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Wang LY, Hu ZY, Chen HX, Zhou CF, Hu XY. Prevalence of mild cognitive impairment and its association with malnutrition in older Chinese adults in the community. Front Public Health 2024; 12:1407694. [PMID: 39206002 PMCID: PMC11353079 DOI: 10.3389/fpubh.2024.1407694] [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: 03/27/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Objective This study aims to characterize the prevalence and associated factors of cognitive impairment in older adults within Chinese community settings. Background Research exploring the interrelation between malnutrition and cognitive impairment in the older adult community-dwelling population is scarce. The impact of nutritional status on cognitive function in aging adults has not been definitively established. Methods A cross-sectional survey was conducted in one urban and one rural community in Chengdu, China, from October 2022 to March 2023. The sample included 706 older adults. Logistic regression was utilized to determine independent risk factors for mild cognitive impairment (MCI). Results The study found a significant prevalence of MCI at 32.0% among the older adult population. Among those suffering from malnutrition, 55.6% were affected by MCI. The logistic regression analysis indicated that malnutrition risk (OR = 2.192, 95% CI 1.431 to 3.357, p < 0.001), rural residence (OR = 1.475, 95% CI 1.003 to 2.170, p = 0.048), age (70-79 years old; OR = 2.425, 95% CI 1.611 to 3.651, p < 0.001; ≥80 years old: OR = 4.773, 95% CI 2.571 to 8.859, p < 0.001), male (OR = 1.584, 95% CI 1.085 to 2.313, p = 0.017), middle education level (OR = 0.986, 95% CI 1.627 to 5.482, p < 0.001), and ADL dependence (OR = 1.810, 95% CI 1.158 to 2.827, p = 0.009) were significantly associated with the occurrence of MCI. Conclusion The findings indicate a widespread occurrence of MCI in community-dwelling older Chinese adults. The association between malnutrition, as measured by the Mini Nutritional Assessment-Short Form (MNA-SF), and cognitive decline is evident. Older adult individuals with nutritional risk, advancing age, rural residence, male gender, moderate education, and ADL dependency are at increased likelihood of developing MCI. Longitudinal research is needed to clarify the temporal relationships between MCI, demographic factors, and whether improvements in nutritional status or ADL can reduce the incidence of MCI in this population.
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Affiliation(s)
- Ling-ying Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Zi-yi Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hong-xiu Chen
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Chun-fen Zhou
- Mental Health Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiu-ying Hu
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Mustafa Khalid N, Ponvel P, Ibrahim AM, Mohd Safien A, Md Fadzil NH, Singh DKA, Mat Ludin AF, Ibrahim N, Subramaniam P, Haron H, Rajikan R, Vanoh D, Shahar S. Development and Evaluation of Content Validity and Acceptance of a Multidomain Intervention Module for Reversal of Cognitive Frailty Among Older Adults. Clin Interv Aging 2024; 19:1189-1202. [PMID: 38974508 PMCID: PMC11226000 DOI: 10.2147/cia.s458600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/25/2024] [Indexed: 07/09/2024] Open
Abstract
Purpose There is a limited availability of multidomain interventions that target cognitive frailty. Thus, the aim of the present study was to develop and evaluate the content validity and acceptance of the multidomain intervention module to reverse cognitive frailty among older adults (iAGELESS). Patients and Methods This study was conducted in two phases: Phase I included the development of the multidomain intervention module iAGELESS and evaluation of content validity, while Phase II consisted of evaluating the acceptance of the module among 18 healthcare and social care providers, 13 older adults with cognitive frailty, and 13 caregivers. Content validity index (CVI) was used to quantify the content validity. Respondents completed a questionnaire which consisted of information on sociodemographic, followed by module acceptance evaluation with respect to content, terminologies, and graphics. The data was then analyzed descriptively. Results A multidomain intervention module, iAGELESS was developed. The module was found to have appropriate content validity (overall CVI = 0.83). All the caregivers, 92% of older adults with cognitive frailty and 83% of healthcare and social care providers were satisfied with the overall content of the module. More than 50% of those who accepted the module had satisfactory consensus on the ease of the terminologies, length of sentences, pictures, information, color, and font size included in the module. Conclusion The iAGELESS module demonstrated good content validity and was well accepted, thus warranting its utilization in future studies to determine its effectiveness in reversing cognitive frailty among older adults.
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Affiliation(s)
- Norhayati Mustafa Khalid
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Pavapriya Ponvel
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Azianah Mohamad Ibrahim
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A’isyah Mohd Safien
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Hidayah Md Fadzil
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Roslee Rajikan
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Divya Vanoh
- Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Suzana Shahar
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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M Zapawi MM, You YX, Shahar S, Shahril MR, Malek Rivan NF, Nik Mohd Fakhruddin NNI, Yap AXW. Development of Malaysian-MIND diet scores for prediction of mild cognitive impairment among older adults in Malaysia. BMC Geriatr 2024; 24:387. [PMID: 38693524 PMCID: PMC11064310 DOI: 10.1186/s12877-024-04966-7] [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: 01/03/2024] [Accepted: 04/11/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Mild Cognitive impairment (MCI) is a pre-demented state in the elderly populace. The Mediterranean & Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has shown promise in reducing the risk of MCI and Alzheimer's disease in older people. Notably, the existing MIND diet is not adapted to the specific needs of older adults in Malaysia, considering distinct food cultures and availability. Consequently, this study aimed to develop the Malaysian version of the MIND diet (MY-MINDD) scores and investigate their association with MCI in the older adult populace of Malaysia. METHODS A comprehensive pooled data analysis was conducted on combined data from 810 participants sourced from the longitudinal Long-Term Research Grant Scheme-Towards Useful Aging (LRGS-TUA) and Fundamental Research Grant Scheme (FRGS) studies. The MY-MINDD scores were developed by incorporating existing MIND diet food groups, their corresponding scoring mechanisms, and consideration of common Malaysian foods which are proven to be beneficial and detrimental to cognitive function. To substantiate the MY-MINDD scoring system, its association with MCI was evaluated using a series of validated neuropsychological test batteries. RESULTS MY-MINDD consists of seven food groups promote brain health and four food groups exert negative cognitive outcomes. The study participants had an average age of 67.9 ± 4.7 years. The collective MY-MINDD score for all participants was 6.4 ± 0.1 (out of a maximum 11 points), revealing a lower score in individuals with MCI at 6.0 ± 1.7 compared to those without MCI at 6.6 ± 1.6 (p < 0.001). According to hierarchical multivariate binary logistic regression analysis, being in the highest tertile of MY-MINDD score was linked to reduced odds of MCI (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.26-0.72, p < 0.001) in the fully adjusted model in comparison to the lowest tertile. CONCLUSION The development of the MY-MINDD scores for Malaysian older population revealed that a stronger adherence to this diet is linked to a reduced risk of MCI. Further substantiation of the MY-MINDD scores using more objective measures, such as neuroimaging approaches and other neuropsychological batteries, is necessary.
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Affiliation(s)
- Muhamad Mustaqim M Zapawi
- Dietetic Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Yee Xing You
- Dietetic Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Suzana Shahar
- Dietetic Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Mohd Razif Shahril
- Nutrition Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Nurul Fatin Malek Rivan
- Nutrition Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Nik Nur Izzati Nik Mohd Fakhruddin
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan, 47500, Malaysia
| | - Anastasia Xin Wei Yap
- Nutrition Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
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Mustafa Khalid N, Haron H, Shahar S, Fenech M. Current Evidence on the Association of Micronutrient Malnutrition with Mild Cognitive Impairment, Frailty, and Cognitive Frailty among Older Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15722. [PMID: 36497797 PMCID: PMC9736259 DOI: 10.3390/ijerph192315722] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 06/17/2023]
Abstract
Micronutrient malnutrition is thought to play an important role in the cause of cognitive impairment and physical frailty. The purpose of this scoping review was to map current evidence on the association between micronutrient deficiency in blood and mild cognitive impairment, frailty, and cognitive frailty among older adults. The scoping review was conducted based on the 2005 methodological framework by Arksey and O'Malley. The search strategy for potential literature on micronutrient concentration in blood and cognitive frailty was retrieved based on the keywords using electronic databases (PubMed, Cochrane Library, Google Scholar, Ovid, and Science Direct) from January 2010 to December 2021. Gray literature was also included in the searches. A total of 4310 articles were retrieved and 43 articles were incorporated in the review. Findings revealed a trend of significant association between low levels of B vitamins (folate and vitamin B12), vitamin D, vitamin A, vitamin E, omega 3 fatty acid, and albumin, and high homocysteine levels in blood with an increased risk of mild cognitive impairment among older adults. The results also indicated that low vitamin D levels, albumin, and antioxidants (lutein and zeaxanthin) in blood were significantly associated with frailty among older adults, while β-cryptoxanthin and zeaxanthin in blood were inversely associated with the risk of cognitive frailty. Vitamin D and antioxidants seemed to be targeted nutrients for the prevention of cognitive frailty. In conclusion, a wide range of micronutrient deficiency was associated with either mild cognitive impairment or frailty; however, little evidence exists on the dual impairment, i.e., cognitive frailty. This scoping review can serve as preliminary evidence for the association between micronutrient deficiency in blood and mild cognitive impairment, frailty, and cognitive frailty among older adults and prove the relevancy of the topic for future systematic reviews.
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Affiliation(s)
- Norhayati Mustafa Khalid
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Hasnah Haron
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Suzana Shahar
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Michael Fenech
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Genome Health Foundation, North Brighton, SA 5048, Australia
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Liu H, Liu Y, Shi M, Zhou Y, Zhao Y, Xia Y. Meta-analysis of sugar-sweetened beverage intake and the risk of cognitive disorders. J Affect Disord 2022; 313:177-185. [PMID: 35780967 DOI: 10.1016/j.jad.2022.06.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/23/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous epidemiological studies revealed inconsistent associations between sugar-sweetened beverage (SSB) consumption and cognitive disorders, but there have been no meta-analyses of the pooled results. Thus, a meta-analysis was performed to determine the association between SSB consumption and cognitive disorders. METHODS A systematic search of the literature prior to May 20, 2022 was performed using the PubMed and Web of Science databases. Random effects models were used to calculate and combine odds ratios (ORs) depending on the degree of heterogeneity. RESULTS 13 studies met the inclusion criteria. A total of 242,014 participants (2752 in three cross-sectional studies and 239,262 in ten cohort studies) were included. A random effects meta-analysis, according to the comprehensive analysis of SSB consumption, was associated with a greater prevalence of cognitive disorders (OR = 1.17, 95 % CI = 1.05-1.29; I2 = 90.1 %). Subgroup analyses of study design, type of SSB, or cognitive disorders outcome was performed. In subgroup analyses, we found that SSB intake was associated with a higher prevalence of cognitive disorders in cohort studies, middle-aged and elderly population, and participants with sugar-sweetened soft drinks. However, no significant association was found in other subgroups. CONCLUSION Our results indicate that SSB intake is positively associated with the prevalence of cognitive disorders. Therefore, attention should be paid to reducing SSB intake as an early intervention for cognitive disorders.
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Affiliation(s)
- Huiyuan Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yashu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mengyuan Shi
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhan Zhou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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Malek Rivan NF, Shahar S, Fakhruddin NNINM, You YX, Che Din N, Rajikan R. The effect of dietary patterns on mild cognitive impairment and dementia incidence among community-dwelling older adults. Front Nutr 2022; 9:901750. [PMID: 36003836 PMCID: PMC9395130 DOI: 10.3389/fnut.2022.901750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple studies have shown that dietary patterns have beneficial health effects on cognitive function. However, information on this relationship is presently limited, particularly among older adults. Thus, this study aimed to determine the effects of dietary patterns on mild cognitive impairment (MCI) and dementia incidence among Malaysian community-dwelling older adults. In this prospective cohort study, a total of 280 participants aged 60 years and above were included in the 5-year follow-up analysis. Participants' sociodemographic, medical history, anthropometry, blood pressure, body composition, biochemical indices, cognitive assessments, psychosocial functions, functional status, and dietary intake were obtained. MCI was classified based on Petersen criteria, whereas dementia status was assessed using clinical dementia rating (CDR). Univariate analysis was performed for all variables, followed by multinomial regression analysis to identify the ability of dietary patterns in predicting the incidence of MCI and dementia. After controlling for confounding factors, the findings indicated that "local snacks-fish and seafood-high salt foods" dietary pattern was associated with an increased risk of MCI incidence, where the T3 [adjusted OR = 3.943 (95% CI: 1.212-12.832), p = 0.032] had the highest OR compared to T2 [adjusted OR = 3.252 (95% CI: 1.108-9.546), p = 0.023]. Meanwhile, a negative association across the tertiles of tropical fruits-oats dietary pattern and dementia incidence was observed [T2: adjusted OR = 0.152 (95% CI: 0.026-0.871), p = 0.034; T3: Adjusted OR = 0.101 (95% CI: 0.011-0.967), p = 0.047]. In conclusion, specific dietary patterns, particularly "local snacks-fish and seafoods-high salt foods," were shown to increase the risk of MCI, while increasing intakes of "tropical fruits-oats" dietary patterns would protect against the dementia incidence among Malaysian older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nik Nur Izzati Nik Mohd Fakhruddin
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Yee Xing You
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Roslee Rajikan
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Ooi TC, Meramat A, Rajab NF, Shahar S, Sharif R. Antioxidant Potential, DNA Damage, Inflammation, Glycemic Control and Lipid Metabolism Alteration: A Mediation Analysis of Islamic Sunnah Intermittent Fasting on Cognitive Function among Older Adults with Mild Cognitive Impairment. J Nutr Health Aging 2022; 26:272-281. [PMID: 35297471 DOI: 10.1007/s12603-022-1757-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES This study aimed to determine the relationship between oxidative stress, DNA damage, inflammation, and metabolic biomarkers as the mediating factor between Islamic Sunnah intermittent fasting (IF) practice and cognitive function among older adults with mild cognitive impairment (MCI). DESIGN This study was a 36 months prospective cohort study. SETTING Community-dwelling older participants recruited through a stratified random sampling method from four states representing Malaysia's central, north-west, northeast and southern regions. PARTICIPANTS Ninety-nine Malay Muslim older adults (n= 99) aged 60 and above with MCI and no known critical illnesses were included in the current analysis. The participants were divided into regularly practicing IF (r-IF), irregularly practicing IF (i-IF) and not practicing IF (n-IF) groups. MEASUREMENTS Fasting venous blood was collected and used to determine the levels of oxidative stress, DNA damage, inflammatory and metabolic biomarkers. Mini-Mental State Examination, Montreal Cognitive Assessment, Rey Auditory Verbal Learning Test, Digit Span and Digit symbol were used to evaluate the cognitive function. Then, the mediation analysis was conducted using a multistep regression model to determine the mediating role of various biomarkers between IF practice and cognitive function. RESULTS When comparing the r-IF and n-IF groups, higher SOD activity, lower DNA damage (percentage of DNA in tail), lower CRP levels and higher HDL-cholesterol levels established partial mediation while lower insulin levels established complete mediation between IF practice and better cognitive function. Meanwhile, when comparing the r-IF and i-IF groups, higher SOD activity and lower CRP levels completely mediated the effects of IF practice on better cognitive function. CONCLUSION It can be concluded that changes in antioxidant function, DNA damage, inflammation and a limited set of metabolic biomarkers (insulin and HDL cholesterol) may mediate improvements in cognitive function among older participants with MCI who practice Islamic Sunnah IF.
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Affiliation(s)
- T C Ooi
- Razinah Sharif, Address: Centre for Healthy Ageing and Wellness, Faculty of Health Science, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia, Telephone: +603-9289 7459, Email address:
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A Scoping Review for Usage of Telerehabilitation among Older Adults with Mild Cognitive Impairment or Cognitive Frailty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074000. [PMID: 35409683 PMCID: PMC8997970 DOI: 10.3390/ijerph19074000] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/12/2022]
Abstract
Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes and telerehabilitation appears to be a potential platform to reverse cognitive frailty among older adults. The aim of this coping review is to identify the usage of telerehabilitation and its common platform of delivery among older adults with mild cognitive impairment (MCI) or cognitive frailty (CF). Articles published from January 2015 until October 2020 were selected. Out of the 1738 articles retrieved, six studies were identified. Two articles were randomized controlled trials, one was a pilot study and three were qualitative studies. The outcome suggests that telerehabilitation may improve the quality of life among participants as well as it can be a useful and supportive digital platform for health care. Some types of technologies commonly used were smartphones or telephones with internet, television-based assistive integrated technology, mobile application and videoconference. Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be implemented among older adults with MCI and CF, some social support is still required to improve the adherence and effectiveness of telerehabilitation. Future research should focus on the evaluation of acceptance and participants’ existing knowledge towards telerehabilitation to achieve its target.
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You YX, Shahar S, Mohamad M, Rajab NF, Che Din N, Lau HJ, Abdul Hamid H. Is There Any Relationship Between Biochemical Indices and Anthropometric Measurements With Dorsolateral Prefrontal Cortex Activation Among Older Adults With Mild Cognitive Impairment? Front Hum Neurosci 2022; 15:765451. [PMID: 35046782 PMCID: PMC8762169 DOI: 10.3389/fnhum.2021.765451] [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: 08/27/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Working memory is developed in one region of the brain called the dorsolateral prefrontal cortex (DLPFC). The dysfunction of this region leads to synaptic neuroplasticity impairment. It has been reported that several biochemical parameters and anthropometric measurements play a vital role in cognition and brain health. This study aimed to investigate the relationships between cognitive function, serum biochemical profile, and anthropometric measurements using DLPFC activation. A cross-sectional study was conducted among 35 older adults (≥60 years) who experienced mild cognitive impairment (MCI). For this purpose, we distributed a comprehensive interview-based questionnaire for collecting sociodemographic information from the participants and conducting cognitive tests. Anthropometric values were measured, and fasting blood specimens were collected. We investigated their brain activation using the task-based functional MRI (fMRI; N-back), specifically in the DLPFC region. Positive relationships were observed between brain-derived neurotrophic factor (BDNF) (β = 0.494, p < 0.01) and Mini-Mental State Examination (MMSE) (β = 0.698, p < 0.01); however, negative relationships were observed between serum triglyceride (β = −0.402, p < 0.05) and serum malondialdehyde (MDA) (β = −0.326, p < 0.05) with right DLPFC activation (R2 = 0.512) while the participants performed 1-back task after adjustments for age, gender, and years of education. In conclusion, higher serum triglycerides, higher oxidative stress, and lower neurotrophic factor were associated with lower right DLPFC activation among older adults with MCI. A further investigation needs to be carried out to understand the causal-effect mechanisms of the significant parameters and the DLPFC activation so that better intervention strategies can be developed for reducing the risk of irreversible neurodegenerative diseases among older adults with MCI.
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Affiliation(s)
- Yee Xing You
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Suzana Shahar,
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hui Jin Lau
- Nutritional Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Hasnieza Mohd Rosli N, Mastura Yahya H, Shahar S, Wahida Ibrahim F, Fadilah Rajab N. Alzheimer's Disease and Functional Foods: An Insight on Neuroprotective Effect of its Combination. Pak J Biol Sci 2021; 23:575-589. [PMID: 32363814 DOI: 10.3923/pjbs.2020.575.589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease which impairs memory and cognitive function. Currently, AD has no cure and treatments are focused on relieving its symptoms. Several functional plants and foods, such as pomegranate, date fruits, honey, black seeds and figs, possess nutritious properties which alleviate AD. In vitro and in vivo studies reported that these functional foods exert neuroprotective effects through their antioxidant and anti-inflammatory properties. This review are going to discusses the bioactive components and neuroprotective activities of the functional foods such as pomegranate, dates, honey, black seeds and figs and the potential of functional foods combinations to alleviate AD. Functional food combinations have potential to be consumed for health benefit for the prevention and treatment of AD. This review summarises the functional foods which can be useful for the prevention, treatment and management of AD via oxidative and inflammatory mechanisms. Besides, it provides a new insight on the potential of functional food combinations for the prevention and treatment of AD.
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You YX, Shahar S, Rajab NF, Haron H, Yahya HM, Mohamad M, Din NC, Maskat MY. Effects of 12 Weeks Cosmos caudatus Supplement among Older Adults with Mild Cognitive Impairment: A Randomized, Double-Blind and Placebo-Controlled Trial. Nutrients 2021; 13:nu13020434. [PMID: 33572715 PMCID: PMC7912368 DOI: 10.3390/nu13020434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 01/10/2023] Open
Abstract
Cosmos caudatus (CC) contains high flavonoids and might be beneficial in neuroprotection. It has the potential to prevent neurodegenerative diseases. Therefore, we aimed to investigate the effects of 12 weeks of Cosmos caudatus supplement on cognitive function, mood status, blood biochemical profiles and biomarkers among older adults with mild cognitive impairment (MCI) through a double-blind, placebo-controlled trial. The subjects were randomized into CC supplement (n = 24) and placebo group (n = 24). Each of them consumed one capsule of CC supplement (250 mg of CC/capsule) or placebo (500 mg maltodextrin/capsule) twice daily for 12 weeks. Cognitive function and mood status were assessed at baseline, 6th week, and 12th week using validated neuropsychological tests. Blood biochemical profiles and biomarkers were measured at baseline and 12th week. Two-way mixed analysis of variance (ANOVA) analysis showed significant improvements in mini mental state examination (MMSE) (partial η2 = 0.150, p = 0.049), tension (partial η2 = 0.191, p = 0.018), total mood disturbance (partial η2 = 0.171, p = 0.028) and malondialdehyde (MDA) (partial η2 = 0.097, p = 0.047) following CC supplementation. In conclusion, 12 weeks CC supplementation potentially improved global cognition, tension, total mood disturbance, and oxidative stress among older adults with MCI. Larger sample size and longer period of intervention with incorporation of metabolomic approach should be conducted to further investigate the underlying mechanism of CC supplementation in neuroprotection.
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Affiliation(s)
- Yee Xing You
- Dietetics Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Correspondence: ; Tel.: +60-3-9289-7651
| | - Nor Fadilah Rajab
- Biomedical Science Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Hasnah Haron
- Nutritional Sciences Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (H.H.); (H.M.Y.)
| | - Hanis Mastura Yahya
- Nutritional Sciences Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (H.H.); (H.M.Y.)
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Programme and Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Normah Che Din
- Health Psychology Programme, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Mohamad Yusof Maskat
- Department of Food Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Malaysia;
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12
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Vanoh D, Shahar S, Yahya HM, Che Din N, Mat Ludin AF, Ajit Singh DK, Sharif R, Rajab NF. Dietary Supplement Intake and Its Association with Cognitive Function, Physical Fitness, Depressive Symptoms, Nutritional Status and Biochemical Indices in a 3-Year Follow-Up Among Community Dwelling Older Adults: A Longitudinal Study. Clin Interv Aging 2021; 16:161-175. [PMID: 33531799 PMCID: PMC7847381 DOI: 10.2147/cia.s266587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Use of dietary supplements by older adults has been increasing for improving micronutrient deficiencies, cognitive function, and overall health status. Thus, the objective of this secondary investigation is to explore the longitudinal association of baseline supplement intake in improving cognitive function, biochemical parameters, anthropometric variables and physical fitness among older adults. Methods Towards Useful Aging (TUA) is a three-year longitudinal study conducted at baseline (2013–2014) and at follow-up (2015–2017) surveys. The number of participants dropped from 2322 during baseline study to 1787 and 1560 during the 18th and 36th month follow-up, respectively. Data on socio-demography, use of dietary supplement, biochemical indices, anthropometry, cognitive function, physical fitness and depressive symptoms were obtained. Longitudinal associations were done using the linear mixed model analysis among 1285 subjects with complete data. Results The most common vitamin and mineral supplementations consumed were multivitamin, B-complex, and calcium. Meanwhile, the herbal supplements consumed by participants were Eurycoma longifolia, Morinda citrifolia and Orthosiphon aristatus. Longitudinal analysis adjusted for multiple covariates showed improvement in both supplement users and non-users for global cognitive function, working memory, visual memory, 2-minute step test, chair stand test, chair sit and reach and time up and go test, waist circumference and hip circumference in both the supplement users and non-users. Conclusion Our findings indicated that dietary supplement intake is not associated with cognitive function, physical fitness, nutritional status, depressive symptoms or biochemical indices since improvement in the parameters was observed among both supplement users and non-users.
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Affiliation(s)
- Divya Vanoh
- Nutrition & Dietetics Programme, School of Health Science, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Suzana Shahar
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Razinah Sharif
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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13
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McGrattan AM, Zhu Y, Richardson CD, Mohan D, Soh YC, Sajjad A, van Aller C, Chen S, Paddick SM, Prina M, Siervo M, Robinson LA, Stephan BC. Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review. J Alzheimers Dis 2021; 79:743-762. [DOI: 10.3233/jad-201043] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Mild cognitive impairment (MCI) is a cognitive state associated with increased risk of dementia. Little research on MCI exists from low-and middle-income countries (LMICs), despite high prevalence of dementia in these settings. Objective: This systematic review aimed to review epidemiological reports to determine the prevalence of MCI and its associated risk factors in LMICs. Methods: Medline, Embase, and PsycINFO were searched from inception until November 2019. Eligible articles reported on MCI in population or community-based studies from LMICs and were included as long as MCI was clearly defined. Results: 5,568 articles were screened, and 78 retained. In total, n = 23 different LMICs were represented; mostly from China (n = 55 studies). Few studies were from countries defined as lower-middle income (n = 14), low income (n = 4), or from population representative samples (n = 4). There was large heterogeneity in how MCI was diagnosed; with Petersen criteria the most commonly applied (n = 26). Prevalence of amnesic MCI (aMCI) (Petersen criteria) ranged from 0.6%to 22.3%. Similar variability existed across studies using the International Working Group Criteria for aMCI (range 4.5%to 18.3%) and all-MCI (range 6.1%to 30.4%). Risk of MCI was associated with demographic (e.g., age), health (e.g., cardio-metabolic disease), and lifestyle (e.g., social isolation, smoking, diet and physical activity) factors. Conclusion: Outside of China, few MCI studies have been conducted in LMIC settings. There is an urgent need for population representative epidemiological studies to determine MCI prevalence in LMICs. MCI diagnostic methodology also needs to be standardized. This will allow for cross-study comparison and future resource planning.
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Affiliation(s)
| | - Yueping Zhu
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, China
| | | | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Malaysia
| | - Yee Chang Soh
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Malaysia
| | - Ayesha Sajjad
- Erasmus School of Health Policy and Management; Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Carla van Aller
- Population Health Sciences Institute, Newcastle University, UK
| | - Shulin Chen
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, China
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute, Newcastle University, UK
- Gateshead NHS Community Health Foundation Trust, Gateshead, UK
| | - Matthew Prina
- Social Epidemiology Research Group, Health Service and Population Research Department, King’s College London, London, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Nottingham, UK
| | | | - Blossom C.M. Stephan
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, Nottingham University, UK
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Fu J, Liu Q, Du Y, Zhu Y, Sun C, Lin H, Jin M, Ma F, Li W, Liu H, Zhang X, Chen Y, Sun Z, Wang G, Huang G. Age- and Sex-Specific Prevalence and Modifiable Risk Factors of Mild Cognitive Impairment Among Older Adults in China: A Population-Based Observational Study. Front Aging Neurosci 2020; 12:578742. [PMID: 33192471 PMCID: PMC7662098 DOI: 10.3389/fnagi.2020.578742] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background Minimal data are available on the prevalence of mild cognitive impairment (MCI) in older Chinese adults. Moreover, the current information on MCI shows important geographical variations. Objective We aimed to assess the prevalence and risk factors for MCI by age and sex among older adults in a North Chinese population. Methods In this population-based cross-sectional study, we enrolled a random sample of 4,943 adults aged ≥ 60 years between March 2018 and June 2019 in Tianjin, China. Of these, 312 individuals were excluded due to a lack of data (e.g., fasting blood test). As a result, 4,631 subjects were assessed. Individuals with MCI were identified using neuropsychological assessments, including the Mini-Mental State Examination and Activities of Daily Living scale, based on a modified version of the Petersen’s criteria. Results The mean (SD) age of the 4,631 participants was 67.6 (4.89) years, and 2,579 (55.7%) were female. The overall age- and sex-standardized prevalence of MCI in our study population was 10.7%. There were significant associations of MCI with age [65–69 vs. 60–64 years, OR = 0.74; 95% confidence interval (CI): 0.58, 0.96], physical activity (≥23.0 vs. <23.0 MET-hours/week, OR = 0.79; 95% CI: 0.64, 0.96), body mass index (BMI) (OR = 0.92; 95% CI: 0.89, 0.95), grip strength (OR = 0.50; 95% CI: 0.38, 0.67), hypertension (yes vs. no, OR = 1.44; 95% CI: 1.18, 1.77), higher levels of sleepiness (OR = 1.80; 95% CI: 1.36, 2.37), and longer sleep duration (OR = 1.40; 95% CI: 1.14, 1.72). The inverse association between BMI and MCI was stronger in older age groups (P for heterogeneity = 0.003). Moreover, the magnitude of association between triglycerides and MCI was different between the sexes (P for heterogeneity = 0.029). Conclusion The age- and sex-standardized prevalence of MCI was 10.7% in the study sample. Physical activity, BMI, grip strength, sleepiness, sleep duration, and hypertension were associated with the prevalence of MCI. Additionally, triglycerides and BMI might be differently associated with the presence of MCI for different sexes and age stages, respectively.
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Affiliation(s)
- Jingzhu Fu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Qian Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yue Du
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yun Zhu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Changqing Sun
- Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Hongyan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Mengdi Jin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Fei Ma
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Huan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yongjie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhuoyu Sun
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guangshun Wang
- Department of Tumor, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
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15
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Pais R, Ruano L, P. Carvalho O, Barros H. Global Cognitive Impairment Prevalence and Incidence in Community Dwelling Older Adults-A Systematic Review. Geriatrics (Basel) 2020; 5:geriatrics5040084. [PMID: 33121002 PMCID: PMC7709591 DOI: 10.3390/geriatrics5040084] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 01/20/2023] Open
Abstract
(1) Background: We proposed to review worldwide estimates of cognitive impairment prevalence and incidence in adults older than 50 years of age living in the community. (2) Methods: Systematic searches were performed in January 2019 using MEDLINE/PubMed. Articles were selected if they referred to cognitive impairment, prevalence, incidence, elders, and population or community-based studies. Analysis, aggregated by different methodologic features, was performed. (3) Results: Prevalence (80 studies) ranged between 5.1% and 41% with a median of 19.0% (25th percentile = 12.0%; 75th percentile = 24.90%). Incidence (11 studies) ranged from 22 to 76.8 per 1000 person-years with a median of 53.97 per 1000 person-years (25th percentile = 39.0; 75th percentile = 68.19). No statistically significant effects were found except for inclusion age. (4) Conclusion: We propose that the homogenization and clarification of the definition of what constitutes cognitive impairment are essential to refine the epidemiological understanding of this entity. The results of this review reinforce the importance of adherence to standardized cut-off scores for cognitive tests to promote study comparability.
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Affiliation(s)
- Ricardo Pais
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (L.R.); (O.P.C.); (H.B.)
- Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Unidade de Saúde Familiar Lusitana, Aces Dão Lafões, A.R.S. Centro, Av. António José Almeida, 3514-511 Viseu, Portugal
- Correspondence: ; Tel.: +351-222-061-820
| | - Luís Ruano
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (L.R.); (O.P.C.); (H.B.)
- Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Departamento de Neurologia, Hospital de São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Rua Cândido Pinho, 4520-211 Santa Maria da Feira, Portugal
| | - Ofélia P. Carvalho
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (L.R.); (O.P.C.); (H.B.)
- Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Henrique Barros
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (L.R.); (O.P.C.); (H.B.)
- Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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16
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Murukesu RR, Singh DKA, Shahar S, Subramaniam P. A Multi-Domain Intervention Protocol for the Potential Reversal of Cognitive Frailty: "WE-RISE" Randomized Controlled Trial. Front Public Health 2020; 8:471. [PMID: 33014971 PMCID: PMC7495818 DOI: 10.3389/fpubh.2020.00471] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/27/2020] [Indexed: 12/20/2022] Open
Abstract
Following the rapid increase of the aging population, health promotion and prevention of physical disability and dementia in older persons are essential for healthy aging. For example, there may be a potential to prevent or reverse cognitive frailty, the co-existence of both physical frailty and cognitive impairment in older persons. However, evidence-based interventions targeting the prevention or potential reversibility of cognitive frailty among community dwelling older adults are scarce. In this paper, we described the rationale, development and delivery of a multi-domain intervention comprising multi-component physical exercise prescription, cognitive training, dietary counseling and promotion of psychosocial support, called the WE-RISE trial. The aim of WE-RISE intervention is to potentially reverse cognitive frailty. This is a two-armed, single blinded, randomized controlled trial conducted over a duration of 6 months, at senior citizen activity centers within the Klang Valley, Malaysia. Ambulating, community dwelling older adults aged 60 years and above with cognitive frailty are randomized into two groups; (1) intervention group: which receives an instructor based "WE-RISE" intervention for the first 3 months, and then a home-based "WE-RISE at Home" intervention for the following 3 months; (2) control group: usual care with no modifications to their daily routine. Primary outcome is cognitive frailty status and secondary outcome include physical function, cognitive performance, nutritional status, psychosocial status and quality of life which are obtained during baseline screening and subsequent follow ups at 3rd and 6th month. Description of the intervention is done using the template for intervention description and replication (TIDieR) checklist. This trial protocol has received approval from Research Ethics Committee of Universiti Kebangsaan Malaysia (UKM PPI/111/8/JEP-2018-558) and the Department of Social Welfare Malaysia (MyResearch Reference: JKMM 100/12/5/2: 2018/405). Trial registration number: ACTRN12619001055190.
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Affiliation(s)
- Resshaya Roobini Murukesu
- Physiotherapy Programme and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetic Program and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Health Psychology Programme and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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17
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Intermittent Fasting Enhanced the Cognitive Function in Older Adults with Mild Cognitive Impairment by Inducing Biochemical and Metabolic changes: A 3-Year Progressive Study. Nutrients 2020; 12:nu12092644. [PMID: 32872655 PMCID: PMC7551340 DOI: 10.3390/nu12092644] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
Abstract
Intermittent fasting (IF) refers to various dietary regimens that cycle between a period of non-fasting and a period of total fasting. This study aimed to determine the effects of IF on cognitive function among elderly individuals who practice IF who have mild cognitive impairment (MCI). A total of 99 elderly subjects with MCI of Malay ethnicity without any terminal illness were recruited from a larger cohort study, LRGS TUA. The subjects were divided into three groups, comprising those who were regularly practicing IF (r-IF), irregularly practicing IF (i-IF), and non-fasters (n-IF). Upon 36 months of follow-up, more MCI subjects in the r-IF group reverted to successful aging with no cognitive impairment and diseases (24.3%) compared to those in i-IF (14.2%) and n-IF groups (3.7%). The r-IF group’s subjects exhibited significant increment in superoxide dismutase (SOD) activity and reduction in body weight, levels of insulin, fasting blood glucose, malondialdehyde (MDA), C-reactive protein (CRP), and DNA damage. Moreover, metabolomics analysis showed that IF may modulate cognitive function via various metabolite pathways, including the synthesis and degradation of ketone bodies, butanoate metabolism, pyruvate metabolism, and glycolysis and gluconeogenesis pathways. Overall, the MCI-afflicted older adults who practiced IF regularly had better cognitive scores and reverted to better cognitive function at 36 months follow-up.
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18
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Hussin NM, Shahar S, Yahya HM, Din NC, Singh DKA, Omar MA. Incidence and predictors of mild cognitive impairment (MCI) within a multi-ethnic Asian populace: a community-based longitudinal study. BMC Public Health 2019; 19:1159. [PMID: 31438929 PMCID: PMC6704715 DOI: 10.1186/s12889-019-7508-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 08/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Limited information is available from longitudinal studies regarding the predictors and incidence of MCI in older Asian adults. Thus, a community-based longitudinal study was conducted to determine the incidence of MCI among multi-ethnic older adults in Malaysia. The role of health and lifestyle as predictors of MCI was also examined. METHODS Analysis of data obtained from the Towards Useful Aging (TUA) study (2014-2016), wave 1 (baseline) and wave 2 (1½ years of follow-up) was conducted. For the baseline, comprehensive, interview-based questionnaires were administered to 1227 subjects who were 60 years old and above. MCI is a unique transitional state between normal ageing and dementia. MCI characteristics include a decline and disturbance of cognition, minimal impairment of complex activities, ability to perform regular daily functions, and absence of dementia. The incidence of MCI was assessed using comprehensive neuropsychological batteries. The study then performed a logistic regression analysis to examine the effect of each possible predictor of MCI. This analysis began with univariate analyses and a separate review of the effect of every variable. Binary logistic analyses followed hereafter. RESULTS During the follow-up after 1½ years, 179 (14.6%) of the participants who did not exhibit MCI at baseline were observed to have developed MCI. Among the participants who did not exhibit MCI at baseline, the incidence rate was 10.5 per 100 person-years. Male sex and lack of engagement in mental activities were predictors of MCI among participants without MCI at baseline. CONCLUSION After the 1½-year follow-up, the incidence rate for MCI was considerably high among the respondents. Being male and being less engaged in mental activities were predictors of the occurrence of MCI. Mental activities need to be promoted for the prevention of MCI incidence among older adults.
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Affiliation(s)
- Norlela Mohd Hussin
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia.
| | - Hanis Mastura Yahya
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Institute of Public Health, Ministry of Health, Jalan Bangsar, Federal Hill, 59000, Kuala Lumpur, Malaysia
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19
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Chong CP, Shahar S, Haron H, Din NC. Habitual sugar intake and cognitive impairment among multi-ethnic Malaysian older adults. Clin Interv Aging 2019; 14:1331-1342. [PMID: 31413554 PMCID: PMC6662517 DOI: 10.2147/cia.s211534] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Sugar is widely consumed in Malaysia, and the excessive intake of sugar has been associated with cognitive functions. However, the association between sugar intake and cognitive impairment among Malaysian older adults is yet to be determined. Purpose: The objective of this study was to evaluate the associations between types and sources of sugar intake and cognitive functions and to identify their risk in predicting cognitive impairment (MMSE score <24). Subjects and methods: A total of 1,209 subjects aged ≥60 years were recruited through multi-stage random sampling from selected states in Malaysia. Dietary intake was derived using a 7-day dietary history questionnaire and supplemented with a quantitative food frequency questionnaire for added sugar intake. Results: The prevalence of cognitive impairment as defined by Mini-Mental State Examination (MMSE) less than 24 was 31.9%, while the prevalence of mild cognitive
impairment was 13.1%. The median (IQR) for total sugar intake was 44.60 g/day (26.21–68.81) or 8 tsp, and free sugar intake was 33.08 g/day (17.48–57.26) or 6 tsp. The higher intake of total sugars, free sugars, sucrose, lactose, sugar-sweetened beverages, sugar-sweetened cakes, and dessert was found to be significantly associated with a lower MMSE score, after adjusting for covariates. On the other hand, the consumption of cooked dishes and fruits was significantly associated with a better MMSE score. The adjusted OR for risk of cognitive impairment (MMSE score <24) was 3.30 (95% CI 2.15–5.08) for total sugars and 3.58 (95% CI 2.32–5.52) for free sugars, comparing the highest with the lowest intake percentiles. Conclusion: Excessive sugar consumption among older adults showed a notable association with poor cognitive functions, but longitudinal studies and clinical trials are further needed to clarify the direction of causality and to investigate the underlying mechanism.
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Affiliation(s)
- C P Chong
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - S Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - H Haron
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - N Che Din
- Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
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Lau H, Mat Ludin AF, Shahar S, Badrasawi M, Clark BC. Factors associated with motoric cognitive risk syndrome among low-income older adults in Malaysia. BMC Public Health 2019; 19:462. [PMID: 31196017 PMCID: PMC6565538 DOI: 10.1186/s12889-019-6869-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Motoric cognitive risk (MCR) syndrome is characterized by slow gait and memory complaints that could be used to predict an increased risk of dementia. This study aims to determine the MCR syndrome and its risk factors among low-income (B40) older adults in Malaysia. Methods Data from TUA cohort study involving 1366 older adults (aged 60 years and above) categorized as low-income were analysed, for risk of MCR syndrome based on defined criteria. Chi-square analysis and independent t test were employed to examine differences in socioeconomic, demographic, chronic diseases and lifestyle factors between MCR and non-MCR groups. Risk factors of MCR syndrome were determined using hierarchical logistic regression. Results A total of 3.4% of participants fulfilled the criteria of MCR syndrome. Majority of them were female (74.5%, p = 0.001), single/widow/widower/divorced (55.3%, p = 0.002), living in rural area (72.3%, p = 0.011), older age (72.74 ± 7.08 year old, p < 0.001) and had lower years of education (3.26 ± 2.91 years, p = 0.001) than non-MCR group. After adjustment for age, gender and years of education, participants living in rural area (Adjusted OR = 2.19, 95% CI = 1.10–4.35, p = 0.026), with obesity (Adjusted OR = 3.82, 95% CI = 1.70–8.57, p = 0.001), diabetes (Adjusted OR = 2.04, 95% CI = 1.01–4.11, p = 0.046), heart disease (Adjusted OR = 2.50, 95% CI = 1.00–6.20, p = 0.049) and cancer (Adjusted OR = 6.57, 95% CI = 1.18–36.65, p = 0.032) were associated with increased risk of MCR syndrome. Conclusion Only 3.4% of older adults from low-income group were identified as having MCR syndrome. Women, those living in rural areas, had obesity, diabetes, heart disease and cancer were more likely to have MCR syndrome. Further investigation on MCR as a predementia syndrome will help in development of preventive strategies and interventions to reduce the growing burden of dementia, especially among individuals with low socioeconomic status.
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Affiliation(s)
- Huijin Lau
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia. .,Program of Biomedical Science, Faculty of Health Sciences, UKM KL Jalan Raja Muda Abd Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Manal Badrasawi
- Department of Applied Chemistry and Applied Biology, College of Applied Sciences, Palestine Polytechnic University, Hebron, West Bank, Palestine
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI) and Department of Biomedical Sciences, Ohio University, Athens, OH, USA
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21
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Factors associated with poor socioeconomic status among Malaysian older adults: an analysis according to urban and rural settings. BMC Public Health 2019; 19:549. [PMID: 31196023 PMCID: PMC6565532 DOI: 10.1186/s12889-019-6866-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Poverty at old age is associated with poor dietary habit, nutritional status and higher rates of chronic diseases and psychosocial problems. However, there is limited information about this matter according to urban and rural settings. The aim of this study was to identify dietary, nutritional, physical and cognitive factors associated with poor socioeconomic status (SES) among older adults according to urban and rural settings in Malaysia. Methods An analysis was conducted among 2237 older adults who participated in a longitudinal study on aging (LRGS TUA). This study involved four states in Malaysia, with 49.4% from urban areas. Respondents were divided into three categories of SES based on percentile, stratified according to urban and rural settings. SES was measured using household income. Results The prevalence of low SES was higher among older adults in the rural area (50.6%) as compared to the urban area (49.4%). Factors associated with low SES among older adults in an urban setting were low dietary fibre intake (Adj OR:0.91),longer time for the Timed up and Go Test (Adj OR:1.09), greater disability (Adj OR:1.02), less frequent practice of caloric restriction (Adj OR:1.65), lower cognitive processing speed score (Adj OR:0.94) and lower protein intake (Adj OR:0.94). Whilst, among respondents from rural area, the factors associated with low SES were lack of dietary fibre intake (Adj OR:0.79), lower calf circumference (Adj OR: 0.91), lesser fresh fruits intake (Adj OR:0.91), greater disability (Adj OR:1.02) and having lower score in instrumental activities of daily living (Adj OR: 0.92). Conclusion Lower SES ismore prevalent in rural areas. Poor dietary intake, lower fitness and disability were common factors associated with low in SES, regardless of settings. Factors associated with low SES identifiedin both the urban and rural areas in our study may be useful inplanning strategies to combat low SES and its related problems among older adults.
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PESSOA REBECAMENDESP, BOMFIM ANAJULIAL, FERREIRA BIANCALCAVALMORETTI, CHAGAS MARCOSHORTESN. Diagnostic criteria and prevalence of mild cognitive impairment in older adults living in the community: a systematic review and meta-analysis. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000197] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
| | | | | | - MARCOS HORTES N. CHAGAS
- University of São Paulo, Brazil; Federal University of São Carlos, Brazil; Federal University of São Carlos, Brazil
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Lau H, Shahar S, Mohamad M, Rajab NF, Yahya HM, Din NC, Hamid HA. Relationships between dietary nutrients intake and lipid levels with functional MRI dorsolateral prefrontal cortex activation. Clin Interv Aging 2018; 14:43-51. [PMID: 30613138 PMCID: PMC6307498 DOI: 10.2147/cia.s183425] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Dorsolateral prefrontal cortex (DLPFC) is a key node in the cognitive control network that supports working memory. DLPFC dysfunction is related to cognitive impairment. It has been suggested that dietary components and high-density lipoprotein cholesterol (HDL-C) play a vital role in brain health and cognitive function. Purpose This study aimed to investigate the relationships between dietary nutrient intake and lipid levels with functional MRI (fMRI) brain activation in DLPFC among older adults with mild cognitive impairment. Participants and methods A total of 15 community-dwelling older adults with mild cognitive impairment, aged ≥60 years, participated in this cross-sectional study at selected senior citizen clubs in Klang Valley, Malaysia. The 7-day recall Diet History Questionnaire was used to assess participants’ dietary nutrient intake. Fasting blood samples were also collected for lipid profile assessment. All participants performed N-back (0- and 1-back) working memory tasks during fMRI scanning. DLPFC (Brodmann’s areas 9 and 46, and inferior, middle, and superior frontal gyrus) was identified as a region of interest for analysis. Results Positive associations were observed between dietary intake of energy, protein, cholesterol, vitamins B6 and B12, potassium, iron, phosphorus, magnesium, and HDL-C with DLPFC activation (P<0.05). Multivariate analysis showed that vitamin B6 intake, β=0.505, t (14)=3.29, P=0.023, and Digit Symbol score, β=0.413, t (14)=2.89, P=0.045; R2=0.748, were positively related to DLPFC activation. Conclusion Increased vitamin B6 intake and cognitive processing speed were related to greater activation in the DLPFC region, which was responsible for working memory, executive function, attention, planning, and decision making. Further studies are needed to elucidate the mechanisms underlying the association.
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Affiliation(s)
- Huijin Lau
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Suzana Shahar
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Normah Che Din
- Health Psychology Program, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Adherence of Malaysian Adults' Energy and Macronutrient Intakes to National Recommendations: A Review and Meta-Analysis. Nutrients 2018; 10:nu10111584. [PMID: 30373303 PMCID: PMC6266340 DOI: 10.3390/nu10111584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 01/22/2023] Open
Abstract
The present study examined the best available evidence regarding energy and macronutrient intake during adulthood (age 19 to 59 years) in Malaysia and assessed whether intakes adhere to national recommendations, in order to develop recommendations for dietary improvement based on population consumption patterns. A literature review and meta-analysis evaluated intake based on the following characteristics, using information from food balance sheets, national surveys, and individual studies: (1) levels of intake, (2) proportion of the population whose diets adhere to/exceed/fail to meet Malaysian Recommended Nutrient Intake (RNI) levels, and (3) sources of macronutrients observed in these studies. Food balance data suggested high levels of available energy, animal source protein, vegetable fat, and refined carbohydrates. Twenty studies (five nationwide, 15 individual) indicated that Malaysian adults generally met or exceeded recommendations for fat and protein, but were inconsistent with respect to energy and carbohydrates. Information on dietary sources was limited. Due to methodological limitations, insufficient evidence exists regarding energy and macronutrient intakes of Malaysian adults. Improved dietary assessment methods (including use of biomarkers), better data analysis, and updated food composition data, will provide more reliable information on which to base policy decisions and recommendations for improvement.
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Vanoh D, Ishak IH, Shahar S, Manaf ZA, Ali NM, Noah SAM. Development and assessment of a web-based intervention for educating older people on strategies promoting healthy cognition. Clin Interv Aging 2018; 13:1787-1798. [PMID: 30271134 PMCID: PMC6152600 DOI: 10.2147/cia.s157324] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background The increase in the population of aging people has increased the occurrence of cognitive decline leading to predemented stage of dementia, ie, mild cognitive impairment (MCI). The cognitive tools that are web-based have been proven to be useful in decreasing the risk of MCI. Thus, in the present study, an education tool that is web-based, called WESIHAT 2.0©, had been created to educate elderly people about precautionary strategies against MCI. Methodology WESIHAT 2.0 was devised in a senior-friendly style, which includes touch screen, greater font size, larger icons, and employed multimedia components of text, images, and videos. The components employed in WESIHAT 2.0 were a screening tool called TUA-WELLNESS, 10 guides for memory improvement, health diary, and guide for a healthy menu. This application assessed a group of 73 candidates consisting of elderly people, health professionals, caregivers, and information technology (IT) professionals for 1 month. Results All the elderly people, caregivers, and 75% of IT and health professionals were satisfied with the subject matter of WESIHAT 2.0. About more than half of the elderly people, caregivers, and IT and health professionals had given a consensus on the comprehensive ease of the terminologies, sentences, images, table, and advice related to diet included in the web application. Proposals for improvements of the web portal included suggestions such as using smaller sentences, using greater font size, adding more images, and avoiding the use of unfamiliar terminologies. Conclusion WESIHAT 2.0 is a suitable tool for educating older people about the lifestyle modification strategies to slower progression to cognitive impairment, with regard to the significance of expert advice.
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Affiliation(s)
- Divya Vanoh
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia, .,Dietetics Programme, School of Health Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Intan Hafizah Ishak
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Zahara Abdul Manaf
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Nazlena Mohamad Ali
- Institute of Visual Informatics (IVI), Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Shahrul Azman Mohd Noah
- School of Information Technology, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
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Foong HF, Hamid TA, Ibrahim R, Haron SA. Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults. Aging Ment Health 2018; 22:483-488. [PMID: 28060527 DOI: 10.1080/13607863.2016.1274376] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Research has found that depression in later life is associated with cognitive impairment. Thus, the mechanism to reduce the effect of depression on cognitive function is warranted. In this paper, we intend to examine whether intrinsic religiosity mediates the association between depression and cognitive function. METHOD The study included 2322 nationally representative community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, cognitive function, depression and intrinsic religiosity. A four-step moderated hierarchical regression analysis was employed to test the moderating effect. Statistical analyses were performed using SPSS (version 15.0). RESULTS Bivariate analyses showed that both depression and intrinsic religiosity had significant relationships with cognitive function. In addition, four-step moderated hierarchical regression analysis revealed that the intrinsic religiosity moderated the association between depression and cognitive function, after controlling for selected socio-demographic characteristics. CONCLUSION Intrinsic religiosity might reduce the negative effect of depression on cognitive function. Professionals who are working with depressed older adults should seek ways to improve their intrinsic religiosity as one of the strategies to prevent cognitive impairment.
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Affiliation(s)
- Hui Foh Foong
- a Malaysian Research Institute on Aging (MyAging) , Universiti Putra Malaysia , Serdang , Malaysia
| | - Tengku Aizan Hamid
- a Malaysian Research Institute on Aging (MyAging) , Universiti Putra Malaysia , Serdang , Malaysia.,b Department of Human Development and Family Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia
| | - Rahimah Ibrahim
- a Malaysian Research Institute on Aging (MyAging) , Universiti Putra Malaysia , Serdang , Malaysia.,b Department of Human Development and Family Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia
| | - Sharifah Azizah Haron
- a Malaysian Research Institute on Aging (MyAging) , Universiti Putra Malaysia , Serdang , Malaysia.,c Department of Resource Management and Consumer Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia
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Jacob L, Bohlken J, Kostev K. Risk Factors for Mild Cognitive Impairment in German Primary Care Practices. J Alzheimers Dis 2018; 56:379-384. [PMID: 27911316 DOI: 10.3233/jad-160875] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a common mental disorder affecting around 16% of elderly people without dementia. MCI is considered an intermediate state between normal cognition and dementia. OBJECTIVE To analyze risk factors for the development of MCI in German primary care practices. METHODS In total, 3,604 MCI patients and 3,604 controls without MCI were included between January 2010 and December 2015. Several disorders potentially associated with MCI were determined. Multivariate logistic regression models were fitted with MCI as a dependent variable and other disorders as potential predictors. RESULTS The mean age was 75.2 years and 45.3% of patients were men. MCI development was found to be associated with 12 disorders: intracranial injury, anxiety disorder, depression, mental and behavioral disorders due to alcohol use, stroke, hyperlipidemia, obesity, hypertension, Parkinson's disease, sleep disorder, coronary heart disease, and diabetes with odds ratios ranging from 1.13 (diabetes) to 2.27 (intracranial injury). CONCLUSION Intracranial injury, anxiety, and depression showed the strongest association with MCI. Further analyses are needed to gain a better understanding of the MCI risk factors.
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Affiliation(s)
- Louis Jacob
- Department of Biology, École Normale Supérieure de Lyon, Lyon, France
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Foong HF, Hamid TA, Ibrahim R, Haron SA, Shahar S. Predicting cognitive function of the Malaysian elderly: a structural equation modelling approach. Aging Ment Health 2018; 22:109-120. [PMID: 27732054 DOI: 10.1080/13607863.2016.1231172] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aim of this study was to identify the predictors of elderly's cognitive function based on biopsychosocial and cognitive reserve perspectives. METHOD The study included 2322 community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, biomarkers, psychosocial status, disability, and cognitive function. A biopsychosocial model of cognitive function was developed to test variables' predictive power on cognitive function. Statistical analyses were performed using SPSS (version 15.0) in conjunction with Analysis of Moment Structures Graphics (AMOS 7.0). RESULTS The estimated theoretical model fitted the data well. Psychosocial stress and metabolic syndrome (MetS) negatively predicted cognitive function and psychosocial stress appeared as a main predictor. Socio-demographic characteristics, except gender, also had significant effects on cognitive function. However, disability failed to predict cognitive function. CONCLUSION Several factors together may predict cognitive function in the Malaysian elderly population, and the variance accounted for it is large enough to be considered substantial. Key factor associated with the elderly's cognitive function seems to be psychosocial well-being. Thus, psychosocial well-being should be included in the elderly assessment, apart from medical conditions, both in clinical and community setting.
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Affiliation(s)
- Hui Foh Foong
- a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia
| | - Tengku Aizan Hamid
- a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia.,b Department of Human Development and Family Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia
| | - Rahimah Ibrahim
- a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia.,b Department of Human Development and Family Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia
| | - Sharifah Azizah Haron
- a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia.,c Department of Resource Management and Consumer Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia
| | - Suzana Shahar
- d Dietetic Programme, School of Healthcare Sciences, Faculty of Health Sciences , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
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