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Imamura K, Kawai H, Ejiri M, Abe T, Yamashita M, Sasai H, Obuchi S, Suzuki H, Fujiwara Y, Awata S, Toba K. Association of the combination of social isolation and living alone with cognitive impairment in community-dwelling older adults: The IRIDE Cohort Study. Arch Gerontol Geriatr 2024; 127:105571. [PMID: 39002518 DOI: 10.1016/j.archger.2024.105571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/30/2024] [Accepted: 07/06/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Living alone has been associated with cognitive impairment; however, findings have been inconsistent. Social isolation among older adults who live alone may contribute to cognitive impairment. This study was carried out to examine the association of social isolation and living alone with cognitive impairment in community-dwelling older adults. METHODS In this cross-sectional study, data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which comprises pooled data from five community-based geriatric cohorts, was used. Social isolation was defined as infrequent interactions with others. Participants were categorized into four groups based on their social isolation and living alone statuses. Cognitive function was assessed using the Mini-Mental State Examination, with a score <24 indicating cognitive impairment. The association between social isolation combined with living alone and cognitive impairment was analyzed using logistic regression. RESULTS Of the 4362 participants included in the analysis (mean age 75.6 years, 44.3 % male), 11 % had cognitive impairment. Regardless of living alone, social isolation was associated with cognitive impairment (no social isolation x not living alone: reference, social isolation x not living alone; odds ratio (OR): 1.74, 95 % confidence interval (CI): 1.29-2.33, social isolation x living alone; OR: 2.10, 95 % CI: 1.46-3.01). CONCLUSIONS Social isolation is associated with cognitive impairment; however, living alone is not intrinsically associated with cognitive impairment in older adults. Healthcare providers must focus on social interactions to prevent cognitive impairment in older adults rather than simply focusing on living arrangements.
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Affiliation(s)
- Keigo Imamura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan.
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Manami Ejiri
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Takumi Abe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; School of Commerce, Meiji University, 1-9-1 Eifuku, Suginami-Ku, Tokyo 168-8555, Japan
| | - Mari Yamashita
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Hiroyuki Suzuki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Shuichi Awata
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
| | - Kenji Toba
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan
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Astolphi Lima C, Alsunaidi S, Lowe S, Hogan DB, Dennett L, Jones CA, Yamamoto S. Exploring the influence of weather variability and climate change on health outcomes in people living with dementia: A scoping review protocol. PLoS One 2024; 19:e0304181. [PMID: 38913693 PMCID: PMC11195938 DOI: 10.1371/journal.pone.0304181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 05/04/2024] [Indexed: 06/26/2024] Open
Abstract
Environmental factors resulting from climate change and air pollution are risk factors for many chronic conditions including dementia. Although research has shown the impacts of air pollution in terms of cognitive status, less is known about the association between climate change and specific health-related outcomes of older people living with dementia. In response, we outline a scoping review protocol to systematically review the published literature regarding the evidence of climate change, including temperature and weather variability, on health-related quality of life, morbidity, mobility, falls, the utilization of health resources, and mortality among older adults living with dementia. This scoping review will be guided by the framework proposed by Arksey and O'Malley. Electronic search (Medline, Embase, PsycINFO, CINAHL, Scopus, Web of Science) using relevant subject headings and synonyms for two concepts (older people with dementia, weather/ climate change). No publication date or other restrictions will be applied to the search strategy. No language restriction will be applied in order to understand the impact of non-English studies in the literature. Eligible studies must include older adults (65+years) with dementia living in the community and investigate the impacts of climate change and/or weather on their health-related quality of life, morbidity, mobility, falls, use of health resources and mortality. Two independent reviewers will screen abstracts and select those for a full-text review, perform these reviews, select articles for retention, and extract data from them in a standardized manner. This data will then be synthesized and interpreted. OSF registration: DOI: 10.17605/OSF.IO/YRFM8.
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Affiliation(s)
- Camila Astolphi Lima
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - Sara Alsunaidi
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - Samuel Lowe
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - David B. Hogan
- Cumming School of Medicine, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Liz Dennett
- Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - C. Allyson Jones
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - Shelby Yamamoto
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
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Clare L, Gamble LD, Martyr A, Henderson C, Knapp M, Matthews FE. Living Alone With Mild-to-Moderate Dementia Over a Two-Year Period: Longitudinal Findings From the IDEAL Cohort. Am J Geriatr Psychiatry 2024:S1064-7481(24)00352-X. [PMID: 38897833 DOI: 10.1016/j.jagp.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES To compare the experiences of people with dementia living alone or with others and how these may change over two years. DESIGN We analysed longitudinal data from three assessment waves, one year apart, in the British IDEAL cohort. SETTING Participants with mild-to-moderate dementia were recruited through National Health Service providers, where possible with a family caregiver, and interviewed at home. PARTICIPANTS The current analyses include 281 people with dementia living alone and 1,244 living with others at baseline; follow-up data were available for 200 and 965 respectively at time 2 and 144 and 696 respectively at time 3. For those living alone, 140 nonresident caregivers contributed at baseline, 102 at time 2 and 81 at time 3. For those living with others, 1,127 family caregivers contributed at baseline, 876 at time 2 and 670 at time 3. MEASUREMENTS Assessments covered: cognitive and functional ability; self-reported perceptions of health, mood, social engagement, quality of life, satisfaction with life and well-being; use of in-home and community care; and transitions into residential care. RESULTS People living alone tended to have better cognitive and functional ability and were more frequent users of in-home care. However, they experienced poorer physical, social, and psychological health and reduced quality of life, satisfaction with life, and well-being. These differences persisted over time and rates of transition into residential care were higher. CONCLUSIONS To facilitate continuing in place for people with dementia living alone, a dual focus on supporting functional ability and addressing psychosocial needs is essential in the context of an enabling policy framework.
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Affiliation(s)
- Linda Clare
- University of Exeter Medical School, University of Exeter, (L.C, A.M), Exeter, UK; NIHR Applied Research Collaboration South-West Peninsula, (L.C), Exeter, UK.
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, (L.D.G, F.E.M) Newcastle, UK
| | - Anthony Martyr
- University of Exeter Medical School, University of Exeter, (L.C, A.M), Exeter, UK
| | - Catherine Henderson
- Care Policy and Evaluation Centre, London School of Economics and Political Science, (C.H, M.K), London, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, (C.H, M.K), London, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Newcastle University, (L.D.G, F.E.M) Newcastle, UK; Institute for Clinical and Applied Health Research, Hull York Medical School, (F.E.M), University of Hull, Hull, UK
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Stephan BCM, Cochrane L, Kafadar AH, Brain J, Burton E, Myers B, Brayne C, Naheed A, Anstey KJ, Ashor AW, Siervo M. Population attributable fractions of modifiable risk factors for dementia: a systematic review and meta-analysis. THE LANCET. HEALTHY LONGEVITY 2024; 5:e406-e421. [PMID: 38824956 PMCID: PMC11139659 DOI: 10.1016/s2666-7568(24)00061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND More than 57 million people have dementia worldwide. Evidence indicates a change in dementia prevalence and incidence in high-income countries, which is likely to be due to improved life-course population health. Identifying key modifiable risk factors for dementia is essential for informing risk reduction and prevention strategies. We therefore aimed to estimate the population attributable fraction (PAF) for dementia associated with modifiable risk factors. METHODS In this systematic review and meta-analysis, we searched Embase, MEDLINE, and PsycINFO, via Ovid, from database inception up to June 29, 2023, for population-derived or community-based studies and reviews reporting a PAF value for one or more modifiable risk factor for later-life dementia (prevalent or incident dementia in people aged ≥60 years), with no restrictions on dementia subtype, the sex or baseline age of participants, or the period of study. Articles were independently screened for inclusion by four authors, with disagreements resolved through consensus. Data including unweighted and weighted PAF values (weighted to account for communality or overlap in risk) were independently extracted into a predefined template by two authors and checked by two other authors. When five or more unique studies investigated a given risk factor or combination of the same factors, random-effects meta-analyses were used to calculate a pooled PAF percentage estimate for the factor or combination of factors. The review protocol was registered on PROSPERO, CRD42022323429. FINDINGS 4024 articles were identified, and 74 were included in our narrative synthesis. Overall, PAFs were reported for 61 modifiable risk factors, with sufficient data available for meta-analysis of 12 factors (n=48 studies). In meta-analyses, the highest pooled unweighted PAF values were estimated for low education (17·2% [95% CI 14·4-20·0], p<0·0001), hypertension (15·8% [14·7-17·1], p<0·0001), hearing loss (15·6% [10·3-20·9], p<0·0001), physical inactivity (15·2% [12·8-17·7], p<0·0001), and obesity (9·4% [7·3-11·7], p<0·0001). According to weighted PAF values, low education (9·3% [6·9-11·7], p<0·0001), physical inactivity (7·3% [3·9-11·2], p=0·0021), hearing loss (7·2% [5·2-9·7], p<0·0001), hypertension (7·1% [5·4-8·8], p<0·0001), and obesity (5·3% [3·2-7·4], p=0·0001) had the highest pooled estimates. When low education, midlife hypertension, midlife obesity, smoking, physical inactivity, depression, and diabetes were combined (Barnes and Yaffe seven-factor model; n=9 studies), the pooled unweighted and weighted PAF values were 55·0% (46·5-63·5; p<0·0001) and 32·0% (26·6-37·5; p<0·0001), respectively. The pooled PAF values for most individual risk factors were higher in low-income and middle-income countries (LMICs) versus high-income countries. INTERPRETATION Governments need to invest in a life-course approach to dementia prevention, including policies that enable quality education, health-promoting environments, and improved health. This investment is particularly important in LMICs, where the potential for prevention is high, but resources, infrastructure, budgets, and research focused on ageing and dementia are limited. FUNDING UK Research and Innovation (Medical Research Council).
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Affiliation(s)
- Blossom C M Stephan
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK.
| | - Louie Cochrane
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
| | | | - Jacob Brain
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Elissa Burton
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Bronwyn Myers
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Mental Health, Alcohol, Substance Use, and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa; Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Aliya Naheed
- Non-Communicable Diseases, Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Kaarin J Anstey
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia; Brain Health and Dementia Centre, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Ammar W Ashor
- Department of Internal Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Mario Siervo
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; School of Population Health, Curtin University, Perth, WA, Australia
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Mameno T, Moynihan P, Nakagawa T, Inagaki H, Akema S, Murotani Y, Takeuchi S, Kimura A, Okada Y, Tsujioka Y, Higashi K, Hagino H, Mihara Y, Kosaka T, Takahashi T, Wada M, Gondo Y, Kamide K, Akasaka H, Kabayama M, Ishizaki T, Masui Y, Ikebe K. Exploring the association between number of teeth, food intake, and cognitive function: A 9-year longitudinal study. J Dent 2024; 145:104991. [PMID: 38608831 DOI: 10.1016/j.jdent.2024.104991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the association between the number of teeth, food intake, and cognitive function in Japanese community-dwelling older adults. METHODS This 9-year longitudinal study included a total of 293 analyzable participants who participated in baseline and follow-up surveys. Dental status (number of teeth and periodontal pocket depth), dietary assessment using the brief-type self-administered diet history questionnaire, cognitive function, and the following confounding factors were evaluated: educational level, financial satisfaction, living situation, smoking and drinking habits, history of chronic diseases, apolipoprotein E-ε4 carrier, body mass index, handgrip strength, instrumental activities of daily living, and depressive symptomatology. The Japanese version of the Montreal Cognitive Assessment was used to evaluate cognitive function. A multinomial logistic regression analysis for the intake level of each food categorized into three groups (low, moderate, high), and a generalized estimating equation (GEE) for cognitive function over nine years were performed. RESULTS After controlling for confounding factors, the number of teeth was shown to be associated with the intake of green-yellow vegetables and meat. Furthermore, the GEE indicated that the lowest quartile of intake of green-yellow vegetables significantly associated with lower cognitive function (unstandardized regression coefficient [B] = -0.96, 95 % confidence interval [CI]: -1.72 to -0.20), and the lowest quartile of intake of meat significantly associated with lower cognitive function (B = -1.42, 95 % CI: -2.27 to -0.58). CONCLUSIONS The intake of green and yellow vegetables and meat, which is influenced by the number of teeth, was associated with cognitive function in Japanese community-dwelling older adults. CLINICAL SIGNIFICANCE There are few studies that have examined the association between oral health, food intake, and cognitive function. This 9-year longitudinal study suggests that it is important to maintain natural teeth to enable the functional means to consume green-yellow vegetables and meat, and thereby help maintain cognitive function.
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Affiliation(s)
- Tomoaki Mameno
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Paula Moynihan
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia 5005, Australia
| | - Takeshi Nakagawa
- Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obushi, Aichi 474-8511 Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Suzuna Akema
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yuki Murotani
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Satoko Takeuchi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Ayaka Kimura
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshie Okada
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshitaka Tsujioka
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kotaro Higashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiromasa Hagino
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yusuke Mihara
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takayuki Kosaka
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Toshihito Takahashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masahiro Wada
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, 1-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
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Hersh D, Williamson C, Brogan E, Stanley M. "It's day to day problems:" Experiences of people with aphasia who live alone. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:367-379. [PMID: 38912681 DOI: 10.1080/17549507.2024.2358830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
PURPOSE Living alone is increasing and associated with health and social risks. Aphasia compounds these risks but there is little research on how living alone interacts with aphasia. This study is a preliminary exploration of this issue. METHOD Five people with aphasia who lived alone participated in two supported semi-structured interviews, with the second interview including sharing an artefact that held significance for living alone with aphasia. Interviews were recorded, transcribed verbatim, and analysed through reflexive thematic analysis. RESULT Four themes encompassed meaning-making about living alone with aphasia: relationships and reliance on others; risk, vulnerability, and uncertainty; loneliness and time alone; self-reliance and the need to keep busy. Participants had to continuously manage and renegotiate daily challenges around living alone with aphasia. CONCLUSION Living alone increases the risk of loneliness. For people with aphasia, the buffer against loneliness provided by social connection and meaningful activity may be more difficult to achieve because of communication challenges. While experiences vary, reliance on others, managing practical and administrative tasks, and negotiating risks are all important issues when alone. The intersection of living alone, loneliness, and living with aphasia needs more research, and more explicit clinical focus when discussing and planning intervention and support.
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Affiliation(s)
- Deborah Hersh
- Speech Pathology, School of Allied Health and EnAble Institute, Curtin University, Perth, Australia
- Speech Pathology, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- School of Allied Health Science and Practice, Adelaide University, Adelaide, Australia
| | | | - Emily Brogan
- Speech Pathology, School of Allied Health and EnAble Institute, Curtin University, Perth, Australia
- Speech Pathology, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Speech Pathology, Fiona Stanley Fremantle Hospital Group, Perth, Australia
| | - Mandy Stanley
- Occupational Therapy, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Cong CH, Li PL, Qiao Y, Li YN, Yang JT, Zhao L, Zhu XR, Tian S, Cao SS, Liu JR, Su JJ. Association between household size and risk of incident dementia in the UK Biobank study. Sci Rep 2024; 14:11026. [PMID: 38744903 PMCID: PMC11094068 DOI: 10.1038/s41598-024-61102-6] [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: 11/21/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
Currently, the relationship between household size and incident dementia, along with the underlying neurobiological mechanisms, remains unclear. This prospective cohort study was based on UK Biobank participants aged ≥ 50 years without a history of dementia. The linear and non-linear longitudinal association was assessed using Cox proportional hazards regression and restricted cubic spline models. Additionally, the potential mechanisms driven by brain structures were investigated by linear regression models. We included 275,629 participants (mean age at baseline 60.45 years [SD 5.39]). Over a mean follow-up of 9.5 years, 6031 individuals developed all-cause dementia. Multivariable analyses revealed that smaller household size was associated with an increased risk of all-cause dementia (HR, 1.06; 95% CI 1.02-1.09), vascular dementia (HR, 1.08; 95% CI 1.01-1.15), and non-Alzheimer's disease non-vascular dementia (HR, 1.09; 95% CI 1.03-1.14). No significant association was observed for Alzheimer's disease. Restricted cubic splines demonstrated a reversed J-shaped relationship between household size and all-cause and cause-specific dementia. Additionally, substantial associations existed between household size and brain structures. Our findings suggest that small household size is a risk factor for dementia. Additionally, brain structural differences related to household size support these associations. Household size may thus be a potential modifiable risk factor for dementia.
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Affiliation(s)
- Chao-Hua Cong
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China
| | - Pan-Long Li
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450001, China
- School of Electrical and Information Engineering, Zhengzhou University of Light Industry, No. 5 Dongfeng Road, Zhengzhou, 450001, China
| | - Yuan Qiao
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China
| | - Yu-Na Li
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China
| | - Jun-Ting Yang
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China
| | - Lei Zhao
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China
| | - Xi-Rui Zhu
- School of Electrical and Information Engineering, Zhengzhou University of Light Industry, No. 5 Dongfeng Road, Zhengzhou, 450001, China
| | - Shan Tian
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China
| | - Shan-Shan Cao
- Department of Neurology, Gongli Hospital of Shanghai Pudong New Area, No. 219 Miaopu Road, Pudong New District, Shanghai, 200135, China
| | - Jian-Ren Liu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China.
| | - Jing-Jing Su
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizhaoju Road, Huangpu District, Shanghai, 200011, China.
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Liu Q, Wang B, Huang Y, Bian Y, Li Y, Zhou W, Yu J, Chen H, Wang C. Joint trajectories of loneliness, social isolation and sarcopenia and associations with adverse outcomes: A prospective cohort study. Geriatr Nurs 2024; 57:132-139. [PMID: 38642489 DOI: 10.1016/j.gerinurse.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
This study aimed to examine joint trajectories of loneliness, social isolation and sarcopenia and their associations with adverse outcomes. A total of 4701 participants aged ≥60 years who had a baseline and at least one follow-up assessment of loneliness, social isolation and sarcopenia across 2011, 2013 and 2015 waves in China Health and Retirement Longitudinal Study. Adverse outcomes were obtained in 2018 wave. Joint trajectories were fit using the parallel process latent class growth analysis, and their associations with adverse outcomes were evaluated using modified Poisson regression. Joint trajectory patterns for social relationship and sarcopenia did not vary by the assessment for sarcopenia, but did vary by the assessment for social relationship. Older adults exhibit distinct joint trajectories and those with persistent combination of loneliness or social isolation and sarcopenia experience greatest risk of adverse outcomes. These findings implicate integration of health care and social care for community-dwelling older adults.
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Affiliation(s)
- Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Binlin Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yuli Huang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanhui Bian
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Wendie Zhou
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Hejing Chen
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
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9
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Imamura K, Kawai H, Ejiri M, Sasai H, Hirano H, Fujiwara Y, Ihara K, Obuchi S. Social isolation, regardless of living alone, is associated with mortality: the Otassha study. Front Public Health 2024; 12:1365943. [PMID: 38560448 PMCID: PMC10978664 DOI: 10.3389/fpubh.2024.1365943] [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: 01/05/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Social isolation has been recognized as a contributing factor to negative health outcomes. Although living alone is associated with health-related outcomes, existing findings are inconsistent. It is not the act of living alone that may predict poor health, but rather social isolation that can lead to increased mortality risk. This study investigated the combined associations of social isolation and living alone with mortality among community-dwelling older adults. Methods We included older adults from Itabashi ward, Tokyo, who participated in comprehensive health checkups. Participants were categorized into four groups based on their social isolation status and living alone. The primary outcome was all-cause mortality, analyzed using Cox proportional hazards models. Results Of the 1,106 participants (mean age 73, 42% male), 4.5% experienced both social isolation and living alone. This combination was associated with a worse prognosis regarding all-cause mortality (hazard ratio (HR): 2.08 [95% confidence interval (CI), 1.08-4. 00]). Those who were socially isolated but not living alone also showed a trend towards higher mortality risk (HR: 1.41 [95% CI, 0.90-2.20]). Contrastingly, those who were not socially isolated and lived alone did not show an increased mortality risk (HR: 0.81 [95% CI, 0.44-1.49]). Discussion and conclusion Living alone is not inherently associated with a poor prognosis in older adults; however, social isolation was associated with a higher mortality risk. Healthcare providers should focus on enhancing social interactions and support for older adults because of their effects on health rather than solely addressing living arrangements to prevent adverse health events.
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Affiliation(s)
- Keigo Imamura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Manami Ejiri
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | | | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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10
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Rosenau C, Köhler S, Soons LM, Anstey KJ, Brayne C, Brodaty H, Engedal K, Farina FR, Ganguli M, Livingston G, Lyketsos CG, Mangialasche F, Middleton LE, Rikkert MGMO, Peters R, Sachdev PS, Scarmeas N, Salbæk G, van Boxtel MPJ, Deckers K. Umbrella review and Delphi study on modifiable factors for dementia risk reduction. Alzheimers Dement 2024; 20:2223-2239. [PMID: 38159267 PMCID: PMC10984497 DOI: 10.1002/alz.13577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
A 2013 systematic review and Delphi consensus study identified 12 modifiable risk and protective factors for dementia, which were subsequently merged into the "LIfestyle for BRAin health" (LIBRA) score. We systematically evaluated whether LIBRA requires revision based on new evidence. To identify modifiable risk and protective factors suitable for dementia risk reduction, we combined an umbrella review of systematic reviews and meta-analyses with a two-round Delphi consensus study. The review of 608 unique primary studies and opinions of 18 experts prioritized six modifiable factors: hearing impairment, social contact, sleep, life course inequalities, atrial fibrillation, and psychological stress. Based on expert ranking, hearing impairment, social contact, and sleep were considered the most suitable candidates for inclusion in updated dementia risk scores. As such, the current study shows that dementia risk scores need systematic updates based on emerging evidence. Future studies will validate the updated LIBRA score in different cohorts. HIGHLIGHTS: An umbrella review was combined with opinions of 18 dementia experts. Various candidate targets for dementia risk reduction were identified. Experts prioritized hearing impairment, social contact, and sleep. Re-assessment of dementia risk scores is encouraged. Future work should evaluate the predictive validity of updated risk scores.
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Affiliation(s)
- Colin Rosenau
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Lion M. Soons
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Kaarin J. Anstey
- School of PsychologyUniversity of New South WalesKensingtonNew South WalesAustralia
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
- UNSW Ageing Futures InstituteKensingtonNew South WalesAustralia
| | - Carol Brayne
- Cambridge Public HealthUniversity of CambridgeCambridgeUK
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Knut Engedal
- Norwegian National Centre for Ageing and HealthVestfold Hospital TrustTønsbergNorway
| | - Francesca R. Farina
- Feinberg School of MedicineDepartment of Medical Social SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Mary Ganguli
- Departments of PsychiatryNeurologyand EpidemiologySchool of Medicine and School of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Constantine G. Lyketsos
- Richman Family Precision Medicine Center of Excellence in Alzheimer's DiseaseJohns Hopkins BayviewJohns Hopkins MedicineBaltimoreMarylandUSA
| | - Francesca Mangialasche
- Division of Clinical GeriatricsDepartment of NeurobiologyCare Sciences and SocietyCenter for Alzheimer ResearchKarolinska InstitutetStockholmSweden
- Theme Inflammation and AgingMedical Unit AgingKarolinska University HospitalStockholmSweden
| | - Laura E. Middleton
- Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
- Schlegel‐UW Research Institute for AgingWaterlooOntarioCanada
| | - Marcel G. M. Olde Rikkert
- Department of Geriatric MedicineRadboud University Medical CenterNijmegenthe Netherlands
- Radboudumc Alzheimer CenterDonders Center of Medical NeurosciencesNijmegenthe Netherlands
| | - Ruth Peters
- UNSW Ageing Futures InstituteKensingtonNew South WalesAustralia
- The George Institute for Global HealthNewtownNew South WalesAustralia
- School of Biomedical SciencesUniversity of New South WalesKensingtonNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nikolaos Scarmeas
- 1st Department of NeurologyAiginition HospitalNational and Kapodistrian University of Athens Medical SchoolAthensGreece
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA
| | - Geir Salbæk
- Norwegian National Centre for Ageing and HealthVestfold Hospital TrustTønsbergNorway
- Department of Geriatric MedicineOslo University HospitalOsloNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Martin P. J. van Boxtel
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Kay Deckers
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
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11
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Jones A, Ali MU, Kenny M, Mayhew A, Mokashi V, He H, Lin S, Yavari E, Paik K, Subramanian D, Dydynsky R, Aryal K, Correia RH, Dash D, Manis DR, O'Connell M, Liu-Ambrose T, Taler V, McMillan JM, Hogan DB, Kirkland S, Costa AP, Wolfson C, Raina P, Griffith L. Potentially Modifiable Risk Factors for Dementia and Mild Cognitive Impairment: An Umbrella Review and Meta-Analysis. Dement Geriatr Cogn Disord 2024; 53:91-106. [PMID: 38346414 DOI: 10.1159/000536643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/31/2024] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION The prevalence of mild and major neurocognitive disorders (NCDs), also referred to as mild cognitive impairment and dementia, is rising globally. The prevention of NCDs is a major global public health interest. We sought to synthesize the literature on potentially modifiable risk factors for NCDs. METHODS We conducted an umbrella review using a systematic search across multiple databases to identify relevant systematic reviews and meta-analyses. Eligible reviews examined potentially modifiable risk factors for mild or major NCDs. We used a random-effects multi-level meta-analytic approach to synthesize risk ratios for each risk factor while accounting for overlap in the reviews. We further examined risk factors for major NCD due to two common etiologies: Alzheimer's disease and vascular dementia. RESULTS A total of 45 reviews with 212 meta-analyses were synthesized. We identified fourteen broadly defined modifiable risk factors that were significantly associated with these disorders: alcohol consumption, body weight, depression, diabetes mellitus, diet, hypertension, less education, physical inactivity, sensory loss, sleep disturbance, smoking, social isolation, traumatic brain injury, and vitamin D deficiency. All 14 factors were associated with the risk of major NCD, and five were associated with mild NCD. We found considerably less research for vascular dementia and mild NCD. CONCLUSION Our review quantifies the risk associated with 14 potentially modifiable risk factors for mild and major NCDs, including several factors infrequently included in dementia action plans. Prevention strategies should consider approaches that reduce the incidence and severity of these risk factors through health promotion, identification, and early management.
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Affiliation(s)
- Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Muhammad Usman Ali
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Meghan Kenny
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
| | - Vishal Mokashi
- School of Life Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Henry He
- Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada
| | - Sabrina Lin
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ehsan Yavari
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karen Paik
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Robert Dydynsky
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Komal Aryal
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca H Correia
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Darly Dash
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Derek R Manis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Megan O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Vanessa Taler
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Jacqueline M McMillan
- Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan Kirkland
- Department of Community Health and Epidemiology and Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrew P Costa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Christina Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health and Department of Medicine, McGill University, QC, Montreal, Canada
- Research Institute of the McGill University Health Centre, QC, Montreal, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
| | - Lauren Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
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12
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Lay-Yee R, Hariri AR, Knodt AR, Barrett-Young A, Matthews T, Milne BJ. Social isolation from childhood to mid-adulthood: is there an association with older brain age? Psychol Med 2023; 53:7874-7882. [PMID: 37485695 PMCID: PMC10755222 DOI: 10.1017/s0033291723001964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Older brain age - as estimated from structural MRI data - is known to be associated with detrimental mental and physical health outcomes in older adults. Social isolation, which has similar detrimental effects on health, may be associated with accelerated brain aging though little is known about how different trajectories of social isolation across the life course moderate this association. We examined the associations between social isolation trajectories from age 5 to age 38 and brain age assessed at age 45. METHODS We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and persistent 'child-adult' isolation. A brain age gap estimate (brainAGE) - the difference between predicted age from structural MRI date and chronological age - was derived at age 45. We undertook analyses of brainAGE with trajectory group as the predictor, adjusting for sex, family socio-economic status, and a range of familial and child-behavioral factors. RESULTS Older brain age in mid-adulthood was associated with trajectories of social isolation after adjustment for family and child confounders, particularly for the 'adult-only' group compared to the 'never-isolated' group. CONCLUSIONS Although our findings are associational, they indicate that preventing social isolation, particularly in mid-adulthood, may help to avert accelerated brain aging associated with negative health outcomes later in life.
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Affiliation(s)
- Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences, and School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
| | - Ahmad R. Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Annchen R. Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | | | - Timothy Matthews
- Department of Social Genetic & Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Barry J. Milne
- Centre of Methods and Policy Application in the Social Sciences, and School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
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13
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Li Y, Wang W, Zhu L, Yang L, Wu H, Zhang X, Guo L, Lu C. Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older. JAMA Netw Open 2023; 6:e2349241. [PMID: 38147332 PMCID: PMC10751597 DOI: 10.1001/jamanetworkopen.2023.49241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/09/2023] [Indexed: 12/27/2023] Open
Abstract
Importance It remains unclear whether pet ownership is associated with cognitive decline and to what extent pet ownership mitigates the association between living alone and cognitive decline. Objective To explore the association of pet ownership with cognitive decline, the interaction between pet ownership and living alone, and the extent to which pet ownership mitigates the association between living alone and cognitive decline in older adults. Design, Setting, and Participants This cohort study used data from waves 5 (June 2010 to July 2011) to 9 (from June 2018 to July 2019) in the English Longitudinal Study of Ageing. Participants included adults 50 years and older. Data were analyzed from April 1 to June 30, 2023. Exposures Pet ownership and living alone in wave 5. Main Outcomes and Measures In waves 5 to 9, verbal memory and verbal fluency were assessed, and composite verbal cognition was further calculated. Results Of the 7945 participants included, the mean (SD) age was 66.3 (8.8) years, and 4446 (56.0%) were women. Pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.008 [95% CI, 0.002-0.014] SD/y), verbal memory (β = 0.006 [95% CI, 0.001-0.012] SD/y), and verbal fluency (β = 0.007 [95% CI, 0.001-0.013] SD/y). Three-way interaction tests showed that living alone was a significant modifier in all 3 associations. Stratified analyses showed that pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.023 [95% CI, 0.011-0.035] SD/y), verbal memory (β = 0.021 [95% CI, 0.008-0.034] SD/y), and verbal fluency (β = 0.018 [95% CI, 0.005-0.030] SD/y) among individuals living alone, but not among those living with others. Joint association analyses showed no significant difference in rates of decline in composite verbal cognition, verbal memory, or verbal fluency between pet owners living alone and pet owners living with others. Conclusions and Relevance In this cohort study, pet ownership was associated with slower rates of decline in verbal memory and verbal fluency among older adults living alone, but not among those living with others, and pet ownership offset the associations between living alone and declining rates in verbal memory and verbal fluency. Further studies are needed to assess whether pet ownership slows the rate of cognitive decline in older adults living alone.
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Affiliation(s)
- Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liwan Zhu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liwen Yang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Herui Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaojuan Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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14
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Mahalingam G, Samtani S, Lam BCP, Lipnicki DM, Lima-Costa MF, Blay SL, Castro-Costa E, Shifu X, Guerchet M, Preux PM, Gbessemehlan A, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Riedel-Heller S, Dardiotis T, Röhr S, Kim KW, Pabst A, Shahar S, Numbers K, Ganguli M, Hughes TF, Chang CCH, Crowe M, Ng TP, Gwee X, Chua DQL, Rymaszewska J, Wolf-Ostermann K, Welmer AK, Stafford J, Mélis R, Vernooij-Dassen M, Jeon YH, Sachdev PS, Brodaty H. Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing. Alzheimers Dement 2023; 19:5114-5128. [PMID: 37102417 PMCID: PMC10603208 DOI: 10.1002/alz.13072] [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: 01/10/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Previous meta-analyses have linked social connections and mild cognitive impairment, dementia, and mortality. However, these used aggregate data from North America and Europe and examined a limited number of social connection markers. METHODS We used individual participant data (N = 39271, Mage = 70.67 (40-102), 58.86% female, Meducation = 8.43 years, Mfollow-up = 3.22 years) from 13 longitudinal ageing studies. A two-stage meta-analysis of Cox regression models examined the association between social connection markers with our primary outcomes. RESULTS We found associations between good social connections structure and quality and lower risk of incident mild cognitive impairment (MCI); between social structure and function and lower risk of incident dementia and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality. DISCUSSION Different aspects of social connections - structure, function, and quality - are associated with benefits for healthy aging internationally. HIGHLIGHTS Social connection structure (being married/in a relationship, weekly community group engagement, weekly family/friend interactions) and quality (never lonely) were associated with lower risk of incident MCI. Social connection structure (monthly/weekly friend/family interactions) and function (having a confidante) were associated with lower risk of incident dementia. Social connection structure (living with others, yearly/monthly/weekly community group engagement) and function (having a confidante) were associated with lower risk of mortality. Evidence from 13 longitudinal cohort studies of ageing indicates that social connections are important targets for reducing risk of incident MCI, incident dementia, and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality.
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Affiliation(s)
- Gowsaly Mahalingam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Suraj Samtani
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
- School of Psychology and Public Health, La Trobe University Melbourne, UNSW Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Sergio Luis Blay
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | - Erico Castro-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Antoine Gbessemehlan
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | | | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Health and Ageing Research Team, School of Psychology, Massey University, Palmerston, New Zealand
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Mary Ganguli
- Departments of Psychiatry, Epidemiology, and Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Chung-Chou H. Chang
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tze Pin Ng
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Denise Qian Ling Chua
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | | | - Karin Wolf-Ostermann
- Department of Health Services and Nursing Science Research, Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Anna-Karin Welmer
- Aging Research Center & Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jean Stafford
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - René Mélis
- Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Gelderland, The Netherlands
| | | | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
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Yang J, Huang J, Yang X, Li S, Wu X, Ma X. The association of living alone and social isolation with sarcopenia: A systematic review and meta-analysis. Ageing Res Rev 2023; 91:102043. [PMID: 37647996 DOI: 10.1016/j.arr.2023.102043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Living alone can cause social isolation and is correlated with multiple adverse health outcomes. Evidence about the association of living alone and social isolation with sarcopenia is limited. This meta-analysis aims to investigate the correlation between living alone, social isolation, and sarcopenia. METHODS According to the PRISMA guidelines, we systematically searched Medline, Embase, Web of Science, and Scopus for literature published up to June 30, 2023. We conducted reference checking to supplement the references. Two investigators independently screened the references for eligibility and assessed the quality of the references. We included references involving data on living alone, social isolation, and sarcopenia. Two investigators recorded study data for meta-analysis and study characteristics. RESULTS Data regarding living alone and sarcopenia were available from 13 studies. Meta-analysis demonstrated that living alone is correlated with sarcopenia (odds ratio, 1.51; 95 % CI, 1.31-1.75; p < 0.001). The gender-stratified analysis demonstrated that women living alone are more likely to have sarcopenia (odds ratio, 1.81; 95 % CI, 1.32-2.48; p < 0.001) but not men (odds ratio, 1.24; 95 % CI, 0.56-2.74; p = 0.60). Data regarding social isolation and sarcopenia were available from five studies. Social isolation is also associated with sarcopenia (odds ratio, 1.70; 95 % CI, 1.51-1.92; p < 0.001). And subgroup analysis demonstrated that social isolation is a risk factor for sarcopenia (odds ratio, 1.79; 95 % CI, 1.55-2.06; p < 0.001). CONCLUSIONS This meta-analysis revealed the association of living alone and social isolation with sarcopenia. Gender differences can help to screen high-risk groups of sarcopenia and reduce healthcare expenditures. As a further development of living alone, social isolation may play a more important role in sarcopenia than living alone.
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Affiliation(s)
- Jiaqing Yang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China School of Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, Sichuan 610041, China
| | - Jing Huang
- Department of Ultrasound, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan Province 610041, China
| | - Xinggang Yang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Shen Li
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China School of Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, Sichuan 610041, China
| | - Xin Wu
- Head & Neck Oncology Ward, Division of Radiotherapy Oncology, Cancer Center, West China Hospital, Sichuan University, Guoxue Road 37, Chengdu 610041, China.
| | - Xuelei Ma
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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16
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Park S, Jeong K, Lee S. A Study on the Longitudinal Relationship between Changes in Depression and Cognitive Function among Older Adults Living Alone. Healthcare (Basel) 2023; 11:2712. [PMID: 37893786 PMCID: PMC10606759 DOI: 10.3390/healthcare11202712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND As South Korea faces unprecedented population aging, this longitudinal study examined the relationship between depression and cognitive function changes in older individuals living alone. METHODS The study used data from the Korean Longitudinal Study of Aging (KLoSA). A total of 1354 participants with data available over a period of at least three years, from 2016 (wave 1) to 2020 (wave 8), were included, and latent growth modeling (LGM) was used for analysis. RESULTS Depression levels increased gradually among older individuals living alone and cognitive function declined over time among older adults living alone. Moreover, higher initial depression levels were associated with lower initial cognitive function levels and a more rapid cognitive decline over time. Therefore, it is imperative that depression be addressed as a potential cause of cognitive impairment and dementia. Furthermore, rapid increases in depression corresponded to rapid declines in cognitive function, indicating the need for continuous monitoring and intervention in cases of escalating depression, as it may negatively affect cognitive abilities. CONCLUSIONS These findings highlight the complex interplay between depression and cognitive function among older individuals living alone. Policy support to encourage participation in these programs is crucial to enhance the well-being of this vulnerable population.
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Affiliation(s)
- Soyoung Park
- Department of Social Welfare, Semyung University, 65 Semyung-ro, Jecheon 27136, Republic of Korea;
| | - Kyuhyoung Jeong
- Department of Social Welfare, Semyung University, 65 Semyung-ro, Jecheon 27136, Republic of Korea;
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
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17
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Wang J, Zhang L, Wang S, Zhang L. Living arrangements, health lifestyles, and health outcomes among Chinese oldest-old. Front Public Health 2023; 11:1235768. [PMID: 37876711 PMCID: PMC10591327 DOI: 10.3389/fpubh.2023.1235768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/04/2023] [Indexed: 10/26/2023] Open
Abstract
Background Prior literature has documented a strong correlation between living arrangements and older adults' health outcomes. However, few studies have explained why this association exists. This study took the health lifestyle theory approach and brought health lifestyles into the link between living arrangements and Chinese oldest-old health outcomes. It examined (1) whether healthy lifestyle behaviors among the oldest-old varied by household contexts and (2) whether the health disparities among the Chinese oldest-old in different household contexts could be partially explained by their healthy lifestyles. Methods Using the most recent 2018 data released by the Chinese Longitudinal Healthy Longevity Survey (CLHLS), latent class analysis was applied to identify predominant health lifestyles among the Chinese oldest-old aged 85-105 years. Regression analyses were used to test the mediating effect of health lifestyles. Results Three distinct classes representing the health lifestyles of Chinese oldest-old emerged; health lifestyle patterns were found to vary by elders' living arrangements. The respondent's health lifestyles in diverse residential structures served as a mediator which can partially explain the health disparities among the oldest-old. Conclusion The results suggested that health lifestyles can serve as a mediator to explain the association between oldest-old living arrangement patterns and their health outcomes. The findings highlighted the importance of family, lifestyles, and cultural contexts to the health of the oldest-old.
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Affiliation(s)
- Jie Wang
- School of Law, Anhui Normal University, Wuhu, Anhui, China
| | - Lanxi Zhang
- Department of Sociology and Anthropology, School of Oriental and African Studies, University of London, London, United Kingdom
| | - Shen Wang
- School of International Relations, Beijing International Studies University, Beijing, China
| | - Li Zhang
- School of Sociology, China University of Political Science and Law, Beijing, China
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18
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Wang X, Yuan X, Xia B, He Q, Jie W, Dai M. Living Alone Increases the Risk of Hypertension in Older Chinese Adults: A Population-Based Longitudinal Study. Innov Aging 2023; 7:igad071. [PMID: 37502337 PMCID: PMC10370894 DOI: 10.1093/geroni/igad071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Indexed: 07/29/2023] Open
Abstract
Background and Objectives Cross-sectional studies have suggested a potential association between living alone and hypertension risk, but longitudinal evidence remains limited. We aimed to investigate the correlation between living alone, alterations in living arrangements, and hypertension risk among older adults utilizing a population-based longitudinal design. Research Design and Methods The study included 8 782 older adults (≥65 years) without hypertension from the Chinese Longitudinal Healthy Longevity Survey. Participants were surveyed during the 2008 and 2011/2012 waves and were subsequently followed up in the next wave. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or a self-reported diagnosis of hypertension by a physician. Cox proportional hazards model was used to explore the association between living alone and hypertension. Additionally, we analyzed how switching living arrangements during the follow-up period affects hypertension. Results During a median follow-up of 2.8 (1.7-3.0) years, 2 750 hypertension events occurred. Compared with living with family, the hazard ratio (HR) (95% confidence interval [CI]) of living alone was 1.19 (1.06-1.33) for hypertension. Similarly, persisting in living alone during follow-up increased the risk of hypertension compared to continuing to live with family (HR 1.24; 95% CI: 1.06-1.45). Compared to married participants who continued to live with family, widowed/divorced participants who transitioned from living with family to living alone experienced a higher risk of hypertension (HR 1.21; 95% CI: 1.00-1.47). Stratified analyses showed that living alone was only associated with an increased hypertension risk for participants aged >80, men, and rural residents. Discussion and Implications Living alone at baseline or persisting in living alone during follow-up correlated with increased hypertension risk. Divorced or widowed individuals who transitioned from living with family to living alone were still at risk. These results indicate that social support and living arrangements may be important in preventing hypertension in older adults.
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Affiliation(s)
- Xiang Wang
- Department of Cardiology, Jiujiang No. 1 People’s Hospital, Jiujiang, Jiangxi, China
| | - Xiangyang Yuan
- Department of Cardiology, Jiujiang No. 1 People’s Hospital, Jiujiang, Jiangxi, China
| | - Bin Xia
- Department of Geriatrics, Jiujiang No. 1 People’s Hospital, Jiujiang, Jiangxi, China
| | - Quan He
- Medical Records Department, Jiujiang No. 1 People’s Hospital, Jiujiang, Jiangxi, China
| | - Wei Jie
- Department of Geriatrics, Jiujiang No. 1 People’s Hospital, Jiujiang, Jiangxi, China
| | - Miao Dai
- Department of Geriatrics, Jiujiang No. 1 People’s Hospital, Jiujiang, Jiangxi, China
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19
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Iverson GL, Castellani RJ, Cassidy JD, Schneider GM, Schneider KJ, Echemendia RJ, Bailes JE, Hayden KA, Koerte IK, Manley GT, McNamee M, Patricios JS, Tator CH, Cantu RC, Dvorak J. Examining later-in-life health risks associated with sport-related concussion and repetitive head impacts: a systematic review of case-control and cohort studies. Br J Sports Med 2023; 57:810-821. [PMID: 37316187 DOI: 10.1136/bjsports-2023-106890] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Concern exists about possible problems with later-in-life brain health, such as cognitive impairment, mental health problems and neurological diseases, in former athletes. We examined the future risk for adverse health effects associated with sport-related concussion, or exposure to repetitive head impacts, in former athletes. DESIGN Systematic review. DATA SOURCES Search of MEDLINE, Embase, Cochrane, CINAHL Plus and SPORTDiscus in October 2019 and updated in March 2022. ELIGIBILITY CRITERIA Studies measuring future risk (cohort studies) or approximating that risk (case-control studies). RESULTS Ten studies of former amateur athletes and 18 studies of former professional athletes were included. No postmortem neuropathology studies or neuroimaging studies met criteria for inclusion. Depression was examined in five studies in former amateur athletes, none identifying an increased risk. Nine studies examined suicidality or suicide as a manner of death, and none found an association with increased risk. Some studies comparing professional athletes with the general population reported associations between sports participation and dementia or amyotrophic lateral sclerosis (ALS) as a cause of death. Most did not control for potential confounding factors (eg, genetic, demographic, health-related or environmental), were ecological in design and had high risk of bias. CONCLUSION Evidence does not support an increased risk of mental health or neurological diseases in former amateur athletes with exposure to repetitive head impacts. Some studies in former professional athletes suggest an increased risk of neurological disorders such as ALS and dementia; these findings need to be confirmed in higher quality studies with better control of confounding factors. PROSPERO REGISTRATION NUMBER CRD42022159486.
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Affiliation(s)
- Grant L Iverson
- Sports Concussion Program, MassGeneral Hospital for Children, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, Massachusetts, USA
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Rudolph J Castellani
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - J David Cassidy
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Geoff M Schneider
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Ruben J Echemendia
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
- University Orthopedic Centre, Concussion Care Clinic, State College, Pennsylvania, USA
| | - Julian E Bailes
- Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, USA
- Department of Neurosurgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Inga K Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Mass General Brigham, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Geoffrey T Manley
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
| | - Michael McNamee
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
- School of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - Jon S Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charles H Tator
- Department of Surgery and Division of Neurosurgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Canadian Concussion Centre, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Robert C Cantu
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Robert C. Cantu Concussion Center, Emerson Hospital, Concord, Massachusetts, USA
| | - Jiri Dvorak
- Schulthess Clinic Zurich, Zurich, Switzerland
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20
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Patricios JS, Schneider KJ, Dvorak J, Ahmed OH, Blauwet C, Cantu RC, Davis GA, Echemendia RJ, Makdissi M, McNamee M, Broglio S, Emery CA, Feddermann-Demont N, Fuller GW, Giza CC, Guskiewicz KM, Hainline B, Iverson GL, Kutcher JS, Leddy JJ, Maddocks D, Manley G, McCrea M, Purcell LK, Putukian M, Sato H, Tuominen MP, Turner M, Yeates KO, Herring SA, Meeuwisse W. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med 2023; 57:695-711. [PMID: 37316210 DOI: 10.1136/bjsports-2023-106898] [Citation(s) in RCA: 152] [Impact Index Per Article: 152.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 06/16/2023]
Abstract
For over two decades, the Concussion in Sport Group has held meetings and developed five international statements on concussion in sport. This 6th statement summarises the processes and outcomes of the 6th International Conference on Concussion in Sport held in Amsterdam on 27-30 October 2022 and should be read in conjunction with the (1) methodology paper that outlines the consensus process in detail and (2) 10 systematic reviews that informed the conference outcomes. Over 3½ years, author groups conducted systematic reviews of predetermined priority topics relevant to concussion in sport. The format of the conference, expert panel meetings and workshops to revise or develop new clinical assessment tools, as described in the methodology paper, evolved from previous consensus meetings with several new components. Apart from this consensus statement, the conference process yielded revised tools including the Concussion Recognition Tool-6 (CRT6) and Sport Concussion Assessment Tool-6 (SCAT6, Child SCAT6), as well as a new tool, the Sport Concussion Office Assessment Tool-6 (SCOAT6, Child SCOAT6). This consensus process also integrated new features including a focus on the para athlete, the athlete's perspective, concussion-specific medical ethics and matters related to both athlete retirement and the potential long-term effects of SRC, including neurodegenerative disease. This statement summarises evidence-informed principles of concussion prevention, assessment and management, and emphasises those areas requiring more research.
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Affiliation(s)
- Jon S Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jiri Dvorak
- Spine Unit, Schulthess Clinic Human Performance Lab, Zurich, Switzerland
| | - Osman Hassan Ahmed
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, UK
- The FA Centre for Para Football Research, The Football Association, Burton-Upon-Trent, Staffordshire, UK
| | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation/Harvard Medical School, Boston, Massachusetts, USA
- Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation, Boston, Massachusetts, USA
| | - Robert C Cantu
- CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Gavin A Davis
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Cabrini Health, Malvern, Victoria, Australia
| | - Ruben J Echemendia
- Psychology, University of Missouri Kansas City, Kansas City, Missouri, USA
- Psychological and Neurobehavioral Associates, Inc, Miami, Florida, USA
| | - Michael Makdissi
- Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, Melbourne, Victoria, Australia
| | - Michael McNamee
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
- School of Sport and Exercise Medicine, Swansea University, Swansea, UK
| | - Steven Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Nina Feddermann-Demont
- University Hospital Zurich, Zurich, Switzerland
- Sports Neuroscience, University of Zurich, Zurich, Switzerland
| | - Gordon Ward Fuller
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Christopher C Giza
- Neurosurgery, UCLA Steve Tisch BrainSPORT Program, Los Angeles, California, USA
- Pediatrics/Pediatric Neurology, Mattel Children's Hospital UCLA, Los Angeles, California, USA
| | - Kevin M Guskiewicz
- Matthew Gfeller Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Grant L Iverson
- Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Sports Concussion Program, MassGeneral Hospital for Children, Boston, Massachusetts, USA
| | | | - John J Leddy
- UBMD Orthopaedics and Sports Medicne, SUNY Buffalo, Buffalo, New York, USA
| | - David Maddocks
- Melbourne Neuropsychology Services & Perry Maddocks Trollope Lawyers, Melbourne, Victoria, Australia
| | - Geoff Manley
- Neurosurgery, University of California, San Francisco, San Francisco, California, USA
| | - Michael McCrea
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Laura K Purcell
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | | | - Haruhiko Sato
- Neurosurgery, Seirei Mikatahara Hospital, Hamamatsu, Japan
| | | | - Michael Turner
- International Concussion and Head Injury Research Foundation, London, UK
- University College London, London, UK
| | | | - Stanley A Herring
- Department of Rehabilitation Medicine, Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, USA
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
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21
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Wang J, Zhang WS, Jiang CQ, Zhu F, Jin YL, Thomas GN, Cheng KK, Lam TH, Xu L. Persistence of social isolation and mortality: 10-year follow-up of the Guangzhou Biobank Cohort study. Psychiatry Res 2023; 322:115110. [PMID: 36827858 DOI: 10.1016/j.psychres.2023.115110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/22/2023]
Abstract
Although social isolation has been associated with higher mortality risk, the associations of persistence of social isolation with mortality are unclear. We investigated the prospective associations of intermittent and persistent social isolation with all-cause and cause-specific mortality, considering the social contact types (face-to-face and non-face-to-face). 30,518 participants were recruited in 2003-2008 initially and 18,104 participants with re-assessed social isolation information in 2008-2012 were followed up to Dec 2019 in Guangzhou Biobank Cohort Study (GBCS). During an average of 9.7 years of follow-up, 2,119 deaths occurred. The isolation at baseline survey, isolation at second survey and persistent isolation were positively associated with all-cause mortality in the minimal adjusted model (adjusted hazard ratio (AHR) =1.24, 95% CI 1.12-1.38, 1.11, 1.00-1.23 and 1.23, 1.05-1.43, respectively). Totally 47.2% of the risk was explained by health status, SEP, and biological, behavioural and psychological factors. Persistent isolation from face-to-face with co-inhabitants, versus no isolation, was associated with higher risks of all-cause (HR=1.40, 1.09-1.81) and CVD (subdistribution hazard ratio (SHR)=1.92, 1.31-2.81) mortality in fully adjusted model. Our study showed that intermittent and persistent isolation were generally associated with higher risks of mortality, and the risks were even higher in those with persistent face-to-face isolation with co-inhabitants.
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Affiliation(s)
- Jiao Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, China.
| | | | - Feng Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Ya Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Graham Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong, China.
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22
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Klein CB, McQuaid GA, Charlton RA, Klinger LG, Wallace GL. Self-reported cognitive decline among middle and older age autistic adults. Autism Res 2023; 16:605-616. [PMID: 36513614 DOI: 10.1002/aur.2877] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
Very little is known about autistic adults as they age. Early evidence suggests a potentially high risk for dementia and atypical cognitive decline in autistic middle and older age adults. Research in the general population indicates that self-reported cognitive decline may predict future dementia earlier than performance-based measures. Nevertheless, self-report dementia screeners have not been used to date in autism research. In a sample of middle and older age autistic adults (N = 210), participants completed a self-rated dementia screener, the AD8, to describe the rate of cognitive decline, examine associations of cognitive decline with age, educational level, sex designated at birth, and autistic traits, and document the psychometrics of a dementia screener in autistic adults. We found high rates of cognitive decline with 30% of the sample screening positive. The most common symptoms were declining interest in leisure activities, and increases in everyday problems with thinking, memory, and judgment. There was evidence that autistic individuals designated female at birth may be more vulnerable to cognitive decline than autistic individuals designated male at birth. Notably, reports of cognitive decline did not vary by age or educational level. Modestly elevated autistic traits were found in those screening positive versus negative for cognitive decline. Finally, the dementia screener showed good psychometrics, including convergent validity with an independent measure of current memory problems. These results could signal an emerging public health crisis in autistic adults as they age, and support the potential utility of self-report measures for early screening for cognitive decline in this population.
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Affiliation(s)
- Claire B Klein
- Department of Psychiatry, The University of North Carolina TEACCH Autism Program, Chapel Hill, North Carolina, USA
| | - Goldie A McQuaid
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| | | | - Laura G Klinger
- Department of Psychiatry, The University of North Carolina TEACCH Autism Program, Chapel Hill, North Carolina, USA
| | - Gregory L Wallace
- Department of Speech, Language and Hearing Sciences, The George Washington University, Washington, District of Columbia, USA
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Jiang Y, Li M, Chung T. Living alone and all-cause mortality in community-dwelling older adults: The moderating role of perceived neighborhood cohesion. Soc Sci Med 2023; 317:115568. [PMID: 36442301 PMCID: PMC9839549 DOI: 10.1016/j.socscimed.2022.115568] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/23/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The adverse effect of living alone on health has been well-documented in community-dwelling older adults. A less understood topic in this research area is whether some neighborhood characteristics may mitigate the negative impact of living alone on health outcomes and mortality. This study aimed to extend the existing work on living arrangements and health by examining the potential interactive effect of living alone and perceived neighborhood cohesion on all-cause mortality among older Chinese Americans. METHODS Data were drawn from 3154 (58.0% female) participants from a prospective cohort study of community-dwelling US older Chinese adults aged 60 and older in the greater Chicago area. Living arrangements and perceived neighborhood cohesion were assessed at baseline from 2011 to 2013. Mortality status was tracked through December 2021. Covariates, including sociodemographic characteristics, health and behavioral covariates, loneliness, depression, and social engagement, were assessed at baseline. Cox proportional hazards regression model was used to test our hypotheses. RESULTS Living alone was significantly associated with an increased risk of all-cause mortality among participants reporting low levels of perceived neighborhood cohesion but not among those reporting high levels of perceived neighborhood cohesion. This protective effect of perceived neighborhood cohesion was robust to the inclusion of covariates. CONCLUSIONS Our results suggest that strong perceived neighborhood cohesion may protect against the increased risk of premature mortality associated with living alone in community-dwelling older Chinese Americans.
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Affiliation(s)
- Yanping Jiang
- Center for Population Behavioral Health, Institute for Health, Health Care Policy and Aging Research, The State University of New Jersey, New Brunswick, NJ, United States; Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States.
| | - Mengting Li
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Tammy Chung
- Center for Population Behavioral Health, Institute for Health, Health Care Policy and Aging Research, The State University of New Jersey, New Brunswick, NJ, United States; Department of Psychiatry, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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Hajek A, Kretzler B, Riedel-Heller SG, König HH. Frequency and correlates of mild cognitive impairment and dementia among the oldest old - Evidence from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)". Arch Gerontol Geriatr 2023; 104:104804. [PMID: 36084607 DOI: 10.1016/j.archger.2022.104804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Since there is limited knowledge with regard to the frequency and correlates of mild cognitive impairment and dementia among the oldest old based on large representative data (including institutionalized individuals), our objective was to fill this research gap. METHODS For our study, data came from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)". This study included community-dwelling and institutionalized individuals aged 80 years and over (n = 1,173, mean age: 86 years) residing in the most populous state of Germany (North Rhine-Westphalia). The DemTect was used to quantify cognitive impairment (i.e., probable mild cognitive impairment and probable dementia). RESULTS Overall, 73.1% of the individuals were not cognitively impaired, 17.0% of the individuals had probable mild cognitive impairment and 9.9% of the individuals had probable dementia. Compared to individuals without cognitive impairment, individuals with probable mild cognitive impairment were more likely to be male, live in an institutionalized setting, have a lower educational level, have a smaller network size, and have lower functional abilities. Moreover, compared to individuals without cognitive impairment, individuals with probable dementia were more likely to be older, live in an institutionalized setting, have a lower educational level, have a smaller network size, not be multimorbid, and have lower functional abilities. CONCLUSIONS Our study identified several sociodemographic and health-related factors which are associated with probable mild cognitive impairment and probable dementia among the oldest old. This knowledge may help to address individuals at risk for mild cognitive impairment and dementia.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Bell G, Singham T, Saunders R, Buckman JEJ, Charlesworth G, Richards M, John A, Stott J. Positive psychological constructs and cognitive function: A systematic review and meta-analysis. Ageing Res Rev 2022; 82:101745. [PMID: 36210034 DOI: 10.1016/j.arr.2022.101745] [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: 04/28/2022] [Accepted: 10/04/2022] [Indexed: 01/31/2023]
Abstract
AIM To synthesise evidence regarding the association between positive psychological constructs (PPCs) and cognitive function in adults aged 50 +. METHODS Literature searches: Medline, PsycINFO, and Scopus (inception to February 2022). Studies were included if they reported on the association between at least one PPC and one objective measure of cognitive function in people aged 50 + without cognitive impairment at baseline. Where at least two studies reported on the same PPC and cognitive outcome, estimates were pooled through meta-analysis. FINDINGS In total, 37 studies were included. There was evidence of cross-sectional associations for 'meaning in life' (verbal fluency: b = 0.09, 95 %CI [0.07, 0.11], p < .001; memory: b = 0.10, 95 %CI [0.08, 0.12], p < .001), 'purpose in life' (verbal fluency: b = 0.07, 95 %CI [0.05, 0.08], p < .001; memory: r = 0.13, 95 %CI [0.08, 0.18], p < .001), and positive affect (cognitive state: r = 0.25, 95 %CI [0.14, 0.36], p < .001; memory: r = 0.05, 95 %CI [0.02, 0.08], p < .001) with various domains of cognitive function. However, no significant results were found for life satisfaction (p = .13) or longitudinal studies investigating positive affect and memory (p = .48). Other PPCs were included in narrative syntheses only. IMPLICATIONS Purpose and meaning in life may be sensible primary targets for interventions to promote healthy cognitive aging. More longitudinal and causal inference research is needed to better understand this association and its implications for clinical practice.
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Affiliation(s)
- Georgia Bell
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Timothy Singham
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rob Saunders
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joshua E J Buckman
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; iCope - Camden & Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK
| | - Georgina Charlesworth
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Amber John
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joshua Stott
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
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Lin Y, Zhang Q, Wang T, Zeng Z. Effect of living arrangements on cognitive function in Chinese elders: a longitudinal observational study. BMJ Open 2022; 12:e050410. [PMID: 36202581 PMCID: PMC9540837 DOI: 10.1136/bmjopen-2021-050410] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine how living arrangement as a social contextual factor can affect Chinese elders' cognitive function. SETTING AND PARTICIPANTS Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China's 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80-112 in China. OUTCOME MEASURES Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement was divided into living in an institution, living alone and living with household members. Generalised linear regressions were carried out to examine the associations between baseline characteristics and cognitive function, while controlling age, gender and residential area. RESULTS A total of 2486 participants were included in the study at baseline in 2014. Of these, 1162 (46.7%) were men and 1324 (53.3%) were women. The mean age at baseline was 75.07 (±8.31) years. The mean years of schooling were 2.86 (±3.68). The number (proportion) of the three living arrangements (lived in institutions, lived alone and lived with household members) were 93 (3.8%), 463 (18.6%) and 1930 (77.6%), respectively. Among all participants, cognitive function declined over time. Those who lived alone presented with the highest MMSE scores at baseline and showed the lowest decline after 4 years. Living arrangements had significant effects on decreasing cognitive function. CONCLUSION Chinese elders living in institutions were most vulnerable to cognitive decline. Living alone was not a risk condition in itself for the elderly in terms of cognitive decline. In addition, the benefits of living with household members to support cognitive function were not found in our study.
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Affiliation(s)
- Yanwei Lin
- Department of Health Sociology, School of Humanities and Management, Guangdong Medical University, Dongguan, Guangdong, China
- Institute of Public Health and Wellness, Guangdong Medical University, Dongguan, Guangdong, China
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA
| | - Tingxian Wang
- School of public health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Zhirong Zeng
- Institute of Public Health and Wellness, Guangdong Medical University, Dongguan, Guangdong, China
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What Do We Know about Social and Non-Social Factors Influencing the Pathway from Cognitive Health to Dementia? A Systematic Review of Reviews. Brain Sci 2022; 12:brainsci12091214. [PMID: 36138950 PMCID: PMC9497077 DOI: 10.3390/brainsci12091214] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/21/2022] Open
Abstract
The heterogeneous and multi-factorial nature of dementia requires the consideration of all health aspects when predicting the risk of its development and planning strategies for its prevention. This systematic review of reviews provides a comprehensive synthesis of those factors associated with cognition in the context of dementia, identifying the role of social aspects and evidencing knowledge gaps in this area of research. Systematic reviews and meta-analyses from 2009–2021 were searched for within Medline, PsycINFO, CINAHL Complete, Cochrane, and Epistemonikos. Reviewers independently screened, reviewed, and assessed the records, following the PRISMA-2020 guidelines. From 314 included studies, 624 cognitive-related factors were identified, most of them risk factors (61.2%), mainly belonging to the group of ‘somatic comorbidities’ (cardiovascular disease and diabetes) and ‘genetic predispositions’. The protective factors (20%) were mainly related to lifestyle, pointing to the Mediterranean diet, regular physical activity, and cognitively stimulating activities. Social factors constituted 9.6% of all identified factors. Research on biological and medical factors dominates the reviewed literature. Greater social support and frequent contact may confer some protection against cognitive decline and dementia by delaying its onset or reducing the overall risk; however, overall, our findings are inconsistent. Further research is needed in the fields of lifestyle, psychology, social health, and the protective factors against cognitive decline and dementia.
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Health Outcomes of Elder Orphans: an Umbrella and Scoping Review of the Literature. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09387-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hu H, Bi YL, Shen XN, Ma YH, Ou YN, Zhang W, Ma LZ, Hu HY, Dong Q, Tan L, Yu JT. Application of the amyloid/tau/neurodegeneration framework in cognitively intact adults: the CABLE Study. Ann Neurol 2022; 92:439-450. [PMID: 35700125 DOI: 10.1002/ana.26439] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The amyloid/tau/neurodegeneration (AT[N]) framework has conceptualized Alzheimer's disease (AD) continuum as a continuum of disease with evidences of amyloid-related pathologies independent of clinical manifestation. Based on this framework, it is necessary to reveal the distribution and risk factors of AD continuum in the cognitively intact population among different cohorts and races, including the northern Chinese Han population. METHODS This study classified cognitively intact Chinese Alzheimer's Biomarker and LifestylE (CABLE) participants through the AT(N) scheme. Gaussian mixture models were used to identity the cutoff values of cerebrospinal fluid biomarkers, which distinguished AD continuum (A + T-N-, A + T + N-, A + T-N+ and A + T + N+) from 1,005 participants (mean age: 61 years; 40% female). Multivariable logistic regressions and Cochran-Armitage trend tests were used to test neuropsychological performance and risk factors for AD continuum. RESULTS Approximately one-third of individuals (33.7%) belonged to AD continuum. Four potential modifiable risk factors, including hypertension, thyroid diseases, social isolation and minimal depression symptoms, were identified for AD continuum (odds ratio [OR] ranging from 1.68 to 6.90). A trend toward higher prevalence of AD continuum was associated with a larger number of risk factors (P for trend <0.0001). The risk of AD continuum increased by about two times for each additional modifiable risk factor (OR 1.9, 95% CI 1.65-2.24, P < 0.0001). INTERPRETATION This study revealed the distribution and potential risk factors of AD continuum in cognitively intact Han population in northern China, which filled the gap in the area about the performance of the AT(N) framework in the Asian population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hao Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan-Lin Bi
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao University, China
| | - Xue-Ning Shen
- From Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ling-Zhi Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - He-Ying Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Qiang Dong
- From Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- From Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China
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Boku Y, Ota M, Nemoto M, Numata Y, Kitabatake A, Takahashi T, Nemoto K, Tamura M, Sekine A, Ide M, Kaneda Y, Arai T. The Multicomponent Day-Care Program Prevents Volume Reduction in a Memory-Related Brain Area in Patients with Mild Cognitive Impairment. Dement Geriatr Cogn Disord 2022; 51:120-127. [PMID: 35320811 DOI: 10.1159/000522654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/13/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is considered an important period for interventions to prevent progression to dementia. Nonpharmacological interventions for MCI include exercise training, cognitive intervention, and music therapy. These play an important role in improving cognitive function, but their effects on brain plasticity in individuals with MCI are largely unknown. We investigated the effects of a multicomponent day-care program provided by the University of Tsukuba Hospital on the longitudinal brain volume changes in MCI patients. METHODS MCI patients who participated in the multicomponent day-care program and underwent whole-brain magnetic resonance imaging (MRI) twice during their participation (n = 14), were included. We divided them into two groups according to their attendance rate and conducted a between-group analysis of longitudinal volume changes in the whole cerebral cortex. Regional brain volumes derived from the patients' MRI were calculated with Freesurfer 6.0.0. RESULTS The neuroimaging analysis demonstrated that the left rostral anterior cingulate cortex volume was significantly preserved in the high-attendance group compared to that of the low-attendance group. CONCLUSION Our results suggest that continuous participation in a multicomponent day-care program could help prevent a volume reduction in memory-related brain areas in patients with MCI.
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Affiliation(s)
- Youshun Boku
- Department of Psychiatry, Degree Programs in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.,Department of Clinical Psychology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Miho Ota
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Miyuki Nemoto
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuriko Numata
- Department of Clinical Psychology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Ayako Kitabatake
- Department of Clinical Psychology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Takumi Takahashi
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kiyotaka Nemoto
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masashi Tamura
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Aya Sekine
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masayuki Ide
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuko Kaneda
- Department of Clinical Psychology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Tetsuaki Arai
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Associations of face-to-face and non-face-to-face social isolation with all-cause and cause-specific mortality: 13-year follow-up of the Guangzhou Biobank Cohort study. BMC Med 2022; 20:178. [PMID: 35501792 PMCID: PMC9059436 DOI: 10.1186/s12916-022-02368-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/06/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although social isolation has been associated with a higher mortality risk, little is known about the potential different impacts of face-to-face and non-face-to-face isolation on mortality. We examined the prospective associations of four types of social isolation, including face-to-face isolation with co-inhabitants and non-co-inhabitants, non-face-to-face isolation, and club/organization isolation, with all-cause and cause-specific mortality separately. METHODS This prospective cohort study included 30,430 adults in Guangzhou Biobank Cohort Study (GBCS), who were recruited during 2003-2008 and followed up till Dec 2019. RESULTS During an average of 13.2 years of follow-up, 4933 deaths occurred during 396,466 person-years. Participants who lived alone had higher risks of all-cause (adjusted hazard ratio (AHR) 1.24; 95% confidence interval (CI) 1.04-1.49) and cardiovascular disease (CVD) (1.61; 1.20-2.03) mortality than those who had ≥ 3 co-habitant contact after adjustment for thirteen potential confounders. Compared with those who had ≥ 1 time/month non-co-inhabitant contact, those without such contact had higher risks of all-cause (1.60; 1.20-2.00) and CVD (1.91; 1.20-2.62) mortality. The corresponding AHR (95% CI) in participants without telephone/mail contact were 1.27 (1.14-1.42) for all-cause, 1.30 (1.08-1.56) for CVD, and 1.37 (1.12-1.67) for other-cause mortality. However, no association of club/organization contact with the above mortality and no association of all four types of isolation with cancer mortality were found. CONCLUSIONS In this cohort study, face-to-face and non-face-to-face isolation were both positively associated with all-cause, CVD-, and other-cause (but not cancer) mortality. Our finding suggests a need to promote non-face-to-face contact among middle-aged and older adults.
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Bell G, Singham T, Saunders R, John A, Stott J. Positive psychological constructs and association with reduced risk of mild cognitive impairment and dementia in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 77:101594. [PMID: 35192960 DOI: 10.1016/j.arr.2022.101594] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/09/2022] [Accepted: 02/18/2022] [Indexed: 12/13/2022]
Abstract
Understanding factors associated with dementia risk is important for informing future interventions aimed at dementia prevention. There is accumulating evidence for the association between depression and risk of dementia, however less is known about the association between positive psychological factors and dementia incidence. This review aims to synthesise evidence regarding the association between positive psychological constructs (PPCs) and later risk of MCI and dementia in adults aged 50 and over. Literature searches were conducted in Medline, PsycINFO, and Scopus until March 2021. Papers reporting on the association between at least one PPC and later risk of MCI or dementia in people aged 50 + without cognitive impairment at baseline were included. Results from the meta-analyses revealed that purpose in life was significantly associated with a reduced risk of dementia (HR = 0.81, 95% CI [0.78, 0.85], p < .001), however results for positive affect were non-significant (HR = 0.94, 95% CI [0.76, 1.15], p = .54). Results for other PPCs are described narratively. Mixed findings for different PPCs highlight the importance of investigating these factors individually. Understanding which factors may play a protective role in their association with risk of mild cognitive impairment and dementia could have important implications for informing dementia prevention interventions.
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Wen C, Hu H, Ou YN, Bi YL, Ma YH, Tan L, Yu JT. Risk factors for subjective cognitive decline: the CABLE study. Transl Psychiatry 2021; 11:576. [PMID: 34753917 PMCID: PMC8578345 DOI: 10.1038/s41398-021-01711-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/13/2022] Open
Abstract
Increasing evidences supported that subjective cognitive decline (SCD) might be a potential first symptomatic manifestation of Alzheimer's disease (AD). The rapidly growing number of SCD individuals who seek medical help and advice also makes it urgent to develop more precise strategy for SCD. Therefore, this study aimed to explore the risk factors for SCD. Logistics and linear regression models were performed to investigate 41 factors for SCD in 1165 participants without objective cognitive impairment. Cochran-Armitage trend test was used to confirm the constant trend toward higher prevalence of SCD with an increasing number of risk factors. A high overall prevalence of SCD was found in total participants (42%). Eight factors were eventually identified as risk factors for SCD, including four stable factors associated with both SCD statues and severity (older age, thyroid diseases, minimal anxiety symptoms, and day time dysfunction; odds ratio (OR) ranging from 1.74 to 2.29) as well as four suggestive factors associated with either SCD statues or severity (female sex, anemia, lack of physical exercises, and living alone; OR ranging from 1.30 to 2.29). The prevalence of SCD gradually increased with the number of risk factors clustering increased in individuals (p for trend <0.001). Five of these eight factors were further proved among individuals with SCD-plus features. These findings revealed several risk factors for SCD, providing some new clues for formulating priority strategies for early prevention of SCD.
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Affiliation(s)
- Chen Wen
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Hao Hu
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Nan Ou
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan-Lin Bi
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Hui Ma
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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Singham T, Bell G, Saunders R, Stott J. Widowhood and cognitive decline in adults aged 50 and over: A systematic review and meta-analysis. Ageing Res Rev 2021; 71:101461. [PMID: 34534681 DOI: 10.1016/j.arr.2021.101461] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/02/2021] [Accepted: 09/11/2021] [Indexed: 01/21/2023]
Abstract
While widowhood is known to be associated with poorer physical and mental health outcomes, studies examining the association of widowhood with cognition have yielded mixed results. This review aimed to elucidate the link between widowhood and cognitive decline. A systematic search of Medline, Embase, PsycInfo, CINAHL and Scopus (until December 2020) was conducted to identify studies on the association between widowhood (vs. being married) and cognition in cognitively healthy adults aged 50 +. A cross-sectional meta-analysis (of 10 studies; n = 24,668) found a significant association of widowhood with cognition (g = - 0.36, 95% CI [- 0.47, - 0.25], p = < 0.001). Meta-regressions suggested that study design, cognitive domain measured, sample age, difference in mean age between widowed and married groups, and study continent did not account for observed heterogeneity. A longitudinal meta-analysis (of 3 studies; n = 10,378) found that the "continually widowed" group (from baseline to follow-up) showed significantly steeper declines in cognition compared to the "continually married" group (g = - 0.15, 95%CI [- 0.19, - 0.10], p = < 0.001). Findings indicate that widowhood may be a risk factor for cognitive decline. As there are no effective treatments for cognitive impairment, studying mechanisms by which widowhood might be associated with poorer cognition could inform prevention programs for those who have experienced spousal bereavement.
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Atrial Fibrillation and Dementia. Am J Geriatr Psychiatry 2021; 29:1099-1100. [PMID: 33663984 DOI: 10.1016/j.jagp.2021.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/21/2022]
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Ferdous F. Social Distancing vs Social Interaction for Older Adults at Long-Term Care Facilities in the Midst of the COVID-19 Pandemic: A Rapid Review and Synthesis of Action Plans. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211044287. [PMID: 34612063 PMCID: PMC8504216 DOI: 10.1177/00469580211044287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The present study aimed to systematically analyze the impact of COVID-19-related social distancing requirements on older adults living in long-term care facilities (LTCFs) and to synthesize the literature into thematic action plans to minimize the adverse effects of social isolation. The search included articles published between December 2019 and August 2020 across four databases. The inclusion criteria were used to screen for studies that reported on social isolation and loneliness due to the COVID-19 pandemic in older adults living in LTCFs. This rapid review identified 29 relevant studies and synthesized them into four thematic action plans: technological advancement, remote communication, therapeutic care/stress management, and preventive measures. These thematic action plans and cost-effective strategies can be immediately adopted and used as a resource for all LTCF administrators, healthcare design professionals, and researchers in battling current COVID-19-related issues, and improving social interaction in older adults living in care facilities.
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Affiliation(s)
- Farhana Ferdous
- Department of Architecture, College of Engineering and Architecture, 8369Howard University, Washington, DC, USA
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Forward C, Khan HTA, Fox P. Older Women Living Alone in the UK: Does Their Health and Wellbeing Differ from Those Who Cohabit? JOURNAL OF POPULATION AGEING 2021; 16:103-119. [PMID: 34394768 PMCID: PMC8349464 DOI: 10.1007/s12062-021-09344-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Abstract
With an increased prevalence of people living alone in later life, understanding the health and wellbeing of older women living alone in the UK is an important area of research. Little is known about health and wellbeing in this population and whether they differ from those who cohabit. This paper fills this research gap. Analysis was undertaken of Wave 8 of the Understanding Society Household Panel Survey, including variables such as internet use and volunteering. Differences were found between those who live alone and cohabit. Volunteering was a predictor of better health outcomes for those who lived alone but not for those who cohabit, despite similar rates of volunteering. Internet use predicted some better health outcome for those who cohabit but poorer for those who live alone. This suggests lifestyle factors vary in how they affect the health and wellbeing of older women, depending on cohabitation status.
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Affiliation(s)
- Catherine Forward
- College of Nursing, Midwifery and Healthcare, University of West London, England, UK
| | - Hafiz T. A. Khan
- Public Health Group, College of Nursing, Midwifery and Healthcare, University of West London, England, UK
| | - Pauline Fox
- The Graduate Centre, University of West London, London, England UK
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Ma'u E, Cullum S, Cheung G, Livingston G, Mukadam N. Differences in the potential for dementia prevention between major ethnic groups within one country: A cross sectional analysis of population attributable fraction of potentially modifiable risk factors in New Zealand. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 13:100191. [PMID: 34527984 PMCID: PMC8358157 DOI: 10.1016/j.lanwpc.2021.100191] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/16/2021] [Accepted: 05/27/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Twelve potentially modifiable risk factors (less education, hypertension, obesity, alcohol, traumatic brain injury (TBI), hearing loss, smoking, depression, physical inactivity, social isolation, diabetes, air pollution) account for an estimated 40% of worldwide dementia cases. We aimed to calculate population attributable fractions (PAFs) for dementia for the four largest New Zealand ethnic groups (European, Māori, Asian, and Pacific peoples) to identify whether optimal dementia prevention targets differed by ethnicity. METHODS We calculated risk factor prevalence for 10 risk factors using the New Zealand Health Survey 2018/19 and published reports for hearing loss and TBI prevalences. We calculated the PAF for each risk factor using calculated prevalence and relative risk estimates from previous meta-analyses. To account for risk factor overlap, we calculated communality of risk factors and a weighted PAF. FINDINGS The weighted PAF for dementia was 47.7% overall in New Zealand, 47.6% for Europeans, 51.4% for Māori, 50.8% for Pacific peoples, and 40.8% for Asians. Highest PAFs for Europeans were hearing loss (8%) and social isolation (5.7%), and for Asians hearing loss (7.3%) and physical inactivity (5.5%). For Māori and Pacific peoples, highest PAFs were for obesity (7.3% and 8.9% respectively) and hearing loss (6.5% and 6.6%). INTERPRETATION New Zealand has higher dementia prevention potential than worldwide estimates with high prevalences of untreated hearing loss and obesity. The relative contribution of individual risk factors PAFs varies by ethnic group. Public health strategies for dementia prevention need to be tailored to these differences. FUNDING Health Research Council of New Zealand (HRC:20/021).
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Affiliation(s)
- Etuini Ma'u
- Department of Psychological Medicine, University of Auckland, New Zealand
- Waikato District Health Board
| | - Sarah Cullum
- Department of Psychological Medicine, University of Auckland, New Zealand
- Counties Manukau District Health Board
| | - Gary Cheung
- Department of Psychological Medicine, University of Auckland, New Zealand
- Auckland District Health Board
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
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Peterson RL, George KM, Tran D, Malladi P, Gilsanz P, Kind AJH, Whitmer RA, Besser LM, Meyer OL. Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7166. [PMID: 34281103 PMCID: PMC8296955 DOI: 10.3390/ijerph18137166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia. METHODS A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels. RESULTS Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level. CONCLUSIONS Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.
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Affiliation(s)
- Rachel L. Peterson
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Kristen M. George
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Duyen Tran
- Department of Psychology, University of California Davis, Davis, CA 95616, USA;
| | - Pallavi Malladi
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA 95616, USA;
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Amy J. H. Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
- Health Services and Care Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Geriatrics Research Education and Clinical Center, Department of Veterans Affairs, Madison, WI 53726, USA
| | - Rachel A. Whitmer
- Public Health Sciences, Division of Epidemiology, University of California Davis, Davis, CA 95616, USA;
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
| | - Lilah M. Besser
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Oanh L. Meyer
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
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Park S, Kim TH, Eom TR. Impact of Social Network Size and Contact Frequency on Resilience in Community-Dwelling Healthy Older Adults Living Alone in the Republic of Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116061. [PMID: 34199964 PMCID: PMC8200182 DOI: 10.3390/ijerph18116061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 01/28/2023]
Abstract
The aim of this study was to investigate the characteristics of social health and its association with resilience among older adults living alone excluded from the public care service due to their relatively good health. For this cross-sectional study, we surveyed older adults aged between 65 and 80 years using questionnaires to measure the social health status and levels of resilience of the participants. We conducted a hierarchical regression analysis to confirm the association between resilience and social network. Finally, data from 266 community-dwelling older adults were analyzed. We discovered that participants had social networks with a mean score on the Lubben Social Network Scale 18.13 ± 7.98, which means they were socially isolated. The network size (standardized β = −0.149, p < 0.05) and contact frequency (standardized β = 0.136, p < 0.05) correlated positively with higher levels of resilience. A hierarchical model accounted for 48.0% of the variance in resilience. The results suggested that interventions by the public health service to protect social health are needed for older adults living alone even when they are physically, emotionally, and cognitively healthy. In addition, smaller network size and higher frequency of contacts may be considered to strengthen resilience, which is a protective factor in social health.
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Affiliation(s)
- Sangmi Park
- Department of Occupational Therapy, Yonsei University, Wonju 26493, Gangwon-do, Korea;
| | - Tae-Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon-do, Korea
- Correspondence: ; Tel.: +82-33-741-0531
| | - Tae-Rim Eom
- Health Insurance Research Institute, National Health Insurance Service, Wonju 26464, Gangwon-do, Korea;
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Santabárbara J, Bueno-Notivol J, Lipnicki DM, de la Cámara C, López-Antón R, Lobo A, Gracia-García P. A Novel Score for Predicting Alzheimer's Disease Risk from Late Life Psychopathological and Health Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1802. [PMID: 33673250 PMCID: PMC7918511 DOI: 10.3390/ijerph18041802] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
With the increasing size of the aging population, dementia risk reduction has become a main public health concern. Dementia risk models or indices may help to identify individuals in the community at high risk to develop dementia. We have aimed to develop a novel dementia risk index focused on the late-life (65 years or more) population, that addresses risk factors for Alzheimer's disease (AD) easily identifiable at primary care settings. These risk factors include some shown to be associated with the risk of AD but not featured in existing indices, such as hearing loss and anxiety. Our index is also the first to account for the competing risk of death. The Zaragoza Dementia and Depression Project (ZARADEMP) Alzheimer Dementia Risk Score predicts an individual´s risk of developing AD within 5 years. The probability of late onset AD significantly increases in those with risk scores between 21 and 28 and, furthermore, is almost 4-fold higher for those with risk scores of 29 or higher. Our index may provide a practical instrument to identify subjects at high risk of AD and to design preventive strategies targeting the contributing risk factors.
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Affiliation(s)
- Javier Santabárbara
- Department of Preventive Medicine and Public Health, Universidad de Zaragoza, 50001 Zaragoza, Spain;
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
| | - Juan Bueno-Notivol
- Psychiatry Service, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Medicine, 2052 Randwick, Australia;
| | - Concepción de la Cámara
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Psychiatry Service, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50001 Zaragoza, Spain
| | - Raúl López-Antón
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, 50001 Zaragoza, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50001 Zaragoza, Spain
| | - Patricia Gracia-García
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Psychiatry Service, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50001 Zaragoza, Spain
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Kim S, Choe K, Lee K. Depression, Loneliness, Social Support, Activities of Daily Living, and Life Satisfaction in Older Adults at High-Risk of Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249448. [PMID: 33348548 PMCID: PMC7767125 DOI: 10.3390/ijerph17249448] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
As the number of older adults with dementia increases, early diagnosis and intervention are crucially important. The purpose of this study was to conduct dementia screening on older adults to determine whether there are differences in depression, loneliness, social support, daily activities of living, and life satisfaction between older adults at high-risk for dementia compared with low-risk older adults. We hypothesized a negative relationship between high-risk older adults and these factors. This study also hypothesized a moderating effect for social support on the relationship between daily living activities and life satisfaction. This study used a cross-sectional design with survey data. Participants were recruited at 15 public community health centers in South Korea. A total of 609 older adults (male 208, female 401) living in the community were screened for early dementia, and 113 participants (18.9%) were assigned to the high-risk group. As hypothesized, participants in the high-risk group showed significantly more negative results in terms of activities of daily living, depression, loneliness, social support, and life satisfaction compared with participants in the low-risk group. The findings of this study provide a theoretical basis for the importance of early screening for dementia and policies for effective dementia prevention.
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