons,Paula K Ogrocki,Alan Jay Lerner,Gordon J Chelune,Virginia G Wadley,Margaret L Scales,Nancy F Woolard,Letitia H Perdue,Kathryn E Callahan,Jeff D Williamson","doi":"10.1212/wnl.0000000000213334","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213334","url":null,"abstract":"BACKGROUND AND OBJECTIVESThe Systolic Blood Pressure Intervention Trial suggested that intensive lowering of systolic blood pressure (SBP) decreases the risk of developing dementia. However, an insufficient number of probable dementia cases stemming from the trial's early termination made results inconclusive. The goal of this study was to estimate the effect of intensive vs standard SBP lowering on the longer term incidence of cognitive impairment leveraging extended follow-up for cognitive status.METHODSThis is a prespecified secondary analysis of a randomized clinical trial. Between 2010 and 2013, patients aged 50 years and older with hypertension and increased cardiovascular risk excluding those with diabetes mellitus or history of stroke were recruited from 102 clinics in the United States and Puerto Rico. Participants were randomized to a SBP goal of <120 mm Hg (intensive treatment) or <140 mm Hg (standard treatment) and received treatment for 3.3 years. In-person cognitive assessment follow-up occurred through July 2018. Continued ascertainment of cognitive status by telephone began in December 2019 for participants who had not withdrawn consent or been previously adjudicated with probable dementia, but provided consent for future research. Data were analyzed using survival analyses.RESULTSOf 9,361 randomized participants, 7,221 (77%) were eligible to be re-contacted. Cognitive status of 4,232 (59%) was ascertained (mean age 67 years, 36% female). We accrued a total of 216 new cases of probable dementia, less than our target of 326. Over a median follow-up of 7 years, 248 participants of the intensive treatment group (8.5 per 1,000 person-years) were adjudicated with probable dementia, compared with 293 participants (10.2 per 1,000 person-years) in the standard treatment group (hazard ratio [HR], 0.86; 95% CI, 0.72-1.02). Consistent with earlier results from the trial, the rate of both mild cognitive impairment (MCI; HR, 0.87 95% CI, 0.76-1.00) and a composite of MCI or probable dementia was lower with intensive treatment (HR, 0.89; 95% CI, 0.79, 0.99).DISCUSSIONAmong ambulatory adults with hypertension and high cardiovascular risk, intensive treatment vs standard treatment of SBP for 3.3 years resulted in a lower risk of MCI and cognitive impairment including MCI or probable dementia, but not for probable dementia alone.CLASSIFICATION OF EVIDENCEThis study provides Class II evidence that intensively reducing SBP (target <120 mm Hg) decreases the risk of cognitive impairment in individuals aged 50 years and older with hypertension.CLINICAL TRIAL INFORMATIONClinical trial number NCT01206062.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"83 1","pages":"e213334"},"PeriodicalIF":9.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the Number of Vaccine Doses Before Starting Anti-CD20 Therapy on Seroprotection Rates Against Hepatitis B Virus in People With MS.","authors":"René Carvajal,David Guananga-Álvarez,Carmen Tur,Juliana Esperalba,Marta Rodríguez-Barranco,Ariadna Rando-Segura,Blanca Borras-Bermejo,Alvaro Cobo-Calvo,Pere Carbonell-Mirabent,Ricardo Zules-Oña,Jose Angel Rodrigo-Pendas,Xavier Martínez-Gómez,Xavier Montalban,Mar Tintore,Susana Otero-Romero","doi":"10.1212/wnl.0000000000210281","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210281","url":null,"abstract":"BACKGROUND AND OBJECTIVESHepatitis B vaccination (HBV) requires 6 months to complete and is recommended for patients with multiple sclerosis (PWMS), particularly those who are candidates for anti-CD20 therapy. However, limited data exist on HBV immunogenicity in PWMS receiving disease-modifying therapies (DMTs) and the impact of starting anti-CD20 therapy during immunization. We aimed to evaluate HBV immunogenicity in PWMS starting anti-CD20 therapy during vaccination, focusing on the number of doses received before anti-CD20 initiation.METHODSWe conducted a retrospective analysis of a prospective cohort of adult PWMS at a single center in Spain, from April 2015 to May 2023. Eligible participants completed a 4-dose HBV course and underwent postvaccination serologic testing. We assess seroprotection rates (SRs), defined as the percentage of patients achieving anti-hepatitis B surface antibody titers ≥10 IU/L, focusing on those who switched to anti-CD20 therapy during vaccination, based on doses received before starting anti-CD20 and type of DMT at vaccination start. A multivariate generalized linear model (GLM) was used to identify factors associated with higher seroconversion.RESULTSA total of 289 PWMS (median [interquartile range (IQR)] age, 47.7 [42.8-54.4] years; 65.7% female; median [IQR] disease duration, 14.8 [6.7-21.2] years) were included. SRs progressively declined with fewer doses before anti-CD20 initiation, from 92.8% (95% CI 87.1-96.5) for 4 doses to 24.0% (95% CI 9.4-45.1) for 1 dose. Patients transitioning from sphingosine 1-phosphate (S1P) modulators showed the lowest SR at 25.0% (95% CI 7.3-52.4). The multivariate GLM confirmed these findings, with 3 doses (SR ratio 3.23 [95% CI 1.68-6.23]; p = 0.0005) or 4 doses (SR ratio 3.76 [95% CI 1.96-7.24]; p < 0.0001) before anti-CD20 therapy significantly associated with higher SRs, while starting S1P modulators at vaccination onset was significantly associated with lower SRs (SR ratio 0.42 [95% CI 0.23-0.78]; p = 0.0058). Female sex (SR ratio 1.15 [95% CI 1.01-1.32]; p = 0.0389) and younger age (SR ratio 0.90 [95% CI 0.83-0.97]; p = 0.0036) were also significantly associated with higher SRs.DISCUSSIONInitiating anti-CD20 therapy during HBV negatively affects SRs, with a direct correlation with the number of doses received before anti-CD20 initiation. Early planning and execution of required vaccinations are crucial in managing PWMS.CLASSIFICATION OF EVIDENCEThis study provides Class III evidence that HBV during initiation of anti-CD20 therapy is less effective in establishing seroprotection to hepatitis B than in patients in whom HBV is completed before initiation of anti-CD20 therapy.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"55 1","pages":"e210281"},"PeriodicalIF":9.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Fatigue and Associations With Depression and Cognitive Impairment in Patients With CADASIL.","authors":"Amy A Jolly,Success Anyanwu,Fatemeh Koohi,Robin G Morris,Hugh S Markus","doi":"10.1212/wnl.0000000000213335","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213335","url":null,"abstract":"BACKGROUND AND OBJECTIVESFatigue is a common and disabling symptom in cerebrovascular disease and has been associated with white matter damage, but the underlying disease mechanisms are poorly understood. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common genetic form of stroke and causes a cerebral small vessel disease arteriopathy with white matter ischemia. We determined the prevalence of fatigue in CADASIL, the factors associated with it, and its relationship with both depression and cognitive impairment.METHODSProspectively recruited genetically confirmed patients with CADASIL were assessed using the Fatigue Severity Scale. The prevalence of fatigue in CADASIL was compared with that of healthy controls from the community. We determined associations between fatigue and clinical features, cardiovascular risk factors, MRI parameters, cognition, and depression. Cognition was measured using the Brief Memory and Executive Test (BMET) and depression using the Geriatric Depression Scale (GDS). Mediation and path analyses were performed to determine relationships between fatigue, depression, and cognitive impairment.RESULTSOne hundred seventy-four patients with CADASIL (mean age [SD] of 51.3 [12.30] years, 59.66% female) and 50 healthy controls were included in the analysis (mean age [SD] of 51.42 [12.58] years, 38.0% female). Fatigue was present in 51.7% of patients with CADASIL and was almost 5 times more common than in controls (OR: 4.99, 95% CI [2.28-10.95], p < 0.001). There was no association of fatigue with history of stroke or MRI parameters including white matter hyperintensity lesion volume. Logistic regression showed both GDS total score (OR: 1.11 [1.05-1.17], p = 0.0002) and BMET total score (OR: 0.86 [0.75-0.98], p = 0.02) to be predictors of fatigue. Fatigue, depression, and cognition were frequently comorbid. Mediation analysis showed depression to have a greater effect on fatigue prevalence than cognitive impairment. Path analysis confirmed depression to be the largest predictor of fatigue and found this relationship to be bidirectional.DISCUSSIONFatigue was present in over half of the patients with CADASIL. Depression and cognition were the main predictors of fatigue, and all 3 symptoms were frequently comorbid. The relationship between depression and fatigue was the strongest and was bidirectional. This suggests targeting depressive symptoms may have benefit in fatigue management.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"37 1","pages":"e213335"},"PeriodicalIF":9.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-Centered Social Determinants and Neighborhood-Level Deprivation Associated With Disability in Hispanic People With Multiple Sclerosis.","authors":"Lilyana Amezcua,Carlos Cardenas-Iniguez,Christopher Orlando,Andrea Martinez,Iffat Nahar,Silvia R Delgado,Clara Patricia Manrique,Ivonne Vicente,Angel Chinea,Jacob L McCauley,Khandaker Talat S Islam","doi":"10.1212/wnl.0000000000213332","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213332","url":null,"abstract":"BACKGROUND AND OBJECTIVESMultiple sclerosis (MS)-related disability in Hispanic people with MS is associated with inequities in social determinants of health (SDOH) as measured by composite indices of areal-level census data. Studies of individual-level measures of SDOH are lacking. This study examined the separate and joint effects of person-centered SDOH indicators and an area-level composite on MS disability measures.METHODSHispanic people diagnosed with MS (≤5 years) who had SDOH and Social Deprivation Index (SDI) based on 2015-2019 American Community Survey estimates were included. At study entry, data on MS disability outcomes were collected: Expanded Disability Status Scale (EDSS) score, Symbol Digit Modality Test (SDMT) score, Hauser Ambulation Index (HA index), and 25-Foot Walk Time (25FWT). Principal component analysis was used to identify person-centered SDOH factors, mapped across a socioecological model. Multivariable regression modeling measured separate and joint effects of SDOH principal components (PCs) and SDI on outcome measures.RESULTSOf the 170 participants with MS, most were women (71.9%) and had a mean age at first symptom of 34.01 (SD ±11.24) years and at diagnosis of 36.27 (SD ±10.68) years. The top 2 PCs were identified to represent person-centered SDOH related to assimilation and socioeconomic disadvantage in multivariable models. In both separate and joint effect models, both PC1 and PC2 were significantly associated with longer 25FWT (β 0.43, 95% CI 0.04-0.82, and β 0.66, 95% CI 0.28-1.05), higher HA index (β 0.22, 95% CI 0.04-0.41, and β 0.31, 95% CI 0.12-0.51), and higher EDSS score (β 0.39, 95% CI 0.16-0.62, and β 0.36, 95% CI 0.13-0.60). PC1 was also significantly associated with a lower SDMT score (β -4.15, 95% CI -5.60 to -2.69). SDI was significantly associated with lower SDMT score and higher HA index in separate effect models but was not associated with any outcome measure in joint effect models with PCs.DISCUSSIONOur findings suggest that census-based indicators may underestimate the effect of SDOH on MS outcomes and the person-centered level measures are better markers of disease severity in Hispanic people with MS. Future research and policy change can focus on the amelioration of assimilation barriers and socioeconomic disadvantage because these were strongly associated with MS-related ambulatory and cognitive disability.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"50 1","pages":"e213332"},"PeriodicalIF":9.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Intake of Red Meat in Relation to Dementia Risk and Cognitive Function in US Adults.","authors":"Yuhan Li,Yanping Li,Xiao Gu,Yuxi Liu,Danyue Dong,Jae Hee Kang,Molin Wang,Heather Eliassen,Walter C Willett,Meir J Stampfer,Dong Wang","doi":"10.1212/wnl.0000000000210286","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210286","url":null,"abstract":"BACKGROUND AND OBJECTIVESPrevious studies have shown inconsistent associations between red meat intake and cognitive health. Our objective was to examine the association between red meat intake and multiple cognitive outcomes.METHODSIn this prospective cohort study, we included participants free of dementia at baseline from 2 nationwide cohort studies in the United States: the Nurses' Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS). Diets were assessed using a validated semiquantitative food frequency questionnaire. We ascertained incident dementia cases from both NHS participants (1980-2023) and HPFS participants (1986-2023). Objective cognitive function was assessed using the Telephone Interview for Cognitive Status (1995-2008) among a subset of NHS participants. Subjective cognitive decline (SCD) was self-reported by NHS participants (2012, 2014) and HPFS participants (2012, 2016). Cox proportional hazards models, general linear regression, and Poisson regression models were applied to assess the associations between red meat intake and different cognitive outcomes.RESULTSThe dementia analysis included 133,771 participants (65.4% female) with a mean baseline age of 48.9 years, the objective cognitive function analysis included 17,458 female participants with a mean baseline age of 74.3 years, and SCD analysis included 43,966 participants (77.1% female) with a mean baseline age of 77.9 years. Participants with processed red meat intake ≥0.25 serving per day, compared with <0.10 serving per day, had a 13% higher risk of dementia (hazard ratio [HR] 1.13; 95% CI 1.08-1.19; plinearity < 0.001) and a 14% higher risk of SCD (relative risk [RR] 1.14; 95% CI 1.04-1.25; plinearity = 0.004). Higher processed red meat intake was associated with accelerated aging in global cognition (1.61 years per 1 serving per day increment [95% CI 0.20-3.03]) and in verbal memory (1.69 years per 1 serving per day increment [95% CI 0.13-3.25], both plinearity = 0.03). Unprocessed red meat intake of ≥1.00 serving per day, compared with <0.50 serving per day, was associated with a 16% higher risk of SCD (RR 1.16; 95% CI 1.03-1.30; plinearity = 0.04). Replacing 1 serving per day of nuts and legumes for processed red meat was associated with a 19% lower risk of dementia (HR 0.81, 95% CI 0.75-0.86), 1.37 fewer years of cognitive aging (95% CI -2.49 to -0.25), and a 21% lower risk of SCD (RR 0.79, 95% CI 0.68-0.92).DISCUSSIONHigher intake of red meat, particularly processed red meat, was associated with a higher risk of developing dementia and worse cognition. Reducing red meat consumption could be included in dietary guidelines to promote cognitive health. Further research is needed to assess the generalizability of these findings to populations with diverse ethnic backgrounds.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"30 1","pages":"e210286"},"PeriodicalIF":9.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}