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Matison AP, Flood VM, Lam BCP, Lipnicki DM, Tucker KL, Preux PM, Guerchet M, d'Orsi E, Quialheiro A, Rech CR, Skoog I, Najar J, Rydberg Sterner T, Scarmeas N, Kosmidis MH, Yannakoulia M, Gureje O, Ojagbemi A, Bello T, Shahar S, Fakhruddin NNINM, Rivan NFM, Anstey KJ, Cherbuin N, Mortby ME, Ho R, Brodaty H, Sachdev PS, Reppermund S, Mather KA. Associations between fruit and vegetable intakes and incident depression in middle-aged and older adults from 10 diverse international longitudinal cohorts. J Affect Disord 2024; 359:373-381. [PMID: 38788860 DOI: 10.1016/j.jad.2024.05.096] [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: 02/04/2024] [Revised: 04/26/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Emerging observational evidence supports a role for higher fruit and vegetable intake in protecting against the development of depression. However, there is a scarcity of research in older adults or in low- to middle-income countries (LMICs). METHODS Participants were 7801 community-based adults (mean age 68.6 ± 8.0 years, 55.8 % female) without depression, from 10 diverse cohorts, including four cohorts from LMICs. Fruit and vegetable intake was self-reported via comprehensive food frequency questionnaire, short food questionnaire or diet history. Depressive symptoms were assessed using validated measures, and depression defined applying validated cut-offs. The associations between baseline fruit and vegetable intakes and incident depression over a follow-up period of three to nine years were examined using Cox regression. Analyses were performed by cohort with results meta-analysed. RESULTS There were 1630 cases of incident depression (21 % of participants) over 40,258 person-years of follow-up. Higher intake of fruit was associated with a lower risk of incident depression (HR 0.87, 95%CI [0.77, 0.99], I2 = 4 %). No association was found between vegetable intake and incident depression (HR 0.93, 95%CI [0.84, 1.04], I2 = 0 %). LIMITATIONS Diverse measures used across the different cohorts and the modest sample size of our study compared with prior studies may have prevented an association being detected for vegetable intake. CONCLUSIONS Our study supports a role for fruit, but not vegetable intake in protecting against depression. Research investigating different types of fruits and vegetables using standardised measures in larger cohorts of older adults from low- and middle-income countries is warranted.
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Affiliation(s)
- Annabel P Matison
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia.
| | - Victoria M Flood
- The University of Sydney, Faculty of Medicine and Health, New South Wales, Australia; University Centre for Rural Health, Northern Rivers, Lismore, University of Sydney, New South Wales, Australia
| | - Ben C P Lam
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Katherine L Tucker
- Department of Biomedical & Nutritional Sciences, Center for Population Health, University of Massachusetts Lowell, Lowell, USA
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Eleonora d'Orsi
- Federal University of Santa Catarina, Trindade University Campus, Florianópolis, Santa Catarina, Brazil
| | - Anna Quialheiro
- Federal University of Santa Catarina, Trindade University Campus, Florianópolis, Santa Catarina, Brazil; IA&Saúde - The Artificial Intelligence and Health Research Unit, Instituto Politécnico de Saúde do Norte, CESPU, Vila Nova de Famalicão, Portugal
| | - Cassiano R Rech
- Federal University of Santa Catarina, Program in Postgraduate Physical Education, Santa Catarina, Brazil
| | - Ingmar Skoog
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Jenna Najar
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Human Genetics, Genomics of Neurodegenerative Diseases and Aging at the Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Therese Rydberg Sterner
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Nikolaos Scarmeas
- Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Neurology, Columbia University, New York, NY, USA
| | - Mary H Kosmidis
- Lab of Neuropsychology & Behavioral Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Oye Gureje
- University of Ibadan, World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, Ibadan, Nigeria
| | - Akin Ojagbemi
- University of Ibadan, World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, Ibadan, Nigeria
| | - Toyin Bello
- University of Ibadan, World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, Ibadan, Nigeria
| | - Suzana Shahar
- Center for Healthy Ageing & Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Nik N I N M Fakhruddin
- Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Nurul F M Rivan
- Center for Healthy Ageing & Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Kaarin J Anstey
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Moyra E Mortby
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - Roger Ho
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, New South Wales, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry (3DN), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Karen A Mather
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
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2
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Xu X, Catts VS, Harris K, Wang N, Numbers K, Trollor J, Brodaty H, Sachdev PS, Schutte AE. The contribution of cumulative blood pressure load to dementia, cognitive function and mortality in older adults. J Hypertens 2024:00004872-990000000-00505. [PMID: 38989713 DOI: 10.1097/hjh.0000000000003808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
BACKGROUND Few studies evaluated the contribution of long-term elevated blood pressure (BP) towards dementia and deaths. We examined the association between cumulative BP (cBP) load and dementia, cognitive decline, all-cause and cardiovascular deaths in older Australians. We also explored whether seated versus standing BP were associated with these outcomes. METHODS The Sydney Memory and Aging Study included 1037 community-dwelling individuals aged 70-90 years, recruited from Sydney, Australia. Baseline data was collected in 2005-2007 and the cohort was followed for seven waves until 2021. cSBP load was calculated as the area under the curve (AUC) for SBP ≥140 mmHg divided by the AUC for all SBP values. Cumulative diastolic BP (cDBP) and pulse pressure (cPP) load were calculated using thresholds of 90 mmHg and 60 mmHg. Cox and mixed linear models were used to assess associations. RESULTS Of 527 participants with both seated and standing BP data (47.7% men, median age 77), 152 (28.8%) developed dementia over a mean follow-up of 10.5 years. Higher cPP load was associated with a higher risk of all-cause deaths, and cSBP load was associated with a higher risk of cardiovascular deaths in multivariate models (P for trend < 0.05). Associations between cPP load, dementia and cognitive decline lost statistical significance after adjustment for age. Differences between sitting and standing BP load were not associated with the outcomes. CONCLUSION Long-term cPP load was associated with a higher risk of all-cause deaths and cSBP load associated with a higher risk of cardiovascular deaths in older Australians.
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Affiliation(s)
- Xiaoyue Xu
- School of Population Health, Faculty of Medicine and Health
- The George Institute for Global Health
| | - Vibeke S Catts
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | | | | | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | - Julian Trollor
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
- Department of Developmental Disability Neuropsychiatry, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | - Aletta E Schutte
- School of Population Health, Faculty of Medicine and Health
- The George Institute for Global Health
- Hypertension in Africa Research Team; Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
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3
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Nielsen RL, Bornæs O, Iversen E, Strejby Christensen LW, Kallemose T, Jawad B, Rasmussen HH, Munk T, Lund TM, Andersen O, Houlind MB, Leegaard Andersen A, Tavenier J. Growth differentiation factor 15 (GDF15) levels are associated with malnutrition in acutely admitted older adults. Clin Nutr 2024; 43:1685-1693. [PMID: 38879915 DOI: 10.1016/j.clnu.2024.06.005] [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: 04/05/2024] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND AND AIMS The aging process is often accompanied by high risk of malnutrition and elevated levels of growth differentiation factor 15 (GDF15). GDF15 is an increasingly recognized biomarker for regulation of metabolism, but few studies have investigated the connection between GDF15 and malnutrition in older age and how it relates to other features of aging such as decreased appetite and physical function. Therefore, we investigated the associations between GDF15 levels and nutritional status, appetite, and physical function in acutely admitted older adults. METHODS Plasma GDF15 levels were measured using immunoassays in 302 older adults (≥65 years) admitted to the emergency department (ED). Nutritional status was evaluated with the Mini Nutritional Assessment Short-Form (MNA®-SF), appetite was evaluated with the Simplified Nutritional Appetite Questionnaire (SNAQ), and physical function was evaluated with handgrip strength (HGS), 30-s chair stand test (30s-RSS), and gait speed (GS). Associations between GDF15 and each outcome was determined by logistic regression adjusted for age, sex, and C-reactive protein (CRP). RESULTS Each doubling in plasma GDF15 level was associated with an adjusted odds ratio (OR) (95% confidence interval) of 1.59 (1.10-2.29, P = 0.01) for risk of malnutrition compared to normal nutrition and 1.19 (0.85-1.69, P = 0.3)) for malnutrition compared to risk of malnutrition. Each doubling in GDF15 was associated with an adjusted OR of 1.63 (1.21-2.23)) for having poor appetite, 1.46 (1.07-1.99) for having low HGS, 1.74 (1.23-2.51) for having low 30s-RSS, and 1.99 (1.39-2.94) for having low GS. CONCLUSION Among older adults admitted to the ED, higher GDF15 levels were significantly associated with malnutrition, poor appetite, and low physical function independent of age, sex, and CRP.
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Affiliation(s)
- Rikke Lundsgaard Nielsen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Olivia Bornæs
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Esben Iversen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Louise Westberg Strejby Christensen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; The Capital Region Pharmacy, Marielundvej 25, 2730 Herlev, Denmark.
| | - Thomas Kallemose
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Baker Jawad
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Henrik Højgaard Rasmussen
- Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg University, 9220 Aalborg, Denmark; The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital-Herlev and Gentofte, 2100 Copenhagen, Denmark.
| | - Tina Munk
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital-Herlev and Gentofte, 2100 Copenhagen, Denmark.
| | - Trine Meldgaard Lund
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Emergency Department, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
| | - Morten Baltzer Houlind
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; The Capital Region Pharmacy, Marielundvej 25, 2730 Herlev, Denmark; Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
| | - Aino Leegaard Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Juliette Tavenier
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
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4
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Van Asbroeck S, Köhler S, van Boxtel MPJ, Lipnicki DM, Crawford JD, Castro‐Costa E, Lima‐Costa MF, Blay SL, Shifu X, Wang T, Yue L, Lipton RB, Katz MJ, Derby CA, Guerchet M, Preux P, Mbelesso P, Norton J, Ritchie K, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Dardiotis T, Rolandi E, Davin A, Rossi M, Gureje O, Ojagbemi A, Bello T, Kim KW, Han JW, Oh DJ, Trompet S, Gussekloo J, Riedel‐Heller SG, Röhr S, Pabst A, Shahar S, Rivan NFM, Singh DKA, Jacobsen E, Ganguli M, Hughes T, Haan M, Aiello AE, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Gao Q, Brodaty H, Trollor J, Kochan N, Lobo A, Santabárbara J, Gracia‐Garcia P, Sachdev PS, Deckers K. Lifestyle and incident dementia: A COSMIC individual participant data meta‐analysis. Alzheimers Dement 2024; 20:3972-3986. [PMID: 38676366 PMCID: PMC11180928 DOI: 10.1002/alz.13846] [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: 09/14/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis. RESULTS A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed. DISCUSSION Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups. HIGHLIGHTS A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.
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Grants
- AG03949 NIH HHS
- Netherlands Programme for Research on Aging (NESTOR)
- The Alzheimer's Association Zenith Award
- 2009BAI77B03 China Ministry of Science and Technology
- CRC2017ZD02 Clinical Research Center, Shanghai Mental Health Center
- 03/0815 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- R01 AG057531 NIA NIH HHS
- Greek National Resources
- DCP-2017-002/1 Universiti Kebangsaan Malaysia Grand Challenge
- 20H04030 JSPS KAKENHI
- Stiftelsen Professor Bror Gadelius' Minnesfond
- 01/0255 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- The Alzheimer's Association Stephanie B Overstreet Scholars
- AgeCap-Center for Aging and Health
- The Bank of Sweden Tercentenary Foundation
- European Social Fund
- HJSV2023023 Stiftelsens Hjalmar Svenssons forskningsfond
- 06/0617 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Fondo de Investigación Sanitaria
- R37AG02365 NIH/NIA
- Instituto de Salud Carlos III
- Epilife
- 16/00896 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- B15_23R Gobierno de Aragón
- B15_17R Gobierno de Aragón
- G03/128 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- AG03949 NIH/NIA
- LRGS/BU/2012/UKM-UKM/K/01 Long-term Research Grant Scheme (LGRS) Ministry of Higher Education, Malaysia
- Limoges University Hospital Appel à Projet des Equipes Émergentes et Labellisées scheme (APREL)
- 189 10276/8/9/2011 Alzheimer's Association
- NMRC/1108/2007 National Medical Research Council
- 97/1321E Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- AG03949 NIA NIH HHS
- Swedish Brain Power
- FORTE
- 2012-Project Public Health Institute [Inserm]-PREUXPierre-Marie AXA Research Fund
- National Strategic Reference Framework (NSFR) - EU Program Excellence Grant (ARISTEIA)
- PI16/00896 Fondo Europeo de Desarrollo Regional (FEDER) of the European Union "Una manera de hacer Europa"
- Shanghai Brain Health Foundation
- JP17K09146 JSPS KAKENHI
- NMRC/CIRG/1409/2014 National Medical Research Council
- AF-967865 Alzheimersfonden
- R37AG02365 NIH HHS
- HJSV2022059 Stiftelsens Hjalmar Svenssons forskningsfond
- 98/0103 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- RF1AG057531 NIH HHS
- Riksbankens Jubileumsfond
- Handlanden Hjalmar Svenssons Forskningsfond
- Stiftelsen för Gamla Tjänarinnor
- P01 AG003949 NIA NIH HHS
- IIRG-09-133014 Alzheimer's Association
- LRGS/1/2019/UM-UKM/1/4 Long-term Research Grant Scheme (LGRS) Ministry of Higher Education, Malaysia
- Wellcome Trust
- Swedish Research Council
- Leonard and Sylvia Marx Foundation
- Maastricht University Medical Center
- 733050511 Netherlands Organisation for Health Research and Development (ZonMw)
- BMRC/08/1/21/19/567 Agency for Science Technology and Research (A*STAR) Biomedical Research Council
- Associazione Alzheimer Milano
- 2017-0557 Fondazione CARIPLO, FrailBioTrack Project
- DCP-2017-002/2 Universiti Kebangsaan Malaysia Grand Challenge
- PI/19/01874 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- 72660 ALF-agreement
- 12/02254 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Ministry for Health and Social Solidarity (Greece)
- 94/1562 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- 01KS9504 Interdisciplinary Centre for Clinical Research University of Leipzig (Interdisziplinäres Zentrum für Klinische Forschung/IZKF)
- Czap Foundation
- ANR-09-MNPS-009-01 French National Research Agency
- Stiftelsen Söderström-Königska Sjukhemmet
- National Institute on Aging
- National Institutes of Health
- Wellcome Trust
- Gobierno de Aragón
- Alzheimer's Association
- National Medical Research Council
- French National Research Agency
- AXA Research Fund
- Riksbankens Jubileumsfond
- FORTE
- Swedish Brain Power
- Swedish Research Council
- Stiftelsen för Gamla Tjänarinnor
- Instituto de Salud Carlos III
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Affiliation(s)
- Stephanie Van Asbroeck
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Martin P. J. van Boxtel
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - John D. Crawford
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | | | | | - Sergio Luis Blay
- Department of PsychiatryFederal University of São PauloSão PauloBrazil
| | - Xiao Shifu
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Tao Wang
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Department of Psychiatry & Affective Disorders CenterRuijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Ling Yue
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Richard B. Lipton
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Psychiatry and Behavioral MedicineAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Mindy J. Katz
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Carol A. Derby
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
| | - Pierre‐Marie Preux
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
| | - Pascal Mbelesso
- Department of NeurologyAmitié HospitalBanguiCentral African Republic
| | - Joanna Norton
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, InsermMontpellierFrance
| | - Karen Ritchie
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, InsermMontpellierFrance
- Institut du Cerveau TrocadéroParisFrance
| | - Ingmar Skoog
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
| | - Jenna Najar
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
- Department of Clinical GeneticsSection Genomics of Neurodegenerative Diseases and Aging, Vrije Universiteit Amsterdam, Amsterdam UMCAmsterdamThe Netherlands
| | - Therese Rydberg Sterner
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Department of NeurobiologyAging Research CenterCare Sciences and Society, Karolinska Institute and Stockholm UniversityStockholmSweden
| | - Nikolaos Scarmeas
- 1st Department of NeurologyAiginition Hospital, Medical School, National and Kapodistrian University of AthensAthensGreece
- Department of NeurologyTaub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia UniversityNew YorkNew YorkUSA
| | - Mary Yannakoulia
- Department of Nutrition and DieteticsHarokopio UniversityAthensGreece
| | | | - Elena Rolandi
- Golgi Cenci FoundationMilanItaly
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | | | | | - Oye Gureje
- Department of PsychiatryWHO Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, University of IbadanIbadanNigeria
| | - Akin Ojagbemi
- Department of PsychiatryCollege of Medicine University of IbadanIbadanNigeria
| | - Toyin Bello
- Department of PsychiatryCollege of Medicine University of IbadanIbadanNigeria
| | - Ki Woong Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamRepublic of Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulRepublic of Korea
- Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulRepublic of Korea
| | - Ji Won Han
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamRepublic of Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulRepublic of Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineSeoulRepublic of Korea
| | - Stella Trompet
- Department of Internal Medicinesection of Gerontology and GeriatricsLeiden University Medical CenterLeidenthe Netherlands
| | - Jacobijn Gussekloo
- Department of Internal Medicinesection of Gerontology and GeriatricsLeiden University Medical CenterLeidenthe Netherlands
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenthe Netherlands
| | - Steffi G. Riedel‐Heller
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Susanne Röhr
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
- Health and Ageing Research Team (HART), School of Psychology, Massey UniversityPalmerston NorthAotearoa New Zealand
- Global Brain Health Institute (GBHI), Trinity College DublinDublinIreland
| | - Alexander Pabst
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Suzana Shahar
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Nurul Fatin Malek Rivan
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Erin Jacobsen
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Mary Ganguli
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Departments of Neurology, and EpidemiologyUniversity of Pittsburgh School of Medicine and School of Public HealthPittsburghPennsylvaniaUSA
| | - Tiffany Hughes
- Department of Graduate Studies in Health and Rehabilitation SciencesBitonte College of Health and Human Services, Youngstown State UniversityYoungstownOhioUSA
| | - Mary Haan
- Department of Epidemiology and BiostatisticsSchool of Medicine, University of California San FranciscoSan FranciscoCaliforniaUSA
| | - Allison E. Aiello
- Columbia Aging Center and the Department of EpidemiologyMailman School of Public Health, Columbia UniversityNew YorkNew YorkUSA
| | - Ding Ding
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Qianhua Zhao
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Zhenxu Xiao
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of TechnologyHigashi‐kuFukuokaJapan
| | - Tao Chen
- Department of Physical EducationSports and Health Research CenterTongji UniversityShanghaiChina
| | - Sanmei Chen
- Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHiroshimaJapan
| | - Tze Pin Ng
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Xinyi Gwee
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Qi Gao
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - Julian Trollor
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
- Department of Developmental Disability NeuropsychiatryDiscipline of Psychiatry and Mental Health, University of New South WalesSydneyNew South WalesAustralia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - Antonio Lobo
- Department of Medicine and PsychiatryUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
| | - Javier Santabárbara
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
- Department of Public HealthUniversidad de ZaragozaZaragozaSpain
| | - Patricia Gracia‐Garcia
- Department of Medicine and PsychiatryUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
- Neuropsychiatric Institute, The Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Kay Deckers
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
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Chan LLY, Delbaere K, Numbers K, Lam B, Menant J, Sturnieks DL, Trollor JN, Brodie MA, Lord SR. Poor mobility and lower limb weakness are associated with three distinct depressive symptom trajectories over 6 years in older people. Australas J Ageing 2024; 43:333-342. [PMID: 38217882 DOI: 10.1111/ajag.13273] [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: 12/27/2022] [Revised: 11/03/2023] [Accepted: 11/24/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES Physical decline can be associated with the onset of depressive symptoms in later life. This study aimed to identify physical and lifestyle risk factors for depressive symptom trajectories in community-dwelling older adults. METHODS Participants were 553 people aged 70-90 years who underwent baseline physical, psychological and lifestyle assessments. Group-based trajectory analysis was used to identify patterns of depressive symptom development over 6 years of follow-up. Strengths of associations between baseline functional test performances and depressive symptom trajectories were evaluated with univariable ordinal models. Subsequently, the adjusted cumulative odds ratio for the association between identified risk factors, demographic factors and baseline anti-depressant use were measured using multivariable ordinal logistic regression. RESULTS Three distinct depressive symptom trajectories were identified: a low-and-stable course (10% of participants), a low-and-increasing course (81%) and a moderate-and-increasing course (9%). Timed Up and Go test time was the strongest risk factor of depressive symptom trajectory, followed by Five Times Sit-to-Stand test performance, planned physical activity levels, and knee extension strength (adjusted standardised ORs 1.65, 95% CI 1.34-2.04; 1.44, 95% CI 1.16-1.77; 1.44, 95% CI 1.17-1.76 and 1.41, 95% CI 1.15-1.73 respectively). After adjusting for age, sex, body mass index and baseline anti-depressant use, Timed Up and Go test performance and knee extension strength were independently and significantly associated with depressive trajectories. CONCLUSIONS Timed Up and Go test times, Five Times Sit-to-Stand test performance, planned physical activity levels and knee extension strength are associated with three discrete depressive symptom trajectories. These clinical tests may help identify older adults aged 70-90 years at risk of developing depressive symptoms and help guide subsequent strength and mobility interventions.
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Affiliation(s)
- Lloyd L Y Chan
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Ben Lam
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew A Brodie
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Mewton L, Visontay R, Hughes G, Browning C, Wen W, Topiwala A, Draper B, Crawford JD, Brodaty H, Sachdev PS. Longitudinal alcohol-related brain changes in older adults: The Sydney Memory and Ageing Study. Addict Biol 2024; 29:e13402. [PMID: 38797559 PMCID: PMC11128337 DOI: 10.1111/adb.13402] [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: 11/09/2023] [Revised: 03/25/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024]
Abstract
Increases in harmful drinking among older adults indicate the need for a more thorough understanding of the relationship between later-life alcohol use and brain health. The current study investigated the relationships between alcohol use and progressive grey and white matter changes in older adults using longitudinal data. A total of 530 participants (aged 70 to 90 years; 46.0% male) were included. Brain outcomes assessed over 6 years included total grey and white matter volume, as well as volume of the hippocampus, thalamus, amygdala, corpus callosum, orbitofrontal cortex and insula. White matter integrity was also investigated. Average alcohol use across the study period was the main exposure of interest. Past-year binge drinking and reduction in drinking from pre-baseline were additional exposures of interest. Within the context of low-level average drinking (averaging 11.7 g per day), higher average amount of alcohol consumed was associated with less atrophy in the left (B = 7.50, pFDR = 0.010) and right (B = 5.98, pFDR = 0.004) thalamus. Past-year binge-drinking was associated with poorer white matter integrity (B = -0.013, pFDR = 0.024). Consuming alcohol more heavily in the past was associated with greater atrophy in anterior (B = -12.73, pFDR = 0.048) and posterior (B = -17.88, pFDR = 0.004) callosal volumes over time. Across alcohol exposures and neuroimaging markers, no other relationships were statistically significant. Within the context of low-level drinking, very few relationships between alcohol use and brain macrostructure were identified. Meanwhile, heavier drinking was negatively associated with white matter integrity.
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Affiliation(s)
- Louise Mewton
- The Matilda Centre for Mental Health and Substance Use, Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
| | - Rachel Visontay
- The Matilda Centre for Mental Health and Substance Use, Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
| | - Gerard Hughes
- Centre for Healthy Brain Ageing, Faculty of Medicine and HealthUniversity of New South WalesSydneyAustralia
| | - Catherine Browning
- Centre for Healthy Brain Ageing, Faculty of Medicine and HealthUniversity of New South WalesSydneyAustralia
| | - Wei Wen
- Centre for Healthy Brain Ageing, Faculty of Medicine and HealthUniversity of New South WalesSydneyAustralia
| | - Anya Topiwala
- Nuffield Department Population Health, Big Data InstituteUniversity of OxfordOxfordUK
| | - Brian Draper
- Centre for Healthy Brain Ageing, Faculty of Medicine and HealthUniversity of New South WalesSydneyAustralia
| | - John D. Crawford
- Centre for Healthy Brain Ageing, Faculty of Medicine and HealthUniversity of New South WalesSydneyAustralia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Faculty of Medicine and HealthUniversity of New South WalesSydneyAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, Faculty of Medicine and HealthUniversity of New South WalesSydneyAustralia
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Litkouhi PN, Numbers K, Valenzuela M, Crawford JD, Lam BCP, Litkouhi PN, Sachdev PS, Kochan NA, Brodaty H. Critical periods for cognitive reserve building activities for late life global cognition and cognitive decline: the Sydney memory and aging cohort study. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:387-403. [PMID: 36852741 DOI: 10.1080/13825585.2023.2181941] [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: 12/01/2022] [Accepted: 02/14/2023] [Indexed: 03/01/2023]
Abstract
Cognitive, social, and physical activities, collectively linked to cognitive reserve, are associated with better late-life cognitive outcomes. To better understand the building of cognitive reserve, we investigated which of these activities, during which stages of life, had the strongest associations with late-life cognitive performance. From the Sydney Memory and Aging Study, 546 older Australians, who were community-dwelling and without a dementia diagnosis at recruitment (Mage 80.13 years, 52.2% female), were asked about their engagement in social, physical, and cognitive activities throughout young adulthood (YA), midlife (ML), and late-life (LL). Comprehensive neuropsychological testing administered biennially over 6 years measured baseline global cognition and cognitive decline. In our study, YA, but not ML nor LL, cognitive activity was significantly associated with late-life global cognition (β = 0.315, p < .001). A follow-up analysis pointed to the formal education component of the YA cognitive activity measure, rather than YA cognitive leisure activities, as a significant predictor of better late-life global cognition (β = 0.146, p = .003). YA social activity and LL cognitive activity were significantly associated with less cognitive decline (β = 0.023, p < .001, and β = 0.016, p = .022, respectively). Physical activity was not found to be associated with global cognition or cognitive decline. Overall, YA cognitive activity was associated with better late-life cognition, and YA social and LL cognitive activities were associated with less cognitive decline. Formal education emerges as the key contributor in the association between YA cognitive activity and late-life global cognition.
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Affiliation(s)
- Princess Neila Litkouhi
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Katya Numbers
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | | | - John D Crawford
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | | | - Perminder S Sachdev
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
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Chantanachai T, Sturnieks DL, Lord SR, Menant J, Delbaere K, Sachdev PS, Brodaty H, Humburg P, Taylor ME. Cognitive and physical declines and falls in older people with and without mild cognitive impairment: a 7-year longitudinal study. Int Psychogeriatr 2024; 36:306-316. [PMID: 37078463 DOI: 10.1017/s1041610223000315] [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: 04/21/2023]
Abstract
OBJECTIVES We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI). DESIGN Prospective cohort study with assessments every 2 years (for up to 6 years). SETTING Community, Sydney, Australia. PARTICIPANTS Four hundred and eighty one people were classified into three groups: those with MCI at baseline and MCI or dementia at follow-up assessments (n = 92); those who fluctuated between cognitively normal and MCI throughout follow-up (cognitively fluctuating) (n = 157), and those who were cognitively normal at baseline and all reassessments (n = 232). MEASUREMENTS Cognitive and physical function measured over 2-6 years follow-up. Falls in the year following participants' final assessment. RESULTS In summary, 27.4%, 38.5%, and 34.1% of participants completed 2, 4, and 6 years follow-up of cognitive and physical performance, respectively. The MCI and cognitive fluctuating groups demonstrated cognitive decline, whereas the cognitively normal group did not. The MCI group had worse physical function than the cognitively normal group at baseline but decline over time in physical performance was similar across all groups. Decline in global cognitive function and sensorimotor performance were associated with multiple falls in the cognitively normal group and decline in mobility (timed-up-and-go test) was associated with multiple falls across the whole sample. CONCLUSIONS Cognitive declines were not associated with falls in people with MCI and fluctuating cognition. Declines in physical function were similar between groups and decline in mobility was associated with falls in the whole sample. As exercise has multiple health benefits including maintaining physical function, it should be recommended for all older people. Programs aimed at mitigating cognitive decline should be encouraged in people with MCI.
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Affiliation(s)
- Thanwarat Chantanachai
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Peter Humburg
- Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia
| | - Morag E Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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9
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Truong QC, Cervin M, Choo CC, Numbers K, Bentvelzen AC, Kochan NA, Brodaty H, Sachdev PS, Medvedev ON. Examining the validity of the Mini-Mental State Examination (MMSE) and its domains using network analysis. Psychogeriatrics 2024; 24:259-271. [PMID: 38131467 DOI: 10.1111/psyg.13069] [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: 06/06/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The Mini-Mental State Examination (MMSE) is the most widely used standardised screener for impairments across a range of cognitive domains. However, the degree to which its domains (orientation, registration, attention, recall, language, and visuospatial) capture cognitive functioning measured using standardised neuropsychological tests is unclear. METHOD A longitudinal research design with four biannual assessments over a 6-year period was used with an initial sample of 1037 older adults (aged above 70 years). Participants completed MMSE and neuropsychological tests at each assessment. Network analysis was utilised to investigate unique associations among the MMSE and its domains and neuropsychological test performance at each time point. RESULTS The total MMSE and two of its domains, language and recall, were associated with neuropsychological memory performance. The MMSE orientation, registration and visuospatial domains did not have any unique associations with neuropsychological performance. No stable internal interconnections between MMSE domains were found over time. The association of total MMSE as well as its recall domain with neuropsychological memory performance remained very similar over the 6-year period. CONCLUSIONS The present study adds evidence to the validity of the MMSE and supports the clinical usage of the MMSE, whereby the total score is used for screening patients with or without cognitive impairments, with repeated administration to monitor cognitive changes over time, to inform intervention. However, the tool is not able to diagnose the cases for changes in specific cognitive domains and as such, should not replace a complete neuropsychological assessment.
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Affiliation(s)
| | - Matti Cervin
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden
| | - Carol C Choo
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Adam C Bentvelzen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Oleg N Medvedev
- University of Waikato, School of Psychology, Hamilton, New Zealand
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10
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Truong QC, Choo C, Numbers K, Merkin AG, Sachdev PS, Feigin VL, Brodaty H, Kochan NA, Medvedev ON. Enhancing precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) using Rasch methodology. Int Psychogeriatr 2024; 36:166-176. [PMID: 34794521 DOI: 10.1017/s1041610221002568] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to investigate psychometric properties and enhance precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) up to interval-level scale using Rasch methodology. DESIGN Partial Credit Rasch model was applied to the IQCODE-16 scores using longitudinal data spanning 10 years of biennial follow-up. SETTING Community-dwelling older adults aged 70-90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study (MAS). PARTICIPANTS The sample included 400 participants of the MAS aged 70 years and older, 109 out of those were diagnosed with dementia 10 years after the baseline assessment. MEASUREMENTS The IQCODE-16. RESULTS Initial analysis indicated excellent reliability of the IQCODE-16, Person Separation Index (PSI) = 0.92, but there were four misfitting items and local dependency issues. Combining locally dependent items into four super-items resulted in the best Rasch model fit with no misfitting or locally dependent items, strict unidimensionality, strong reliability, and invariance across person factors such as participants' diagnosis and relationship to their informants, as well as informants' age and sex. This permitted the generation of conversion algorithms to transform ordinal scores into interval data to enhance precision of measurement. CONCLUSIONS The IQCODE-16 demonstrated strong reliability and satisfied expectations of the unidimensional Rasch model after minor modifications. Ordinal-to-interval transformation tables published here can be used to increase accuracy of the IQCODE-16 without altering its current format. These findings could contribute to enhancement of precision in assessing clinical conditions such as cognitive decline in older people.
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Affiliation(s)
- Quoc Cuong Truong
- School of Psychology, University of Waikato, Hamilton, New Zealand
- Faculty of Psychology, Vietnam National University Ho Chi Minh City, University of Social Sciences and Humanities, Ho Chi Minh City, Vietnam
| | - Carol Choo
- College of Healthcare Sciences, Division of Tropical Health and Medicine, James Cook University, Queensland, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Alexander G Merkin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
- Centre for Precise Psychiatry and Neurosciences, Kaufbeuren, Germany
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Oleg N Medvedev
- School of Psychology, University of Waikato, Hamilton, New Zealand
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11
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Zeng M, Cicuttini F, Lim YZ, Samaras K, Brodaty H, Sachdev PS, Crawford JD, Wang Y. Associations of Osteoarthritis with Prevalence and Incidence of Cardiovascular Disease over 10 Years in Community-Dwelling Older Adults: The Sydney Memory and Ageing Study. Gerontology 2024; 70:351-360. [PMID: 38330922 PMCID: PMC11006274 DOI: 10.1159/000537721] [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: 07/13/2023] [Accepted: 02/02/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION The data are limited for the association between osteoarthritis (OA) and cardiovascular disease (CVD) in community-based older populations and whether there is sex difference. This study aimed to examine the relationship between OA and prevalence and incidence of CVD over 10 years in community-dwelling older adults. METHODS Data on self-reported OA, high cholesterol, hypertension, and type 2 diabetes were collected from 1,025 community-dwelling participants aged 70-90 years in the Sydney Memory and Ageing Study. The presence of CVD at baseline was defined as self-reported presence of stroke, heart attack, transient ischaemic attack, angina, aortic aneurysm, or claudication. The incidence of CVD was defined by a combination of incident self-reported CVD or CVD mortality at different follow-up timepoints over 10 years. RESULTS At baseline, 395 (38.5%) participants self-reported OA (252 [44.6%] women, 143 [31.1%] men). Self-reported OA was associated with increased prevalence of CVD in women (OR 1.67, 95% CI 1.12-2.47) but not men (1.26, 0.80-1.98). In the total population, self-reported OA at baseline was associated with increased incidence of CVD at 4 years (OR 1.77, 95% CI 1.10-2.83), 6 years (1.59, 1.03-2.46), 8 years (1.56, 1.02-2.38), and 10 years (1.66, 1.10-2.50), but not at 2 years (1.43, 0.79-2.57). Significant associations were observed in female participants at 4, 8, and 10 years, with no significant associations seen in male participants. CONCLUSION OA was associated with increased prevalence at baseline and incidence of CVD over 10 years in community-based older adults, especially women. Identifying those with OA to target their cardiovascular risk factors while managing their OA has the potential to reduce the burden of CVD in older people, particularly women.
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Affiliation(s)
- Mengjie Zeng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
| | - Flavia Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuan Z Lim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Katherine Samaras
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia
- St Vincent's Clinical School, University of New South Wales Sydney, Kensington, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales Sydney, Kensington, New South Wales, Australia
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales Sydney, Kensington, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales Sydney, Kensington, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales Sydney, Kensington, New South Wales, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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12
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Kalam S, Numbers K, Lipnicki DM, Lam BCP, Brodaty H, Reppermund S. The combination of olfactory dysfunction and depression increases the risk of incident dementia in older adults. Int Psychogeriatr 2024; 36:130-141. [PMID: 37264675 DOI: 10.1017/s1041610223000480] [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: 06/03/2023]
Abstract
OBJECTIVES Olfactory dysfunction and depression are common in later life, and both have been presented as risk factors for dementia. Our purpose was to investigate the associations between these two risk factors and determine if they had an additive effect on dementia risk. DESIGN Olfactory function was assessed using the Brief Smell Identification Test (BSIT), and depression was classified using a combination of the 15-item Geriatric Depression Scale (GDS) score and current antidepressant use. Cross-sectional associations between depression and olfactory function were examined using correlations. Cox regression analyses were conducted to examine the longitudinal relationship between olfaction and depression and incident dementia across 12-years of follow-up. PARTICIPANTS Participants were 780 older adults (aged 70-90 years; 56.5% female) from the Sydney Memory and Ageing Study (MAS) without a diagnosis of dementia at baseline. RESULTS Partial correlation revealed a nonsignificant association between baseline depression and olfactory function after accounting for covariates (r = -.051, p = .173). Cox regression showed that depression at baseline (hazard ratio = 1.706, 95% CI 1.185-2.456, p = .004) and lower BSIT scores (HR = .845, 95%CI .789-.905, p < .001) were independently associated with a higher risk of incident dementia across 12 years. Entering both predictors together improved the overall predictive power of the model. CONCLUSIONS Lower olfactory identification scores and depressive symptoms predict incident dementia over 12 years. The use of BSIT scores and depression in conjunction provides a greater ability to predict dementia than either used alone. Assessment of olfactory function and depression screening may provide clinical utility in the early detection of dementia.
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Affiliation(s)
- Shafi Kalam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Public Health, La Trobe University, VIC, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
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13
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Lin K, Wen W, Lipnicki DM, Mewton L, Chen R, Du J, Wang D, Skoog I, Sterner TR, Najar J, Kim KW, Han JW, Kim JS, Ng TP, Ho R, Chua DQL, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Kochan N, Sachdev PS, Jiang J. Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: The COSMIC consortium. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12567. [PMID: 38487075 PMCID: PMC10937819 DOI: 10.1002/dad2.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well documented in populations of different ethnicities and/or from different geographical regions. METHODS We investigated how WMHs were associated with vascular risk factors and cognition in both Whites and Asians, using data from five population-based cohorts of non-demented older individuals from Australia, Singapore, South Korea, and Sweden (N = 1946). WMH volumes (whole brain, periventricular, and deep) were quantified with UBO Detector and harmonized using the ComBat model. We also harmonized various vascular risk factors and scores for global cognition and individual cognitive domains. RESULTS Factors associated with larger whole brain WMH volumes included diabetes, hypertension, stroke, current smoking, body mass index, higher alcohol intake, and insufficient physical activity. Hypertension and stroke had stronger associations with WMH volumes in Whites than in Asians. No associations between WMH volumes and cognitive performance were found after correction for multiple testing. CONCLUSION The current study highlights ethnic differences in the contributions of vascular risk factors to WMHs.
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Affiliation(s)
- Keshuo Lin
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Wei Wen
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Darren M. Lipnicki
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Louise Mewton
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rory Chen
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Jing Du
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Dadong Wang
- Quantitative Imaging Research TeamCSIRO Informatics and StatisticsNorth RydeNew South WalesAustralia
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Psychiatry, Cognition and Old Age Psychiatry ClinicSahlgrenska University HospitalGothenburgSweden
| | - Therese Rydberg Sterner
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Section Genomics of Neurodegenerative Diseases and AgingDepartment of Human GeneticsAmsterdam Universitair Medische CentraAmsterdamthe Netherlands
| | - Ki Woong Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulSouth Korea
- Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulSouth Korea
| | - Ji Won Han
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulSouth Korea
| | - Jun Sung Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Tze Pin Ng
- Department of Psychological MedicineKhoo Teck Puat HospitalYishunSingapore
- Geriatric Education and Research InstituteMinistry of HealthSingaporeSingapore
| | - Roger Ho
- Institute for Health Innovation and Technology (iHealthtech)National University of SingaporeSingaporeSingapore
| | - Denise Qian Ling Chua
- Department of Psychological MedicineNational University of SingaporeSingaporeSingapore
| | - Kaarin J. Anstey
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Department of NeurodegenerationNeuroscience Research AustraliaSydneyNew South WalesAustralia
- Ageing Futures InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population HealthCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Moyra E. Mortby
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Department of NeurodegenerationNeuroscience Research AustraliaSydneyNew South WalesAustralia
- Ageing Futures InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Henry Brodaty
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nicole Kochan
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
- Neuropsychiatric InstituteThe Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Jiyang Jiang
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
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14
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Sprague B, Zhu X, Rosso A, Verghese J, Delbaere K, Lipnicki D, Sachdev P, Ng T, Gwee X, Yap K, Kim KW, Han J, Oh D, Narazaki K, Chen T, Chen S, Brodaty H, Numbers K, Kochan N, Walker R, Paddick SM, Gureje O, Ojagbemi A, Bello T, Rosano C. Correlates of Gait Speed Among Older Adults From 6 Countries: Findings From the COSMIC Collaboration. J Gerontol A Biol Sci Med Sci 2023; 78:2396-2406. [PMID: 36975099 PMCID: PMC10692426 DOI: 10.1093/gerona/glad090] [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: 06/13/2022] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Few studies have compared gait speed and its correlates among different ethnogeographic regions. The goals of this study were to describe usual and rapid gait speed, and identify their correlates across Australian, Asian, and African countries. METHODS We used data from 6 population-based cohorts of adults aged 65+ from 6 countries and 3 continents (N = 6 472), with samples ranging from 231 to 1 913. All cohorts are members of the Cohort Studies of Memory in an International Consortium collaboration. We investigated whether clinical (body mass index [BMI], hypertension, stroke, apolipoprotein status), psychological (cognition, mood, general health), and behavioral factors (smoking, drinking, physical activity) correlated with usual (N = 4 cohorts) and rapid gait speed (N = 3 cohorts) similarly across cohorts. Regression models were controlled for age, sex, and education, and were sex-stratified. RESULTS Age- and sex-standardized usual gait speed means ranged from 0.61 to 1.06 m/s and rapid gait speed means ranged from 1.16 to 1.64 m/s. Lower BMI and better cognitive function consistently correlated with faster gait speed in all cohorts. Less consistently, not having hypertension and greater physical activity engagement were associated with faster gait speed. Associations with mood, smoking, and drinking were largely nonsignificant. These patterns were not attenuated by demographics. There was limited evidence that the associations differed by sex, except physical activity, where the greater intensity was associated with usual gait among men but not women. CONCLUSIONS This study is among the first to describe the usual and rapid gait speeds across older adults in Africa, Asia, and Australia.
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Affiliation(s)
- Briana N Sprague
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Tze Pin Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong Hospital, Singapore, Singapore
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai, China
| | - Sanmei Chen
- Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Richard W Walker
- Department of Medicine, North Tyneside General Hospital, North Shields, UK
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute; Newcastle University, Newcastle upon Tyne, UK
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
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15
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Powell A, Lam BCP, Foxe D, Close JCT, Sachdev PS, Brodaty H. Frequency of cognitive "super-aging" in three Australian samples using different diagnostic criteria. Int Psychogeriatr 2023:1-17. [PMID: 37997622 DOI: 10.1017/s1041610223000935] [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] [Indexed: 11/25/2023]
Abstract
OBJECTIVES To investigate the frequency of exceptional cognition (cognitive super-aging) in Australian older adults using different published definitions, agreement between definitions, and the relationship of super-aging status with function, brain imaging markers, and incident dementia. DESIGN Three longitudinal cohort studies. SETTING Participants recruited from the electoral roll, Australian Twins Registry, and community advertisements. PARTICIPANTS Older adults (aged 65-106) without dementia from the Sydney Memory and Ageing Study (n = 1037; median age 78), Older Australian Twins Study (n = 361; median age 68), and Sydney Centenarian Study (n = 217; median age 97). MEASUREMENTS Frequency of super-aging was assessed using nine super-aging definitions based on performance on neuropsychological testing. Levels of agreement between definitions were calculated, and associations between super-aging status for each definition and functioning (Bayer ADL score), structural brain imaging measures, and incident dementia were explored. RESULTS Frequency of super-aging varied between 2.9 and 43.4 percent with more stringent definitions associated with lower frequency. Agreement between different criteria varied from poor (K = 0.04, AC1 = .24) to very good (K = 0.83, AC1 = .91) with better agreement between definitions using similar tests and cutoffs. Super-aging was associated with better functional performance (4.7-11%) and lower rates of incident dementia (hazard ratios 0.08-0.48) for most definitions. Super-aging status was associated with a lower burden of white matter hyperintensities (3.8-33.2%) for all definitions. CONCLUSIONS The frequency of super-aging is strongly affected by the demographic and neuropsychological testing parameters used. Greater consistency in defining super-aging would enable better characterization of this exceptional minority.
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Affiliation(s)
- Alice Powell
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - David Foxe
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Jacqueline C T Close
- Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
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16
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Mahalingam G, Samtani S, Lam BCP, Lipnicki DM, Lima-Costa MF, Blay SL, Castro-Costa E, Shifu X, Guerchet M, Preux PM, Gbessemehlan A, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Riedel-Heller S, Dardiotis T, Röhr S, Kim KW, Pabst A, Shahar S, Numbers K, Ganguli M, Hughes TF, Chang CCH, Crowe M, Ng TP, Gwee X, Chua DQL, Rymaszewska J, Wolf-Ostermann K, Welmer AK, Stafford J, Mélis R, Vernooij-Dassen M, Jeon YH, Sachdev PS, Brodaty H. Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing. Alzheimers Dement 2023; 19:5114-5128. [PMID: 37102417 PMCID: PMC10603208 DOI: 10.1002/alz.13072] [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: 01/10/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Previous meta-analyses have linked social connections and mild cognitive impairment, dementia, and mortality. However, these used aggregate data from North America and Europe and examined a limited number of social connection markers. METHODS We used individual participant data (N = 39271, Mage = 70.67 (40-102), 58.86% female, Meducation = 8.43 years, Mfollow-up = 3.22 years) from 13 longitudinal ageing studies. A two-stage meta-analysis of Cox regression models examined the association between social connection markers with our primary outcomes. RESULTS We found associations between good social connections structure and quality and lower risk of incident mild cognitive impairment (MCI); between social structure and function and lower risk of incident dementia and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality. DISCUSSION Different aspects of social connections - structure, function, and quality - are associated with benefits for healthy aging internationally. HIGHLIGHTS Social connection structure (being married/in a relationship, weekly community group engagement, weekly family/friend interactions) and quality (never lonely) were associated with lower risk of incident MCI. Social connection structure (monthly/weekly friend/family interactions) and function (having a confidante) were associated with lower risk of incident dementia. Social connection structure (living with others, yearly/monthly/weekly community group engagement) and function (having a confidante) were associated with lower risk of mortality. Evidence from 13 longitudinal cohort studies of ageing indicates that social connections are important targets for reducing risk of incident MCI, incident dementia, and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality.
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Affiliation(s)
- Gowsaly Mahalingam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Suraj Samtani
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
- School of Psychology and Public Health, La Trobe University Melbourne, UNSW Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Sergio Luis Blay
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | - Erico Castro-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Antoine Gbessemehlan
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | | | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Health and Ageing Research Team, School of Psychology, Massey University, Palmerston, New Zealand
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Mary Ganguli
- Departments of Psychiatry, Epidemiology, and Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Chung-Chou H. Chang
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tze Pin Ng
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Denise Qian Ling Chua
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | | | - Karin Wolf-Ostermann
- Department of Health Services and Nursing Science Research, Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Anna-Karin Welmer
- Aging Research Center & Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jean Stafford
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - René Mélis
- Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Gelderland, The Netherlands
| | | | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
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Harrison F, Mortby ME, Mather KA, Sachdev PS, Brodaty H. Apathy as a determinant of health behaviors in older adults: Implications for dementia risk reduction. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12505. [PMID: 38026759 PMCID: PMC10668002 DOI: 10.1002/dad2.12505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 08/04/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Long-term improvements in physical inactivity and other behavioral risk factors are integral to dementia risk reduction; however, sustained behavior change is challenging. Apathy, depression, and fatigue may impact engagement in health behaviors, but their presentation overlaps. This study investigates whether these symptoms are differentially associated with multiple health behaviors. METHODS In 1037 community-dwelling older adults without dementia (aged 70-90, 55% women), regression analyses examined apathy, depression, and fatigue as predictors of health behaviors (physical activity, diet, alcohol, smoking) and a behavioral risk index. RESULTS Apathy was associated with reduced physical activity and alcohol use, and one or multiple behavioral risk factors. No or inconsistent relations were found between depression or fatigue and health behaviors. DISCUSSION Apathy is relevant to multiple health behaviors and should be considered when designing health promotion for older adults, including interventions for dementia risk reduction. Findings highlight the importance of distinguishing apathy from comorbid symptoms. Highlights Novel theory-based perspective on behavioural risk factors for dementia.Higher apathy predicted less physical activity and alcohol use, and increased odds of lifestyle risk factors.Depressive symptoms were not associated with any health behavior.Apathy may be a determinant of multiple health behaviors in older adults, distinct from depression and fatigue.Considering apathy in precision prevention of dementia appears warranted.
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Affiliation(s)
- Fleur Harrison
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
| | - Moyra E. Mortby
- School of Psychology, UNSW SydneySydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures Institute, UNSW SydneySydneyNew South WalesAustralia
| | - Karen A. Mather
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- NeuroPsychiatric InstitutePrince of Wales HospitalRandwickNew South WalesAustralia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- Older People's Mental Health ServicePrince of Wales HospitalRandwickNew South WalesAustralia
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Kootar S, Huque MH, Kiely KM, Anderson CS, Jorm L, Kivipelto M, Lautenschlager NT, Matthews F, Shaw JE, Whitmer RA, Peters R, Anstey KJ. Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk. BMJ Open 2023; 13:e076860. [PMID: 37739460 PMCID: PMC10533692 DOI: 10.1136/bmjopen-2023-076860] [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: 06/19/2023] [Accepted: 09/05/2023] [Indexed: 09/24/2023] Open
Abstract
INTRODUCTION Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual's risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners. METHODS AND ANALYSIS Ten high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors' contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression. ETHICS AND DISSEMINATION Ethics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool will be accessible as a public health resource. Knowledge translation and implementation work will explore strategies to apply the tool in clinical practice.
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Affiliation(s)
- Scherazad Kootar
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Md Hamidul Huque
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim M Kiely
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Craig S Anderson
- The George Institute for Global Health, George Institute for Global Health, Newtown, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Miia Kivipelto
- Division of Geriatric Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Nicola T Lautenschlager
- Academic Unit of Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
- Older Adult Mental Health Program, Royal Melbourne Hospital Mental Health Service, Parkville, Victoria, Australia
| | - Fiona Matthews
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Ruth Peters
- University of New South Wales, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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19
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Lennon MJ, Lam BCP, Lipnicki DM, Crawford JD, Peters R, Schutte AE, Brodaty H, Thalamuthu A, Rydberg-Sterner T, Najar J, Skoog I, Riedel-Heller SG, Röhr S, Pabst A, Lobo A, De-la-Cámara C, Lobo E, Bello T, Gureje O, Ojagbemi A, Lipton RB, Katz MJ, Derby CA, Kim KW, Han JW, Oh DJ, Rolandi E, Davin A, Rossi M, Scarmeas N, Yannakoulia M, Dardiotis T, Hendrie HC, Gao S, Carrière I, Ritchie K, Anstey KJ, Cherbuin N, Xiao S, Yue L, Li W, Guerchet MM, Preux PM, Aboyans V, Haan MN, Aiello AE, Ng TP, Nyunt MSZ, Gao Q, Scazufca M, Sachdev PSS. Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life: An Individual Participant Data Meta-Analysis. JAMA Netw Open 2023; 6:e2333353. [PMID: 37698858 PMCID: PMC10498335 DOI: 10.1001/jamanetworkopen.2023.33353] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
Importance The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested. Objectives To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group. Data Source and Study Selection Longitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece). Data Extraction and Synthesis Participants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines. Main Outcomes and Measures The key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group. Results The analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P = .001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P = .02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P = .07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses. Conclusions and Relevance This individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive use was associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.
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Affiliation(s)
- Matthew J. Lennon
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ben Chun Pan Lam
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Darren M. Lipnicki
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - John D. Crawford
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ruth Peters
- The George Institute for Global Health, Sydney, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Aletta E. Schutte
- The George Institute for Global Health, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Eastern Suburbs Older Persons’ Mental Health Service, Sydney, Australia
| | - Anbupalam Thalamuthu
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Therese Rydberg-Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
- School of Psychology, Manawatu Campus, Massey University, Palmerston North, New Zealand
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Concepción De-la-Cámara
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Elena Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Toyin Bello
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mindy J. Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Carol A. Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Elena Rolandi
- Golgi Cenci Foundation, Abbiategrasso, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | | | | | - Nikolaos Scarmeas
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, New York
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Themis Dardiotis
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Hugh C. Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
| | - Sujuan Gao
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis
| | - Isabelle Carrière
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
| | - Karen Ritchie
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Institut du Cerveau Trocadéro, Paris, France
| | - Kaarin J. Anstey
- University of New South Wales, School of Psychology, Sydney, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Maëlenn M. Guerchet
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Pierre-Marie Preux
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Victor Aboyans
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
- Department of Cardiology, Dupuytren 2 University Hospital, Limoges, France
| | - Mary N. Haan
- School of Medicine, University of California, San Francisco
| | - Allison E. Aiello
- Robert N. Butler Columbia Aging Center, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Geriatric Education and Research Institute, Ministry of Health, Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marcia Scazufca
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Perminder S. S. Sachdev
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
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Grainger SA, McKay KT, Riches JC, Chander RJ, Cleary R, Mather KA, Kochan NA, Sachdev PS, Henry JD. Measuring Empathy Across the Adult Lifespan: A Comparison of Three Assessment Types. Assessment 2023; 30:1870-1883. [PMID: 36210740 DOI: 10.1177/10731911221127902] [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: 07/22/2023]
Abstract
Empathy is a core component of social cognition that can be indexed via behavioral, informant-report, or self-report methods of assessment. However, concerns have been raised regarding the lack of convergence between these assessment approaches for cognitive empathy. Here, we provided the first comparison of all three measurement approaches for cognitive and affective empathy in a large adult sample (N = 371) aged 18 to 101 years. We found that poor convergence was more of a problem for cognitive empathy than affective empathy. While none of the cognitive empathy measures correlated with each other, for affective empathy, self-report was significantly associated with both behavioral and informant-report assessments. However, for both cognitive and affective empathy, there was evidence for poor discriminant validity within the measures. Out of the three assessment approaches, only the informant-report measures were consistently associated with indices of social functioning. Importantly, age did not moderate any of the tested relationships, indicating that both the strengths and the limitations of these different types of assessment do not appear to vary as a function of age. These findings highlight the variation that exists among empathy measures and are discussed in relation to their practical implications for the assessment of empathy.
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Affiliation(s)
| | - Kate T McKay
- The University of Queensland, St Lucia, Brisbane, Australia
| | | | | | - Rhiagh Cleary
- The University of Sydney, New South Wales, Australia
| | - Karen A Mather
- The University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | | | - Perminder S Sachdev
- The University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Julie D Henry
- The University of Queensland, St Lucia, Brisbane, Australia
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Portilla-Tamarit I. Exploring remote tools for neurocognitive impairment assessment. Eur J Clin Invest 2023; 53:e14053. [PMID: 37401614 DOI: 10.1111/eci.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Affiliation(s)
- I Portilla-Tamarit
- Department of Health Psychology, University of Alicante, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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22
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Truong QC, Cervin M, Choo CC, Numbers K, Bentvelzen AC, Merkin AG, Sachdev PS, Feigin VL, Brodaty H, Kochan NA, Medvedev ON. Using network analysis to validate domains of the modified telephone interview for cognitive status. Eur J Clin Invest 2023; 53:e14016. [PMID: 37191060 DOI: 10.1111/eci.14016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND The modified Telephone Interview for Cognitive Status (TICS-M) is a widely used tool for assessing global cognitive functions and screening for cognitive impairments. The tool was conceptualised to capture various cognitive domains, but the validity of such domains has not been investigated against comprehensive neuropsychological assessments tools. Therefore, this study aimed to explore the associations between the TICS-M domains and neuropsychological domains to evaluate the validity of the TICS-M domains using network analysis. MATERIALS AND METHODS A longitudinal research design was used with a large sample of older adults (aged above 70 years; n = 1037 at the baseline assessment) who completed the TICS-M and comprehensive neuropsychological assessments biennially. We applied network analysis to identify unique links between the TICS-M domains and neuropsychological test scores. RESULTS At baseline, there were weak internal links between the TICS-M domains. The TICS-M memory and language domains were significantly related to their corresponding neuropsychological domains. The TICS-M attention domain had significant associations with executive function and visuospatial abilities. The TICS-M orientation domain was not significantly associated with any of the five neuropsychological domains. Despite an attrition of almost 50% at wave four, weak internal links between the TICS-M domains and most associations between TICS-M and neuropsychological domains that were found initially, remained stable at least over two waves within the 6-year period. CONCLUSIONS This study supports the overall structural validity of the TICS-M screener in assessing enduring global cognitive function. However, separate TICS-M cognitive domains should not be considered equivalent to the analogous neuropsychological domains.
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Affiliation(s)
| | - Matti Cervin
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden
| | - Carol C Choo
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Adam C Bentvelzen
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexander G Merkin
- Auckland University of Technology, Auckland, New Zealand
- Centre for Precise Psychiatry and Neurosciences, Kaufbeuren, Germany
- Centre for Precise Psychiatry and Neurosciences, Schaffhausen, Switzerland
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Oleg N Medvedev
- School of Psychology, University of Waikato, Hamilton, New Zealand
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23
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Lin K, Wen W, Lipnicki DM, Mewton L, Chen R, Du J, Wang D, Skoog I, Sterner TR, Najar J, Kim KW, Han JW, Kim JS, Ng TP, Ho R, Chua DQL, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Kochan N, Sachdev PS, Jiang J. Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: the COSMIC consortium. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.30.23294876. [PMID: 37693599 PMCID: PMC10491386 DOI: 10.1101/2023.08.30.23294876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well-documented in populations of different ethnicities and/or from different geographical regions. METHOD Magnetic resonance imaging data of five population-based cohorts of non-demented older individuals from Australia, Singapore, South Korea, and Sweden (N = 1,946) were examined for WMH and their associations with vascular risk factors and cognition. RESULT Factors associated with larger whole brain WMH volumes included diabetes, hypertension, stroke, current smoking, body mass index, higher alcohol intake and insufficient physical activity. Participants with moderate or higher physical activity had less WMH than those who never exercised, but the former two groups did not differ. Hypertension and stroke had stronger associations with WMH volumes in the White, compared to Asian subsample. DISCUSSION The current study highlighted the ethnic differences in the contributions of vascular risk factors to WMH.
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Affiliation(s)
- Keshuo Lin
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Rory Chen
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jing Du
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Dadong Wang
- CSIRO Informatics and Statistics, Locked Bag 17, North Ryde, NSW 1670, Australia
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Box 100, Goeteborg, Vaestra Goetaland 405 30, Sweden
| | - Therese Rydberg Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Nobels väg 6, 171 77 Stockholm, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Section Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Amsterdam Universitair Medische Centra, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 03080, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jun Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
| | - Tze Pin Ng
- Khoo Teck Puat Hospital, 768828, Singapore
- Geriatric Education and Research Institute, Ministry of Health, 768024, Singapore
| | - Roger Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, 119077, Singapore
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, National University of Singapore, 119077, Singapore
| | - Kaarin J. Anstey
- School of Psychology, University of New South Wales, NSW 2052,Australia
- Neuroscience Research Australia, NSW 2031, Australia
- Ageing Futures Institute, University of New South Wales, NSW 2052,Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, ACT 2600, Canberra, Australia
| | - Moyra E. Mortby
- School of Psychology, University of New South Wales, NSW 2052,Australia
- Neuroscience Research Australia, NSW 2031, Australia
- Ageing Futures Institute, University of New South Wales, NSW 2052,Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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24
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Oh DJ, Bae JB, Lipnicki DM, Han JW, Sachdev PS, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Skoog I, Najar J, Sterner TR, Guaita A, Vaccaro R, Rolandi E, Scarmeas N, Yannakoulia M, Kosmidis MH, Riedel-Heller SG, Roehr S, Dominguez J, Guzman MFD, Fowler KC, Lobo A, Saz P, Lopez-Anton R, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Trollor J, Kochan N, Kim KW. Parental history of dementia and the risk of dementia: A cross-sectional analysis of a global collaborative study. Psychiatry Clin Neurosci 2023; 77:449-456. [PMID: 37165609 PMCID: PMC10524874 DOI: 10.1111/pcn.13561] [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: 01/03/2023] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Parental history of dementia appears to increase the risk of dementia, but there have been inconsistent results. We aimed to investigate whether the association between parental history of dementia and the risk of dementia are different by dementia subtypes and sex of parent and offspring. METHODS For this cross-sectional study, we harmonized and pooled data for 17,194 older adults from nine population-based cohorts of eight countries. These studies conducted face-to-face diagnostic interviews, physical and neurological examinations, and neuropsychological assessments to diagnose dementia. We investigated the associations of maternal and paternal history of dementia with the risk of dementia and its subtypes in offspring. RESULTS The mean age of the participants was 72.8 ± 7.9 years and 59.2% were female. Parental history of dementia was associated with higher risk of dementia (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.15-1.86) and Alzheimer's disease (AD) (OR = 1.72, 95% CI = 1.31-2.26), but not with the risk of non-AD. This was largely driven by maternal history of dementia, which was associated with the risk of dementia (OR = 1.51, 95% CI = 1.15-1.97) and AD (OR = 1.80, 95% CI = 1.33-2.43) whereas paternal history of dementia was not. These results remained significant when males and females were analyzed separately (OR = 2.14, 95% CI = 1.28-3.55 in males; OR = 1.68, 95% CI = 1.16-2.44 for females). CONCLUSIONS Maternal history of dementia was associated with the risk of dementia and AD in both males and females. Maternal history of dementia may be a useful marker for identifying individuals at higher risk of AD and stratifying the risk for AD in clinical trials.
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Affiliation(s)
- Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Bin Bae
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ji Won Han
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Medical Center, Seoul, South Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Therese R Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
| | - Antonio Guaita
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Elena Rolandi
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, NY
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Jacqueline Dominguez
- Institute for Neurosciences, St. Luke’s Medical Center, Quezon City, Philippines
- Institute for Dementia Care Asia, Quezon City, Philippines
| | | | | | - Antonio Lobo
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Pedro Saz
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Raul Lopez-Anton
- Departamento de Psicología y Sociología. Universidad de Zaragoza, Aragon, Spain
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia
- Centre for Mental Health Research, Australian National University, Canberra, Australia
- Neuroscience Australia, Sydney, Australia
| | - Nicolas Cherbuin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Moyra E Mortby
- School of Psychology, University of New South Wales, Sydney, Australia
- Neuroscience Australia, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine & Health, University of New South Wales, Sydney, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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Hirase T, Okubo Y, Delbaere K, Menant JC, Lord SR, Sturnieks DL. Risk Factors for Falls and Fall-Related Fractures in Community-Living Older People with Pain: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6040. [PMID: 37297643 PMCID: PMC10252250 DOI: 10.3390/ijerph20116040] [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: 02/28/2023] [Revised: 04/28/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
(1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical activity level measures were obtained at baseline. Falls were monitored with monthly falls calendars for 12 months. Logistic regression analyses were performed to identify predictors of falls and fall-related fractures during a 12-month follow-up; (3) Results: Of the 389 participants, 175 (45.0%) and 20 (5.1%) reported falls and fall-related fractures during the 12-month follow-up, respectively. Greater postural sway on foam, more depressive symptoms and lower physical activity levels at baseline were associated with falls during the 12-month follow-up. Slower walking speed at baseline was associated with fall-related fractures during the 12-month follow-up. These associations remained significant after adjusting for age, sex, body mass index, comorbidities and medication use; (4) Conclusions: This study suggests poor balance, low mood and a less active lifestyle are predictors of falls, and slower walking speed predicts fall-related fractures among community-dwelling older people with pain.
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Affiliation(s)
- Tatsuya Hirase
- Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, Kanagawa 238-8522, Japan
| | - Yoshiro Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Jasmine C. Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Stephen R. Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Daina L. Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
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Pham H, Waterhouse M, Rahman S, Baxter C, Romero BD, McLeod DSA, Armstrong BK, Ebeling PR, English DR, Hartel G, Kimlin MG, O'Connell RL, van der Pols JC, Venn AJ, Webb PM, Whiteman DC, Almeida OP, Neale RE. Vitamin D supplementation and cognition-Results from analyses of the D-Health trial. J Am Geriatr Soc 2023; 71:1773-1784. [PMID: 36715270 DOI: 10.1111/jgs.18247] [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: 08/21/2022] [Revised: 12/15/2022] [Accepted: 12/26/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Observational studies have consistently found a link between low serum 25-hydroxyvitamin D concentration and higher risk of cognitive impairment. Results from randomized controlled trials have been mixed, and few have been conducted in the general population. METHODS We recruited 21,315 community-dwelling Australians aged between 60 and 84 years to participate in the D-Health Trial, a randomized, double-blind, placebo-controlled trial. The intervention was monthly oral doses of 60,000 international units of vitamin D or placebo for 5 years. We assessed cognitive function in a randomly sampled group of participants aged ≥70 years using the Telephone Interview for Cognitive Status (TICS) at 2 and 5 years after randomization. The primary outcome for this analysis was TICS score; the secondary outcome was the proportion of people who had cognitive impairment (defined as TICS score ≤25). We analyzed data using mixed models (linear and logistic). RESULTS We interviewed 3887 participants at year 2 and 3614 participants at year 5. The mean TICS score at these time points was 32.3 and 32.2, respectively. Vitamin D supplementation did not affect cognitive function as measured by TICS score (mean difference between vitamin D and placebo groups 0.04; 95% CI -0.14 to 0.23), or alter risk of cognitive impairment (odds ratio 1.00; 95% CI 0.75 to 1.33). CONCLUSIONS Monthly bolus doses of vitamin D supplementation neither enhanced nor hindered cognitive function among older adults. Population-wide vitamin D supplementation of older adults that are largely vitamin D replete is unlikely to substantially benefit cognition.
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Affiliation(s)
- Hai Pham
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Mary Waterhouse
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sabbir Rahman
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Catherine Baxter
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Briony Duarte Romero
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Donald S A McLeod
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | | | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Dallas R English
- Melbourne School of Population Health, University of Melbourne, and Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Gunter Hartel
- Statistics Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Michael G Kimlin
- School of Biomedical Sciences, Queensland University of Technology, Australia
| | | | - Jolieke C van der Pols
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Penelope M Webb
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Public Health, University of Queensland, Brisbane, Australia
| | - David C Whiteman
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Public Health, University of Queensland, Brisbane, Australia
| | | | - Rachel E Neale
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Public Health, University of Queensland, Brisbane, Australia
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27
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Hopkins EG, Leman PJ, Cervin M, Numbers K, Brodaty H, Kochan NA, Sachdev PS, Medvedev ON. Network of mental activities, cognitive function and depression in older men and women. J Psychiatr Res 2023; 162:113-122. [PMID: 37148602 DOI: 10.1016/j.jpsychires.2023.05.030] [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: 12/29/2022] [Revised: 03/28/2023] [Accepted: 05/01/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Evidence suggests that lifestyle activities impact cognitive and mental health in older populations. However, how lifestyle factors are associated with one another, and which factors are most important for cognitive function and mental health has received comparatively little attention. DESIGN Bayesian-Gaussian network analysis was used to investigate unique associations between mental activities (MA; i.e., activities involving cognitive engagement), global cognition, and depression at three time-points in a large sample of older adults (baseline, 2 years, and 4 years follow-up). SETTING This study used longitudinal data from participants living in Australia and participating in the Sydney Memory and Ageing Study. PARTICIPANTS The sample included 998 participants (55% female) aged between 70 and 90, without a diagnosis of dementia at baseline. MEASUREMENTS Neuropsychological assessment of global cognition, self-reported depressive symptoms, and self-reported information about daily MA. RESULTS Cognitive functioning was positively associated with playing tabletop games and using the internet in both sexes at all time-points. MA were differentially linked in men and women. Depression was not consistently associated with MA in men across the three time-points; women who visited artistic events consistently had lower depression scores. CONCLUSIONS Engaging with tabletop games and using the internet was associated with better cognition in both sexes, however sex acted as a modifier for other associations. These findings are useful for future investigations that consider interactive associations between MA, cognition, and mental health in older adults, and their possible roles in promoting healthy aging.
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Affiliation(s)
- Ella G Hopkins
- University of Waikato, School of Psychology, Hamilton, New Zealand.
| | - Patrick J Leman
- University of Waikato, School of Psychology, Hamilton, New Zealand.
| | | | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, Australia.
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, Australia.
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, Australia.
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, Australia.
| | - Oleg N Medvedev
- University of Waikato, School of Psychology, Hamilton, New Zealand.
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28
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Mewton L, Visontay R, Hoy N, Lipnicki DM, Sunderland M, Lipton RB, Guerchet M, Ritchie K, Najar J, Scarmeas N, Kim K, Riedel Heller S, van Boxtel M, Jacobsen E, Brodaty H, Anstey KJ, Haan M, Scazufca M, Lobo E, Sachdev PS. The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies. Addiction 2023; 118:412-424. [PMID: 35993434 PMCID: PMC9898084 DOI: 10.1111/add.16035] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 08/04/2022] [Indexed: 02/06/2023]
Abstract
AIM To synthesize international findings on the alcohol-dementia relationship, including representation from low- and middle-income countries. METHODS Individual participant data meta-analysis of 15 prospective epidemiological cohort studies from countries situated in six continents. Cox regression investigated the dementia risk associated with alcohol use in older adults aged over 60 years. Additional analyses assessed the alcohol-dementia relationship in the sample stratified by sex and by continent. Participants included 24 478 community dwelling individuals without a history of dementia at baseline and at least one follow-up dementia assessment. The main outcome measure was all-cause dementia as determined by clinical interview. RESULTS At baseline, the mean age across studies was 71.8 (standard deviation = 7.5, range = 60-102 years), 14 260 (58.3%) were female and 13 269 (54.2%) were current drinkers. During 151 636 person-years of follow-up, there were 2124 incident cases of dementia (14.0 per 1000 person-years). When compared with abstainers, the risk for dementia was lower in occasional [hazard ratio (HR) = 0.78; 95% confidence interval (CI) = 0.68-0.89], light-moderate (HR = 0.78; 95% CI = 0.70-0.87) and moderate-heavy drinkers (HR = 0.62; 95% CI = 0.51-0.77). There was no evidence of differences between life-time abstainers and former drinkers in terms of dementia risk (HR = 0.98; 95% CI = 0.81-1.18). In dose-response analyses, moderate drinking up to 40 g/day was associated with a lower risk of dementia when compared with lif-time abstaining. Among current drinkers, there was no consistent evidence for differences in terms of dementia risk. Results were similar when the sample was stratified by sex. When analysed at the continent level, there was considerable heterogeneity in the alcohol-dementia relationship. CONCLUSIONS Abstinence from alcohol appears to be associated with an increased risk for all-cause dementia. Among current drinkers, there appears to be no consistent evidence to suggest that the amount of alcohol consumed in later life is associated with dementia risk.
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Affiliation(s)
- Louise Mewton
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Rachel Visontay
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Nicholas Hoy
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Darren M. Lipnicki
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | | | - Richard B. Lipton
- The Matilda Centre for Mental Health and Substance UseUniversity of SydneySydneyAustralia
- Saul R. Korey, Department of Neurology, Albert Einstein College of MedicineYeshiva UniversityNew YorkNYUSA
- Department of Epidemiology and Population Health, Albert Einstein College of MedicineYeshiva UniversityNew YorkNYUSA
| | - Maëlenn Guerchet
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of MedicineYeshiva UniversityNew YorkNYUSA
| | - Karen Ritchie
- Limoges University, CHU Limoges, EpiMaCT, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
- Neuropsychiatry, Epidemiological and Clinical Research, La Colombière HospitalMontpellierFrance
- Université de MontpellierMontpellierFrance
| | - Jenna Najar
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of GothenburgMölndalSweden
| | - Nikolaos Scarmeas
- Region Västra GötalandSahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
- Department of Neurology, Aiginition HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Ki‐Woong Kim
- Department of NeurologyColumbia UniversityNew YorkNYUSA
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of Psychiatry, College of MedicineSeoul National UniversitySeoulSouth Korea
| | - Steffi Riedel Heller
- Department of Brain and Cognitive SciencesSeoul National UniversitySeoulSouth Korea
| | - Martin van Boxtel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical FacultyUniversity of LeipzigLeipzigGermany
| | - Erin Jacobsen
- School for Mental Health and Neuroscience/Alzheimer Centrum Limburg, Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
| | - Henry Brodaty
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Kaarin J. Anstey
- Department of Psychiatry, School of MedicineUniversity of PittsburghPittsburghPAUSA
- School of PsychologyUniversity of New South WalesSydneyAustralia
- Neuroscience Research AustraliaUniversity of New South WalesSydneyAustralia
| | - Mary Haan
- Centre for Research on Ageing, Health and WellbeingAustralian National UniversityCanberraAustralia
| | - Marcia Scazufca
- Department of Epidemiology and Biostatistics, School of MedicineUniversity of CaliforniaSan FranciscoCAUSA
| | - Elena Lobo
- LIM‐23, Hospital das Clinicas (HCFMUSP), Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
- Department of Preventive Medicine and Public HealthUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigacion Sanitaria AragonZaragozaSpain
| | - Perminder S. Sachdev
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM)Ministry of Science and InnovationMadridSpain
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Measuring distress in older population: Rasch analysis of the Kessler Psychological Distress Scale. J Affect Disord 2023; 330:117-124. [PMID: 36863471 DOI: 10.1016/j.jad.2023.02.116] [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: 09/07/2022] [Revised: 02/11/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES The 10-item Kessler Psychological Distress Scale (K-10) is a widely applied distress measure; however, its psychometric properties were not established with older populations using advanced methodology. The aim of this study was to examine psychometric properties of the K-10 through application of Rasch methodology and if possible, develop an ordinal-to-interval conversion to improve its reliability in older populations. METHOD The Partial Credit Rasch Model was applied to analyse K-10 scores of the sample including 490 participants (56.3 % females) aged 70 to 90 years and without dementia from the Sydney Memory and Ageing Study (MAS). RESULTS The initial analysis of the K-10 showed poor reliability and significant deviation from the expectations of the Rasch model. The best model fit was evident after correcting disordered thresholds and creating two testlet models to address local dependency between items (χ2(35) = 29.87, p = 0.71). The modified K-10 demonstrated strict unidimensionality, enhanced reliability and scale invariance across personal factors, such as sex, age, and education and permitted development of ordinal-to-interval transformation algorithms. LIMITATIONS Ordinal-to-interval conversion can only be applied for older adults with complete data. CONCLUSIONS The K-10 satisfied principles of fundamental measurement defined by Rasch model after minor modifications. Clinicians and researchers can transform K-10 raw scores into interval-level data using converging algorithms published here without altering the original scale response format, which increases reliability of the K-10.
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Truong QC, Numbers K, Choo CC, Bentvelzen AC, Catts VS, Cervin M, Jorm AF, Kochan NA, Brodaty H, Sachdev PS, Medvedev ON. Establishing conversion of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly scores into interval-level data across multiple samples using Rasch methodology. Psychogeriatrics 2023; 23:411-421. [PMID: 36781176 DOI: 10.1111/psyg.12946] [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: 12/14/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND The 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) is a well-validated and widely-used measure of cognitive changes (CCs) among older adults. This study aimed to use Rasch methodology to establish psychometric properties of the IQCODE-16 and validate the existing ordinal-to-interval transformation algorithms across multiple large samples. METHODS A Partial Credit Rasch model was employed to examine psychometric properties of the IQCODE-16 using data (n = 918) from two longitudinal studies of participants aged 57-99 years: the Older Australian Twins Study (n = 450) and the Canberra Longitudinal Study (n = 468), and reusing the Sydney Memory and Ageing Study (MAS) sample (n = 400). RESULTS Initial analyses indicated good reliability for the IQCODE-16 (Person Separation Index range: 0.82-0.90). However, local dependency was identified between items, with several items showing misfit to the model. Replicating the existing Rasch solution could not reproduce the best Rasch model fit for all samples. Combining locally dependent items into three testlets resolved all misfit and local dependency issues and resulted in the best Rasch model fit for all samples with evidence of unidimensionality, strong reliability, and invariance across person factors. Accordingly, new ordinal-to-interval transformation algorithms were produced to convert the IQCODE-16 ordinal scores into interval data to improve the accuracy of its scores. CONCLUSIONS The findings of this study support the reliability and validity of the IQCODE-16 in measuring CCs among older adults. New ordinal-to-interval conversion tables generated using samples from multiple independent datasets are more generalizable and can be used to enhance the precision of the IQCODE-16 without changing its original format. An easy-to-use converter has been made available for clinical and research use.
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Affiliation(s)
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Carol C Choo
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Adam C Bentvelzen
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Vibeke S Catts
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Matti Cervin
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Oleg N Medvedev
- School of Psychology, University of Waikato, Hamilton, New Zealand
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Revelas M, Thalamuthu A, Zettergren A, Oldmeadow C, Najar J, Seidu NM, Armstrong NJ, Riveros C, Kwok JB, Schofield PR, Trollor JN, Waern M, Wright MJ, Zetterberg H, Ames D, Belnnow K, Brodaty H, Scott RJ, Skoog I, Attia JR, Sachdev PS, Mather KA. High polygenic risk score for exceptional longevity is associated with a healthy metabolic profile. GeroScience 2023; 45:399-413. [PMID: 35972662 PMCID: PMC9886704 DOI: 10.1007/s11357-022-00643-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/08/2022] [Indexed: 02/03/2023] Open
Abstract
Healthy metabolic measures in humans are associated with longevity. Dysregulation leads to metabolic syndrome (MetS) and negative health outcomes. Recent exceptional longevity (EL) genome wide association studies have facilitated estimation of an individual's polygenic risk score (PRS) for EL. We tested the hypothesis that individuals with high ELPRS have a low prevalence of MetS. Participants were from five cohorts of middle-aged to older adults. The primary analyses were performed in the UK Biobank (UKBB) (n = 407,800, 40-69 years). Replication analyses were undertaken using three Australian studies: Hunter Community Study (n = 2122, 55-85 years), Older Australian Twins Study (n = 539, 65-90 years) and Sydney Memory and Ageing Study (n = 925, 70-90 years), as well as the Swedish Gothenburg H70 Birth Cohort Studies (n = 2273, 70-93 years). MetS was defined using established criteria. Regressions and meta-analyses were performed with the ELPRS and MetS and its components. Generally, MetS prevalence (22-30%) was higher in the older cohorts. In the UKBB, high EL polygenic risk was associated with lower MetS prevalence (OR = 0.94, p = 1.84 × 10-42) and its components (p < 2.30 × 10-8). Meta-analyses of the replication cohorts showed nominal associations with MetS (p = 0.028) and 3 MetS components (p < 0.05). This work suggests individuals with a high polygenic risk for EL have a healthy metabolic profile promoting longevity.
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Affiliation(s)
- Mary Revelas
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia.
- Neuroscience Research Australia, Sydney, NSW, Australia.
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Anna Zettergren
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | | | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Nazib M Seidu
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - Nicola J Armstrong
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia
- Mathematics and Statistics, Curtin University, Perth, Australia
| | - Carlos Riveros
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - John B Kwok
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, UNSW, Sydney, Australia
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, UNSW, Sydney, Australia
| | - Julian N Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia
| | - Margda Waern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Hong Kong Centre for Neurodegenerative Diseases, Hong Kong, China
| | - David Ames
- University of Melbourne Academic Unit for Psychiatry of Old Age, St George's Hospital, Kew, VIC, Australia
- National Ageing Research Institute, Parkville Victoria, Australia
| | - Kaj Belnnow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia
- Dementia Centre for Research Collaboration, UNSW, Sydney, Australia
| | - Rodney J Scott
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Pathology North, John Hunter Hospital, Newcastle, NSW, Australia
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - John R Attia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Pathology North, John Hunter Hospital, Newcastle, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Karen A Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine & Health, UNSW, Sydney, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
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Spooner A, Mohammadi G, Sachdev PS, Brodaty H, Sowmya A. Ensemble feature selection with data-driven thresholding for Alzheimer's disease biomarker discovery. BMC Bioinformatics 2023; 24:9. [PMID: 36624372 PMCID: PMC9830744 DOI: 10.1186/s12859-022-05132-9] [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: 09/28/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Feature selection is often used to identify the important features in a dataset but can produce unstable results when applied to high-dimensional data. The stability of feature selection can be improved with the use of feature selection ensembles, which aggregate the results of multiple base feature selectors. However, a threshold must be applied to the final aggregated feature set to separate the relevant features from the redundant ones. A fixed threshold, which is typically used, offers no guarantee that the final set of selected features contains only relevant features. This work examines a selection of data-driven thresholds to automatically identify the relevant features in an ensemble feature selector and evaluates their predictive accuracy and stability. Ensemble feature selection with data-driven thresholding is applied to two real-world studies of Alzheimer's disease. Alzheimer's disease is a progressive neurodegenerative disease with no known cure, that begins at least 2-3 decades before overt symptoms appear, presenting an opportunity for researchers to identify early biomarkers that might identify patients at risk of developing Alzheimer's disease. RESULTS The ensemble feature selectors, combined with data-driven thresholds, produced more stable results, on the whole, than the equivalent individual feature selectors, showing an improvement in stability of up to 34%. The most successful data-driven thresholds were the robust rank aggregation threshold and the threshold algorithm threshold from the field of information retrieval. The features identified by applying these methods to datasets from Alzheimer's disease studies reflect current findings in the AD literature. CONCLUSIONS Data-driven thresholds applied to ensemble feature selectors provide more stable, and therefore more reproducible, selections of features than individual feature selectors, without loss of performance. The use of a data-driven threshold eliminates the need to choose a fixed threshold a-priori and can select a more meaningful set of features. A reliable and compact set of features can produce more interpretable models by identifying the factors that are important in understanding a disease.
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Affiliation(s)
- Annette Spooner
- grid.1005.40000 0004 4902 0432School of Computer Science and Engineering, University of New South Wales, Sydney, Australia
| | - Gelareh Mohammadi
- grid.1005.40000 0004 4902 0432School of Computer Science and Engineering, University of New South Wales, Sydney, Australia
| | - Perminder S. Sachdev
- grid.1005.40000 0004 4902 0432Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- grid.1005.40000 0004 4902 0432Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Arcot Sowmya
- grid.1005.40000 0004 4902 0432School of Computer Science and Engineering, University of New South Wales, Sydney, Australia
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Wu W, Ding D, Zhao Q, Xiao Z, Luo J, Ganguli M, Hughes TF, Jacobsen E, Haan MN, van Dang K, Lima-Costa MF, Blay SL, de Castro-Costa E, Ng TP, Gwee X, Gao Q, Gureje O, Ojagbemi A, Bello T, Shahar S, Ludin AFM, Rivan NFM, Scarmeas N, Anastasiou CA, Yannakoulia M, Brodaty H, Crawford JD, Lipton RB, Derby CA, Katz MJ, Lipnicki DM, Sachdev PS. Dose-response relationship between late-life physical activity and incident dementia: A pooled analysis of 10 cohort studies of memory in an international consortium. Alzheimers Dement 2023; 19:107-122. [PMID: 35290713 PMCID: PMC9652610 DOI: 10.1002/alz.12628] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Though consistent evidence suggests that physical activity may delay dementia onset, the duration and amount of activity required remains unclear. METHODS We harmonized longitudinal data of 11,988 participants from 10 cohorts in eight countries to examine the dose-response relationship between late-life physical activity and incident dementia among older adults. RESULTS Using no physical activity as a reference, dementia risk decreased with duration of physical activity up to 3.1 to 6.0 hours/week (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.67 to 1.15 for 0.1 to 3.0 hours/week; HR 0.68, 95% CI 0.52 to 0.89 for 3.1 to 6.0 hours/week), but plateaued with higher duration. For the amount of physical activity, a similar pattern of dose-response curve was observed, with an inflection point of 9.1 to 18.0 metabolic equivalent value (MET)-hours/week (HR 0.92, 95% CI 0.70 to 1.22 for 0.1 to 9.0 MET-hours/week; HR 0.70, 95% CI 0.53 to 0.93 for 9.1 to 18.0 MET-hours/week). DISCUSSION This cross-national analysis suggests that performing 3.1 to 6.0 hours of physical activity and expending 9.1 to 18.0/MET-hours of energy per week may reduce dementia risk.
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Affiliation(s)
- Wanqing Wu
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Tiffany F Hughes
- Department of Health Professions, Youngstown State University, OH, USA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, USA
| | - Kristine van Dang
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, USA
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Sergio Luis Blay
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Erico de Castro-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Tze Pin Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, Singapore, Singapore
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Suzana Shahar
- Dietetic Program, Centre for Healthy Aging, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Biomedical Science Program, Centre for Healthy Aging, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Fatin Malek Rivan
- Nutritional Sciences Program, Centre for Healthy Aging, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, USA
| | - Carol A Derby
- Department of Neurology, Albert Einstein College of Medicine, New York, USA
| | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, New York, USA
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
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Numbers K, Lam BCP, Crawford JD, Kochan NA, Sachdev PS, Brodaty H. Longitudinal changes in participant and informant reports of subjective cognitive complaints are associated with dementia risk. Front Aging Neurosci 2023; 15:1044807. [PMID: 36891557 PMCID: PMC9987247 DOI: 10.3389/fnagi.2023.1044807] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/27/2023] [Indexed: 02/22/2023] Open
Abstract
Background Individuals with subjective cognitive complaints (SCCs) are at an increased risk of dementia. Questions remain about participant-reported versus informant-reported SCCs as indicators of future dementia and about longitudinal changes in participant-and informant-reported SCCs and risk of incident dementia. Method Participants were 873 older adults (M = 78.65-years; 55% female) and 849 informants from the Sydney Memory and Ageing Study. Comprehensive assessments occurred biennially, and clinical diagnoses were made by expert consensus for 10-years. SCCs were participants' and informants' responses to a single binary question concerning their/the participant's memory decline (Yes/No) over the first 6-years. Categorical latent growth curve analyses, using the logit transformation, were used to model SCC change over time. Associations of initial propensity to report SCCs at baseline, and change in propensity to report SCCs over time, with dementia risk were examined using Cox regression. Results 70% of participants reported SCCs at baseline, with a proportional increase in the odds of reporting by 11% for each additional year in the study. In contrast, 22% of informants reported SCCs at baseline, with a proportional increase by 30% in the odds of reporting per year. Participants' initial level of (p = 0.007), but not change in SCC reporting (p = 0.179), was associated with risk of dementia controlling for all covariates. Both informants' initial level of (p < 0.001), and change in (p < 0.001), SCCs significantly predicted incident dementia. When modelled together, informants' initial level of, and change in, SCCs were still independently associated with increased dementia risk (p's < 0.001). Conclusion These data suggest that informants' initial impressions, and increased reporting, of SCCs appear to be uniquely prognostic of future dementia compared to participants', even based on a single SCC question.
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Affiliation(s)
- Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Applying generalizability theory to examine assessments of subjective cognitive complaints: whose reports should we rely on - participant versus informant? Int Psychogeriatr 2022; 34:1023-1033. [PMID: 33847260 DOI: 10.1017/s1041610221000363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study aimed to apply the generalizability theory (G-theory) to investigate dynamic and enduring patterns of subjective cognitive complaints (SCC), and reliability of two widely used SCC assessment tools. DESIGN G-theory was applied to assessment scales using longitudinal measurement design with five assessments spanning 10 years of follow-up. SETTING Community-dwelling older adults aged 70-90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study. PARTICIPANTS The sample included 232 participants aged 70 years and older, and 232 associated informants. Participants were predominantly White Europeans (97.8%). The sample of informants included 76 males (32.8%), 153 females (65.9%), and their age ranged from 27 to 86 years, with a mean age of 61.3 years (SD = 14.38). MEASUREMENTS The Memory Complaint Questionnaire (MAC-Q) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). RESULTS The IQCODE demonstrated strong reliability in measuring enduring patterns of SCC with G = 0.86. Marginally acceptable reliability of the 6-item MAC-Q (G = 0.77-0.80) was optimized by removing one item resulting in G = 0.80-0.81. Most items of both assessments were measuring enduring SCC with exception of one dynamic MAC-Q item. The IQCODE significantly predicted global cognition scores and risk of dementia incident across all occasions, while MAC-Q scores were only significant predictors on some occasions. CONCLUSIONS While both informants' (IQCODE) and self-reported (MAC-Q) SCC scores were generalizable across sample population and occasions, self-reported (MAC-Q) scores may be less accurate in predicting cognitive ability and diagnosis of each individual.
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Comparison of Computerised and Pencil-and-Paper Neuropsychological Assessments in Older Culturally and Linguistically Diverse Australians. J Int Neuropsychol Soc 2022; 28:1050-1063. [PMID: 34889177 DOI: 10.1017/s1355617721001314] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Computerised neuropsychological assessments (CNAs) are proposed as an alternative method of assessing cognition to traditional pencil-and-paper assessment (PnPA), which are considered the "gold standard" for diagnosing dementia. However, limited research has been conducted with culturally and linguistically diverse (CALD) individuals. This study investigated the suitability of PnPAs and CNAs for measuring cognitive performance in a heterogenous sample of older, Australian CALD English-speakers compared to a native English-speaking background (ESB) sample. METHODS Participants were 1037 community-dwelling individuals aged 70-90 years without a dementia diagnosis from the Sydney Memory and Ageing Study (873 ESB, 164 CALD). Differences in the level and pattern of cognitive performance in the CALD group were compared to the ESB group on a newly developed CNA and a comprehensive PnPA in English, controlling for covariates. Multiple hierarchical regression was used to identify the extent to which linguistic and acculturation variables explained performance variance. RESULTS CALD participants' performance was consistently poorer than ESB participants on both PnPA and CNA, and more so on PnPA than CNA, controlling for socio-demographic and health factors. Linguistic and acculturation variables together explained approximately 20% and 25% of CALD performance on PnPA and CNA respectively, above demographics and self-reported computer use. CONCLUSIONS Performances of CALD and ESB groups differed more on PnPAs than CNAs, but caution is needed in concluding that CNAs are more culturally-appropriate for assessing cognitive decline in older CALD individuals. Our findings extend current literature by confirming the influence of linguistic and acculturation variables on cognitive assessment outcomes for older CALD Australians.
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Samtani S, Mahalingam G, Lam BCP, Lipnicki DM, Lima-Costa MF, Blay SL, Castro-Costa E, Shifu X, Guerchet M, Preux PM, Gbessemehlan A, Skoog I, Najar J, Rydberg Sterner T, Scarmeas N, Kim KW, Riedel-Heller S, Röhr S, Pabst A, Shahar S, Numbers K, Ganguli M, Jacobsen E, Hughes TF, Crowe M, Ng TP, Maddock J, Marseglia A, Mélis R, Szcześniak D, Wiegelmann H, Vernooij-Dassen M, Jeon YH, Sachdev PS, Brodaty H. Associations between social connections and cognition: a global collaborative individual participant data meta-analysis. THE LANCET. HEALTHY LONGEVITY 2022; 3:e740-e753. [PMID: 36273484 PMCID: PMC9750173 DOI: 10.1016/s2666-7568(22)00199-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Poor social connections (eg, small networks, infrequent interactions, and loneliness) are modifiable risk factors for cognitive decline. Existing meta-analyses are limited by reporting aggregate responses, a focus on global cognition, and combining social measures into single constructs. We aimed to investigate the association between social connection markers and the rate of annual change in cognition (ie, global and domain-specific), as well as sex differences, using an individual participant data meta-analysis. METHODS We harmonised data from 13 longitudinal cohort studies of ageing in North America, South America, Europe, Africa, Asia, and Australia. Studies were eligible for inclusion if they had baseline data for social connection markers and at least two waves of cognitive scores. Follow-up periods ranged from 0 years to 15 years across cohorts. We included participants with cognitive data for at least two waves and social connection data for at least one wave. We then identified and excluded people with dementia at baseline. Primary outcomes were annual rates of change in global cognition and cognitive domain scores over time until final follow-up within each cohort study analysed by use of an individual participant data meta-analysis. Linear mixed models within cohorts used baseline social connection markers as predictors of the primary outcomes. Effects were pooled in two stages using random-effects meta-analyses. We assessed the primary outcomes in the main (partially adjusted) and fully adjusted models. Partially adjusted models controlled for age, sex, and education; fully adjusted models additionally controlled for diabetes, hypertension, smoking, cardiovascular risk, and depression. FINDINGS Of the 40 006 participants in the 13 cohort studies, we excluded 1392 people with dementia at baseline. 38 614 individual participants were included in our analyses. For the main models, being in a relationship or married predicted slower global cognitive decline (b=0·010, 95% CI 0·000-0·019) than did being single or never married; living with others predicted slower global cognitive (b=0·007, 0·002-0·012), memory (b=0·017, 0·006-0·028), and language (b=0·008, 0·000-0·015) decline than did living alone; and weekly interactions with family and friends (b=0·016, 0·006-0·026) and weekly community group engagement (b=0·030, 0·007-0·052) predicted slower memory decline than did no interactions and no engagement. Never feeling lonely predicted slower global cognitive (b=0·047, 95% CI 0·018-0·075) and executive function (b=0·047, 0·017-0·077) decline than did often feeling lonely. Degree of social support, having a confidante, and relationship satisfaction did not predict cognitive decline across global cognition or cognitive domains. Heterogeneity was low (I2=0·00-15·11%) for all but two of the significant findings (association between slower memory decline and living with others [I2=58·33%] and community group engagement, I2=37·54-72·19%), suggesting robust results across studies. INTERPRETATION Good social connections (ie, living with others, weekly community group engagement, interacting weekly with family and friends, and never feeling lonely) are associated with slower cognitive decline. FUNDING EU Joint Programme-Neurodegenerative Disease Research grant, funded by the National Health and Medical Research Council Australia, and the US National Institute on Aging of the US National Institutes of Health.
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Affiliation(s)
- Suraj Samtani
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
| | - Gowsaly Mahalingam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Sergio Luís Blay
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Erico Castro-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Antoine Gbessemehlan
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition University Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University College of Medicine and Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, South Korea
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Katya Numbers
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erin Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tiffany F Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, OH, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Anna Marseglia
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - René Mélis
- Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Henrik Wiegelmann
- Department of Health Care Research, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | | | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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Zhao H, Wen W, Cheng J, Jiang J, Kochan N, Niu H, Brodaty H, Sachdev P, Liu T. An accelerated degeneration of white matter microstructure and networks in the nondemented old-old. Cereb Cortex 2022; 33:4688-4698. [PMID: 36178117 DOI: 10.1093/cercor/bhac372] [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: 07/15/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/12/2022] Open
Abstract
The nondemented old-old over the age of 80 comprise a rapidly increasing population group; they can be regarded as exemplars of successful aging. However, our current understanding of successful aging in advanced age and its neural underpinnings is limited. In this study, we measured the microstructural and network-based topological properties of brain white matter using diffusion-weighted imaging scans of 419 community-dwelling nondemented older participants. The participants were further divided into 230 young-old (between 72 and 79, mean = 76.25 ± 2.00) and 219 old-old (between 80 and 92, mean = 83.98 ± 2.97). Results showed that white matter connectivity in microstructure and brain networks significantly declined with increased age and that the declined rates were faster in the old-old compared with young-old. Mediation models indicated that cognitive decline was in part through the age effect on the white matter connectivity in the old-old but not in the young-old. Machine learning predictive models further supported the crucial role of declines in white matter connectivity as a neural substrate of cognitive aging in the nondemented older population. Our findings shed new light on white matter connectivity in the nondemented aging brains and may contribute to uncovering the neural substrates of successful brain aging.
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Affiliation(s)
- Haichao Zhao
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Jian Cheng
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Haijun Niu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Tao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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Grainger SA, Crawford JD, Riches JC, Kochan NA, Chander RJ, Mather KA, Sachdev PS, Henry JD. Aging Is Associated With Multidirectional Changes in Social Cognition: Findings From an Adult Life-Span Sample Ranging From 18 to 101 Years. J Gerontol B Psychol Sci Soc Sci 2022; 78:62-72. [PMID: 35985278 PMCID: PMC9890910 DOI: 10.1093/geronb/gbac110] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Normal adult aging is associated with changes in social cognition. Although 4 social cognitive domains have been identified (social perception, theory of mind [ToM], affective empathy, and social behavior), no study has tested all 4 domains concurrently in a life-span sample, limiting understanding of the relative magnitude of age-related changes across domains. This study addresses this gap by providing the first assessment of all 4 social cognitive domains in an adult life-span sample. METHODS Three hundred and seventy-two participants ranging from 18 to 101 years of age took part in this study. Participants completed a testing battery that assessed social perception, ToM, affective empathy, and social behavior, as well as broader cognitive function and well-being. RESULTS The results showed that adult aging is associated with multidirectional changes in social cognitive abilities, with ToM and social perception showing nonlinear decline across much of the life-span, and affective empathy and social behavior showing improvement. Age remained a significant predictor of all 4 social cognitive domains, even after accounting for broader cognitive function. Weak associations emerged between some of the social cognitive abilities and and indices of broader well-being. DISCUSSION These findings provide novel and important evidence that normative aging is associated with both gains and losses in social cognition that occur at distinct points of the adult life-span, and that are at least partially independent of general age-related cognitive decline.
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Affiliation(s)
- Sarah A Grainger
- Address correspondence to: Sarah A. Grainger, PhD, School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia. E-mail:
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, The University of New South Wales, Sydney, Australia
| | | | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, The University of New South Wales, Sydney, Australia
| | - Russell J Chander
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, The University of New South Wales, Sydney, Australia
| | - Karen A Mather
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, The University of New South Wales, Sydney, Australia,Neuroscience Research Australia (NeuRA), Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, The University of New South Wales, Sydney, Australia,Neuropsychiatric Institute, Princes of Wales Hospital, Sydney, Australia
| | - Julie D Henry
- School of Psychology, The University of Queensland, Queensland, Australia
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Chalmers RA, Cervin M, Choo C, Baune BT, Trollor JN, Numbers K, Sachdev PS, Brodaty H, Kochan NA, Medvedev ON. Networks of inflammation, depression, and cognition in aging males and females. Aging Clin Exp Res 2022; 34:2387-2398. [PMID: 35895279 DOI: 10.1007/s40520-022-02198-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prioritizing the maintenance of healthy cognitive aging and personalizing preventive interventions to enhance their effectiveness is crucial as the global population ages. Systemic inflammation and depression in older people have been associated with decreased levels of cognition but results have been inconsistent. AIMS To explore the interactive network of inflammation, depression and cognition by sex in older people. METHODS We used novel network analysis to explore the unique associations between inflammatory biomarkers, depression, cognition, and somatic, genetic, and lifestyle risk factors in an older (aged 70-90 years), non-demented, community-dwelling sample from the longitudinal Sydney Memory and Aging Study (N = 916) at baseline and at a two-year follow-up. RESULTS The networks of biomarkers, depression, cognition, and relevant covariates were significantly different between males and females. A stable negative link between depression and cognition was found in females only; a stable positive association between biomarker interleukin-6 and depression was found in females only; and a stable positive association between biomarker interleukin-8 and alcohol was found in females only. For both males and females, a stable, positive relationship was found between the presence of APOE-ε4 gene and biomarker C-reactive protein; between education and cognition; and between biomarker interleukin-6 and all other biomarkers. CONCLUSIONS These findings suggest different psychophysiological mechanisms underlie the interactive network of biomarkers, depression and cognition in males and females that should be considered when designing personalized preventive interventions to maintain cognitively healthy aging.
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Affiliation(s)
| | | | - Carol Choo
- College of Healthcare Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Bernhard T Baune
- Department of Psychiatry, University of Muenster, Munster, Germany.,Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Julian N Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia.,Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia.,Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
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Numbers K, Jang S, Brodaty H, Sachdev PS, Draper B, Reppermund S. Instrumental Activities of Daily Living by Subjective and Objective Measures: The Impact of Depression and Personality. Front Aging Neurosci 2022; 14:829544. [PMID: 35936773 PMCID: PMC9353936 DOI: 10.3389/fnagi.2022.829544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Previous research shows that depression and personality are independently associated with self- and informant-reports of the ability to perform instrumental activities of daily living (IADLs). However, less is known about the association between depression and personality and performance-based measures of IADLs. We aimed to determine how depression and personality predict self-and informant-reports of IADL compared to performance-based measures of IADLs in a sample of older adults with normal cognition (NC) and Mild Cognitive Impairment (MCI). Methods Participants consisted of 385 older adults with NC (n = 235), or a diagnosis of MCI (n = 150), aged between 76 and 99-years from the Sydney Memory and Ageing Study. Participants underwent comprehensive neuropsychological and clinical assessments to determine global cognition and clinical diagnoses. Personality traits were measured by the NEO Five-Factor Inventory (NEO-FFI) and depression by the Geriatric Depression Scale (GDS). Subjective IADLs were self- and informant-reported Bayer Activities of Daily Living (B-ADL) scales and objective IADL was the Sydney Test of Activities of Daily Living in Memory Disorders (STAM). Linear regressions examined the relationship between depression and personality and the three types of IADL measures, controlling for all covariates and global cognition. Results Participant-reported IADL, although associated with global cognition, was more strongly associated with GDS and NEO-FFI scores (conscientiousness and neuroticism). Informant-reported IADL was strongly associated with both global cognition and participants' GDS scores. STAM scores were not associated with participants' GDS or NEO-FFI scores; instead, they were predicted by demographics and global cognition. Conclusion These results suggest that performance-based measures of IADL may provide more objective and reliable insight into an individual's underlying functional ability and are less impacted by the participants' mood and personality compared to subjectively reported IADL. We argue that performance-based IADL measures are preferable when trying to accurately assess everyday functional ability and its relationship to cognitive status. Where performance-based measures are not available (e.g., in some clinical settings), informant ratings should be sought as they are less influenced by the participant's personality and mood compared to self-reports.
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Affiliation(s)
- Katya Numbers
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Sujin Jang
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Brian Draper
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, Faculty of Medicine and Health, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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Cognitive decline is associated with frequency-specific resting state functional changes in normal aging. Brain Imaging Behav 2022; 16:2120-2132. [PMID: 35864341 DOI: 10.1007/s11682-022-00682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/02/2022]
Abstract
Resting state low-frequency brain activity may aid in our understanding of the mechanisms of aging-related cognitive decline. Our purpose was to explore the characteristics of the amplitude of low-frequency fluctuations (ALFF) in different frequency bands of fMRI to better understand cognitive aging. Thirty-seven cognitively normal older individuals underwent a battery of neuropsychological tests and MRI scans at baseline and four years later. ALFF from five different frequency bands (typical band, slow-5, slow-4, slow-3, and slow-2) were calculated and analyzed. A two-way ANOVA was used to explore the interaction effects in voxel-wise whole brain ALFF of the time and frequency bands. Paired-sample t-test was used to explore within-group changes over four years. Partial correlation analysis was performed to assess associations between the altered ALFF and cognitive function. Significant interaction effects of time × frequency were distributed over inferior frontal gyrus, superior frontal gyrus, right rolandic operculum, left thalamus, and right putamen. Significant ALFF reductions in all five frequency bands were mainly found in the right hemisphere and the posterior cerebellum; whereas localization of the significantly increased ALFF were mainly found in the cerebellum at typical band, slow-5 and slow-4 bands, and left hemisphere and the cerebellum at slow-3, slow-2 bands. In addition, ALFF changes showed frequency-specific correlations with changes in cognition. These results suggest that changes of local brain activity in cognitively normal aging should be investigated in multiple frequency bands. The association between ALFF changes and cognitive function can potentially aid better understanding of the mechanisms underlying normal cognitive aging.
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Chantanachai T, Taylor ME, Lord SR, Menant J, Delbaere K, Sachdev PS, Kochan NA, Brodaty H, Sturnieks DL. Risk factors for falls in community-dwelling older people with mild cognitive impairment: a prospective one-year study. PeerJ 2022; 10:e13484. [PMID: 35663527 PMCID: PMC9161814 DOI: 10.7717/peerj.13484] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/03/2022] [Indexed: 01/17/2023] Open
Abstract
Objective Mild cognitive impairment (MCI) is considered an intermediate stage between normal cognitive function and dementia. Fall risk is increased in this group, but there is limited literature exploring specific fall risk factors that may be addressed in fall prevention strategies. The aim of this study was to examine risk factors for falls in older people with MCI, focusing on cognitive, psychological and physical factors. Methods Participants (n = 266, 45% women) were community-dwelling older people aged 70-90 years who met the criteria for MCI. Cognitive, psychological, sensorimotor and physical assessments, physical activity levels, medication use, general health and disability were ascertained at baseline. Falls were monitored prospectively for 12 months. Results During follow-up, 106 (40%) participants reported one or more falls. Poorer visual contrast sensitivity, increased postural sway, lower levels of weekly walking activity, higher levels of depressive symptoms and psychotropic medication use were significantly associated with faller status (≥1 falls) in univariable analyses. Of these factors, poor visual contrast sensitivity, increased postural sway and psychotropic medication use were found to be significant independent predictors of falls in multivariable analysis while controlling for age and sex. No measures of cognitive function were associated with falls. Conclusions Poor visual contrast sensitivity, impaired balance and psychotropic medication use predicted falls in community-dwelling people with MCI. These risk factors may be amenable to intervention, so these factors could be carefully considered in fall prevention programs for this population.
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Affiliation(s)
- Thanwarat Chantanachai
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Morag E. Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen R. Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S. Sachdev
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia,Faculty of Medicine and Health, University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Sydney, New South Wales, Australia
| | - Nicole A. Kochan
- Faculty of Medicine and Health, University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Faculty of Medicine and Health, University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Sydney, New South Wales, Australia
| | - Daina L. Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
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Memory decline in older individuals predicts an objective indicator of oral health: findings from the Sydney Memory and Ageing Study. BMC Oral Health 2022; 22:93. [PMID: 35346157 PMCID: PMC8962025 DOI: 10.1186/s12903-022-02128-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/17/2022] [Indexed: 12/03/2022] Open
Abstract
Background Growing evidence suggests that there is an association between poor oral health and cognitive function in late adulthood. However, most studies to date have relied on cross-sectional research methods that do not permit inferences about the temporality of any association. Moreover, the few longitudinal studies that do exist have typically relied on small samples and quite limited cognitive or oral health assessments. The aim of the present study was therefore designed to provide the first direct evaluation of whether cognitive function is predictive of poor oral health in older adults. Methods This longitudinal research included data from 339 participants aged 70 years or older from The Sydney Memory and Ageing Study (MAS), a large cohort of healthy community-dwelling older adults. Cognitive function was assessed using a battery of tests at baseline (Wave 1) in 2005 and six years later (Wave 4) in 2011. In 2015 (Wave 6), participants were assessed for oral health using the Oral Health Assessment Tool (OHAT), number of functional occluding pairs of natural teeth and sublingual resting saliva pH (SRSpH). Ordinal least squares regression analysis was used to model the effect of cognitive function on total OHAT score, and binomial logistic regression used for SRSpH and occluding pairs of functional teeth. Results Two models were tested. In the partially adjusted model, age, gender and years of education were included. The fully adjusted model additionally included medical conditions, general health, depression, smoking, alcohol consumption, functionality, and dental care utilization. The key finding to emerge was that a six-year change in memory (from Wave 1 to Wave 4) was associated with lower sublingual resting saliva pH at Wave 6 in partially (Odds Ratio (OR) = 0.65) and fully adjusted model (OR = 0.63). Conclusions This longitudinal study provides further evidence that a relationship between cognitive function and oral health exists, and also points to this relationship potentially being bi-directional, as previous evidence suggests. The findings from the study also suggest that older adults who present with greater than normal memory decline at an earlier point in life were more likely to experience poor oral health when this was evaluated at a later time-point, four years later. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02128-y.
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Chinnappa-Quinn L, Lam BCP, Harvey L, Kochan NA, Bennett M, Crawford JD, Makkar SR, Brodaty H, Sachdev PS. Surgical Hospitalization Is Not Associated With Cognitive Trajectory Over 6 Years in Healthy Older Australians. J Am Med Dir Assoc 2022; 23:608-615. [PMID: 35304131 DOI: 10.1016/j.jamda.2022.01.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/28/2022] [Accepted: 01/29/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim was to investigate the association of cognitive trajectories and overnight surgical hospitalization in older adults, while controlling for and comparing with the association with acute medical hospitalizations. DESIGN This is a secondary analysis of data from a population-based, longitudinal cohort study of older Australians. SETTING AND PARTICIPANTS Cognition was assessed with 4 biennial waves of prospective neuropsychological data from 1026 Sydney Memory and Aging Study participants age 70 to 90 years at baseline. Hospitalization exposure was obtained from 10 years of electronically linked data from the New South Wales Admitted Patient Data Collection. METHODS Latent growth curve modeling estimated global cognition z score baseline and slope over 6 years, and the effects of contemporaneous surgical and medical hospitalization predictors while controlling for potential demographic and comorbidity confounders. RESULTS After controlling for confounding variables, this analysis showed that overnight surgical hospitalizations were not associated with worse baseline global cognition or accelerated cognitive decline over 6 years. This was despite this cohort having more surgeries and more complex surgeries compared with Australian data for overnight hospitalizations in over 70-year-olds. Conversely, recent medical hospitalizations were associated with accelerated cognitive decline. CONCLUSIONS AND IMPLICATIONS This analysis finds that surgery and anesthesia are unlikely to be risk factors for medium to long-term global cognitive decline in healthy older adults, while controlling for contemporaneous medical hospitalizations. These findings are contrary to prior conclusions from several surgical studies that may have been impeded by insufficient comparison groups. They are, however, consistent with recent population-based studies suggesting surgery has minimal association with cognitive decline in the medium to long-term. Future research needs to clarify the association of surgical hospitalization with the full spectrum of cognitive outcomes including subjective cognitive complaints and dementia, and importantly, how these cognitive outcomes correlate with clinically significant functional changes.
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Affiliation(s)
- Lucia Chinnappa-Quinn
- Department of Anesthesia, Eastern Health, Box Hill, Victoria, Australia; Center for Healthy Brain Aging (CHeBA), School of Psychiatry, Center for Healthy Brain Aging, University of New South Wales (UNSW), Sydney, Australia
| | - Ben C P Lam
- Center for Healthy Brain Aging (CHeBA), School of Psychiatry, Center for Healthy Brain Aging, University of New South Wales (UNSW), Sydney, Australia
| | - Lara Harvey
- Falls, Balance and Injury Research Center, Neuroscience Research Australia; School of Population Health, University of New South Wales, Australia
| | - Nicole A Kochan
- Center for Healthy Brain Aging (CHeBA), School of Psychiatry, Center for Healthy Brain Aging, University of New South Wales (UNSW), Sydney, Australia
| | - Michael Bennett
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Australia; Department of Anesthesia and Hyperbaric Medicine, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - John D Crawford
- Center for Healthy Brain Aging (CHeBA), School of Psychiatry, Center for Healthy Brain Aging, University of New South Wales (UNSW), Sydney, Australia
| | - Steve Robert Makkar
- Center for Healthy Brain Aging (CHeBA), School of Psychiatry, Center for Healthy Brain Aging, University of New South Wales (UNSW), Sydney, Australia
| | - Henry Brodaty
- Dementia Center for Research Collaboration, School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Perminder S Sachdev
- Center for Healthy Brain Aging (CHeBA), School of Psychiatry, Center for Healthy Brain Aging, University of New South Wales (UNSW), Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia.
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Merkin A, Krishnamurthi R, Medvedev ON. Machine learning, artificial intelligence and the prediction of dementia. Curr Opin Psychiatry 2022; 35:123-129. [PMID: 34861656 DOI: 10.1097/yco.0000000000000768] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Artificial intelligence and its division machine learning are emerging technologies that are increasingly applied in medicine. Artificial intelligence facilitates automatization of analytical modelling and contributes to prediction, diagnostics and treatment of diseases. This article presents an overview of the application of artificial intelligence in dementia research. RECENT FINDINGS Machine learning and its branch Deep Learning are widely used in research to support in diagnosis and prediction of dementia. Deep Learning models in certain tasks often result in better accuracy of detection and prediction of dementia than traditional machine learning methods, but they are more costly in terms of run times and hardware requirements. Both machine learning and Deep Learning models have their own strengths and limitations. Currently, there are few datasets with limited data available to train machine learning models. There are very few commercial applications of machine learning in medical practice to date, mostly represented by mobile applications, which include questionnaires and psychometric assessments with limited machine learning data processing. SUMMARY Application of machine learning technologies in detection and prediction of dementia may provide an advantage to psychiatry and neurology by promoting a better understanding of the nature of the disease and more accurate evidence-based processes that are reproducible and standardized.
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Affiliation(s)
| | | | - Oleg N Medvedev
- University of Waikato, School of Psychology, Hamilton, New Zealand
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Truong QC, Choo C, Numbers K, Merkin AG, Brodaty H, Kochan NA, Sachdev PS, Feigin VL, Medvedev ON. Clinical investigation of dynamic and enduring aspects of global cognition in aged population. Eur J Clin Invest 2022; 52:e13681. [PMID: 34528247 DOI: 10.1111/eci.13681] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND A major issue in evaluating the cognitive status of ageing populations is a clear distinction between enduring and dynamic aspects of global cognition necessary for evaluating risks of dementia and effectiveness of preventive interventions. MATERIALS AND METHODS Generalizability Theory was applied to investigate dynamic and enduring aspects of global cognition using longitudinal data over 10 years of follow-up. Measures included the Mini-Mental Status Examination (MMSE) and the Telephone Interview for Cognitive Status-modified (TICS-M). The sample (N = 238) included 154 females, mean age = 76.54 years, SD = 3.94 from the Sydney Memory and Ageing Study. RESULTS The MMSE measured dynamic and enduring aspects of cognition to a comparable degree with 56% of variance explained by enduring aspects and 44% by dynamic aspects and showed low sensitivity/high specificity in detecting dementia. A shortened version of the MMSE (MMSE-D8) better captured dynamic aspects of cognition after removing three items less sensitive to change. The TICS-M predominantly measured enduring aspects of cognition (72%) with the remaining 28% due to dynamic aspects and displayed high sensitivity/high specificity for dementia screening. CONCLUSIONS The MMSE measures both dynamic and enduring cognitive aspects and is suitable for general clinical assessments, while the MMSE-D8 can be used to monitor transitory changes of global cognition over time. The TICS-M is more useful for measuring enduring features of cognition and screening for dementia. Our findings highlight the value of generalizability theory to distinguish dynamic and enduring features of cognition, which may contribute to preventive interventions and monitoring cognitive ability over time.
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Affiliation(s)
- Quoc C Truong
- School of Psychology, University of Waikato, Hamilton, New Zealand.,Faculty of Psychology, University of Social Sciences and Humanities, Vietnam National University Ho Chi Minh City, Hồ Chí Minh City, Viet Nam
| | - Carol Choo
- School of Psychology, University of Waikato, Hamilton, New Zealand
| | - Katya Numbers
- University of New South Wales, Sydney, New South Wales, Australia
| | - Alexander G Merkin
- Auckland University of Technology, Auckland, New Zealand.,Centre for Precise Psychiatry and Neurosciences, Kaufbeuren, Germany
| | - Henry Brodaty
- University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Oleg N Medvedev
- School of Psychology, University of Waikato, Hamilton, New Zealand
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Tarnanas I, Vlamos P, Harms DR. Can detection and prediction models for Alzheimer's Disease be applied to Prodromal Parkinson's Disease using explainable artificial intelligence? A brief report on Digital Neuro Signatures. OPEN RESEARCH EUROPE 2022; 1:146. [PMID: 37645162 PMCID: PMC10445877 DOI: 10.12688/openreseurope.14216.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 08/31/2023]
Abstract
Parkinson's disease (PD) is the fastest growing neurodegeneration and has a prediagnostic phase with a lot of challenges to identify clinical and laboratory biomarkers for those in the earliest stages or those 'at risk'. Despite the current research effort, further progress in this field hinges on the more effective application of digital biomarker and artificial intelligence applications at the prediagnostic stages of PD. It is of the highest importance to stratify such prediagnostic subjects that seem to have the most neuroprotective benefit from drugs. However, current initiatives to identify individuals at risk or in the earliest stages that might be candidates for future clinical trials are still challenging due to the limited accuracy and explainability of existing prediagnostic detection and progression prediction solutions. In this brief paper, we report on a novel digital neuro signature (DNS) for prodromal-PD based on selected digital biomarkers previously discovered on preclinical Alzheimer's disease. (AD). Our preliminary results demonstrated a standard DNS signature for both preclinical AD and prodromal PD, containing a ranked selection of features. This novel DNS signature was rapidly repurposed out of 793 digital biomarker features and selected the top 20 digital biomarkers that are predictive and could detect both the biological signature of preclinical AD and the biological mechanism of a-synucleinopathy in prodromal PD. The resulting model can provide physicians with a pool of patients potentially eligible for therapy and comes along with information about the importance of the digital biomarkers that are predictive, based on SHapley Additive exPlanations (SHAP). Similar initiatives could clarify the stage before and around diagnosis, enabling the field to push into unchartered territory at the earliest stages of the disease.
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Affiliation(s)
| | - Panagiotis Vlamos
- Bioinformatics and Human Electrophysiology Laboratory (BiHELab), Department of Informatics, Ionian University, 7 Tsirigoti Square, Corfu, Greece
| | | | - The RADAR-AD Consortium
- Altoida Inc., Washington DC, Washington, DC (DC), 20003, USA
- Bioinformatics and Human Electrophysiology Laboratory (BiHELab), Department of Informatics, Ionian University, 7 Tsirigoti Square, Corfu, Greece
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Hyun J, Hall CB, Katz MJ, Derby CA, Lipnicki DM, Crawford JD, Guaita A, Vaccaro R, Davin A, Kim KW, Han JW, Bae JB, Röhr S, Riedel-Heller S, Ganguli M, Jacobsen E, Hughes TF, Brodaty H, Kochan NA, Trollor J, Lobo A, Santabarbara J, Lopez-Anton R, Sachdev PS, Lipton RB. Education, Occupational Complexity, and Incident Dementia: A COSMIC Collaborative Cohort Study. J Alzheimers Dis 2022; 85:179-196. [PMID: 34776437 PMCID: PMC8748312 DOI: 10.3233/jad-210627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Education and occupational complexity are main sources of mental engagement during early life and adulthood respectively, but research findings are not conclusive regarding protective effects of these factors against late-life dementia. OBJECTIVE This project aimed to examine the unique contributions of education and occupational complexity to incident dementia, and to assess the mediating effects of occupational complexity on the association between education and dementia across diverse cohorts. METHOD We used data from 10,195 participants (median baseline age = 74.1, range = 58∼103), representing 9 international datasets from 6 countries over 4 continents. Using a coordinated analysis approach, the accelerated failure time model was applied to each dataset, followed by meta-analysis. In addition, causal mediation analyses were performed. RESULT The meta-analytic results indicated that both education and occupational complexity were independently associated with increased dementia-free survival time, with 28%of the effect of education mediated by occupational complexity. There was evidence of threshold effects for education, with increased dementia-free survival time associated with 'high school completion' or 'above high school' compared to 'middle school completion or below'. CONCLUSION Using datasets from a wide range of geographical regions, we found that both early life education and adulthood occupational complexity were independently predictive of dementia. Education and occupational experiences occur during early life and adulthood respectively, and dementia prevention efforts could thus be made at different stages of the life course.
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Affiliation(s)
- Jinshil Hyun
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Charles B. Hall
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A. Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - John D. Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jong Bin Bae
- Department of Brain & Cognitive Sciences, Seoul National University, Seoul, South Korea
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | | | | | | | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A. Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabarbara
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Raul Lopez-Anton
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Teruel, Spain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard B. Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Jayasena T, Bustamante S, Poljak A, Sachdev P. Assay of Fatty Acids and Their Role in the Prevention and Treatment of COVID-19. Methods Mol Biol 2022; 2511:213-234. [PMID: 35838963 DOI: 10.1007/978-1-0716-2395-4_16] [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] [Indexed: 06/15/2023]
Abstract
Since the emergence of COVID-19, concerted worldwide efforts have taken place to minimize global spread of the contagion. Its widespread effects have also facilitated evolution of new strains, such as the delta and omicron variants, which emerged toward the end of 2020 and 2021, respectively. While these variants appear to be no more deadly than the previous alpha, beta, and gamma strains, and widespread population vaccinations notwithstanding, greater virulence makes the challenge of minimizing spread even greater. One of the peculiarities of this virus is the extreme heath impacts, with the great majority of individuals minimally affected, even sometimes unaware of infection, while for a small minority, it is deadly or produces diverse long-term effects. Apart from vaccination, another approach has been an attempt to identify treatments, for those individuals for whom the virus represents a threat of particularly severe health impact(s). These treatments include anti-SARS-CoV-2 monoclonal antibodies, anticoagulant therapies, interleukin inhibitors, and anti-viral agents such as remdesivir. Nutritional factors are also under consideration, and a variety of clinical trials are showing promise for the use of specific fatty acids, or related compounds such as fat-soluble steroid vitamin D, to mitigate the more lethal aspects of COVID-19 by modulating inflammation and by anti-viral effects. Here we explore the potential protective role of fatty acids as a potential prophylactic as well as remedial treatment during viral infections, particularly COVID-19. We present a multiplexed method for the analysis of free and phospholipid bound fatty acids, which may facilitate research into the role of fatty acids as plasma biomarkers and therapeutic agents in minimizing pre- and post-infection health impacts.
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Affiliation(s)
- Tharusha Jayasena
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia.
| | - Sonia Bustamante
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, NSW, Australia
| | - Anne Poljak
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Euroa Centre, Prince of Wales Hospital, Sydney, NSW, Australia
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