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New and Emerging Concepts in Cardiometabolic Risk Factors and Cognitive...
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New and Emerging Concepts in Cardiometabolic Risk Factors and Cognitive Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 5408

Special Issue Editors

Prof. Dr. Mo-Kyung Sin

E-Mail Website
Guest Editor
College of Nursing, Seattle University, Seattle, WA 98122, USA
Interests: cardiovascular health promotion; older adults; neurology; Alzheimer’s disease
Prof. Dr. Ihab M. Hajjar

E-Mail Website
Guest Editor
School of Medicine, University of Texas Southwestern, Dallas, TX 75390, USA
Interests: neurology; geriatric medicine; Alzheimer's disease; hypertension

Special Issue Information

Dear Colleagues,

Hypertension is related to vascular cognitive impairment and vascular dementia as well as Alzheimer’s disease dementia, with many studies supporting the association between mid-life hypertension and cognition; however, less is known about the relationships with late-life hypertension, especially with Alzheimer’s disease dementia. Further study is needed on the underlying pathological mechanisms that link hypertension to cognitive impairment due to Alzheimer’s disease in older adults; thus, we invite the submission of innovative studies exploring the links between late-life hypertension and cognition in older adults.

Prof. Dr. Mo-Kyung Sin
Prof. Dr. Ihab M. Hajjar
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Alzheimer’s disease
  • cognition
  • dementia
  • hypertension
  • older adults

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Published Papers (4 papers)

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Research

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10 pages, 837 KiB  
Article
Associations Between High-Density Lipoprotein Cholesterol Efflux and Brain Grey Matter Volume
by John M. Giacona, Jijia Wang, Rong Zhang, Brendan J. Kelley, Ihab Hajjar, Binu P. Thomas, Fang F. Yu, James A. de Lemos, Anand Rohatgi and Wanpen Vongpatanasin
J. Clin. Med. 2024, 13(20), 6218; https://doi.org/10.3390/jcm13206218 - 18 Oct 2024
Viewed by 651
Abstract
Objective: High-density lipoprotein cholesterol efflux function may prevent brain amyloid beta deposition and neurodegeneration. However, the relevance of this finding has not been established in the diverse middle-aged population. Methods: We examined 1826 adults (47% Black adults) who participated in the Dallas Heart [...] Read more.
Objective: High-density lipoprotein cholesterol efflux function may prevent brain amyloid beta deposition and neurodegeneration. However, the relevance of this finding has not been established in the diverse middle-aged population. Methods: We examined 1826 adults (47% Black adults) who participated in the Dallas Heart Study to determine associations between high-density lipoprotein (HDL) measures and brain structure and function. White matter hyperintensities (WMH) and whole-brain grey matter volume (GMV) were measured using brain MRI, and the Montreal Cognitive Assessment (MoCA) was used to measure neurocognitive function. HDL cholesterol efflux capacity (HDL-CEC) was assessed using fluorescence-labeled cholesterol efflux from J774 macrophages, and HDL particle size measures were assessed using nuclear magnetic resonance (NMR) spectroscopy (LipoScience). Multivariable linear regressions were performed to elucidate associations between HDL-CEC and brain and cognitive phenotypes after adjustment for traditional risk factors such as age, smoking status, time spent in daily physical activity, and education level. Results: Higher HDL-CEC and small HDL particle (HDL-P) concentration were positively associated with higher GMV normalized to total cranial volume (TCV) (GMV/TCV) after adjustment for relevant risk factors (β = 0.078 [95% CI: 0.029, 0.126], p = 0.002, and β = 0.063 [95% CI: 0.014, 0.111], p = 0.012, respectively). Conversely, there were no associations between HDL measures and WMH or MoCA (all p > 0.05). Associations of HDL-CEC and small HDL-P with GMV/TCV were not modified by ApoE-ε4 status or race/ethnicity. Interpretation: Higher HDL cholesterol efflux and higher plasma concentration of small HDL-P were associated with higher GMV/TCV. Additional studies are needed to explore the potential neuroprotective functions of HDL. Full article
(This article belongs to the Special Issue New and Emerging Concepts in Cardiometabolic Risk Factors and Cognitive Disorders)
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Review

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19 pages, 705 KiB  
Review
Role of Peripheral and Central Insulin Resistance in Neuropsychiatric Disorders
by Kannayiram Alagiakrishnan and Tyler Halverson
J. Clin. Med. 2024, 13(21), 6607; https://doi.org/10.3390/jcm13216607 - 3 Nov 2024
Viewed by 1191
Abstract
Insulin acts on different organs, including the brain, which helps it regulate energy metabolism. Insulin signaling plays an important role in the function of different cell types. In this review, we have summarized the key roles of insulin and insulin receptors in healthy [...] Read more.
Insulin acts on different organs, including the brain, which helps it regulate energy metabolism. Insulin signaling plays an important role in the function of different cell types. In this review, we have summarized the key roles of insulin and insulin receptors in healthy brains and in different brain disorders. Insulin signaling, as well as insulin resistance (IR), is a major contributor in the regulation of mood, behavior, and cognition. Recent evidence showed that both peripheral and central insulin resistance play a role in the pathophysiology, clinical presentation, and management of neuropsychiatric disorders like Cognitive Impairment/Dementia, Depression, and Schizophrenia. Many human studies point out Insulin Resistance/Metabolic Syndrome can increase the risk of dementia especially Alzheimer’s dementia (AD). IR has been shown to play a role in AD development but also in its progression. This review article discusses the pathophysiological pathways and mechanisms of insulin resistance in major neuropsychiatric disorders. The extent of insulin resistance can be quantified using IR biomarkers like insulin levels, HOMA-IR index, and Triglyceride glucose–body mass index (TyG–BMI) levels. IR has been shown to precede neurodegeneration. Human trials showed current treatment with certain antidiabetic drugs, as well as life style management, like weight loss and exercise for IR, have shown promise in the management of cognitive/neuropsychiatric disorders. This may pave the pathway to the development of new therapeutic approaches to these challenging disorders of dementia and psychiatric diseases. Recent clinical trials are showing some encouraging evidence for these pharmacological and nonpharmacological approaches for IR in psychiatric and cognitive disorders, even though more research is needed to apply this evidence into clinical practice. Early identification and management of IR may help as a strategy to potentially alter neuropsychiatric disorders onset as well as its progression Full article
(This article belongs to the Special Issue New and Emerging Concepts in Cardiometabolic Risk Factors and Cognitive Disorders)
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11 pages, 232 KiB  
Review
Association of Hypertension with Different Cognitive Disorders
by Lillian Huang and Wilbert S. Aronow
J. Clin. Med. 2024, 13(20), 6029; https://doi.org/10.3390/jcm13206029 - 10 Oct 2024
Viewed by 1330
Abstract
This literature review explores the association between hypertension and major neurocognitive disorders, including delirium, Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal dementia, which contribute significantly to global mortality and morbidity. Hypertension is a potentially modifiable risk factor for cognitive decline, as [...] Read more.
This literature review explores the association between hypertension and major neurocognitive disorders, including delirium, Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal dementia, which contribute significantly to global mortality and morbidity. Hypertension is a potentially modifiable risk factor for cognitive decline, as it contributes to the progression of neurodegenerative pathologies via vascular damage, inflammation, and the disruption of the blood–brain barrier. Despite this, the effectiveness of antihypertensive treatments in preventing or alleviating cognitive decline remains contentious. While some research highlights the potential benefits of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, other studies show inconsistent results, complicated by variations in hypertension definitions, diagnostic criteria for cognitive disorders, and confounding factors like medication adherence. Furthermore, the complex bidirectional relationship between hypertension and major neurocognitive disorders warrants more investigation, as cognitive decline can exacerbate cardiovascular risks through heightened inflammatory responses and compromised autonomic regulation. This review underscores the need for prospective, long-term studies to elucidate the relationships between hypertension and cognitive disorders and to evaluate the potential therapeutic benefits of antihypertensive treatments. Full article
(This article belongs to the Special Issue New and Emerging Concepts in Cardiometabolic Risk Factors and Cognitive Disorders)
19 pages, 703 KiB  
Review
Association of Atrial Fibrillation and Cognitive Dysfunction: A Comprehensive Narrative Review of Current Understanding and Recent Updates
by Siddhant Passey, Jay Patel, Haris Patail and Wilbert Aronow
J. Clin. Med. 2024, 13(18), 5581; https://doi.org/10.3390/jcm13185581 - 20 Sep 2024
Viewed by 1463
Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. The prevalence of both AF and dementia is steadily rising and is expected to rise further in the coming decades. There is increasing evidence to suggest an association between AF and various [...] Read more.
Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. The prevalence of both AF and dementia is steadily rising and is expected to rise further in the coming decades. There is increasing evidence to suggest an association between AF and various degrees of cognitive dysfunction, from mild cognitive impairment to severe dementia. In this review, we aimed to discuss the epidemiological aspects, pathophysiological mechanisms, role of neuroimaging, impact of treatment modalities, and clinical and socioeconomic impact of this association. Numerous observational studies and meta-analyses have revealed this association to exist in AF patients with and without a history of stroke, and the association also persists after adjusting for shared risk factors such as hypertension and diabetes mellitus. Various pathophysiological mechanisms have been proposed for this association, including silent cerebral infarcts, cerebral microbleeds, cerebral hypoperfusion, inflammation, and atherosclerosis. While neuroimaging findings have been utilized to suggest some of these pathophysiological mechanisms, more studies are needed to further elucidate this and to determine the potential role of neuroimaging in altering anticoagulation and other treatment decisions. Anticoagulants have shown effectiveness in reducing the rate of cognitive decline in AF patients; however, their role in low-risk AF patients remains under investigation. Even though AF patients receiving catheter ablation may have post-operative cognitive dysfunction in the short term, long-term follow-up studies have shown an improvement in cognitive function following ablation. Cognitive decline in AF patients often occurs with greater functional decline and other psychosocial impairments such as depression and anxiety and future research on this association must incorporate aspects of social determinants of health and associated outcomes. Full article
(This article belongs to the Special Issue New and Emerging Concepts in Cardiometabolic Risk Factors and Cognitive Disorders)
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