1.
Diet and biomarkers of Alzheimer's disease: a systematic review and meta-analysis.
Hill, E, Goodwill, AM, Gorelik, A, Szoeke, C
Neurobiology of aging. 2019;:45-52
Abstract
Alzheimer's disease (AD) risk increases with age and lacks efficacious pharmacological options. Summaries of the existing evidence reveal an association between Mediterranean-style diet adherence and reduced AD incidence; however, no review has investigated this relationship with respect to the hallmark AD biomarkers (tau and beta-amyloid) that manifest decades before clinical symptomatology. MEDLINE, PubMed, PsycINFO, Google Scholar, and SCOPUS databases were systematically searched to identify peer-reviewed articles investigating diet and AD biomarkers in the last 2 decades. Two thousand seven hundred twenty-six records were extracted, quality assessed, and double-blind screened by 2 authors. Fifteen studies met the inclusion criteria and 13 studies found a significant relationship. Of these, 4 studies found a high-glycemic load was related to an increase in AD biomarker burden; 6 found adherence to a Mediterranean or "AD-protective" dietary pattern conferred a reduction in AD biomarker burden. Meta-analysis revealed a small but significant effect of diet on AD biomarkers (β = 0.11 [95% CI 0.04-0.17], p = 0.002). This systematic review supports the notion that diet and nutrition display potential for nonpharmacological AD prevention.
2.
Cerebrospinal fluid β-amyloid1-42 levels in the differential diagnosis of Alzheimer's disease--systematic review and meta-analysis.
Mo, JA, Lim, JH, Sul, AR, Lee, M, Youn, YC, Kim, HJ
PloS one. 2015;(2):e0116802
Abstract
OBJECTIVES The purpose of this study was to carry out systematic review of the literature and meta-analysis to evaluate the diagnostic utility of cerebrospinal fluid (CSF) levels of the 42 amino acid form of amyloid-beta (Aβ1-42) as a biomarker for differentiating Alzheimer's disease (AD) from non-AD dementia. METHODS Design. Systematic literature review was used to evaluate the effectiveness of the Aβ for the diagnosis of AD. The Scottish Intercollegiate Guidelines Network (SIGN) tool was used to evaluate independently the quality of the studies. Data sources. The literature review covered from January 1, 2004, to October 22, 2013, and searched eight domestic databases including Korea Med and international databases including Ovid-MEDLINE, EMBASE, and Cochrane Library. Data Extraction and Synthesis. Primary criteria for inclusion were valid studies on (i) patients with mild cognitive impairment with confirmed or suspected AD and non-AD dementia, and (ii) assessment of Aβ1-42 levels using appropriate comparative tests. RESULTS A total of 17 diagnostic evaluation studies were identified in which levels of CSF Aβ1-42 were assessed. Meta-analysis was performed on 11 robust studies that compared confirmed AD (n = 2211) with healthy individuals (n = 1030), 10 studies that compared AD with non-AD dementias (n = 627), and 5 studies that compared amnestic mild cognitive impairment (n = 1133) with non-amnestic type subjects (n = 1276). Overall, the CSF Aβ1-42 levels were reduced in AD compared to controls or non-AD dementia. The effectiveness of test was evaluated for diagnostic accuracy (pooled sensitivity, 0.80 (95% CI 0.78-0.82); pooled specificity, 0.76 (95% CI 0.74-0.78). CONCLUSIONS Reduced CSF Aβ1-42 levels are of potential utility in the differential diagnosis of AD versus non-AD dementias and controls. Diagnostic accuracy was high in AD versus healthy controls. However, differential diagnosis for MCI or non-AD might be evaluated by other biomarkers.