NAOMI VIDAL FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
LIM/66, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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- Association between carotid intima-media thickness and cognitive decline differs by race(2023) FERREIRA, Naomi Vidal; BERTOLA, Laiss; SANTOS, Itamar S.; GOULART, Alessandra C.; BITTENCOURT, Marcio S.; BARRETO, Sandhi Maria; GIATTI, Luana; CARAMELLI, Paulo; PEREIRA, Alexandre; LOTUFO, Paulo Andrade; BENSENOR, Isabela M.; SUEMOTO, Claudia KimieIntroductionCommon carotid intima-media thickness (cIMT) is a marker of subclinical atherosclerosis and is associated with cognitive decline. Although carotid atherosclerosis is more frequent in White than in Black participants, little is known whether race modifies the association between cIMT and cognitive decline. MethodsIn this longitudinal analysis of the ELSA-Brasil, we assessed cIMT using ultrasound and cognitive performance using different domain tests. We used linear mixed models, interaction analysis, and race stratified analyses. ResultsBaseline high IMT values were associated with memory (p < 0.001), verbal fluency (p < 0.001), TMT-B (p < 0.001)), and global cognitive decline (p < 0.001). Race was an effect modifier in the association between IMT and global cognitive decline (0.043), with stronger association in White (p < 0.001) than in Black (p = 0.009) participants. DiscussionBaseline IMT was associated with global and domain-specific cognitive decline and race modified this relationship, with stronger associations in White participants. HighlightsCarotid intima-media thickness (cIMT) was associated with cognitive decline.cIMT and cognitive decline association was stronger in White than in Black participants.We used inverse probability weighting to address attrition bias.
- Risk and protective factors for dementia: epidemiological evidence and windows of opportunity(2022) SUEMOTO, C. K.; NITRINI, R.; GRINBERG, L. T.; LEITE, R. E. P.; PASQUALLUCCI, C. A.; BERTOLA, L.; VIDAL-FERREIRA, N.; SZLEFJ, C.; CARAMELLI, P.; BENSENOR, I. M.; LOTUFO, P. A.; ALIBERTI, M. J. R.; FERRI, C. P.; JACOB-FILHO, W.Background: Most people with dementia already live in low- to middle-income countries (LMIC). However, most evidence regarding dementia prevention comes from high-income countries that have different socioeconomic status (SES) and risk factors prevalence than LMIC. In this session, we will present results on risk and protective factors for dementia from the Longitudinal Study of Adult Health (ELSA-Brasil), the Brazilian Longitudinal Study of Aging (ELSI-Brazil), and the Brazilian Biobank for Aging Studies (BAS). Method: The ELSA-Brasil follows 15,105 public servants since 2008-10. The ELSI-Brazil is a nationally representative study with 9,412 adults aged 50 years and older, who were enrolled in 2015-16. The BAS is a neuropathology study that started in 2004 and is the largest brain bank in Latin America with a collection of 1,441 brains. The focus of this presentation will be on the associations of education, SES, and cardiovascular factors with dementia using data from these three studies. Result: In the BAS, 77% of the sample has less than 5 years of education and 56% unskilled occupations. Compared to the group without education, those with formal education had better cognitive performance (1-4 years: β = -0.99, 95%CI = –1.85; –0.14, p = 0.02; ≥5 years: = –1.42, 95% CI = –2.47; –0.38, p = 0.008). On the other hand, occupation complexity and demands were unrelated to cognition. Similarly, we showed that education and early-life SES were the main contributors to cognitive performance in the ELSA-Brasil, while later SES had a lower influence on cognitive scores. Cardiovascular factors are also important contributors to brain health. Ideal vascular health was related to better cognitive function in the ELSA-Brasil. Participants with intermediate (β = 0.064, 95%CI = 0.033; 0.096) and optimal health (β = 0.108, 95%CI = 0.052; 0.164) had better cognitive z-scores. Moreover, carotid artery atherosclerosis evaluated by morphometric measurements was related to cognitive impairment in BAS and with cognitive decline in the ELSA-Brasil after 8 years of follow-up (β = -0.028, 95%CI = -0.036; -0.020, p<0.001). Finally, hypertension was related to worse cognition (β = -0.09; 95%CI = -0.15, -0.04; p = 0.001) in ELSI-Brazil, mainly in non-frail participants. Conclusion: Studies from LMIC regarding dementia risk factors are essential to implement tailored public policies for dementia primary prevention. © 2022 the Alzheimer's Association.
article 6 Citação(ões) na Scopus Association Between Adherence to the MIND Diet and Cognitive Performance is Affected by Income The ELSA-Brasil Study(2022) V, Naomi Ferreira; LOTUFO, Paulo A.; MARCHIONI, Dirce M. L.; BARRETO, Sandhi M.; VIANA, Maria C.; CARAMELLI, Paulo; BENSENOR, Isabela J. M.; SUEMOTO, Claudia K.Background: The relationship between the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) diet and cognition has not been widely investigated in low- to middle-income countries. We investigated the relationship between MIND diet and cognition in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. Methods: We included 11,788 participants. MIND diet adherence was based on the intake of 15 components according to a food frequency questionnaire. We analyzed the association between MIND diet adherence and global cognition, memory, and executive function using adjusted linear regression. We examined the interaction between income and MIND diet adherence on cognition and presented income stratified analyses. Results: MIND diet adherence was not associated with cognition in the whole sample. Income was an effect modifier of MIND adherence on global cognition (P= 0.03) and executive function (P< 0.001). For participants with high income, greater adherence was associated with better executive function [ss= 0.015, 95% confidence interval (CI)= 0.002; 0.028, P= 0.025]; while for participants with low income, greater adherence was associated with lower global cognition (ss=-0.020, 95% CI= -0.036; -0.005, P= 0.010) and executive function (ss= -0.023, 95% CI=-0.039; -0.007, P= 0.004). Adherence to the MIND diet was higher among participants with high income (P< 0.001). Conclusion: For high-income participants, greater adherence was associated with better cognitive performance; for low-income participants, greater adherence was associated with lower cognitive performance.- Association Between Consumption of Ultraprocessed Foods and Cognitive Decline(2023) GONCALVES, Natalia Gomes; FERREIRA, Naomi Vidal; KHANDPUR, Neha; STEELE, Euridice Martinez; LEVY, Renata Bertazzi; LOTUFO, Paulo Andrade; BENSENOR, Isabela M.; CARAMELLI, Paulo; MATOS, Sheila Maria Alvim de; MARCHIONI, Dirce M.; SUEMOTO, Claudia KimieImportance Although consumption of ultraprocessed food has been linked to higher risk of cardiovascular disease, metabolic syndrome, and obesity, little is known about the association of consumption of ultraprocessed foods with cognitive decline.Objective To investigate the association between ultraprocessed food consumption and cognitive decline in the Brazilian Longitudinal Study of Adult Health.Design, Setting, and Participants This was a multicenter, prospective cohort study with 3 waves, approximately 4 years apart, from 2008 to 2017. Data were analyzed from December 2021 to May 2022. Participants were public servants aged 35 to 74 years old recruited in 6 Brazilian cities. Participants who, at baseline, had incomplete food frequency questionnaire, cognitive, or covariate data were excluded. Participants who reported extreme calorie intake (6000 kcal/day) and those taking medication that could negatively interfere with cognitive performance were also excluded.Exposures Daily ultraprocessed food consumption as a percentage of total energy divided into quartiles.Main Outcomes and MeasuresChanges in cognitive performance over time evaluated by the immediate and delayed word recall, word recognition, phonemic and semantic verbal fluency tests, and Trail-Making Test B version.Results A total of 15 105 individuals were recruited and 4330 were excluded, leaving 10 775 participants whose data were analyzed. The mean (SD) age at the baseline was 51.6 (8.9) years, 5880 participants (54.6%) were women, 5723 (53.1%) were White, and 6106 (56.6%) had at least a college degree. During a median (range) follow-up of 8 (6-10) years, individuals with ultraprocessed food consumption above the first quartile showed a 28% faster rate of global cognitive decline (beta = -0.004; 95% CI, -0.006 to -0.001; P = .003) and a 25% faster rate of executive function decline (beta = -0.003, 95% CI, -0.005 to 0.000; P = .01) compared with those in the first quartile.Conclusions and Relevance A higher percentage of daily energy consumption of ultraprocessed foods was associated with cognitive decline among adults from an ethnically diverse sample. These findings support current public health recommendations on limiting ultraprocessed food consumption because of their potential harm to cognitive function.
- Dietary folate intake and its association with longitudinal changes in cognition function(2023) PALCHETTI, Cecilia Zanin; GONCALVES, Natalia Gomes; FERREIRA, Naomi Vidal; SANTOS, Itamar S.; LOTUFO, Paulo Andrade; BENSENOR, Isabela M.; SUEMOTO, Claudia Kimie; MARCHIONI, Dirce Maria LoboBackground & aims: Folate (vitamin B9) is an essential co-factor for one-carbon metabolism. Contro-versial evidence has emerged regarding the association between folate and cognitive performance. The aim of the study was to investigate the association between baseline dietary folate intake and cognitive decline in a population exposed to mandatory fortification during a median follow-up of 8 years. Methods: Multicenter, prospective cohort study involving 15,105 public servants aged 35-74 years old, both sexes, from The Brazilian Longitudinal Study of Adult Health (EL SA-Brasil). Baseline dietary intake was assessed by a Food Frequency Questionnaire (FFQ). Six cognitive tests were performed in the three waves to assess memory, executive function and global cognition. Linear mixed-effects models were used to assess the association between dietary folate intake at baseline and changes in cognition over time. Results: Data from 11,276 participants were analyzed. The mean (SD) age was 51.7 (9) years, 50% were women, 63% were overweight/obese, and 56% had graduated from college or more. Overall dietary folate intake was not associated with cognitive decline; neither vitamin B12 intake was a modifier of this association. General dietary supplements and specifically multivitamins use did not affect these findings. Natural food folate group was associated with a slower rate of global cognitive decline (b (95% CI): 0.001 (0.000; 0.002), P 1/4 0.015). There was no association between fortified food group and cognition scores. Conclusion: Overall dietary folate intake was not associated with cognitive function in this Brazilian population. However, folate naturally occurring in food sources may slow global cognitive decline.(c) 2023 European Society for Clinical Nutrition and Metabolism.