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Teshale AB, Htun HL, Owen AJ, Ryan J, Baker JR, Vered M, Reid CM, Woods RL, Berk M, Tonkin A, Neumann JT, Kilkenny MF, Phyo AZZ, Nelson MR, Stocks N, Britt C, Freak-Poli R. Gender-specific aspects of socialisation and risk of cardiovascular disease among community-dwelling older adults: a prospective cohort study using machine learning algorithms and a conventional method. J Epidemiol Community Health 2024:jech-2023-221860. [PMID: 38839108 DOI: 10.1136/jech-2023-221860] [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: 12/23/2023] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Gender influences cardiovascular disease (CVD) through norms, social relations, roles and behaviours. This study identified gender-specific aspects of socialisation associated with CVD. METHODS A longitudinal study was conducted, involving 9936 (5,231 women and 4705 men) initially healthy, community-dwelling Australians aged 70 years or more from the ASPirin in Reducing Events in the Elderly (ASPREE) study and ASPREE Longitudinal Study of Older Persons, with a median follow-up time of 6.4 years. Variable categorisation, variable selection (using machine learning (ML) models; Elastic Net and extreme gradient boosting) and Cox-regression were employed separately by binary gender to identity socialisation factors (n=25 considered) associated with CVD. RESULTS Different socialisation factors were identified using the ML models. In the Cox model, for both genders, being married/partnered was associated with a reduced risk of CVD (men: HR 0.76, 95% CI 0.60 to 0.96; women: HR 0.67, 95% CI 0.58 to 0.95). For men, having 3-8 relatives they felt close to and could call on for help (HR 0.76, 95% CI 0.58 to 0.99; reference <3 relatives), having 3-8 relatives they felt at ease talking with about private matters (HR 0.70, 95% CI 0.55 to 0.90; reference <3 relatives) or playing games such as chess or cards (HR 0.82, 95% CI 0.67 to 1.00) was associated with reduced risk of CVD. For women, living with others (HR 0.71, 95% CI 0.55 to 0.91) or having ≥3 friends they felt at ease talking with about private matters (HR 0.74, 95% CI 0.58 to 0.95; reference <3 friends) was associated with a lower risk of CVD. CONCLUSIONS This study demonstrates the need to prioritise gender-specific social factors to improve cardiovascular health in older adults.
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Affiliation(s)
| | - Htet Lin Htun
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J R Baker
- Primary & Community Care Services Ltd, Thornleigh, New South Wales, Australia
| | - Mor Vered
- Department of Data Science and AI, Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael Berk
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University and Barwon Health, Geelong, Victoria, Australia
| | - Andrew Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Johannes T Neumann
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Cardiology, University Heart & Vascular Centre, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Monique F Kilkenny
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, The University of Melbourne, Heidelberg, Victoria, Australia
| | - Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Carlene Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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Zhu L, Wang Y, Wu Y, Wilson A, Zhou H, Li N, Wang Y. Longitudinal associations between the frequency of playing Mahjong and cognitive functioning among older people in China: evidence from CLHLS, 2008-2018. Front Public Health 2024; 12:1352433. [PMID: 38550318 PMCID: PMC10973127 DOI: 10.3389/fpubh.2024.1352433] [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: 12/08/2023] [Accepted: 03/01/2024] [Indexed: 04/02/2024] Open
Abstract
Background Cognitive decline is prevalent among older adults, often resulting in decreased capabilities for self-care and a diminished quality of life. Mahjong, a culturally cherished and extensively played intellectual game in China, demands considerable cognitive function. While the cognitive benefits of playing Mahjong have been widely accepted, this study investigates an under explored aspect and aimed to ascertain the game's potential contributions toward bolstering self-care abilities, enhancing overall quality of life, and mitigating against rising societal healthcare costs. Methods The data analyzed in the study is collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with cognitive functioning being assessed through the Mini-Mental State Examination (MMSE). The frequency of playing Mahjong was measured through a self-reported questionnaire. Multiple linear regression models, latent variable growth models, and cross-lagged models were used to investigate the longitudinal relationship between game frequency and cognitive function in older people. Results Of the 7,535 participants, the mean (SD) age was 81.96 (10.53) years. There were 7,308 (97%), 4,453 (59%), and 1,974 (26%) participants in 2011, 2014, and 2018, respectively. The results showed that Mahjong players had significantly higher MMSE scores compared to non-players from 2008 to 2018 (β = 0.893; p < 0.001), and non-players had significantly lower scores in 2011, 2014, and 2018 than in 2008 (β = -1.326, -0.912, -0.833; Ps > 0.05). Moreover, the frequency of playing Mahjong was associated with improved various cognitive domains. The declining frequency of playing Mahjong was substantially associated with the declining rate of MMSE scores (r = 0.336; p < 0.001). Mahjong frequency showed positive effects on MMSE scores, while the influence of Mahjong on MMSE scores were not significant. Conclusion Playing Mahjong has a positive influence on the cognitive functioning among older people. It can help buffer against the decline in cognitive function and maintain cognitive function levels. The higher frequency of playing Mahjong is associated with improved reaction, attention and calculation, and self-coordination. A decline in the frequency of playing Mahjong was associated with a declining rate of cognitive function. The higher frequency of playing Mahjong among older people unilaterally influenced the improvement of cognitive function levels in older people in China.
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Affiliation(s)
- Lan Zhu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yixi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuju Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Amanda Wilson
- Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Huan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ningxiu Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
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Lee YH, Kong D, Hu CM, Chang YC. Participation in mahjong and the associated smoking and alcohol consumption behaviors among Chinese older adults. J Ethn Subst Abuse 2023:1-14. [PMID: 38109064 DOI: 10.1080/15332640.2023.2293942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This study examined the relationship of playing mahjong with smoking and alcohol consumption behaviors among Chinese older adults. We used a large and nationally representative dataset, the 8th wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Older adults who were 65 years old or above were included in the final analysis sample (n = 10,954). Multivariable logistic regressions were used to examine the associations of playing mahjong with current and former smoking/alcohol consumption status. Additionally, we used negative binomial and multiple linear regressions to investigate the number of cigarettes smoked per day and the amount of alcohol consumed per day. Compared with older adults who did not play mahjong, those who played mahjong at least once per month were more likely to report both current and prior smoking/alcohol consumption habits (all p < 0.05). The sub-analysis revealed that older adults who played mahjong at least once per week tended to smoke more cigarettes per day (all p < 0.05) than those who did not play mahjong at all. When public health practitioners advocate for the health benefits of playing mahjong, they should also consider its associations with smoking/alcohol consumption behaviors among Chinese older adults.
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Affiliation(s)
- Yen-Han Lee
- University of Central Florida, Orlando, Florida
| | - Dexia Kong
- The Chinese University of Hong Kong, Shatin, Hong Kong
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Lin W, Yin W, Yuan D. Association of home and community-based services and cognitive function of Chinese older adults: social participation as a mediator. BMC Geriatr 2023; 23:691. [PMID: 37875828 PMCID: PMC10599025 DOI: 10.1186/s12877-023-04414-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND This study makes an effort to examine the impact of home and community-based services on maintaining cognitive function and understand the mediating effect of social participation on the relationship of community services and older adults' cognitive function in China. METHOD The empirical data comes from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 38,582 (person-time) respondents were gathered for this study. The two-way fixed effects regression model is used to estimate the associations between independent variables, mediating variables and cognitive ability after controlling for socio-demographic, family responsibility, and time variables. RESULT This study has confirmed that participating in daily and social activities is associated with the cognitive functions of Chinese older adults. Social participation can stimulate cognition. Active participation in outdoor activities, doing housework or taking care of kids, daily playing cards or mah-jong, reading books and newspapers, watching TV, and listening to the radio can significantly promote the cognitive ability of older adults. In addition, the findings have indicated the importance of community services for older adults. This study shows personal daily care services, legal aid services, health education services, as well as dealing with family and neighborhood disputes have a positive effect on maintaining older adults' cognitive functions. Meanwhile, the provision of door-to-door medical services hurts their cognitive functions. This study also illustrates that community-based services can increase the level of older adults' social participation, and then enhance their level of cognitive function. CONCLUSION This study can inform service provision agencies to develop targeted programs to support older adults' continued engagement.
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Affiliation(s)
- Wenyi Lin
- School of Public Administration, Jinan University, Guangzhou, China
- Common Prosperity and National Governance Institute, Jinan University, Guangzhou, China
| | - Wanxia Yin
- School of Public Administration, Jinan University, Guangzhou, China
| | - Dinghuan Yuan
- School of Public Administration, Jinan University, Guangzhou, China.
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Shi X, Wang Y, Wu Y, Li J. The effect of the leisure activities based on chess and cards for improving cognition of older adults: study protocol for a cluster randomized controlled trial. Trials 2023; 24:484. [PMID: 37516846 PMCID: PMC10386780 DOI: 10.1186/s13063-023-07528-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND With the increase in age, the probability of cognitive impairment in the older people is increasing. More and more evidence shows that participating in leisure activities, especially chess and cards, is beneficial to the cognition and mental state of the older people. But the evidence for causal inference is limited. There is a need to conduct a fully powered randomized controlled trial (RCT) and long-term follow-up to test the effectiveness of intervention measures in improving cognitive function and mental state. This paper describes the methodology of a cluster RCT designed to determine the effect of chess and cards leisure activities on the cognitive function of the older people over 60 years old. METHODS/DESIGN A cluster RCT consisting of 8 clusters will be conducted in four regions of Ningxia, China (Helan, Litong, Qingtongxia, and Shapotou). Clusters will be randomly assigned to the advocacy intervention group, which is also delivered with free leisure activities tools (chess and cards), or the control group. A baseline survey will be conducted before the intervention. A mid-term and final survey will be carried out twelve and twenty-four months after the intervention, respectively. The primary outcome is a change in cognitive function, and the secondary outcomes are changes in anxiety, depression, and loneliness. DISCUSSION The results of this RCT will be helpful to (1) confirm the effectiveness of chess and cards leisure activities in improving the cognitive function of the older people over 60 years old; (2) determine the relationship between the frequency and duration of chess and cards leisure activities and cognitive function; (3) provide evidence of promoting participation in leisure activities through education campaigns and free provision of chess and cards tools; and (4) provide valuable information for successful aging. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2200066817. Registered on 19 December 2022.
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Affiliation(s)
- Xiaojuan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yanrong Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yueping Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China.
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Hui Autonomous Region, Yinchuan, 750004, Ningxia, China.
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Lee SY, Nyunt MSZ, Gao Q, Gwee X, Chua DQL, Yap KB, Wee SL, Ng TP. Risk Factors of Progression to Cognitive Frailty: Singapore Longitudinal Ageing Study 2. Gerontology 2023; 69:1189-1199. [PMID: 37285817 PMCID: PMC10614261 DOI: 10.1159/000531421] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/30/2023] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Cognitive frailty is associated with higher risk of dementia and adverse health outcomes. However, multidimensional factors that influence cognitive frailty transitions are not known. We aimed to investigate risk factors of incident cognitive frailty. METHODS Prospective cohort study participants were community-dwelling adults without dementia and other degenerative disorders and baseline and follow-up, including N = 1,054 participants aged ≥55 free of cognitive frailty at baseline, with complete baseline (March 6, 2009, to June 11, 2013) and follow-up data at 3-5 years later (January 16, 2013, to August 24, 2018). Incident cognitive frailty was defined by one or more criteria of the physical frailty phenotype and <26 of Mini-Mental State Examination (MMSE) score. Potential risk factors assessed at baseline included demographic, socioeconomic, medical, psychological and social factors, and biochemical markers. Data were analyzed using least absolute shrinkage selection operator (LASSO) multivariable logistic regression models. RESULTS A total of 51 (4.8%) participants, including 21 (3.5%) of the cognitively normal and physically robust participants, 20 (4.7%) of the prefrail/frail only, and 10 (45.4%) of cognitively impaired only, transited to cognitive frailty at follow-up. Risk factors for transition to cognitive frailty were having eye problem (OR = 2.6, 95% CI 1.24-5.43) and low HDL cholesterol (OR = 4.1, 95% CI 2.03-8.40), while protective factors for cognitive frailty transition were higher levels of education (OR = 0.3, 95% CI 0.10-0.74) and participation in cognitive stimulating activities (OR = 0.4, 95% CI 0.17-0.82). CONCLUSION Multi-domain modifiable factors especially related to leisure activities predict cognitive frailty transition and may be targeted for prevention of dementia and associated adverse health outcomes.
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Affiliation(s)
- Shuen Yee Lee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Office of the Senior Deputy President and Provost, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Shiou Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Geriatric Education and Research Institute, Singapore, Singapore
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Woods B, Rai HK, Elliott E, Aguirre E, Orrell M, Spector A. Cognitive stimulation to improve cognitive functioning in people with dementia. Hippokratia 2023. [DOI: 10.1002/14651858.cd005562.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Bob Woods
- Dementia Services Development Centre Wales; Bangor University; Bangor UK
| | - Harleen Kaur Rai
- Department of Psychiatry and Applied Psychology; Institute of Mental Health, University of Nottingham; Nottingham UK
| | - Emma Elliott
- Institute of Cardiovascular and Medical Sciences; University of Glasgow; Glasgow UK
| | | | - Martin Orrell
- Institute of Mental Health; University of Nottingham; Nottingham UK
| | - Aimee Spector
- Research Department of Clinical, Educational and Health Psychology; University College London; London UK
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Pozzi FE, Appollonio I, Ferrarese C, Tremolizzo L. Can Traditional Board Games Prevent or Slow Down Cognitive Impairment? A Systematic Review and Meta-Analysis. J Alzheimers Dis 2023; 95:829-845. [PMID: 37638443 DOI: 10.3233/jad-230473] [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] [Indexed: 08/29/2023]
Abstract
BACKGROUND Traditional board games can entail significant skills encompassing several cognitive functions across different domains. Therefore, they may potentially represent effective cognitive interventions in the aging population with or without Alzheimer's disease or other types of dementia. OBJECTIVE We aimed at verifying the hypothesis that traditional board games can prevent or slow down cognitive decline, through a systematic review on traditional board games and dementia. METHODS We searched five databases with tailored search strings. We included studies assessing the impact of board games on elderly subjects at risk of or suffering from cognitive impairment, or subjects with cognitive impairment irrespective of age. Studies where the effect of board games was not separated by cards or other games were excluded. A meta-analysis was performed for specific cognitive and non-cognitive outcomes. RESULTS Board games improved mental function, as measured by Montreal Cognitive Assessment (p = 0.003) and Mini-Mental State Examination (p = 0.02). Ska and Go improved Trail Making Test -A, while Mahjong improved executive functions. There was no consistent effect across different games on Digit Span or Categorical Fluency. Chess improved quality of life measured with the WHO-QoL-OLD scale (p < 0.00001). Mahjong temporarily improved depressive symptoms. Go increased BDNF levels and left middle temporal gyrus and bilateral putamen metabolism. CONCLUSIONS Traditional board games may slow global cognitive decline and improve the quality of life in elderly subjects. Different games have varying impacts on specific cognitive domains, possibly mediated by functional and biological factors.
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Affiliation(s)
| | - Ildebrando Appollonio
- Neurology Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy
| | - Carlo Ferrarese
- Neurology Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy
| | - Lucio Tremolizzo
- Neurology Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy
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Higashijima T, Akimoto T, Sakata K. Effect of Mahjong on children's intelligence quotient. Front Psychol 2022; 13:934453. [PMID: 36225701 PMCID: PMC9549265 DOI: 10.3389/fpsyg.2022.934453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
This study investigated the effect of Mahjong, which is a table game played by three or four players and involves intellectual activity, on the intelligence quotient (IQ) of children. The participants were children between the age of 6 and 15 years, and their IQ was assessed immediately after enrolling in children's Mahjong classes and 1 year after the enrollment using the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). Twenty children were included in the analysis. Their mean age at the time of the initial evaluation was 9 years and 6 months. In addition, we conducted a 1-year post-examination. The change in the IQ of this group was compared to that of a historical control group with a similar age range and test–retest interval. The mean overall full-scale IQ of the 20 children during the initial and post-1-year examinations was 106.05 and 113.75, respectively, and showed a statistically significant increase (p < 0.01). Based on the subscale index, the verbal comprehension index (VCI) and processing speed index (PSI) scores both showed a statistically significant increase from 100.6 to 106.75 and from 108.05 to 119.05 (p < 0.01), respectively. The PSI of the children included in the analysis showed a statistically significant increase compared to the historical control group. This study suggests that children who participate in Mahjong classes during their childhood have increased PSI scores of WISC-IV.
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Wang J, Liu N, Zhao X. Association of Playing Cards or Mahjong with Cognitive Function in Chinese Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159249. [PMID: 35954599 PMCID: PMC9368645 DOI: 10.3390/ijerph19159249] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022]
Abstract
Cognitive decline in older adults is a major public health threat. This study aimed to explore the association of participation in cards or mahjong with cognitive function in older adults. A total of 7308 older adults were selected from the 2018 Chinese Longitudinal Healthy Longevity Survey. A modified Mini-Mental State Examination (MMSE) was used to assess cognitive function. The participants were classified according to the frequency of playing cards or mahjong into the “regularly” (R) group, “occasionally” (O) group, or “never” (N) group. The results showed that older persons in the R group and O group had better cognitive function than those in the N group. Specifically, significant differences were found in attention and calculation, language, and total MMSE score between the R group and the N group. However, significant differences were not observed for adults aged 60–69 years old. Regression analysis indicated that playing cards or mahjong, together with age, educational level, sex, marital status, and occupation before age 60 could explain the cognitive function. The findings suggest that there is an association between participation in cards or mahjong and cognitive function in the population of Chinese older adults, and that the frequency of participation plays an important role in the association.
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Affiliation(s)
- Jin Wang
- Faculty of Sport Science, Ningbo University, Ningbo 315211, China; (J.W.); (N.L.)
| | - Nan Liu
- Faculty of Sport Science, Ningbo University, Ningbo 315211, China; (J.W.); (N.L.)
| | - Xiaoguang Zhao
- Faculty of Sport Science, Ningbo University, Ningbo 315211, China; (J.W.); (N.L.)
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
- Correspondence: ; Tel.: +86-574-87609369
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Mahjong Playing and Leisure Physical Activity Alleviate Cognitive Symptoms in Older Community Residents. J Aging Phys Act 2021; 30:89-97. [PMID: 34388703 DOI: 10.1123/japa.2020-0383] [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: 09/22/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/18/2022]
Abstract
Leisure activities, particularly physically and cognitively stimulating leisure activities, mitigate cognitive decline. The present study aimed to examine the relationship between mahjong playing, leisure physical activity, and mild cognitive impairment (MCI). Older adults with and without MCI were recruited (n = 489, healthy group; and n = 187, MCI group). The regression results showed that years of mahjong playing (odds ratio = 0.595, 95% confidence interval [0.376, 0.961], p = .032) and physical activity (odds ratio = 0.572, 95% confidence interval [0.381, 0.849], p = .012) were associated with reduced odds of having MCI after adjusting for a series of covariates. Leisure physical activity and mahjong playing interacted with each other and produced combined effects on the odds of having MCI. Combined cognitive and physical interventions may produce larger benefits on cognition than either intervention alone.
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Zhou Y, Chen Z, Shaw I, Wu X, Liao S, Qi L, Huo L, Liu Y, Wang R. Association between social participation and cognitive function among middle- and old-aged Chinese: A fixed-effects analysis. J Glob Health 2021; 10:020801. [PMID: 33110597 PMCID: PMC7568928 DOI: 10.7189/jogh.10.020801] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Social Participation (SP) is known to benefit cognitive function. However, whether the positive relationship holds across different types of SP and dimensions of cognitive function, and whether the statement stays true in middle- and old-aged Chinese have not been investigated. The present study aimed to understand the current patterns of SP and cognitive function in China’s context, and therefore, explore the associations between cognitive function and SP at different levels from various aspects. Methods A total of 7973 community residents aged 45 years and older were selected from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015). A fixed-effects analysis was used to explore the association between changes in SP (diversity, frequency, and type) and that in cognitive function (memory and mental status) over a four-year period. Results Changing from no SP to more variety (β = 0.377, 95% confidence interval (CI) = 0.192-0.562 for 1 type, β = 0.703, 95% CI = 0.470-0.937 for ≥2 types) or higher frequency (β = 0.235, 95% CI = 0.007-0.462 for not regularly, β = 0.604, 95% CI = 0.411-0.798) of SP was associated with improvements in cognitive function. Playing mah-jong and using Internet were associated with improved memory but not with mental status. Sports and volunteering were associated with improved mental status but not with memory. The same pattern was observed in men and in women. Conclusions The study confirmed that more diversity and higher frequency of SP was associated with improved cognitive function, whereas reminded policymakers to consider cultural context when developing target strategies to improve cognitive function.
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Affiliation(s)
- Yongjie Zhou
- Department of Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens, Georgia, USA.,School of Economics, University of Nottingham Ningbo China, Ningbo, China
| | - Ian Shaw
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Xiang Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiming Liao
- School of Public Health, Fudan University, Shanghai, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Lijuan Huo
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, Hubei, China
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13
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Vujic A, Mowszowski L, Meares S, Duffy S, Batchelor J, Naismith SL. Engagement in cognitively stimulating activities in individuals with Mild Cognitive Impairment: relationships with neuropsychological domains and hippocampal volume. AGING NEUROPSYCHOLOGY AND COGNITION 2021; 29:1000-1021. [PMID: 34330189 DOI: 10.1080/13825585.2021.1955822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Late-life participation in cognitively stimulating activities is thought to contribute to an individual's cognitive reserve and thus protect against cognitive decline, yet its association with clinical markers of neurodegeneration is not well established. To investigate, we developed a 13-item self-report "cognitively stimulating activities" questionnaire (CSA-Q), which was completed by a community sample of 269 older adults (>50 years) at risk of dementia. Participants met criteria for Mild Cognitive Impairment (MCI) and were classified as amnestic (aMCI; n = 93) or non-amnestic (naMCI; n = 176). Weighted CSA-Q dimensions were calculated for activity intensity, mental engagement and social engagement via a panel of 23 inter-raters. The CSA-Q mean and its dimensions were examined in relation to: (a) demographics (age, sex), (b) cognitive reserve proxies (years of education, premorbid IQ), (c) neuropsychological markers across cognitive domains of executive function, processing speed, learning, and memory storage, and (d) neuroimaging markers (left and right hippocampal volume). Analyses were conducted for all MCI, as well as for aMCI and naMCI sub-types. The CSA-Q was found to have concurrent validity with cognitive reserve proxies. Among all MCI, the CSA-Q dimensions of intensity and mental engagement had moderate associations with left hippocampal volume, but not with neuropsychological performance. For naMCI, the CSA-Q had moderate associations with left hippocampal volume, and small associations with aspects of executive functioning and processing speed. No equivalent associations emerged for the aMCI subtype. Our findings show that the CSA-Q may be particularly useful for older adults with non-amnestic cognitive deficits.
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Affiliation(s)
- Adam Vujic
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Department of Science, School of Psychology, University of Sydney, Sydney, Australia
| | - Susanne Meares
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Shantel Duffy
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Charles Perkins Centre, University of Sydney, Australia.,Faculty of Health Sciences, Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Jennifer Batchelor
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Department of Science, School of Psychology, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Australia
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14
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Estrada-Plana V, Montanera R, Ibarz-Estruga A, March-Llanes J, Vita-Barrull N, Guzmán N, Ros-Morente A, Ayesa Arriola R, Moya-Higueras J. Cognitive training with modern board and card games in healthy older adults: two randomized controlled trials. Int J Geriatr Psychiatry 2021; 36:839-850. [PMID: 33275804 DOI: 10.1002/gps.5484] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/29/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The aim of this study was to assess the effectiveness of a cognitive intervention based on modern board and card games. METHODS We conducted two two-arm parallel-group, randomized controlled trials. The first one (pilot study) was nonblind. The second one (main study) was a double-blind design. Participants (14 in a pilot study and 35 in the main study) were healthy older adults over 65 years old who were assisting to adult care institutions. In the pilot study, participants in the experimental group (n = 6) played modern board and card games which activated cognitive processes; whereas the control group (n = 6) was in the wait-list condition. In the main study, participants in the experimental group (n = 12) also played modern board and card games; whereas the control group (n = 15) performed standardized paper-and-pencil cognitive tasks. Psychologists specialized in older-people conducted all the interventions. In both studies, intervention sessions were bi-weekly for 5 weeks. The outcomes of both studies were cognitive status and executive functioning, depressive symptomatology, and quality of life measures. All assessment and intervention sessions took place in their habitual centers. RESULTS In the pilot study, participants in the games intervention showed a significant improvement in semantic verbal fluency. In the main study, both interventions showed significant improvements in phonemic verbal fluency. Whilst board and card games maintained motor impulsivity control, paper-and-pencil tasks improved speed in an inhibition task. CONCLUSIONS Modern board and card games could be an effective cognitive intervention to maintain some cognitive functions.
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Affiliation(s)
| | - Roger Montanera
- Department of Psychology, University of Lleida, Lleida, Spain.,Residencia Comtes Urgell, Balaguer, Spain
| | | | | | | | | | | | - Rosa Ayesa Arriola
- Department of Psychiatry, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.,Center for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Moya-Higueras
- Department of Psychology, University of Lleida, Lleida, Spain.,Center for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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15
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Yu Z, Wu X, Jiang R, Chen Y, Shen Y, Li C, Feng W. Feasibility and Engagement of Multi-domain Cognitive Training in Community-Dwelling Healthy Elderly in Shanghai. Front Psychiatry 2021; 12:781050. [PMID: 35153853 PMCID: PMC8826872 DOI: 10.3389/fpsyt.2021.781050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/09/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In recent years, cognitive training has been one of the important non-pharmaceutical treatment methods that could delay cognitive decline and improve quality of life in the elderly. In different types of cognitive training, both the cognitive domains focused on and their training methods widely vary. This study aimed to explore the feasibility and engagement of multidomain cognitive training in Chinese community-dwelling healthy elderly. METHODS Based on the cluster sampling method, a total of 151 healthy elderly, aged 70 or above, who lived in the neighborhoods in Shanghai met the inclusion criteria and agreed to participate in the study. Among them, 90 participants were assigned to the cognitive training group (intervention group), and 61 were assigned to the no cognitive training group (control group). Participants in the intervention group attended a 1-h multidomain cognitive training course twice a week for 12 weeks (total of 24 times), which targeted memory, reasoning, strategy-based problem-solving skills, etc. The control group did not receive any intervention. RESULTS There was a significant increase in test scores of story recall (t = -8.61, p = 0.00) and Raven's Standard Progressive Matrices (RSPM) (t = -10.60, p = 0.00) after in-class interventions. The overall completion of homework was 77.78%. Fifty percent of the 90 participants completed self-training. The top three self-training methods were physical exercise, reading books and newspapers, and watching TV. The overall attendance rate of the intervention group was 76.14%, and more than 50% of them had an attendance rate of 77.8%. The attendance rate was positively correlated with years of education and baseline SF-36 (physical functioning, general health, vitality, and mental health) scores, whereas it was negatively correlated with baseline disease index and fatalism of personality indicators (p < 0.05). CONCLUSION The elderly with higher educational levels and better physical and psychological conditions had a higher engagement in multidomain cognitive training. The training course proved to be rational, feasible, and effective for community-scale application.
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Affiliation(s)
- Ze Yu
- Department of Psychological Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xia Wu
- Department of Endocrinology, Jing'an District Centre Hospital of Shanghai (Huashan Hospital Fudan University Jing'an Branch), Shanghai, China
| | - Rui Jiang
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - You Chen
- Shanghai Yangpu District Mental Health Center, Shanghai, China
| | - Yuan Shen
- Department of Psychiatry, Tenth People's Hospital, Tongji University, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Feng
- Department of Psychological Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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16
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Zhang H, Peng Y, Li C, Lan H, Xing G, Chen Z, Zhang B. Playing Mahjong for 12 Weeks Improved Executive Function in Elderly People With Mild Cognitive Impairment: A Study of Implications for TBI-Induced Cognitive Deficits. Front Neurol 2020; 11:178. [PMID: 32292385 PMCID: PMC7120035 DOI: 10.3389/fneur.2020.00178] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Mild cognitive impairment (MCI) is common among elderly people. So far, effective treatment that can stabilize or reverse the cognitive decline associated with MCI is lacking. Recent studies suggest that playing mahjong may improve attention and memory in elderly people. However, its effect on executive function remains unknown. Methods: 56 elderly people (74.3 ± 4.3 years of age) with MCI from the First Social Welfare the First Nursing Home of Nanchong were randomized into mahjong and control groups (N = 28, each group). Subjects in the mahjong group played mahjong three times a week for 12 weeks, while people in the control group assumed normal daily activity. Executive function was evaluated using the Montreal Cognitive Assessment—Beijing (MoCA-B), the Shape Trail Test (STT), and the Functional Activities Questionnaire (FAQ) before the study and then at 6 and 12 weeks after mahjong administration. Results: There were no baseline differences in MoCA-B, STT, and FAQ scoring between the two groups. The MoCA-B, STT, and FAQ scores, however, improved significantly in the mahjong group but not in the control group after the 12-week mahjong administration. Significant correlations were also found between STT and FAQ scores. Conclusions: Playing Mahjong for 12 weeks improved the executive function of elderly people with MCI. Because Mahjong is a simple, low-cost entertainment activity, it could be widely applied to slow down or reverse the progression of cognitive decline in people with MCI, including those with traumatic brain injury.
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Affiliation(s)
- Han Zhang
- Department of Medical Rehabilitation, The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Yi Peng
- Department of Medical Rehabilitation, The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Chunliu Li
- Department of Medical Rehabilitation, The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Hong Lan
- Department of Medical Rehabilitation, The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Guoqiang Xing
- The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong, China
| | - Zhu Chen
- Department of Medical Rehabilitation, The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Bo Zhang
- Department of Medical Rehabilitation, The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
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17
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Lee YH, Chang YC, Shelley M, Liu CT. A panel analysis of the Mahjong card game and social activity with sleep-related measurements among Chinese older adults. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-019-00249-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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18
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Teh JK, Tey NP. Effects of selected leisure activities on preventing loneliness among older Chinese. SSM Popul Health 2019; 9:100479. [PMID: 31646167 PMCID: PMC6804430 DOI: 10.1016/j.ssmph.2019.100479] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/08/2019] [Accepted: 09/09/2019] [Indexed: 01/29/2023] Open
Abstract
This study examined three types of leisure activities (playing cards/mahjong, watching TV/listening to the radio, and participation in social activities) among the older segment of the Chinese population, and the effects of these activities in preventing the feelings of loneliness. Data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), conducted in 2005, 2008, and 2011. The males, those who were educated, the young-old (aged between 65 and 74 years), urban dwellers, and living in institutions were more likely to participate in all three activities frequently. Frequent or occasional participation in these three activities was negatively associated with feelings of loneliness. The longitudinal study from 2005 to 2011 showed that respondents who frequently played cards/mahjong at baseline were less likely to feel persistent loneliness at the end of the 2011 wave. Instead, frequently watching TV/listening to the radio in 2008 was associated with lower odds in feeling persistent loneliness at the end of 2011. Hence, active participation in playing cards/mahjong and TV/radio entertainment can be effective treatment intervention against persistent loneliness among older Chinese. For the Chinese, a leisure activity steeped in a nation's culture and heritage, such as playing mahjong, may be used as an intervention strategy to prevent and alleviate chronic loneliness among older adults.
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Affiliation(s)
- Jane K.L. Teh
- School of Mathematical Sciences, Sunway University, No. 5 Jalan Universiti, Bandar Sunway, 47500, Selangor, Malaysia
| | - Nai Peng Tey
- Population Studies Unit, Faculty of Economics and Administration, University of Malaya, 50603, Kuala Lumpur, Malaysia
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19
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Kim W. Healthy mahjong, little mahjong: social gambling among older Chinese immigrants in the U.S. INTERNATIONAL GAMBLING STUDIES 2019. [DOI: 10.1080/14459795.2019.1672767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Wooksoo Kim
- Immigrant and Refugee Research Institute,School of Social Work, University at Buffalo, The State University of New York, Buffalo, NY, USA
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20
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Wang R, Chen Z, Zhou Y, Shen L, Zhang Z, Wu X. Melancholy or mahjong? Diversity, frequency, type, and rural-urban divide of social participation and depression in middle- and old-aged Chinese: A fixed-effects analysis. Soc Sci Med 2019; 238:112518. [PMID: 31473574 DOI: 10.1016/j.socscimed.2019.112518] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/17/2019] [Accepted: 08/22/2019] [Indexed: 12/20/2022]
Abstract
The potential benefit of social participation (SP) to one's mental health has been widely acknowledged. Nevertheless, the specific type and amount of SP that is associated with improved depressive symptoms in middle- and old-aged Chinese awaits further investigation. This study aimed to understand the patterns of depression and SP by comparing urban vs rural China, and according to which, measure the associations between changes in SP and that in depressive symptoms. A total of 10,988 community residents aged 45 years and above were selected from wave 1 (2011), wave 2 (2013), and wave 4 (2015) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. The fixed-effects analysis was used to explore the association between the changes in diversity, frequency, and type of SP and the changes in depressive symptoms. The results indicated that rural respondents suffered from a significantly higher risk of depression and took less SP than their urban counterparts. Transitioning from no SP to 1 or more types of SP or to a once a week or higher frequency was associated with a decline in depressive symptoms. For urban respondents, playing mah-jong or cards and joining sports or social clubs predicted a decline in depressive symptoms. For rural residents, interacting with friends regularly was associated with fewer depressive symptoms. In conclusion, more diverse and higher frequency of SP was associated with better mental health, while the social significance of SP varied across different types of SP and between rural and urban areas.
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Affiliation(s)
- Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens, GA 30606, USA; School of Economics, University of Nottingham Ningbo China, Ningbo, 315100, China.
| | - Yongjie Zhou
- Affiliated Mental Health Center of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430012, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei, 430074, China.
| | - Lining Shen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Hubei Provincial Research Center for Health Technology Assessment, Wuhan, Hubei, 430030, China.
| | - Zhiguo Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Hubei Provincial Research Center for Health Technology Assessment, Wuhan, Hubei, 430030, China.
| | - Xiang Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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21
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Empty-nest elderly: mahjong and Chinese square dance for improving the cognitive function in the community. FRONTIERS OF NURSING 2019. [DOI: 10.2478/fon-2019-0011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
The elderly population has proliferated worldwide. The empty-nest family pattern has become predominant among the aging people, and they are more vulnerable to the development of cognitive disorders. However, there is no standardized service in the community nursing care that includes procedures on how to improve the cognitive function of the elderly. Meanwhile, the booming number of empty-nest elderly stimulates the community nurses to assume the responsibility for their care. All of these bring more difficulties and opportunities for community nurses who are dedicated to the prevention of geriatric cognitive disorders.
Methods
The authors reviewed the literature related to “empty-nest elderly”, “cognitive function”, “mahjong”, and “Chinese square dance” in the Elsevier, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), Springer and PubMed databases. The study illustrates the utility possibility of an efficient and straightforward method for improving the cognitive function among the elderly in the context of community nursing care in China and even in the rest of the world.
Results
Mental and physical activity contributes to cognitive fitness and may be beneficial in delaying cognitive decline. Mental activities, such as playing mahjong, and physical activities, such as the Chinese square dance, are common Chinese activities. Both of them can affect cognitive function in some way.
Conclusions
China is experiencing one of its most severe aging problems. Community health personnel and related professionals may consider using mahjong and Chinese square dance to promote psychological health in empty-nest elderly individuals in the community.
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22
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Iizuka A, Suzuki H, Ogawa S, Kobayashi-Cuya KE, Kobayashi M, Takebayashi T, Fujiwara Y. Can cognitive leisure activity prevent cognitive decline in older adults? A systematic review of intervention studies. Geriatr Gerontol Int 2019; 19:469-482. [PMID: 31020777 DOI: 10.1111/ggi.13671] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 03/04/2019] [Accepted: 03/25/2019] [Indexed: 02/05/2023]
Abstract
The aims of this systematic review were to investigate what kind of cognitive leisure activities have been used in intervention studies targeting older adults, and whether these activities improve cognitive function or inhibit cognitive decline. Based on the PRISMA declaration, we searched keywords using three electronic databases: PubMed, PsycINFO and PsycARTICLES. Intervention studies involving cognitive leisure activities with cognitive assessments set as outcomes were included. We regarded cognitive leisure activities as activities for enjoyment or well-being that cause intellectual stimulation (e.g. reading, playing board games). To investigate the influence of each activity on cognitive domains, multicomponent programs (e.g. combined music and art) were excluded. In total, 20 studies were included in the evaluation. Consequently, intervention studies related to arts, writing, board games, reading, handicrafts, a crossword puzzle and learning computer skills were identified. Of the 20 studies, 13 showed improvement in some cognitive domain. In 12 of these 13 studies, the intervention effects were not observed in a specific cognitive domain; rather, the intervention effects were observed across multiple cognitive domains and on working memory. The results of the present review suggest that cognitive function in older adults can be improved through cognitive leisure activity interventions. Activities related to learning new skills, that cause strong intellectual stimulation and that include communication elements were considered particularly effective tools. However, as the number of studies is small, more high-quality research needs to be accumulated. Geriatr Gerontol Int 2019; 19: 469-482.
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Affiliation(s)
- Ai Iizuka
- Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Hiroyuki Suzuki
- Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Susumu Ogawa
- Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kimi Estela Kobayashi-Cuya
- Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Momoko Kobayashi
- Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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23
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Zhu QB, Bao AM, Swaab D. Activation of the Brain to Postpone Dementia: A Concept Originating from Postmortem Human Brain Studies. Neurosci Bull 2019; 35:253-266. [PMID: 30721394 PMCID: PMC6426905 DOI: 10.1007/s12264-019-00340-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/29/2018] [Indexed: 01/27/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by decreased neuronal activity and atrophy, while hyperactivity of neurons seems to make them resistant to aging and neurodegeneration, a phenomenon which we have paraphrased as 'use it or lose it'. Our hypothesis proposes that (1) during their functioning, neurons are damaged; (2) accumulation of damage that is not repaired is the basis of aging; (3) the vulnerability to AD is determined by the genetic background and the balance between the amount of damage and the efficiency of repair, and (4) by stimulating the brain, repair mechanisms are stimulated and cognitive reserve is increased, resulting in a decreased rate of aging and risk for AD. Environmental stimulating factors such as bilingualism/multilingualism, education, occupation, musical experience, physical exercise, and leisure activities have been reported to reduce the risk of dementia and decrease the rate of cognitive decline, although methodological problems are present.
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Affiliation(s)
- Qiong-Bin Zhu
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310020, China
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Ai-Min Bao
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Dick Swaab
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands
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24
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Gauthier A, Kato PM, Bul KCM, Dunwell I, Walker-Clarke A, Lameras P. Board Games for Health: A Systematic Literature Review and Meta-Analysis. Games Health J 2018; 8:85-100. [PMID: 30256159 DOI: 10.1089/g4h.2018.0017] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Nondigital board games are being used to engage players and impact outcomes in health and medicine across diverse populations and contexts. This systematic review and meta-analysis describes and summarizes their impact based on randomized and nonrandomized controlled trials. An electronic search resulted in a review of n = 21 eligible studies. Sample sizes ranged from n = 17 to n = 3110 (n = 6554 total participants). A majority of the board game interventions focused on education to increase health-related knowledge and behaviors (76%, n = 16). Outcomes evaluated included self-efficacy, attitudes/beliefs, biological health indicators, social functioning, anxiety, and executive functioning, in addition to knowledge and behaviors. Using the Cochrane Collaboration tool for assessing bias, most studies (52%, n = 11) had an unclear risk of bias (33% [n = 7] had a high risk and 14% [n = 3] had a low risk). Statistical tests of publication bias were not significant. A random-effects meta-analysis showed a large average effect of board games on health-related knowledge (d* = 0.82, 95% confidence interval; CI [0.15-1.48]), a small-to-moderate effect on behaviors (d* = 0.33, 95% CI [0.16-0.51]), and a small-to-moderate effect on biological health indicators (d* = 0.37, 95% CI [0.21-0.52]). The findings contribute to the literature on games and gamified approaches in healthcare. Future research efforts should aim for more consistent high scientific standards in their evaluation protocols and reporting methodologies to provide a stronger evidence base.
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Affiliation(s)
- Andrea Gauthier
- 1 Faculty of Medicine, Institute of Medical Sciences, University of Toronto, Mississauga, Canada
| | - Pamela M Kato
- 2 Faculty of Engineering, Environment, and Computing, School of Computing, Electronics, and Mathematics, Coventry University, Coventry, United Kingdom
| | - Kim C M Bul
- 3 Faculty of Health and Life Sciences, Center for Innovative Research across the Life Course (CIRAL), Coventry University, Coventry, United Kingdom
| | - Ian Dunwell
- 2 Faculty of Engineering, Environment, and Computing, School of Computing, Electronics, and Mathematics, Coventry University, Coventry, United Kingdom
| | - Aimee Walker-Clarke
- 4 Warwick Manufacturing Group, Department of Engineering Psychology, International Digital Laboratory, University of Warwick, Coventry, United Kingdom
| | - Petros Lameras
- 2 Faculty of Engineering, Environment, and Computing, School of Computing, Electronics, and Mathematics, Coventry University, Coventry, United Kingdom
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25
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Iizuka A, Suzuki H, Ogawa S, Kobayashi-Cuya KE, Kobayashi M, Takebayashi T, Fujiwara Y. Pilot Randomized Controlled Trial of the GO Game Intervention on Cognitive Function. Am J Alzheimers Dis Other Demen 2018; 33:192-198. [PMID: 29345144 PMCID: PMC10852449 DOI: 10.1177/1533317517753362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This study investigated the effects of an intervention using the game "GO" on cognitive function in nursing home residents and evaluated the acquisition of GO according to each stage of dementia. Participants were randomly assigned to either the GO intervention group or a control group, and the intervention was performed once weekly for 15 weeks. Cognitive tests were conducted before and after intervention, and 17 participants were included in the final analysis. Analysis of covariance demonstrated that in the intervention group, the digit span total score significantly improved and the digit span backward score was maintained, whereas these scores decreased in the control group. All participants, including those who had moderate dementia, acquired the rules of the game, and participants with mild cognitive impairment and mild dementia could play the game successfully. This study indicates that GO might improve the cognitive function of residents living in nursing homes.
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Affiliation(s)
- Ai Iizuka
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroyuki Suzuki
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Susumu Ogawa
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Kimi Estela Kobayashi-Cuya
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Momoko Kobayashi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
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Tsang WWN, Wong GCK, Gao KL. Mahjong playing and eye-hand coordination in older adults-a cross-sectional study. J Phys Ther Sci 2016; 28:2955-2960. [PMID: 27821969 PMCID: PMC5088160 DOI: 10.1589/jpts.28.2955] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/08/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Eye-hand coordination declines with age, but physical activity is known to slow
down the degeneration. Playing mahjong involves lots of eye-hand coordination. The
objective was to investigate the relationship between playing mahjong and eye-hand
coordination in older adults using a fast finger-pointing paradigm. [Subjects and Methods]
Forty-one community dwelling older adults aged sixty or above were recruited by
convenience sampling in this cross-sectional study. They were tested on their ability to
point quickly and accurately 1) toward a stationary visual target and 2) toward a moving
visual target. [Results] The mahjong players demonstrated significantly better end-point
accuracy when pointing with their non-dominant hand toward a stationary target. They also
demonstrated significantly faster movement of their dominant hands; shorter reaction times
and better end-point accuracy when pointing with their non-dominant hands toward a moving
target. [Conclusion] Mahjong players have better eye-hand coordination than non-players.
Playing mahjong could usefully be introduced to older adults as a leisure time
activity.
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Affiliation(s)
- William W N Tsang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China
| | - Gloria C K Wong
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China
| | - Kelly L Gao
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China
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Fang EF, Scheibye-Knudsen M, Jahn HJ, Li J, Ling L, Guo H, Zhu X, Preedy V, Lu H, Bohr VA, Chan WY, Liu Y, Ng TB. A research agenda for aging in China in the 21st century. Ageing Res Rev 2015; 24:197-205. [PMID: 26304837 PMCID: PMC5179143 DOI: 10.1016/j.arr.2015.08.003] [Citation(s) in RCA: 335] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/03/2015] [Accepted: 08/17/2015] [Indexed: 12/19/2022]
Abstract
China is encountering formidable healthcare challenges brought about by the problem of aging. By 2050, there will be 400 million Chinese citizens aged 65+, 150 million of whom will be 80+. The undesirable consequences of the one-child policy, rural-to-urban migration, and expansion of the population of 'empty nest' elders are eroding the traditional family care of the elders, further exacerbating the burden borne by the current public healthcare system. The challenges of geriatric care demand prompt attention by proposing strategies for improvement in several key areas. Major diseases of the elderly that need more attention include chronic non-communicable diseases and mental health disorders. We suggest the establishment of a home care-dominated geriatric care system, and a proactive role for researchers on aging in reforming geriatric care through policy dialogs. We propose ideas for preparation of the impending aging burden and the creation of a nurturing environment conducive to healthy aging in China.
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Affiliation(s)
- Evandro Fei Fang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Laboratory of Molecular Gerontology, National Institute on Ageing, National Institutes of Health, Baltimore, MD 21224, USA.
| | - Morten Scheibye-Knudsen
- Laboratory of Molecular Gerontology, National Institute on Ageing, National Institutes of Health, Baltimore, MD 21224, USA.
| | - Heiko J Jahn
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld 33615, Germany.
| | - Juan Li
- Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Li Ling
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Sun Yat-sen Center for Migrant Health Policy, Guangzhou 510080, China.
| | - Hongwei Guo
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Xinqiang Zhu
- Institute of Nutrition and Food Safety, and Department of Toxicology and Nutrition, School of Public Health, Zhejiang University, Hangzhou 310058, China.
| | - Victor Preedy
- Diabetes & Nutritional Sciences Division, School of Medicine, King's College London, London WC2R 2LS, UK.
| | - Huiming Lu
- Laboratory of Molecular Gerontology, National Institute on Ageing, National Institutes of Health, Baltimore, MD 21224, USA.
| | - Vilhelm A Bohr
- Laboratory of Molecular Gerontology, National Institute on Ageing, National Institutes of Health, Baltimore, MD 21224, USA.
| | - Wai Yee Chan
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Yuanli Liu
- Peking Union School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100006, China; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Tzi Bun Ng
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Subramaniam M, Abdin E, Shahwan S, Vaingankar JA, Picco L, Browning CJ, Thomas SA, Chong SA. Culture and age influences upon gambling and problem gambling. Addict Behav Rep 2015. [PMID: 29531980 PMCID: PMC5845977 DOI: 10.1016/j.abrep.2015.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to (i) examine the prevalence and types of gambling, (ii) establish prevalence of ‘pathological’ gambling, (iii) explore the correlates of gambling, and (iv) establish psychiatric and physical comorbidity in a sample of older adult gamblers (≥ 60 years) in contrast to younger gamblers in a representative population sample in Singapore. Method This paper reports the results of a secondary analysis of data from a representative community survey of 6616 participants, of which 2252 had engaged in gambling activities at least once in their lifetime. Results 48.9% of older adults reported lifetime gambling. Older gamblers were more likely to be males, married or widowed (vs. never married), with pre-primary, primary and secondary education (vs. university), economically inactive (vs. employed) and had personal annual income of SGD $19,999 and below (vs. SGD $50,000 and above). Older gamblers had significantly higher rates of betting on horses, playing numbers or betting on lotteries, and playing Mahjong. After adjusting for demographic variables in multiple logistic regression analyses, gamblers aged 60 years and older had significantly lower odds of having pathological gambling than those in the younger age group (OR = 0.4). Older gamblers had significantly higher odds of having diabetes (OR = 3.2), hypertension (OR = 4.9), and any comorbid chronic physical condition assessed in this study. Conclusions For the majority of older adults, gambling remains a recreational activity that is entertaining and a way of socialization. However, one must remain cognizant of the possible risks for some to develop disordered gambling. 48.9% of older adults in Singapore reported lifetime gambling. Older gamblers were more likely to be males, married or widowed, and had lower education. Older gamblers had significantly lower odds of having pathological gambling.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore.,Saw Swee Hock School of Public Health, Singapore
| | | | | | | | - Louisa Picco
- Research Division, Institute of Mental Health, Singapore
| | - Colette Joy Browning
- School of Primary Health Care, Monash University, Australia.,Research Institute, RDNS, Australia
| | - Shane Andrew Thomas
- School of Primary Health Care, Monash University, Australia.,Office of the Pro Vice-Chancellor (International) University of Adelaide, Australia
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Yu F, Demorest SL, Vock DM. Testing a modified perceived exertion scale for Alzheimer's disease. Psych J 2015; 4:38-46. [DOI: 10.1002/pchj.82] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 11/17/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Fang Yu
- School of Nursing; University of Minnesota; Minneapolis Minnesota USA
| | | | - David M. Vock
- Department of Biostatistics; University of Minnesota; Minneapolis Minnesota USA
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Dong X, Li Y, Simon MA. Social engagement among U.S. Chinese older adults--findings from the PINE Study. J Gerontol A Biol Sci Med Sci 2014; 69 Suppl 2:S82-9. [PMID: 25378453 PMCID: PMC4453751 DOI: 10.1093/gerona/glu152] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Social engagement is a key indicator of older adults' later life quality and health status, but few studies have comprehensively examined social engagement patterns of U.S. Chinese older adults. This study assesses social engagement patterns among U.S. Chinese older adults. METHODS Data were collected by the Population Study of Chinese Elderly project, a cross-sectional population-based study of 3,159 U.S. Chinese older adults aged 60 and older in the greater Chicago area. Social engagement patterns were examined with a list of 16 social engagement activity related questions. Analysis of variance and Pearson or Spearman correlation coefficients were used to examine correlations between sociodemographic and health characteristics and social engagement. RESULTS Age was negatively associated with social engagement actives for Chinese older adults. Although education had a significant positive correlation on older adults' participation in social engagement activities, income did not show any significant correlation. Perceived health status and quality of life were also positively correlated with social engagement. Chinese older adults were more likely to visit community centers than any other social or cultural venues. CONCLUSIONS This study highlights the important role community centers play in the lives of Chinese older adults. Further, longitudinal studies are also necessary to understand the predictors and outcomes of social engagement levels among Chinese older adults.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois.
| | - Yu Li
- Department of Obstetrics/Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Melissa A. Simon
- Department of Obstetrics/Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Cheng ST. Response to Park's letter to the editor. Am J Geriatr Psychiatry 2014; 22:524-5. [PMID: 24725629 DOI: 10.1016/j.jagp.2014.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 02/12/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Sheung-Tak Cheng
- Department of Health and Physical Education, Hong Kong Institute of Education, Tai Po, N.T., Hong Kong.
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Mental and physical activities delay cognitive decline in older persons with dementia. Am J Geriatr Psychiatry 2014; 22:63-74. [PMID: 23582750 DOI: 10.1016/j.jagp.2013.01.060] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 06/27/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine the effects of cognitive stimulation (mahjong) and physical exercise (tai chi [TC]) on cognitive performance in persons with dementia. DESIGN Cluster-randomized open-label controlled design. SETTING Nursing homes. PARTICIPANTS One hundred ten residents, most of whom were cholinesterase-inhibitor naive. Inclusion criteria were Mini-Mental State Examination (MMSE) = 10-24 and suffering from at least very mild dementia (Clinical Dementia Rating ≥ 0.5). Exclusion criteria were being bedbound, audio/visual impairment, regular activity participation before study, or contraindications for physical or group activities. INTERVENTIONS Homes were randomized into three conditions (mahjong, TC, and simple handicrafts [control]). Activities were conducted three times weekly for 12 weeks. MEASUREMENTS Primary outcome was MMSE. Secondary outcomes were immediate/delayed recall, categorical fluency, and digit span. Various biological risk factors, including apolipoprotein E ε4 allele, were included as covariates. Measures were collected at 0 (baseline), 3 (posttreatment), 6, and 9 months. RESULTS Intent-to-treat analyses were performed using mixed-effects regression. Mahjong's effect varied by time for MMSE, delayed recall, and forward digit span. TC had similar effects but not for delayed recall. The typical pattern was that control participants deteriorated while mahjong and TC participants maintained their abilities over time, leading to enlarged treatment effects as time progressed. By 9 months, mahjong and TC differed from control by 4.5 points (95% confidence interval: 2.0-6.9; d = 0.48) and 3.7 points (95% confidence interval: 1.4-6.0; d = 0.40), respectively, on MMSE. No treatment effects were observed for immediate recall and backward digit span. CONCLUSIONS Mahjong and TC can preserve functioning or delay decline in certain cognitive domains, even in those with significant cognitive impairment.
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Bossers WJR, van der Woude LHV, Boersma F, Scherder EJA, van Heuvelen MJG. Recommended measures for the assessment of cognitive and physical performance in older patients with dementia: a systematic review. Dement Geriatr Cogn Dis Extra 2012; 2:589-609. [PMID: 23341825 PMCID: PMC3551396 DOI: 10.1159/000345038] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim/Goal To recommend a set of neuropsychological and physical exercise tests for researchers to assess cognition and physical fitness in clinical trials with older patients with dementia; to create consensus, decrease heterogeneity, and improve research quality. Methods A literature search (2005–2011) yielded 89 randomized controlled trials. To provide information on test recommendations the frequency of test use, effect size of the test outcome, study quality, and psychometric properties of tests were analyzed. Results Fifty-nine neuropsychological tests (cognitive domains: global cognition, executive functioning, memory, and attention) and 10 exercise tests (physical domains: endurance capacity, muscle strength, balance, and mobility) were found. Conclusion The Severe Impairment Battery, Mini Mental State Examination, and Alzheimer Disease Assessment Scale – cognitive subscale were recommended to measure global cognition. The Verbal Fluency Test Category/Letters, Clock Drawing Test, and Trail Making Test-B were recommended to measure executive functioning. No specific memory test could be recommended. The Digit Span Forward, Digit Span Backward, and Trail Making Test-A were recommended to measure attention. As physical exercise tests, the Timed Up and Go and Six Meter Walk for mobility, the Six Minute Walk Distance for endurance capacity, and the Tinetti Balance Scale were recommended.
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Affiliation(s)
- Willem J R Bossers
- Center for Human Movement Sciences, Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Boyd A, Payne J, Hutcheson C, Bell S. Bored to death: tackling lack of activity in care homes. ACTA ACUST UNITED AC 2012. [DOI: 10.12968/bjmh.2012.1.4.232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Andrea Boyd
- Occupational Therapist, NHS Ayrshire and Arran
| | | | | | - Sheena Bell
- Occupational Therapist, NHS Ayrshire and Arran
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Cheung Y, Shwe M, Tan Y, Fan G, Ng R, Chan A. Cognitive changes in multiethnic Asian breast cancer patients: a focus group study. Ann Oncol 2012; 23:2547-2552. [DOI: 10.1093/annonc/mds029] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
In 2010, approximately 500,000 Canadians suffered from a dementia-related illness. The number of sufferers is estimated to double in about 25 years. Due to this growing demographic, dementia (most frequently caused by Alzheimer's disease) will increasingly have a significant impact on our aging community and their caregivers. Dementia is associated with challenging behaviours such as agitation, wandering, and aggression. Care providers must find innovative strategies that facilitate the quality of life for this population; moreover, such strategies must value the individual person. Social commitment robots - designed specifically with communication and therapeutic purposes - provide one means towards attaining this goal. This paper describes a study in which Paro (a robotic baby harp seal) was used as part of a summer training program for students. Preliminary conclusions suggest that the integration of social commitment robots may be clinically valuable for older, agitated persons living with dementia in long-term care settings.
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Woods B, Aguirre E, Spector AE, Orrell M. Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev 2012:CD005562. [PMID: 22336813 DOI: 10.1002/14651858.cd005562.pub2] [Citation(s) in RCA: 328] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive stimulation is an intervention for people with dementia which offers a range of enjoyable activities providing general stimulation for thinking, concentration and memory usually in a social setting, such as a small group. Its roots can be traced back to Reality Orientation (RO), which was developed in the late 1950s as a response to confusion and disorientation in older patients in hospital units in the USA. RO emphasised the engagement of nursing assistants in a hopeful, therapeutic process but became associated with a rigid, confrontational approach to people with dementia, leading to its use becoming less and less common.Cognitive stimulation is often discussed in normal ageing as well as in dementia. This reflects a general view that lack of cognitive activity hastens cognitive decline. With people with dementia, cognitive stimulation attempts to make use of the positive aspects of RO whilst ensuring that the stimulation is implemented in a sensitive, respectful and person-centred manner.There is often little consistency in the application and availability of psychological therapies in dementia services, so a systematic review of the available evidence regarding cognitive stimulation is important in order to identify its effectiveness and to place practice recommendations on a sound evidence base. OBJECTIVES To evaluate the effectiveness and impact of cognitive stimulation interventions aimed at improving cognition for people with dementia, including any negative effects. SEARCH METHODS The trials were identified from a search of the Cochrane Dementia and Cognitive Improvement Group Specialized Register, called ALOIS (updated 6 December 2011). The search terms used were: cognitive stimulation, reality orientation, memory therapy, memory groups, memory support, memory stimulation, global stimulation, cognitive psychostimulation. Supplementary searches were performed in a number of major healthcare databases and trial registers to ensure that the search was up to date and comprehensive. SELECTION CRITERIA All randomised controlled trials (RCTs) of cognitive stimulation for dementia which incorporated a measure of cognitive change were included. DATA COLLECTION AND ANALYSIS Data were extracted independently by two review authors using a previously tested data extraction form. Study authors were contacted for data not provided in the papers. Two review authors conducted independent assessments of the risk of bias in included studies. MAIN RESULTS Fifteen RCTs were included in the review. Six of these had been included in the previous review of RO. The studies included participants from a variety of settings, interventions that were of varying duration and intensity, and were from several different countries. The quality of the studies was generally low by current standards but most had taken steps to ensure assessors were blind to treatment allocation. Data were entered in the meta-analyses for 718 participants (407 receiving cognitive stimulation, 311 in control groups). The primary analysis was on changes that were evident immediately at the end of the treatment period. A few studies provided data allowing evaluation of whether any effects were subsequently maintained. A clear, consistent benefit on cognitive function was associated with cognitive stimulation (standardised mean difference (SMD) 0.41, 95% CI 0.25 to 0.57). This remained evident at follow-up one to three months after the end of treatment. In secondary analyses with smaller total sample sizes, benefits were also noted on self-reported quality of life and well-being (standardised mean difference: 0.38 [95% CI: 0.11, 0.65]); and on staff ratings of communication and social interaction (SMD 0.44, 95% CI 0.17 to 0.71). No differences in relation to mood (self-report or staff-rated), activities of daily living, general behavioural function or problem behaviour were noted. In the few studies reporting family caregiver outcomes, no differences were noted. Importantly, there was no indication of increased strain on family caregivers in the one study where they were trained to deliver the intervention. AUTHORS' CONCLUSIONS There was consistent evidence from multiple trials that cognitive stimulation programmes benefit cognition in people with mild to moderate dementia over and above any medication effects. However, the trials were of variable quality with small sample sizes and only limited details of the randomisation method were apparent in a number of the trials. Other outcomes need more exploration but improvements in self-reported quality of life and well-being were promising. Further research should look into the potential benefits of longer term cognitive stimulation programmes and their clinical significance.
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Affiliation(s)
- Bob Woods
- Dementia ServicesDevelopment CentreWales, Bangor University, Bangor, UK.
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