Dimitris Vassilopoulos

Diet, physical activity and cognitive impairment among elders : the EPIC-Greece cohort (European Prospective Investigation into Cancer and Nutrition)

OBJECTIVES To identify dietary and lifestyle variables that may affect cognitive function in the elderly. DESIGN Population-based prospective cohort study. SETTING General community residing in Athens and the surrounding Attica region of Greece. SUBJECTS A total of 732 men and women, 60 years or older, participating in the EPIC-Greece cohort (European Prospective Investigation into Cancer and Nutrition) and residing in the Attica region had sociodemographic, anthropometric, medical, dietary and lifestyle variables ascertained at enrolment (1993-1999). Six to 13 years later, cognitive function was evaluated through the Mini-Mental State Examination (MMSE) score and affective state through the Geriatric Depression Scale (GDS). RESULTS MMSE score was positively associated with years of formal education, height and physical activity and inversely with age, diabetes mellitus and GDS score (P < 0.05 for all). Among dietary variables, intake of PUFA was inversely associated with cognitive function and this association was largely accounted for by a similar association with seed oils. Adherence to the Mediterranean diet, as well as intake of olive oil, MUFA and SFA exhibited weakly positive but not significant associations. CONCLUSION Physical activity and early life factors as reflected in height are significant predictors of cognitive function in the elderly. Seed oil consumption may adversely affect cognition, whereas other nutritional factors do not appear to have a quantitatively large effect.

A normative study of the trail making test A and B in Greek adults.

The purpose of this study was to explore the effects of age and education on the performance of the Trail Making Test (TMT), and to provide normative data in the Greek population. The TMT was administered to 643 healthy participants. All participants satisfied the criteria excluding dementia and other medical, psychiatric, and neurological disorders. Statistical analysis revealed that, age, education, and general level of intelligence significantly influence individual performance. Performance on TMT, especially part B, decreases with increasing age and lower levels of education. Current norms of the Greek version of TMT represent a useful set of norms for clinical practice.

Origin of nondisjunction in trisomy 8 and trisomy 8 mosaicism.

Causes of chromosomal nondisjunction is one of the remaining unanswered questions in human genetics. In order to increase our understanding of the mechanisms underlying nondisjunction we have performed a molecular study on trisomy 8 and trisomy 8 mosaicism. We report the results on analyses of 26 probands (and parents) using 19 microsatellite DNA markers mapping along the length of chromosome 8. The 26 cases represented 20 live births, four spontaneous abortions, and two prenatal diagnoses (CVS). The results of the nondisjunction studies show that 20 cases (13 maternal, 7 paternal) were probably due to mitotic (postzygotic) duplication as reduction to homozygosity of all informative markers was observed and as no third allele was ever detected. Only two cases from spontaneous abortions were due to maternal meiotic nondisjunction. In four cases we were not able to detect the extra chromosome due to a low level of mosaicism. These results are in contrast to the common autosomal trisomies (including mosaics), where the majority of cases are due to errors in maternal meiosis.

Dietary and lifestyle variables in relation to incidence of Parkinson’s disease in Greece

Identification of dietary and lifestyle variables associated with the development of Parkinson’s disease (PD) may offer pathogenetic clues and prevention opportunities. In a population-based prospective cohort study, 26,173 participants in the EPIC–Greece cohort had sociodemographic, anthropometric, medical, dietary and lifestyle variables ascertained at enrolment and periodically reassessed with follow-up contacts. Based on these data, subjects were screened as possible PD cases if they (1) reported either a medical diagnosis of PD or use of anti-PD drugs and (2) did not report preceding causes of secondary parkinsonism. For diagnostic validation, possible incident PD cases were assessed by a focused 3-item telephone questionnaire. Cox proportional hazards regression was used to evaluate associations between potential predictors and incident PD. The main multivariate model included gender, age, marital status, schooling years, farming occupation, smoking status, caffeinated coffee, body mass index, physical activity and energy intake. Additional models included all above variables plus one dietary item at a time. Incidence rate adjusted to the European population was 16.9 per 100,000 person-years. In multivariate models, incident PD exhibited strong positive association with consumption of milk, but not cheese or yoghurt. This finding may help narrow down the search for potential dairy product components with a facilitatory role in PD. Concerning other dietary components, inverse association was found between polyunsaturated fat intake and incident PD. Also, inverse association was found with tobacco smoking, in line with previous studies, but not with caffeine.

Associations of the Expanded Disability Status Scale with anxiety and depression in multiple sclerosis outpatients

Objectives – We evaluated cross‐sectionally the associations of depression and anxiety with age, sex, duration of illness, educational level, degree of disability and treatment with interferon‐β in outpatients with relapsing–remitting multiple sclerosis (RRMS) during a clinically stable phase of their illness.

Apolipoprotein E polymorphism in the Greek population

The APOE gene is located on chromosome 19, and the three common alleles are designated ε2, ε3, and ε4. The ε4 allele is associated with increased plasma cholesterol, atherosclerosis and cardiovascular disease, Alzheimers disease, and decreased longevity. The objective of the present study was to estimate the distribution of APOE alleles in the Greek population by DNA analysis. The material consisted of 216 voluntary, healthy Greek blood donors (146 males/70 females). The APOE allele frequencies were ε2: 5.3%, ε3: 88.2%, ε4: 6.5%. The ε4 allele frequency of 6.5% in the Greek population is, together with the frequency in the Chinese population, among the lowest in the world.

Dietary lipids and geriatric depression scale score among elders: The EPIC-Greece cohort

In a prospective epidemiological investigation aiming to identify dietary lipids potentially associated with affective state and depression, 610 healthy men and women aged 60 years or older, participating in the EPIC-Greece cohort and residing in the Attika region had dietary, sociodemographic, anthropometric, medical and lifestyle variables ascertained at enrollment. Six to 13 years later, affective state was evaluated through the 15-point geriatric depression scale (GDS) score along with cognitive function and medical variables. In multivariate linear regression analysis, while adjusting for potential confounders, GDS score was negatively associated with dietary intake of monounsaturated lipids (MUFA) and their main source, olive oil, and positively associated with intake of polyunsaturated lipids (PUFA) and one of their principal sources, seed oils. Intake of calories, total lipids, fish and seafood or saturated lipids did not exhibit significant association with GDS. Potential non-linearities were assessed by quantile multivariate regression analysis: The median GDS score was positively associated with PUFA and seed oils intake, while other lipid groups showed no appreciable associations. The 90th percentile of the GDS score (towards the high end) exhibited significant negative associations with MUFA and olive oil, weaker positive associations with PUFA and seed oils and no appreciable association with other lipid group dietary intakes. We conclude that among Attika elders, lower intake of seed oils and higher intake of olive oil prospectively predict a healthier affective state. Olive oil intake, in particular, predicts a lower chance of scoring in the highest part of the GDS.

Incidence and clinical presentation of neurosyphilis: a retrospective study of 81 cases.

Aim of the report was the study of the clinical features of neurosyphilis in the last 40 years (1965–2005). The investigation was based on the retrospective review of patients with neurosyphilis hospitalized in our hospital from 1965 to 2005 (period A: 1965–1984 and B: 1985–2005). Eighty one patients with neurosyphilis were studied. Typical forms represent 68.6% of cases of neurosyphilis in period A. In period B, 85.7% of the cases are presented with atypical clinical patterns. Typical forms of the disease were no longer common, while atypical and masked clinical patterns prevailed. Neuropsychiatric symptoms were the most common manifestations of the disease.

Huntington's disease in Greece: the experience of 14 years.

Panas M, Karadima G, Vassos E, Kalfakis N, Kladi A, Christodoulou K, Vassilopoulos D. Huntingtons disease in Greece: the experience of 14 years.

Twenty four hour pulse pressure predicts long term recurrence in acute stroke patients

Objectives: The impact of different blood pressure (BP) components during the acute stage of stroke on the risk of recurrent stroke is controversial. The present study aimed to investigate by 24 hour BP monitoring a possible association between acute BP values and long term recurrence. Methods: A total of 339 consecutive patients with first ever acute stroke underwent 24 hour BP monitoring within 24 hours of ictus. Known stroke risk factors and clinical findings on admission were documented. Patients given antihypertensive medication during BP monitoring were excluded. The outcome of interest during the one year follow up was recurrent stroke. The Cox proportional hazard model was used to analyse association of casual and 24 hour BP recordings with one year recurrence after adjusting for stroke risk factors, baseline clinical characteristics, and secondary prevention therapies. Results: The cumulative one year recurrence rate was 9.2% (95% CI 5.9% to 12.3%). Multivariate Cox regression analyses revealed age, diabetes mellitus, and 24 hour pulse pressure (PP) as the only significant predictors for stroke recurrence. The relative risk for one year recurrence associated with every 10 mm Hg increase in 24 hour PP was 1.323 (95% CI 1.019 to 1.718, p = 0.036). Higher casual PP levels were significantly related to an increased risk of one year recurrence on univariate analysis, but not in the multivariate Cox regression model. Conclusions: Elevated 24 hour PP levels in patients with acute stroke are independently associated with higher risk of long term recurrence. Further research is required to investigate whether the risk of recurrent stroke can be reduced to a greater extent by decreasing the pulsatile component of BP in patients with acute stroke.