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Sheng Z, Xia B, Wu J, Zhao X, He X, Wen X, Yuan C, Pang T, Xu X. Associations Between Abdominal Obesity, Chewing Difficulty and Cognitive Impairment in Dementia-Free Chinese Elderly. Am J Alzheimers Dis Other Demen 2023; 38:15333175231167118. [PMID: 37186941 PMCID: PMC10578445 DOI: 10.1177/15333175231167118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To investigate the independent and synergistic associations between abdominal obesity, chewing difficulty and cognitive impairment in a community-dwelling older adults sample in China. METHODS Cognitive function was measured by the 5 min- Montreal Cognitive Assessment (5 min-MoCA) and abdominal obesity was measured by A Body Shape Index (ABSI) in 572 participants recruited from local communities. Chewing difficulty was assessed via a self-report questionnaire. Linear regression and general logistic regression were performed to investigate the association of chewing difficulty and abdominal obesity with cognition. RESULTS Chewing difficulty score [β (95% CI) = -.30 (-.49, -.11)] and ABSI [β (95%CI) = -.30 (-.55, -.05)] were independently associated with worse performance on the 5 min-MoCA. Whilst ABSI was not associated with cognitive impairment, the co-existence of chewing difficulty and abdominal obesity [OR (95% CI) = 2.22 (1.18, 4.17)] was found associated with the presence of cognitive impairment. CONCLUSION Chewing difficulty and abdominal obesity were independently associated with cognition. Abdominal obesity and chewing may have an additive effect on cognitive function.
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Affiliation(s)
| | - Binte Xia
- Zhejiang University, Hangzhou, China
| | - Jing Wu
- Zhejiang University, Hangzhou, China
| | - Xuhao Zhao
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Xindi He
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Xu Wen
- Department of Sport Science, College of Education, Zhejiang University, Hangzhou, China
| | - Changzheng Yuan
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, China
| | - Ting Pang
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Xin Xu
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, China
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Lo JW, Crawford JD, Desmond DW, Bae HJ, Lim JS, Godefroy O, Roussel M, Kang Y, Jahng S, Köhler S, Staals J, Verhey F, Chen C, Xu X, Chong EJ, Kandiah N, Yatawara C, Bordet R, Dondaine T, Mendyk AM, Brodaty H, Traykov L, Mehrabian S, Petrova N, Kim KW, Bae JB, Han JW, Lipnicki DM, Lam B, Sachdev PS. Long-Term Cognitive Decline After Stroke: An Individual Participant Data Meta-Analysis. Stroke 2021; 53:1318-1327. [PMID: 34775838 DOI: 10.1161/strokeaha.121.035796] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Poststroke cognitive impairment is common, but the trajectory and magnitude of cognitive decline after stroke is unclear. We examined the course and determinants of cognitive change after stroke using individual participant data from the Stroke and Cognition Consortium. METHODS Nine longitudinal hospital-based cohorts from 7 countries were included. Neuropsychological test scores and normative data were used to calculate standardized scores for global cognition and 5 cognitive domains. One-step individual participant data meta-analysis was used to examine the rate of change in cognitive function and risk factors for cognitive decline after stroke. Stroke-free controls were included to examine rate differences. Based on the literature and our own data that showed short-term improvement in cognitive function after stroke, key analyses were restricted to the period beginning 1-year poststroke to focus on its long-term effects. RESULTS A total of 1488 patients (mean age, 66.3 years; SD, 11.1; 98% ischemic stroke) were followed for a median of 2.68 years (25th-75th percentile: 1.21-4.14 years). After an initial period of improvement through up to 1-year poststroke, decline was seen in global cognition and all domains except executive function after adjusting for age, sex, education, vascular risk factors, and stroke characteristics (-0.053 SD/year [95% CI, -0.073 to -0.033]; P<0.001 for global cognition). Recurrent stroke and older age were associated with faster decline. Decline was significantly faster in patients with stroke compared with controls (difference=-0.078 SD/year [95% CI, -0.11 to -0.045]; P<0.001 for global cognition in a subgroup analysis). CONCLUSIONS Patients with stroke experience cognitive decline that is faster than that of stroke-free controls from 1 to 3 years after onset. An increased rate of decline is associated with older age and recurrent stroke.
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Affiliation(s)
- Jessica W Lo
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | | | - Hee-Joon Bae
- Department of Neurology, Seoul National University School of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (H.-J.B.)
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, Seoul, Republic of Korea (J.-S.L., Y.K.)
| | - Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences, University Hospital of Amiens, France (O.G., M.R.)
| | - Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences, University Hospital of Amiens, France (O.G., M.R.)
| | - Yeonwook Kang
- Department of Neurology, Asan Medical Center, Seoul, Republic of Korea (J.-S.L., Y.K.).,Department of Psychology, Hallym University, Republic of Korea (Y.K.)
| | - Seungmin Jahng
- Department of Psychology, Sungkyunkwan University, Republic of Korea (S.J.)
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht University, The Netherlands (S.K., F.V.)
| | - Julie Staals
- Department of Neurology, School for Cardiovascular diseases (CARIM), Maastricht University Medical Center (MUMC+), The Netherlands (J.S.)
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht University, The Netherlands (S.K., F.V.)
| | - Christopher Chen
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (C.C., E.J.C.)
| | - Xin Xu
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (X.X.)
| | - Eddie J Chong
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (C.C., E.J.C.)
| | - Nagaendran Kandiah
- National Neuroscience Institute, Singapore (N.K., C.Y.).,Duke-NUS Medical School, Singapore (N.K.)
| | | | - Régis Bordet
- University of Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, France (R.B., T.D., A.-M.M.)
| | - Thibaut Dondaine
- University of Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, France (R.B., T.D., A.-M.M.)
| | - Anne-Marie Mendyk
- University of Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, France (R.B., T.D., A.-M.M.)
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.).,Dementia Collaborative Research Centre, UNSW Medicine, UNSW, Sydney, Australia (H.B., P.S.S.)
| | - Latchezar Traykov
- Clinic of Neurology, UH "Alexandrovska", Medical University - Sofia, Bulgaria (L.T., S.M.)
| | - Shima Mehrabian
- Clinic of Neurology, UH "Alexandrovska", Medical University - Sofia, Bulgaria (L.T., S.M.)
| | - Neli Petrova
- Kaneff University Hospital, Ruse, Bulgaria (N.P.)
| | - Ki Woong Kim
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Republic of Korea (K.W.K.).,Department of Psychiatry, Seoul National University, College of Medicine, Republic of Korea (K.W.K.).,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (K.W.K., J.B.B., J.W.H.)
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (K.W.K., J.B.B., J.W.H.)
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (K.W.K., J.B.B., J.W.H.)
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | - Ben Lam
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.).,Dementia Collaborative Research Centre, UNSW Medicine, UNSW, Sydney, Australia (H.B., P.S.S.)
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