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Bhagwasia M, Rao AR, Banerjee J, Bajpai S, Raman AV, Talukdar A, Jain A, Rajguru C, Sankhe L, Goswami D, Shanthi GS, Kumar G, Varghese M, Dhar M, Gupta M, A-Koul P, Mohanty RR, Chakrabarti SS, Yadati SR, Dey S, Dey AB. Association Between Cognitive Performance and Nutritional Status: Analysis From LASI-DAD. Gerontol Geriatr Med 2023; 9:23337214231194965. [PMID: 37743872 PMCID: PMC10515514 DOI: 10.1177/23337214231194965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 09/26/2023] Open
Abstract
Malnutrition in low- and middle-income countries causes cognitive decline and other health problems. Harmonized Diagnostic Assessment of Dementia for Longitudinal Aging Study in India (LASI DAD) is an extensive study on late-life cognition and dementia. This study examines the link between nutrition and cognitive abilities in older adults using data from the LASI DAD. We conducted descriptive statistics on nutritional parameters (body-mass index, waist-hip ratio, and Mini-Nutritional Assessment), cognitive functions, and socio-demographic variables in 2,892 adults aged ≥60 years. Cognitive domains assessed included delayed recall, orientation, language, executive function, abstract reasoning, and attention. Cognitive impairment was defined as impaired performance in two or more domains. Mean age was 69.3 ± 7.1 years, 52.9% were female, and 57.5% were illiterate. Low body-mass index (adjusted OR: 1.88, p < .001), at risk of malnutrition (adjusted OR: 1.89, p < .001) and malnourished (adjusted OR: 2.86, p < .001) on Mini-Nutritional Assessment were associated with the presence of cognitive impairment. Better cognitive performance was associated with increased body mass index (adjusted OR: 0.74, p-.03), hemoglobin (adjusted OR: 0.91, p-.006), and serum albumin (adjusted OR: 0.38, p < .001). This study shows that nutritional status assessed by anthropometric measures and blood markers is strongly linked to cognitive performance in older adults.
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Affiliation(s)
| | | | | | - Swati Bajpai
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Arvind Jain
- Dr S. N. Medical College, Jodhpur, Rajasthan, India
| | - Chhaya Rajguru
- Grant Medical College and J.J. Hospital, Mumbai, Maharashtra, India
| | - Lalit Sankhe
- Grant Medical College and J.J. Hospital, Mumbai, Maharashtra, India
| | | | | | - Govind Kumar
- Indira Gandhi Institute of Medical Science, Patna, Bihar, India
| | - Mathew Varghese
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Minakshi Dhar
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monica Gupta
- Government Medical College and Hospital, Chandigarh, Punjab, India
| | - Parvaiz A-Koul
- Sher-e-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | | | | | | | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - Aparajit Ballav Dey
- All India Institute of Medical Sciences, New Delhi, India
- Venu Geriatric Institute, New Delhi, India
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Zhang T, Zhang Y, Lv Z, Xiang J. Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model. BMC Geriatr 2022; 22:141. [PMID: 35183116 PMCID: PMC8857782 DOI: 10.1186/s12877-022-02802-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/27/2022] [Indexed: 02/07/2023] Open
Abstract
Background Sarcopenia has been identified as a risk factor for cognitive impairment, and motoric cognitive risk syndrome (MCR) is a recently defined pre-dementia syndrome. It is not known whether they are related. We aimed to investigate the association and potential pathways between sarcopenia and MCR in the community elderly by establishing a moderated mediation model. Methods 846 community residents aged ≥ 60 years were recruited from May 2021 to September 2021 and had a comprehensive geriatric evaluation. The diagnosis of sarcopenia followed the criteria issued by the Asian Working Group for Sarcopenia in 2019. MCR was defined as subjective cognitive decline and slow gait. Apathy symptoms and physical activity were assessed by the Apathy Evaluation Scale (AES) and the International Physical Activity Questionnaire (IPAQ). Logistic regression and moderated mediation analyses were conducted to explore the association between the four. Results 60 (7.1%) had MCR among 846 participants. After full adjustment, sarcopenia (odds ratio [OR] = 3.81, 95% confidence interval [CI] = 1.69–8.60, P = 0.001), AES score (OR = 1.09, 95% CI = 1.04–1.14, P < 0.001), and IPAQ level (OR = 0.43, 95% CI = 0.28–0.66, P < 0.001) were associated with MCR. Apathy partially mediated the relationship between sarcopenia and MCR. Physical activity played a moderation role in the indirect pathway of the mediation model. The increase in physical activity can alleviate the indirect effect of sarcopenia on MCR. Conclusion We established a moderated mediation model to uncover the underlying association mechanism of sarcopenia and MCR preliminarily. These findings suggest that attention should be paid to the management of apathy and physical activity in the context of sarcopenia to prevent early dementia actively. Further validation is needed in future longitudinal studies.
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Jacob L, Kostev K, Smith L, Oh H, López-Sánchez GF, Shin JI, Abduljabbar AS, Haro JM, Koyanagi A. Sarcopenia and Mild Cognitive Impairment in Older Adults from Six Low- and Middle-Income Countries. J Alzheimers Dis 2021; 82:1745-1754. [PMID: 34219725 DOI: 10.3233/jad-210321] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Little is known about the relationship between sarcopenia and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs). OBJECTIVE This study aimed to investigate this association among community-dwelling adults aged≥65 years from six LMICs. METHODS Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. These data were obtained in China, Ghana, India, Mexico, Russia, and South Africa in 2007-2010. Participants were considered to have sarcopenia if they had low skeletal muscle mass (i.e., lower skeletal mass index) and a weak handgrip strength. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Multivariable logistic regression analysis was conducted to assess associations. RESULTS The final analytical sample consisted of 12,912 individuals aged≥65 years with preservation in functional abilities without stroke (mean [standard deviation] age 72.2 [10.8] years; 45.2% males). The overall prevalence of sarcopenia and MCI were 11.3% and 18.1%, respectively. After adjusting for potential confounders, there was a positive association between sarcopenia and MCI in all countries (i.e., odds ratio [OR] > 1) with the exception of South Africa, and the overall estimate was OR = 1.60 (95% confidence interval [CI] = 1.32-1.93) with a low level of between-country heterogeneity (I2 = 0.0%). CONCLUSION There was a positive association between sarcopenia and MCI in this sample of older adults living in LMICs. Causality should be assessed in future longitudinal research, while the utility of sarcopenia as a marker of MCI should also be investigated.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Karel Kostev
- Philipps University of Marburg, Marburg, Germany
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | | | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,King Saud University, Riyadh, Saudi Arabia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,ICREA, Barcelona, Spain
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Lee YH, Chang YC, Ang TFA, Chiang T, Shelley M, Liu CT. Associations of staple food consumption and types of cooking oil with waist circumference and body mass index in older Chinese men and women: a panel analysis. Int Health 2021; 13:178-187. [PMID: 33045038 PMCID: PMC7902270 DOI: 10.1093/inthealth/ihaa074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/15/2020] [Accepted: 09/18/2020] [Indexed: 01/23/2023] Open
Abstract
Background The dietary landscape has changed rapidly in China in the past few decades. This research investigates the associations of older adults’ choices and consumption of staple foods and cooking oils with obesity-related measurements. Methods Panel data were extracted from the Chinese Longitudinal Health Longevity Survey from 3253 older participants with 6506 observations. Ordinary least squares and ordered logistic regression models were estimated with the outcomes of obesity determined by waist circumference (WC) and body mass index (BMI), respectively. Results Older men who consumed wheat had wider WCs (β=2.84 [95% confidence interval {CI} 1.55 to 4.13], p<0.01) and higher BMIs (adjusted odds ratio 1.74 [95% CI 1.40 to 2.17], p<0.01) than those who preferred rice. Female participants who used animal-based cooking oil had lower WCs and BMIs than their counterparts who consumed vegetable-based cooking oil. Increased consumption of staple foods was associated with increased rates of obesity in both sexes. Conclusion Dieticians and nutritionists should design appropriate dietary plans to help reduce obesity and chronic diseases among older Chinese adults. Further clinical trials are needed to continue investigating this topic.
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Affiliation(s)
- Yen-Han Lee
- Indiana University, School of Public Health, Department of Applied Health Sciences, Bloomington, IN 47401, USA
| | - Yen-Chang Chang
- National Tsing Hua University, Center for General Education, Hsinchu City, Taiwan 300
| | - Ting Fang Alvin Ang
- Boston University School of Medicine, Department of Anatomy and Neurobiology, Boston, MA 02118, USA.,Boston University School of Medicine, Slone Epidemiology Center, Boston, MA 02118, USA
| | - Timothy Chiang
- Pennsylvania State University, College of Medicine, Hershey, PA 17033, USA
| | - Mack Shelley
- Iowa State University, Department of Political Science and Department of Statistics, Ames, IA 50011, USA
| | - Ching-Ti Liu
- Boston University, School of Public Health, Department of Biostatistics, Boston, MA 02118, USA
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Effects of nutrition, depression symptoms and demographic characteristics on dementia in the elderly population. MARMARA MEDICAL JOURNAL 2021. [DOI: 10.5472/marumj.939806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Age-Related Changes in the Association Between Traumatic Brain Injury and Dementia in Older Men and Women. J Head Trauma Rehabil 2020; 36:E139-E146. [PMID: 33201033 DOI: 10.1097/htr.0000000000000624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate age-related changes in the association between traumatic brain injury (TBI) and dementia in older men and women separately. SETTING A total of 243 general practices in the UK. PARTICIPANTS This study included 4760 patients who received a first TBI diagnosis between 1995 and 2010 (index date), and 4760 patients without TBI who were matched to those with TBI by age, sex, index year, Charlson Comorbidity Index, alcohol dependence, and physician (index date: a randomly selected visit date). DESIGN Retrospective cohort study. MAIN MEASURES Incidence of dementia in the decade following index date. RESULTS Within 10 years of index date, 8.8% of men with TBI and 4.8% of those without TBI were diagnosed with dementia, while the respective figures were 9.0% and 6.7% in women (P values < .01). There was a significant association between TBI and dementia in men (hazard ratio [HR] = 2.29, 95% confidence interval [CI]: 1.64-3.19) and in women (HR = 1.33, 95% CI: 1.07-1.64). Furthermore, the association between TBI and dementia was significant in men aged 60 to 70 (HR = 2.51, 95% CI: 1.27-4.96) and 71 to 80 years (HR = 3.00, 95% CI: 1.82-4.93), whereas the relationship was only significant and potentially unreliable in women aged 81 to 90 years (HR = 1.49, 95% CI: 1.03-2.14). CONCLUSIONS The age-related relationship between TBI and dementia differed between men and women. More research of a prospective nature and including behavioral data is needed to better understand these differences.
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Legdeur N, Badissi M, Yaqub M, Beker N, Sudre CH, Ten Kate M, Gordon MF, Novak G, Barkhof F, van Berckel BNM, Holstege H, Muller M, Scheltens P, Maier AB, Visser PJ. What determines cognitive functioning in the oldest-old? The EMIF-AD 90+ Study. J Gerontol B Psychol Sci Soc Sci 2020; 76:1499-1511. [PMID: 32898275 DOI: 10.1093/geronb/gbaa152] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Determinants of cognitive functioning in individuals aged 90 years and older, the oldest-old, remain poorly understood. We aimed to establish the association of risk factors, white matter hyperintensities (WMH), hippocampal atrophy and amyloid aggregation with cognition in the oldest-old. METHODS We included 84 individuals without cognitive impairment and 38 individuals with cognitive impairment from the EMIF-AD 90+ Study (mean age 92.4 years) and tested cross-sectional associations between risk factors (cognitive activity, physical parameters, nutritional status, inflammatory markers and cardiovascular risk factors), brain pathology biomarkers (WMH and hippocampal volume on MRI, and amyloid binding measured with PET) and cognition. Additionally, we tested whether the brain pathology biomarkers were independently associated with cognition. When applicable, we tested whether the effect of risk factors on cognition was mediated by brain pathology. RESULTS Lower values for handgrip strength, Short Physical Performance Battery (SPPB), nutritional status, HbA1c and hippocampal volume, and higher values for WMH volume and amyloid binding were associated with worse cognition. Higher past cognitive activity and lower BMI were associated with increased amyloid binding, lower muscle mass with more WMH, and lower SPPB scores with more WMH and hippocampal atrophy. The brain pathology markers were independently associated with cognition. The association of SPPB with cognition was partially mediated by hippocampal volume. DISCUSSION In the oldest-old, physical parameters, nutritional status, HbA1c, WMH, hippocampal atrophy and amyloid binding are associated with cognitive impairment. Physical performance may affect cognition through hippocampal atrophy. This study highlights the importance to consider multiple factors when assessing cognition in the oldest-old.
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Affiliation(s)
- Nienke Legdeur
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maryam Badissi
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maqsood Yaqub
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nina Beker
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Carole H Sudre
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Dementia Research Centre, Institute of Neurology, University College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Mara Ten Kate
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Gerald Novak
- Janssen Pharmaceutical Research and Development, Titusville, NJ, USA
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Bart N M van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Henne Holstege
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Majon Muller
- Department of Internal Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Research Institute Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurobiology, Care Sciences Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
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Duan J, Lv YB, Gao X, Zhou JH, Kraus VB, Zeng Y, Su H, Shi XM. Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China. BMC Geriatr 2020; 20:29. [PMID: 31992221 PMCID: PMC6988297 DOI: 10.1186/s12877-020-1424-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluated by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and further explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China. METHODS A total of 13,906 and 13,873 Chinese elderly aged 65 years and older were included in the 2002-2008 and 2008-2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality. RESULTS For the 2002-2008 and 2008-2014 cohorts, 55,277 and 53,267 person-years were followed up, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.32 (95% confidence interval [CI], 1.25-1.39) in 2002-2008 cohort and 1.26 (95% CI, 1.19-1.32) in 2008-2014 cohort, stratified by educational levels. The trend of cognitive impairment with all-cause mortality risk decreased from 2002 to 2008 to 2008-2014 cohort, while no significant interaction of cognitive impairment with cohort for all-cause mortality was observed. The associations of cognitive impairment and mortality were decreased with age in the two cohorts. CONCLUSIONS Cognitive impairment evaluated by different cut-offs were associated with increased risk of mortality, especially among those aged 65-79 years in the two cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.
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Affiliation(s)
- Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, #7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, #7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Xiang Gao
- Nutritional Epidemiology Lab, Pennsylvania State University, Philadelphia, PA, USA
| | - Jin-Hui Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, #7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Yi Zeng
- Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA.,Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, #7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China.
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Xie J, Feng H, Ding R, Dong W, Xin L, Liu J. Risk factors for readmission of rheumatoid arthritis patients receiving integrative medicine: A retrospective analysis. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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