Correlates of sedentary behavior in middle-aged and old age people with mild cognitive impairment: a multinational study

Vagal activity mediates the relationship between active housework and delayed neurocognitive recovery in elderly patients: a prospective nested case-control study

BACKGROUND

Regular physical activity has been shown to ameliorate cognitive decline associated with aging, and to improve autonomic nervous function. However, the effect of active housework, a form of light to moderate physical activity, on postoperative cognitive function in the elderly remain unknown. The aim of this study is to investigate whether active housework exerts a protective effect against delayed neurocognitive recovery (dNCR), and to explore the role of vagal activity in this relationship.

METHODS

This is a prospective nested case-control study that enrolled 152 elderly patients scheduled for elective knee replacement surgery. The neuropsychological assessments were conducted to evaluate dNCR both preoperatively and one week postoperatively. Physical activity levels were quantified based on the Physical Activity Scale for the Elderly and categorized into active housework and sedentary behavior groups using hierarchical clustering. High-frequency spectral analysis of heart rate variability was used to assess vagal activity. Multivariable logistic regression analysis was employed to examine the association between active housework, vagal activity, and dNCR. Additionally, mediation analysis was performed to explore the possible mediating effect of vagal activity.

RESULTS

dNCR occurred in 33/141 (23.4%) patients. Active housework was associated with 84.7% lower odds of developing dNCR [OR = 0.153, 95% CI (0.042 to 0.550), p = 0.004]. There was significant interaction between vagal activity and dNCR [OR = 0.003, 95% CI (0.001 to 0.052), p < 0.001]. Vagal activity mediated the association between active housework and dNCR, accounting for 31.92% of the mediation effect.

CONCLUSIONS

Active housework is associated with decreased incidence of dNCR, with vagal activity serving as a mediating factor. This study provides valuable insights for predicting and preventing of perioperative neurocognitive disorders in elderly patients.

TRIAL REGISTRATION

Trial registration number: ChiCTR2300070834, date of registration: April 24, 2023.

Social-Ecological Correlates of Physical Activity Among Older Adults With Subjective Cognitive Decline in Chinese Community: A Cross-Sectional Study

BACKGROUND

 Subjective cognitive decline (SCD) is an important time window for early prevention of Alzheimer's disease. Regular physical activity (PA) has positive effects on cognitive functions. Little is known about the actual PA levels and social-ecological correlates in people with SCD. This study aimed to describe PA level and examine the individual, interpersonal, and neighborhood environmental correlates of PA among older adults with SCD in the Chinese community.

METHODS

 A total of 246 older adults with SCD who participated in community physical examinations in three community health service centers in Baoding City from May to July 2023 were selected as the investigation subjects through convenience sampling. Questionnaires were conducted on PA, self-efficacy, self-regulation, social support, and community environment of older adults. Multivariate logistic regression was employed to analyze the factors influencing PA in older adults with SCD.

RESULTS

 Only 25.2% of older adults with SCD were physically active enough. Multivariate logistic regression analysis showed that PA was positively correlated with self-reported health status, self-efficacy, self-regulation, social support, and community facilities. It was negatively associated with age, income, and overweight/obesity.

CONCLUSIONS

 Factors on three levels were all significantly associated with PA. Interventions that incorporate individual, interpersonal, and social factors may be considered to promote PA in older adults with SCD. However, only a few older adults achieve the goal of 150 min/week of moderate activity.

Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis

This review was performed to determine sleep disturbance prevalence in individuals with mild cognitive impairment (MCI). The MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were systematically searched from inception to January 20, 2024. Fifty-two studies fulfilling the eligibility criteria were included. However, six of these studies were excluded from data synthesis due to poor methodological quality. The subjective sleep disturbance prevalence among all individuals with MCI was 35.8 % (95 % CI: 31.9-39.7) across 44 studies, and the objective sleep disturbance prevalence was 46.3 % (95 % CI: 36.3-56.3) across 6 studies. Five studies examined TST and WASO, while three assessed SE. Among all potential objective assessments of sleep disturbance prevalence, only TST, WASO, and SE could be meta-analyzed in MCI because of the limited number of studies available. The estimated sleep disturbance prevalence differed significantly according to measurement method, geographical region, and research design. However, the data source did not significantly influence prevalence estimates. In meta-regression analysis, publication year, participant age, percentage of females, and study quality did not predict prevalence. As subjective and objective sleep disturbances are common in people with MCI, effective intervention strategies should be developed to alleviate them.

Changes in sedentary behavior in the chronic phase following stroke

BACKGROUND

Sedentary behavior increases risk for cardiovascular diseases. Little is known about sedentary behavior through the chronic phase after stroke. We aimed to describe how long and short bouts of sedentary behavior changed over the first three years after stroke and if cognition at baseline was an independent risk factor for sedentary behavior.

METHODS

This is a sub-study of the Norwegian cognitive impairment after stroke (Nor-COAST) study, a multicenter study recruiting patients with acute stroke. Sedentary behavior was monitored with a thigh-worn sensor (ActivPal3®), at three-, 18- and 36-months post stroke. Stroke severity was assessed by National Institutes of Health Stroke Scale (NIHSS) and cognition by Montreal cognitive assessment (MoCA). Mixed model analysis with mean number of sedentary minutes accumulated daily as the dependent variable was repeated for all four zones (<30min, 30-60min, 60-90min, >90min) and for total sedentary time.

RESULTS

The number of included participants was 528 (mean age 71.4, NIHSS on day 1, 2.7). The total amount of sedentary time accumulated between 08.00-22.00 increased significantly from about 9.8 hours at three months to 10.1 hours at 36 months post stroke (p=0.002). Patient characteristics associated with prolonged duration of the sedentary bouts and sedentary time were age, high BMI, comorbidities, and impaired physical function. No significant associations between MoCA score and sedentary time were found.

CONCLUSION

The participants became increasingly sedentary and had fewer breaks in sedentary time from three to 36 months after stroke. Baseline cognition was not related to later sedentary behavior.

Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use

Background

There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however.

Objective

The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons.

Methods

Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency.

Results

From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses.

Conclusion

This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.

The association of aerobic and muscular fitness with cognitive impairment: Findings from a nationally representative survey

This study aimed to characterize the combined association between cardiorespiratory fitness (CRF), muscular strength, and cognitive outcomes in middle-aged and older adults from low and middle-income countries (LMICs). We analyzed cross-sectional, population-based data from adults aged 50 years or older from six LMICs. Mild cognitive impairment (MCI) was defined according to the National Institute on Aging-Alzheimer's Association criteria. Estimated CRF (eCRF) was calculated using previously validated, sex-specific equations. Handgrip strength (HS) was used as an indicator of muscular strength. We used linear and robust Poisson regression models to examine the associations between eCRF, HS, and MCI. Data from 28,339 adults (63.1 [9.5] years) were analyzed. Participants with low eCRF (PR: 1.45; 95%CI: 1.11, 1.90) and HS (PR: 1.92; 95%CI: 1.79, 2.04) were more prone to have MCI. Participants with low HS showed higher likelihood of MCI than those with preserved HS through the CRF range; however, this difference was not seen among highly fit individuals (10 METs or higher). Each 1-MET (PR: 0.77; 95%CI: 0.67, 0.86) and 5-kgf (PR: 0.63; 95%CI: 0.48, 0.79) increase was associated with a reduction in the likelihood of MCI. eCRF and HS were strongly and independently associated with MCI in middle-aged and older adults.

Sedentary Behavior in Older Adults With Preclinical Cognitive Impairment With and Without Chronic Kidney Disease

Older adults with preclinical cognitive impairment can have chronic conditions and lifestyle factors that influence health. Sedentary behavior is common in older adults with and without chronic kidney disease (CKD). The objective of the current study was to determine the differences in sedentary behavior for older adults with preclinical cognitive impairment with and without CKD. Our study evaluated 48 older adults with preclinical cognitive impairment with and without CKD who underwent assessment of sedentary behavior via accelerometry. We found that older adults with preclinical cognitive impairment with and without CKD were sedentary, but there were no significant differences between groups. Fragmentation index was different (p < 0.05), with a lower fragmentation index found in those with CKD. Sedentary behavior should be assessed and evaluated as a potential target for interventions to improve health in these at-risk older adults; however, further investigation is needed. [Journal of Gerontological Nursing, 47(6), 35-42.].

Prevalence and risk factors of the co-occurrence of physical frailty and cognitive impairment in Chinese community-dwelling older adults

This cross-sectional study aimed to determine the prevalence of the co-occurrence of physical frailty and cognitive impairment and to identify its associated demographic, psychosocial and behavioural factors. Participants were recruited from 32 neighbourhoods using multistage sampling method in Xuhui District, Shanghai, China. A total of 1585 older adults were included who lived in community, were 75 years or older and without a clinical diagnosis of dementia. Based on the presences of frailty (using the modified frailty phenotype criteria) and/or cognitive impairment (using Chinese version Mini-Mental Status Examination stratified by educational level), the participants were classified into four groups: normal, cognitive impairment alone, frailty alone and co-occurrence. Multinomial logistic regression analyses were conducted to identify the demographic, psychosocial (depression, social participation and social support) and behavioural (sedentary lifestyle and sleep problems) characteristics associated with the co-occurrence of physical frailty and cognitive impairment. The prevalence of frailty alone, cognitive impairment alone and the co-occurrence of physical frailty and cognitive impairment in the study sample were 7%, 26.94% and 7.19% respectively. The results of multinomial logistic regression show the following characteristics significantly associated with the co-occurrence of physical frailty and cognitive impairment: advanced age (81-85 years old, Odds Ratio, OR = 1.99, 95% CI = 1.10-3.59; 86 years or older, OR = 6.43, 95% CI = 3.66-11.29), number of co-morbidities (OR = 1.34, 95% CI = 1.01-1.77), depression (OR = 3.88, 95% CI = 2.39-6.29), social participation (OR = 0.61, 95% CI = 0.39-0.96), sedentary lifestyle (OR = 2.69, 95% CI = 1.66-4.34) and sleep problems (insomnia occasionally, OR = 1.84, 95% CI = 1.07-3.17; insomnia every day, OR = 2.38, 95% CI = 1.33-4.26). The co-occurrence of physical frailty and cognitive impairment is a prevalent health issue in oldest old community-dwelling older adults. Advanced age, co-morbidity, depression, sedentary lifestyle and sleep problems are risk factors for cognitive frailty while good social participation may have a protective effect on it.

Effects of Progressive Resistance Training on Cognition and IGF-1 Levels in Elder Women Who Live in Areas with High Air Pollution

The aim of this study was to determine the effects of a muscular strength programme on the levels of insulin-like growth factor-1 (IGF-1) and cognitive status in elder women with mild cognitive impairment who lived in areas of high air pollution. A total of 157 women participated in the study, distributed in four groups: Active/Clean (AC n = 38) and Active/Pollution (AP n = 37), who carried out a progressive resistance training programme for 24 months, and Sedentary/Clean (SC n = 40) and Sedentary/Pollution (SP n = 42). Maximum strength in the upper and lower limbs (1RM), cognition (Mini-Mental Scale Examination (MMSE)) and blood IGF-1 were evaluated. At the beginning of the intervention, there were no differences between the groups in the assessed variables. The active groups which carried out the resistance training programme (AC and AP), registered better results in IGF-1 than the sedentary groups. These differences were statistically significant in AC vs. SC (p < 0.01) and AP vs. SC (p < 0.05). Regarding MMSE, group AC registered the highest score increases (+8.2%) (significantly better than the other groups), while group SP worsened (−7%) significantly compared to the other three groups. In conclusion, resistance training had a positive effect on IGF-1, while sedentary behaviour and air pollution had a negative effect on cognitive status.