The Association Between Dietary Inflammatory Index and Cognitive Performance in Older Adults Aged 60 Years and Older.

Background: Neuroinflammation has been linked to the development of cognitive performance. Epidemiological evidence on dietary inflammatory potential and cognitive performance is scarce. We evaluated the association between dietary inflammatory index (DII) and cognitive performance in older adults. Methods: This study included adults aged 60 years or older from the 2011-2014 National Health and Nutrition Examination Survey. The DII scores were calculated based on 27 nutritional parameters. Cognitive performance was assessed with four cognitive tests: the Digit Symbol Substitution Test (DSST, n = 2,780), the Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL, n = 2,859) and Delayed Recall (CERAD-DR, n = 2,857), and the Animal Fluency (AF, n = 2,844) tests. Restricted cubic splines and logistic regression were adopted to assess the associations. Results: Comparing the highest to lowest tertile of DII scores, the odds ratio (95% CI) of lower cognitive functioning was 1.97 (1.08-3.58) [P-trend = 0.02, per 1 unit increment: 1.17 (1.01-1.38)] on DSST, 1.24 (0.87-1.76) [P-trend = 0.24, per 1 unit increment: 1.09 (0.96-1.23)] on CERAD-WL, 0.93 (0.57-1.51) [P-trend = 0.74, per 1 unit increment: 1.02 (0.87-1.20)] on CERAD-DR, and 1.76 (1.30-2.37) [P-trend < 0.01, per 1 unit increment: 1.17 (1.05-1.29)] on AF. The above-mentioned associations were observed in both men and women. In non-linear dose-response analysis, the association between DII and lower cognitive functioning was not significant at lower DII scores up to 3.0, after which the association was significant and the curve rose steeply. Conclusion: Higher DII is associated with lower scores on DSST and AF tests in older adults.

Associations between lead, cadmium, mercury, and arsenic exposure and alanine aminotransferase elevation in the general adult population: an exposure-response analysis.

Cadmium, lead, mercury, and arsenic are among the most toxic environmental contaminants. Serum alanine aminotransferase (ALT) is the most common liver biomarker. This analysis aimed to explore the associations between blood cadmium, lead, mercury, urinary total arsenic, and dimethylarsinic acid and ALT elevation in adults. Data were extracted from 5 National Health and Nutrition Examination Survey cycles (NHANES) 2007-2016. Patients with chronic viral hepatitis and excessive alcohol consumption were excluded. ALT elevation was defined according to the 2017 American College of Gastroenterology Clinical Guideline. Logistic models and restricted cubic splines were adopted to assess the exposure-response relationships. Comparing the highest to lowest quintile of exposure, the multivariable-adjusted odds ratios (95% confidence intervals) of ALT elevation were 1.38 (1.07-1.78) for blood lead (Pfor trend = 0.01), 1.37 (1.16-1.62) for blood mercury (Pfor trend < 0.01), 0.94 (0.78-1.14) for blood cadmium (Pfor trend = 0.64), 1.07 (0.79-1.45) for urinary total arsenic (Pfor trend = 0.81), and 1.25 (0.94-1.66) for urinary dimethylarsinic acid (Pfor trend = 0.18). The associations between blood lead and mercury and ALT elevation were only observed in women. In addition, the associations between urinary total arsenic [1.53 (1.02-2.29), Pfor trend = 0.02] and dimethylarsinic acid [2.17 (1.05-4.49), Pfor trend = 0.02] and ALT elevation were also observed in women. Dose-response analysis showed that there was no safe exposure threshold of blood lead and mercury's toxic effect on ALT elevation, respectively. In conclusion, lead, mercury and arsenic were associated with ALT elevation in adults, and the associations were mainly observed in women.

Serum Copper and Zinc Concentrations and Cognitive Impairment in Older Adults Aged 60 Years and Older.

Epidemiological evidence on serum zinc and copper and cognitive impairment in older adults are not consistent. Results on serum zinc and copper and cognitive impairment in older adults from the National Health and Nutrition Examination Survey (NHANES) have not been reported. Data on serum zinc and copper and cognitive impairment from individuals ≥ 60 years of age were obtained from the 2011-2014 NHANES. Serum zinc and copper concentrations were determined with inductively coupled plasma dynamic reaction cell mass spectrometry. Cognitive impairment was assessed with four cognitive tests: the Digit Symbol Substitution Test (DSST), the Animal Fluency (AF), the Consortium to Establish a Registry for Alzheimer's Disease Delayed Recall (CERAD-DR), and the Word Learning (CERAD-WL) tests. Compared with the lowest tertile of serum copper, the multivariate-adjusted odds ratios of scoring low on the AF were 0.86 (0.44-1.68) in tertile 2 and 0.46 (0.25-0.82) in tertile 3, and the inverse association was also found in women. No association was found between serum copper and the DSST, CERAD-DR, and CRAD-WL, respectively. Compared with the lowest tertile of serum zinc, the multivariate-adjusted odds ratios of scoring low on the DSST were 0.83 (0.37-1.90) in tertile 2 and 0.42 (0.22-0.80) in tertile 3, and the inverse association was also found in men. No association was found between serum zinc and the AF, CERAD-DR, and CRAD-WL, respectively. In conclusion, serum copper and zinc were associated with certain cognitive performance tests among older adults, and the causality deserves to be confirmed further.

Association between serum iron concentrations and cognitive impairment in older adults aged 60 years and older: A dose-response analysis of National Health and Nutrition Examination Survey.

Epidemiological evidence on peripheral iron and cognitive impairment in older adults is sparse and limited. Results on serum iron and cognitive impairment in older adults from the National Health and Nutrition Examination Survey have not been reported. Data on serum iron and cognitive impairment from individuals ≥ 60 years of age were obtained from the 2011-2014 NHANES (N = 3,131). Serum iron concentrations were determined with DcX800 method. Cognitive impairment was assessed with four cognitive tests: the Digit Symbol Substitution Test (DSST), the Animal Fluency (AF), the Consortium to Establish a Registry for Alzheimer's Disease Delayed Recall (CERAD-DR) and Word Learning (CERAD-WL) tests. Logistic regression and restricted cubic splines were adopted to explore the dose-response relationship between serum iron concentrations and cognitive impairment. Comparing the highest to lowest tertile of serum iron concentrations, the multivariate-adjusted odds ratios of scoring low on the DSST were 0.70 (0.49-1.00), 0.88 (0.65-1.20) for CERAD-WL, 0.65 (0.48-0.88) for CERAD-DR, and 0.78 (0.53-1.15) for AF. Stratified analyses by sex showed that the above-mentioned associations were mainly found in men; however, the interaction with sex was not significant. Dose-response analysis showed that relationships between serum iron and cognitive impairment evaluated by DSST and CERAD-DR were linear, respectively.