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Shen C, Rolls ET, Cheng W, Kang J, Dong G, Xie C, Zhao XM, Sahakian BJ, Feng J. Associations of Social Isolation and Loneliness With Later Dementia. Neurology 2022; 99:e164-e175. [PMID: 35676089 DOI: 10.1212/wnl.0000000000200583] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/08/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the independent associations of social isolation and loneliness with incident dementia and to explore the potential neurobiological mechanisms. METHODS We utilized the UK Biobank cohort to establish Cox proportional hazard models with social isolation and loneliness as separate exposures. Demographic (sex, age, and ethnicity), socioeconomic (education level, household income, and Townsend deprivation index), biological (body mass index, APOE genotype, diabetes, cancer, cardiovascular disease, and other), cognitive (speed of processing and visual memory), behavioral (current smoker, alcohol intake, and physical activity), and psychological (social isolation or loneliness, depressive symptoms, and neuroticism) factors measured at baseline were adjusted. Then, voxel-wise brainwide association analyses were used to identify gray matter volumes (GMVs) associated with social isolation and with loneliness. Partial least squares regression was performed to test the spatial correlation of GMV differences and gene expression using the Allen Human Brain Atlas. RESULTS We included 462,619 participants (mean age at baseline 57.0 years [SD 8.1]). With a mean follow-up of 11.7 years (SD 1.7), 4,998 developed all-cause dementia. Social isolation was associated with a 1.26-fold increased risk of dementia (95% CI, 1.15-1.37) independently of various risk factors including loneliness and depression (i.e., full adjustment). However, the fully adjusted hazard ratio for dementia related to loneliness was 1.04 (95% CI, 0.94-1.16) and 75% of this relationship was attributable to depressive symptoms. Structural MRI data were obtained from 32,263 participants (mean age 63.5 years [SD 7.5]). Socially isolated individuals had lower GMVs in temporal, frontal, and other (e.g., hippocampal) regions. Mediation analysis showed that the identified GMVs partly mediated the association between social isolation at baseline and cognitive function at follow-up. Social isolation-related lower GMVs were related to underexpression of genes that are downregulated in Alzheimer disease and to genes that are involved in mitochondrial dysfunction and oxidative phosphorylation. DISCUSSION Social isolation is a risk factor for dementia that is independent of loneliness and many other covariates. Social isolation-related brain structural differences coupled with different molecular functions also support the associations of social isolation with cognition and dementia. Social isolation may thus be an early indicator of an increased risk of dementia.
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Affiliation(s)
- Chun Shen
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Edmund T Rolls
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Wei Cheng
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Jujiao Kang
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Guiying Dong
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Chao Xie
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Xing-Ming Zhao
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Barbara J Sahakian
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Jianfeng Feng
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China.
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Wang Y, Shirai K, Ohira T, Hirosaki M, Kondo N, Takeuchi K, Yamaguchi C, Tamada Y, Kondo K, Cadar D, Iso H. Occasions for laughter and dementia risk: Findings from a six-year cohort study. Geriatr Gerontol Int 2022; 22:392-398. [PMID: 35289045 DOI: 10.1111/ggi.14371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/10/2022] [Accepted: 02/19/2022] [Indexed: 11/28/2022]
Abstract
AIM Currently, there is little evidence on the relationship between laughter and the risk of dementia, and since laughter is mainly a social behavior, we aimed to examine the association between various occasions for laughter and the risk of dementia in Japanese older adults. METHODS We draw upon 6-year follow-up data from the Japan Gerontological Evaluation Study, including 12 165 independent older adults aged 65 years or over. Occasions for laughter were assessed using a questionnaire, while dementia was diagnosed using the standardized dementia scale of the long-term care insurance system in Japan. Cox proportional hazards models were estimated, yielding hazard ratios and 95% confidence intervals (CIs). RESULTS The multivariable hazard ratio of dementia incidence for all participants in the groups for high versus low variety of occasions for laughter was 0.84 (95% CI: 0.72-0.98, P for trend <0.001). A greater variety of occasions for laughter was associated with a lower risk of dementia 0.78 (95% CI: 0.63-0.96, P for trend <0.001) among women, but was less pronounced for men, with significant associations only for the medium group. Laughing during conversations with friends, communicating with children or grandchildren, and listening to the radio were primarily associated with decreased risk. CONCLUSION A greater variety of laughter occasions in individual and social settings was associated with a reduced risk of dementia. Geriatr Gerontol Int 2022; 22: 392-398.
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Affiliation(s)
- Yu Wang
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mayumi Hirosaki
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Division of Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Chikae Yamaguchi
- Department of Community Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Dorina Cadar
- Department of Behavioural Science and Health, University College London, London, UK.,Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
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Levene T, Livingston G, Banerjee S, Sommerlad A. Minimum clinically important difference of the Social Functioning in Dementia Scale (SF-DEM): cross-sectional study and Delphi survey. BMJ Open 2022; 12:e058252. [PMID: 35351729 PMCID: PMC8966522 DOI: 10.1136/bmjopen-2021-058252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Good social functioning is important for people living with dementia and their families. The Social Functioning in Dementia Scale (SF-DEM) is a valid and reliable instrument measuring social functioning in dementia. However the minimum clinically important difference (MCID) has not yet been derived for SF-DEM. This study aims to define the MCID for the SF-DEM. DESIGN We used triangulation, incorporating data from a cross-sectional study to calculate the MCID using distribution-based and anchor-based methods, and a Delphi survey. SETTING AND PARTICIPANTS The cross-sectional survey comprised 299 family carers of people with dementia. Twenty dementia experts (researchers, clinicians, family carers) rated whether changes on clinical vignettes represented a meaningful change in the Delphi survey. PRIMARY OUTCOME MEASURES We calculated the distribution-based MCID as 0.5 of an SD for each of the three SF-DEM domains (1-spending time with others, 2-communicating with others, 3-sensitivity to others). We used the carers' rating of social functioning to calculate the anchor-based MCID. For the Delphi survey, we defined consensus as ≥75% agreement. Where there was lack of consensus, experts were asked to complete a further survey round. RESULTS We found that 0.5 SD of SF-DEM was 1.9 points, 2.2 and 1.4 points in domains 1, 2 and 3, respectively. Using the anchoring analysis, the MCIDs were 1.7 points, 1.7 points, and 0.9 points in domains 1, 2 and 3, respectively. The Delphi method required two rounds. In the second round, a consensus was reached that a 2-point change was considered significant in all three domains, but no consensus was reached on a 1-point change. CONCLUSIONS By triangulating all three methods, the SF-DEM's MCIDs were 1.9, 2.0 and 1.4 points for domains 1, 2 and 3, respectively. For individuals, these values should be rounded to a 2-point change for each domain.
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Affiliation(s)
- Tamara Levene
- Division of Psychiatry, University College London, London, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Völter C, Götze L, Bajewski M, Dazert S, Thomas JP. Cognition and Cognitive Reserve in Cochlear Implant Recipients. Front Aging Neurosci 2022; 14:838214. [PMID: 35391751 PMCID: PMC8980358 DOI: 10.3389/fnagi.2022.838214] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/24/2022] [Indexed: 12/16/2022] Open
Abstract
At present, dementia is a hot topic. Hearing loss is considered to be a modifiable risk factor for cognitive decline. The underlying mechanism remains unclear and might be mediated by socioeconomic and psychosocial factors. Cochlear implantation has been shown not only to restore auditory abilities, but also to decrease mental distress and to improve cognitive functions in people with severe hearing impairment. However, the promising results need to be confirmed. In a prospective single-center study, we tested the neurocognitive abilities of a large group of 71 subjects with bilateral severe hearing impairment with a mean age of 66.03 (SD = 9.15) preoperatively and 6, 12, and 24 months after cochlear implantation using a comprehensive non-auditory computer-based test battery, and we also assessed the cognitive reserve (CR) [Cognitive Reserve Index (CRI)], health-related quality of life (QoL) (Nijmegen Cochlear Implant Questionnaire), and depression (Geriatric Depression Scale-15). Cognitive functions significantly increased after 6 months in attention (p = 0.00004), working memory (operation span task; p = 0.002), and inhibition (p = 0.0002); and after 12 months in recall (p = 0.003) and verbal fluency (p = 0.0048), and remained stable up to 24 months (p ≥ 0.06). The CR positively correlated with cognitive functions pre- and post-operatively (both p < 0.005), but postoperative improvement in cognition was better in subjects with poor CR (p = 0.003). Depression had only a slight influence on one subtest. No correlation was found among cognitive skills, quality of life, and speech perception (each p ≥ 0.05). Cochlear implantation creates an enriched environment stimulating the plasticity of the brain with a global positive impact on neurocognitive functions, especially in subjects with poor preoperative cognitive performance and low cognitive reserve.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
- *Correspondence: Christiane Völter,
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
| | - Marcel Bajewski
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
| | - Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, St.-Johannes-Hospital, Dortmund, Germany
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Plangger B, Unterrainer C, Kreh A, Gatterer G, Juen B. Psychological Effects of Social Isolation During the COVID-19 Pandemic 2020. GEROPSYCH 2022. [DOI: 10.1024/1662-9647/a000283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract. The SARS-CoV2 pandemic meant considerable restrictions in the social life of many people. Older people belong to the high-risk group for a severe to fatal course of the SARS-CoV2 disease, which is why these groups received special protection. This protection included drastic restrictions on their personal and social contacts, including the suspension of psychosocial therapies. This study examines the cognitive and emotional effects of social isolation on older people. A group of 49 participants who lived in nursing homes was tested before and after social isolation in 2020. The results of the present study provide empirical evidence for the negative effects of social isolation of older people in nursing homes regarding cognitive performance, anxiety, depressive symptoms, and quality of life.
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Affiliation(s)
| | | | - Alexander Kreh
- Department of Psychology, University of Innsbruck, Austria
| | - Gerald Gatterer
- Department of Psychology, Sigmund Freud Private University, Vienna, Austria
| | - Barbara Juen
- Department of Psychology, University of Innsbruck, Austria
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van Leeuwen JEP, Boomgaard J, Bzdok D, Crutch SJ, Warren JD. More Than Meets the Eye: Art Engages the Social Brain. Front Neurosci 2022; 16:738865. [PMID: 35281491 PMCID: PMC8914233 DOI: 10.3389/fnins.2022.738865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Here we present the viewpoint that art essentially engages the social brain, by demonstrating how art processing maps onto the social brain connectome-the most comprehensive diagram of the neural dynamics that regulate human social cognition to date. We start with a brief history of the rise of neuroaesthetics as the scientific study of art perception and appreciation, in relation to developments in contemporary art practice and theory during the same period. Building further on a growing awareness of the importance of social context in art production and appreciation, we then set out how art engages the social brain and outline candidate components of the "artistic brain connectome." We explain how our functional model for art as a social brain phenomenon may operate when engaging with artworks. We call for closer collaborations between the burgeoning field of neuroaesthetics and arts professionals, cultural institutions and diverse audiences in order to fully delineate and contextualize this model. Complementary to the unquestionable value of art for art's sake, we argue that its neural grounding in the social brain raises important practical implications for mental health, and the care of people living with dementia and other neurological conditions.
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Affiliation(s)
- Janneke E. P. van Leeuwen
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- The Thinking Eye, ACAVA Limehouse Arts Foundation, London, United Kingdom
| | - Jeroen Boomgaard
- Research Group Art and Public Space, Gerrit Rietveld Academie, Amsterdam, Netherlands
| | - Danilo Bzdok
- Department of Biomedical Engineering, McGill University, Montréal, ON, Canada
| | - Sebastian J. Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jason D. Warren
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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Elovainio M, Lahti J, Pirinen M, Pulkki-Råback L, Malmberg A, Lipsanen J, Virtanen M, Kivimäki M, Hakulinen C. Association of social isolation, loneliness and genetic risk with incidence of dementia: UK Biobank Cohort Study. BMJ Open 2022; 12:e053936. [PMID: 35197341 PMCID: PMC8867309 DOI: 10.1136/bmjopen-2021-053936] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Social isolation and loneliness have been associated with increased risk of dementia, but it is not known whether this risk is modified or confounded by genetic risk of dementia. METHODS We used the prospective UK Biobank study with 155 070 participants (mean age 64.1 years), including self-reported social isolation and loneliness. Genetic risk was indicated using the polygenic risk score for Alzheimer's disease and the incident dementia ascertained using electronic health records. RESULTS Overall, 8.6% of participants reported that they were socially isolated and 5.5% were lonely. During a mean follow-up of 8.8 years (1.36 million person years), 1444 (0.9% of the total sample) were diagnosed with dementia. Social isolation, but not loneliness, was associated with increased risk of dementia (HR 1.62, 95% CI 1.38 to 1.90). There were no interaction effects between genetic risk and social isolation or between genetic risk and loneliness predicting incident dementia. Of the participants who were socially isolated and had high genetic risk, 4.4% (95% CI 3.4% to 5.5%) were estimated to developed dementia compared with 2.9% (95% CI 2.6% to 3.2%) of those who were not socially isolated but had high genetic risk. Comparable differences were also in those with intermediate and low genetic risk levels. CONCLUSIONS Socially isolated individuals are at increased risk of dementia at all levels of genetic risk.
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Affiliation(s)
- Marko Elovainio
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Matti Pirinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland
- Helsinki Institute for Information Technology and Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Research Centre of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
| | - Anni Malmberg
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Mika Kivimäki
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Christian Hakulinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Piolatto M, Bianchi F, Rota M, Marengoni A, Akbaritabar A, Squazzoni F. The effect of social relationships on cognitive decline in older adults: an updated systematic review and meta-analysis of longitudinal cohort studies. BMC Public Health 2022; 22:278. [PMID: 35148704 PMCID: PMC8831686 DOI: 10.1186/s12889-022-12567-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/12/2022] [Indexed: 04/11/2023] Open
Abstract
Background A previous meta-analysis (Kuiper et al., 2016) has shown that multiple aspects of social relationships are associated with cognitive decline in older adults. Yet, results indicated possible bias in estimations of statistical effects due to the heterogeneity of study design and measurements. We have updated this meta-analysis adding all relevant publications from 2012 to 2020 and performed a cumulative meta-analysis to map the evolution of this growing field of research (+80% of studies from 2012-2020 compared to the period considered in the previous meta-analysis). Methods Scopus and Web of Science were searched for longitudinal cohort studies examining structural, functional and combined effects of social relationships. We combined Odds Ratios (OR) with 95% confidence intervals (CI) using random effects meta-analysis and assessed sources of heterogeneity and the likelihood of publication bias. The risk of bias was evaluated with the Quality of Prognosis Studies in Systematic Reviews (QUIPS) tool. Results The review was prospectively registered on PROSPERO (ID: CRD42019130667). We identified 34 new articles published in 2012-2020. Poor social relationships were associated with cognitive decline with increasing precision of estimates compared to previously reviewed studies [(for structural, 17 articles, OR: 1.11; 95% CI: 1.08; 1.14) (for functional, 16 articles, OR: 1.12; 95% CI: 1.05; 1.20) (for combined, 5 articles, OR: 1.15; 95% CI: 1.06; 1.24)]. Meta-regression, risk and subgroup analyses showed that the precision of estimations improved in recent studies mostly due to increased sample sizes. Conclusions Our cumulative meta-analysis would confirm that multiple aspects of social relationships are associated with cognitive decline. Yet, there is still evidence of publication bias and relevant information on study design is often missing, which could lead to an over-estimation of their statistical effects. Supplementary Information The online version contains supplementary material available at (10.1186/s12889-022-12567-5).
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Affiliation(s)
- Matteo Piolatto
- Cluster of Excellence, Department of Sociology, University of Konstanz, Universität-Str. 10, Konstanz, Germany
| | - Federico Bianchi
- Department of Social and Political Sciences, University of Milan, Via Conservatorio 7 20122, Milan, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, Brescia, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy
| | - Aliakbar Akbaritabar
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, Rostock, Germany
| | - Flaminio Squazzoni
- Department of Social and Political Sciences, University of Milan, Via Conservatorio 7 20122, Milan, Italy.
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Daley S, Akarsu N, Armsby E, Farina N, Feeney Y, Fine B, Hughes L, Pooley J, Tabet N, Towson G, Banerjee S. What factors have influenced quality of life in people with dementia and their family carers during the COVID-19 pandemic: a qualitative study. BMJ Open 2022; 12:e053563. [PMID: 35144951 PMCID: PMC8845096 DOI: 10.1136/bmjopen-2021-053563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has led to significant disruption to health and social care services. For people with dementia and their family carers this is problematic, as a group who rely on timely and responsive services to live well with the condition. This study has sought to understand how COVID-19 has affected the quality of life of people diagnosed with dementia and their family carers. DESIGN Our mixed-methods study was nested in a larger cohort study of an education programme, Time for Dementia. SETTING The study took place in the South-East of England. PARTICIPANTS Existing study participants, family carers were approached about the COVID-19 nested study. A purposeful sample of participants were invited to take part in in-depth qualitative interview. The sample included family carers in a range of different caring situations. MEASUREMENT Interviews were undertaken remotely by telephone. Interviews sought to understand quality of life before the pandemic, impact of the restrictions on both the person with dementia and family carer, role of services and other agencies as well as supportive factors. Data were analysed using thematic analysis. RESULTS 16 family carers were interviewed. Seven themes were identified from our analysis: (1) decreased social interaction; (2) reduced support; (3) deteriorating cognitive and physical health for the person with dementia; (4) decreased carer well-being; (5) difficulties understanding COVID-19 restrictions; (6) limited impact for some and (7) trust and relationship with care home. There was little change between themes during the first and second wave of national lockdowns. CONCLUSIONS Our study provides an understanding the short-term impact of COVID-19 on the quality of life of people with dementia and their family carers. Our findings suggest that recovery between the first and second wave of the restrictions did not automatically take place.
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Affiliation(s)
- Stephanie Daley
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Nazire Akarsu
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Elise Armsby
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Yvonne Feeney
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Bethany Fine
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Laura Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Joanna Pooley
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Naji Tabet
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | | | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
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Bransby L, Buckley RF, Rosenich E, Franks KH, Yassi N, Maruff P, Pase MP, Lim YY. The relationship between cognitive engagement and better memory in midlife. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12278. [PMID: 35155733 PMCID: PMC8828986 DOI: 10.1002/dad2.12278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Engagement in cognitively stimulating work and activities may slow cognitive decline and dementia. We examined the individual and combined associations of four cognitive engagement indices (educational attainment, occupational complexity, social engagement, and cognitively stimulating leisure activities) with objective and subjective cognition. METHODS Middle-aged adults (n = 1864) enrolled in the Healthy Brain Project completed the Cogstate Brief Battery, the Cognitive Function Instrument, and self-report questionnaires of cognitive engagement. RESULTS Educational attainment and leisure activity engagement were individually associated with memory performance. Participants were classified based on whether they rated highly in zero to four cognitive engagement indices. Compared to participants with no indices, participants with two or more indices performed moderately better on memory. DISCUSSION Results suggest that greater variety of cognitive engagement across different areas of life is related to better memory in midlife. Possible explanation for this relationship may be increased opportunity for enhancing cognitive reserve, but further investigations are required.
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Affiliation(s)
- Lisa Bransby
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Rachel F Buckley
- Melbourne School of Psychological Sciences University of Melbourne Parkville Victoria Australia
- Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Boston Massachusetts USA
| | - Emily Rosenich
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Katherine H Franks
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
- Melbourne School of Psychological Sciences University of Melbourne Parkville Victoria Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
- Population Health and Immunity Division The Walter and Eliza Hall Institute of Medical Research Parkville Victoria Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health Parkville Victoria Australia
- Cogstate Ltd. Melbourne Victoria Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
- Harvard T.H. Chan School of Public Health Boston Massachusetts USA
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
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Can dietary patterns prevent cognitive impairment and reduce Alzheimer's disease risk: exploring the underlying mechanisms of effects. Neurosci Biobehav Rev 2022; 135:104556. [PMID: 35122783 DOI: 10.1016/j.neubiorev.2022.104556] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) is one of the fastest growing cognitive decline-related neurological diseases. To date, effective curative strategies have remained elusive. A growing body of evidence indicates that dietary patterns have significant effects on cognitive function and the risk of developing AD. Previous studies on the association between diet and AD risk have mainly focused on individual food components and specific nutrients, and the mechanisms responsible for the beneficial effects of dietary patterns on AD are not well understood. This article provides a comprehensive overview of the effects of dietary patterns, including the Mediterranean diet (MedDiet), dietary approaches to stop hypertension (DASH) diet, Mediterranean-DASH diet intervention for neurological delay (MIND), ketogenic diet, caloric restriction, intermittent fasting, methionine restriction, and low-protein and high-carbohydrate diet, on cognitive impairment and summarizes the underlying mechanisms by which dietary patterns attenuate cognitive impairment, especially highlighting the modulation of dietary patterns on cognitive impairment through gut microbiota. Furthermore, considering the variability in individual metabolic responses to dietary intake, we put forward a framework to develop personalized dietary patterns for people with cognitive disorders or AD based on individual gut microbiome compositions.
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Giebel C, Hanna K, Cannon J, Marlow P, Tetlow H, Mason S, Shenton J, Rajagopal M, Gabbay M. Are we allowed to visit now? Concerns and issues surrounding vaccination and infection risks in UK care homes during COVID-19. Age Ageing 2022; 51:afab229. [PMID: 34849537 PMCID: PMC8689977 DOI: 10.1093/ageing/afab229] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/29/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits. METHODS family carers of care home residents with dementia and care home staff from across the UK took part in baseline (October/November 2020) and follow-up interviews (March 2021). Public advisers were involved in all elements of the research. Data were analysed using thematic analysis. RESULTS across 62 baseline and follow-up interviews with family carers (n = 26; 11) and care home staff (n = 16; 9), five core themes were developed: delayed and inconsistent offers of face-to-face visits; procedures and facilitation of visits; variable uptake of the COVID-19 vaccine; misinformation, education and free choice; frustration and anger among family carers. The variable uptake in staff, compared to family carers, was a key factor seemingly influencing visitation, with a lack of clear guidance leading care homes to implement infection control measures and visitation rights differently. CONCLUSIONS we make five recommendations in this paper to enable improved care home visitation in the ongoing, and in future, pandemics. Visits need to be enabled and any changes to visiting rights must be used as a last resort, reviewed regularly in consultation with residents and carers and restored as soon as possible as a top priority, whilst more education needs to be provided surrounding vaccination for care home staff.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | - Kerry Hanna
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | | | | | | | - Stephen Mason
- Palliative Care Unit, University of Liverpool, Liverpool, UK
| | | | | | - Mark Gabbay
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
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Bao X, Xu J, Meng Q, Gan J, Wang XD, Wu H, Liu S, Ji Y. Impact of the COVID-19 Pandemic and Lockdown on Anxiety, Depression and Nursing Burden of Caregivers in Alzheimer's Disease, Dementia With Lewy Bodies and Mild Cognitive Impairment in China: A 1-Year Follow-Up Study. Front Psychiatry 2022; 13:921535. [PMID: 35873235 PMCID: PMC9301460 DOI: 10.3389/fpsyt.2022.921535] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many countries have adopted lockdown strategies to prevent the spread of COVID-19. The goal of this study was to investigate the effects of the pandemic on anxiety, depression and care burden in caregivers of nursing patients with Alzheimer's disease (AD), Dementia with Lewy Bodies (DLB) and Mild Cognitive Impairment (MCI), over a one-year period. METHODS We collected data on consecutive patients and their caregivers recruited at T0 (from 30 September to 31 December 2019) before the pandemic of COVID-19 at the memory clinic of Tianjin Huanhu Hospital. The patients and caregivers were followed up on face-to-face at T1 (from 30 September to 31 December 2020) during the pandemic to assess changes in physical activity, social contact, sleep quality, caregiver burden, anxiety and depression. RESULTS A total of 105 AD, 22 DLB and 50 MCI patients and caregivers were enrolled. A total of 36.6 % of the AD, 81.6% of the DLB, 38% of the MCI caregivers had worsening ZBI, whereas 31.7 % of the AD, 54.4% of the DLB, 26 % of the MCI caregivers had worsening GAD-7, and 29.6 % of the AD, 54.4% of the DLB, and 32 % of the MCI caregivers had worsening PHQ-9. DLB caregivers exhibited a rapid deterioration of ZBI (by 4.27 ± 5.43, P < 0.001), GAD-7 (by 2.23 ± 3.26, P = 0.003) and PHQ-9 (by 1.32 ± 2.25, P = 0.003) compared to AD and MCI caregivers. CONCLUSION Social isolation, physical inactivity and sleep disturbance after lockdown for at least 12 months were significantly related to increased caregiver burden and worsened psychological states of caregivers of AD, DLB and MCI sufferers, especially among DLB caregivers.
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Affiliation(s)
- Xinran Bao
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China.,Department of Neurology, First Hospital of Qinhuangdao, Hebei, China
| | - Junying Xu
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.,Department of Neurology, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Qingbo Meng
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Jinghuan Gan
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Dan Wang
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Hao Wu
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Shuai Liu
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Yong Ji
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China.,Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Risk factors, ethnicity and dementia: A UK Biobank prospective cohort study of White, South Asian and Black participants. PLoS One 2022; 17:e0275309. [PMID: 36223334 PMCID: PMC9555673 DOI: 10.1371/journal.pone.0275309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/14/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Our knowledge of the effect of potentially modifiable risks factors on people developing dementia is mostly from European origin populations. We aimed to explore if these risk factors had similar effects in United Kingdom (UK) White, South Asian and Black UK Biobank participants recruited from 2006-2010 and followed up until 2020. METHODS We reviewed the literature to 25.09.2020 for meta-analyses identifying potentially modifiable risk factors preceding dementia diagnosis by ≥10 years. We calculated prevalence of each identified risk factor and association with dementia for participants aged ≥55 at registration in UK Biobank. We calculated hazard ratios using Cox regression for each risk factor, stratified by ethnic group, and tested for differences using interaction effects between each risk factor and ethnicity. FINDINGS We included education, hearing loss, hypertension, obesity, excess alcohol consumption, physical inactivity, smoking, high total cholesterol, depression, diabetes, social isolation, and air pollution as risks. Out of 294,162 participants, there were 287,806 White, 3590 South Asian and 2766 Black people, followed up for up to 14.8 years, with a total follow-up time of 3,392,095 years. During follow-up, 5,972 people (2.03%) developed dementia. Risk of dementia was higher in Black participants than White participants (HR for dementia compared to White participants as reference 1.43, 95% CI 1.16-1.77, p = 0.001) but South Asians had a similar risk. Association between each risk factor and dementia was similar in each ethnic group with no evidence to support any differences. INTERPRETATION We find that Black participants were more likely to develop dementia than White participants, but South Asians were not. Identified risk factors in White European origin participants had a similar effect in Black and South Asian origin participants. Volunteers in UK Biobank are not representative of the population and interaction effects were underpowered so further work is needed.
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Rahman M, Mim SA, Islam R, Parvez A, Islam F, Uddin MB, Rahaman S, Shuvo PA, Ahmed M, Greig NH, Kamal MA. Exploring the Recent Trends in Management of Dementia and Frailty: Focus on Diagnosis and Treatment. Curr Med Chem 2022; 29:5289-5314. [PMID: 35400321 PMCID: PMC10477961 DOI: 10.2174/0929867329666220408102051] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 02/08/2023]
Abstract
Dementia and frailty increase health adversities in older adults, which are topics of growing research interest. Frailty is considered to correspond to a biological syndrome associated with age. Frail patients may ultimately develop multiple dysfunctions across several systems, including stroke, transient ischemic attack, vascular dementia, Parkinson's disease, Alzheimer's disease, frontotemporal dementia, dementia with Lewy bodies, cortico-basal degeneration, multiple system atrophy, amyotrophic lateral sclerosis, and Creutzfeldt-Jakob disease. Patients with dementia and frailty often develop malnutrition and weight loss. Rigorous nutritional, pharmacological, and non-pharmacological interventions generally are required for these patients, which is a challenging issue for healthcare providers. A healthy diet and lifestyle instigated at an early age can reduce the risk of frailty and dementia. For optimal treatment, accurate diagnosis involving clinical evaluation, cognitive screening, essential laboratory evaluation, structural imaging, functional neuroimaging, and neuropsychological testing is necessary. Diagnosis procedures best apply the clinical diagnosis, identifying the cause(s) and the condition(s) appropriate for treatment. The patient's history, caregiver's interview, physical examination, cognitive evaluation, laboratory tests, and structural imaging should best be involved in the diagnostic process. Varying types of physical exercise can aid the treatment of these disorders. Nutrition maintenance is a particularly significant factor, such as exceptionally high-calorie dietary supplements and a Mediterranean diet to support weight gain. The core purpose of this article is to investigate trends in the management of dementia and frailty, focusing on improving diagnosis and treatment. Substantial evidence builds the consensus that a combination of balanced nutrition and good physical activity is an integral part of treatment. Notably, more evidence-based medicine knowledge is required.
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Affiliation(s)
- Mominur Rahman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Sadia Afsana Mim
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Rezaul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Anwar Parvez
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Fahadul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Mohammad Borhan Uddin
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Saidur Rahaman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Pollob Ahmed Shuvo
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Muniruddin Ahmed
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
| | - Nigel H. Greig
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Mohammad Amjad Kamal
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka-1207, Bangladesh
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- King Fahd Medical Research Center, King Abdulaziz University, Saudi Arabia
- Enzymoics, NSW; Novel Global Community Educational Foundation, Peterlee Place, Hebersham, NSW 2770, Australia
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Giebel C, Ivan B, Ddumba I. COVID-19 Public Health Restrictions and Older Adults' Well-being in Uganda: Psychological Impacts and Coping Mechanisms. Clin Gerontol 2022; 45:97-105. [PMID: 33843497 DOI: 10.1080/07317115.2021.1910394] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Older adults across the globe have been particularly affected by the novel coronavirus due to their increased susceptibility to the virus. With limited existing research, the aim of this study was to explore the psychological effects of COVID-19 public health measures on older adults in Uganda and their coping mechanisms. METHODS Thirty semi-structured interviews were conducted with older Ugandans (aged 60+) in June 2020. Participants were asked about their experiences of public health measures, and their effects on the lives of older adults compared to pre-pandemic. RESULTS Three themes were identified: Impact on emotional well-being; Implications on physical well-being; and Coping mechanisms. Older adults experienced both psychological and physical effects, including upset, fear, and frustration about restrictions and the virus, as well as early signs of increased frailty, thus causing concerns for the long-term emotional and physical health of older Ugandans. CONCLUSIONS Public health measures need to be considerate of the potential long-term implications on the well-being of older adults in low-, middle-, and high-income countries, and ensure the possibility for continued physical exercise and social connection. This can be particularly challenging for people from more disadvantaged backgrounds who may not be able to afford a smartphone or laptop, with older adults further requiring support in using digital technologies. CLINICAL IMPLICATIONS Older adults need to receive adequate psychological support to cope with the mental health impacts of the pandemic.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | - Bwire Ivan
- African Research Centre for Ageing and Dementia (ARCAD), Mukono, Uganda
| | - Isaac Ddumba
- African Research Centre for Ageing and Dementia (ARCAD), Mukono, Uganda
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Araghi M, Shipley MJ, Anand A, Mills NL, Kivimaki M, Singh-Manoux A, Tabák A, Sabia S, Brunner EJ. Serum transthyretin and risk of cognitive decline and dementia: 22-year longitudinal study. Neurol Sci 2021; 42:5093-5100. [PMID: 33770310 PMCID: PMC9136660 DOI: 10.1007/s10072-021-05191-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/15/2021] [Indexed: 12/17/2022]
Abstract
Serum transthyretin (TTR) may be an early biomarker for Alzheimer's disease and related disorders (ADRD). We investigated associations of TTR measured at baseline with cognitive decline and incident ADRD and whether TTR trajectories differ between ADRD cases and non-cases, over 22 years before diagnosis. A total of 6024 adults aged 45-69 in 1997-1999 were followed up until 2019. TTR was assessed three times, and 297 cases of dementia were recorded. Higher TTR was associated with higher cognitive function at baseline; however, TTR was unrelated to subsequent change in cognitive function. TTR at baseline did not predict ADRD risk (hazard ratio per SD TTR (4.8 mg/dL) = 0.97; 95% confidence interval: 0.94-1.00). Among those later diagnosed with ADRD, there was a marginally steeper downward TTR trajectory than those free of ADRD over follow-up (P=0.050). Our findings suggest TTR is not neuroprotective. The relative decline in TTR level in the preclinical stage of ADRD is likely to be a consequence of disease processes.
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Affiliation(s)
- Marzieh Araghi
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Martin J Shipley
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Atul Anand
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Nicholas L Mills
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Adam Tabák
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Budapest, Hungary
- Department of Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Séverine Sabia
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Eric J Brunner
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Zhao YL, Qu Y, Ou YN, Zhang YR, Tan L, Yu JT. Environmental factors and risks of cognitive impairment and dementia: A systematic review and meta-analysis. Ageing Res Rev 2021; 72:101504. [PMID: 34755643 DOI: 10.1016/j.arr.2021.101504] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dementia is a challenging neurodegenerative disease. This systematic review aimed to summarize natural, physical, and social environmental factors that are associated with age-related cognitive impairment and dementia. METHODS We systematically searched PubMed, EMBASE, Web of Science, and PsychINFO till January 11, 2021 for observational studies. The hazard ratio (HR), relative risk (RR), and odds ratio (OR) with 95% confidence interval (CI) were aggregated using random-effects methods. The quality of evidence for each association was evaluated. RESULTS Of the 48,399 publications identified, there were 185 suitable for review across 44 environmental factors. Meta-analyses were performed for 22 factors. With high-to-moderate quality of evidence, risks were suggested in exposure to PM2.5 (HR=1.24, 95%CI: 1.17-1.31), NO2 (HR=1.07, 95%CI: 1.02-1.12), aluminum (OR=1.35, 95%CI: 1.14-1.59), solvents (OR=1.14, 95%CI: 1.07-1.22), road proximity (OR=1.08, 95%CI: 1.04-1.12) and other air pollutions, yet more frequent social contact (HR=0.82, 95%CI: 0.76-0.90) and more greenness (OR=0.97, 95%CI: 0.95-0.995) were protective. With low-to-very low quality, electromagnetic fields, pesticides, SO2, neighborhood socioeconomic status, and rural living were suggested risks, but more community cultural engagement might be protective. No significant associations were observed in exposure to PM10, NOx, noise, silicon, community group, and temperature. For the remaining 22 factors, only a descriptive analysis was undertaken as too few studies or lack of information. CONCLUSIONS This review highlights that air pollutions, especially PM2.5 and NO2 play important role in the risk for age-related cognitive impairment and dementia.
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Siervo M, Shannon OM, Llewellyn DJ, Stephan BC, Fontana L. Mediterranean diet and cognitive function: From methodology to mechanisms of action. Free Radic Biol Med 2021; 176:105-117. [PMID: 34562607 DOI: 10.1016/j.freeradbiomed.2021.09.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
The traditional Mediterranean diet (MedDiet), rich in minimally processed plant foods and fish, has been widely recognized to be one of the healthiest diets. Data from multiple randomized clinical trials have demonstrated its powerful effect against oxidative stress, inflammation and the development and progression of cardiovascular disease, type 2 diabetes, and other metabolic conditions that play a crucial role in the pathogenesis of neurodegenerative diseases. The protecting effects of the MedDiet against cognitive decline have been investigated in several observational and experimental studies. Data from observational studies suggest that the MedDiet may represent an effective dietary strategy for the early prevention of dementia, although these findings require further substantiation in clinical trials which have so far produced inconclusive results. Moreover, as we discuss in this review, accumulating data emphasizes the importance of: 1) maintaining an optimal nutritional and metabolic status for the promotion of healthy cognitive aging, and 2) implementing cognition-sparing dietary and lifestyle interventions during early time-sensitive windows before the pathological cascades turn into an irreversible state. In summary, components of the MedDiet pattern, such as essential fatty acids, polyphenols and vitamins, have been associated with reduced oxidative stress and the current evidence from observational studies seems to assign to the MedDiet a beneficial role in promoting brain health; however, results from clinical trials have been inconsistent. While we advocate for longitudinal analyses and for larger and longer clinical trials to be conducted, we assert our interim support to the use of the MedDiet as a protective dietary intervention for cognitive function based on its proven cardiovascular and metabolic benefits.
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Affiliation(s)
- Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK.
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - David J Llewellyn
- University of Exeter Medical School, Exeter, UK; Alan Turing Institute, London, UK
| | - Blossom Cm Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
| | - Luigi Fontana
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Department of Clinical and Experimental Sciences, Brescia University School of Medicine, Brescia, Italy
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70
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Giebel C, Morley N, Komuravelli A. A socially prescribed community service for people living with dementia and family carers and its long-term effects on well-being. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1852-1857. [PMID: 33528081 DOI: 10.1111/hsc.13297] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/14/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Support services for people with dementia are variable depending on the area or town they live. People with dementia and family carers can often get very little support after a diagnosis. Services might not be suitable or they may not be aware of the service in the first place. The aim of this study was to evaluate a socially prescribed community service provided to people with dementia and family carers offering physical and mental activities. People with dementia and family carers were recruited from a community centre in the North West of England to complete in this study. Participants provided demographic information and completed the Short Warwick-Edinburgh Mental Well-Being Scale at baseline, and after 3 and 6 months. Postcode data were used to generate an Index of Multiple Deprivation score for information on participants' socioeconomic background. Data were analysed using paired samples t-tests to compare well-being scores between baseline and follow-up assessments. A total of 25 people with dementia (n = 14) and family carers (n = 11) participated in the service. Visits ranged from 1 to 36, with 22 and 15 participants completing the 3- and 6-month follow-up respectively. Some reasons for discontinuation were lack of transport and other commitments. Most participants lived in some of the most disadvantaged neighbourhoods. Compared to baseline, well-being was significantly higher at both follow-ups. This is one of the first studies reporting the benefits of a social prescribing service in dementia. Future implementation work needs to design an implementation plan so that the service can be implemented in other community centres across the country.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | | | - Aravind Komuravelli
- NIHR ARC NWC, Liverpool, UK
- North West Boroughs NHS Foundation Trust, Warrington, UK
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71
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Frailty and dementia: what can the body tell us about the brain? Int Psychogeriatr 2021; 33:1001-1003. [PMID: 34078500 DOI: 10.1017/s1041610220004160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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72
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Shea TB. Improvement of cognitive performance by a nutraceutical formulation: Underlying mechanisms revealed by laboratory studies. Free Radic Biol Med 2021; 174:281-304. [PMID: 34352370 DOI: 10.1016/j.freeradbiomed.2021.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/28/2022]
Abstract
Cognitive decline, decrease in neuronal function and neuronal loss that accompany normal aging and dementia are the result of multiple mechanisms, many of which involve oxidative stress. Herein, we review these various mechanisms and identify pharmacological and non-pharmacological approaches, including modification of diet, that may reduce the risk and progression of cognitive decline. The optimal degree of neuronal protection is derived by combinations of, rather than individual, compounds. Compounds that provide antioxidant protection are particularly effective at delaying or improving cognitive performance in the early stages of Mild Cognitive Impairment and Alzheimer's disease. Laboratory studies confirm alleviation of oxidative damage in brain tissue. Lifestyle modifications show a degree of efficacy and may augment pharmacological approaches. Unfortunately, oxidative damage and resultant accumulation of biomarkers of neuronal damage can precede cognitive decline by years to decades. This underscores the importance of optimization of dietary enrichment, antioxidant supplementation and other lifestyle modifications during aging even for individuals who are cognitively intact.
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Affiliation(s)
- Thomas B Shea
- Laboratory for Neuroscience, Department of Biological Sciences, University of Massachusetts Lowell, Lowell, MA, 01854, USA.
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73
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Perry BL, McConnell WR, Coleman ME, Roth AR, Peng S, Apostolova LG. Why the cognitive "fountain of youth" may be upstream: Pathways to dementia risk and resilience through social connectedness. Alzheimers Dement 2021; 18:934-941. [PMID: 34482619 PMCID: PMC8897512 DOI: 10.1002/alz.12443] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 12/21/2022]
Abstract
Research suggests social connectedness may help older adults with dementia maintain cognitive functionality and quality of life. However, little is known about its specific social and biological mechanisms. This paper proposes two pathways through social bridging (i.e., cognitive enrichment through expansive social networks) and bonding (i.e., neuroendocrine benefits of integration in cohesive social networks). We provide preliminary evidence for these pathways using neuroimaging, cognitive, and egocentric social network data from the Social Networks and Alzheimer's Disease (SNAD) study (N = 280). We found that network size, density, and presence of weak ties (i.e., social bridging) moderated the association between brain atrophy and cognitive function, while marriage/cohabitation (i.e., social bonding) moderated the association between perceived stress and cognitive function. We argue that social connectedness may have downstream implications for multiple pathophysiological processes in cognitive aging, even negating existing structural damage to the brain, making it a strong candidate for clinical or policy intervention.
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Affiliation(s)
- Brea L Perry
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Will R McConnell
- Department of Sociology, Florida Atlantic University, Boca Raton, Florida, USA
| | - Max E Coleman
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Adam R Roth
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Siyun Peng
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Liana G Apostolova
- Departments of Neurology, Radiology and Medical and Molecular Genetics, Indiana University School of Medicine, IU Health Neuroscience Center, Indianapolis, Indiana, USA
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Janoutová J, Kovalová M, Machaczka O, Ambroz P, Zatloukalová A, Němček K, Janout V. Risk Factors for Alzheimer's Disease: An Epidemiological Study. Curr Alzheimer Res 2021; 18:372-379. [PMID: 34420505 DOI: 10.2174/1567205018666210820124135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/04/2021] [Accepted: 06/15/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Dementia becomes a major public health challenge in both the Czech Republic and worldwide. The most common form of dementia is Alzheimer's disease (AD). OBJECTIVE We conducted two successive epidemiological projects in 2012-2015 and 2016-2019. Their aim was to study the effect of selected potential genetic, vascular and psychosocial risk factors on the development of AD by comparing their frequencies in AD patients and controls. METHODS Epidemiological case-control studies were conducted. In total, data from 2106 participants (1096 cases, 1010 controls) were analyzed. RESULTS Three times more females than males suffered from AD. The highest proportion of cases were those with primary education, unlike controls. There were statistically significantly more manual workers among cases than among controls. Of selected vascular risk factors, coronary heart disease was found to be statistically significantly more frequent in cases than in controls. The onset of hypertension and diabetes mellitus was earlier in controls than in cases. As for hobbies and interests, there were statistically significant differences in physical activity, reading and solving crosswords between the groups, with these activities being more common in controls. CONCLUSION The prevalence of chronic neurodegenerative diseases, in particular AD, is currently increasing. Given the aging of the population, these conditions may be expected to rise in prevalence. Potential risk of AD needs to be studied, analyzed and confirmed; a detailed knowledge of the risks of AD and early detection of the pathology may therefore be very beneficial for prevention and early treatment of this condition.
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Affiliation(s)
- Jana Janoutová
- Department Of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Martina Kovalová
- Department Of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Ondřej Machaczka
- Department Of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Petr Ambroz
- Department Of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Anna Zatloukalová
- Department Of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Kateřina Němček
- Department Of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Vladimír Janout
- Department Of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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75
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Perry BL, McConnell WR, Peng S, Roth A, Coleman M, Manchella M, Roessler M, Francis H, Sheean H, Apostolova L. Social Networks and Cognitive Function: An Evaluation of Social Bridging and Bonding Mechanisms. THE GERONTOLOGIST 2021; 62:865-875. [PMID: 34338287 PMCID: PMC9290895 DOI: 10.1093/geront/gnab112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Social connectedness has been linked prospectively to cognitive aging, but there is little agreement about the social mechanisms driving this relationship. This study evaluated nine measures of social connectedness, focusing on two forms of social enrichment - access to an expansive and diverse set of loosely connected individuals (i.e., social bridging) and integration in a supportive network of close ties (i.e., social bonding). RESEARCH DESIGN AND METHODS This study used egocentric network and cognitive data from 311 older adults in the Social Networks in Alzheimer Disease (SNAD) study. Linear regressions were used to estimate the association between social connectedness and global cognitive function, episodic memory, and executive function. RESULTS Measures indicative of social bridging (larger network size, lower density, presence of weak ties, and proportion non-kin) were consistently associated with better cognitive outcomes, while measures of social bonding (close ties, multiplex support, higher frequency of contact, better relationship quality, and being married) largely produced null effects. DISCUSSION AND IMPLICATIONS These findings suggest that the protective benefits of social connectedness for cognitive function and memory may operate primarily through a cognitive reserve mechanism that is driven by irregular contact with a larger and more diverse group of peripheral others.
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Affiliation(s)
- Brea L Perry
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - William R McConnell
- Department of Sociology, Florida Atlantic University, Boca Raton, Florida, USA
| | - Siyun Peng
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Adam Roth
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Max Coleman
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Mohit Manchella
- Department of Biology, University of Southern Indiana, Evansville, Indiana, USA
| | | | - Heather Francis
- Kinsey Institute, Indiana University, Bloomington, Indiana, USA
| | - Hope Sheean
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Liana Apostolova
- Radiology and Imaging Sciences, Indiana University, Indianapolis, Indiana, USA
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Peterson RL, George KM, Tran D, Malladi P, Gilsanz P, Kind AJH, Whitmer RA, Besser LM, Meyer OL. Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7166. [PMID: 34281103 PMCID: PMC8296955 DOI: 10.3390/ijerph18137166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia. METHODS A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels. RESULTS Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level. CONCLUSIONS Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.
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Affiliation(s)
- Rachel L. Peterson
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Kristen M. George
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Duyen Tran
- Department of Psychology, University of California Davis, Davis, CA 95616, USA;
| | - Pallavi Malladi
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA 95616, USA;
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Amy J. H. Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
- Health Services and Care Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Geriatrics Research Education and Clinical Center, Department of Veterans Affairs, Madison, WI 53726, USA
| | - Rachel A. Whitmer
- Public Health Sciences, Division of Epidemiology, University of California Davis, Davis, CA 95616, USA;
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
| | - Lilah M. Besser
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Oanh L. Meyer
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
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Giebel C, Rodgers S, Barr B, Collins B, Akpan A, Shenton J, Fuller E, Gabbay M. Does Social Support Affect Older Adults' General Practitioner Attendance Rates? Findings from the North West Coast Household Health Survey. Clin Gerontol 2021; 44:381-391. [PMID: 32594861 DOI: 10.1080/07317115.2020.1783044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to explore whether social support and socio-economic status have an effect on primary care attendance in older adults (aged 65+). METHODS This study used data from the longitudinal North West Coast (NWC) Household Health Survey (HHS) from across 20 disadvantaged and 8 less disadvantaged neighborhoods. Data included the EQ-5D, social support, frailty-related measures, healthcare utilization, and the Index of Multiple Deprivation (IMD). Principal component analysis was used to derive a factor for social support. Poisson regression analysis was employed to explore the effects of frailty, social support, General Practitioner (GP) distance, education, IMD, living situation, and depression on the number of GP attendances in the past 12 months. RESULTS 1,685 older adults were included in this analysis. Of those older adults who visited their GP (87.4%), most had visited their GP twice in the past 12 months. Having an educational qualification, higher levels of social support, and being physically fit reduced GP utilization. Being moderately frail, depressed, and living further away from the nearest GP increased attendance. Older adults living in the most disadvantaged neighborhoods were more likely to visit their GP. CONCLUSIONS Increasing social support impacts to a small, but important, extent on reducing GP attendance in older adults. Future research needs to explore whether improving social support in old age can reduce GP utilization. CLINICAL IMPLICATIONS Findings suggest a need for improving social prescribing in older adults to reduce some GP visits which could be avoided and might not be necessary.
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Affiliation(s)
- Clarissa Giebel
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | - Sarah Rodgers
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | - Ben Barr
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | - Brendan Collins
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Asan Akpan
- Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.,Aintree University Hospital, Liverpool, UK.,NIHR CRN NWC, Liverpool, UK
| | | | | | - Mark Gabbay
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
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Quigley TP, Amdam GV. Social modulation of ageing: mechanisms, ecology, evolution. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190738. [PMID: 33678020 DOI: 10.1098/rstb.2019.0738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Human life expectancy increases, but the disease-free part of lifespan (healthspan) and the quality of life in old people may not show the same development. The situation poses considerable challenges to healthcare systems and economies, and calls for new strategies to increase healthspan and for sustainable future approaches to elder care. This call has motivated innovative research on the role of social relationships during ageing. Correlative data from clinical surveys indicate that social contact promotes healthy ageing, and it is time to reveal the causal mechanisms through experimental research. The fruit fly Drosophila melanogaster is a prolific model animal, but insects with more developed social behaviour can be equally instrumental for this research. Here, we discuss the role of social contact in ageing, and identify lines of study where diverse insect models can help uncover the mechanisms that are involved. This article is part of the theme issue 'Ageing and sociality: why, when and how does sociality change ageing patterns?'
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Affiliation(s)
- Tyler P Quigley
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA
| | - Gro V Amdam
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA.,Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, PO Box 5002, N-1432 Aas, Norway
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79
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Rafnsson SB, Maharani A, Tampubolon G. Social Contact Mode and 15-Year Episodic Memory Trajectories in Older Adults With and Without Hearing Loss: Findings from the English Longitudinal Study of Ageing. J Gerontol B Psychol Sci Soc Sci 2021; 77:10-17. [PMID: 33606882 DOI: 10.1093/geronb/gbab029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Frequent social contact benefits cognition in later life although evidence is lacking on the potential relevance of the modes chosen by older adults, including those living with hearing loss, for interacting with others in their social network. METHOD 11,418 participants in the English Longitudinal Study of Ageing provided baseline information on hearing status and social contact mode and frequency of use. Multilevel growth curve models compared episodic memory (immediate and delayed recall) at baseline and longitudinally in participants who interacted frequently (offline only or offline and online combined), compared to infrequently, with others in their social network. RESULTS Frequent offline (B=0.23; SE=0.09) and combined offline and online (B=0.71; SE=0.09) social interactions predicted better episodic memory after adjustment for multiple confounders. We observed positive, longitudinal associations between combined offline and online interactions and episodic memory in participants without hearing loss (B=0.50, SE=0.11) but not with strictly offline interactions (B=0.01, SE=0.11). In those with hearing loss, episodic memory was positively related to both modes of engagement (offline only: B=0.79, SE=0.20; combined online and offline: B=1.27, SE=0.20). Sensitivity analyses confirmed the robustness of these findings. DISCUSSION Supplementing conventional social interactions with online communication modes may help older adults, especially those living with hearing loss, sustain, and benefit cognitively from, personal relationships.
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Affiliation(s)
- Snorri Bjorn Rafnsson
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, United Kingdom
| | - Asri Maharani
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom
| | - Gindo Tampubolon
- Global Development Institute and Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, United Kingdom
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Health Inequities in the Care Pathways for People Living with Young- and Late-Onset Dementia: From Pre-COVID-19 to Early Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020686. [PMID: 33466948 PMCID: PMC7831042 DOI: 10.3390/ijerph18020686] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 11/16/2022]
Abstract
Background: Little is known about how people with dementia and/or their family carers access health and social care services after a diagnosis. The aim of this study was to explore potential inequalities in care pathways for people with young-onset and late on-set dementia (YOD/LOD), including their family carers, with coronavirus disease 2019 (COVID-19) occurring throughout the course of the study and enabling a comparison between pre-pandemic and COVID-19 times. Methods: People with YOD and LOD with their family carers were recruited via local support groups in the North West Coast region of England. Semi-structured interviews explored the experiences of people with YOD and LOD and family carers on their access to both health and social care services and community-based services. Transcripts were coded by two researchers and analysed using thematic analysis. Fifteen interviews were conducted with seven people with YOD or LOD and 14 family carers between January and March 2020. Some interviews were conducted only with the person with dementia, because they did not have a family carer, and others were conducted only with the family carer, because the person with dementia was in the severe stages of the condition. Results: Four themes emerged from the interviews: (1) Getting the ball rolling: the process of diagnosis; (2) Balancing the support needs of people with dementia and carers; (3) Barriers to accessing support; and (4) Facilitators to accessing support. Inequities existed for both YOD and LOD, with emerging evidence of unequal experiences in accessing care at the beginning of the COVID-19 pandemic. Discussion: People with YOD and LOD and their carers require better support in accessing services after a diagnosis. Greater understanding of the pathways through which inequalities materialise are needed, especially those that might have been disrupted or exacerbated by the COVID-19 pandemic.
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Sommerlad A, Marston L, Huntley J, Livingston G, Lewis G, Steptoe A, Fancourt D. Social relationships and depression during the COVID-19 lockdown: longitudinal analysis of the COVID-19 Social Study. Psychol Med 2021; 52:1-10. [PMID: 33436126 PMCID: PMC7844174 DOI: 10.1017/s0033291721000039] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic led to measures that reduced social contact and support. We explored whether UK residents with more frequent or supportive social contact had fewer depressive symptoms during March-August 2020, and potential factors moderating the relationship. METHODS A convenience sample of UK dwelling participants aged ⩾18 in the internet-based longitudinal COVID-19 Social Study completed up to 22 weekly questionnaires about face-to-face and phone/video social contact frequency, perceived social support, and depressive symptoms using the PHQ-9. Mixed linear models examined associations between social contact and support, and depressive symptoms. We examined for interaction by empathic concern, perspective taking and pre-COVID social contact frequency. RESULTS In 71 117 people with mean age 49 years (standard deviation 15), those with high perceived social support scored 1.836 (1.801-1.871) points lower on PHQ-9 than those with low support. Daily face-to-face or phone/video contact was associated with lower depressive symptoms (0.258 (95% confidence interval 0.225-0.290) and 0.117 (0.080-0.154), respectively) compared to no contact. The negative association between social relationships and depressive symptoms was stronger for those with high empathic concern, perspective taking and usual sociability. CONCLUSIONS We found during lockdown that those with higher quality or more face-to-face or phone/video contact had fewer depressive symptoms. Contact quality was more strongly associated than quantity. People who were usually more sociable or had higher empathy had more depressive symptoms during enforced reduced contact. The results have implications for COVID-19 and potential future pandemic management, and for understanding the relationship between social factors and mental health.
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Affiliation(s)
- Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Louise Marston
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Gemma Lewis
- Division of Psychiatry, University College London, London, UK
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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82
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Chen ZC, Liu S, Gan J, Ma L, Du X, Zhu H, Han J, Xu J, Wu H, Fei M, Dou Y, Yang Y, Deng P, Wang XD, Ji Y. The Impact of the COVID-19 Pandemic and Lockdown on Mild Cognitive Impairment, Alzheimer's Disease and Dementia With Lewy Bodies in China: A 1-Year Follow-Up Study. Front Psychiatry 2021; 12:711658. [PMID: 34393864 PMCID: PMC8355429 DOI: 10.3389/fpsyt.2021.711658] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/07/2021] [Indexed: 01/19/2023] Open
Abstract
Background: While the lockdown strategies taken by many countries effectively limited the spread of COVID-19, those were thought to have a negative impact on older people. This study aimed to investigate the impact of lockdown on cognitive function and neuropsychiatric symptoms over a 1-year follow-up period in patients with mild cognitive impairment (MCI), Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Methods: We enrolled consecutive patients with MCI, probable AD or DLB who were receiving outpatient memory care before the COVID-19 pandemic and followed-up with them after 1 year by face-to-face during the COVID-19 pandemic to assess changes in physical activity, social contact, cognitive function and neuropsychiatric symptoms (NPS). Results: Total 105 probable AD, 50 MCI and 22 probable DLB patients were included and completed the 1-year follow-up between October 31 and November 30, 2020. Among the respondents, 42% of MCI, 54.3% of AD and 72.7% of DLB patients had a decline in MMSE scores and 54.4% of DLB patients had worsening Neuropsychiatric inventory (NPI) scores. Patients with DLB showed a more rapid decline of MMSE than those with AD. Diminished physical activity and social contact might have hastened the deterioration of cognition and the worsening of NPS. Conclusion: Social isolation and physical inactivity even after strict lockdown for at least 6 months were correlated with accelerated decline of cognitive function and NPS in patients with AD and DLB.
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Affiliation(s)
- Zhi-Chao Chen
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Liu
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Jinghuan Gan
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lingyun Ma
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoshan Du
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Han Zhu
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Jiuyan Han
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Junying Xu
- Department of Neurology, Tianjin Baodi People's Hospital, Tianjin, China
| | - Hao Wu
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Min Fei
- Department of Neurology, Yuncheng Central Hospital, Shanxi, China
| | - Yuchao Dou
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Yaqi Yang
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Peng Deng
- Tianjin Umbilical Cord Blood Hematopoietic Stem Cell Bank, Tianjin, China
| | - Xiao-Dan Wang
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Yong Ji
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
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83
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Minihane AM. Nutrition and brain health. NUTR BULL 2020. [DOI: 10.1111/nbu.12477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anne Marie Minihane
- Nutrition and Preventive Medicine Norwich Medical School BCRE University of East Anglia (UEA) Norwich UK
- Norwich Institute of Healthy Ageing Norwich UK
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84
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Mayeda ER, Mobley TM, Weiss RE, Murchland AR, Berkman LF, Sabbath EL. Association of work-family experience with mid- and late-life memory decline in US women. Neurology 2020; 95:e3072-e3080. [PMID: 33148811 PMCID: PMC7734924 DOI: 10.1212/wnl.0000000000010989] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/03/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the hypothesis that life course patterns of employment, marriage, and childrearing influence later-life rate of memory decline among women, we examined the relationship of work-family experiences between ages 16 and 50 years and memory decline after age 55 years among US women. METHODS Participants were women ages ≥55 years in the Health and Retirement Study. Participants reported employment, marital, and parenthood statuses between ages 16 and 50 years. Sequence analysis was used to group women with similar work-family life histories; we identified 5 profiles characterized by similar timing and transitions of combined work, marital, and parenthood statuses. Memory performance was assessed biennially from 1995 to 2016. We estimated associations between work-family profiles and later-life memory decline with linear mixed-effects models adjusted for practice effects, baseline age, race/ethnicity, birth region, childhood socioeconomic status, and educational attainment. RESULTS There were 6,189 study participants (n = 488 working nonmothers, n = 4,326 working married mothers, n = 530 working single mothers, n = 319 nonworking single mothers, n = 526 nonworking married mothers). Mean baseline age was 57.2 years; average follow-up was 12.3 years. Between ages 55 and 60, memory scores were similar across work-family profiles. After age 60, average rate of memory decline was more than 50% greater among women whose work-family profiles did not include working for pay after childbearing, compared with those who were working mothers. CONCLUSIONS Women who worked for pay in early adulthood and midlife experienced slower rates of later-life memory decline, regardless of marital and parenthood status, suggesting participation in the paid labor force may protect against later-life memory decline.
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Affiliation(s)
- Elizabeth Rose Mayeda
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA.
| | - Taylor M Mobley
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Robert E Weiss
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Audrey R Murchland
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Lisa F Berkman
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Erika L Sabbath
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
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Shadarevian J, Chan C, Berndt A, Son C, Gregorio M, Horne N, Mann J, Wallsworth C, Chow B, O'Neill R, Hung L. Creating a toolkit with stakeholders for leveraging tablet computers to support person-centred dementia care in hospitals. J Rehabil Assist Technol Eng 2020; 7:2055668320960385. [PMID: 33282336 PMCID: PMC7691942 DOI: 10.1177/2055668320960385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/01/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction People with dementia may refuse care because they feel overwhelmed by an
unfamiliar environment. Everyday technology such as tablets have the
potential to support person-centred dementia care in hospitals. Aims We aimed to identify barriers and enabling factors in order to develop a
toolkit to support the use of tablets in engaging individual and group
activities, especially to play family videos, for hospitalized older people
with dementia. Methods A participatory action research approach was employed. We facilitated staff
focus groups and conducted interviews with stakeholders. A toolkit was
developed based on participants’ perspectives on how to support successful
adoption. Results Our analysis identified two enabling factors: users’ engagement in developing
a toolkit for support and adapting implementation to meet local needs.
Barriers included staff and family inexperience, mechanical instability of
hardware, issues around privacy and data access, technology use and
personalization of messages. The toolkit includes short videos, a brochure
for family caregivers, and a pocket card for staff. Discussion and implications: Staff, family and patients start
with varying levels of experience with the use of tablets, making education
and support vitally important to implementation. Health organizations should
involve staff, patients, and families to find practical solutions.
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Affiliation(s)
- John Shadarevian
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Cheryl Chan
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Annette Berndt
- Community Engagement Advisory Network, Vancouver, BC, Canada
| | - Cathy Son
- School of Nursing, Trinity Western University, Langley, BC, Canada
| | - Mario Gregorio
- Community Engagement Advisory Network, Vancouver, BC, Canada
| | - Neil Horne
- Community Engagement Advisory Network, Vancouver, BC, Canada
| | - Jim Mann
- Community Engagement Advisory Network, Vancouver, BC, Canada
| | | | - Bryan Chow
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Ryan O'Neill
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Lillian Hung
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
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86
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Sommerlad A, Sabia S, Livingston G, Kivimäki M, Lewis G, Singh-Manoux A. Leisure activity participation and risk of dementia: An 18-year follow-up of the Whitehall II Study. Neurology 2020; 95:e2803-e2815. [PMID: 33115773 PMCID: PMC7734721 DOI: 10.1212/wnl.0000000000010966] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/22/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To test the hypothesis that leisure activity participation is associated with lower dementia risk, we examined the association between participation in leisure activities and incident dementia in a large longitudinal study with average 18-year follow-up. METHODS We used data from 8,280 participants of the Whitehall II prospective cohort study. A 13-item scale assessed leisure activity participation in 1997-1999, 2002-2004, and 2007-2009, and incidence of dementia (n cases = 360, mean age at diagnosis 76.2 years, incidence rate 2.4 per 1,000 person-years) was ascertained from 3 comprehensive national registers with follow-up until March 2017. Primary analyses were based on complete cases (n = 6,050, n cases = 247) and sensitivity analyses used multiple imputation for missing data. RESULTS Participation in leisure activities at mean age 55.8 (1997-1999 assessment), with 18.0-year follow-up, was not associated with dementia (hazard ratio [HR] 0.92 [95% confidence interval 0.79-1.06]), but those with higher participation at mean age 65.7 (2007-2009 assessment) were less likely to develop dementia with 8.3-year follow-up (HR 0.82 [0.69-0.98]). No specific type of leisure activity was consistently associated with dementia risk. Decline in participation between 1997-1999 and 2007-2009 was associated with subsequent dementia risk. CONCLUSION Our findings suggest that participation in leisure activities declines in the preclinical phase of dementia; there was no robust evidence for a protective association between leisure activity participation and dementia. Future research should investigate the sociobehavioral, cognitive, and neurobiological drivers of decline in leisure activity participation to determine potential approaches to improving social participation of those developing dementia.
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Affiliation(s)
- Andrew Sommerlad
- From the Division of Psychiatry (A.S., G. Livingston, G. Lewis) and Department of Epidemiology and Public Health (S.S., M.K., A.-S.M.), University College London; Camden and Islington NHS Foundation Trust (A.S., G. Livingston, G. Lewis), London, UK; Université de Paris (S.S., A.-S.M.), Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France; and Clinicum and Helsinki Institute of Life Science (M.K.), University of Helsinki, Finland.
| | - Séverine Sabia
- From the Division of Psychiatry (A.S., G. Livingston, G. Lewis) and Department of Epidemiology and Public Health (S.S., M.K., A.-S.M.), University College London; Camden and Islington NHS Foundation Trust (A.S., G. Livingston, G. Lewis), London, UK; Université de Paris (S.S., A.-S.M.), Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France; and Clinicum and Helsinki Institute of Life Science (M.K.), University of Helsinki, Finland
| | - Gill Livingston
- From the Division of Psychiatry (A.S., G. Livingston, G. Lewis) and Department of Epidemiology and Public Health (S.S., M.K., A.-S.M.), University College London; Camden and Islington NHS Foundation Trust (A.S., G. Livingston, G. Lewis), London, UK; Université de Paris (S.S., A.-S.M.), Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France; and Clinicum and Helsinki Institute of Life Science (M.K.), University of Helsinki, Finland
| | - Mika Kivimäki
- From the Division of Psychiatry (A.S., G. Livingston, G. Lewis) and Department of Epidemiology and Public Health (S.S., M.K., A.-S.M.), University College London; Camden and Islington NHS Foundation Trust (A.S., G. Livingston, G. Lewis), London, UK; Université de Paris (S.S., A.-S.M.), Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France; and Clinicum and Helsinki Institute of Life Science (M.K.), University of Helsinki, Finland
| | - Glyn Lewis
- From the Division of Psychiatry (A.S., G. Livingston, G. Lewis) and Department of Epidemiology and Public Health (S.S., M.K., A.-S.M.), University College London; Camden and Islington NHS Foundation Trust (A.S., G. Livingston, G. Lewis), London, UK; Université de Paris (S.S., A.-S.M.), Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France; and Clinicum and Helsinki Institute of Life Science (M.K.), University of Helsinki, Finland
| | - Archana Singh-Manoux
- From the Division of Psychiatry (A.S., G. Livingston, G. Lewis) and Department of Epidemiology and Public Health (S.S., M.K., A.-S.M.), University College London; Camden and Islington NHS Foundation Trust (A.S., G. Livingston, G. Lewis), London, UK; Université de Paris (S.S., A.-S.M.), Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France; and Clinicum and Helsinki Institute of Life Science (M.K.), University of Helsinki, Finland
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Rockwood K, Andrew MK, Aubertin‐Leheudre M, Belleville S, Bherer L, Bowles SK, Kehler DS, Lim A, Middleton L, Phillips N, Wallace LM. CCCDTD5: Reducing the risk of later-life dementia. Evidence informing the Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5). ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12083. [PMID: 33204818 PMCID: PMC7656906 DOI: 10.1002/trc2.12083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022]
Abstract
The Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5) was a year-long process to synthesize the best available evidence on several topics. Our group undertook evaluation of risk reduction, in eight domains: nutrition; physical activity; hearing; sleep; cognitive training and stimulation; social engagement and education; frailty; and medications. Here we describe the rationale for the undertaking and summarize the background evidence-this is also tabulated in the Appendix. We further comment specifically on the relationship between age and dementia, and offer some suggestions for how reducing the risk of dementia in the seventh decade and beyond might be considered if we are to improve prospects for prevention in the near term. We draw to attention that a well-specified model of success in dementia prevention need not equate to the elimination of cognitive impairment in late life.
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Affiliation(s)
- Kenneth Rockwood
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - Melissa K. Andrew
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | | | - Sylvie Belleville
- Research CenterInstitut Universitaire de Gériatrie de MontréalMontréalQuebecCanada
- Psychology DepartmentUniversité de MontréalMontréalCanada
| | - Louis Bherer
- Département de Médecine, Faculté de médecine, Université de Montréal, Centre de recherche, Institut de cardiologie de Montréal, Centre de rechercheInstitut universitaire de gériatrie de MontréalMontréalQuébecCanada
| | - Susan K. Bowles
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
- College of PharmacyDalhousie UniversityHalifaxNova ScotiaCanada
| | - D Scott Kehler
- School of PhysiotherapyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Andrew Lim
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Laura Middleton
- Department of KinesiologyUniversity of WaterlooWaterlooOntarioCanada
| | - Natalie Phillips
- Department of PsychologyConcordia UniversityMontréalQuébecCanada
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88
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Hung L. Using virtual care interventions to provide person-centred care to hospitalised older people with dementia. Nurs Older People 2020:e1294. [PMID: 33174401 DOI: 10.7748/nop.2020.e1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Being in an unfamiliar environment away from family can exacerbate emotional stress in hospitalised older people with dementia. Technology solutions can be used to address their mental and emotional health needs. AIM To generate greater understanding of technology adoption and to test strategies supporting virtual care interventions in hospitalised older people with dementia, such as the use of an iPad to connect them with their family members. METHOD Older people with dementia in two Canadian hospitals were observed and interviewed to explore their experiences of using an iPad. Focus groups were conducted with staff and interviews were undertaken with two frontline nurses and three research partners with lived experience of dementia in hospitalised older people. Data were thematically analysed in collaboration with 12 stakeholders. Strategies to overcome the barriers identified were tested as part of the study. FINDINGS There were three main barriers to implementing virtual care interventions: lack of familiarity with the technology; difficulties with operating the device; and privacy and connectivity issues. Strategies to overcome these barriers included providing personalised support, working with users to support adaptation, and ensuring privacy and optimal connectivity. CONCLUSION Using an iPad has the potential to enable hospitalised older people with dementia to connect with their family members and take part in activities that support person-centred care. This is particularly important in times, such as the COVID-19 pandemic, when restrictions to hospital visits lead to social isolation.
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89
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Casey ANS, Liu Z, Kochan NA, Sachdev PS, Brodaty H. Cross-Lagged Modeling of Cognition and Social Network Size in the Sydney Memory and Ageing Study. J Gerontol B Psychol Sci Soc Sci 2020; 76:1716-1725. [DOI: 10.1093/geronb/gbaa193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Indexed: 12/26/2022] Open
Abstract
Abstract
Objectives
This study assessed whether reciprocal relationships exist between cognitive function and the social network size of older adults, controlling for age, sex, education, medical conditions, and depressive symptoms.
Methods
Data were collected at biennial follow-ups over 6 years in the Sydney Memory and Ageing Study, a longitudinal cohort study including 1,037 community-based Sydney residents aged 70–90 years without dementia at baseline. We used random intercept cross-lagged panel models to investigate reciprocal associations between social network size and scores in each of 7 cognitive domains including a global score.
Results
Standardized models indicated that within-person deviation in expected language score predicted deviation in expected network size. Within-person deviation in prior expected social network size predicted deviation in expected executive function at year 6. Cross-lagged effects in models of both global cognition and memory, respectively, could not be attributed solely to within-person change.
Discussion
Findings support a co-constitutive view of cognitive function and social relationships in older age. Although both cognition and network size declined over time, slower than expected decline in language ability predicted less than expected contraction in social networks. A similar influence of network size on executive functioning indicated that relationships with friends and family outside of the home contributed significantly to the maintenance of higher order cognitive abilities in older late life. Diverse patterns of influence between cognitive domains and social network size over 6 years underscore the importance of assessing the complex and nuanced interplay between brain health and social relationships in older age.
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Affiliation(s)
- Anne-Nicole S Casey
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
| | | | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
- Neuropsychiatric Institute (NPI), Prince of Wales Hospital, Randwick, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
- Dementia Centre for Research Collaboration (DCRC), School of Psychiatry, UNSW Sydney, Australia
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90
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Sugita A, Ling L, Tsuji T, Kondo K, Kawachi I. Cultural engagement and incidence of cognitive impairment: A six-year longitudinal follow-up of the Japan Gerontological Evaluation Study (JAGES). J Epidemiol 2020; 31:545-553. [PMID: 32963208 PMCID: PMC8421199 DOI: 10.2188/jea.je20190337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Active engagement in intellectually enriching activities reportedly lowers the risk of cognitive decline; however, few studies have examined this association, including engagement in traditional cultural activities. This study aimed to elucidate the types of cultural engagement associated with lower risk of cognitive impairment. Methods We examined the association between cultural engagement and cognitive impairment using Cox proportional hazards models in a cohort of 44,985 participants (20,772 males and 24,213 females) aged 65 years or older of the Japan Gerontological Evaluation Study from 2010 to 2016. Intellectual activities (eg, reading books, magazines, and/or newspapers), creative activities (eg, crafts and painting), and traditional cultural activities (eg, poetry composition [haiku], calligraphy, and tea ceremony/flower arrangement) were included among cultural engagement activities. Results Over a follow-up period of 6 years, incident cognitive disability was observed in 4,198 respondents (9.3%). After adjusting for potential confounders, such as depression and social support, intellectual activities were protectively associated with the risk of cognitive impairment (hazard ratio [HR] for those who read and stated that reading was their hobby, 0.75; 95% confidence interval [CI] 0.66–0.85 and HR for those who read but did not consider reading a hobby, 0.72; 95% CI, 0.65–0.80). Engagement in creative activities was also significantly correlated with lower risk of cognitive impairment (crafts: HR 0.71; 95% CI, 0.62–0.81 and painting: HR 0.80; 95% CI, 0.66–0.96). The association between traditional cultural activities and the risk of cognitive impairment was not statistically significant. Conclusions Engagement in intellectual and creative activities may be associated with reduced risk of dementia.
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Affiliation(s)
| | - Ling Ling
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba.,Center for Preventive Medical Sciences, Chiba University
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
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91
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Abstract
Clinicians should use a systematic approach to evaluating patients presenting with a concern for cognitive impairment. This approach includes interviewing a knowledgeable informant and performing a thorough mental status examination in order to determine the presence of functional impairments and the domains of cognition that are impaired. The results of this interview and examination determine the next steps of the diagnostic work-up. The pattern of cognitive impairment shapes the differential diagnosis. Treatment should address symptoms, and environmental, psychological, and behavioral interventions are essential.
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Affiliation(s)
- Lauren McCollum
- Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA; Ralston House, Penn Memory Center, ATTN: Maria Crudele, 3615 Chestnut Street, Philadelphia, PA 19104-2612, USA.
| | - Jason Karlawish
- Ralston House, Penn Memory Center, ATTN: Maria Crudele, 3615 Chestnut Street, Philadelphia, PA 19104-2612, USA; Division of Geriatrics, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA. https://twitter.com/jasonkarlawish
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92
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Desai R, John A, Stott J, Charlesworth G. Living alone and risk of dementia: A systematic review and meta-analysis. Ageing Res Rev 2020; 62:101122. [PMID: 32659336 DOI: 10.1016/j.arr.2020.101122] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/15/2020] [Accepted: 07/08/2020] [Indexed: 01/11/2023]
Abstract
AIMS To systematically review longitudinal studies on living alone and incident dementia, to pool the results in a meta-analysis and calculate the population risk. METHODS Embase, Medline and PsycInfo were searched from inception to August 2019 for longitudinal cohort studies of people living alone and risk of dementia. Relative risks (RR) were extracted and effect sizes pooled, with a sensitivity analysis for risk of bias (QUIPS quality rating tool). Population Attributable Fraction (PAF) was calculated, with prevalence of living alone calculated from UK Census data. RESULTS Twelve studies were identified for inclusion, nine of which had low risk of bias. The pooled effect size indicated an elevated risk of incident dementia when living alone (all studies RR = 1.30; 95 % CI: 1.15-1.46; low risk of bias studies (RR = 1.31; 95 % CI: 1.13-1.51). The PAF for living alone was 8.9 %. CONCLUSIONS Social isolation is a more important risk factor for dementia than previously identified, with living alone associated with greater population risk than physical inactivity, hypertension, diabetes and obesity.
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Xiang X, Lai PHL, Bao L, Sun Y, Chen J, Dunkle RE, Maust D. Dual Trajectories of Social Isolation and Dementia in Older Adults: A Population-Based Longitudinal Study. J Aging Health 2020; 33:63-74. [PMID: 32865104 DOI: 10.1177/0898264320953693] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To identify the interrelations between the trajectories of social isolation and dementia in older adults. Methods: Data came from the National Health and Aging Trends Study 2011-2018 surveys. Group-based dual trajectory modeling was used to examine trajectories and their interrelations. Results: Four trajectories of social isolation-rarely isolated (62.2%), steady increase (13.5%), steady decrease (7.4%), and persistently isolated (16.9%) and dementia risk-persistently low risk (80.4%), increasing with early onset (3.9%), increasing with late onset (4.5%), and persistently high risk (11.2%) emerged. Two-thirds of the low-risk dementia group were in the rarely isolated group. The high-risk dementia group had the most overlap with the decreasing social isolation group (47%), followed by the persistently isolated group (28%). Conclusions: Social isolation and dementia mostly evolved in the same direction. However, the pattern of associations between these trajectories is intricate and may be reversed among long-term dementia survivors.
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Affiliation(s)
- Xiaoling Xiang
- School of Social Work, 1259University of Michigan, MI, USA
| | | | - Luoman Bao
- 14669California State University, Los Angeles, CA, USA
| | - Yihang Sun
- School of Social Work, 1259University of Michigan, MI, USA
| | - Jieling Chen
- 26451The Chinese University of Hong Kong, Hong Kong
| | - Ruth E Dunkle
- School of Social Work, 1259University of Michigan, MI, USA
| | - Donovan Maust
- Department of Psychiatry, 1259University of Michigan, MI, USA.,Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI, USA
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94
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Promotion of Healthy Aging Within a Community Center Through Behavior Change: Health and Fitness Findings From the AgeWell Pilot Randomized Controlled Trial. J Aging Phys Act 2020; 29:80-88. [PMID: 32781433 DOI: 10.1123/japa.2019-0396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this randomized controlled trial was to determine if behavior change through individual goal setting (GS) could promote healthy aging, including health and fitness benefits in older adults who attended a community "AgeWell" Center for 12 months. Seventy-five older adults were randomly allocated to either a control or a GS group. Health outcomes were measured at baseline and after 12 months of the participants' having access to the exception of Agewell Center facilities. The findings demonstrate that participation in the Center in itself was beneficial, with improved body composition and reduced cardiovascular risk in both groups (p < .05), and that this kind of community-based resource offers valuable potential for promoting protective behaviors and reducing health risk. However, a specific focus on identifying individual behavior change goals was required in order to achieve increased activity engagement (p < .05) and to bring about more substantial improvements in a range of health, diet, and physical function measures (p < .05).
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95
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Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396:413-446. [PMID: 32738937 PMCID: PMC7392084 DOI: 10.1016/s0140-6736(20)30367-6] [Citation(s) in RCA: 4340] [Impact Index Per Article: 1085.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - David Ames
- National Ageing Research Institute and Academic Unit for Psychiatry of Old Age, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | - Sube Banerjee
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Alistair Burns
- Department of Old Age Psychiatry, University of Manchester, Manchester, UK
| | - Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Heczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel; Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Goa, India
| | - Nick Fox
- Dementia Research Centre, UK Dementia Research Institute, University College London, London, UK; Institute of Neurology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Karen Ritchie
- Inserm, Unit 1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, University of Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine Dalhousie University, Halifax, NS, Canada
| | - Elizabeth L Sampson
- Division of Psychiatry, University College London, London, UK; Barnet, Enfield, and Haringey Mental Health Trust, London, UK
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MA, USA
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, Leonard Davis School of Gerontology of the University of Southern California, Los Angeles, CA, USA
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Linda Teri
- Department Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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96
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Siette J, Georgiou A, Brayne C, Westbrook JI. Social networks and cognitive function in older adults receiving home- and community-based aged care. Arch Gerontol Geriatr 2020; 89:104083. [DOI: 10.1016/j.archger.2020.104083] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/02/2020] [Accepted: 04/19/2020] [Indexed: 11/26/2022]
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97
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Affiliation(s)
- Amy Jennings
- Nutrition and Preventive Medicine Group, Norwich Medical School, University of East Anglia, Norwich NR4 7UK, UK
| | - Stephen C Cunnane
- Research Center on Aging and Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Anne Marie Minihane
- Nutrition and Preventive Medicine Group, Norwich Medical School, University of East Anglia, Norwich NR4 7UK, UK,
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98
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Peakman G, Karunatilake N, Seynaeve M, Perera G, Aarsland D, Stewart R, Mueller C. Clinical factors associated with progression to dementia in people with late-life depression: a cohort study of patients in secondary care. BMJ Open 2020; 10:e035147. [PMID: 32448792 PMCID: PMC7252968 DOI: 10.1136/bmjopen-2019-035147] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/06/2020] [Accepted: 04/27/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Depression can be a prodromal feature or a risk factor for dementia. We aimed to investigate which clinical factors in patients with late-life depression are associated with a higher risk of developing dementia and a more rapid conversion. DESIGN Retrospective cohort study. SETTING South London and Maudsley NHS Foundation Trust (SLaM) secondary mental healthcare services. PARTICIPANTS The SLaM Clinical Record Interactive Search was used to retrieve anonymised data on 3659 patients aged 65 years or older who had received a diagnosis of depression in mental health services and had been followed up for at least 3 months. OUTCOME MEASURES Predictors of development of incident dementia were investigated, including demographic factors, health status rated on the Health of the National Outcome scale for older people (HoNOS65+), depression recurrence and treatments including psychotropic drugs and cognitive behavioural therapy (CBT). RESULTS In total, 806 (22.0%) patients developed dementia over a mean follow-up time of 2.7 years. Significant predictors of receiving a dementia diagnosis in fully adjusted models and after accounting for multiple comparisons were older age (adjusted HR=1.04, 95% CI 1.03 to 1.06 per year difference from sample mean) and the HoNOS65+ subscale measuring cognitive problems (HR=4.72, 95% CI 3.67 to 6.06 for scores in the problematic range). Recurrent depressive disorder or past depression (HR=0.65, 95% CI 0.55 to 0.77) and the receipt of CBT (HR=0.73 95% CI 0.61 to 0.87) were associated with a lower dementia risk. Over time, hazards related to age increased and hazards related to cognitive problems decreased. CONCLUSIONS In older adults with depression, a higher risk of being subsequently diagnosed with dementia was predicted by higher age, new onset depression, severity of cognitive symptoms and not receiving CBT. Further exploration is needed to determine whether the latter risk factors are responsive to interventions.
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Affiliation(s)
- Georgia Peakman
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - Mathieu Seynaeve
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Gayan Perera
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Dag Aarsland
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Robert Stewart
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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99
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Rutter EC, Tyas SL, Maxwell CJ, Law J, O'Connell ME, Konnert CA, Oremus M. Association between functional social support and cognitive function in middle-aged and older adults: a protocol for a systematic review. BMJ Open 2020; 10:e037301. [PMID: 32265252 PMCID: PMC7245373 DOI: 10.1136/bmjopen-2020-037301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Maintenance of cognitive function into old age is important for ageing populations. Researchers seek to identify modifiable risk and protective factors for cognitive function. One such modifiable factor is functional social support, that is, one's perception of whether their social network can provide resources such as material help, companionship, information and emotional contact, if needed. While the literature generally reports positive associations between functional social support and cognitive function, results vary according to study methods such as the tool used to measure functional social support or the specific cognitive domain under investigation. Our review will summarise the association between functional social support and cognitive function in middle-aged and older-aged adults who reside in any setting (eg, community dwelling, long-term care facilities). We will also identify sources of discrepant findings between studies. METHODS AND ANALYSIS This protocol was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guideline. PubMed, PsycINFO, Sociological Abstracts, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Scopus will be searched from inception to the present using a search strategy developed with a medical librarian's help. We will supplement the database searches with a grey literature search. English-language or French-language studies with a comparison group will be subject to inclusion, regardless of the measures used to assess functional social support or cognitive function. We will assess risk of bias with the Cochrane Risk of Bias Tool-Version 2 or the Newcastle-Ottawa Scale, narratively synthesise the extracted data and conduct a meta-analysis of studies with similar characteristics (eg, sample age and sex, cognitive function outcomes). Two independent raters will screen articles and assess risk of bias. ETHICS AND DISSEMINATION This review is timely given the push toward early diagnosis and treatment of dementia/major neurocognitive disorder and other types of cognitive impairment. This protocol does not require a formal ethics review. We will publish our findings in a peer-reviewed journal.
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Affiliation(s)
- Emily C Rutter
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Suzanne L Tyas
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen J Maxwell
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, University of Waterloo, Waterlo, Ontario, Canada
| | - Jane Law
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Candace A Konnert
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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100
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Leong FTL. Diversified Portfolio Model of Adaptability: A Natural History Perspective. COUNSELING PSYCHOLOGIST 2020. [DOI: 10.1177/0011000020904639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Using a natural history perspective, the diversified portfolio model (DPM) of adaptability developed by Chandra and Leong (2016) is described in this article as a representation of the latter author’s life work in researching diversity and adaptability. The primary thesis of the DPM is that a diversified portfolio of activities, roles, and experiences will lead to greater adaptability in life. The DPM was intended to address a gap in the literature by illuminating the antecedents of adaptive processes that have been studied in current models, including those for self-complexity, risk and resilience, and self-efficacy. This description is followed by an example of the application of the DPM in academic careers. The mechanisms underlying the DPM are then discussed in relation to mental models and mindfulness. Next, the negative effects of nondiversification are illustrated with examples of workaholism and loneliness. Finally, the DPM is linked to the author’s own diversified portfolio of roles and activities to illustrate its positive impact.
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