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Associations Between Medications, Vi...

Dinesh, Deepika C.

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Associations Between Medications, Vitamin B12, Gastrointestinal Health, Gut Microbiome and Cognitive Function.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Associations Between Medications, Vitamin B12, Gastrointestinal Health, Gut Microbiome and Cognitive Function./
Author:	Dinesh, Deepika C.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2024,
Description:	192 p.
Notes:	Source: Dissertations Abstracts International, Volume: 85-08, Section: B.
Contained By:	Dissertations Abstracts International85-08B.
Subject:	Pharmaceutical sciences. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30695960
ISBN:	9798381448399

Associations Between Medications, Vitamin B12, Gastrointestinal Health, Gut Microbiome and Cognitive Function.
Dinesh, Deepika C.

Associations Between Medications, Vitamin B12, Gastrointestinal Health, Gut Microbiome and Cognitive Function. - Ann Arbor : ProQuest Dissertations & Theses, 2024 - 192 p.

Source: Dissertations Abstracts International, Volume: 85-08, Section: B.

Thesis (Ph.D.)--University of Massachusetts Lowell, 2024.

Introduction: The burden of cognitive impairment is increasing in older adults. Recent estimates report that the largest increase in Alzheimer disease (AD) and related dementias, by 2060, will be among Hispanics and Latinos. Medication use, gastrointestinal (GI) dysfunction and gut dysbiosis are increasingly recognized as modifiable risk factors for cognitive impairment and deficiency of neuroprotective micronutrients, such as vitamin B12. These associations are under-reported in Hispanics and Latinos including Puerto Ricans.Objectives: The broad focus of this dissertation is to examine the associations of medication use, bowel health, gut microbial composition, serum biomarkers of vitamin B12 status, and cognitive function in a prospective cohort of Boston-area Puerto Ricans adults.Methods: This study utilizes cross-sectional and longitudinal data from four waves of data collection over 12 years of follow-up in the Boston Puerto Rican Health Study (BPRHS) among participants aged 45-75 years at baseline. Association between proton pump inhibitors (PPI) and cognitive function (chapter 1), and the associations between acid lowering agents (ALAs, i.e., use of PPIs or histamine type-2 receptor antagonists), metformin use, including long-term medication use, and serum vitamin B12 status are examined (chapter 2). Next, the differences in microbial composition and functions associated with PPI use are examined (chapter 3). The associations between bowel frequency and the primary outcomes of cognitive function measured by cognitive scores and supporting outcomes based on magnetic resonance imaging (MRI) brain structural measures are examined (chapter 4). Finally, the differences in microbial composition and functions associated with bowel frequency and cognitive function are also examined (chapter 5).Conclusions: Overall, the associations between PPI use and cognitive function did not reach statistical significance (chapter 1). We did not observe associations between ALAs and vitamin B12 status. However, the use of metformin alone, or concomitantly with ALAs was inversely associated with baseline serum vitamin B12 concentration. These associations did not extend to long-term medication use (chapter 2). Further, we observed an enrichment of certain microbial taxa and microbial pathways among PPI users compared to PPI non-users (chapter 3). Next, compared to normal bowel frequency, we observed U-shaped and inverse associations between low and high daily bowel frequency and MMSE scores, although these associations did not reach statistical significance with other cognitive or MRI outcomes (chapter 4). Finally, we observed differential enrichment or depletion of certain microbial taxa based on low and high, compared to normal, bowel frequency, but there were no statistically significant microbial differences based on cognitive scores (chapter 5). Our results suggest that metformin use and concomitant use of ALAs and metformin may be inversely associated with serum vitamin B12 concentration, low or high bowel frequency may be associated with general cognitive function, and PPIs and bowel frequency may alter gut microbial composition.

ISBN: 9798381448399Subjects--Topical Terms:

3173021
Pharmaceutical sciences.
Subjects--Index Terms:

Alzheimer disease

Associations Between Medications, Vitamin B12, Gastrointestinal Health, Gut Microbiome and Cognitive Function.
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520 $a Introduction: The burden of cognitive impairment is increasing in older adults. Recent estimates report that the largest increase in Alzheimer disease (AD) and related dementias, by 2060, will be among Hispanics and Latinos. Medication use, gastrointestinal (GI) dysfunction and gut dysbiosis are increasingly recognized as modifiable risk factors for cognitive impairment and deficiency of neuroprotective micronutrients, such as vitamin B12. These associations are under-reported in Hispanics and Latinos including Puerto Ricans.Objectives: The broad focus of this dissertation is to examine the associations of medication use, bowel health, gut microbial composition, serum biomarkers of vitamin B12 status, and cognitive function in a prospective cohort of Boston-area Puerto Ricans adults.Methods: This study utilizes cross-sectional and longitudinal data from four waves of data collection over 12 years of follow-up in the Boston Puerto Rican Health Study (BPRHS) among participants aged 45-75 years at baseline. Association between proton pump inhibitors (PPI) and cognitive function (chapter 1), and the associations between acid lowering agents (ALAs, i.e., use of PPIs or histamine type-2 receptor antagonists), metformin use, including long-term medication use, and serum vitamin B12 status are examined (chapter 2). Next, the differences in microbial composition and functions associated with PPI use are examined (chapter 3). The associations between bowel frequency and the primary outcomes of cognitive function measured by cognitive scores and supporting outcomes based on magnetic resonance imaging (MRI) brain structural measures are examined (chapter 4). Finally, the differences in microbial composition and functions associated with bowel frequency and cognitive function are also examined (chapter 5).Conclusions: Overall, the associations between PPI use and cognitive function did not reach statistical significance (chapter 1). We did not observe associations between ALAs and vitamin B12 status. However, the use of metformin alone, or concomitantly with ALAs was inversely associated with baseline serum vitamin B12 concentration. These associations did not extend to long-term medication use (chapter 2). Further, we observed an enrichment of certain microbial taxa and microbial pathways among PPI users compared to PPI non-users (chapter 3). Next, compared to normal bowel frequency, we observed U-shaped and inverse associations between low and high daily bowel frequency and MMSE scores, although these associations did not reach statistical significance with other cognitive or MRI outcomes (chapter 4). Finally, we observed differential enrichment or depletion of certain microbial taxa based on low and high, compared to normal, bowel frequency, but there were no statistically significant microbial differences based on cognitive scores (chapter 5). Our results suggest that metformin use and concomitant use of ALAs and metformin may be inversely associated with serum vitamin B12 concentration, low or high bowel frequency may be associated with general cognitive function, and PPIs and bowel frequency may alter gut microbial composition.
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