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1. A giant prostatic hyperplasia treated by open surgery

Author

Ogawa S, Manome M, Yabe M, Kuma Y, Yamaoka M, Sato Y, Akaihata H, Oguro T, Kataoka M, Kumagai S, and Kojima Y

Subjects
Medicine (General), R5-920
Abstract

Soichiro Ogawa,1 Masahiko Manome,2 Michihiro Yabe,2 Yoshinobu Kuma,2 Masaaki Yamaoka,1 Yuichi Sato,1 Hidenori Akaihata,1 Toshiki Oguro,1 Masao Kataoka,1 Shin Kumagai,1 Yoshiyuki Kojima11Department of Urology, Fukushima Medical University, Fukushima, Japan; 2Department of Urology, Public Soma General Hospital, Soma, JapanAbstract: We report a rare case of giant prostatic hyperplasia treated by open surgery. A 70-year-old man was suffering from macrohematuria. Computed tomography revealed a markedly enlarged prostate measuring 580 mL. The serum prostate-specific antigen level was 9.430 ng/mL. Prostatic biopsy showed benign prostatic hyperplasia. We perfomed retropubic open prostatectomy, since macrohematuria continued and he was also suffering from lower urinary tract symptoms. The adenoma was completely enucleated in one piece. The removed specimen was 13 × 11 × 6 cm in size and weighed 475 g. Histological examination also demonstrated prostatic fibromuscular hyperplasia. This is the 15th-heaviest adenoma ever reported in English-language journals. Transurethral surgical techniques or other minimally invasive approaches are performed for patients with small to medium-sized prostates. However, open surgery is recommended for markedly enlarged prostatic hyperplasia.Keywords: benign prostatic enlargement, benign prostatic hyperplasia, giant, retropubic open prostatectomy

Published
2012

4. VOLTAGE-2: multicenter phase II study of nivolumab monotherapy in patients with mismatch repair-deficient resectable locally advanced rectal cancer

Author

Bando, H., primary, Tsukada, Y., additional, Kumagai, S., additional, Miyashita, Y., additional, Taketomi, A., additional, Yuki, S., additional, Komatsu, Y., additional, Akiyoshi, T., additional, Shinozaki, E., additional, Kanemitsu, Y., additional, Takashima, A., additional, Shiozawa, M., additional, Shiomi, A., additional, Yamazaki, K., additional, Matsuhashi, N., additional, Hasegawa, H., additional, Kato, T., additional, Oki, E., additional, Fukui, M., additional, Wakabayashi, M., additional, Fuse, N., additional, Nishikawa, H., additional, Ito, M., additional, and Yoshino, T., additional

Published
2024
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9. Unified 1-D Simulations of Gamma-Ray Line Emission from Type Ia Supernovae

Author

Milne, P. A., Hungerford, A. L., Fryer, C. L., Evans, T. M., Urbatsch, T. J., Boggs, S. E., Isern, J., Bravo, E., Hirschmann, A., Kumagai, S., Pinto, P. A., and The, L. -S.

Subjects
Astrophysics
Abstract

The light curves of Type Ia Supernovae (SN Ia) are powered by gamma-rays emitted by the decay of radioactive elements such as $^{56}$Ni and its decay products. These gamma-rays are downscattered,absorbed, and eventually reprocessed into the optical emission which makes up the bulk of all supernova observations. Detection of the gamma-rays that escape the expanding star provide the only direct means to study this power source for SN Ia light curves. Unfortunately, disagreements between calculations for the gamma-ray lines have made it difficult to interpret any gamma-ray observations. Here we present a detailed comparison of the major gamma-ray line transport codes for a series of 1-dimensional Ia models. Discrepancies in past results were due to errors in the codes, and the corrected versions of the seven different codes yield very similar results. This convergence of the simulation results allows us to infer more reliable information from the current set of gamma-ray observations of SNe Ia. The observations of SNe 1986G, 1991T and 1998bu are consistent with explosion models based on their classification: sub-luminous, super-luminous and normally-luminous respectively., Comment: Accepted to the Astrophysical Journal

Published
2004
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10. Gamma-Ray Signatures of Supernovae and Hypernovae

Author

Nomoto, K., Maeda, K., Mochizuki, Y., Kumagai, S., Umeda, H., Nakamura, T., and Tanihata, I.

Subjects
Astrophysics
Abstract

We review the characteristics of nucleosynthesis and radioactivities in 'Hypernovae', i.e., supernovae with very large explosion energies ($ \gsim 10^{52} $ ergs) and their $\gamma$-ray line signatures. We also discuss the $^{44}$Ti line $\gamma$-rays from SN1987A and the detectability with INTEGRAL. Signatures of hypernova nucleosynthesis are seen in the large [(Ti, Zn)/Fe] ratios in very metal poor stars. Radioactivities in hypernovae compared to those of ordinary core-collapse supernovae show the following characteristics: 1) The complete Si burning region is more extended, so that the ejected mass of $^{56}$Ni can be much larger. 2) Si-burning takes place in higher entropy and more $\alpha$-rich environment. Thus the $^{44}$Ti abundance relative to $^{56}$Ni is much larger. In aspherical explosions, $^{44}$Ti is even more abundant and ejected with velocities as high as $\sim$ 15,000 km s$^{-1}$, which could be observed in $\gamma$-ray line profiles. 3) The abundance of $^{26}$Al is not so sensitive to the explosion energy, while the $^{60}$Fe abundance is enhanced by a factor of $\sim$ 3., Comment: Invited talk at the ``GAMMA2001'' Symposium, April 4-6, 2001, Baltimore. To be published in ``Gamma-Ray Astronomy 2001'' (American Institute of Physics)

Published
2001
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11. Metal Rich Plasma at the Center Portion of the Cygnus Loop

Author

Miyata, Emi, Tsunemi, H., Kohmura, T., Suzuki, S., and Kumagai, S.

Subjects
Astrophysics
Abstract

We observed the center portion of the Cygnus Loop supernova remnant with the ASCA observatory. The X-ray spectrum of the center portion was significantly different from that obtained at the North-East (NE) limb. The emission lines from Si and S were quite strong while those of O and the continuum emission were similar to those obtained at the NE limb. Based on the spectral analysis, Si and S emission lines originated from a high-kTe and low ionization plasma whereas O and most of the continuum emission arose from a low-kTe and high ionization plasma. We suppose that Si and S emitting gas are present at the interior of the Loop while O lines and continuum emission mainly arise from the shell region. Therefore, we subtracted the spectrum of the NE limb from that of the center. Obtained abundances of Si, S, and Fe were 4 $\pm$ 1, 6 $\pm$ 2, and ${1.3}^{+0.6}_{-0.3}$ times higher than those of the cosmic abundances, respectively, and are $\sim$40 times richer than those obtained at the NE limb. These facts strongly support that some of the crude ejecta must be left at the center portion of the Cygnus Loop. The low abundance of Fe relative to Si and S suggests a type II SN with a massive progenitor star as the origin of the Cygnus Loop., Comment: Accepted for Publications of the Astronomical Society of Japan, 40 pages, 12 Postscript figures, uses PASJ95.sty, PASJadd.sty, and psbox.sty

Published
1998
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19. 1240P Activation status of CD8+ T and Treg cells in the tumor microenvironment potentially predicts the clinical efficacy of nivolumab in advanced esophageal squamous cell carcinoma

Author

Mikuni, H., primary, Watanabe, G., additional, Kumagai, S., additional, Yamamoto, S., additional, Sawada, R., additional, Yokoyama, K., additional, Honma, Y., additional, Sekine, S., additional, Kashihara, T., additional, Ishiyama, K., additional, Oguma, J., additional, Igaki, H., additional, Saruta, M., additional, Daiko, H., additional, Koyama, S., additional, Nishikawa, H., additional, and Kato, K., additional

Published
2022
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20. 1211P A multicenter phase II study of atezolizumab monotherapy following definitive chemoradiotherapy for unresectable locally advanced esophageal squamous cell carcinoma (EPOC1802)

Author

Bando, H., primary, Kumagai, S., additional, Kotani, D., additional, Saori, M., additional, Habu, T., additional, Tsushima, T., additional, Hara, H., additional, Kadowaki, S., additional, Kato, K., additional, Chin, K., additional, Yamaguchi, K., additional, Kageyama, S-I., additional, Hojo, H., additional, Nakamura, M., additional, Tachibana, H., additional, Wakabayashi, M., additional, Fukutani, M., additional, Fuse, N., additional, Nishikawa, H., additional, and Kojima, T., additional

Published
2022
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42. Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study

Author

Bae, J.B. Lipnicki, D.M. Han, J.W. Sachdev, P.S. Kim, T.H. Kwak, K.P. Kim, B.J. Kim, S.G. Kim, J.L. Moon, S.W. Park, J.H. Ryu, S.-H. Youn, J.C. Lee, D.Y. Lee, D.W. Lee, S.B. Lee, J.J. Jhoo, J.H. Llibre-Rodriguez, J.J. Llibre-Guerra, J.J. Valhuerdi-Cepero, A.J. Ritchie, K. Ancelin, M.-L. Carriere, I. Skoog, I. Najar, J. Sterner, T.R. Scarmeas, N. Yannakoulia, M. Dardiotis, E. Meguro, K. Kasai, M. Nakamura, K. Riedel-Heller, S. Roehr, S. Pabst, A. Van Boxtel, M. Köhler, S. Ding, D. Zhao, Q. Liang, X. Scazufca, M. Lobo, A. De-La-Cámara, C. Lobo, E. Kim, K.W. Makkar, S.R. Crawford, J.D. Thalamuthu, A. Kochan, N.A. Leung, Y. Lo, J.W. Turana, Y. Castro-Costa, E. Larijani, B. Nabipour, I. Rockwood, K. Shifu, X. Lipton, R.B. Katz, M.J. Preux, P.-M. Guerchet, M. Lam, L. Ninimiya, T. Walker, R. Hendrie, H. Guaita, A. Chen, L.-K. Shahar, S. Dominguez, J. Krishna, M. Ganguli, M. Anstey, K.J. Crowe, M. Haan, M.N. Kumagai, S. Ng, T.P. Brodaty, H. Mayeux, R. Schupf, N. Petersen, R. Lipton, R. Lowe, E.S. Jorm, L.

Subjects
mental disorders
Abstract

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. © 2020 The Author(s).

Published
2020

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

Author

Makkar, S.R., Lipnicki, D.M., Crawford, J.D., Kochan, N.A., Castro-Costa, E., Lima-Costa, M.F., Diniz, B.S., Brayne, C., Stephan, B., Matthews, F., Llibre-Rodriguez, J.J., Llibre-Guerra, J.J., Valhuerdi-Cepero, A.J., Lipton, R.B., Katz, M.J., Zammit, A., Ritchie, K., Carles, S., Carriere, I., Scarmeas, N., Yannakoulia, M., Kosmidis, M., Lam, L., Fung, A., Chan, W.C., Guaita, A., Vaccaro, R., Davin, A., Kim, K.W., Han, J.W., Suh, S.W., Riedel-Heller, S.G., Roehr, S., Pabst, A., Ganguli, M., Hughes, T.F., Jacobsen, E.P., Anstey, K.J., Cherbuin, N., Haan, M.N., Aiello, A.E., Dang, K., Kumagai, S., Narazaki, K., Chen, S., Ng, T.P., Gao, Q., Nyunt, M.S.Z., Meguro, K., Yamaguchi, S., Ishii, H., Lobo, A., Lobo Escolar, E., De la Cámara, C., Brodaty, H., Trollor, J.N., Leung, Y., Lo, J.W., Sachdev, P., for, Cohort, Studies, of, Memory, in, an, International, Consortium, (COSMIC), University of New South Wales [Sydney] (UNSW), Fiocruz Minas - René Rachou Research Center / Instituto René Rachou [Belo Horizonte, Brésil], Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), University of Toronto, University of Cambridge [UK] (CAM), Newcastle University [Newcastle], University of Havana (Universidad de la Habana) (UH), University of California [San Francisco] (UCSF), University of California, Universidad de Matanzas, Albert Einstein College of Medicine [New York], Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Edinburgh, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital de la Colombière, Columbia University [New York], National and Kapodistrian University of Athens (NKUA), Harokopio University of Athens, Aristotle University of Thessaloniki, The Chinese University of Hong Kong [Hong Kong], The Hong Kong Polytechnic University [Hong Kong] (POLYU), The University of Hong Kong (HKU), Golgi Cenci Foundation, Seoul National University College of Natural Sciences, Seoul National University Bundang Hospital (SNUBH), Universität Leipzig [Leipzig], University of Pittsburgh School of Medicine, Pennsylvania Commonwealth System of Higher Education (PCSHE), Youngstown State University (YSU), Australian National University (ANU), University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Kyushu University [Fukuoka], Fukuoka Institute of Technology (FIT), National Center for Global Health and Medicine [Japan] (NCGM), National University of Singapore (NUS), Tohoku University [Sendai], and University of Zaragoza - Universidad de Zaragoza [Zaragoza]

Subjects
Apolipoprotein E, Male, Aging, Health (social science), Apolipoprotein B, [SDV]Life Sciences [q-bio], Apolipoprotein E4, Ethnic group, Cognitive decline, MESH: Cognitive Dysfunction, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Risk Factors, Risk Factors, 80 and over, Ethnicity, Medicine, 030212 general & internal medicine, Longitudinal Studies, MESH: Apolipoprotein E4, Cognitive impairment, MESH: Longitudinal Studies, Aged, 80 and over, MESH: Aged, biology, Hazard ratio, Educational Status, MESH: Ethnic Groups, Female, Sex, Clinical Sciences, Article, Education, 03 medical and health sciences, Age, Clinical Research, Acquired Cognitive Impairment, Humans, Cognitive Dysfunction, Aged, MESH: Humans, 030214 geriatrics, business.industry, Prevention, Neurosciences, Educational attainment, MESH: Male, Brain Disorders, Quality Education, Ageing, for Cohort Studies of Memory in an International Consortium, Geriatrics, biology.protein, Dementia, Geriatrics and Gerontology, business, MESH: Educational Status, Gerontology, MESH: Female, Demography
Abstract

International audience; 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.

Published
2020

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

Author

Makkar, S.R. Lipnicki, D.M. Crawford, J.D. Kochan, N.A. Castro-Costa, E. Lima-Costa, M.F. Diniz, B.S. Brayne, C. Stephan, B. Matthews, F. Llibre-Rodriguez, J.J. Llibre-Guerra, J.J. Valhuerdi-Cepero, A.J. Lipton, R.B. Katz, M.J. Zammit, A. Ritchie, K. Carles, S. Carriere, I. Scarmeas, N. Yannakoulia, M. Kosmidis, M. Lam, L. Fung, A. Chan, W.C. Guaita, A. Vaccaro, R. Davin, A. Kim, K.W. Han, J.W. Suh, S.W. Riedel-Heller, S.G. Roehr, S. Pabst, A. Ganguli, M. Hughes, T.F. Jacobsen, E.P. Anstey, K.J. Cherbuin, N. Haan, M.N. Aiello, A.E. Dang, K. Kumagai, S. Narazaki, K. Chen, S. Ng, T.P. Gao, Q. Nyunt, M.S.Z. Meguro, K. Yamaguchi, S. Ishii, H. Lobo, A. Lobo Escolar, E. De la Cámara, C. Brodaty, H. Trollor, J.N. Leung, Y. Lo, J.W. Sachdev, P. for Cohort Studies of Memory in an International Consortium (COSMIC)

Abstract

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. © 2020 Elsevier B.V.

Published
2020

47. Leakage current suppression and resistance to tracking and erosion of HTV silicone rubber with added silicone plasticizer

Author

Kumagai, S.

Subjects
Silicone rubber -- Properties, Silicone rubber -- Analysis, Business, Electronics, Electronics and electrical industries
Abstract

The present study evaluated the leakage current suppression and the resistance to tracking and erosion of high-temperature vulcanized silicone rubbers (HTV-SIRs) containing different levels of silicone plasticizer. Slab HTV-SIRs unfilled and filled with alumina trihydrate (ATH, 50 wt %) and with added linear silicone plasticizer (0-6.0 wt %), which was terminated with hydroxyl groups and of which repetition number was 13-18, were tested. Evaluation using the IEC 60587 inclined-plane method indicated that the plasticizer had no influence on the tracking and erosion behavior. Salt-fog test results indicated that a higher level of plasticizer in the ATH-filled HTV-SIR showed smaller leakage current. Gas chromatography and mass spectrometry suggested that the enhanced suppression of the leakage current for ATH-filled HTV-SIR can be attributed to migration of the linear silicone plasticizer onto the surface contaminants. It was concluded that the addition of silicone plasticizer is useful for improving the leakage current suppression ability of HTV-SIR without reducing its tracking and erosion resistance in the above laboratory tests. Index Terms--Outdoor insulation, polymer insulator, silicone rubber, filler, plasticizer, tracking, erosion, leakage current, hydrophobicity.

Published
2007

48. Assessment of different minute zooplankton in the larval rearing of rusty angelfish centropyge ferrugata

Author

Wullur, S., Kumagai, S., Sakakura, Y., and Atsushi Hagiwara

Subjects
Live food, Rotifer, Brachionus rotundiformis, Proales similis, Copepod
Abstract

Angelfishes of the genus Centropyge are commercially valuable aquarium fish. Although success in domesticating the broodstock of angelfishes is already reported, larval rearing remains a failure because their larvae require very small live food. Recognizing this demand, we assess the acceptability of four minute zooplankton including rotifers Proales similis, Keratella sinensis, Brachionus rotundiformis (SS-type), and nauplii of copepod Paracyclopina nana as feed for rusty angelfish Centropyge ferrugata larvae. The average size of the four zooplankton we used ranged from 80 to 160 μm. Results showed that feeding incidence on P. similis on the first day of feeding (3 days after hatching, 3 DAH) was 40%, and as high as 60% on day 6 after hatching (6 DAH), while it was 0 to 20% on other zooplankton tested. Larvae in the control group (without feeding) did not survive on 5 DAH. Standard length of the larvae in the two trials was not significantly different among treatments, but survival was significantly higher in P. similis (19 to 38%) than other zooplanktons (0 to10%). Results of this study indicate the usefulness of P. similis as starter food for C. ferrugata larvae., AACL Bioflux, 11(5), pp.1495-1501; 2018

Published
2018

49. Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study

Author

Röhr, S, Pabst, A, Riedel-Heller, SG, Jessen, F, Turana, Y, Handajani, YS, Brayne, C, Matthews, FE, Stephan, BCM, Lipton, RB, Katz, MJ, Wang, C, Guerchet, M, Preux, PM, Mbelesso, P, Ritchie, K, Ancelin, ML, Carrière, I, Guaita, A, Davin, A, Vaccaro, R, Kim, KW, Han, JW, Suh, SW, Shahar, S, Din, NC, Vanoh, D, van Boxtel, M, Köhler, S, Ganguli, M, Jacobsen, EP, Snitz, BE, Anstey, KJ, Cherbuin, N, Kumagai, S, Chen, S, Narazaki, K, Ng, TP, Gao, Q, Gwee, X, Brodaty, H, Kochan, NA, Trollor, J, Lobo, A, López-Antón, R, Santabárbara, J, Crawford, JD, Lipnicki, DM, Sachdev, PS, Röhr, S, Pabst, A, Riedel-Heller, SG, Jessen, F, Turana, Y, Handajani, YS, Brayne, C, Matthews, FE, Stephan, BCM, Lipton, RB, Katz, MJ, Wang, C, Guerchet, M, Preux, PM, Mbelesso, P, Ritchie, K, Ancelin, ML, Carrière, I, Guaita, A, Davin, A, Vaccaro, R, Kim, KW, Han, JW, Suh, SW, Shahar, S, Din, NC, Vanoh, D, van Boxtel, M, Köhler, S, Ganguli, M, Jacobsen, EP, Snitz, BE, Anstey, KJ, Cherbuin, N, Kumagai, S, Chen, S, Narazaki, K, Ng, TP, Gao, Q, Gwee, X, Brodaty, H, Kochan, NA, Trollor, J, Lobo, A, López-Antón, R, Santabárbara, J, Crawford, JD, Lipnicki, DM, and Sachdev, PS

Abstract

Background: Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer’s disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts. Methods: We combined individual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence. Results: The sample comprised 39,387 cognitively unimpaired individuals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI = 23.3–24.4%) and IRT (25.6%, 95%CI = 25.1–26.1%); however, prevalence estimates varied largely between studies (QH 6.1%, 95%CI = 5.1–7.0%, to 52.7%, 95%CI = 47.4–58.0%; IRT: 7.8%, 95%CI = 6.8–8.9%, to 52.7%, 95%CI = 47.4–58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in Asian and Black African people compared to White people, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades. Conclusions: SCD is frequent in old age. Having a quarter of older individuals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help individuals with SCD who seek medical advice. Moreover, a standardized instrument to measure SCD is needed to overcome the measurement variability currently dominant in the field.

Published
2020

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

Author

Makkar, SR, Lipnicki, DM, Crawford, JD, Kochan, NA, Castro-Costa, E, Lima-Costa, MF, Diniz, BS, Brayne, C, Stephan, B, Matthews, F, Llibre-Rodriguez, JJ, Llibre-Guerra, JJ, Valhuerdi-Cepero, AJ, Lipton, RB, Katz, MJ, Zammit, A, Ritchie, K, Carles, S, Carriere, I, Scarmeas, N, Yannakoulia, M, Kosmidis, M, Lam, L, Fung, A, Chan, WC, Guaita, A, Vaccaro, R, Davin, A, Kim, KW, Han, JW, Suh, SW, Riedel-Heller, SG, Roehr, S, Pabst, A, Ganguli, M, Hughes, TF, Jacobsen, EP, Anstey, KJ, Cherbuin, N, Haan, MN, Aiello, AE, Dang, K, Kumagai, S, Narazaki, K, Chen, S, Ng, TP, Gao, Q, Nyunt, MSZ, Meguro, K, Yamaguchi, S, Ishii, H, Lobo, A, Lobo Escolar, E, De la Cámara, C, Brodaty, H, Trollor, JN, Leung, Y, Lo, JW, Sachdev, P, Makkar, SR, Lipnicki, DM, Crawford, JD, Kochan, NA, Castro-Costa, E, Lima-Costa, MF, Diniz, BS, Brayne, C, Stephan, B, Matthews, F, Llibre-Rodriguez, JJ, Llibre-Guerra, JJ, Valhuerdi-Cepero, AJ, Lipton, RB, Katz, MJ, Zammit, A, Ritchie, K, Carles, S, Carriere, I, Scarmeas, N, Yannakoulia, M, Kosmidis, M, Lam, L, Fung, A, Chan, WC, Guaita, A, Vaccaro, R, Davin, A, Kim, KW, Han, JW, Suh, SW, Riedel-Heller, SG, Roehr, S, Pabst, A, Ganguli, M, Hughes, TF, Jacobsen, EP, Anstey, KJ, Cherbuin, N, Haan, MN, Aiello, AE, Dang, K, Kumagai, S, Narazaki, K, Chen, S, Ng, TP, Gao, Q, Nyunt, MSZ, Meguro, K, Yamaguchi, S, Ishii, H, Lobo, A, Lobo Escolar, E, De la Cámara, C, Brodaty, H, Trollor, JN, Leung, Y, Lo, JW, and Sachdev, P

Abstract

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.

Published
2020

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