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Mukherjee U, Sehar U, Brownell M, Reddy PH. Mechanisms, Consequences and Role of Interventions for Sleep Deprivation: Focus on Mild Cognitive Impairment and Alzheimer's Disease in Elderly. Ageing Res Rev 2024; 100:102457. [PMID: 39154978 DOI: 10.1016/j.arr.2024.102457] [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: 08/02/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
Sleep is established as an essential physiological need that impacts physical, emotional, and cognitive functions profoundly. Physiologically, inadequate sleep weakens immune function, heightening susceptibility to infections and chronic illnesses such as obesity, diabetes, and cardiovascular diseases. Hormonal disruptions due to sleep loss further exacerbate metabolic dysregulation, contributing to weight gain and other health complications. Emotionally, sleep deprivation leads to mood disturbances, including increased irritability, heightened stress responses, and a greater likelihood of mood disorders like depression and anxiety. These effects are compounded by cognitive impairments such as reduced alertness, impaired memory consolidation, and compromised decision-making abilities, akin to the impairments caused by alcohol consumption. Motor skills and coordination also suffer, elevating the risk of accidents, particularly in high-stress environments. For older adults, sleep quality is closely linked to cognitive function and overall longevity. Optimal sleep patterns are associated with slower brain aging and improved health outcomes. However, sleep disorders exacerbate existing conditions such as epilepsy and asthma, necessitating interventions like cognitive behavioral therapy (CBT) and medications such as melatonin to mitigate their impact. Education emerges as a crucial tool in promoting healthier sleep habits across all age groups. Addressing misconceptions about sleep and integrating sleep health into public health policies are essential steps toward improving overall well-being. Additionally, lifestyle factors such as diet and physical activity play significant roles in regulating sleep patterns, further emphasizing the interconnectedness of sleep with broader health outcomes. In summary, the articles underscore the intricate mechanisms through which sleep influences physiological functions and advocate for comprehensive approaches to enhance sleep hygiene and mitigate the adverse effects of sleep deprivation on human health.
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Affiliation(s)
- Upasana Mukherjee
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Malcolm Brownell
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Callow DD, Spira AP, Zipunnikov V, Lu H, Wanigatunga SK, Rabinowitz JA, Albert M, Bakker A, Soldan A. Sleep and physical activity measures are associated with resting-state network segregation in non-demented older adults. Neuroimage Clin 2024; 43:103621. [PMID: 38823249 PMCID: PMC11179421 DOI: 10.1016/j.nicl.2024.103621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
Greater physical activity and better sleep are associated with reduced risk of cognitive decline and dementia among older adults, but little is known about their combined associations with measures of brain function and neuropathology. This study investigated potential independent and interactive cross-sectional relationships between actigraphy-estimated total volume of physical activity (TVPA) and sleep patterns [i.e., total sleep time (TST), sleep efficiency (SE)] with resting-state functional magnetic resonance imaging (rs-fMRI) measures of large scale network connectivity and positron emission tomography (PET) measures of amyloid-β. Participants were 135 non-demented older adults from the BIOCARD study (116 cognitively normal and 19 with mild cognitive impairment; mean age = 70.0 years). Using multiple linear regression analyses, we assessed the association between TVPA, TST, and SE with connectivity within the default-mode, salience, and fronto-parietal control networks, and with network modularity, a measure of network segregation. Higher TVPA and SE were independently associated with greater network modularity, although the positive relationship of SE with modularity was only present in amyloid-negative individuals. Additionally, higher TVPA was associated with greater connectivity within the default-mode network, while greater SE was related to greater connectivity within the salience network. In contrast, longer TST was associated with lower network modularity, particularly among amyloid-positive individuals, suggesting a relationship between longer sleep duration and greater network disorganization. Physical activity and sleep measures were not associated with amyloid positivity. These data suggest that greater physical activity levels and more efficient sleep may promote more segregated and potentially resilient functional networks and increase functional connectivity within specific large-scale networks and that the relationship between sleep and functional networks connectivity may depend on amyloid status.
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Affiliation(s)
- Daniel D Callow
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Adam P Spira
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America; Johns Hopkins Center on Aging and Health, Baltimore, MD, the United States of America
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America
| | - Jill A Rabinowitz
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ US
| | - Marilyn Albert
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Arnold Bakker
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Anja Soldan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
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Callow DD, Zipunnikov V, Spira AP, Wanigatunga SK, Pettigrew C, Albert M, Soldan A. Actigraphy Estimated Sleep Moderates the Relationship between Physical Activity and Cognition in Older Adults. Ment Health Phys Act 2024; 26:100573. [PMID: 38264712 PMCID: PMC10803079 DOI: 10.1016/j.mhpa.2023.100573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Background and Aims Physical inactivity and poor sleep are common in older adults and may interact to contribute to age- and disease-related cognitive decline. However, prior work regarding the associations among physical activity, and cognition in older adults is primarily limited to subjective questionnaires that are susceptible to inaccuracies and recall bias. Therefore, this study examined whether objectively measured physical activity and sleep characteristics, each estimated using actigraphy, are independently or interactively associated with cognitive performance. Methods The study included 157 older adults free of dementia (136 cognitively unimpaired; 21 MCI; M age = 71.7) from the BIOCARD cohort. Results Using multiple linear regression, cognition was regressed on estimated total volume of physical activity (TVPA), sleep efficiency (SE), wake after sleep onset (WASO), and total sleep time (TST) (adjusted for age, sex, education, diagnosis, vascular risk factors, and Apolipoprotein E (APOE)-e4 genetic status). Models were also run for domain-specific cognitive composite scores. TVPA and SE each were positively associated with a global cognitive composite score. TVPA was positively associated with executive function and language composites, and SE was positively related to executive function, visuospatial, and language composites. Importantly, a TVPA by SE interaction (p = 0.015) suggested that adults with the poorest SE experienced the greatest benefit from physical activity in relation to global cognition. The other sleep metrics were unrelated to cognitive performance. Conclusion These results suggest that TVPA and SE may synergistically benefit cognition in older adults.
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Affiliation(s)
- Daniel D Callow
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adam P Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Corinne Pettigrew
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Anja Soldan
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
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Tang L, Wang YQ, Zhan NN, Li CY, Zhuang Z, Lyu QY, Xiong P. Interaction effect of midday napping duration and depressive symptoms on subjective memory impairment among older people in China: evidence from the China health and retirement longitudinal study database. BMC Public Health 2023; 23:1995. [PMID: 37833684 PMCID: PMC10571240 DOI: 10.1186/s12889-023-16928-6] [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: 02/23/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Subjective memory impairment (SMI) is common in older people. The aim of this study was to investigate the factors influencing SMI among older people in China, with specific focus on the interaction effect of midday napping duration and depressive symptoms on the risk of SMI. METHODS Using a dataset representative of the Chinese population from a longitudinal study of health and retirement in China, subjects with SMI were screened using the question "how do you feel about your memory now?" and the Mini-Mental State Examination. A logistic regression model was applied to explore the factors affecting SMI. Additive and multiplicative models were used to analyze the interaction effect of midday napping duration and depressive symptoms on the risk of SMI. RESULTS We enrolled 8,254 subjects included and the incidence of SMI was 63.9%. Depressive symptoms, nap time, and physical activity were influencing factors of SMI. Midday napping duration and depressive symptoms had positive additive interaction effects on the risk of SMI. When extended-length naps and depressive symptoms coexisted, the risk of SMI was 1.06 times greater than that for either alone (RERI, relative excess risk due to interaction = 0.27, 95% CI = 0.07-0.43; AP, attributable proportion = 0.14, 95% CI = 0.01-0.23; S, synergy index = 1.06, 95% CI = 0.57-1.62). When short naps and depressive symptoms coexisted, the risk of SMI was 1.2 times higher than that for either alone (RERI = 0.12, 95% CI=-0.14-0.39; AP = 0.13, 95% CI=-0.07-0.22; S = 1.20, 95% CI = 0.79-1.82). LIMITATIONS Since this was a cross-sectional study, the cause-and-effect relationships between the associated variables cannot be inferred. CONCLUSIONS The interaction effect that exists between nap time and depressive symptoms in older people is important for the identification and early intervention of people at risk for SMI.
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Affiliation(s)
- Li Tang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Ya-Qi Wang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Na-Ni Zhan
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Can-Yang Li
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Zhuang Zhuang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Qi-Yuan Lyu
- School of Nursing, Jinan University, Room 1015, Guangzhou, China.
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, China.
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Sewell KR, Smith NDW, Rainey-Smith SR, Peiffer J, Sohrabi HR, Erickson KI, Brown BM. The effect of acute exercise on objectively measured sleep and cognition in older adults. Front Psychol 2023; 14:1207199. [PMID: 37868603 PMCID: PMC10585032 DOI: 10.3389/fpsyg.2023.1207199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Background Exercise can improve cognition in aging, however it is unclear how exercise influences cognition, and sleep may partially explain this association. The current study aimed to investigate whether objectively measured sleep mediates the effect of an acute exercise intervention on cognition in older adults. Methods Participants were 30 cognitively unimpaired, physically active older adults (69.2 ± 4.3 years) with poor sleep (determined via self-report). After a triple baseline cognitive assessment to account for any natural fluctuation in cognitive performance, participants completed either a single bout of 20-minutes of high intensity exercise on a cycle ergometer, or a control condition, in a cross-over trial design. Cognition was measured immediately post-intervention and the following day, and sleep (total sleep time, sleep onset latency, sleep efficiency, % of rapid eye movement sleep, light sleep and deep sleep) was characterized using WatchPAT™ at baseline (5 nights) and measured for one night after both exercise and control conditions. Results Results showed no effect of the exercise intervention on cognition immediately post-intervention, nor an effect of acute exercise on any sleep variable. There was no mediating effect of sleep on associations between exercise and cognition. However, a change from baseline to post-intervention in light sleep and deep sleep did predict change in episodic memory at the ~24 h post-intervention cognitive assessment, regardless of intervention condition. Discussion There was no effect of acute high intensity exercise on sleep or cognition in the current study. However, results suggest that associations between sleep and cognition may exist independently of exercise in our sample. Further research is required, and such studies may aid in informing the most effective lifestyle interventions for cognitive health.
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Affiliation(s)
- Kelsey R. Sewell
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
| | - Nathan D. W. Smith
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
| | - Stephanie R. Rainey-Smith
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Australian Alzheimer’s Research Foundation, Sarich Neuroscience Research Institute, Nedlands, WA, Australia
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Jeremiah Peiffer
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
| | - Hamid R. Sohrabi
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Australian Alzheimer’s Research Foundation, Sarich Neuroscience Research Institute, Nedlands, WA, Australia
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- AdventHealth Research Institute, Orlando, FL, United States
| | - Belinda M. Brown
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Australian Alzheimer’s Research Foundation, Sarich Neuroscience Research Institute, Nedlands, WA, Australia
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Sewell KR, Rainey-Smith SR, Peiffer J, Sohrabi HR, Doecke J, Frost NJ, Markovic SJ, Erickson K, Brown BM. The influence of baseline sleep on exercise-induced cognitive change in cognitively unimpaired older adults: A randomised clinical trial. Int J Geriatr Psychiatry 2023; 38:e6016. [PMID: 37864564 DOI: 10.1002/gps.6016] [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: 07/31/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES Observational studies consistently demonstrate that physical activity is associated with elevated cognitive function, however, there remains significant heterogeneity in cognitive outcomes from randomized exercise interventions. Individual variation in sleep behaviours may be a source of variability in the effectiveness of exercise-induced cognitive change, however this has not yet been investigated. The current study aimed to (1) investigate the influence of a 6-month exercise intervention on sleep, assessed pre- and post-intervention and, (2) investigate whether baseline sleep measures moderate exercise-induced cognitive changes. METHODS We utilised data from the Intense Physical Activity and Cognition (IPAC) study (n = 89), a 6-month moderate intensity and high intensity exercise intervention, in cognitively unimpaired community-dwelling older adults aged 60-80 (68.76 ± 5.32). Exercise was supervised and completed on a stationary exercise bicycle, and cognitive function was measured using a comprehensive neuropsychological battery administered pre- and post-intervention. Sleep was measured using the Pittsburgh sleep quality index. There was no effect of the exercise intervention on any sleep outcomes from pre- to post-intervention. RESULTS There was a significant moderating effect of baseline sleep efficiency on both episodic memory and global cognition within the moderate intensity exercise group, such that those with poorer sleep efficiency at baseline showed greater exercise-induced improvements in episodic memory. CONCLUSIONS These results suggest that those with poorer sleep may have the greatest exercise-induced cognitive benefits and that baseline sleep behaviours may be an important source of heterogeneity in previous exercise interventions targeting cognitive outcomes.
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Affiliation(s)
- Kelsey R Sewell
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Stephanie R Rainey-Smith
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Jeremiah Peiffer
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Hamid R Sohrabi
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
- Department of Biomedical Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - James Doecke
- Royal Brisbane and Women's Hospital, CSIRO Health and Biosecurity/Australian E-Health Research Centre, Brisbane, Queensland, Australia
| | - Natalie J Frost
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Shaun J Markovic
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
| | - Kirk Erickson
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- AdventHealth Research Institute, Orlando, Florida, USA
| | - Belinda M Brown
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
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Bao Q, Liu Y, Zhang X, Li Y, Wang Z, Ye F, He X, Xia M, Chen Z, Yao J, Zhong W, Wu K, Wang Z, Sun M, Chen J, Hong X, Zhao L, Yin Z, Liang F. Clinical observation and mechanism of acupuncture on amnestic mild cognitive impairment based on the gut-brain axis: study protocol for a randomized controlled trial. Front Med (Lausanne) 2023; 10:1198579. [PMID: 37415772 PMCID: PMC10321407 DOI: 10.3389/fmed.2023.1198579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
Background Amnestic mild cognitive impairment (aMCI) is a pre-dementia condition associated with declined cognitive function dominated by memory impairment. The occurrence of aMCI is associated with the gut-brain axis. Previous studies have shown cognitive improvements in MCI after acupuncture treatment. This study evaluates whether acupuncture can produce a therapeutic effect in patients with aMCI by modulating the gut-brain axis. Methods and design This is a prospective, parallel, multicenter randomized controlled trial. A total of 40 patients with aMCI will be randomly assigned to an acupuncture group (AG) or a waiting-list group (WG), participants in both groups will receive health education on improving cognitive function at each visit, and acupuncture will be conducted twice a week for 12 weeks in the AG. Another 20 matched healthy volunteers will be enrolled as normal control. The primary outcome will be the change in Alzheimer's Disease Assessment Scale-cognitive scale score before and after treatment. Additionally, functional magnetic resonance imaging data, faeces, and blood will be collected from each participant to characterize the brain function, gut microbiota, and inflammatory cytokines, respectively. The differences between patients with aMCI and healthy participants, and the changes in the AG and WG groups before and after treatment will be observed. Ultimately, the correlation among brain function, gut microbiota, inflammatory cytokines, and clinical efficacy evaluation in patients with aMCI will be analyzed. Discussion This study will identify the efficacy and provide preliminary data on the possible mechanism of acupuncture in treating aMCI. Furthermore, it will also identify biomarkers of the gut microbiota, inflammatory cytokines, and brain function correlated with therapeutic effects. The results of this study will be published in peer-reviewed journals. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2200062084.
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Affiliation(s)
- Qiongnan Bao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Yiwei Liu
- The West China Hospital, Chengdu, China
| | - Xinyue Zhang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Yaqin Li
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ziqi Wang
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fang Ye
- The Sichuan Province People's Hospital, Chengdu, China
| | - Xia He
- The Rehabilitation Hospital of Sichuan Province, Chengdu, China
| | - Manze Xia
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Zhenghong Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Jin Yao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Wanqi Zhong
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Kexin Wu
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Ziwen Wang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Mingsheng Sun
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Jiao Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Xiaojuan Hong
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Ling Zhao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Zihan Yin
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Fanrong Liang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
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Smith PJ, Sherwood A, Avorgbedor F, Ingle KK, Kraus WE, Hinderliter AE, Blumenthal JA. Sleep Quality, Metabolic Function, Physical Activity, and Neurocognition Among Individuals with Resistant Hypertension. J Alzheimers Dis 2023:JAD230029. [PMID: 37212110 DOI: 10.3233/jad-230029] [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] [Indexed: 05/23/2023]
Abstract
BACKGROUND Resistant hypertension (RH) is a major risk factor for stroke, cognitive decline, and dementia. Sleep quality is increasingly suggested to play an important role linking RH to cognitive outcomes, although the mechanisms linking sleep quality to poor cognitive function have yet to be fully delineated. OBJECTIVE To delineate biobehavioral mechanisms linking sleep quality, metabolic function, and cognitive function among 140 overweight/obese adults with RH in the TRIUMPH clinical trial. METHODS Sleep quality was indexed using actigraphy measures of sleep quality and sleep fragmentation, as well as self-reported sleep quality from the Pittsburgh Sleep Quality Index (PSQI). Cognitive function was assessed using a 45-minute battery assessing executive function, processing speed, and memory. Participants were randomized to a cardiac rehabilitation-based lifestyle program (C-LIFE) or a standardized education and physician advice condition (SEPA) for 4 months. RESULTS Better sleep quality at baseline was associated with better executive function (B = 0.18 p = 0.027), as well as greater fitness (B = 0.27, p = 0.007) and lower HBA1c (B = -0.25, p = 0.010). Cross-sectional analyses revealed that the sleep quality executive function association was mediated by HBA1c (B = 0.71 [0.05, 2.05]). C-LIFE improved sleep quality (-1.1 [-1.5, -0.6] versus+-0.1 [-0.8, 0.7]) and actigraphy steps (+922 [529, 1316] versus+56 [-548, 661]), with actigraphy mediating improvements in executive function (B = 0.40 [0.02, 1.07]). CONCLUSION Better metabolic function and improved physical activity patterns levels play important roles linking sleep quality and executive function in RH.
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Affiliation(s)
- Patrick J Smith
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Forgive Avorgbedor
- Department of Nursing, University of North Carolina at Greensboro, NC, USA
| | - Krista K Ingle
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - William E Kraus
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Alan E Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, NC, USA
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Paul P, Mahfoud ZR, Malik RA, Kaul R, Muffuh Navti P, Al-Sheikhly D, Chaari A. Knowledge, Awareness, and Attitude of Healthcare Stakeholders on Alzheimer's Disease and Dementia in Qatar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4535. [PMID: 36901551 PMCID: PMC10002196 DOI: 10.3390/ijerph20054535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Dementia is characterized by progressive cognitive decline, memory impairment, and disability. Alzheimer's disease (AD) accounts for 60-70% of cases, followed by vascular and mixed dementia. Qatar and the Middle East are at increased risk owing to aging populations and high prevalence of vascular risk factors. Appropriate levels of knowledge, attitudes, and awareness amongst health care professionals (HCPs) are the need of the hour, but literature indicates that these proficiencies may be inadequate, outdated, or markedly heterogenous. In addition to a review of published quantitative surveys investigating similar questions in the Middle East, a pilot cross-sectional online needs-assessment survey was undertaken to gauge these parameters of dementia and AD among healthcare stakeholders in Qatar between 19 April and 16 May 2022. Overall, 229 responses were recorded between physicians (21%), nurses (21%), and medical students (25%), with two-thirds from Qatar. Over half the respondents reported that >10% of their patients were elderly (>60 years). Over 25% reported having contact with >50 patients with dementia or neurodegenerative disease annually. Over 70% had not undertake related education/training in the last 2 years. The knowledge of HCPs regarding dementia and AD was moderate (mean score of 5.3 ± 1.5 out of 7) and their awareness of recent advances in basic disease pathophysiology was lacking. Differences existed across professions and location of respondents. Our findings lay the groundwork for a call-to-action for healthcare institutions to improve dementia care within Qatar and the Middle East region.
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Affiliation(s)
| | - Ziyad Riyad Mahfoud
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, NY 10065, New York, USA
| | - Rayaz A. Malik
- Division of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, UK
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| | | | - Phyllis Muffuh Navti
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Deema Al-Sheikhly
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Ali Chaari
- Premedical Division, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
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Mellow ML, Dumuid D, Wade AT, Stanford T, Olds TS, Karayanidis F, Hunter M, Keage HAD, Dorrian J, Goldsworthy MR, Smith AE. Twenty-four-hour time-use composition and cognitive function in older adults: Cross-sectional findings of the ACTIVate study. Front Hum Neurosci 2022; 16:1051793. [PMID: 36504624 PMCID: PMC9729737 DOI: 10.3389/fnhum.2022.1051793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Physical activity, sedentary behaviour and sleep are associated with cognitive function in older adults. However, these behaviours are not independent, but instead make up exclusive and exhaustive components of the 24-h day. Few studies have investigated associations between 24-h time-use composition and cognitive function in older adults. Of these, none have considered how the quality of sleep, or the context of physical activity and sedentary behaviour may impact these relationships. This study aims to understand how 24-h time-use composition is associated with cognitive function across a range of domains in healthy older adults, and whether the level of recreational physical activity, amount of television (TV) watching, or the quality of sleep impact these potential associations. Methods 384 healthy older adults (age 65.5 ± 3.0 years, 68% female, 63% non-smokers, mean education = 16.5 ± 3.2 years) participated in this study across two Australian sites (Adelaide, n = 207; Newcastle, n = 177). Twenty-four-hour time-use composition was captured using triaxial accelerometry, measured continuously across 7 days. Total time spent watching TV per day was used to capture the context of sedentary behaviours, whilst total time spent in recreational physical activity was used to capture the context of physical activity (i.e., recreational accumulation of physical activity vs. other contexts). Sleep quality was measured using a single item extracted from the Pittsburgh Sleep Quality Index. Cognitive function was measured using a global cognition index (Addenbrooke's Cognitive Examination III) and four cognitive domain composite scores (derived from five tests of the Cambridge Neuropsychological Test Automated Battery: Paired Associates Learning; One Touch Stockings of Cambridge; Multitasking; Reaction Time; Verbal Recognition Memory). Pairwise correlations were used to describe independent relationships between time use variables and cognitive outcomes. Then, compositional data analysis regression methods were used to quantify associations between cognition and 24-h time-use composition. Results After adjusting for covariates and false discovery rate there were no significant associations between time-use composition and global cognition, long-term memory, short-term memory, executive function, or processing speed outcomes, and no significant interactions between TV watching time, recreational physical activity engagement or sleep quality and time-use composition for any cognitive outcomes. Discussion The findings highlight the importance of considering all activities across the 24-h day against cognitive function in older adults. Future studies should consider investigating these relationships longitudinally to uncover temporal effects.
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Affiliation(s)
- Maddison L. Mellow
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Alexandra T. Wade
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Ty Stanford
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Timothy S. Olds
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of Psychological Sciences, The University of Newcastle, Newcastle, NSW, Australia
- Healthy Minds Research Program, Hunter Medical Research Institute (HMRI), Newcastle, NSW, Australia
| | - Montana Hunter
- Functional Neuroimaging Laboratory, School of Psychological Sciences, The University of Newcastle, Newcastle, NSW, Australia
- Healthy Minds Research Program, Hunter Medical Research Institute (HMRI), Newcastle, NSW, Australia
| | - Hannah A. D. Keage
- Behaviour-Brain-Body Research Centre, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Jillian Dorrian
- Behaviour-Brain-Body Research Centre, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Mitchell R. Goldsworthy
- Lifespan Human Neurophysiology Group, School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Ashleigh E. Smith
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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