1
|
Thunborg C, Wang R, Rosenberg A, Sindi S, Andersen P, Andrieu S, Broersen LM, Coley N, Couderc C, Duval CZ, Faxen-Irving G, Hagman G, Hallikainen M, Håkansson K, Kekkonen E, Lehtisalo J, Levak N, Mangialasche F, Pantel J, Rydström A, Stigsdotter-Neely A, Wimo A, Ngandu T, Soininen H, Hartmann T, Solomon A, Kivipelto M. Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer's disease: the MIND-AD mini randomized controlled trial. Alzheimers Res Ther 2024; 16:118. [PMID: 38812047 PMCID: PMC11138035 DOI: 10.1186/s13195-024-01468-x] [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: 02/18/2024] [Accepted: 04/27/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed cognitive benefits from a multidomain lifestyle intervention in at-risk older people. The LipiDiDiet trial highlighted benefits of medical food in prodromal Alzheimer's disease (AD). However, the feasibility and impact of multimodal interventions combining lifestyle with medical food in prodromal AD is unclear. METHODS MIND-ADmini was a 6-month multinational (Sweden, Finland, Germany, France) proof-of-concept randomized controlled trial (RCT). Participants were 60-85 years old, had prodromal AD (International Working Group-1 criteria), and vascular/lifestyle risk factors. The parallel-group RCT had three arms: multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); multimodal lifestyle intervention + medical food (Fortasyn Connect); and regular health advice/care (control). Participants were randomized 1:1:1 (computer-generated allocation at each site). Outcome evaluators were blinded to randomization. Primary outcome was feasibility of the multimodal intervention, evaluated by recruitment rate during a 6-month recruitment phase, overall adherence in each intervention arm, and 6-month retention rate. Successful adherence was pre-specified as attending ≥ 40% of sessions/domain in ≥ 2/4 domains (lifestyle intervention), and consuming ≥ 60% of the medical food (lifestyle intervention + medical food). The secondary outcomes included adherence/participation to each intervention component and overall adherence to healthy lifestyle changes, measured using a composite score for healthy lifestyle. Cognitive assessments were included as exploratory outcomes, e.g. Clinical Dementia Rating scale. RESULTS During September 2017-May 2019, 93 individuals were randomized (32 lifestyle intervention, 31 lifestyle + medical food, and 30 control group). Overall recruitment rate was 76.2% (64.8% during the first 6 months). Overall 6-month retention rate was 91.4% (lifestyle intervention 87.5%; lifestyle + medical food 90.3%; control 96.7%). Domain-specific adherence in the lifestyle intervention group was 71.9% to cognitive training, 78.1% exercise, 68.8% nutritional guidance, and 81.3% vascular risk management; and in the lifestyle + medical food group, 90.3% to cognitive training, 87.1% exercise, 80.7% nutritional guidance, 87.1% vascular risk management, and 87.1% medical food. Compared with control, both intervention arms showed healthy diet improvements (βLifestyle×Time = 1.11, P = 0.038; βLifestyle+medical food×Time = 1.43, P = 0.007); the lifestyle + medical food group also showed vascular risk reduction (P = 0.043) and less cognitive-functional decline (P < 0.05, exploratory analysis). There were 5 serious adverse events (control group: 1; lifestyle intervention: 3; lifestyle + medical food: 1) unrelated to interventions. CONCLUSIONS The multidomain lifestyle intervention, alone or combined with medical food, had good feasibility and adherence in prodromal AD. Longer-term cognitive and other health benefits should be further investigated in a larger-scale trial. TRIAL REGISTRATION ClinicalTrials.gov NCT03249688.
Collapse
Affiliation(s)
- Charlotta Thunborg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, Solna, Stockholm, 171 64, Sweden
- Department of Caring Sciences, Faculty of Health and Occupational Studies, Gävle, 801 76, Sweden
| | - Rui Wang
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, Stockholm, SE-114 86, Sweden
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave J5/1 Mezzanine, Madison, WI, 53792, USA
| | - Anna Rosenberg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, Kuopio, 70210, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Pia Andersen
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, Solna, Stockholm, 171 64, Sweden
| | - Sandrine Andrieu
- Department of Clinical Epidemiology and Public Health, CHU de Toulouse, and Aging Research Team, CERPOP Inserm UMR 1295, Jules Guesde, Toulouse, 31000, France
- IHU HealthAge, Toulouse, 31059, France
| | | | - Nicola Coley
- Department of Clinical Epidemiology and Public Health, CHU de Toulouse, and Aging Research Team, CERPOP Inserm UMR 1295, Jules Guesde, Toulouse, 31000, France
- IHU HealthAge, Toulouse, 31059, France
| | - Celine Couderc
- Department of Clinical Epidemiology and Public Health, CHU de Toulouse, and Aging Research Team, CERPOP Inserm UMR 1295, Jules Guesde, Toulouse, 31000, France
| | - Celine Z Duval
- German Institute for Dementia Prevention (DIDP), Saarland University, Homburg, 66424, Germany
- Institute of General Practice, Goethe University Frankfurt a.M, Frankfurt, 60590, Germany
| | - Gerd Faxen-Irving
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
| | - Göran Hagman
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, Solna, Stockholm, 171 64, Sweden
| | - Merja Hallikainen
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Krister Håkansson
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, Solna, Stockholm, 171 64, Sweden
- Stockholm Gerontology Research Center, Tomtebodavägen 18a, Solna, 171 65, Sweden
| | - Eija Kekkonen
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Jenni Lehtisalo
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, Helsinki, Finland
| | - Nicholas Levak
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, Solna, Stockholm, 171 64, Sweden
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
| | - Johannes Pantel
- German Institute for Dementia Prevention (DIDP), Saarland University, Homburg, 66424, Germany
- Institute of General Practice, Goethe University Frankfurt a.M, Frankfurt, 60590, Germany
| | - Anders Rydström
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
| | - Anna Stigsdotter-Neely
- Department of Social and Psychological Studies, Karlstad University, Karlstad, 651 88, Sweden
- Engineering Psychology, Luleå University of Technology, Luleå, 971 87, Sweden
| | - Anders Wimo
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
| | - Tiia Ngandu
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, Helsinki, Finland
| | - Hilkka Soininen
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Tobias Hartmann
- German Institute for Dementia Prevention (DIDP), Saarland University, Homburg, 66424, Germany
- Department of Experimental Neurology, Medical Faculty, Saarland University, Homburg, 66424, Germany
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, Kuopio, 70210, Finland
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, Solna, 171 64, Sweden.
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, Solna, Stockholm, 171 64, Sweden.
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, Kuopio, 70210, Finland.
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK.
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 8, Kuopio, 70210, Finland.
| |
Collapse
|
2
|
Tainta M, Ecay-Torres M, de Arriba M, Barandiaran M, Otaegui-Arrazola A, Iriondo A, Garcia-Sebastian M, Estanga A, Saldias J, Clerigue M, Gabilondo A, Ros N, Mugica J, Barandiaran A, Mangialasche F, Kivipelto M, Arrospide A, Mar J, Martinez-Lage P. GOIZ ZAINDU study: a FINGER-like multidomain lifestyle intervention feasibility randomized trial to prevent dementia in Southern Europe. Alzheimers Res Ther 2024; 16:44. [PMID: 38413990 PMCID: PMC10898038 DOI: 10.1186/s13195-024-01393-z] [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: 09/11/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND GOIZ ZAINDU ("caring early" in Basque) is a pilot study to adapt the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) methodology to the Basque population and evaluate the feasibility and adherence to a FINGER-like multidomain intervention program. Additional aims included the assessment of efficacy on cognition and data collection to design a large efficacy trial. METHOD GOIZ ZAINDU is a 1-year, randomized, controlled trial of a multidomain intervention in persons aged 60+ years, with Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score ≥ 6, no diagnosis of dementia, and below-than-expected performance in at least one of three cognitive screening tests. Randomization to a multidomain intervention (MD-Int) or regular health advice (RHA) was stratified by sex, age (>/≤ 75), and cognitive status (mild cognitive impairment (MCI)/normal cognition). MD-Int included cardiovascular risk factor control, nutritional counseling, physical activity, and cognitive training. The primary outcomes were retention rate and adherence to the intervention program. Exploratory cognitive outcomes included changes in the Neuropsychological Test Battery z-scores. Analyses were performed according to the intention to treat. RESULTS One hundred twenty-five participants were recruited (mean age: 75.64 (± 6.46); 58% women). The MD-Int (n = 61) and RHA (n = 64) groups were balanced in terms of their demographics and cognition. Fifty-two (85%) participants from the RHA group and 56 (88%) from the MD-Int group completed the study. More than 70% of the participants had high overall adherence to the intervention activities. The risk of cognitive decline was higher in the RHA group than in the MD-Int group in terms of executive function (p =.019) and processing speed scores (p =.026). CONCLUSIONS The GOIZ-ZAINDU study proved that the FINGER methodology is adaptable and feasible in a different socio-cultural environment. The exploratory efficacy results showed a lower risk of decline in executive function and processing speed in the intervention group. These results support the design of a large-scale efficacy trial. TRIAL REGISTRATION GOIZ ZAINDU feasibility trial was approved and registered by the Euskadi Drug Research Ethics Committee (ID: PI2017134) on 23 January 2018. Retrospectively registered in ClinicalTrials.gov (NCT06163716) on 8 December 2023.
Collapse
Affiliation(s)
- Mikel Tainta
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | | | - Maria de Arriba
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | - Myriam Barandiaran
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | | | - Ane Iriondo
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | | | - Ainara Estanga
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | - Jon Saldias
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | | | - Alazne Gabilondo
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Bidasoa, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | - Naia Ros
- University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
| | - Justo Mugica
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
| | - Aitziber Barandiaran
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Arantzazu Arrospide
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | - Javier Mar
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
- Instituto de Investigación en Servicios Sanitarios Kronikgune, Barakaldo, Spain
| | | |
Collapse
|
3
|
Li X, Cao X, Zhang J, Fu J, Mohedaner M, Zhuogadanzeng, Sun X, Yang G, Yang Z, Kuo CL, Chen X, Cohen AA, Liu Z. Accelerated aging mediates the associations of unhealthy lifestyles with cardiovascular disease, cancer, and mortality. J Am Geriatr Soc 2024; 72:181-193. [PMID: 37789775 PMCID: PMC11078652 DOI: 10.1111/jgs.18611] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND With two well-validated aging measures capturing mortality and morbidity risk, this study examined whether and to what extent aging mediates the associations of unhealthy lifestyles with adverse health outcomes. METHODS Data were from 405,944 adults (40-69 years) from UK Biobank (UKB) and 9972 adults (20-84 years) from the US National Health and Nutrition Examination Survey (NHANES). An unhealthy lifestyles score (range: 0-5) was constructed based on five factors (smoking, drinking, physical inactivity, unhealthy body mass index, and unhealthy diet). Two aging measures, Phenotypic Age Acceleration (PhenoAgeAccel) and Biological Age Acceleration (BioAgeAccel) were calculated using nine and seven blood biomarkers, respectively, with a higher value indicating the acceleration of aging. The outcomes included incident cardiovascular disease (CVD), incident cancer, and all-cause mortality in UKB; CVD mortality, cancer mortality, and all-cause mortality in NHANES. A general linear regression model, Cox proportional hazards model, and formal mediation analysis were performed. RESULTS The unhealthy lifestyles score was positively associated with PhenoAgeAccel (UKB: β = 0.741; NHANES: β = 0.874, all p < 0.001). We further confirmed the respective associations of PhenoAgeAccel and unhealthy lifestyles with the outcomes in UKB and NHANES. The mediation proportion of PhenoAgeAccel in associations of unhealthy lifestyles with incident CVD, incident cancer, and all-cause mortality were 20.0%, 17.8%, and 26.6% (all p < 0.001) in UKB, respectively. Similar results were found in NHANES. The findings were robust when using another aging measure-BioAgeAccel. CONCLUSIONS Accelerated aging partially mediated the associations of lifestyles with CVD, cancer, and mortality in UK and US populations. The findings reveal a novel pathway and the potential of geroprotective programs in mitigating health inequality in late life beyond lifestyle interventions.
Collapse
Affiliation(s)
- Xueqin Li
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Xingqi Cao
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Jingyun Zhang
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Jinjing Fu
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Mayila Mohedaner
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Zhuogadanzeng
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Xiaoyi Sun
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Gan Yang
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Zhenqing Yang
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Chia-Ling Kuo
- Department of Community Medicine and Health Care, Connecticut Convergence Institute for Translation in Regenerative Engineering, Institute for Systems Genomics, University of Connecticut Health, Farmington, CT 06030, USA
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT 06520, USA
- Department of Economics, Yale University, New Haven, CT 06520, USA
| | - Alan A Cohen
- Department of Family Medicine, Research Centre on Aging, CHUS Research Centre, University of Sherbrooke, Sherbrooke, QC, Canada
- Butler Columbia Aging Center and Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| |
Collapse
|
4
|
Peng S, Chen Y, Li J, Wang Y, Liu X, Wang Y, Gu S, Pei M, Zhang P. Correlation among sleep quality, physical frailty and cognitive function of the older adults in China: the mediating role. Front Public Health 2023; 11:1143033. [PMID: 37680277 PMCID: PMC10482234 DOI: 10.3389/fpubh.2023.1143033] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/04/2023] [Indexed: 09/09/2023] Open
Abstract
Objective To explore the correlation among sleep quality, physical frailty, and cognitive function in the older adults in community, and to explore the mediating role of sleep quality. Methods A total of 1,182 community-based older adults were investigated with frailty phenotype (FP), Pittsburgh sleep quality index (PISQI), Montreal cognitive assessment (MoCA) and self-made general information questionnaire. Results The incidence of physical frailty among the older adults in the community was 25.8% and the incidence of cognitive decline was 19.5%. Cognitive function was negatively correlated with physical frailty (r = -0.236, p < 0.01) and sleep quality (r = -0.558, p < 0.01). Sleep quality was positively correlated with physical frailty (r = 0.337, p < 0.01). Conclusion The physical frailty of the older adults has a direct prediction effect on cognitive function, and is regulated by the mediating role of sleep quality. Sleep quality partially mediates the relationship between cognitive dysfunction and physical frailty, which is a new insight into the study of cognition and physical frailty in the older adults. In the future, we can take measures to improve the sleep quality of the older adults, so as to reduce the occurrence of cognitive dysfunction and physical frailty of the older adults.
Collapse
Affiliation(s)
- Shuzhi Peng
- Graduate School of Nursing, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Graduate School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanping Chen
- Department of General Surgery, Funing People’s Hospital, Yancheng, Jiangsu, China
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jie Li
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yan Wang
- Graduate School of Nursing, Huzhou University, Huzhou, Zhejiang, China
| | - Xingyue Liu
- Graduate School of Nursing, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Graduate School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Wang
- Graduate School of Nursing, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Graduate School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Sainan Gu
- Graduate School of Nursing, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Graduate School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengyun Pei
- Graduate School of Nursing, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Graduate School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peng Zhang
- School of Management, Hainan Medical University, Haikou, Hainan, China
- School of Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| |
Collapse
|
5
|
Rajeev V, Chai YL, Poh L, Selvaraji S, Fann DY, Jo DG, De Silva TM, Drummond GR, Sobey CG, Arumugam TV, Chen CP, Lai MKP. Chronic cerebral hypoperfusion: a critical feature in unravelling the etiology of vascular cognitive impairment. Acta Neuropathol Commun 2023; 11:93. [PMID: 37309012 PMCID: PMC10259064 DOI: 10.1186/s40478-023-01590-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/14/2023] Open
Abstract
Vascular cognitive impairment (VCI) describes a wide spectrum of cognitive deficits related to cerebrovascular diseases. Although the loss of blood flow to cortical regions critically involved in cognitive processes must feature as the main driver of VCI, the underlying mechanisms and interactions with related disease processes remain to be fully elucidated. Recent clinical studies of cerebral blood flow measurements have supported the role of chronic cerebral hypoperfusion (CCH) as a major driver of the vascular pathology and clinical manifestations of VCI. Here we review the pathophysiological mechanisms as well as neuropathological changes of CCH. Potential interventional strategies for VCI are also reviewed. A deeper understanding of how CCH can lead to accumulation of VCI-associated pathology could potentially pave the way for early detection and development of disease-modifying therapies, thus allowing preventive interventions instead of symptomatic treatments.
Collapse
Affiliation(s)
- Vismitha Rajeev
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Yuek Ling Chai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Luting Poh
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Sharmelee Selvaraji
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore
| | - David Y Fann
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dong-Gyu Jo
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - T Michael De Silva
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Grant R Drummond
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Christopher G Sobey
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Thiruma V Arumugam
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Christopher P Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
- NUS Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mitchell K P Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
- NUS Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| |
Collapse
|