The role of modifiable risk factors in the development of dementia in Central and Eastern Europe remains understudied. We aimed to examine the association between 12 risk factors and the incidence of dementia in the Czech Republic and estimate the proportion of new dementia cases that can be attributed to these risk factors. Data of 3805 Czech participants in the Survey of Health, Ageing, and Retirement in Europe (mean age: 70 years, median 6.5-year follow-up) were analyzed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox hazard models for the association between the risk factors (low education, alcohol use, living alone, obesity, smoking, physical inactivity, high blood pressure, high cholesterol, diabetes mellitus, hearing loss, vision problem, and depression) and probable dementia diagnosis defined based on adapted Lang-Weir algorithm. We estimated the proportion of dementia cases attributable to each risk factor using weighted population attributable fractions (wPAFs). Four risk factors, low education (HR 1.72), depression (HR 1.42), diabetes mellitus (HR 1.53), and physical inactivity (HR 2.13), were significantly associated with dementia and accounted for the largest proportion of attributable risk. The total weighted PAF for all factors was 39.18%. If all risk factors for dementia were eliminated, almost 40% of dementia cases in the Czech Republic could be prevented. More systematic approach is essential for mitigating the adverse impact of risk factors on the incidence of dementia, such as improving education, preventing and treating depression and diabetes mellitus, and promoting physical.

• MeSH
• demence * epidemiologie   MeSH
• deprese epidemiologie   MeSH
• důchod statistika a číselné údaje   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• proporcionální rizikové modely MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• zdravotnické přehledy MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Epidemiological studies suggest an association between Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM). This study aimed to investigate the pathophysiological markers of AD vs. T2DM for each sex separately and propose models that would distinguish control, AD, T2DM, and AD-T2DM comorbidity groups. AD and T2DM differed in levels of some circulating steroids (measured mostly by GC-MS) and in other observed characteristics, such as markers of obesity, glucose metabolism, and liver function tests. Regarding steroid metabolism, AD patients (both sexes) had significantly higher sex hormone binding globulin (SHBG), cortisol, and 17-hydroxy progesterone, and lower estradiol and 5α-androstane-3α,17β-diol, compared to T2DM patients. However, compared to healthy controls, changes in the steroid spectrum (especially increases in levels of steroids from the C21 group, including their 5α/β-reduced forms, androstenedione, etc.) were similar in patients with AD and patients with T2DM, though more expressed in diabetics. It can be assumed that many of these steroids are involved in counter-regulatory protective mechanisms that mitigate the development and progression of AD and T2DM. In conclusion, our results demonstrated the ability to effectively differentiate AD, T2DM, and controls in both men and women, distinguish the two pathologies from each other, and differentiate patients with AD and T2DM comorbidities.

• Klíčová slova
• Alzheimer’s disease, GC-MS, differential diagnostics, multivariate statistics, steroidome, type 2 diabetes mellitus,
• MeSH
• Alzheimerova nemoc * metabolismus   MeSH
• androstendion MeSH
• diabetes mellitus 2. typu * diagnóza   epidemiologie   MeSH
• komorbidita MeSH
• lidé MeSH
• steroidy metabolismus   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• androstendion MeSH
• steroidy MeSH

Excessive adipose tissue, particularly with a central distribution, consists of visceral fat, which is metabolically active and could impinge upon central nervous system functioning. The aim of the current study was to examine levels of visceral adiposity in relation to key cerebral metabolite ratios localized in the occipitoparietal grey matter. Seventy-three adults, aged between 40 and 60 years, underwent structural magnetic resonance imaging and single voxel 1H Magnetic Resonance Spectroscopy (1H MRS). Visceral fat was assessed using Dual Energy X Ray Absorptiometry (DXA). Individuals with higher visceral fat mass and volume had significantly lower ratios of N-acetyl-aspartate to total creatine (phosphocreatine + creatine, PCr + Cr) (NAA/PCr + Cr) (β = -0.29, p = 0.03, β = -0.28, p = 0.04). They also had significantly higher ratios of myo-inositol to total creatine (mI/PCr + Cr ) (β = 0.36, p = 0.01, β = 0.36, p = 0.01). Visceral fat mass and volume were not significantly related to ratios of glutamate to total creatine (Glu/PCr + Cr). While future studies are necessary, these results indicate central adiposity is associated with metabolic changes that could impinge upon the central nervous system in middle age.

• Klíčová slova
• 1H-MRS, Neurochemistry, Obesity, Visceral fat,
• MeSH
• absorpční fotometrie metody   MeSH
• dospělí MeSH
• kyselina asparagová analogy a deriváty   metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nitrobřišní tuk diagnostické zobrazování   metabolismus   MeSH
• průřezové studie MeSH
• temenní lalok diagnostické zobrazování   metabolismus   MeSH
• týlní lalok diagnostické zobrazování   metabolismus   MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• kyselina asparagová MeSH
• N-acetylaspartate MeSH Prohlížeč