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Stauder M, Hiersche KJ, Hayes SM. Examining cross-sectional and longitudinal relationships between multidomain physical fitness metrics, education, and cognition in Black older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:646-660. [PMID: 37345613 PMCID: PMC10739568 DOI: 10.1080/13825585.2023.2225848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/10/2023] [Indexed: 06/23/2023]
Abstract
A limited number of studies examine cognitive aging in Black or African American older adults. The purpose of this study was to explore the relationship between health-related fitness metrics, education, and cognition at baseline and over a 4-year follow-up in a sample of 321 Black or African American older adults in the Health and Retirement Study (HRS). Physical fitness was assessed with measures of gait speed, peak expiratory flow, grip strength, and body mass index. Global cognition was assessed with an adapted version of the Telephone Interview for Cognitive Status (TICS). Analyses of relative importance and hierarchical multiple regression were used to examine baseline cross-sectional relationships. Multiple logistic regression was used to examine prospective relationships with longitudinal cognitive status. Education was the strongest predictor of global cognition at baseline and follow-up. More years of education significantly increased the odds of maintaining cognitive status at 4-year follow-up. After accounting for education, gait speed was independently associated with baseline cognitive performance and accounted for additional variance. Grip strength, peak expiratory flow, and body mass index were not significantly associated with cognition. The results indicated that modifiable variables, including years of educational attainment and gait speed, were more strongly associated with global cognition than other modifiable variables including body mass index, grip strength, and peak expiratory flow. The lack of observed associations between other fitness variables and cognition may be attributable to the brief assessment methods implemented, which was necessitated by the large-scale, epidemiological approach of the HRS.
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Affiliation(s)
- Matthew Stauder
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Kelly J. Hiersche
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Scott M. Hayes
- Department of Psychology, The Ohio State University, Columbus, OH, USA
- Chronic Brain Injury Initiative, The Ohio State University, Columbus, OH, USA
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Wang XL, Feng HL, Xu XZ, Liu J, Han X. Relationship between cognitive function and weight-adjusted waist index in people ≥ 60 years old in NHANES 2011-2014. Aging Clin Exp Res 2024; 36:30. [PMID: 38334839 PMCID: PMC10857983 DOI: 10.1007/s40520-023-02649-8] [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: 08/03/2023] [Accepted: 12/04/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Widespread attention has been given to the detrimental effects of obesity on cognitive function. However, there is no evidence on the connection between low cognitive performance and the WWI (weight-adjusted waist index). This study looked into the connection between poor cognitive performance and the WWI in senior Americans. METHODS A cross-sectional research study was carried out with information from the NHANES 2011-2014. With multivariate linear regression models, the pertinence between the WWI and low cognitive function in persons older than 60 years was examined. The nonlinear link was described using threshold effect analyses and fitted smoothed curves. Interaction tests and subgroup analysis were also conducted. RESULTS The study had 2762 individuals in all, and subjects with higher WWI values were at greater risk for low cognitive function. In the completely adjusted model, the WWI was positively connected with low cognitive performance assessed by CERAD W-L (OR = 1.22, 95% CI 1.03-1.45, p = 0.0239), AFT (OR = 1.30, 95% CI 1.09-1.54, p = 0.0029), and DSST (OR = 1.59, 95% CI 1.30-1.94, p < 0.0001). The effect of each subgroup on the positive correlation between the WWI and low cognitive performance was not significant. The WWI and low cognitive performance as determined by CERAD W-L and AFT had a nonlinear connection (log-likelihood ratio < 0.05). CONCLUSION Among older adults in the United States, the risk of low cognitive performance may be positively related to the WWI.
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Affiliation(s)
- Xue-Li Wang
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hong-Lin Feng
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiao-Zhuo Xu
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Liu
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xu Han
- Geriatric Department, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, China.
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3
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Lin S, Jiang L, Wei K, Yang J, Cao X, Li C. Sex-Specific Association of Body Mass Index with Hippocampal Subfield Volume and Cognitive Function in Non-Demented Chinese Older Adults. Brain Sci 2024; 14:170. [PMID: 38391744 PMCID: PMC10887390 DOI: 10.3390/brainsci14020170] [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: 01/02/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
Recent research suggests a possible association between midlife obesity and an increased risk of dementia in later life. However, the underlying mechanisms remain unclear. Little is known about the relationship between body mass index (BMI) and hippocampal subfield atrophy. In this study, we aimed to explore the associations between BMI and hippocampal subfield volumes and cognitive function in non-demented Chinese older adults. Hippocampal volumes were assessed using structural magnetic resonance imaging. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A total of 66 participants were included in the final analysis, with 35 females and 31 males. We observed a significant correlation between BMI and the hippocampal fissure volume in older females. In addition, there was a negative association between BMI and the RBANS total scale score, the coding score, and the story recall score, whereas no significant correlations were observed in older males. In conclusion, our findings revealed sex-specific associations between BMI and hippocampal subfield volumes and cognitive performance, providing valuable insights into the development of effective interventions for the early prevention of cognitive decline.
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Affiliation(s)
- Shaohui Lin
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Kai Wei
- Department of Traditional Chinese Medicine, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 201108, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai 201108, China
| | - Junjie Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Clinical Neurocognitive Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai 200030, China
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Osiecka Z, Fausto BA, Gills JL, Sinha N, Malin SK, Gluck MA. Obesity reduces hippocampal structure and function in older African Americans with the APOE-ε4 Alzheimer's disease risk allele. Front Aging Neurosci 2023; 15:1239727. [PMID: 37731955 PMCID: PMC10507275 DOI: 10.3389/fnagi.2023.1239727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/15/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Excess body weight and Alzheimer's disease (AD) disproportionately affect older African Americans. While mid-life obesity increases risk for AD, few data exist on the relationship between late-life obesity and AD, or how obesity-based and genetic risk for AD interact. Although the APOE-ε4 allele confers a strong genetic risk for AD, it is unclear if late-life obesity poses a greater risk for APOE-ε4 carriers compared to non-carriers. Here we assessed: (1) the influence of body mass index (BMI) (normal; overweight; class 1 obese; ≥ class 2 obese) on cognitive and structural MRI measures of AD risk; and (2) the interaction between BMI and APOE-ε4 in older African Americans. Methods Seventy cognitively normal older African American participants (Mage = 69.50 years; MBMI = 31.01 kg/m2; 39% APOE-ε4 allele carriers; 86% female) completed anthropometric measurements, physical assessments, saliva collection for APOE-ε4 genotyping, cognitive testing, health and lifestyle questionnaires, and structural neuroimaging [volume/surface area (SA) for medial temporal lobe subregions and hippocampal subfields]. Covariates included age, sex, education, literacy, depressive symptomology, and estimated aerobic fitness. Results Using ANCOVAs, we observed that individuals who were overweight demonstrated better hippocampal cognitive function (generalization of learning: a sensitive marker of preclinical AD) than individuals with normal BMI, p = 0.016, ηp2 = 0.18. However, individuals in the obese categories who were APOE-ε4 non-carriers had larger hippocampal subfield cornu Ammonis region 1 (CA1) volumes, while those who were APOE-ε4 carriers had smaller CA1 volumes, p = 0.003, ηp2 = 0.23. Discussion Thus, being overweight by BMI standards may preserve hippocampal function, but obesity reduces hippocampal structure and function in older African Americans with the APOE-ε4 Alzheimer's disease risk allele.
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Affiliation(s)
- Zuzanna Osiecka
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, United States
| | - Bernadette A. Fausto
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, United States
| | - Joshua L. Gills
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, United States
| | - Neha Sinha
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, United States
| | - Steven K. Malin
- Department of Kinesiology and Health, School of Arts and Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Mark A. Gluck
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, United States
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Liu H, Wang Z, Zou L, Gu S, Zhang M, Hukportie DN, Zheng J, Zhou R, Yuan Z, Wu K, Huang Z, Zhong Q, Huang Y, Wu X. Favourable Lifestyle Protects Cognitive Function in Older Adults With High Genetic Risk of Obesity: A Prospective Cohort Study. Front Mol Neurosci 2022; 15:808209. [PMID: 35677584 PMCID: PMC9169719 DOI: 10.3389/fnmol.2022.808209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
The relationship between body mass index (BMI) and cognitive impairment remains controversial, especially in older people. This study aims to confirm the association of phenotypic and genetic obesity with cognitive impairment and the benefits of adhering to a healthy lifestyle. This prospective study included 10,798 participants (aged ≥ 50 years) with normal cognitive function from the Health and Retirement Study in the United States. Participants were divided into low (lowest quintile), intermediate (quintiles 2–4), and high (highest quintile) groups according to their polygenic risk score (PRS) for BMI. The risk of cognitive impairment was estimated using Cox proportional hazard models. Higher PRS for BMI was associated with an increased risk, whereas phenotypic obesity was related to a decreased risk of cognitive impairment. Never smoking, moderate drinking, and active physical activity were considered favourable and associated with a lower risk of cognitive impairment compared with current smoking, never drinking, and inactive, respectively. A favourable lifestyle was associated with a low risk of cognitive impairment, even in subjects with low BMI and high PRS for BMI. This study suggest that regardless of obesity status, including phenotypic and genetic, adhering to a favourable lifestyle is beneficial to cognitive function.
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Affiliation(s)
- Huamin Liu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhenghe Wang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lianwu Zou
- Baiyun Jingkang Hospital, Guangzhou, China
| | | | - Minyi Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Daniel Nyarko Hukportie
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jiazhen Zheng
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Rui Zhou
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zelin Yuan
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Keyi Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhiwei Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qi Zhong
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yining Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xianbo Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- *Correspondence: Xianbo Wu,
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Fausto BA, Gluck MA. Low body mass and high-quality sleep maximize the ability of aerobic fitness to promote improved cognitive function in older African Americans. ETHNICITY & HEALTH 2022; 27:909-928. [PMID: 32931310 PMCID: PMC7956916 DOI: 10.1080/13557858.2020.1821176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
ABSTRACTObjectives: Because African Americans are at elevated risk for cognitive decline and Alzheimer's disease, it is important to understand which health and lifestyle factors are most important for reducing this risk. Obesity and poor sleep quality are common in lower-income, urban African Americans and have been linked to cognitive decline in older age. Fortunately, increasing aerobic fitness via regular exercise can improve cognitive function. This study sought to (1) examine the cross-sectional relationship between aerobic fitness and cognitive function in older African Americans, and (2) determine whether body mass index and sleep quality moderated the relationship between aerobic fitness and cognition.Design: 402 older African Americans, ages 60-90 (84% female, mean education level = 14 years) completed neuropsychological testing, computerized behavioral tasks, physical performance measures, and health and lifestyle questionnaires. Hierarchical linear regressions were performed to determine associations between aerobic fitness and cognition and whether body mass index and sleep quality moderate the fitness-cognition relationship while controlling for age, sex, education, depressive symptoms, and literacy.Results: Higher aerobic fitness levels were significantly associated with better executive function. The relationships between fitness and hippocampal-dependent cognitive functions (learning and memory, generalization) were attenuated in those who are obese (body mass index ≥ 30 kg/m2) or rated their sleep quality as poor, ps < .05.Conclusion: Our results suggest that while exercise and associated improvements in aerobic fitness are key for improved cognition, these benefits are maximized in those who maintain low body weight and get sufficient, high quality sleep. Exercise programs for older African Americans will be most effective if they are integrated with education programs that emphasize healthy eating, weight control, and sleep hygiene and conceptualize individuals as part of their broader social and environmental context.
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Affiliation(s)
- Bernadette A. Fausto
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, NJ, United States
- Corresponding author: Bernadette A. Fausto, PhD, Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, 197 University Ave., Suite 209, Newark, NJ 07102, United States, Phone: (973) 353-3673,
| | - Mark A. Gluck
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, NJ, United States
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7
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Shin SH, Behrens EA, Parmelee PA, Kim G. The Role of Purpose in Life in the Relationship Between Widowhood and Cognitive Decline Among Older Adults in the U.S. Am J Geriatr Psychiatry 2022; 30:383-391. [PMID: 34417084 DOI: 10.1016/j.jagp.2021.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/18/2021] [Accepted: 07/18/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The objective of this study was to examine the role of purpose in life in the relationship between widowhood and cognitive decline. METHODS This study used a sample of 12,856 respondents (20,408 observations) collected from a national panel survey, the 2006-2014 waves of the Health and Retirement Study (HRS), that sampled older adults aged 50 or older. The study estimated growth-curve models with years since spousal death, purpose in life, and interaction between the two to predict cognition using three measures-total cognition, fluid, and crystallized intelligence scores. We also estimated growth-curve models by sex, race/ethnicity, and education. RESULTS While years since spousal death negatively correlated with cognition, purpose in life positively correlated with cognition. Furthermore, purpose in life had a moderating effect on the relationship between years since spousal death and cognition. This effect was found by using total cognition (coef. = 0.0515; z = 2.64; p < 0.01) and fluid intelligence scores (coef. = 0.0576; z = 3.23; p < 0.05). The same effects were salient among females (coef. = 0.0556; z = 2.19; p < 0.05), Whites (coef. = 0.0526; z = 2.52; p < 0.05), and older adults with more education (coef. = 0.0635; z = 2.10; p < 0.05). CONCLUSION Higher purpose in life relates to the negative correlations between widowhood and cognition of older adults. Educational programs improving purpose in life are a possible avenue for reducing the adverse effect of widowhood on cognition and warrant future exploration.
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Affiliation(s)
- Su Hyun Shin
- Department of Family and Consumer Studies, University of Utah, UT
| | - Emily A Behrens
- Alabama Research Institute on Aging and Department of Psychology, The University of Alabama, AL
| | - Patricia A Parmelee
- Alabama Research Institute on Aging and Department of Psychology, The University of Alabama, AL
| | - Giyeon Kim
- Department of Psychology, Chung-Ang University, Seoul, South Korea.
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Correlation between Body Mass Index (BMI) and Performance on the Montreal Cognitive Assessment (MoCA) in a Cohort of Adult Women in South Africa. Behav Neurol 2022; 2022:8994793. [PMID: 35154508 PMCID: PMC8828333 DOI: 10.1155/2022/8994793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 11/17/2022] Open
Abstract
Objective. Recent evidence suggests that obesity is increasing worldwide and may negatively impact neurocognition. Local studies on the association of weight status with neurocognitive function are sparse. This study is aimed at examining the association between body mass index (BMI) and neurocognitive functioning scores in a cohort of adult women. Methods. A convenience sample of 175 women aged 18 to 59 years (
) recruited in a community-based quantitative study completed the Montreal Cognitive Assessment (MoCA). The BMI metric was used to measure body fat based on weight and height and was stratified as high BMI (overweight or obese) or low BMI (normal weight). The Beck Depression Inventory (BDI) was used to assess depression. Pearson’s correlation analysis and the student’s
-test analysis were performed. Results. We observed a significant inverse association between BMI and performance on MoCA (
,
). Performance on subtest of attention, memory, constructive abstraction, and executive functions significantly and inversely correlated with BMI. Significantly lower scores on the MoCA were found in women with a high BMI compared to women with a low BMI (
vs.
),
,
). Conclusions. BMI and MoCA were inversely associated on both global and domain-specific neurocognitive test of attention, memory, and executive function; key neurocognitive control; and regulatory functions underlying behavior and decision-making. The findings provide a rationale for further research into the long-term effects of BMI on neurocognition.
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Gregory SH, King CR, Ben Abdallah A, Kronzer A, Wildes TS. Abnormal preoperative cognitive screening in aged surgical patients: a retrospective cohort analysis. Br J Anaesth 2020; 126:230-237. [PMID: 32943193 DOI: 10.1016/j.bja.2020.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/24/2020] [Accepted: 08/09/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Preoperative cognitive dysfunction has been associated with adverse postoperative outcomes. There are limited data characterising the epidemiology of preoperative cognitive dysfunction in older surgical patients. METHODS This retrospective cohort included all patients ≥65 yr old seen at the Washington University preoperative clinic between January 2013 and June 2018. Cognitive screening was performed using the Short-Blessed Test (SBT) and Eight-Item Interview to Differentiate Aging and Dementia (AD8) screen. The primary outcome of abnormal cognitive screening was defined as SBT score ≥5 or AD8 score ≥2. Multivariable logistic regression was used to identify associated factors. RESULTS Overall, 21 666 patients ≥65 yr old completed screening during the study period; 23.5% (n=5099) of cognitive screens were abnormal. Abnormal cognitive screening was associated with increasing age, decreasing BMI, male sex, non-Caucasian race, decreased functional independence, and decreased metabolic functional capacity. Patients with a history of stroke or transient ischaemic attack, chronic obstructive pulmonary disease, diabetes mellitus, hepatic cirrhosis, and heavy alcohol use were also more likely to have an abnormal cognitive screen. Predictive modelling showed no combination of patient factors was able to reliably identify patients who had a <10% probability of abnormal cognitive screening. CONCLUSIONS Routine preoperative cognitive screening of unselected aged surgical patients often revealed deficits consistent with cognitive impairment or dementia. Such deficits were associated with increased age, decreased function, decreased BMI, and several common medical comorbidities. Further research is necessary to characterise the clinical implications of preoperative cognitive dysfunction and identify interventions that may reduce related postoperative complications.
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Affiliation(s)
- Stephen H Gregory
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA.
| | - Christopher R King
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Arbi Ben Abdallah
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Alex Kronzer
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Troy S Wildes
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
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Abstract
Objectives: This study examined the relationship between body mass index (BMI) and trajectories of cognitive decline among older Korean adults.Methods: Participants were a nationally representative sample of 5126 Korean adults aged 60 or older from the Korean Longitudinal Study of Aging (KLoSA: 2006-2014). The main outcome variable, cognitive function, was measured with the Korean Mini-Mental State Examination (K-MMSE). According to the BMI values, respondents were divided into four groups at each wave: underweight (<18.5 kg/m2), healthy weight (18.5-22.9 kg/m2), overweight (23.0-24.9 kg/m2), and obese (≥25.0 kg/m2). Growth curve modeling was used to analyze the relationship of interest.Results: The growth curve modeling revealed that, regardless of BMI values, cognitive functioning declined as participants aged, and the rate of cognitive decline accelerated with age. After adjusting for all covariates, older Korean adults who were underweight displayed steeper declines in cognitive functioning, compared to those with a healthy weight. Conversely, overweight or obese older adults showed a much slower cognitive decline as they aged, after adjusting for covariates.Conclusion: Compared to people with a healthy BMI, people with a low BMI may be at risk for cognitive dysfunction, whereas a high BMI could function as a protective factor for cognitive dysfunction in older adulthood. Future research examining the mechanism for these trajectories are needed. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Giyeon Kim
- Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Sunha Choi
- Department of Public Administration, Seoul National University of Science and Technology, Seoul, South Korea
| | - Jiyoung Lyu
- Institute of Aging, Hallym University, Chuncheon, South Korea
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11
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Liu L, Huang X, Feng L, Wu Y. Internal Lipid Profile and Body Lipid Profile in Relation to Cognition: A Cross-Sectional Study in Southern China. Am J Alzheimers Dis Other Demen 2020; 35:1533317520962660. [PMID: 33089704 PMCID: PMC10624072 DOI: 10.1177/1533317520962660] [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] [Indexed: 11/16/2022]
Abstract
AIM There are currently no established, clinically relevant, non-invasive markers of cognitive impairment, except for age and APOE genotype. METHODS A cross-sectional study of 1,296 participants from Nanchang, China, has been conducted. We collected data from Mini-Mental State Examination (MMSE) scores, internal lipid profiles and body lipid profiles, age and other factors that may have an effect on cognitive impairment. RESULTS Internal lipid profiles (OR = 1.03 [95%CI, 1.00-1.06], P = 0.024), body lipid profiles (OR = 1.05 [95%CI, 1.01-1.09], P = 0.014), and age (OR = 1.03 [95%CI, 1.01-1.05], P < 0.001) were all positively correlated with cognitive impairment. CONCLUSIONS Cognitive impairment was more frequent in female patients with high internal lipid profiles or body lipid profiles, and these characteristics were related to age and education.
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Affiliation(s)
- Lian Liu
- Department Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, China
- Department Health Care Centre, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, China
| | - Xiao Huang
- Department Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, China
| | - Liang Feng
- Department Health Care Centre, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, China
| | - Yanqing Wu
- Department Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, China
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12
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Arvanitakis Z, Capuano AW, Bennett DA, Barnes LL. Body Mass Index and Decline in Cognitive Function in Older Black and White Persons. J Gerontol A Biol Sci Med Sci 2019; 73:198-203. [PMID: 28961897 PMCID: PMC5861969 DOI: 10.1093/gerona/glx152] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Indexed: 01/13/2023] Open
Abstract
Background While body mass index (BMI) is higher in black compared to white persons, little is known about BMI and change in cognition in cohorts with a large proportion of blacks. We examine relations of BMI with decline in global cognition and five cognitive domains, in older blacks and whites, and determine whether relations differ by race. Methods Participants were 2,134 persons without baseline dementia (33% black; 75% women; mean age =77.9 [range 53-100] and education = 14.7 years, Mini-Mental State Examination = 28.0), enrolled in one of two longitudinal, community-based cohort studies of aging (Minority Aging Research Study; Rush Memory and Aging Project). Summary scores of global cognition and five domains were based on 19 neuropsychological tests administered annually. Mixed-effects models, controlling for age, sex, education, and race, were used to examine the relation of baseline BMI to change in cognition. Results Baseline BMI = 28.4 units (30.3 in blacks [95% confidence interval (CI): 27.2-27.7]; 27.4 in whites [95% CI: 29.8-30.7]). During a mean annual follow-up of 6 years (SD = 4), lower baseline BMI was related to faster decline in global cognition (p = .002), and semantic memory (p < .001) and episodic memory (p = .004), but not working memory, perceptual speed, or visuospatial ability (all p > .08). The relationship of BMI with change in cognition was not modified by race (all p > .09). Conclusions Late-life lower BMI relates to faster rates of decline in cognition, specifically semantic memory and episodic memory, in both blacks and whites. The effect of BMI on cognition appears to be similar in both racial groups.
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Affiliation(s)
- Zoe Arvanitakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
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Peterson RL, Fain MJ, A. Butler E, Ehiri JE, Carvajal SC. The role of social and behavioral risk factors in explaining racial disparities in age-related cognitive impairment: a structured narrative review. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:173-196. [DOI: 10.1080/13825585.2019.1598539] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Noh JW, Kim J, Yang Y, Park J, Cheon J, Kwon YD. Body mass index and self-rated health in East Asian countries: Comparison among South Korea, China, Japan, and Taiwan. PLoS One 2017; 12:e0183881. [PMID: 28846742 PMCID: PMC5573277 DOI: 10.1371/journal.pone.0183881] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/14/2017] [Indexed: 11/19/2022] Open
Abstract
There have been conflicting findings regarding the relationship between body mass index (BMI) and self-rated health (SRH) worldwide. The purpose of this study was to examine the association between BMI and SRH by comparing its relationship in four East Asian countries: South Korea, China, Japan, and Taiwan. Using data from the East Asian Social Survey, the relationship between weight status and SRH status was investigated and compared between four countries, China, Japan, South Korea, and Taiwan. An ordinal logit regression model was estimated for each country, and the results were compared. We found that the relationship between weight status and SRH status differed across the four countries. In China, people who were overweight reported better SRH scores than those of normal weight, whereas in Japan, obese and severely obese people reported poor scores. In contrast, South Koreans who were underweight, obese, or severely obese reported poor ratings of health status than those of normal weight. In Taiwan, however, no differences in respondents' weight status were found across SRH scores. There were notable differences in the relationship between BMI and SRH status in four East Asian countries. Individual countries should consider these relationships when designing and implementing obesity intervention programs.
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Affiliation(s)
- Jin-Won Noh
- Department of Healthcare Management, Eulji University, Seongnam, Korea
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Jinseok Kim
- Department of Social Welfare, Seoul Women's University, Seoul, Korea
| | - Youngmi Yang
- Department of Social Welfare, Seoul Women's University, Seoul, Korea
| | - Jumin Park
- National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America
| | - Jooyoung Cheon
- Department of Nursing Science, Sungshin University, Seoul, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Korea
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15
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Kim S, Kim Y, Park SM. Body Mass Index and Decline of Cognitive Function. PLoS One 2016; 11:e0148908. [PMID: 26867138 PMCID: PMC4751283 DOI: 10.1371/journal.pone.0148908] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/23/2016] [Indexed: 02/05/2023] Open
Abstract
Background The association between body mass index (BMI) and cognitive function is a public health issue. This study investigated the relationship between obesity and cognitive impairment which was assessed by the Korean version of the Mini-mental state examination (K-MMSE) among mid- and old-aged people in South Korea. Methods A cohort of 5,125 adults, age 45 or older with normal cognitive function (K-MMSE≥24) at baseline (2006), was derived from the Korean Longitudinal Study of Aging (KLoSA) 2006~2012. The association between baseline BMI and risk of cognitive impairment was assessed using multiple logistic regression models. We also assessed baseline BMI and change of cognitive function over the 6-year follow-up using multiple linear regressions. Results During the follow-up, 358 cases of severe cognitive impairment were identified. Those with baseline BMI≥25 kg/m2 than normal-weight (18.5≤BMI<23 kg/m2) were marginally less likely to experience the development of severe cognitive impairment (adjusted odds ratio [aOR] = 0.73, 95% CI = 0.52 to 1.03; Ptrend = 0.03). This relationship was stronger among female (aOR = 0.63, 95% CI = 0.40 to 1.00; Ptrend = 0.01) and participants with low-normal K-MMSE score (MMSE: 24–26) at baseline (aOR = 0.59, 95% CI = 0.35 to 0.98; Ptrend<0.01). In addition, a slower decline of cognitive function was observed in obese individuals than those with normal weight, especially among women and those with low-normal K-MMSE score at baseline. Conclusion In this nationally representative study, we found that obesity was associated with lower risk of cognitive decline among mid- and old-age population.
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Affiliation(s)
- Sujin Kim
- Takemi Program in International Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Yongjoo Kim
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Sang Min Park
- Takemi Program in International Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Family Medicine & Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
- * E-mail:
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Tikhonoff V, Casiglia E, Guidotti F, Giordano N, Martini B, Mazza A, Spinella P, Palatini P. Body fat and the cognitive pattern: A population-based study. Obesity (Silver Spring) 2015; 23:1502-10. [PMID: 26110893 DOI: 10.1002/oby.21114] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/13/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The relationship between body fatness and cognitive pattern at a population level was investigated. METHODS Among 500 unselected subjects from the general population, the role of body mass index (BMI) and body fat mass (BFM) on a mini-mental state examination (MMSE) and on a battery of paper and pencil neuropsychological tests was analyzed. Multiple linear regressions, accounting for potential confounders, were used. RESULTS In fully adjusted models, MMSE (coefficient +0.027, 95% confidence intervals, 0.017-0.177), the clock drawing test (+0.141, 0.053-0.226), and the trail making test A (+1.542, 0.478-2.607) were positively associated with BMI. Adding BFM to the models, no associations were observed. The tests were also positively associated with BFM (+0.056, 0.021-0.091; +0.063, 0.025-0.101; +0.592, 0.107-1.077; respectively). At analysis of covariance, the same tests were significantly better performed over 29.4 kg m(-2) of BMI. After adding BFM as further confounder, all differences in performance across BMI were no longer significant. The three tests were better performed over 34.6 kg of BFM. CONCLUSIONS Higher BMI and particularly higher BFM are positively associated with better performance at the cognitive tasks exploring selective attention and executive functions.
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Affiliation(s)
- Valérie Tikhonoff
- Department of Medicine, University of Padova, Padova, Italy
- MRC Unit for Lifelong Health and Ageing at UCL, University College of London, London, UK
| | | | | | | | - Bortolo Martini
- Department of Cardiology, Hospital of Santorso, Thiene, Italy
| | - Alberto Mazza
- Department of Medicine, Hospital of Rovigo, Rovigo, Italy
| | - Paolo Spinella
- Department of Medicine, University of Padova, Padova, Italy
| | - Paolo Palatini
- Department of Medicine, University of Padova, Padova, Italy
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Sutin AR, Stephan Y, Carretta H, Terracciano A. Perceived discrimination and physical, cognitive, and emotional health in older adulthood. Am J Geriatr Psychiatry 2015; 23:171-9. [PMID: 24745563 PMCID: PMC4170050 DOI: 10.1016/j.jagp.2014.03.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 03/05/2014] [Accepted: 03/16/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine whether perceived discrimination based on multiple personal characteristics is associated with physical, emotional, and cognitive health concurrently, prospectively, and with change in health over time among older adults. DESIGN Longitudinal. SETTING Health and Retirement Study (HRS). PARTICIPANTS Participants (N = 7,622) who completed the Leave-Behind Questionnaire as part of the 2006 HRS assessment (mean age 67 years); participants (N = 6,450) completed the same health measures again in 2010. MEASUREMENTS Participants rated their everyday experience with discrimination and attributed those experiences to eight personal characteristics: race, ancestry, sex, age, weight, physical disability, appearance, and sexual orientation. At both the 2006 and 2010 assessments, participants completed measures of physical health (subjective health, disease burden), emotional health (life satisfaction, loneliness), and cognitive health (memory, mental status). RESULTS Discrimination based on age, weight, physical disability, and appearance was associated with poor subjective health, greater disease burden, lower life satisfaction, and greater loneliness at both assessments and with declines in health across the four years. Discrimination based on race, ancestry, sex, and sexual orientation was associated with greater loneliness at both time points, but not with change over time. Discrimination was mostly unrelated to cognitive health. CONCLUSIONS The detrimental effect of discrimination on physical and emotional health is not limited to young adulthood but continues to contribute to health and well-being in old age. These effects were driven primarily by discrimination based on personal characteristics that change over time (e.g., age, weight) rather than discrimination based on more stable characteristics (e.g., race, sex).
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Okereke OI. Racial and ethnic diversity in studies of late-life mental health. Am J Geriatr Psychiatry 2014; 22:637-41. [PMID: 24927878 DOI: 10.1016/j.jagp.2014.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/06/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Olivia I Okereke
- Channing Division of Network Medicine, Department of Medicine, and Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, and Department of Epidemiology, Harvard School of Public Health, Boston, MA.
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