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Randolph JJ, Lacritz LH, Colvin MK, Espe-Pfeifer P, Carter KR, Arnett PA, Fox-Fuller J, Aduen PA, Cullum CM, Sperling SA. Integrating Lifestyle Factor Science into Neuropsychological Practice: A National Academy of Neuropsychology Education Paper. Arch Clin Neuropsychol 2024; 39:121-139. [PMID: 37873931 DOI: 10.1093/arclin/acad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to review evidence and clinical implications related to lifestyle activities associated with promoting brain and cognitive health. Our review targets four key lifestyle factors: physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets. METHOD We conducted a critical review of the lifestyle factor literature in the four domains listed earlier. We contextualize this literature review by translating findings, when possible, into evidence-based recommendations to consider when providing neuropsychological services. RESULTS There is significant current evidence supporting the role of physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets on positive brain and cognitive health outcomes. While some null findings are present in all four areas reviewed, the weight of the evidence supports the notion that engaging in these activities may promote brain and cognitive functioning. CONCLUSIONS Clinical neuropsychologists can have confidence in recommending engagement in physical activity, social activity, and cognitively stimulating activity, and adhering to a Mediterranean-style diet to promote brain and cognitive health. We discuss limitations in existing lifestyle factor research and future directions to enhance the existing evidence base, including additional research with historically underrepresented groups and individuals with neurological conditions.
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Affiliation(s)
- John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Patricia Espe-Pfeifer
- Department of Psychiatry & Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Peter A Arnett
- Psychology Department, The Pennsylvania State University, University Park, PA, USA
| | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Paula A Aduen
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Jacksonville, FL, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Scott A Sperling
- Center for Neurological Restoration, Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA
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Li X, Xu W. A change in social participation affects cognitive function in middle-aged and older Chinese adults: analysis of a Chinese longitudinal study on aging (2011-2018). Front Public Health 2024; 12:1295433. [PMID: 38371232 PMCID: PMC10869472 DOI: 10.3389/fpubh.2024.1295433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024] Open
Abstract
Background One of the biggest challenges facing older adults is cognitive decline and social participation has always been considered a protective factor. However, it is not clear whether social participation predicts cognitive function in this population, rather than depressive symptoms, self-reported health, and activities of daily life, with sufficient capacity to detect unique effects. Methods This study included adults aged 45 and above in China (N = 5,258) who participated in a large national older adult health survey and provided data from 2011, 2013, 2015, and 2018. The unique associations between the predictors of social participation and cognitive function over time and context were evaluated in the Latent Growth Model (LGM). Results Among the 5,258 participants in our study, an overall cognitive decline was observed. Social participation predicts two dimensions of cognitive function, with a degree of impact comparable to depressive symptoms, self-reported health, and activities of daily life. Among them, social participation exhibits a noteworthy prognostic impact on episodic memory during the same period. The regression coefficient is approximately 0.1 (p < 0.05) after controlling other mixed variables (depressive symptoms, self-reported health, and activities of daily life). In contrast, social participation is also a significant predictor of mental intactness in the same period, with a regression coefficient of 0.06 (p < 0.05), even if all mixed variables are controlled. Conclusion Over time, the correlation strength of social participation is comparable to other recognized cognitive function prediction indicators, indicating that promoting social participation among middle-aged and older Chinese adults is a meaningful way to improve cognitive function degradation, which has important policy and practical significance.
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Affiliation(s)
- Xuyang Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Wenyan Xu
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Duffner LA, DeJong NR, Jansen JFA, Backes WH, de Vugt M, Deckers K, Köhler S. Associations between social health factors, cognitive activity and neurostructural markers for brain health - A systematic literature review and meta-analysis. Ageing Res Rev 2023; 89:101986. [PMID: 37356551 DOI: 10.1016/j.arr.2023.101986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
Social health factors (e.g., social activities or social support) and cognitive activity engagement have been associated with dementia risk, but their neural substrates have not been well established. This systematic review and meta-analysis summarizes the available evidence regarding the association between these factors and cerebral macro- and micro-structure. A comprehensive literature search was conducted in various databases, following predefined criteria. Heterogeneity, risk of publication bias and overall certainty of evidence were assessed using standardized scales and, whenever appropriate, random effects meta-analysis was conducted. Of 6715 identified articles, 43 were included. Overall, consistency of findings was low and methodological heterogeneity high for all outcomes. However, in some studies cognitive and social activities were positively associated with total brain, global and cortical grey matter and hippocampal volume as well as white matter microstructural integrity. Furthermore, structural social network characteristics (e.g., social network size) were associated with regional grey matter volumes, while functional social network characteristics (e.g., social support) were additionally associated with total brain volume. Meta-analyses revealed small but significant partial correlations between cognitive and social activities and hippocampal (three studies; n = 892; rz =0.07) and white matter hyperintensity volume (three studies; n = 2934; rz =-0.04). More prospective studies are needed to assess temporal associations.
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Affiliation(s)
- Lukas A Duffner
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Nathan R DeJong
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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Tomioka K, Shima M, Saeki K. Age differences in the association of physical leisure activities with incident disability among community-dwelling older adults. Environ Health Prev Med 2022; 27:16. [PMID: 35354710 PMCID: PMC9251618 DOI: 10.1265/ehpm.21-00018] [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] [Indexed: 11/21/2022] Open
Abstract
Background The relationship between leisure activities (LA) in old age and prevention of disability has not been fully investigated, and age and gender differences of these relationships are unknown. This study aimed to investigate whether physical and cognitive LA predicted incident disability among community-dwelling older adults by age and gender. Methods We prospectively observed 8,275 residents aged 65 or above without disability at baseline for 3 years. Incident disability was defined as a new certification of the public long-term care insurance system. LA were classified into two types: physical LA and cognitive LA. The frequency of LA was categorized into frequent (i.e., once a week or more), moderate (i.e., monthly or yearly), and non-engagement. Covariates included age, gender, family number, education, perceived economic situation, body mass index, chronic medical conditions, alcohol consumption, smoking status, regular dental visits, depression, cognitive functioning, and social participation. Multivariable Poisson regression models were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for incident disability. We performed stratified analyses by age groups (i.e., the young-old aged 65–74 and the old-old aged 75–97) and gender (i.e., men and women). Results The 3-year cumulative incidence of disability was 7.5%. After adjustment for covariates and mutual adjustment for both types of LA, a significant dose-response relationship between more frequent LA and lower risk of incident disability was found in young-old physical LA (P-trend < 0.001), in old-old cognitive LA (P-trend = 0.012), in male cognitive LA (P-trend = 0.006), and in female physical LA (P-trend = 0.030). Compared with people without LA, adjusted CIR (95% CI) of frequent LA was 0.47 (0.30–0.74) in young-old physical, 0.75 (0.58–0.96) in old-old cognitive, 0.65 (0.46–0.89) in male cognitive, and 0.70 (0.52–0.95) in female physical. Regarding the effect modification according to age and gender, only interaction between age and physical LA significantly prevented incident disability (P for interaction = 0.019). Conclusion We found age differences in the association of physical LA with incident disability among community-dwelling older adults. An effective measure to prevent long-term care in the community would be to recommend frequent physical LA for the young-old. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00018.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University
| | - Midori Shima
- Nara Prefectural Health Research Center, Nara Medical University
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University
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Zou H, Li K, Zeng D, Luo S. Bayesian inference and dynamic prediction of multivariate joint model with functional data: An application to Alzheimer's disease. Stat Med 2021; 40:6855-6872. [PMID: 34649301 PMCID: PMC8671252 DOI: 10.1002/sim.9214] [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: 11/24/2020] [Revised: 08/03/2021] [Accepted: 09/20/2021] [Indexed: 01/01/2023]
Abstract
Alzheimer's disease (AD) is a severe neurodegenerative disorder impairing multiple domains, for example, cognition and behavior. Assessing the risk of AD progression and initiating timely interventions at early stages are critical to improve the quality of life for AD patients. Due to the heterogeneous nature and complex mechanisms of AD, one single longitudinal outcome is insufficient to assess AD severity and disease progression. Therefore, AD studies collect multiple longitudinal outcomes, including cognitive and behavioral measurements, as well as structural brain images such as magnetic resonance imaging (MRI). How to utilize the multivariate longitudinal outcomes and MRI data to make efficient statistical inference and prediction is an open question. In this article, we propose a multivariate joint model with functional data (MJM-FD) framework that relates multiple correlated longitudinal outcomes to a survival outcome, and use the scalar-on-function regression method to include voxel-based whole-brain MRI data as functional predictors in both longitudinal and survival models. We adopt a Bayesian paradigm to make statistical inference and develop a dynamic prediction framework to predict an individual's future longitudinal outcomes and risk of a survival event. We validate the MJM-FD framework through extensive simulation studies and apply it to the motivating Alzheimer's Disease Neuroimaging Initiative (ADNI) study.
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Affiliation(s)
- Haotian Zou
- Gillings School of Global Public Health, Department of Biostatistics, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Kan Li
- Merck Research Lab, Merck & Co, North Wales, Pennsylvania
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, CB#7420, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Sheng Luo
- Corresponding author: Sheng Luo, Department of Biostatistics and Informatics, Duke University, 2424 Erwin Rd, Durham, NC 27705, USA ()
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Anatürk M, Suri S, Smith SM, Ebmeier KP, Sexton CE. Leisure Activities and Their Relationship With MRI Measures of Brain Structure, Functional Connectivity, and Cognition in the UK Biobank Cohort. Front Aging Neurosci 2021; 13:734866. [PMID: 34867271 PMCID: PMC8635062 DOI: 10.3389/fnagi.2021.734866] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/05/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction: This study aimed to evaluate whether engagement in leisure activities is linked to measures of brain structure, functional connectivity, and cognition in early old age. Methods: We examined data collected from 7,152 participants of the United Kingdom Biobank (UK Biobank) study. Weekly participation in six leisure activities was assessed twice and a cognitive battery and 3T MRI brain scan were administered at the second visit. Based on responses collected at two time points, individuals were split into one of four trajectory groups: (1) stable low engagement, (2) stable weekly engagement, (3) low to weekly engagement, and (4) weekly to low engagement. Results: Consistent weekly attendance at a sports club or gym was associated with connectivity of the sensorimotor functional network with the lateral visual (β = 0.12, 95%CI = [0.07, 0.18], FDR q = 2.48 × 10-3) and cerebellar (β = 0.12, 95%CI = [0.07, 0.18], FDR q = 1.23 × 10-4) networks. Visiting friends and family across the two timepoints was also associated with larger volumes of the occipital lobe (β = 0.15, 95%CI = [0.08, 0.21], FDR q = 0.03). Additionally, stable and weekly computer use was associated with global cognition (β = 0.62, 95%CI = [0.35, 0.89], FDR q = 1.16 × 10-4). No other associations were significant (FDR q > 0.05). Discussion: This study demonstrates that not all leisure activities contribute to cognitive health equally, nor is there one unifying neural signature across diverse leisure activities.
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Affiliation(s)
- Melis Anatürk
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Sana Suri
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Stephen M. Smith
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Klaus P. Ebmeier
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Claire E. Sexton
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
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Luo L, Xie F, Wang Y, Qin LQ, Yin JY, Wan Z. Taller adult height is associated with better performance of cognitive trajectories in Chinese over 45 years old: Evidence from the China Health and Retirement Longitudinal Study. Geriatr Gerontol Int 2021; 21:732-740. [PMID: 34134174 DOI: 10.1111/ggi.14203] [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: 01/31/2021] [Revised: 05/07/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022]
Abstract
AIM The association between adult height and follow-up cognition requires an update in China. We aimed to examine the association between baseline height and follow-up cognitive trajectories in Chinese subjects from the China Health and Retirement Longitudinal Study (CHARLS). METHODS A total of 6508 adults aged 45 years or older from the CHARLS were included for analysis. Latent class growth modeling was used to determine cognitive trajectories of 2011, 2013 and 2015. Multivariable linear regression and logistic regression models were used to examine the association between baseline adult height and cognitive performance and trajectories, respectively. RESULTS At baseline, an increment of 1 SD (8.3 cm) of height was associated with a higher global cognitive score (β = 0.492, 95% CI, 0.348-0.636), verbal episodic memory (β = 0.155, 95% CI, 0.086-0.224) and mental status (β = 0.337, 95% CI, 0.225-0.449). These associations were still observed even when stratified by sex. Prospectively, for females, the third quartile of height level (i.e., 155 to 158 cm) was associated with a better global cognitive function trajectory (OR = 1.627, P = 0.001, P for trend = 0.009) and mental status trajectory (OR = 1.456, P = 0.012, P for trend = 0.047); and the tallest height level (i.e., 159 cm or taller) was related to a better verbal episodic memory trajectory (OR = 1.574, P = 0.017). For males, no associations were observed. CONCLUSION Increased stature might be associated with better cognitive trajectories for subjects in China. Geriatr Gerontol Int 2021; 21: 732-740.
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Affiliation(s)
- Lan Luo
- School of Public Health, Soochow University, Suzhou, China
| | - Fangfei Xie
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Yun Wang
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Li-Qiang Qin
- School of Public Health, Soochow University, Suzhou, China
| | - Jie-Yun Yin
- School of Public Health, Soochow University, Suzhou, China
| | - Zhongxiao Wan
- School of Public Health, Soochow University, Suzhou, China
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Anatürk M, Kaufmann T, Cole JH, Suri S, Griffanti L, Zsoldos E, Filippini N, Singh‐Manoux A, Kivimäki M, Westlye LT, Ebmeier KP, de Lange AG. Prediction of brain age and cognitive age: Quantifying brain and cognitive maintenance in aging. Hum Brain Mapp 2021; 42:1626-1640. [PMID: 33314530 PMCID: PMC7978127 DOI: 10.1002/hbm.25316] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022] Open
Abstract
The concept of brain maintenance refers to the preservation of brain integrity in older age, while cognitive reserve refers to the capacity to maintain cognition in the presence of neurodegeneration or aging-related brain changes. While both mechanisms are thought to contribute to individual differences in cognitive function among older adults, there is currently no "gold standard" for measuring these constructs. Using machine-learning methods, we estimated brain and cognitive age based on deviations from normative aging patterns in the Whitehall II MRI substudy cohort (N = 537, age range = 60.34-82.76), and tested the degree of correspondence between these constructs, as well as their associations with premorbid IQ, education, and lifestyle trajectories. In line with established literature highlighting IQ as a proxy for cognitive reserve, higher premorbid IQ was linked to lower cognitive age independent of brain age. No strong evidence was found for associations between brain or cognitive age and lifestyle trajectories from midlife to late life based on latent class growth analyses. However, post hoc analyses revealed a relationship between cumulative lifestyle measures and brain age independent of cognitive age. In conclusion, we present a novel approach to characterizing brain and cognitive maintenance in aging, which may be useful for future studies seeking to identify factors that contribute to brain preservation and cognitive reserve mechanisms in older age.
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Affiliation(s)
- Melis Anatürk
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Tobias Kaufmann
- NORMENT, Institute of Clinical MedicineUniversity of Oslo, & Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
| | - James H. Cole
- Centre for Medical Image Computing, Department of Computer ScienceUniversity College LondonLondonUK
- Dementia Research Centre, Institute of NeurologyUniversity College LondonLondonUK
| | - Sana Suri
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Ludovica Griffanti
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Enikő Zsoldos
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Nicola Filippini
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Archana Singh‐Manoux
- Epidemiology of Ageing and Neurodegenerative diseasesUniversité de Paris, INSERM U1153ParisFrance
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Mika Kivimäki
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Lars T. Westlye
- NORMENT, Institute of Clinical MedicineUniversity of Oslo, & Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
- Department of PsychologyUniversity of OsloOsloNorway
| | | | - Ann‐Marie G. de Lange
- Department of PsychiatryUniversity of OxfordOxfordUK
- NORMENT, Institute of Clinical MedicineUniversity of Oslo, & Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
- Department of PsychologyUniversity of OsloOsloNorway
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Egashira R, Mizutani S, Yamaguchi M, Kato T, Umezaki Y, Oku S, Tamai K, Obata T, Naito T. Low Tongue Strength and the Number of Teeth Present Are Associated with Cognitive Decline in Older Japanese Dental Outpatients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8700. [PMID: 33238565 PMCID: PMC7700411 DOI: 10.3390/ijerph17228700] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/21/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022]
Abstract
To mitigate the impact of dementia, initiating early intervention is important. This study aims to investigate the associations between deterioration in oral function and cognitive decline in older outpatients whose oral health was maintained in the dental clinic. This study included 50 outpatients aged ≥65 years. We used the Japanese version of the Montreal Cognitive Assessment (MoCA-J) to assess cognitive decline. Oral function was evaluated by tongue pressure, masticatory performance, and swallowing ability. A full-mouth periodontal examination was conducted, and the occlusal support and number of teeth were recorded. Odds ratios (ORs) and 95% confidence intervals (CIs) for cognitive decline (MoCA-J score ≤ 25 points) were calculated using logistic regression models. The age, number of teeth, tongue pressure, and masticatory performance were significantly correlated with cognitive decline (p < 0.05). Logistic regression analyses revealed that cognitive decline was independently associated with age (OR: 1.25; 95% CI: 1.03-1.52; p = 0.024), number of teeth (OR = 0.83; 95% CI: 0.76-1.00; p = 0.047), and lower tongue pressure (OR: 0.87; 95% CI: 0.77-0.98; p = 0.022). Lower tongue pressure and a small number of remaining teeth may be associated with cognitive decline in Japanese outpatients.
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Affiliation(s)
- Rui Egashira
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | - Shinsuke Mizutani
- OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
| | - Masahiro Yamaguchi
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | - Tomotaka Kato
- Department of Oral Health Sciences, University of Washington, Seattle, WA 98195, USA;
| | - Yojiro Umezaki
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | - Saori Oku
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
| | - Keiko Tamai
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | | | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
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