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Dai Z, Hu T, Wei J, Wang X, Cai C, Gu Y, Hu Y, Wang W, Wu Q, Fang J. Network-based identification and mechanism exploration of active ingredients against Alzheimer's disease via targeting endoplasmic reticulum stress from traditional chinese medicine. Comput Struct Biotechnol J 2024; 23:506-519. [PMID: 38261917 PMCID: PMC10796977 DOI: 10.1016/j.csbj.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 01/25/2024] Open
Abstract
Alzheimer's disease is a neurodegenerative disease that leads to dementia and poses a serious threat to the health of the elderly. Traditional Chinese medicine (TCM) presents as a promising novel therapeutic therapy for preventing and treating dementia. Studies have shown that natural products derived from kidney-tonifying herbs can effectively inhibit AD. Furthermore, endoplasmic reticulum (ER) stress is a critical factor in the pathology of AD. Regulation of ER stress is a crucial approach to prevent and treat AD. Thus, in this study, we first collected kidney-tonifying herbs, integrated chemical ingredients from multiple TCM databases, and constructed a comprehensive drug-target network. Subsequently, we employed the endophenotype network (network proximity) method to identify potential active ingredients in kidney-tonifying herbs that prevented AD via regulating ER stress. By combining the predicted outcomes, we discovered that 32 natural products could ameliorate AD pathology via regulating ER stress. After a comprehensive evaluation of the multi-network model and systematic pharmacological analyses, we further selected several promising compounds for in vitro testing in the APP-SH-SY5Y cell model. Experimental results showed that echinacoside and danthron were able to effectively reduce ER stress-mediated neuronal apoptosis by inhibiting the expression levels of BIP, p-PERK, ATF6, and CHOP in APP-SH-SY5Y cells. Overall, this study utilized the endophenotype network to preliminarily decipher the effective material basis and potential molecular mechanism of kidney-tonifying Chinese medicine for prevention and treatment of AD.
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Affiliation(s)
- Zhao Dai
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Tian Hu
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Junwen Wei
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Xue Wang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Chuipu Cai
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Yong Gu
- Clinical Research Center, Hainan Provincial Hospital of Traditional Chinese Medicine, Hainan Medical University, Haikou 570100, China
| | - Yunhui Hu
- Tasly Pharmaceutical Group Co., Ltd., Tianjin 300402, China
| | - Wenjia Wang
- Tasly Pharmaceutical Group Co., Ltd., Tianjin 300402, China
| | - Qihui Wu
- Clinical Research Center, Hainan Provincial Hospital of Traditional Chinese Medicine, Hainan Medical University, Haikou 570100, China
| | - Jiansong Fang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
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Ningning Y, Ying X, Xiang L, Yue S, Zhongda W, Ruoyu J, Hanwen S, Weiwei T, Yafeng Z, Junjie M, Xiaolan C. Danggui-Shaoyao San alleviates cognitive impairment via enhancing HIF-1α/EPO axis in vascular dementia rats. JOURNAL OF ETHNOPHARMACOLOGY 2024; 331:118306. [PMID: 38723920 DOI: 10.1016/j.jep.2024.118306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/15/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Invigorating blood circulation to remove blood stasis is a primary strategy in TCM for treating vascular dementia (VaD). Danggui-Shaoyao San (DSS), as a traditional prescription for neuroprotective activity, has been proved to be effective in VaD treatment. However, its precise molecular mechanisms remain incompletely understood. AIM OF THE STUDY The specific mechanism underlying the therapeutic effects of DSS on VaD was explored by employing network pharmacology as well as in vivo and in viro experiment validation. MATERIALS AND METHODS We downloaded components of DSS from the BATMAN-TCM database for target prediction. The intersection between the components of DSS and targets, PPI network, as well as GO and KEGG enrichment analysis were then performed. Subsequently, the potential mechanism of DSS predicted by network pharmacology was assessed and validated through VaD rat model induced by 2VO operation and CoCl2-treated PC12 cells. Briefly, the DSS extract were first quantified by HPLC. Secondly, the effect of DSS on VaD was studied using MWM test, HE staining and TUNEL assay. Finally, the molecular mechanism of DSS against VaD was validated by Western blot and RT-QPCR experiments. RESULTS Through network analysis, 137 active ingredients were obtained from DSS, and 67 potential targets associated with DSS and VaD were identified. GO and KEGG analysis indicated that the action of DSS on VaD primarily involves hypoxic terms and HIF-1 pathway. In vivo validation, cognitive impairment and neuron mortality were markedly ameliorated by DSS. Additionally, DSS significantly reduced the expression of proteins related to synaptic plasticity and neuron apoptosis including PSD-95, SYP, Caspase-3 and BCL-2. Mechanistically, we confirmed DSS positively modulated the expression of HIF-1α and its downstream proteins including EPO, p-EPOR, STAT5, EPOR, and AKT1 in the hippocampus of VaD rats as well as CoCl2-induced PC12 cells. HIF-1 inhibitor YC-1 significantly diminished the protection of DSS on CoCl2-induced PC12 cell damage, with decreased HIF-1α, EPO, EPOR expression. CONCLUSION Our results initially demonstrated DSS could exert neuroprotective effects in VaD. The pharmacological mechanism of DSS may be related to its positive regulation on HIF-1α/EPO pathway.
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Affiliation(s)
- Yuan Ningning
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Xu Ying
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Li Xiang
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Su Yue
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Wang Zhongda
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jiang Ruoyu
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Shi Hanwen
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Tao Weiwei
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Zhang Yafeng
- Jiangsu CM Clinical Innovation Center of Degenerative Bone & Joint Disease, Wuxi TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, 214071, China.
| | - Ma Junjie
- School of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
| | - Cheng Xiaolan
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
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Ohta T, Kojima N, Osuka Y, Sasai H. Physical frailty predicts cognitive decline among community-dwelling older Japanese women: A prospective cohort study from the Otassha study. Arch Gerontol Geriatr 2024; 124:105453. [PMID: 38704920 DOI: 10.1016/j.archger.2024.105453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/11/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Physical frailty and cognitive decline are common issues in geriatrics within an aging society, yet the association between them remains controversial. This study aims to evaluate the association between physical frailty and cognitive decline among community-dwelling older Japanese women. METHODS A prospective cohort study was conducted in an urban area of Tokyo, Japan, involving community-dwelling older adults 65 years or older. Physical frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria, consisting of five components: shrinking, weakness, exhaustion, slowness, and low activity. Participants were classified as robust, pre-frail, or frail based on the presence of one or more criteria. Cognitive decline was defined as at least a three-point decrease in the Mini-Mental State Examination score from baseline. The association between physical frailty and cognitive decline was examined using binomial logistic regression, adjusting for potential confounders. The analysis yielded multivariable odds ratios (ORs) and 95 % confidence intervals (CIs), with robust participants using as the reference group. RESULTS A total of 2,122 individuals participated in the baseline survey, with 805 included in the analysis (mean age: 72.9 ± 5.1 years). At baseline, 363 participants were classified as pre-frail, while 32 were classified as frail. During the two-year follow-up period, 68 participants experienced cognitive decline. The multivariable OR (95 % CI) for frailty, using robust as the reference, was 3.50 (1.13, 10.80). Furthermore, a linear relationship was observed between physical frailty and cognitive decline. CONCLUSION Among older Japanese women, there exists a dose-response relationship between physical frailty status and cognitive decline.
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Affiliation(s)
- Takahisa Ohta
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Shen H, Liu K, Kong F, Ren M, Wang X, Wang S. Strategies for measuring concentrations and forms of amyloid-β peptides. Biosens Bioelectron 2024; 259:116405. [PMID: 38776801 DOI: 10.1016/j.bios.2024.116405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/01/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
Alzheimer's disease (AD) is affecting more and more people worldwide without the effective treatment, while the existed pathological mechanism has been confirmed barely useful in the treatment. Amyloid-β peptide (Aβ), a main component of senile plaque, is regarded as the most promising target in AD treatment. Aβ clearance from AD brain seems to be a reliably therapeutic strategy, as the two exited drugs, GV-971 and aducanumab, are both developed based on it. However, doubt still exists. To exhaustive expound on the pathological mechanism of Aβ, rigorous analyses on the concentrations and aggregation forms are essential. Thus, it is attracting broad attention these years. However, most of the sensors have not been used in pathological studies, as the lack of the bridge between analytical chemist and pathologists. In this review, we made a brief introduce on Aβ-related pathological mechanism included in β-amyloid hypothesis to elucidate the detection conditions of sensor methods. Furthermore, a summary of the sensor methods was made, which were based on Aβ concentrations and form detections that have been developed in the past 10 years. As the greatest number of the sensors were built on fluorescent spectroscopy, electrochemistry, and Roman spectroscopy, detailed elucidation on them was made. Notably, the aggregation process is another important factor in revealing the progress of AD and developing the treatment methods, so the sensors on monitoring Aβ aggregation processes were also summarized.
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Affiliation(s)
- Hangyu Shen
- State Key Laboratory of Biobased Materials and Green Papermaking, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, 250353, PR China
| | - Keyin Liu
- State Key Laboratory of Biobased Materials and Green Papermaking, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, 250353, PR China
| | - Fangong Kong
- State Key Laboratory of Biobased Materials and Green Papermaking, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, 250353, PR China
| | - Mingguang Ren
- State Key Laboratory of Biobased Materials and Green Papermaking, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, 250353, PR China
| | - Xiaoying Wang
- State Key Laboratory of Biobased Materials and Green Papermaking, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, 250353, PR China; Shandong Haizhibao Ocean Technology Co., Ltd, Weihai, Shandong, 264333, PR China.
| | - Shoujuan Wang
- State Key Laboratory of Biobased Materials and Green Papermaking, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, 250353, PR China.
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Liu Y, Yang X, Gao J, Xie C, Tian C, Gao T. Association between triglyceride glucose index and cognitive decline: A meta-analysis. J Affect Disord 2024; 359:70-77. [PMID: 38735580 DOI: 10.1016/j.jad.2024.05.049] [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: 02/06/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND The triglyceride glucose (TyG) index, a novel surrogate indicator for insulin resistance (IR), is believed to be associated with various diseases. However, its connection with cognitive decline remains controversy. METHODS The PubMed, EMBASE, Cochrane Library, Web of Science, and Medline databases were systematically searched up to October 2023 to assess the association between the TyG index and the risk of cognitive decline. Effect estimates and 95 % confidence intervals (CIs) were calculated using a random-effects model. RESULTS Our review included 3 cohort studies and 9 case-control/cross-sectional studies with a total of 5,603,350 participants. In comparison to a low TyG index, a higher TyG index was connected to an elevated risk of cognitive decline (RR/HR = 1.14, 95 % CI [1.11, 1.17], P < 0.05; OR = 1.75, 95 % CI [1.34, 2.29], P < 0.05). Furthermore, the dose-response analysis from the case-control/cross-sectional studies revealed a 1.42 times higher risk of cognitive decline per 1 mg/dl increment of the TyG index (OR = 1.42, 95 % CI [1.19, 1.69], P < 0.05). LIMITATIONS The inclusion of observational studies in the meta-analysis demonstrated a lower hierarchy of evidence compared to randomized controlled trials. Moreover, we incorporated a restricted number of studies and identified significant heterogeneity among them, potentially attributed to the presence of numerous confounding variables. CONCLUSION TyG index is related to cognitive decline. In view of some of the limitations of this study, further research will be necessary to confirm this relationship.
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Affiliation(s)
- Yuqin Liu
- School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao 266021, China.
| | - Xingxiang Yang
- School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao 266021, China.
| | - Jie Gao
- School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao 266021, China.
| | - Chenqi Xie
- School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao 266021, China.
| | - Chunyan Tian
- School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao 266021, China
| | - Tianlin Gao
- School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao 266021, China.
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Feng L, Sun J, Xia L, Shi Q, Hou Y, Zhang L, Li M, Fan C, Sun B. Ferroptosis mechanism and Alzheimer's disease. Neural Regen Res 2024; 19:1741-1750. [PMID: 38103240 PMCID: PMC10960301 DOI: 10.4103/1673-5374.389362] [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: 05/08/2023] [Revised: 07/05/2023] [Accepted: 09/09/2023] [Indexed: 12/18/2023] Open
Abstract
Regulated cell death is a genetically determined form of programmed cell death that commonly occurs during the development of living organisms. This process plays a crucial role in modulating homeostasis and is evolutionarily conserved across a diverse range of living organisms. Ferroptosis is a classic regulatory mode of cell death. Extensive studies of regulatory cell death in Alzheimer's disease have yielded increasing evidence that ferroptosis is closely related to the occurrence, development, and prognosis of Alzheimer's disease. This review summarizes the molecular mechanisms of ferroptosis and recent research advances in the role of ferroptosis in Alzheimer's disease. Our findings are expected to serve as a theoretical and experimental foundation for clinical research and targeted therapy for Alzheimer's disease.
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Affiliation(s)
- Lina Feng
- Shandong Key Laboratory of TCM Multi-Target Intervention and Disease Control, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, China
| | - Jingyi Sun
- Shandong Key Laboratory of TCM Multi-Target Intervention and Disease Control, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, China
| | - Ling Xia
- Shandong Key Laboratory of TCM Multi-Target Intervention and Disease Control, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, China
| | - Qiang Shi
- Shandong Key Laboratory of TCM Multi-Target Intervention and Disease Control, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, China
| | - Yajun Hou
- Shandong Key Laboratory of TCM Multi-Target Intervention and Disease Control, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, China
| | - Lili Zhang
- Department of Internal Medicine, Taian Traffic Hospital, Taian, Shandong Province, China
| | - Mingquan Li
- Department of Neurology, the Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Cundong Fan
- Shandong Key Laboratory of TCM Multi-Target Intervention and Disease Control, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, China
| | - Baoliang Sun
- Shandong Key Laboratory of TCM Multi-Target Intervention and Disease Control, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, China
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Shi Y, Stanmore E, McGarrigle L, Wang X, Wang X, Li Y, Todd C. Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach. Maturitas 2024; 186:108027. [PMID: 38820935 DOI: 10.1016/j.maturitas.2024.108027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES There is no precedent for the use of social media in preventing sarcopenia. The aim of this study is to develop a social media-based intervention programme for the young-old population in the community in China to improve their awareness and behaviours regarding sarcopenia prevention. STUDY DESIGN Using guidelines for developing complex interventions, this study was divided into two main phases: a co-development phase and a preliminary test phase. Both were carried out in Changsha, China. The development phase employed co-design methodology with relevant stakeholders, including two rounds of consultation with patient and public involvement (12 members) and two rounds of focus groups (30 participants); this was followed by the three-week preliminary test phase (22 participants). MAIN OUTCOME MEASURES This study evaluated the consultation with patient and public involvement, and mainly collected qualitative data from the two rounds of focus group interviews and a final semi-structured interview following the preliminary test, so as to explore the participants' experiences, comments, and suggestions for revising the social media-based intervention. Handgrip strength was also evaluated. RESULTS The health education included seven videos of 4-6 min each related to sarcopenia, including information on the concept, influencing factors, adverse effects, manifestations, screening methods, and preventions. The exercise video consisted of four types of training (warm-up, aerobic, resistance, and flexibility training) and lasted 30 min, with a suggested engagement of at least 3 days/week. The specific contents and "dosage" of the final intervention were unanimously favourable to the diverse stakeholders involved (older adults with possible sarcopenia, experts, researchers). After the preliminary test, an improvement in handgrip strength was observed, from M15.92±SD5.22 kg to M19.13±SD5.44 kg (T = -5.44, P < 0.001). Subgroup analysis revealed that this improvement was evident in both men and women. CONCLUSIONS The social media-based intervention was universally endorsed by the participants and showed indications of a positive influence on sarcopenia. A feasibility study is now needed.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Nursing, School of Public Health, Yangzhou University, 225009 Yangzhou, Jiangsu Province, China; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Xiuhua Wang
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China.
| | - Xiaoqing Wang
- Department of Geriatrics, the Second Xiangya Affiliated Hospital, Central South University, 410011 Changsha, Hunan Province, China
| | - Yuhua Li
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
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Wang W, Roumell E, Xu C, Lu Z. Home Through Their Eyes: A Qualitative Exploration of the Meaning of Home for Persons With Dementia and Impact of Physical Environment During Meaning-Making. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae107. [PMID: 38863436 DOI: 10.1093/geronb/gbae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Indexed: 06/13/2024] Open
Abstract
OBJECTIVES This study aimed to examine the meaning of home for persons with dementia and the role of the physical environment during their meaning-making process. In response to a growing number of persons with dementia, there has been a strong advocacy for prioritizing the development of dementia-friendly environments within design practice and research agendas, for which "home" has become one of the important loci. However, of the limited studies on the meaning of home from the perspective of those individuals who continue to live in their own homes after developing dementia, even fewer addressed this issue within the Chinese context. METHODS Five dyads, persons with dementia and their family caregivers, participated in the qualitative phenomenology study. Ten home visits-2 visits per dyad-were conducted, during which interview data, photographs, and field notes were collected. Phenomenological analysis was applied within and across the data sets. RESULTS Three key themes emerged-"Three Dimensions of Home" revealed that "home" goes beyond physical residence and immediate family connections, including meaningful objects and places, enduring relationships, self-identity, and lived experiences.; "The Impact of Physical Environment" and "The Impact of Cognitive Impairment" showed the complex interactions between the environment, cognitive impairment, and meaning-making. DISCUSSION An exploration of the essence of meaning of home within the Chinese context, in person-environment relationships with dementia progression, and implications for future research and practice on dementia-related environments and care were further discussed. This study contributes insights into enhancing the well-being of persons with dementia and benefiting their caregivers.
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Affiliation(s)
- Wenjin Wang
- Department of Landscape Architecture & Urban Planning, Texas A&M University, College Station, Texas, USA
| | - Elizabeth Roumell
- Department of Educational Administration & Human Resource Development, Texas A&M University, College Station, Texas, USA
| | - Chuanyue Xu
- Department of Architecture, Texas A&M University, College Station, Texas, USA
| | - Zhipeng Lu
- Department of Architecture, Texas A&M University, College Station, Texas, USA
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Xiong HL, Li ZX, Lu X, Lu YH, Zhong P. Impact of early refined nursing program on prognosis of middle-aged and elderly patients with cognitive dysfunction combined with cerebral infarction. World J Psychiatry 2024; 14:1034-1042. [DOI: 10.5498/wjp.v14.i7.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/10/2024] [Accepted: 05/27/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Cerebral infarction is a local or extensive necrosis of brain tissue. Subsequently, the corresponding neurological deficits appear. The incidence of cerebrovascular diseases in China is increasing gradually. After the onset of cerebrovascular disease, the most common sequelae include movement disorders, language disorders, and cognitive dysfunction.
AIM To investigate the effect of early refined nursing program on the prognosis of middle-aged and elderly patients with cerebral infarction combined with cognitive dysfunction.
METHODS A retrospective study was conducted to divide 60 patients with cerebral infarction and cognitive impairment into an experimental group (n = 32) and a control group (n = 28). The experimental group received early intensive care every day, and the control group received daily routine care. The scores of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT), as well as the latency and amplitude of the event-related potential P300, were used as main indicators to evaluate changes in cognitive function, and changes in BDNF, TGF-β, and GDNF expression were used as secondary indicators.
RESULTS Both groups experienced notable enhancements in MMSE scores, with the experimental group demonstrating higher scores than the control group (experimental: 28.75 ± 2.31; control: 25.84 ± 2.87). Moreover, reductions in TMT-A and TMT-B scores were observed in both groups (experimental: TMT-A 52.36 ± 6.18, TMT-B 98.47 ± 10.23; control: TMT-A 61.48 ± 7.92, TMT-B 112.63 ± 12.55), with the experimental group displaying lower scores. P300 Latency decreased (experimental: 270.63 ms ± 14.28 ms; control: 285.72 ms ± 16.45 ms), while amplitude increased (experimental: 7.82 μV ± 1.05 μV; control: 6.35 μV ± 0.98 μV) significantly in both groups, with superior outcomes in the experimental cohort. Additionally, the levels of the growth factors BDNF, TGF-β1, and GDNF surged (experimental: BDNF 48.37 ng/mL ± 5.62 ng/mL, TGF-β1 52.14 pg/mL ± 4.28 pg/mL, GDNF 34.76 ng/mL ± 3.89 ng/mL; control: BDNF 42.58 ng/mL ± 4.73 ng/mL, TGF-β1 46.23 pg/mL ± 3.94 pg/mL, GDNF 30.25 ng/mL ± 2.98 ng/mL) in both groups, with higher levels in the experimental group.
CONCLUSION For middle-aged and elderly patients with cerebral infarction and cognitive dysfunction, early refined nursing can significantly improve their cognitive function and prognosis.
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Affiliation(s)
- Hui-Lian Xiong
- Ganzhou City Central Blood Station, Ganzhou 341000, Jiangxi Province, China
| | - Zhi-Xin Li
- Department of Rehabilitation Medicine, Ganzhou People's Hospital, Ganzhou 341000, Jiangxi Province, China
| | - Xin Lu
- Department of Rehabilitation Medicine, Ganzhou People's Hospital, Ganzhou 341000, Jiangxi Province, China
| | - Yan-Hua Lu
- Department of Rehabilitation Medicine, Ganzhou People's Hospital, Ganzhou 341000, Jiangxi Province, China
| | - Ping Zhong
- Department of Rehabilitation Medicine, Ganzhou People's Hospital, Ganzhou 341000, Jiangxi Province, China
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Wang P, Sun W, Gong J, Han X, Xu C, Chen Y, Yang Y, Luan H, Li S, Li R, Wen B, Lv S, Wei C. Efficacy and safety of butylphthalide in patients with mild cognitive impairment: a multicentre, randomised, double-blind, placebo-controlled trial (EBMCI study). BMJ Open 2024; 14:e082404. [PMID: 39002963 DOI: 10.1136/bmjopen-2023-082404] [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] [Indexed: 07/15/2024] Open
Abstract
INTRODUCTION The efficacy of multitarget neuroprotective drug DL-3-n-butylphthalide (NBP) in improving cognitive function has been confirmed in patients with vascular cognitive impairment without dementia. However, its efficacy in patients with symptomatic predementia phase of Alzheimer's disease remains uncertain. This study aims to evaluate the efficacy and safety of NBP in improving cognitive function in patients with mild cognitive impairment (MCI) through a clinical randomised controlled trail. METHODS AND ANALYSIS This study is a 12-month, randomised, double-blind, placebo-controlled, multicentric trial, involving 270 patients with MCI. Subjects are randomly assigned to receive either NBP soft capsule (200 mg, three times per day) or placebo with an allocation ratio of 1:1. The efficacy and safety of NBP are assessed by comparing the results of neuropsychological, neuroimaging and laboratory tests between the two groups. The primary endpoint is the change in Alzheimer's Disease Assessment Scale-Cognitive Subscale after 12 months. All patients will be monitored for adverse events. ETHICS AND DISSEMINATION This study involving human participants has been reviewed and approved by Ethics Committee of Xuan Wu Hospital (No.2017058). The participants provide their written informed consent to participate in this study. Results will be published in peer-reviewed medical journals and disseminated to healthcare professionals at local and international conferences. PROTOCOL VERSION V 3.0, 3 September 2022. TRIAL REGISTRATION NUMBER ChiCTR1800018362.
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Affiliation(s)
- Pin Wang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wenxian Sun
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Jin Gong
- College of Integrated Traditional Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Xiaodong Han
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Chang Xu
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yufei Chen
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yuting Yang
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Heya Luan
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Shaoqi Li
- College of Integrated Traditional Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Ruina Li
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Boye Wen
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Sirong Lv
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Cuibai Wei
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
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11
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Hu Q, Zhao M, Teng F, Lin G, Jin Z, Xu T. A model for identifying potentially inappropriate medication used in older people with dementia: a machine learning study. Int J Clin Pharm 2024:10.1007/s11096-024-01730-0. [PMID: 38980590 DOI: 10.1007/s11096-024-01730-0] [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: 12/21/2023] [Accepted: 03/21/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Older adults with dementia often face the risk of potentially inappropriate medication (PIM) use. The quality of PIM evaluation is hindered by researchers' unfamiliarity with evaluation criteria for inappropriate drug use. While traditional machine learning algorithms can enhance evaluation quality, they struggle with the multilabel nature of prescription data. AIM This study aimed to combine six machine learning algorithms and three multilabel classification models to identify correlations in prescription information and develop an optimal model to identify PIMs in older adults with dementia. METHOD This study was conducted from January 1, 2020, to December 31, 2020. We used cluster sampling to obtain prescription data from patients 65 years and older with dementia. We assessed PIMs using the 2019 Beers criteria, the most authoritative and widely recognized standard for PIM detection. Our modeling process used three problem transformation methods (binary relevance, label powerset, and classifier chain) and six classification algorithms. RESULTS We identified 18,338 older dementia patients and 36 PIMs types. The classifier chain + categorical boosting (CatBoost) model demonstrated superior performance, with the highest accuracy (97.93%), precision (95.39%), recall (94.07%), F1 score (95.69%), and subset accuracy values (97.41%), along with the lowest Hamming loss value (0.0011) and an acceptable duration of the operation (371s). CONCLUSION This research introduces a pioneering CC + CatBoost warning model for PIMs in older dementia patients, utilizing machine-learning techniques. This model enables a quick and precise identification of PIMs, simplifying the manual evaluation process.
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Affiliation(s)
- Qiaozhi Hu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Mengnan Zhao
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Fei Teng
- School of Information Science and Technology, Southwest Jiaotong University, Chengdu, China
| | - Gongchao Lin
- School of Information Science and Technology, Southwest Jiaotong University, Chengdu, China
| | - Zhaohui Jin
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.
| | - Ting Xu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
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12
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Xu X, Mo C, Qin J, Cai J, Liu Q, Tang X, Zhang H, Zhang Z. Association between Copper Exposure and Cognitive Function: A Cross-Sectional Study in a County, Guangxi, China. Biol Trace Elem Res 2024:10.1007/s12011-024-04296-0. [PMID: 38965167 DOI: 10.1007/s12011-024-04296-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/28/2024] [Indexed: 07/06/2024]
Abstract
There has been growing attention to the impact of copper exposure on cognitive function; however, current research on the specific information regarding urinary copper and cognitive function is limited, particularly detailed analyses in the Chinese adult population. This study aimed to explore the association between copper exposure and cognitive function in a cross-sectional design. A total of 2617 participants in a county, Guangxi Zhuang Autonomous Region (Guangxi), China, were included. The mini-mental state examination (MMSE) was used to assess cognitive function, and inductively coupled plasma mass spectrometry was used to measure urinary metal levels. Spearman's rank correlation was used to analyze the correlation between urinary copper levels and various cognitive function assessment indices. After adjusting for potential confounders, binary logistic regression was used to explore the association between urinary copper levels and the risk of cognitive impairment (CI) as revealed by MMSE, and restricted cubic spline regression was further used to explore the dose-response relationship. The results showed a negative correlation between urinary copper levels and orientation, attention and calculation, memory, language ability, and MMSE total scores (P < 0.05). Compared with the low copper exposure group, the high exposure group showed a 58.5% increased risk of CI (OR = 1.585, 95%CI: 1.125 to 2.235, P = 0.008). A significant linear dose-response relationship was observed between urinary copper levels and the risk of CI (P overall = 0.045, P nonlinearity = 0.081). Our findings suggest that higher copper exposure may be associated with CI in the population of a county, Guangxi, China.
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Affiliation(s)
- Xia Xu
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Shuangyong Road 22, Nanning, 530021, Guangxi, China
| | - Chunbao Mo
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Jian Qin
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Shuangyong Road 22, Nanning, 530021, Guangxi, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Environment and Health Research, Guangxi Medical University, Nanning, Guangxi, China
- Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiansheng Cai
- School of Public Health, Guilin Medical University, Lequn Road 20, Guilin, 541001, Guangxi, China
- Guangxi Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guilin, Guangxi, China
| | - Qiumei Liu
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Shuangyong Road 22, Nanning, 530021, Guangxi, China
| | - Xu Tang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Shuangyong Road 22, Nanning, 530021, Guangxi, China
| | - Haiying Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Shuangyong Road 22, Nanning, 530021, Guangxi, China.
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, Guangxi, China.
| | - Zhiyong Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Shuangyong Road 22, Nanning, 530021, Guangxi, China.
- School of Public Health, Guilin Medical University, Lequn Road 20, Guilin, 541001, Guangxi, China.
- Guangxi Key Laboratory of Entire Lifecycle Health and Care, Guilin Medical University, Guilin, Guangxi, China.
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Zhou Y, Abuduxukuer K, Wang C, Wei J, Shi W, Li Y, Huang G, Zhou Y, Zhang Y, Luo J. WeChat usage and preservation of cognitive functions in middle-aged and older Chinese adults: indications from a nationally representative survey, 2018-2020. BMC Public Health 2024; 24:1783. [PMID: 38965535 PMCID: PMC11223290 DOI: 10.1186/s12889-024-19210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/20/2024] [Indexed: 07/06/2024] Open
Abstract
PURPOSE To investigate the associations between the most popular social media platform WeChat usage and cognitive performance among the middle-aged and older Chinese population using data from a nationally representative survey. METHODS In total, 17,472 participants (≥ 45 years old) from the China Health and Retirement Longitudinal Study (CHARLS, Wave 4, 2018) were analyzed. Cognitive performance including episodic memory and executive function was assessed using Mini-Mental Status Examination (MMSE). Other confounding variables included socio-economic characteristics, medical status, and lifestyle-related information. Multiple linear regression models were used to test the association between cognitive performance and WeChat usage by introducing covariates hierarchically. Subgroup analyses of age and gender were conducted to estimate the robustness of the primary findings. RESULTS After adjusting for multiple confounders across all linear models, WeChat usage is significantly associated with executive function, episodic memory, and global cognitive performance (all p values<0.05). Such results remained robust in subgroup analyses, stratified by age and gender, and also verified according to longitudinal analyses. Compared to 'Chat-only' users who only used WeChat for online interpersonal communication, further usage of WeChat functions such as using 'Moments' appeared to be significantly associated with better cognitive performance, especially for episodic memory. CONCLUSION Social media usage is significantly and positively associated with better cognitive performance among the middle-aged and older Chinese population. Along with point-to-point messaging, using 'Moments' and extended social media platform functions may correlate to better cognitive performance.
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Affiliation(s)
- Yan Zhou
- Department of Neurology, Putuo People's Hospital, School of Medicine, Tongji University, Shanghai 200060, China
| | - KaiweiSa Abuduxukuer
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Chuchu Wang
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Jin Wei
- Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenming Shi
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yongzhen Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100191, China
| | - Guang Huang
- School of Public Health, Bengbu Medical University, Anhui, China
| | - Yifan Zhou
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Yunfeng Zhang
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China.
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai 200065, China.
| | - Jianfeng Luo
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
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14
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Sun YJ, Song J, Li XP, Wang XH, Wu YX, Huang JJ, Wang SB, Teng YY. Knowledge of Alzheimer's disease and associated factors among adults in Zhuhai, China: a cross-sectional analysis. BMC Public Health 2024; 24:1769. [PMID: 38961390 PMCID: PMC11220978 DOI: 10.1186/s12889-024-19289-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/27/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND This study aimed to assess the public knowledge regarding Alzheimer's Disease (AD) in Zhuhai, China, focusing on identifying knowledge gaps and the influence of demographic and health factors. METHODS A cross-sectional study was conducted in Zhuhai, China, from October to November 2022. A total of 1986 residents from 18 communities were selected employing stratified multi-stage equi-proportional sampling. Questionnaires covering general information and the Alzheimer's Disease Knowledge Scale (ADKS) were investigated face-to-face. Ordinal multiclass logistic regression was applied to assess the relationship between AD awareness and demographic and health characteristics. RESULTS The average ADKS score was 18.5 (SD = 3.36) in Zhuhai. The lowest awareness rates were observed in the "Symptoms" and "Caregiving" subdomains of ADKS, with rates of 51.01% and 43.78%, respectively. The correct rates for the 30 ADKS questions ranged from 16.62 to 92.6%, showing a bimodal pattern with clusters around 80% and 20%. Women (OR = 1.203, 95% CI: 1.009-1.435), individuals aged 60 years or older (OR = 2.073, 95% CI: 1.467-2.932), those living in urban areas (OR = 1.361, 95% CI: 1.117-1.662), higher average monthly household income per capita (OR = 1.641, 95% CI: 1.297-2.082), and without any neurological or mental disorders (OR = 1.810, 95% CI: 1.323-2.478) were more likely to have higher levels of awareness about Alzheimer's disease. CONCLUSIONS Adults in Zhuhai show a limited knowledge of AD, particularly in the 'Symptoms' and 'Caregiving' subdomains. Upcoming health campaigns must focus on bridging the knowledge gaps in different subdomains of AD, especially among subgroups with lower awareness, as identified in our study.
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Affiliation(s)
- Ya-Jun Sun
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Jie Song
- Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Xu-Ping Li
- Xiangya School of Public Health, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410006, China
| | - Xiao-Hui Wang
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Yi-Xuan Wu
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Jia-Ju Huang
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong province, 510080, China.
| | - Yong-Yong Teng
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China.
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15
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Ni W, Niu Y, Cao S, Fan C, Fan J, Zhu L, Wang X. Intermittent hypoxia exacerbates anxiety in high-fat diet-induced diabetic mice by inhibiting TREM2-regulated IFNAR1 signaling. J Neuroinflammation 2024; 21:166. [PMID: 38956653 PMCID: PMC11218348 DOI: 10.1186/s12974-024-03160-1] [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: 03/20/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) are mutual risk factors, with both conditions inducing cognitive impairment and anxiety. However, whether OSA exacerbates cognitive impairment and anxiety in patients with T2DM remains unclear. Moreover, TREM2 upregulation has been suggested to play a protective role in attenuating microglia activation and improving synaptic function in T2DM mice. The aim of this study was to explore the regulatory mechanisms of TREM2 and the cognitive and anxiety-like behavioral changes in mice with OSA combined with T2DM. METHODS A T2DM with OSA model was developed by treating mice with a 60% kcal high-fat diet (HFD) combined with intermittent hypoxia (IH). Spatial learning memory capacity and anxiety in mice were investigated. Neuronal damage in the brain was determined by the quantity of synapses density, the number and morphology of brain microglia, and pro-inflammatory factors. For mechanism exploration, an in vitro model of T2DM combined with OSA was generated by co-treating microglia with high glucose (HG) and IH. Regulation of TREM2 on IFNAR1-STAT1 pathway was determined by RNA sequencing and qRT-PCR. RESULTS Our results showed that HFD mice exhibited significant cognitive dysfunction and anxiety-like behavior, accompanied by significant synaptic loss. Furthermore, significant activation of brain microglia and enhanced microglial phagocytosis of synapses were observed. Moreover, IH was found to significantly aggravate anxiety in the HFD mice. The mechanism of HG treatment may potentially involve the promotion of TREM2 upregulation, which in turn attenuates the proinflammatory microglia by inhibiting the IFNAR1-STAT1 pathway. Conversely, a significant reduction in TREM2 in IH-co-treated HFD mice and HG-treated microglia resulted in the further activation of the IFNAR1-STAT1 pathway and consequently increased proinflammatory microglial activation. CONCLUSIONS HFD upregulated the IFNAR1-STAT1 pathway and induced proinflammatory microglia, leading to synaptic damage and causing anxiety and cognitive deficits. The upregulated TREM2 inT2DM mice brain exerted a negative regulation of the IFNAR1-STAT1 pathway. Mice with T2DM combined with OSA exacerbated anxiety via the downregulation of TREM2, causing heightened IFNAR1-STAT1 pathway activation and consequently increasing proinflammatory microglia.
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MESH Headings
- Animals
- Mice
- Diet, High-Fat/adverse effects
- Membrane Glycoproteins/metabolism
- Membrane Glycoproteins/genetics
- Receptors, Immunologic/metabolism
- Receptors, Immunologic/genetics
- Anxiety/etiology
- Anxiety/metabolism
- Signal Transduction/physiology
- Signal Transduction/drug effects
- Hypoxia/metabolism
- Hypoxia/complications
- Male
- Mice, Inbred C57BL
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/psychology
- Receptor, Interferon alpha-beta/metabolism
- Receptor, Interferon alpha-beta/genetics
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/metabolism
- Microglia/metabolism
- STAT1 Transcription Factor/metabolism
- Sleep Apnea, Obstructive/complications
- Sleep Apnea, Obstructive/metabolism
- Sleep Apnea, Obstructive/psychology
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Affiliation(s)
- Wenyu Ni
- Qidong People's Hospital, Affiliated Qidong Hospital of Nantong University, Qidong Liver Cancer Institute, No.9, Seyuan Road, Chongchuan District, Nantong, Jiangsu, 226000, China
| | - Yun Niu
- Institute of Special Environmental Medicine, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China
| | - Sitong Cao
- Institute of Special Environmental Medicine, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China
| | - Chunsun Fan
- Qidong People's Hospital, Affiliated Qidong Hospital of Nantong University, Qidong Liver Cancer Institute, No.9, Seyuan Road, Chongchuan District, Nantong, Jiangsu, 226000, China
| | - Jian Fan
- Qidong People's Hospital, Affiliated Qidong Hospital of Nantong University, Qidong Liver Cancer Institute, No.9, Seyuan Road, Chongchuan District, Nantong, Jiangsu, 226000, China
| | - Li Zhu
- Institute of Special Environmental Medicine, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China.
| | - Xueting Wang
- Institute of Special Environmental Medicine, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China.
- Medical Research Center Affiliated Hospital 2 of Nantong University, Nantong, China.
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16
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Jiang Y, Wu Y, Hu Y, Li S, Ren L, Wang J, Yu M, Yang R, Liu Z, Zhang N, Hu K, Zhang Y, Livingston G, Zhang JJ, Zeng Y, Chen H, Yao Y. Bi-directional association between outdoor or social activities and cognitive function: do the PM 2.5 exposure catalyze the detrimental inactivity-poor cognition cycle? ENVIRONMENTAL RESEARCH 2024; 252:118868. [PMID: 38580003 DOI: 10.1016/j.envres.2024.118868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Previous research has shown that lack of leisure activities, either outdoor or social activities, impedes cognitive function. However, the interrelationship between poor cognition and deficient activities is understudied. In addition, whether exposure to air pollution, such as PM2.5, can accelerate the detrimental 'inactivity-poor cognition' cycle, is worthy of investigation. METHODS We used data from the 2008, 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We assessed the frequency of outdoor or social activities at each wave. The cognitive function was examined using a China-Modified Mini-mental State Examination. We estimated the residential exposure to fine particular matter (PM2.5) via a satellite-based model. We applied cross-lagged panel (CLP) model to examine the bi-directional relationship between outdoor or social activities and cognitive function. We then examined the effect of PM2.5 exposure with sequent cognitive function and activities using generalized estimation equation (GEE) model. FINDINGS Overall, we observed significant bi-directional associations between outdoor or social activities and cognitive function. Participants with better cognitive function in the last wave were more likely to engage in outdoor or social activities in the following wave (outdoor activities: β = 0.37, 95% CI [0.27,0.48], P < 0.01; social activities: β = 0.05, 95% CI [0.02,0.09] P < 0.01). Meanwhile, higher engagement in outdoor or social activities in the last wave was associated with more favorable cognitive function in the following wave (outdoor activities: β = 0.06, 95% CI [0.03,0.09], P < 0.01; social activities: β = 0.10, 95% CI [0.03,0.18], P < 0.01). Notably, an increase in PM2.5 exposure during the preceding year was significantly associated with a declining cognitive function (β = -0.05, 95% CI [-0.08,-0.03], P < 0.01), outdoor activities (β = -0.02, 95% CI [-0.04, -0.01], P < 0.01) and social activities (β = -0.02, 95% CI [-0.02, -0.01], P < 0.01) in the current year; the lagged effects of the PM2.5 exposure in the past year of the last wave on activities and cognitive function of the following wave were also observed. INTERPRETATION Our findings not only indicate the bi-directional links between the frequency of outdoor or social activities and cognitive function, but also report that PM2.5 exposure plays a role in catalyzing the detrimental inactivity-poor cognition cycle. Future research should investigate whether the policy-driven interventions, such as clean air policies, can break the unfavorable activity-cognition cycle, and thereby promoting health from the dual gains in leisure activities and cognition.
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Affiliation(s)
- Yuling Jiang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Yifei Wu
- School of Public Health, Peking University, Beijing, China
| | - Yang Hu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Longbin Ren
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingjing Wang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Mingzhi Yu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Rui Yang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Zhouwei Liu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Nan Zhang
- Manchester Urban Ageing Research Group (MUARG), The University of Manchester, Manchester, UK
| | - Kejia Hu
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, and Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | - Junfeng Jim Zhang
- Global Health Institute and the Nicholas School of Environment, Duke University, Durham, NC, USA
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, USA
| | - Huashuai Chen
- Business School of Xiangtan University, Xiangtan, China.
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
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17
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Meng X, Dong Y, Gao T, Su J, Zhao Y, Zhu X, He M, Zhang T, Sun J. The Importance of Knowledge on Dementia Risk Factors in the General Public: A Cross-Sectional Study. J Nerv Ment Dis 2024:00005053-990000000-00170. [PMID: 38950421 DOI: 10.1097/nmd.0000000000001785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
ABSTRACT The purpose of this study was to determine the influence of knowledge and beliefs on beneficial behaviors and dementia risk scores. A online survey was conducted among Chinese community residents over 18 years old. Multivariate logistic regression was used to identify the impact of knowledge and beliefs on dementia risk scores and beneficial behaviors. The respondents were 760 adults (mean age = 47.6 years, 60.8% female). Knowledge and beliefs were associated with cognitive activities (knowledge, odds ratio [OR] = 1.04; beliefs, OR = 1.17) and dementia risk scores (knowledge, OR = 0.95; beliefs, OR = 0.82). Additionally, lower perceived susceptibility (OR = 1.68; 95% CI, 1.04 to 2.72) and higher perceived benefits (OR = 0.68; 95% CI, 0.57 to 0.80) were associated with lower dementia risk scores. Knowledge and beliefs can promote beneficial behaviors and reduce dementia risk. In particular, perceptions of dementia susceptibility and benefits should be enhanced, which will greatly reduce dementia risk in the general public.
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Affiliation(s)
| | - Yueyang Dong
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Tianbao Gao
- Department of Internal Medicine, Beian No. 2 People's Hospital, Beian, Heilongjiang, China; and
| | | | - Yanjie Zhao
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xiangning Zhu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Meng He
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Tingmeng Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, Jilin, China
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18
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Yang Y, Xu Z, Guo J, Xiong Z, Hu B. Exploring the gut microbiome-Postoperative Cognitive Dysfunction connection: Mechanisms, clinical implications, and future directions. Brain Behav Immun Health 2024; 38:100763. [PMID: 38682010 PMCID: PMC11052898 DOI: 10.1016/j.bbih.2024.100763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
Postoperative Cognitive Dysfunction (POCD) is a common yet poorly understood complication of surgery that can lead to long-term cognitive decline. The gut-brain axis, a bidirectional communication system between the central nervous system and the gut microbiota, plays a significant role in maintaining cognitive health. The potential for anesthetic agents and perioperative medications to modulate the gut microbiota and influence the trajectory of POCD suggests the need for a more integrated approach in perioperative care. Perioperative medications, including opioids and antibiotics, further compound these disruptions, leading to dysbiosis and consequent systemic and neuroinflammation implicated in cognitive impairment. Understanding how surgical interventions and associated treatments affect this relationship is crucial for developing strategies to reduce the incidence of POCD. Strategies to preserve and promote a healthy gut microbiome may mitigate the risk and severity of POCD. Future research should aim to clarify the mechanisms linking gut flora alterations to cognitive outcomes and explore targeted interventions, such as probiotic supplementation and microbiota-friendly prescription practices, to safeguard cognitive function postoperatively.
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Affiliation(s)
- Yan Yang
- Department of Anesthesiology, Xuzhou Renci Hospital, Xuzhou, 221000, Jiangsu Province, China
| | - Zhipeng Xu
- Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai, 201399, China
| | - Jianrong Guo
- School of Gongli Hospital Medical Technology, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Zhiqiang Xiong
- Shanghai Engineering Research Center of Food Microbiology, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Baoji Hu
- Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai, 201399, China
- School of Gongli Hospital Medical Technology, University of Shanghai for Science and Technology, Shanghai, 200093, China
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19
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Wei Y, Zhou YF, Xiao L, Qin J, Cheng H, Cai H, Chen X, Zou Y, Yang L, Zhang H, Zhang Z, Yang X. Associations of Heavy Metals with Cognitive Function: An Epigenome-Wide View of DNA Methylation and Mediation Analysis. Ann Neurol 2024; 96:87-98. [PMID: 38661228 DOI: 10.1002/ana.26942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Exposure to heavy metals has been reported to be associated with impaired cognitive function, but the underlying mechanisms remain unclear. This pilot study aimed to identify key heavy metal elements associated with cognitive function and further explore the potential mediating role of metal-related DNA methylation. METHODS Blood levels of arsenic, cadmium, lead, copper, manganese, and zinc and genome-wide DNA methylations were separately detected in peripheral blood in 155 older adults. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Least absolute shrinkage and selection operator penalized regression and Bayesian kernel machine regression were used to identify metals associated with cognitive function. An epigenome-wide association study examined the DNA methylation profile of the identified metal, and mediation analysis investigated its mediating role. RESULTS The MMSE scores showed a significant decrease of 1.61 (95% confidence interval [CI]: -2.64, -0.59) with each 1 standard deviation increase in ln-transformed arsenic level; this association was significant in multiple-metal models and dominated the overall negative effect of 6 heavy metal mixture on cognitive function. Seventy-three differentially methylated positions were associated with blood arsenic (p < 1.0 × 10-5). The methylation levels at cg05226051 (annotated to TDRD3) and cg18886932 (annotated to GAL3ST3) mediated 24.8% and 25.5% of the association between blood arsenic and cognitive function, respectively (all p < 0.05). INTERPRETATION Blood arsenic levels displayed a negative association with the cognitive function of older adults. This finding shows that arsenic-related DNA methylation alterations are critical partial mediators that may serve as potential biomarkers for further mechanism-related studies. ANN NEUROL 2024;96:87-98.
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Affiliation(s)
- Yue Wei
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yan-Feng Zhou
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China
| | - Lili Xiao
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Jian Qin
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Hong Cheng
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Haiqing Cai
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Xing Chen
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yunfeng Zou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Li Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Haiying Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Zhiyong Zhang
- Department of Environmental Health and Occupational Medicine, Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath Research, Guilin Medical University, Guilin, China
| | - Xiaobo Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
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20
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Du Y, Luo Y, Ren Z, Gram LZ, Zheng X, Liu J. What impact does hearing impairment have on cognitive health in older married couples in China? Soc Sci Med 2024; 352:116999. [PMID: 38796949 DOI: 10.1016/j.socscimed.2024.116999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 04/10/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
Hearing impairment is a common geriatric health problem and chronic stressor, and it is associated with poor cognitive outcomes. However, little is known about the impact of hearing impairment in married couples, particularly its potential spillover effects on the cognitive health among spouses of individuals with impairment. Drawing on a stress-proliferation perspective, we used actor-partner interdependence models to examine (1) whether an individual's hearing impairment influences their spouse's cognitive function; and (2) whether AL, symptoms of depression, and social participation serve as mediators for such an association. We utilized data from the 2015 (baseline) and 2018 (3-year follow-up) waves of the China Health and Retirement Longitudinal Study. 4434 couples were included at baseline, and 2190 couples remained after the 3-year follow-up. Hearing impairment among married women was associated with negative impacts on their spouses' cognitive function. Symptoms of depression and social participation may have served as potential mediators in this relationship. For married men, there was no statistically significant association between hearing impairment and spouses' cognitive function. Our findings suggest that hearing impairment among one spouse can lead to negative impacts on the other, but that this effect may depend on gender. Early diagnosis and couple-based interventions for hearing impairment are important for the cognitive health of both hearing-impaired individuals and their spouses.
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Affiliation(s)
- Yushan Du
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Ziyang Ren
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lu Z Gram
- Institute for Global Health, University College London, London, United Kingdom
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
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21
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Sun Y, Xia Q, Du L, Gan Y, Ren X, Liu G, Wang Y, Yan S, Li S, Zhang X, Xiao X, Jin H. Neuroprotective effects of Anshen Bunao Syrup on cognitive dysfunction in Alzheimer's disease rat models. Biomed Pharmacother 2024; 176:116754. [PMID: 38810401 DOI: 10.1016/j.biopha.2024.116754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
Alzheimer's disease (AD) presents a significant challenge due to its prevalence and lack of cure, driving the quest for effective treatments. Anshen Bunao Syrup, a traditional Chinese medicine known for its neuroprotective properties, shows promise in addressing this need. However, understanding its precise mechanisms in AD remains elusive. This study aimed to investigate Anshen Bunao Syrup's therapeutic potential in AD treatment using a scopolamine-induced AD rat model. Assessments included novel-object recognition and Morris water maze tasks to evaluate spatial learning and memory, alongside Nissl staining and ELISA analyses for neuronal damage and biomarker levels. Results demonstrated that Anshen Bunao Syrup effectively mitigated cognitive dysfunction by inhibiting amyloid-β and phosphorylation Tau aggregation, thereby reducing neuronal damage. Metabolomics profiling of rats cortex revealed alterations in key metabolites implicated in tryptophan and fatty acid metabolism pathways, suggesting a role in the therapeutic effects of Anshen Bunao Syrup. Additionally, ELISA and correlation analyses indicated attenuation of oxidative stress and immune response through metabolic remodeling. In conclusion, this study provides compelling evidence for the neuroprotective effects of Anshen Bunao Syrup in AD models, shedding light on its potential as a therapeutic agent for AD prevention and treatment.
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Affiliation(s)
- Yuanfang Sun
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China; The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Qi Xia
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Lijing Du
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China; The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Yu Gan
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Xiaopeng Ren
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, China; Institute of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Gang Liu
- Jilin Aodong Yanbian Pharmaceutical Co., Ltd., Yanbian 133700, China
| | - Yongkuan Wang
- Jilin Aodong Yanbian Pharmaceutical Co., Ltd., Yanbian 133700, China
| | - Shikai Yan
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China; Institute of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Shasha Li
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Xiuyun Zhang
- Jilin Aodong Yanbian Pharmaceutical Co., Ltd., Yanbian 133700, China.
| | - Xue Xiao
- Institute of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China.
| | - Huizi Jin
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China.
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22
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Nagasawa K, Matsumura K, Uchida T, Suzuki Y, Nishimura A, Okubo M, Igeta Y, Kobayashi T, Sakurai T, Mori Y. Global cognition and executive functions of older adults with type 1 diabetes mellitus without dementia. J Diabetes Investig 2024; 15:922-930. [PMID: 38525910 PMCID: PMC11215676 DOI: 10.1111/jdi.14191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/23/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
AIMS/INTRODUCTION This study aimed to characterize the global cognition and executive functions of older adults with type 1 diabetes mellitus in comparison with type 2 diabetes mellitus. MATERIALS AND METHODS This study included 37 patients with type 1 diabetes mellitus aged ≥65 years and 37 age- and sex-matched patients with type 2 diabetes mellitus. Patients with dementia scoring <24 on the Mini-Mental State Examination were excluded. General cognition, memory, classic, and practical executive function were investigated. RESULTS Patients with type 1 diabetes mellitus demonstrated lower psychomotor speed scores on Trail Making Tests A and B (P < 0.001, P < 0.013) than those with type 2 diabetes mellitus. The dysexecutive syndrome behavioral assessment revealed similar results in patients with types 1 and 2 diabetes mellitus. The Wechsler Memory Scale-Revised verbal episodic memory and Montreal Cognitive Assessment Japanese version were similar in terms of general cognition, but worse delayed recall subset on the latter was associated with type 2 diabetes mellitus (P = 0.038). A worse Trail Making Test-A performance was associated with type 1 diabetes mellitus and age (P < 0.004, P < 0.029). CONCLUSIONS Executive function of psychomotor speed was worse in older outpatient adults without dementia with type 1 diabetes mellitus than in those with type 2 diabetes mellitus but with no significant differences in the comprehensive and practical behavioral assessment of dysexecutive syndrome. Patients with type 1 diabetes had more severely impaired executive function, whereas those with type 2 had greater impaired memory than executive function.
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Affiliation(s)
- Kaoru Nagasawa
- Department of Endocrinology and MetabolismToranomon HospitalTokyoJapan
| | - Kimio Matsumura
- Department of Endocrinology and MetabolismToranomon HospitalTokyoJapan
| | - Takayasu Uchida
- Department of Endocrinology and MetabolismToranomon HospitalTokyoJapan
| | - Yuya Suzuki
- Department of Endocrinology and MetabolismToranomon HospitalTokyoJapan
| | | | - Minoru Okubo
- Okinaka Memorial Institute for Medical ResearchTokyoJapan
| | | | | | - Takashi Sakurai
- Department of Prevention and Care Science, Research InstituteNational Center for Geriatrics and GerontologyObuJapan
| | - Yasumichi Mori
- Department of Endocrinology and MetabolismToranomon HospitalTokyoJapan
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23
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HUA Q, FAN L, WANG ZW, LI J. 2023 Guideline for the management of hypertension in the elderly population in China. J Geriatr Cardiol 2024; 21:589-630. [PMID: 38973827 PMCID: PMC11224653 DOI: 10.26599/1671-5411.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Affiliation(s)
| | - Qi HUA
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li FAN
- Chinese PLA General Hospital, Beijing, China
| | - Zeng-Wu WANG
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing LI
- Xuanwu Hospital, Capital Medical University, Beijing, China
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24
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Yang T, Liu W, He J, Gui C, Meng L, Xu L, Jia C. The cognitive effect of non-invasive brain stimulation combined with cognitive training in Alzheimer's disease and mild cognitive impairment: a systematic review and meta-analysis. Alzheimers Res Ther 2024; 16:140. [PMID: 38937842 PMCID: PMC11212379 DOI: 10.1186/s13195-024-01505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Non-invasive brain stimulation (NIBS) combined with cognitive training (CT) may have shown some prospects on improving cognitive function in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, data from clinical trials or meta-analysis involving NIBS combined with CT have shown controversial results. The aim of this systematic review and meta-analysis was to evaluate short-term and long-term effects of NIBS combined with CT on improving global cognition and other specific cognitive domains in patients with AD and MCI. METHODS This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five electronic databases including PubMed, Web of Science, EBSCO, Cochrane Library and Embase were searched up from inception to 20 November 2023. The PEDro scale and the Cochrane's risk of bias assessment were used to evaluate risk of bias and methodological quality of included studies. All statistical analyses were conducted with Review Manager 5.3. RESULTS We included 15 studies with 685 patients. The PEDro scale was used to assess methodological quality with a mean score of 7.9. The results of meta-analysis showed that NIBS combined with CT was effective on improving global cognition in AD and MCI (SMD = 0.52, 95% CI (0.18, 0.87), p = 0.003), especially for patients accepting repetitive transcranial magnetic stimulation (rTMS) combined with CT (SMD = 0.46, 95% CI (0.14, 0.78), p = 0.005). AD could achieve global cognition improvement from NIBS combined with CT group (SMD = 0.77, 95% CI (0.19, 1.35), p = 0.01). Transcranial direct current stimulation (tDCS) combined with CT could improve language function in AD and MCI (SMD = 0.29, 95% CI (0.03, 0.55), p = 0.03). At evaluation follow-up, rTMS combined with CT exhibited larger therapeutic responses to AD and MCI in global cognition (SMD = 0.55, 95% CI (0.09, 1.02), p = 0.02). AD could achieve global cognition (SMD = 0.40, 95% CI (0.03, 0.77), p = 0.03) and attention/working memory (SMD = 0.72, 95% CI (0.23, 1.20), p = 0.004) improvement after evaluation follow-up from NIBS combined with CT group. CONCLUSIONS Overall, NIBS combined with CT, particularly rTMS combined with CT, has both short-term and follow-up effects on improving global cognition, mainly in patients with AD. tDCS combined with CT has advantages on improving language function in AD and MCI. Future more studies need evaluate cognitive effects of NIBS combined with CT on other specific cognitive domain in patients with cognitive deterioration.
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Affiliation(s)
- Ting Yang
- Department of Rehabilitation Medicine, West China Tianfu Hospital, Sichuan University, No. 3966, South Section 2, Tianfu Avenue, Tianfu New Area, Chengdu, 610212, Sichuan, China
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Wentao Liu
- Department of Rehabilitation Medicine, West China Tianfu Hospital, Sichuan University, No. 3966, South Section 2, Tianfu Avenue, Tianfu New Area, Chengdu, 610212, Sichuan, China
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Jiali He
- Department of Rehabilitation Medicine, The Second Hospital of Chongzhou, No. 431, Tang'an West Road, Chongyang Town, Chongzhou City, Chengdu, 611230, Sichuan, China
| | - Chenfan Gui
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Lijiao Meng
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Li Xu
- Department of Rehabilitation Medicine, The Second Hospital of Chongzhou, No. 431, Tang'an West Road, Chongyang Town, Chongzhou City, Chengdu, 611230, Sichuan, China
| | - Chengsen Jia
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China.
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China.
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Li K, Ye H, Dong Z, Jilite A, Zhao M, Xu Q, Xu J. The Health and Economic Burden of Ozone Pollution on Alzheimer's Disease and Mild Cognitive Impairment in China. ENVIRONMENTAL RESEARCH 2024:119506. [PMID: 38944103 DOI: 10.1016/j.envres.2024.119506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/23/2024] [Accepted: 06/26/2024] [Indexed: 07/01/2024]
Abstract
Ozone pollution is increasingly recognized as a serious environmental threat that exacerbates dementia risks, including Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI). Amid rapid industrialization, China faces significant air quality challenges. However, there has been a scarcity of detailed studies assessing the health and economic impacts of ozone pollution on these conditions. This study aims to address this gap by utilizing the BenMap-CE tool and incorporating parameters obtained from systematic reviews of epidemiologic studies, official statistics, and weighted averages, to accurately quantify the effects of ozone exposure in China. This research evaluated the health and economic burdens at both national and provincial levels, focusing on the additional impacts attributed to increased ozone levels. The results reveal that in 2023, compared to 2015, ozone pollution contributed to approximately 110,000 new cases (5.6 per 10,000) of AD and 1.6 million new cases (81.7 per 10,000) of MCI, imposing significant economic costs of about 1,200 million USD for AD and 18,000 million USD for MCI, based on 2015 dollar values. Additionally, our projections indicate that reducing the 2023 ozone concentrations to 70 μg/m3 could significantly curb these conditions, potentially preventing over 210,000 new AD cases (10.7 per 10,000) and 2.9 million (148.1 per 10,000) MCI cases. Such reductions are projected to yield substantial economic benefits, estimated at 2,200 million USD for AD and 34,000 million USD for MCI (2015 dollar values). These findings underscore the profound implications of ozone pollution on public health and the economy in China, highlighting the urgent need for effective ozone management strategies to mitigate these impacts.
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Affiliation(s)
- Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Hong Ye
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Ziyu Dong
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Amu Jilite
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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26
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Liao L, Bai X, He X, Tan L, Yang L, Long H, Huang S, Li X, Han Y, Peng X, Chen H, Yang X, Li H, Wang S, Liu Y. Identification of formation mechanism and key elements of quality geriatric care behavior of nursing assistants in nursing homes: a grounded theory study. Front Public Health 2024; 12:1425883. [PMID: 38993701 PMCID: PMC11238187 DOI: 10.3389/fpubh.2024.1425883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/17/2024] [Indexed: 07/13/2024] Open
Abstract
Objectives This study aimed to identify the key elements and develop a formation mechanism model of quality geriatric care behavior for nursing assistants. Methods This qualitative research employed the strategy of grounded theory proposed by Strauss and Corbin. Furthermore, the data was collected by participatory observation and semi-structured interviews. A total of 12 nursing managers, 63 nursing assistants, and 36 older people from 9 nursing homes in 6 cities were interviewed, whereas for the observatory survey, participants were recruited from 2 nursing homes. Results The comparative and analysis process revealed 5 key elements of quality geriatric care behavior, including holistic care, personalized care, respect, positive interaction, and empowerment. Based on the Capability-Opportunity-Motivation-Behavior (COM-B) model, key elements and the 3 stages of quality geriatric care behavior (negative behavior cognition stage, practice exchange run-in stage, and positive behavior reinforcement stage), the theoretical framework of the formation mechanism was established. Conclusion The results indicated that nursing assistants' capabilities, motivation, and organizational and environmental support are vital for quality care behaviors. The theoretical framework established in this study provides theoretical support and practical reference to policymakers, institutional administrators, and healthcare professionals for improving nursing assistant's care behaviors.
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Affiliation(s)
- Lulu Liao
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xue Bai
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoxiao He
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lei Tan
- Jianghan District Social Welfare Institute, Wuhan, Hubei, China
| | - Linghua Yang
- Wuhan Social Welfare Institute, Wuhan, Hubei, China
| | - Huan Long
- Changsha First Social Welfare Institute, Changsha, Hunan, China
| | - Shenglan Huang
- Yueyang City Social Welfare Institute, Yueyang, Hunan, China
| | - Xia Li
- Xinyang City Shengde Nursing Home, Xinyang, Henan, China
| | - Ying Han
- Xianning Central Hospital, Xianning, Hubei, China
| | - Xiao Peng
- Health Science Center, Yangtze University, Jingzhou, Hubei, China
| | - Huijing Chen
- Personal Pension Business Department, Head Office, Ping An Pension Insurance, Shanghai, China
| | - Xiufen Yang
- Department of Geriatric, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Hui Li
- Department of Breast and Nail Surgery, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shuang Wang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Sun S, Lu W, Zhang C, Wang G, Hou Y, Zhou J, Wang Y. Folic acid and S-adenosylmethionine reverse Homocysteine-induced Alzheimer's disease-like pathological changes in rat hippocampus by modulating PS1 and PP2A methylation levels. Brain Res 2024; 1841:149095. [PMID: 38917878 DOI: 10.1016/j.brainres.2024.149095] [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: 01/25/2024] [Revised: 06/10/2024] [Accepted: 06/22/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Abnormally elevated homocysteine (Hcy) is recognized as a biomarker and risk factor for Alzheimer's disease (AD). However, the underlying mechanisms by which Hcy affects AD are still unclear. OBJECTIVES This study aimed to elucidate the effects and mechanisms by which Hcy affects AD-like pathological changes in the hippocampus through in vivo and in vitro experiments, and to investigate whether folic acid (FA) and S-adenosylmethionine (SAM) supplementation could improve neurodegenerative injuries. METHODS In vitro experiments hippocampal neurons of rat were treated with Hcy, FA or SAM for 24 h; while the hyperhomocysteinemia (HHcy) in Wistar rats was established by intraperitoneal injection of Hcy, and FA was added to feed. The expression of β-amyloid (Aβ), phosphorylated tau protein, presenilin 1 (PS1) at the protein level and the activity of protein phosphatase 2A (PP2A) were detected, the immunopositive cells for Aβ and phosphorylated tau protein in the rat hippocampus were also evaluated by immunohistochemical staining. RESULTS FA and SAM significantly repressed Hcy-induced AD-like pathological changes in the hippocampus, including the increased tau protein phosphorylation at Ser214, Ser396 and the expression of Aβ42. In addition, Hcy-induced PS1 expression increased at the protein level and PP2A activity decreased, while FA and SAM were able to retard that. CONCLUSIONS The increase in PS1 expression and decrease in PP2A activity may be the mechanisms underlying the Hcy-induced AD-like pathology. FA and SAM significantly repressed the Hcy-induced neurodegenerative injury by modulating PS1 and PP2A methylation levels.
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Affiliation(s)
- Shoudan Sun
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250031, China
| | - Wei Lu
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250031, China
| | - Chunhong Zhang
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250031, China
| | - Guanyu Wang
- Institute of Environmental and Operational Medicine, Tianjin 30050, China
| | - Yue Hou
- Institute of Environmental and Operational Medicine, Tianjin 30050, China
| | - Jian Zhou
- School of Public Health, Weifang Medical College, Weifang 261053, China.
| | - Yonghui Wang
- Institute of Environmental and Operational Medicine, Tianjin 30050, China.
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Sober J, Woods SP, Webber TA, Thompson Kamar JL, Beltran-Najera I, Gomez EM. Does Social Support Play a Role in the Expression and Everyday Functioning Impact of Apathy in HIV Disease? AIDS Behav 2024:10.1007/s10461-024-04424-w. [PMID: 38904928 DOI: 10.1007/s10461-024-04424-w] [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] [Accepted: 06/18/2024] [Indexed: 06/22/2024]
Abstract
Clinically notable apathy occurs in approximately one-third of persons living with HIV (PLWH). Drawing from psychological theory, this cross-sectional study examined the interplay between apathy and social support in persons with (n = 143) and without (n = 61) HIV disease. Analyses were conducted using multiple regression and mediation procedures with 95th percentile bootstrap confidence intervals. Positive HIV serostatus and lower social support were associated with more frequent apathy, independent of other mood symptoms. Social support did not moderate apathy's associations with everyday functioning among PLWH, but post hoc analyses revealed that apathy mediated the relationship between social support and everyday functioning among PLWH. Stronger social support may provide a buffer against the frequency of apathy symptoms in persons with and without HIV disease. The relationship between lower social support and poorer everyday functioning in HIV might be partly explained by apathy. Longitudinal research is needed to examine the mechanisms of these relationships.
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Affiliation(s)
- Jonathan Sober
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston, Houston, TX, USA.
- , 3695 Cullen Blvd, 126 Heyne Building, Suite 239D, Houston, TX, 77004-5022, USA.
| | - Troy A Webber
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Psychology, University of Houston, Houston, TX, USA
- Psychology Division, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer L Thompson Kamar
- Department of Psychology, University of Houston, Houston, TX, USA
- West Los Angeles VA Healthcare Center, Los Angeles, CA, USA
| | | | - Elliott M Gomez
- Department of Psychology, University of Houston, Houston, TX, USA
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Zhang Y, Zhu R, Ge L, Zhang X, Tian D, Pan F, Wang M, Cai G. Association of handgrip strength asymmetry and weakness with cognitive function: a nationally representative cohort study. Maturitas 2024; 187:108057. [PMID: 38908060 DOI: 10.1016/j.maturitas.2024.108057] [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: 10/16/2023] [Revised: 05/14/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To describe the association of handgrip strength asymmetry and weakness with cognitive function among Chinese middle-aged and older adults. STUDY DESIGN We used data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study. Handgrip strength was measured at baseline. Handgrip strength asymmetry was defined on the basis of the ratio of handgrip strength of the non-dominant hand to that of the dominant hand (i.e. non-dominant/dominant): a ratio of <0.9 defined as dominant handgrip strength asymmetry and >1.1 as non-dominant handgrip strength asymmetry. Weakness was defined as a handgrip strength of <28 kg for males or <18 kg for females. MAIN OUTCOME MEASURES Cognitive function with its two core dimensions (episodic memory and mental status) at each wave was assessed and standardized. RESULTS 9333 participants (48.3 % female, age 58.2 ± 9.0 years) were included. Non-dominant but not dominant handgrip strength asymmetry was significantly associated with poorer cognitive function at baseline (β = -0.121, -0.092, and -0.132 for mental status, episodic memory, and global cognition, respectively). In longitudinal analyses over 2 years, dominant handgrip strength asymmetry significantly slowed cognitive decline (β = -0.078 and -0.069 for mental status and global cognition, respectively), and non-dominant handgrip strength asymmetry accelerated cognitive decline (β = 0.053 and 0.043 for episodic memory and global cognition, respectively). Weakness was associated with poorer cognitive function at baseline and cognitive decline over 2, 4, and 7 years (all P < 0.05). CONCLUSIONS In middle-aged and older adults, non-dominant handgrip strength asymmetry and weakness were associated with poorer cognitive function and predicted accelerated cognitive decline. Dominant handgrip strength asymmetry may be beneficial for maintaining cognitive function.
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Affiliation(s)
- Youyou Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Rui Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Liru Ge
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Xiaoyue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Dalong Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Mengmeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China.
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
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Ding G, Lu M, Li J. BMI, weight change, appetite reduction and cognitive impairment of elderly patients with diabetes. Sci Rep 2024; 14:14050. [PMID: 38890509 PMCID: PMC11189497 DOI: 10.1038/s41598-024-65005-4] [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: 02/21/2024] [Accepted: 06/15/2024] [Indexed: 06/20/2024] Open
Abstract
Body weight is related to both diabetes and cognitive impairment; however, the associations between body mass index (BMI) and cognitive impairment have been reported less frequently among diabetes patients. A total of 1355 patients with type 2 diabetes aged ≥ 60 years were included in this study. The Montreal Cognitive Assessment (MoCA) was administered to assess participants' cognitive status. We collected self-reported body weight, weight loss and appetite loss data using questionnaires. Associations between body weight status (in childhood, midlife age, and late life), weight loss, appetite changes and cognitive impairment were explored using logistic regression. Among the participants, 41.7% exhibited cognitive impairment. Overweight in childhood and late life was associated with cognitive impairment among diabetes patients (OR 2.63, 95% CI 1.52-4.55; OR 1.32, 95% CI 1.03-1.69). Diabetes patients with cognitive impairment were more likely to report a body weight decline and appetite reduction in the past three months (OR 4.18, 95% CI 2.61-6.71; OR 4.41, 95% CI 2.67-7.29). Higher BMI, weight loss, and appetite reduction were positively correlated with cognitive impairment. Given the risk of cognitive impairment, we suggest that body weight and BMI decline should be monitored in patients with diabetes.
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Affiliation(s)
- Gongwu Ding
- Peking Union Medical College, No.9 Dongdansantiao, Beijing, 100730, China
| | - Meng Lu
- No. 8 Shijiazhuang Hospital, Shijiazhuang, 050080, China
| | - Jinlei Li
- Peking Union Medical College, No.9 Dongdansantiao, Beijing, 100730, China.
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Liu X, Li C, Jin S, Cao X, Hoogendijk EO, Han L, Xu X, Allore H, Feng Q, Zhang Q, Liu Z. Functional disability and receipt of informal care among Chinese adults living alone with cognitive impairment. Exp Gerontol 2024; 194:112490. [PMID: 38876449 DOI: 10.1016/j.exger.2024.112490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Adults with cognitive impairment are prone to living alone in large numbers but receive relatively little attention. This study aimed to evaluate whether living alone with cognitive impairment was associated with a higher burden of functional disability but lack of informal care. METHODS 982 observations of adults living alone with cognitive impairment and 50,695 observations of adults living with others and with normal cognition were identified from 4 waves (2011/2012, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS). A matched comparator was selected using propensity score matching (1:2). Functional disability included disability in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), and mobility. The time of receiving informal care was measured in monthly hours. RESULTS Adults living alone with cognitive impairment demonstrated significantly higher odds ratio of ADL disability (OR = 1.59, 95 % CI: 1.30, 1.95), IADL disability (OR = 1.19, 95 % CI: 1.00, 1.44), mobility disability (OR = 1.38, 95 % CI: 1.12, 1.70), but received fewer hours of informal care (β = -127.7 h per month, standard error = 25.83, P < 0.001), compared to the adults living with others and with normal cognition. CONCLUSIONS This study highlights the high burden of functional disability but low coverage of informal care among Chinese adults living alone with cognitive impairment and calls for more resources to be allocated to this vulnerable subpopulation to improve the functional health and to increase the provision of long-term care services.
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Affiliation(s)
- Xiaoting Liu
- Institute of Wenzhou, Zhejiang University, Wenzhou, Zhejiang, China; School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chenxi Li
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shuyi Jin
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xingqi Cao
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, the Netherlands
| | - Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Xin Xu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Heather Allore
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Qiushi Feng
- Department of Sociology, National University of Singapore, Singapore
| | - Qiqi Zhang
- The Center for Ageing and Health Study, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Zhao Z, Zhang J, Wu Y, Xie M, Tao S, Lv Q, Wang Q. Plasma IL-6 levels and their association with brain health and dementia risk: A population-based cohort study. Brain Behav Immun 2024; 120:430-438. [PMID: 38897328 DOI: 10.1016/j.bbi.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/04/2024] [Accepted: 06/16/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Recent studies have associated immune abnormalities with dementia. IL-6 is a crucial cytokine in inflammatory responses, and recent evidence has linked elevated IL-6 levels to changes in brain structure and cognitive decline. However, the connection between IL-6 levels, cognition, brain volumes, and dementia risk requires exploration in large prospective cohorts. METHODS This study utilized a longitudinal cohort from the UK Biobank to analyze the correlation between IL-6 expression levels, cognitive performance, and cortical and subcortical brain volumes through linear regression. Additionally, we assessed the association between IL-6 levels and long-term dementia risk using Cox regression analysis. We also used one-sample Mendelian randomization to analyze the impact of genetic predisposition of dementia on elevated IL-6 levels. RESULTS A total of 50,864 participants were included in this study, with 1,391 new cases of all-cause dementia identified. Higher plasma IL-6 levels are associated with cortical and subcortical atrophy in regions such as the fusiform, thalamus proper, hippocampus, and larger ventricle volumes. IL-6 levels are negatively associated with cognitive performance in pair matching, numeric memory, prospective memory, and reaction time tests. Furthermore, elevated IL-6 levels are linked to a 23-35 % increased risk of all-cause dementia over an average follow-up period of 13.2 years. The one-sample Mendelian randomization analysis did not show associations between the genetic predisposition of dementia and elevated IL-6 levels. CONCLUSIONS Increased IL-6 levels are associated with worse cognition, brain atrophy, and a heightened risk of all-cause dementia. Our study highlights the need to focus on the role of peripheral IL-6 levels in managing brain health and dementia risk.
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Affiliation(s)
- Zhengyang Zhao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jiashuo Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yulu Wu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Min Xie
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shiwan Tao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiuyue Lv
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiang Wang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Zhu W, Zhou X, Ren M, Yin W, Tang Y, Yin J, Sun Y, Zhu X, Sun Z. Process approach as a cognitive biomarker related to gray matter volume in mild cognitive impairment and Alzheimer's disease. BMC Neurol 2024; 24:199. [PMID: 38872077 PMCID: PMC11170873 DOI: 10.1186/s12883-024-03711-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Process approach is valuable for memory assessment in Alzheimer's disease (AD) and mild cognitive impairment (MCI), yet its underlying mechanisms remain elusive. This study aims to synergize the process approach with brain structure analysis to explore both the discriminative capacity and potential mechanisms underlying the process approach. METHODS 37 subjects of MCI, 35 subjects of AD and 38 subjects of healthy control (HC) were included. The process approach in Auditory Verbal Learning Test (AVLT), including discriminability (A'), response bias (B"D), semantic clustering (LBCsem) and serial clustering (LBCser) was performed. The gray matter volume (GMV) was analyzed by voxel-based morphometry. Receiver operating characteristic (ROC) analysis and partial correlations were conducted to explore the value of the process approach and investigate the relationship between the process approach, traditional indices of AVLT and GMV. RESULTS ROC analysis showed the value of A', B"D and LBCser in differentiating MCI and AD. Combining AVLT-Immediately Recall (AVLT-IR) and LBCser showed a higher value in diagnosing MCI. Partial correlations revealed that in the MCI group, A' and B"D were mainly positively associated with GMV of the hippocampus and temporal lobe. CONCLUSION This study indicated that the process approach is a promising cognitive biomarker to detect MCI and AD.
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Affiliation(s)
- Wenhao Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Xia Zhou
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Mengmeng Ren
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Wenwen Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Yating Tang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Jiabin Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Yue Sun
- Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Zhongwu Sun
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China.
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Li S, He X, Wu L, Tang X, Ouyang Y, Jing W, Yang Y, Yang J, Che K, Pan C, Chen X, Zhang X, Zheng X, Xu J, Liao S, Yin M, Ni J. The association of cognitive function and its changes with all-cause mortality among community-dwelling older adults. Front Aging Neurosci 2024; 16:1419235. [PMID: 38934019 PMCID: PMC11199401 DOI: 10.3389/fnagi.2024.1419235] [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: 04/17/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
Background The association of cognitive function, its changes, and all-cause mortality has not reached a consensus, and the independence of the association between changes in cognitive function and mortality remains unclear. The purpose of this study was to evaluate the longitudinal association between baseline cognitive function and cognitive changes over 1 year with subsequent all-cause mortality among the older adults aged 60 and above. Methods A prospective cohort study utilizing the Community Older Adults Health Survey data. Initiated in 2018, the study annually assessed all individuals aged 60+ in Dalang Town, Dongguan City. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). A total of 6,042 older adults individuals were included, and multivariate Cox proportional hazard models were used to examine cognitive function's impact on mortality. Results Participants' median age was 70 years, with 39% men. Over a median 3.08-year follow-up, 525 died. Mortality risk increased by 6% per MMSE score decrease (adjusted HR = 1.06, 95%CI: 1.05-1.08). Compared to those with normal cognitive function at baseline, participants with mild cognitive impairment and moderate to severe cognitive impairment had significantly higher mortality risks (adjusted HR = 1.40, 95%CI: 1.07-1.82; HR = 2.49, 95%CI: 1.91-3.24, respectively). The risk of death was 5% higher for each one-point per year decrease in cognitive function change rate (HR = 1.05, 95%CI: 1.02-1.08). Compared with participants with stable cognitive function, those with rapid cognitive decline had a 79% increased risk of death (adjusted HR = 1.79, 95% CI: 1.11-2.87), with baseline cognitive function influencing this relationship significantly (P for interaction = 0.002). Conclusion Baseline cognitive impairment and rapid cognitive decline are associated with higher all-cause mortality risks in Chinese older adults. Baseline function influences the mortality impact of cognitive changes.
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Affiliation(s)
- Shangjie Li
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xiuping He
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Liang Wu
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xinming Tang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Yijiang Ouyang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Wenyuan Jing
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Ya Yang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jiacheng Yang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Kechun Che
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Congcong Pan
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xiaoting Chen
- Community Health Center of Dongguan Songshan Lake (Public Health Office), Dongguan, China
| | - Xiaoxia Zhang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xueting Zheng
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jiahao Xu
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Shaobin Liao
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Mingjuan Yin
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jindong Ni
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
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Li S, Xiao Z. Recent Research Progress on the Use of Transcranial Magnetic Stimulation in the Treatment of Vascular Cognitive Impairment. Neuropsychiatr Dis Treat 2024; 20:1235-1246. [PMID: 38883416 PMCID: PMC11179638 DOI: 10.2147/ndt.s467357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/01/2024] [Indexed: 06/18/2024] Open
Abstract
Vascular Cognitive Impairment (VCI) is a condition where problems with brain blood vessels lead to a decline in cognitive abilities, commonly affecting the elderly and placing a significant burden on both patients and their families. Compared to medication and surgery, Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment option with fewer risks and side effects, making it particularly suitable for elderly patients. TMS not only assesses the excitability and plasticity of the cerebral cortex, but its effectiveness in treating Vascular Cognitive Impairment (VCI) and its subtypes has also been validated in numerous clinical trials worldwide. However, there is still a lack of review on the physiological mechanisms of TMS treatment for VCI and its specific clinical application parameters. Therefore, this article initially provided a brief overview of the risk factors, pathological mechanisms, and classification of VCI. Next, the article explained the potential physiological mechanisms of TMS in treating VCI, particularly its role in promoting synaptic plasticity, regulating neurotransmitter balance, and improving the function of the default mode network. Additionally, The article also summarizes the application of rTMS in treating VCI and its subtypes, VCI-related sleep disorders, and the use of TMS in follow-up studies of VCI patients, providing empirical evidence for the clinical application of TMS and rTMS technologies.
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Affiliation(s)
- Sijing Li
- Department of Neurology, Multi-Omics Research Center for Brain Disorders, the First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
- Clinical Research Center for Immune‑Related Encephalopathy of Hunan Province (The First Affiliated Hospital), Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Zijian Xiao
- Department of Neurology, Multi-Omics Research Center for Brain Disorders, the First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
- Clinical Research Center for Immune‑Related Encephalopathy of Hunan Province (The First Affiliated Hospital), Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
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Xu M, Wang X, Zhang Y, Ji N, Wang Q, Zhao T, Zhou C, Jia C. Profiling of the Proteins Interacting with Amyloid Beta Peptides in Clinical Samples by PACTS-TPP. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2024; 35:1310-1319. [PMID: 38780475 DOI: 10.1021/jasms.4c00083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The accumulation of amyloid beta (Aβ1-42) results in neurotoxicity and is strongly related to neurodegenerative disorders, especially Alzheimer's disease (AD), but the underlying molecular mechanism is still poorly understood. Therefore, there is an urgent need for researchers to discover the proteins that interact with Aβ1-42 to determine the molecular basis. Previously, we developed peptide-ligand-induced changes in the abundance of proTeinS (PACTS)-assisted thermal proteome profiling (TPP) to identify proteins that interact with peptide ligands. In the present study, we applied this technique to analyze clinical samples to identify Aβ1-42-interacting proteins. We detected 115 proteins that interact with Aβ1-42 in human frontal lobe tissue. Pathway enrichment analysis revealed that the differentially expressed proteins were involved mainly in neurodegenerative diseases. Further orthogonal validation revealed that Aβ1-42 interacted with the AD-associated protein mitogen-activated protein kinase 3 (MAPK3), and knockdown of the Aβ1-42 amyloid precursor protein (APP) inhibited the MAPK signaling pathway, suggesting potential functional roles for Aβ1-42 in interacting with MAPK3. Overall, this study demonstrated the application of the PACTS-TPP in clinical samples and provided a valuable data source for research on neurodegenerative diseases.
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Affiliation(s)
- Mengting Xu
- State Key Laboratory of Medical Proteomics, National Center for Protein Sciences-Beijing, Beijing Proteome Research Center, Beijing Institute of Lifeomics, Beijing, 102206, China
- School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui 230032, China
| | - Xiankun Wang
- State Key Laboratory of Medical Proteomics, National Center for Protein Sciences-Beijing, Beijing Proteome Research Center, Beijing Institute of Lifeomics, Beijing, 102206, China
| | - Yang Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Nan Ji
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, 100070, China
| | - Qianqian Wang
- State Key Laboratory of Medical Proteomics, National Center for Protein Sciences-Beijing, Beijing Proteome Research Center, Beijing Institute of Lifeomics, Beijing, 102206, China
| | - Ting Zhao
- State Key Laboratory of Medical Proteomics, National Center for Protein Sciences-Beijing, Beijing Proteome Research Center, Beijing Institute of Lifeomics, Beijing, 102206, China
| | - Congli Zhou
- State Key Laboratory of Medical Proteomics, National Center for Protein Sciences-Beijing, Beijing Proteome Research Center, Beijing Institute of Lifeomics, Beijing, 102206, China
| | - Chenxi Jia
- State Key Laboratory of Medical Proteomics, National Center for Protein Sciences-Beijing, Beijing Proteome Research Center, Beijing Institute of Lifeomics, Beijing, 102206, China
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Yang H, Chen J, Ye J, Zhou T, Wang W, Pan Y, Wei Y, Lu X, Yuan L, Wu S, Guo J, Xiao A. Factors influencing the level of insight and treatment attitude: a cross-sectional study of 141 elderly patients of major depression in Guangzhou, China. Front Psychiatry 2024; 15:1284559. [PMID: 38903641 PMCID: PMC11188475 DOI: 10.3389/fpsyt.2024.1284559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Objective To explore the insight, treatment attitude, and related influencing factors of hospitalized elderly patients suffering from major depression. Methods A total of 141 hospitalized elderly patients with depression were selected as the research objects. Insight was evaluated by the total score of the Insight and Treatment Attitude questionnaire (ITAQ). The data collected included sociodemographic characteristics, psychiatric symptoms, delirium status, social functioning, social support, suicide risk, and cognitive function. Results The sample included 74.5% of female patients, and the mean age was 67.53 (sd=7.19) years. The influencing factors of inpatients with depression included alcohol consumption, length of hospitalization, admission types, and the main caregivers (P<0.05). The various factors were further analyzed by linear regression, revealing that the insight and treatment attitude of elderly depressed hospitalized patients were mainly related to the Mini-Mental State Examination (MMSE) (β= 0.225, 95% CI 0.055-0.395, P=0.01), dependent on a caregiver (β=-5.810, 95% CI -8.086~-3.535, P<0.001), the type of admission (involuntary admission) (β=-3.365, 95% CI -5.448~-1.283, P=0.002), Functional Activities Questionnaire (FAQ) (β=-0.156, 95% CI -0.303~-0.010, P=0.037), and length of stay (≤28 days) (β=2.272, 95% CI 0.055~-4.489, P=0.045). Conclusion The level of insight was affected by cognitive function, involuntary admission, dependent on a caregiver, social function and length of stay. Future studies should focus on cognitive function recovery, observation of admission mode, and self-care ability in elderly patients with depression.
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Affiliation(s)
- Hang Yang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiao Chen
- Department of Geriatric Neurology, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Junrong Ye
- Department of Nursing Administration, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tingwei Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, China
- Department of Traditional Chinese Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen Wang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Yuanxin Pan
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Yanheng Wei
- Department of Nursing Administration, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xueling Lu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lexin Yuan
- Department of Nursing Administration, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shengwei Wu
- Department of Traditional Chinese Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jianxiong Guo
- Department of Chronic Diseases, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Aixiang Xiao
- Department of Nursing Administration, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Li Y, Xin J, Fang S, Wang F, Jin Y, Wang L. Development and Validation of a Predictive Model for Early Identification of Cognitive Impairment Risk in Community-Based Hypertensive Patients. J Appl Gerontol 2024:7334648241257795. [PMID: 38832577 DOI: 10.1177/07334648241257795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Objective: To investigate the risk factors for the development of mild cognitive dysfunction in hypertensive patients in the community and to develop a risk prediction model. Method: The data used in this study were obtained from two sources: the China Health and Retirement Longitudinal Study (CHARLS) and the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 1121 participants from CHARLS were randomly allocated into a training set and a validation set, following a 70:30 ratio. Meanwhile, an additional 4016 participants from CLHLS were employed for external validation of the model. The patients in this study were divided into two groups: those with mild cognitive impairment and those without. General information, employment status, pension, health insurance, and presence of depressive symptoms were compared between the two groups. LASSO regression analysis was employed to identify the most predictive variables for the model, utilizing 14-fold cross-validation. The risk prediction model for cognitive impairment in hypertensive populations was developed using generalized linear models. The model's discriminatory power was evaluated through the area under the receiver operating characteristic (ROC) curve and calibration curves. Results: In the modeling group, eight variables such as gender, age, residence, education, alcohol use, depression, employment status, and health insurance were ultimately selected from an initial pool of 21 potential predictors to construct the risk prediction model. The area under the curve (AUC) values for the training, internal, and external validation sets were 0.777, 0.785, and 0.782, respectively. All exceeded the threshold of 0.7, suggesting that the model effectively predicts the incidence of mild cognitive dysfunction in community-based hypertensive patients. A risk prediction model was developed using a generalized linear model in conjunction with Lasso regression. The model's performance was evaluated using the area under the receiver operating characteristic (ROC) curve. Hosmer-Lemeshow test values yielded p = .346 and p = .626, both of which exceeded the 0.05 threshold. Calibration curves demonstrated a significant agreement between the nomogram model and observed outcomes, serving as an effective tool for evaluating the model's predictive performance. Discussion: The predictive model developed in this study serves as a promising and efficient tool for evaluating cognitive impairment in hypertensive patients, aiding community healthcare workers in identifying at-risk populations.
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Affiliation(s)
- Yan Li
- Shanxi Medical University, Taiyuan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jimei Xin
- Shanxi Medical University, Taiyuan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Sen Fang
- Shanxi Medical University, Taiyuan, China
- Department of Geriatrics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Fang Wang
- Shanxi Medical University, Taiyuan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yufei Jin
- Shanxi Medical University, Taiyuan, China
- Department of Geriatrics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Lei Wang
- Shanxi Medical University, Taiyuan, China
- Department of Geriatrics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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Zhi S, Zhang S, Yang D, Sun J, Gao S, Song D, Ma D, Fang S, Zhong Q, Wu Y, Sun J. Cross-cultural adaptation and validation of the Australian National University Alzheimer Disease Risk Index (ANU-ADRI) for Chinese community-dwelling residents: A cross-sectional Study. Geriatr Nurs 2024; 58:225-231. [PMID: 38838404 DOI: 10.1016/j.gerinurse.2024.05.031] [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: 02/05/2024] [Revised: 05/19/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To cross-culturally adapt the Australian National University Alzheimer Disease Risk Index (ANU-ADRI) and verify the reliability and validity of its cognitive activity domain. METHODS According to Beaton's guidelines, the ANU-ADRI was were translated into Chinese. The psychometric properties of ANU-ADRI its cognitive activity was conducted among community-dwelling residents (n = 442) in Changchun, Harbin and Hegang from December 2021 to July 2023. RESULTS The Chinese version of the ANU-ADRI had good content validity and face validity. Exploratory factor analysis of cognitive activity revealed a 3-factor structure, with a cumulative variance contribution rate of 64.124 %. Confirmatory factor analysis revealed a good model fit (x2/df = 1.664, RMSEA = 0.055, RMR = 0.090, GFI = 0.942, CFI = 0.919, IFI = 0.921, TLI = 0.902, and NFI = 0.824). The internal consistency (Cronbach's α = 0.807) and test-retest reliability (ICC = 0.787) were considered satisfactory. CONCLUSION The ANU-ADRI showed acceptable reliability and validity for assessing risk factors for Alzheimer's disease among middle-aged and elderly community-dwelling residents.
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Affiliation(s)
- Shengze Zhi
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Shuang Zhang
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | | | - Juanjuan Sun
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Shizheng Gao
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Dongpo Song
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Dongfei Ma
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Shuyan Fang
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Qiqing Zhong
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Yifan Wu
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Jiao Sun
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China.
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Wu LY, Lu YY, Zheng SS, Cui YD, Lu J, Zhang AH. Associations between renal function, hippocampal volume, and cognitive impairment in 544 outpatients. Front Neurol 2024; 15:1347682. [PMID: 38895693 PMCID: PMC11185126 DOI: 10.3389/fneur.2024.1347682] [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: 12/07/2023] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Background Cognitive impairment and brain atrophy are common in chronic kidney disease patients. It remains unclear whether differences in renal function, even within normal levels, influence hippocampal volume (HCV) and cognition. We aimed to investigate the association between estimated glomerular filtration rate (eGFR), HCV and cognition in outpatients. Methods This single-center retrospective study enrolled 544 nonrenal outpatients from our hospital. All participants underwent renal function assessment and 3.0 T magnetic resonance imaging (MRI) in the same year. HCV was also measured, and cognitive assessments were obtained. The correlations between eGFR, HCV, and cognitive function were analyzed. Logistic regression analysis was performed to identify the risk factors for hippocampal atrophy and cognitive impairment. Receiver-operator curves (ROCs) were performed to find the cut-off value of HCV that predicts cognitive impairment. Results The mean age of all participants was 66.5 ± 10.9 years. The mean eGFR of all participants was 88.5 ± 15.1 mL/min/1.73 m2. eGFR was positively correlated with HCV and with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Univariate and multivariate logistic regression analysis showed Age ≥ 65 years, eGFR < 75 mL/min/1.73 m2, Glucose ≥6.1 mmol/L and combined cerebral microvascular diseases were independent risk factors for hippocampal atrophy and Age ≥ 65 years, left hippocampal volume (LHCV) <2,654 mm3 were independent risk factors for cognitive impairment in outpatients. Although initial unadjusted logistic regression analysis indicated that a lower eGFR (eGFR < 75 mL/min/1.73 m2) was associated with poorer cognitive function, this association was lost after adjusting for confounding variables. ROC curve analysis demonstrated that LHCV <2,654 mm3 had the highest AUROC [(0.842, 95% CI: 0.808-0.871)], indicating that LHCV had a credible prognostic value with a high sensitivity and specificity for predicting cognitive impairment compared with age in outpatients. Conclusion Higher eGFR was associated with higher HCV and better cognitive function. eGFR < 75 mL/min/1.73 m2 was an independent risk factor for hippocampal atrophy after adjusting for age. It is suggested that even eGFR < 75 mL/min/1.73 m2, lower eGFR may still be associated with hippocampal atrophy, which is further associated with cognitive impairment. LHCV was a favorable prognostic marker for predicting cognitive impairment rather than age.
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Affiliation(s)
- Lei-Yun Wu
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuan-Yuan Lu
- Department of Neurology and Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Shuang-Shuang Zheng
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Ya-Dong Cui
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Ai-Hua Zhang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China
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Zhao X, Zhang H, Yu J, Liu N. Independent and combined associations of handgrip strength and walking speed with cognitive function in older adults: evidence from a national cross-sectional study. Aging Ment Health 2024:1-8. [PMID: 38835194 DOI: 10.1080/13607863.2024.2360018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/21/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES Although there have been studies on the association of handgrip strength or walking speed alone with cognitive abilities, few studies have determined the combined associations of handgrip strength and walking speed with cognitive function. Therefore we aimed to explore the independent and combined associations of handgrip strength and walking speed with cognitive function in Chinese older adults using a nationally representative sample. METHOD This cross-sectional study included 4,577 adults aged 60 and older. Handgrip strength was measured using a dynamometer and walking speed was assessed using a 2.5-meter walking test. Both handgrip strength and walking speed were organized into low, normal, and high tertiles according to the sample distribution. Cognitive function was measured using the Telephone Interview for Cognitive Status. RESULTS Handgrip strength and walking speed were significantly associated with cognitive function. Participants with low handgrip strength or low walking speed separately had a higher rate of lower cognitive function (adjusted odds ratio (OR): 1.22 (95% CI: 1.04 - 1.44) for low handgrip strength; 1.54 (95% CI: 1.31 - 1.81) for low walking speed). Those with both low handgrip strength and low walking speed had an additively higher rate of lower cognitive function (adjusted OR: 1.72 (95% CI: 1.32 - 2.24)). CONCLUSION Having low handgrip strength or low walking speed is associated with a greater likelihood of lower cognitive function and vice versa. The concurrence of having low handgrip strength and low walking speed has an additive effect on cognitive function in older adults.
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Affiliation(s)
- Xiaoguang Zhao
- Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Hongjun Zhang
- School of Physical Education, Liaoning Finance and Trade College, Xingcheng, Liaoning, China
| | - Jiabin Yu
- Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Nan Liu
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
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Peng J, Mai Y, Liu J. Guideline for the cognitive assessment and follow-up in the Guangdong-Hong Kong-Macao Greater Bay Area (2024 edition). Aging Med (Milton) 2024; 7:258-268. [PMID: 38975298 PMCID: PMC11222743 DOI: 10.1002/agm2.12325] [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: 02/02/2024] [Revised: 04/10/2024] [Accepted: 05/29/2024] [Indexed: 07/09/2024] Open
Abstract
This practice guideline focuses on the cognitive assessment for mild cognitive impairment in the Guangdong-Hong Kong-Macao Greater Bay Area. To achieve the standardization and normalization of its clinical practice and generate individualized intervention, the National Core Cognitive Center of the Second Affiliated Hospital of Guangzhou Medical University, the Cognitive Disorders Branch of Chinese Geriatic Society, the Dementia Group of Neurology Branch of Guangdong Medical Association and specialists from Hong Kong and Macao developed guidelines based on China's actual conditions and efficiency, economic cost and accuracy. The article addresses the significance, background, and the process of the assessment and follow-up to realize the promotion and dissemination of cognitive assessment.
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Affiliation(s)
- Jialing Peng
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated HospitalGuangzhou Medical UniversityGuangzhouChina
| | - Yingreng Mai
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated HospitalGuangzhou Medical UniversityGuangzhouChina
| | - Jun Liu
- Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated HospitalGuangzhou Medical UniversityGuangzhouChina
- National Core Cognitive CenterThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
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Carotenuto A, Andreone V, Amenta F, Traini E. Effect of Treatment of the Cholinergic Precursor Choline Alphoscerate in Mild Cognitive Dysfunction: A Randomized Controlled Trial. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:925. [PMID: 38929542 PMCID: PMC11205363 DOI: 10.3390/medicina60060925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: The focus on mild cognitive dysfunction in adults is of great interest, given the risk of worsening and conversion to dementia. Cognitive dysfunctions are characterized by a decrease in the weight and volume of the brain, due to cortical atrophy, with a widening of the grooves and flattening of the convolutions. Brain atrophy that mainly involves the hippocampus is related to the progression of cognitive impairment and the conversion from mild cognitive dysfunction to dementia. Currently, there is no treatment for MCI. Results from a trial on Alzheimer's disease (ASCOMALVA trial) suggest that a sustained cholinergic challenge can slow the progression of brain atrophy typical of Alzheimer's disease associated with vascular damage. This study intends to evaluate the efficacy of choline alphoscerate in patients with mild cognitive impairment (MCI) and associated vascular damage, in stabilizing and/or slowing brain atrophy typical of adult-onset cognitive dysfunction, and in improving and/or slowing the progression of cognitive and behavioral symptoms associated with MCI. Materials and Methods: This randomized controlled trial will recruit 60 patients that will be evaluated and randomized in a 1:1 ratio to receive choline alphoscerate (1200 mg/day) or placebo, for 12 months. Analyses will be carried out using SPSS vesion No 26 the Statistician in charge of this study, with the statistical significance level chosen as 0.05. Discussion: This trial may provide evidence about the efficacy of treatment with the cholinergic precursor choline alphoscerate in patients with mild cognitive dysfunction. The results of this study will be published in peer-reviewed journals. Registration: EudraCT number: 2020-000576-38.
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Affiliation(s)
- Anna Carotenuto
- Telemedicine and Telepharmacy Centre, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (A.C.); (E.T.)
- Neurology and Stroke Unit-Neurology, A. Cardarelli Hospital, 80131 Naples, Italy;
| | - Vincenzo Andreone
- Neurology and Stroke Unit-Neurology, A. Cardarelli Hospital, 80131 Naples, Italy;
| | - Francesco Amenta
- Telemedicine and Telepharmacy Centre, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (A.C.); (E.T.)
| | - Enea Traini
- Telemedicine and Telepharmacy Centre, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (A.C.); (E.T.)
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Li B, Xu L, He R, Li Y, Li G, Deng Y, Wang Z, Li F, Li T, Rong S. Association of aquatic food consumption, long-chain polyunsaturated n-3 fatty acid intake, and blood mercury levels with cognitive function in middle-aged and older adults. Clin Nutr 2024; 43:1635-1642. [PMID: 38772070 DOI: 10.1016/j.clnu.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND & AIMS Aquatic food is rich in nutrients which benefit the human brain and cognitive health; however, concerns about heavy metal accumulation in aquatic food remain. This study evaluated the associations between aquatic food consumption, long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) intake, and blood mercury levels with cognition in middle-aged and older adults. METHODS This cross-sectional study used baseline data from the Lifestyle and Healthy Aging of Chinese Square Dancer Study. Aquatic food consumption and LC n-3 PUFAs intake were obtained from a food frequency questionnaire. Blood mercury levels were measured using inductively coupled plasma mass spectrometry. A composite z-score was developed to represent global cognition by averaging the z-scores for each cognitive domain. Participants with mild cognitive impairment (MCI) were diagnosed according to Petersen's criteria. Multivariate linear and logistic regression models were used to examine the association between the exposure factors and cognitive performance including cognitive scores and MCI. RESULTS Of 2621 middle-aged and older adults, the mean (SD) age was 63.71 (5.15) years, and 85.73% were females. Compared with the lowest quartile, those in the highest quartile for aquatic food consumption were associated with higher composite z-scores (β = 0.156, 95% CI: 0.088-0.225) and lower MCI odds (OR = 0.598, 95% CI: 0.425-0.841). A similar positive relationship between LC n-3 PUFAs intake and composite z-score and an inverse association between LC n-3 PUFAs intake and MCI were also observed. In addition, the participants in the highest quartile for blood mercury levels had higher composite z-scores than those in the lowest quartile. CONCLUSIONS In this cross-sectional study, higher aquatic food consumption, LC n-3 PUFAs intake, and blood mercury levels were related to better cognitive function. Further studies in Chinese populations are required to confirm these findings.
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Affiliation(s)
- Benchao Li
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China; Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan 430071, China; Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Lijuan Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China; Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan 430071, China
| | - Ruikun He
- BYHEALTH Institute of Nutrition & Health, Guangzhou 510663, China
| | - Yuanyuan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China; Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan 430071, China
| | - Guang Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yan Deng
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Ziping Wang
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Fengping Li
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China; Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan 430071, China
| | - Tingting Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China; Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan 430071, China; Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
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Chen S, Chen X, Hou X, Fang H, Liu GG, Yan LL. Temporal trends and disparities of population attributable fractions of modifiable risk factors for dementia in China: a time-series study of the China health and retirement longitudinal study (2011-2018). THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101106. [PMID: 38872868 PMCID: PMC11170192 DOI: 10.1016/j.lanwpc.2024.101106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/06/2024] [Accepted: 05/16/2024] [Indexed: 06/15/2024]
Abstract
Background In China, dementia poses a significant public health challenge, exacerbated by an ageing population and lifestyle changes. This study assesses the temporal trends and disparities in the population-attributable fractions (PAFs) of modifiable risk factors (MRFs) for new-onset dementia from 2011 to 2018. Methods We used data from the China Health and Retirement Longitudinal Study (CHARLS), covering 75,214 person-waves. We calculated PAFs for 12 MRFs identified by the Lancet Commission (including six early-to mid-life factors and six late-life factors). We also determined the individual weighted PAFs (IW-PAFs) for each risk factor. Subgroup analyses were conducted by sex, socio-economic status (SES), and geographic location. Findings The overall PAF for dementia MRFs had a slight increase from 45.36% in 2011 to 52.46% in 2018, yet this change wasn't statistically significant. During 2011-2018, the most contributing modifiable risk was low education (average IW-PAF 11.3%), followed by depression, hypertension, smoking, and physical inactivity. Over the eight-year period, IW-PAFs for risk factors like low education, hypertension, hearing loss, smoking, and air pollution showed decreasing trends, while others increased, but none of these changes were statistically significant. Sex-specific analysis revealed higher IW-PAFs for traumatic brain injury (TBI), social isolation, and depression in women, and for alcohol and smoking in men. The decline in IW-PAF for men's hearing loss were significant. Lower-income individuals had higher overall MRF PAFs, largely due to later-life factors like depression. Early-life factors, such as TBI and low education, also contributed to SES disparities. Rural areas reported higher overall MRF PAFs, driven by factors like depression, low education, and hearing loss. The study also found that the gap in MRF PAFs across different SES groups or regions either remained constant or increased over the study period. Interpretation The study reveals a slight but non-significant increase in dementia's MRF PAF in China, underscoring the persistent relevance of these risk factors. The findings highlight the need for targeted public health strategies, considering the demographic and regional differences, to effectively tackle and reduce dementia risk in China's diverse population. Funding This work was supported by the PKU Young Scholarship in Global Health and Development.
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Affiliation(s)
- Shanquan Chen
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Xi Chen
- School of Public Health, Yale University, New Haven, CT, United States
| | | | - Hai Fang
- Institute for Global Health and Development, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Gordon G. Liu
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Lijing L. Yan
- Institute for Global Health and Development, Peking University, Beijing, China
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
- School of Public Health, Wuhan University, Wuhan, China
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Wang Y, Wu Z, He Y, Zeng X, Gu Z, Zhou X, Si W, Chen D. Fat mass and obesity-associated protein regulates RNA methylation associated with spatial cognitive dysfunction after chronic cerebral hypoperfusion. Neuropeptides 2024; 105:102428. [PMID: 38583362 DOI: 10.1016/j.npep.2024.102428] [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: 02/20/2024] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 04/09/2024]
Abstract
RNA methylation can epigenetically regulate learning and memory. However, it is unclear whether RNA methylation plays a critical role in the pathophysiology of Vascular dementia (VD). Here, we report that expression of the fat mass and obesity associated gene (FTO), an RNA demethylase, is downregulated in the hippocampus in models of VD. Through prediction and dual-luciferase reporters validation studies, we observed that miRNA-711 was upregulated after VD and could bind to the 3'-untranslated region of FTO mRNA and regulate its expression in vitro. Methylated RNA immunoprecipitation (MeRIP)-qPCR assay and functional study confirmed that Syn1 was an important target gene of FTO. This suggests that FTO is an important regulator of Syn1. FTO upregulation by inhibition of miR-711 in the hippocampus relieves synaptic association protein and synapse deterioration in vivo, whereas FTO downregulation by miR-711 agomir in the hippocampus leads to aggravate the synapse deterioration. FTO upregulation by inhibition of miR-711 relieves cognitive impairment of rats VD model, whereas FTO downregulation by miR-711 deteriorate cognitive impairment. Our findings suggest that FTO is a regulator of a mechanism underlying RNA methylation associated with spatial cognitive dysfunction after chronic cerebral hypoperfusion.
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Affiliation(s)
- Yanqing Wang
- Department of Anatomy, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zimei Wu
- Department of Orthopedic Surgery, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China; School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Yuyang He
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Xiaoying Zeng
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zijuan Gu
- Shenzhen BaoAn District Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Xianxi Zhou
- Department of Anatomy, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenwen Si
- School of Integrated Chinese and Western Medicine, Anhui University of Chinese Medicine, Hefei, China.
| | - Dongfeng Chen
- Department of Anatomy, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.
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Chang J, Liu M, Liu C, Zhou S, Jiao Y, Sun H, Ji Y. Effects of vitamins and polyunsaturated fatty acids on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials. Eur J Nutr 2024; 63:1003-1022. [PMID: 38300291 PMCID: PMC11139751 DOI: 10.1007/s00394-024-03324-y] [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: 08/10/2022] [Accepted: 01/09/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE Vitamins and polyunsaturated fatty acids (PUFAs) have been studied extensively as safe and manageable nutrient interventions for mild cognitive impairment (MCI). The purpose of the current meta-analysis was to examine the effects of vitamins and PUFAs on cognition and to compare the effects of single and multiple nutrient subgroups in patients with MCI. METHODS Randomized controlled trials (RCTs) written in English and Chinese were retrieved from eight databases, namely, PubMed, CENTRAL, Embase, CINAHL, Web of Science, SinoMed, CNKI, and Wanfang Data, from their respective dates of inception until 16 July 2023. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool 2.0. Meta-analyses were performed to determine the standardized mean differences (SMDs) in global cognitive function, memory function, attention, visuospatial skills, executive function, and processing speed between the supplement and control groups using 95% confidence intervals (CI) and I2. Prospero registration number: CRD42021292360. RESULTS Sixteen RCTs that studied different types of vitamins and PUFAs were included. The meta-analysis revealed that vitamins affected global cognitive function (SMD = 0.58, 95% CI = [0.20, 0.96], P = 0.003), memory function (SMD = 2.55, 95% CI = [1.01, 4.09], P = 0.001), and attention (SMD = 3.14, 95% CI = [1.00, 5.28], P = 0.004) in patients with MCI, and PUFAs showed effects on memory function (SMD = 0.65, 95% CI = [0.32, 0.99], P < 0.001) and attention (SMD = 2.98, 95% CI = [2.11, 3.84], P < 0.001). Single vitamin B (folic acid [FA]: SMD = 1.21, 95% CI = [0.87, 1.55]) supplementation may be more effective than multiple nutrients (FA and vitamin B12: SMD = 0.71, 95% CI = [0.41, 1.01]; and FA combined with docosahexaenoic acid [DHA]: SMD = 0.58, 95% CI = [0.34, 0.83]) in global cognitive function. CONCLUSIONS FA, vitamin B6, vitamin B12, and vitamin D may improve global cognitive function, memory function, and attention in patients with MCI. Eicosapentaenoic acid (EPA) and DHA may improve memory function and attention. We also noted that FA may exert a greater effect than a vitamin B combination (FA and vitamin B12) or the combination of FA and DHA. However, because of the low evidence-based intensity, further trials are necessary to confirm these findings.
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Affiliation(s)
- Jing Chang
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, 1160 Shengli South Street of Xingqing District, Yinchuan, 750001, China
| | - Chang Liu
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Shiyu Zhou
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Yuchen Jiao
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Hongyu Sun
- School of Nursing, Peking University, 38 College Road, Haidian District, Beijing, 100191, China.
| | - Yan Ji
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China.
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Liu Y, Gao X, Zhang Y, Zeng M, Liu Y, Wu Y, Hu W, Lai Y, Liao J. Geographical variation in dementia prevalence across China: a geospatial analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101117. [PMID: 38974661 PMCID: PMC11225804 DOI: 10.1016/j.lanwpc.2024.101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/25/2024] [Accepted: 05/30/2024] [Indexed: 07/09/2024]
Abstract
Background Dementia poses great health and social challenges in China. Dementia prevalence may vary across geographic areas, while comparable estimations on provincial level is lacking. This study aims to estimate dementia prevalence by provinces across China, taking into account risk factors of individual level and potential spatial correlation of provinces. Methods In this study, 17,176 adults aged 50 years or older were included from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS 2018), covering 28 provinces, autonomous regions and municipalities. To improve provincial representativeness, we constructed provincial survey weights based on China 7th census (2020). The prevalence of dementia and 95% Bayesian credible intervals (BCIs) were estimated using a Bayesian conditional autoregressive (CAR) model with spatially varying coefficients of covariates. Findings The weighted prevalence of dementia at provincial level in China in 2018 ranged from 2.62% (95%BCI: 1.70%, 3.91%) to 13.53% (95%BCI: 8.82%, 20.93%). High dementia prevalence was concentrated in North China, with a prominent high-high cluster, while provinces of low prevalence were concentrated on East and South China, characterized by a low-low cluster. Ordered by the median estimation of prevalence, the top 10% of provinces, include Xinjiang, Jilin, and Beijing. Meanwhile, Fujian, Zhejiang, and Guangdong rank among the last. The association between dementia prevalence and drinking, smoking, social isolation, physical inactivity, hearing impairment, hypertension, and diabetes exhibits provincial variation. Interpretation Our study identifies a geospatial disparity in dementia prevalence and risk factor effects across China's provinces, with high-high and low-low clusters in some northern and southern provinces, respectively. The findings emphasize the need for targeted strategies, such as addressing hypertension and hearing impairment, in specific regions for more effective dementia prevention and treatment. Funding National Science Foundation of China/the Economic and Social Research Council, UK Research and Innovation joint call: Understanding and Addressing Health and Social Challenges for Ageing in the UK and China. UK-China Health And Social Challenges Ageing Project (UKCHASCAP): present and future burden of dementia, and policy responses (grant number 72061137003, ES/T014377/1).
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Affiliation(s)
- Yixuan Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Xinyuan Gao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yongjin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Minrui Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yuyang Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Yanjuan Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Weihua Hu
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100871, China
| | - Yingsi Lai
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Jing Liao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
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Jiang B, Liu Q, Li JP, Lin SN, Wan HJ, Yu ZW, Wang J, Zhuang W, Tang JH, Chen CH, Li FY, Bi M, Xiao NA, Zheng KM. Prevalence and risk factors for dementia and mild cognitive impairment among older people in Southeast China: a community-based study. BMC Geriatr 2024; 24:466. [PMID: 38807058 PMCID: PMC11134668 DOI: 10.1186/s12877-024-05054-6] [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: 01/29/2024] [Accepted: 05/08/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND With the aging population, the number of individuals with dementia in China is increasing rapidly. This community-based study aimed to investigate the prevalence and risk factors for dementia and mild cognitive impairment (MCI) among older adults in China. METHODS In this study, 20,070 individuals aged ≥ 65 were recruited between January 1, 2022, and February 1, 2023, from ten communities in Xiamen City, China. We collected data on age, sex, level of education, and medical history, as well as global cognition and functional status. The prevalence of dementia and MCI was examined, and the risk factors for different groups were assessed. RESULTS The overall prevalence of dementia and MCI was approximately 5.4% (95% confidence interval [CI], 5.1-5.7) and 7.7% (95% CI, 7.4-8.1), respectively. The results also indicated that dementia and MCI share similar risk factors, including older age, female sex, hypertension, and diabetes mellitus. Compared with individuals with no formal education, those with > 6 years of education had an odds ratio for MCI of 1.83 (95% CI, 1.49-2.25). We also found that only 5.5% of the positive participants chose to be referred to the hospital for further diagnosis and treatment during follow-up visits. CONCLUSIONS This study estimated the prevalence and risk factors for dementia and MCI among individuals aged ≥ 65 years in Southeast China. These findings are crucial for preventing and managing dementia and MCI in China.
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Affiliation(s)
- Bin Jiang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Qi Liu
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Jian-Peng Li
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Si-Ning Lin
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Hui-Juan Wan
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Zi-Wen Yu
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Jing Wang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Wei Zhuang
- Department of Neurology, Nanjing County Hospital, Zhangzhou, China
| | - Jia-Hui Tang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Cai-Hong Chen
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Fa-Yin Li
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Min Bi
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Xiamen Key Laboratory of Brain Center, Xiamen, China.
| | - Nai-An Xiao
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Department of Neurology, The Third Hospital of Xiamen, Xiamen, China.
| | - Kun-Mu Zheng
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Xiamen Key Laboratory of Brain Center, Xiamen, China.
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Miao W, Xiao Y, Lu Y, Sha J, Zheng C, Yang W, Qian X, Geng G. Correlation Between Lifestyle Patterns and Cognitive Function Among Community-Dwelling Older Chinese Adults in the Pre-Dementia Stages: A Latent Class Analysis. J Appl Gerontol 2024:7334648241255529. [PMID: 38806177 DOI: 10.1177/07334648241255529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
Lifestyle activity engagement is a modifiable factor for cognitive decline. We aimed to identify lifestyle patterns (LPs) among community-dwelling older adults in the pre-dementia stages and to explore the links between LPs, cognitive function, and individual characteristics. 702 older Chinese adults were recruited. Three LPs were identified by latent class analysis: active aging lifestyle pattern (AALP), leisure lifestyle pattern (LLP), and work-centered lifestyle pattern (WLP). AALP refers to participation in various activities that are meaningful to individuals and benefit their well-being. LLP is the pattern of activities aimed at recreation. WLP refers to the LP where individuals are most likely to engage in work-related activities. However, only AALP is protected against mild cognitive impairment (MCI). Multinomial logistic regression models revealed the differences in individual characteristics among participants with different LPs, indicating the importance of tailored intervention strategies. As a protective factor against MCI, AALP should be highlighted in community-based care.
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Affiliation(s)
- Weiwei Miao
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Yuhua Xiao
- The Second People's Hospital of Nantong, Nantong, China
| | | | - Jinghua Sha
- The Second People's Hospital of Nantong, Nantong, China
| | - Chen Zheng
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Wenwen Yang
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Xiangyun Qian
- Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China
| | - Guiling Geng
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
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