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Chew J, Tan CH, Chew P, Ng KP, Ali N, Lim WS. Cognitive frailty in older adults: examining the impact of frailty criteria on neuropsychological profile, functional outcomes, activity levels, and quality of life. Eur Geriatr Med 2024:10.1007/s41999-024-01040-8. [PMID: 39287749 DOI: 10.1007/s41999-024-01040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE Cognitive frailty (CF) is the co-existence of cognitive impairment and physical frailty without dementia, conferring greater risks of adverse clinical outcomes compared to either condition alone. However, the impact of physical frailty components on cognitive performance remains unclear. This study aims to evaluate CF by determining the neuropsychological profiles, functional outcomes, activity levels, and quality of life across the Fried Frailty Phenotype (FFP) and its components. METHODS Cross-sectional study involving 120 community-dwelling older adults without dementia, but with subjective cognitive complaints (SCC, defined as AD8 ≥ 1). Participants were stratified into three groups to assess CF: SCC-Robust, SCC-Prefrail, and SCC-Frail, and further categorized by individual FFP components. Cognitive performance was assessed by comparing neuropsychological test battery (NTB) Z-scores between CF and non-CF groups with Cohen's d for effect sizes. We performed linear regression to examine the relationships between both groups with NTB scores, Instrumental Activities of Daily Living (IADL), Frenchay Activities Index (FAI), and quality of life scores. RESULTS NTB scores showed no differences between individuals with CF when classified according to FFP criteria. Individuals with SCC-slow gait speed exhibited reduced processing speed (d = 0.62) and memory (d = 0.61); SCC-fatigue was associated with decreased working memory (d = 0.55). Regression analyses, adjusted for demographic and clinical variables, identified significant associations: slow gait speed with logical memory (- 0.42; 95% CI - 0.79 to - 0.038]) and symbol search (- 0.28; 95% CI - 0.56 to - 0.006]); fatigue with digit span backwards (- 0.66; 95% CI - 1.19 to - 0.14) and color trails 2 (- 0.67; 95% CI, - 1.15 to - 0.20). SCC-slow gait speed and SCC-fatigue were associated with reduced quality of life scores, but not with IADL and FAI scores. CONCLUSION Specific frailty components, notably slow gait speed and fatigue, influence cognitive function and quality of life. Our findings provide greater insights into characterizing CF. Further longitudinal studies are required to determine the cognitive and functional trajectories of CF.
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Affiliation(s)
- J Chew
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore.
| | - C H Tan
- Department of Psychology, Nanyang Technological University, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - P Chew
- Department of Psychological Services, Tan Tock Seng Hospital, Singapore, Singapore
| | - K P Ng
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - N Ali
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
| | - W S Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Qiu X, Kuang J, Huang Y, Wei C, Zheng X. The association between Weight-adjusted-Waist Index (WWI) and cognitive function in older adults: a cross-sectional NHANES 2011-2014 study. BMC Public Health 2024; 24:2152. [PMID: 39118100 PMCID: PMC11308487 DOI: 10.1186/s12889-024-19332-w] [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: 09/20/2023] [Accepted: 07/01/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The impact of obesity on cognitive function has engendered considerable interest. Weight-adjusted waist index (WWI) has emerged as a novel and innovative marker of obesity that reflects weight-independent abdominal obesity. However, the association between WWI and cognitive function remains unclear. To address this gap, the present study aims to explore the relationship between weight-adjusted waist index (WWI) and cognitive performance in older adults. METHODS We conducted a cross-sectional investigation using datasets from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. The study included 3,472 participants (48.59% male, 51.41% female) of various races (Mexican American, Other Hispanic, Non-Hispanic White, Non-Hispanic Black, and Other), with a mean age of 69.95 years (SD = 6.94). Multivariate regression and smoothing curve fitting were used to investigate the linear and nonlinear relationship between WWI and cognitive performance in the following domains: learning and memory, verbal fluency, and processing speed, as measured by Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), respectively. Subgroup analysis and interaction tests were conducted to examine the stability of this relationship across groups. Machine learning models based on random forests were used to analyze the predictive performance of WWI for cognitive function. RESULTS A total of 3,472 participants were included in the analysis. The results revealed significant negative associations between WWI and low scores on the CERAD-WL [-0.96 (-1.30, -0.62)], AFT [-0.77 (-1.05, -0.49)], and DSST [-3.67 (-4.55, -2.79)]. This relationship remained stable after converting WWI to a categorical variable. In addition, this significant negative association was more pronounced in men than women and diminished with advancing age. Non-linear threshold effects were observed, with correlations intensifying between WWI and CERAD-WL when WWI surpassed 12.25, AFT when WWI surpassed 11.54, and DSST when WWI surpassed 11.66. CONCLUSIONS A higher WWI, indicating increased abdominal obesity, was associated with deficits in learning, memory, verbal fluency, and processing speed among older adults. These findings suggest that abdominal obesity may play a crucial role in cognitive decline in this population. The stronger relationship observed between WWI and cognition in men highlights the need for gender-specific considerations in interventions targeting abdominal obesity. The results demonstrate the importance of interventions targeting abdominal obesity to preserve cognitive performance in older adults.
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Affiliation(s)
- Xichenhui Qiu
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China
| | - Jiahao Kuang
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China
| | - Yiqing Huang
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China
| | - Changning Wei
- School of Tech X Academy, Shenzhen Polytechnic University, No. 7098, Liuxian Avenue Nanshan District, Shenzhen, Guangdong Province, 518118, People's Republic of China
| | - Xujuan Zheng
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China.
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Ramezani Kashal F, Nouredini G, Hezaveh ZS, Fakhrzadeh H, Moodi M, Khorashadizadeh M, Khodabakhshi H, Arzaghi SM, Ebrahimpour M, Payab M, Ejtahed HS, Sharifi F. The Association between cognitive impairment and anthropometric indices among the elderly: birjand longitudinal aging study. J Diabetes Metab Disord 2024; 23:1173-1182. [PMID: 38932884 PMCID: PMC11196492 DOI: 10.1007/s40200-024-01404-8] [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: 11/23/2023] [Accepted: 02/11/2024] [Indexed: 06/28/2024]
Abstract
Background The population of older adults has been consistently on the rise. We aimed to assess the possible relationship between cognitive decline and anthropometric indices in older adults, using data from the Birjand longitudinal aging study (BLAS). Methods In this cross-sectional research, the association between cognitive impairment as determined by two tests (Six Item Cognitive Impairment Test (6-CIT)) and (Mini-Mental State Examination (MMSE)) and anthropometric indices including waist circumference (WC), body mass index (BMI), waist to height ratio (WHtR), waist to hip ratio (WHR), body roundness index (BRI), and a body shape index (ABSI) were assessed among 1353 elderly ≥ 60 years old, participating in the BLAS cohort study (September 2018 to April 2019). Ordinal and binary logistic regression were used for analysis. Results According to the MMSE test, 58.3% of participants had cognitive impairment, while this frequency was 64.2% based on the 6-CIT test. A significant reverse association was observed between cognitive decline according to the 6-CIT test and BMI, WHR, and WC (P < 0.05). Cognitive impairment, according to MMSE, was inversely associated with WC and directly associated with WHtR and ABSI in the crude model, which disappeared after adjustment for confounders. BRI was not significantly related to any of the cognitive tests. According to BMI and WC, overweight and obesity could reduce the risk of cognitive impairment. Conclusions Overall, the result of this study showed that the risk of cognitive decline decreased among the elderly as BMI, WC, and WHR increased. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-024-01404-8.
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Affiliation(s)
- Fatemeh Ramezani Kashal
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Golnoush Nouredini
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Sajadi Hezaveh
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
- School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoumeh Khorashadizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Huriye Khodabakhshi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Ebrahimpour
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Fiscella AJ, Andel R. The Association Between Physical Activity, Obesity, and Cognition in Middle-Aged and Older Adults. J Aging Phys Act 2024; 32:397-407. [PMID: 38335949 DOI: 10.1123/japa.2022-0243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/22/2023] [Accepted: 11/21/2023] [Indexed: 02/12/2024]
Abstract
As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function.
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Affiliation(s)
- Andrew J Fiscella
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Ross Andel
- Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
- Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
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Speh A, Kramberger MG, Winblad B, Bäckman L, Qiu C, Laukka EJ. Change in cardiovascular health and rate of cognitive decline in older adults: a 15-year population-based study. BMC Geriatr 2024; 24:263. [PMID: 38500037 PMCID: PMC10949596 DOI: 10.1186/s12877-024-04856-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/29/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Previous research on associations between cardiovascular health, measured at a single timepoint, and rate of age-related cognitive decline shows divergent findings dependent on the participants' age and the health metric studied. The aim of this study was to add to the knowledge in this field by investigating whether change in cardiovascular health, assessed with Life's Simple 7 (LS7) score, is associated with rate of cognitive change in young-old and old-old adults. METHODS The study included 1022 participants aged ≥ 60 years from the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K), who underwent repeated neuropsychological testing (episodic memory, semantic memory, verbal fluency, and perceptual speed) across up to 15 years. LS7, composed of seven cardiovascular health metrics (smoking, diet, physical activity, body mass index, plasma glucose, total serum cholesterol, and blood pressure), was assessed at baseline and at the 6-year follow-up. Change in LS7 was calculated as the difference between baseline and 6 years (range - 5 to 8 points) and categorised into worse (-5 to -2 points), stable (-1 to 1 points), and improved (2 to 8 points). Change in cognitive performance as a function of LS7 change categories was estimated using linear mixed-effects models. RESULTS Participants were classified as stable (67.1%), improved (21.0%), or worse (11.8%) according to changes in LS7 score. Both the worse and improved categories were associated with faster cognitive decline. Age-stratified analyses revealed that worsening of LS7 was clearly associated with faster cognitive decline in the old-old (≥ 78 years), whereas improvement tended be associated with faster cognitive decline in the young-old (< 78 years) group. CONCLUSIONS Change in cardiovascular health in old age may lead to accelerated cognitive decline, particularly in late senescence. These results suggest that it is important to monitor and maintain cardiovascular health status in very old adults.
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Affiliation(s)
- Andreja Speh
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet- Stockholm University, Tomtebodavägen 18A, Solna, Stockholm, Sweden.
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
| | - Milica G Kramberger
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Bengt Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet- Stockholm University, Tomtebodavägen 18A, Solna, Stockholm, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet- Stockholm University, Tomtebodavägen 18A, Solna, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet- Stockholm University, Tomtebodavägen 18A, Solna, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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Zhu L, Lei M, Tan L, Zou M. Sex difference in the association between BMI and cognitive impairment in Chinese older adults. J Affect Disord 2024; 349:39-47. [PMID: 38190856 DOI: 10.1016/j.jad.2024.01.021] [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: 08/05/2023] [Revised: 11/30/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND The association between body mass index (BMI) and cognitive impairment (CI) has been the subject of extensive research, yet the precise dose-response effects remain undefined. METHODS Older adults were selected from the 2011/2012 survey at baseline and the new recruits from the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Multiple logistic regression models were used to evaluate the association between BMI categories and CI, and Restricted Cubic Spline (RCS) was used to explore the nonlinear relationship between BMI and CI. RESULTS The study included 29,380 older adults aged from 65 to 117 years, with an average age of 82 years. Of these, 13,465 were men, and 5359 exhibited cognitive impairment. The logistic model indicated that in female participants, being underweight was positively correlated with CI (OR:1.32; 95%CI 1.20-1.46), whereas being overweight was inversely correlated with CI (OR:0.86; 95%CI 0.75-0.99), and we didn't find any association between BMI category and CI in male participants. RCS modeling revealed a U-shaped relationship between BMI and CI. When stratified by sex, men exhibited a similar trend, with the lowest risk at a BMI of 22.774 kg/ m2, while women had the lowest risk of CI at a BMI of 24.817 kg/ m2. LIMITATION This was a cross-sectional study, it cannot provide information on causal relationships. CONCLUSION A U-shaped relationship was observed between BMI and CI in older adults, more pronounced in the male population, suggesting that male older adults may need to manage their BMI more rigorously.
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Affiliation(s)
- Lin Zhu
- Wuhan Pulmonary Hospital, Wuhan, China
| | - Mei Lei
- Wuhan Pulmonary Hospital, Wuhan, China
| | - Li Tan
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Mingjun Zou
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Zhu W, Li Y, Zhao C, Howard VJ, Wadley VG, Judd SE, Colabianchi N, McClure LA, Hooker SP, Sun Y. Changes in Adiposity and Cognitive Function in Older Adults: The REGARDS Study. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad184. [PMID: 38134240 PMCID: PMC10873843 DOI: 10.1093/geronb/gbad184] [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: 05/18/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVES Adiposity may have a role in the risk of dementia. Fewer studies have focused on the relationship between change in adiposity and cognitive decline. Our study aimed to explore the association between the change in adiposity and cognitive function in Black and White older adults. METHODS The participants were 12,204 older adults without cognitive impairment (62.8 ± 8.0 years) in the United States. The percent body mass index change (%BMI change) and percent waist circumference change (%WC change) were measured at 2 in-home visits (first: 2003-2007, second: 2013-2016). Cognitive status was assessed by the Six-Item Screener annually. Memory and executive function were measured by word list learning, MOCA recall and orientation, and letter and animal fluency every 2 years. Logistic regression or linear regression models were used to estimate the relationship between percent change in adiposity and cognitive function. RESULTS After 12.7 ± 1.7 years, a greater decrease in %BMI change or %WC change was significantly associated with a higher risk of cognitive impairment. Compared to older adults with -5% ≤ change ≤ 5% from baseline, a significantly higher risk of cognitive impairment and greater loss in memory and executive function were found among those who experienced more than a 10% decline in %BMI change or %WC change. Older adults who experienced a 5%-10% decrease in %BMI change had a higher risk of cognitive impairment and greater loss of memory compared to those with -5% ≤ change ≤ 5%. DISCUSSION A greater decrease in %BMI (>5%) and %WC (>10%) change was associated with greater cognitive loss observed over time.
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Affiliation(s)
- Wenfei Zhu
- School of Physical Education, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Yanbing Li
- School of Physical Education, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Chenxi Zhao
- School of Physical Education, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia G Wadley
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Leslie A McClure
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - Yuliang Sun
- School of Physical Education, Shaanxi Normal University, Xi'an, Shaanxi, China
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Ururahy RDR, do Val MS, Ciciliati AMM, Leite REP, Paes VR, Rodrigues RD, Grinberg LT, Pasqualucci CA, Jacob Filho W, Suemoto CK. The Association Between Neuropathological Lesions and Body Mass Index Is Independent of Cognitive Abilities. J Alzheimers Dis 2024; 101:773-785. [PMID: 39213060 DOI: 10.3233/jad-231366] [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: 09/04/2024]
Abstract
Background The association of moderate and severe dementia with low body mass index (BMI) is well described, but weight decline seems to also occur in individuals with preclinical neuropathologies. Considering that up to one-fifth of individuals with normal cognition meet the criteria for a dementia-related neuropathological diagnosis, autopsy studies are key to detecting preclinical neurodegenerative and cerebrovascular diseases that could be underlying weight changes. Objective We investigated the association between dementia-related brain lesions and BMI and evaluated whether the cognitive function was a mediator of this association. Methods In 1,170 participants, sociodemographic data, clinical history, and cognitive post-mortem evaluation were assessed with an informant. Neuropathological evaluation was performed in all cases. Linear regression models were used to investigate the association between neuropathological lesions (exposure variable) and BMI (outcome) adjusted for demographic, clinical, and cognitive variables in the whole sample, and in only those with normal cognition. Corrections for multiple comparisons were performed. In addition, a mediation analysis was performed to investigate the direct and indirect effects of cognitive abilities on the association between neuropathology and BMI. Results Individuals with lower BMI had a higher burden of neuropathological lesions and poorer cognitive abilities. Only neurofibrillary tangles (NFT) and neuropathological comorbidity were associated with low BMI, while other neurodegenerative and cerebrovascular lesions were not. NFT were indirectly associated with BMI through cognitive abilities, and also directly, even in participants with normal cognition. Conclusions Neurofibrillary tangles were directly associated with low BMI even in individuals with preclinical Alzheimer's disease.
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Affiliation(s)
- Raul Dos Reis Ururahy
- Division of Geriatrics - Laboratório de Investigação Médica no Envelhecimento (LIM 66), University of São Paulo Medical School, São Paulo, Brazil
| | | | - Aline Maria Macagnan Ciciliati
- Division of Geriatrics - Laboratório de Investigação Médica no Envelhecimento (LIM 66), University of São Paulo Medical School, São Paulo, Brazil
| | | | - Vitor Ribeiro Paes
- Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Lea Tenenholz Grinberg
- Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil
- Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | | | - Wilson Jacob Filho
- Division of Geriatrics - Laboratório de Investigação Médica no Envelhecimento (LIM 66), University of São Paulo Medical School, São Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics - Laboratório de Patologia Cardiovascular (LIM 22), University of São Paulo Medical School, São Paulo, Brazil
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Roy A. Association Between Body Mass Index and Cognitive Function Among Older Adults in India: Findings from a Cross-Sectional Study. Exp Aging Res 2024; 50:102-116. [PMID: 36701477 DOI: 10.1080/0361073x.2023.2171686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The study aimed to explore the association between body mass index (BMI) and cognitive function among older adults in India. METHODS Cross-sectional data on 21,000 older adults aged 60 years and older from the first wave of the Longitudinal Ageing Study of India (LASI), conducted in India during 2017-18, were used. Bivariate analysis and multivariate linear regression models were applied. The cognition tests include memory, orientation, arithmetic function, executive function, and object naming. RESULTS The mean overall cognition score was 24.6 in the study population. Further, BMI status showed a significant and positive association with cognition. The association of underweight with poor cognition (β=-0.72; 95% CI = -0.89, -0.54) whereas overweight (β = 0.57; 95% CI = 0.39, 0.75) and obese (β = 0.97; 95% CI = 0.68, 1.26) with better cognition remained statistically significant after adjusting for sociodemographic, health-related behavior, and health covariates. The mean cognition score of female older adults was always lower than male older adults with normal BMI, irrespective of their BMI categories. CONCLUSIONS This study shows that an underweight BMI is associated with poor cognition in both male and female older adults. In the context of providing health care for older individuals, underweight individuals should be given more attention in India.
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Affiliation(s)
- Alok Roy
- Department of Geography, Krishnagar Govt. College, Krishnanagar, WB, India
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Qin Z, Liu Z, Li R, Luo Y, Wei Z, He L, Pei Y, Su Y, Hu X, Peng X. Association between BMI trajectories in late-middle age and subsequent dementia risk in older age: a 26-year population-based cohort study. BMC Geriatr 2023; 23:773. [PMID: 38001429 PMCID: PMC10675868 DOI: 10.1186/s12877-023-04483-z] [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: 06/16/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The association between body mass index (BMI) and dementia risk differs depending on follow-up time and age at BMI measurement. The relationship between BMI trajectories in late-middle age (50-65 years old) and the risk of dementia in older age (> 65 years old) has not been revealed. METHODS In the present study, participants from the Health and Retirement Study were included. BMI trajectories were constructed by combining BMI trend and variation information. The association between BMI trajectories at the age of 50-65 years and dementia risk after the age of 65 years was investigated. Participants with European ancestry and information on polygenic scores for cognitive performance were pooled to examine whether genetic predisposition could modify the association. RESULTS A total of 10,847 participants were included in the main analyses. A declining BMI trend and high variation in late-middle age were associated with the highest subsequent dementia risk in older age compared with an ascending BMI trend and low variation (RR = 1.76, 95% CI = 1.45-2.13). Specifically, in stratified analyses on BMI trajectories and dementia risk based on each individual's mean BMI, the strongest association between a declining BMI trend with high variation and elevated dementia risk was observed in normal BMI group (RR = 2.66, 95% CI = 1.72-4.1). Similar associations were found when participants were stratified by their genetic performance for cognition function without interaction. CONCLUSIONS A declining BMI trend and high variation in late-middle age were associated with a higher risk of dementia. Early monitoring of these individuals is needed to prevent dementia in older individuals.
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Affiliation(s)
- Zijian Qin
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zheran Liu
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ruidan Li
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yaxin Luo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zhigong Wei
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ling He
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yiyan Pei
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yonglin Su
- West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Xiaolin Hu
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Xingchen Peng
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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11
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Aiken-Morgan AT, McDonough IM, Parisi JM, Clay OJ, Thomas KR, Rotblatt LJ, Thorpe RJ, Marsiske M. Associations Between Body Mass Index and Cognitive Change in the ACTIVE Study: Variations by Race and Social Determinants of Health. J Aging Health 2023; 35:59S-73S. [PMID: 37994849 DOI: 10.1177/08982643221109645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objectives: The current study examines relationships between Body Mass Index (BMI) and cognitive performance and change in processing speed, memory, and reasoning, while accounting for variations by race and the influence of social determinants of health. Methods: Secondary data analysis of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, which included participants who self-identified as African American or Black (n = 728) and White (n = 2028). Latent growth curve modeling was used to assess study aims. Results: Increases in BMI were associated with less cognitive decline over 10 years across each cognition domain. Race moderation effects were noted for speed and memory. Relationships between BMI and cognitive trajectories were mediated by economic stability for speed and reasoning. Discussion: Overall, these findings are consistent with the "obesity paradox." Further research is needed to elucidate patterns of results by race.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Department of Psychiatry, University of North Carolina - Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Ian M McDonough
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama, Birmingham, AL, USA
| | - Kelsey R Thomas
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Lindsay J Rotblatt
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Roland J Thorpe
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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12
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Nien SW, Lin IH, Wu HC, Chen YH, Yang SC. Evaluation of Dietary Intake in Individuals with Mild Cognitive Impairment. Nutrients 2023; 15:3694. [PMID: 37686726 PMCID: PMC10490258 DOI: 10.3390/nu15173694] [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: 07/08/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
The phase of mild cognitive impairment (MCI) holds significant importance for postponing the onset of dementia. Therefore, MCI has become a central focus in research related to dementia prevention. The purpose of this study was to investigate the dietary intake and dietary patterns of MCI patients in Taiwan. In total, 40 subjects were enrolled in this cross-sectional study that was conducted from July 2019 to September 2021 at the Linkou Chang Gung Memorial Hospital. The results of the clinical dementia rating (CDR) and mini-mental state examination (MMSE) were obtained from medical records. Participants were divided into two groups: a healthy group (MMSE ≥ 26 points, CDR = 0) and an MCI group (MMSE ≥ 26 points, CDR = 0.5). Results indicated that the MCI group had significantly higher copper and lower low-fat meat intake compared to the healthy group. Furthermore, the high MIND (Mediterranean dietary approaches to stop hypertension intervention for neurodegenerative delay) diet score represented a lower risk of MCI. After adjusting for age, gender, diabetes mellitus, hypertension, and calorie intake in the multivariate regression analysis, calcium and fruit intake levels were positively associated with the MMSE, whereas low-fat meat intake was negatively associated with the CDR. In conclusion, the prevalence of MCI demonstrated a close correlation with nutrient intake, including copper and calcium. Furthermore, a MIND diet, particularly one high in n-3 polyunsaturated fatty acids, might be useful for preventing MCI. However, more extensive research with larger populations is needed to confirm this potential.
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Affiliation(s)
- Shih-Wei Nien
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 11031, Taiwan; (S.-W.N.); (Y.-H.C.)
- Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan;
| | - I-Hsin Lin
- Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan;
| | - Hsiu-Chuan Wu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan;
| | - Yi-Hsiu Chen
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 11031, Taiwan; (S.-W.N.); (Y.-H.C.)
| | - Suh-Ching Yang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 11031, Taiwan; (S.-W.N.); (Y.-H.C.)
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
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13
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Liu Q, Liao X, Pan Y, Xiang X, Zhang Y. The Obesity Paradox: Effect of Body Mass Index and Waist Circumference on Post-Stroke Cognitive Impairment. Diabetes Metab Syndr Obes 2023; 16:2457-2467. [PMID: 37605774 PMCID: PMC10440092 DOI: 10.2147/dmso.s420824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023] Open
Abstract
Background Obesity is a risk factor for dementia within the old population however not within the middle-aged population, that is referred to the "obesity paradox". This study explored the association of body mass index (BMI) and waist circumference (WC) with post-stroke cognitive impairment (PSCI) in middle-aged (40-65 years) versus old population (≥ 65 years). Methods The current study enrolled 1735 individuals over the age of 40 who had their first ischemic stroke from the Impairment of Cognition and Sleep (ICONS) subgroup of the China National Stroke Registry-3 (CNSR-3). BMI and WC were used for the diagnosis of obesity and central obesity, respectively. PSCI was diagnosed according to the Montreal Cognitive Assessment (MoCA). The main clinical outcome was the incidence of PSCI assessed at three months after stroke. Multivariable regression analysis was performed to evaluate the association between obesity and three-month PSCI. Stratified analysis was also performed to explore the effect of age on the relationship between obesity and PSCI. Results In the general population, multivariable logistic regression found that the adjusted odds ratio (OR) with 95% confidence interval (CI) of general obesity was 1.45 (1.06-1.98) and that of central obesity was 1.54 (1.24-1.91) for the three-month incidence of PSCI. Stratified analysis by age showed that the adjusted OR with a 95% CI of general obesity was 1.84 (1.24-2.72) in middle-aged patients and 0.89 (0.52-1.54) in elderly patients (p-value for interaction = 0.05). Central obesity was associated with PSCI in all age groups: 1.57 (1.18-2.09) in middle-aged patients and 1.52 (1.08-2.15) in elderly patients (p-value for interaction= 0.93). Conclusion General obesity was related to an increased risk of PSCI in middle-aged but not elderly patients, whereas central obesity was associated with an increased risk of PSCI in all age groups, suggesting that the obesity paradox arises only obesity is outlined by BMI.
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Affiliation(s)
- Qi Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaoling Liao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China
- China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China
| | - Yuesong Pan
- China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China
| | - Xianglong Xiang
- China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China
| | - Yumei Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China
- Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China
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14
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Crane B, Nichols E, Carlson M, Deal J, Gross A. Body Mass Index and Cognition: Associations Across
Mid- to Late Life and Gender Differences. J Gerontol A Biol Sci Med Sci 2023; 78:988-996. [PMID: 36638277 PMCID: PMC10235201 DOI: 10.1093/gerona/glad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Higher mid-life body mass index (BMI) is associated with lower late-life cognition. Associations between later-life BMI and cognition are less consistent; evidence suggests reverse causation may play a role. We aimed to characterize associations between BMI and cognition across a wide age range during mid- to late life (55-85 years) and examine whether associations vary by gender. METHODS We used data from the Health and Retirement Study (HRS) (N = 39,153) to examine the association between BMI and 3 cognitive outcomes: cognitive level, cognitive decline, and cognitive impairment. We used a series of linear regression, mixed effects regression, and logistic regression models, adjusting for potential confounders. RESULTS Higher BMI before age 65 (midlife) was associated with lower cognitive performance, faster rates of cognitive decline, and higher odds of cognitive impairment in late life. Averaging across analyses assessing associations between BMI measured before age 60 and late-life cognition, a 5-unit higher level of BMI was associated with a 0.26 point lower cognitive score. Beyond age 65, associations flipped, and higher BMI was associated with better late-life cognitive outcomes. Associations in both directions were stronger in women. Excluding those with BMI loss attenuated findings among women in older ages, supporting the reverse causation hypothesis. CONCLUSIONS In this sample, age 65 represented a critical turning point between mid- and late life for the association between BMI and cognition, which has important implications for recruitment strategies for studies focused on risk factors for late-life cognitive outcomes. Evidence of gender differences raises the need to further investigate plausible mechanisms.
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Affiliation(s)
- Breanna M Crane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Emma Nichols
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alden L Gross
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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15
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Grapsa I, Mamalaki E, Ntanasi E, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Scarmeas N, Yannakoulia M. Longitudinal Examination of Body Mass Index and Cognitive Function in Older Adults: The HELIAD Study. Nutrients 2023; 15:nu15071795. [PMID: 37049637 PMCID: PMC10096583 DOI: 10.3390/nu15071795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Given the increase in the aging population and thus in the prevalence of dementia, the identification of protective factors against cognitive decline is necessary. In a cohort of 1076 non-demented adults ≥ 65 years old (59.7% women) from the HELIAD study, we assessed whether changes in body mass index (BMI) were associated with changes in cognition over a 3-year follow-up period separately for those ≤ 75 and >75 years old. We identified six BMI trajectory groups based on participants' BMI status at baseline and at the first follow-up visit; normal to normal BMI was the reference group. Major cognitive domains were evaluated, and a composite index reflecting global cognition was calculated. In participants aged ≤75 years, weight loss-moving from obesity to overweight or normal BMI-was associated with less decline in the memory composite score over time (β = 0.141; p = 0.035), while 3-year maintenance of a BMI ≥ 25 kg/m2 was related to greater reduction in the visuospatial composite score over time (β = -0.093; p = 0.020). Regarding participants aged >75 years, 3-year maintenance of a BMI ≥ 30 kg/m2 contributed to a slower rate of decline in the memory composite score over time (β = 0.102; p = 0.042), whereas weight loss-from overweight to normal BMI-was associated with a decreased attention/processing speed composite score longitudinally (β = -0.275; p = 0.043). Our findings indicated that the association between changes in BMI and cognitive functioning was modified by age. Weight management may have the potential to delay cognitive decline in older adults.
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Affiliation(s)
- Ismini Grapsa
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Eva Ntanasi
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, 11636 Maroussi, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17671 Athens, Greece
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16
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Zhou T, Chen H, Huang Y, Wang B, Zheng Y, Wang L, Rong S, Ma Y, Yuan C. Longitudinal body weight dynamics in relation to cognitive decline over two decades: A prospective cohort study. Obesity (Silver Spring) 2023; 31:852-860. [PMID: 36782381 DOI: 10.1002/oby.23671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/07/2022] [Accepted: 11/03/2022] [Indexed: 02/15/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the associations of body weight change (BWC) and body weight variability (BWV) with changes in cognitive function. METHODS In 10,340 Health and Retirement Study participants (mean age: 68.0 years), body weight was reported biennially from 1993/1994 to 2016, and cognitive function was measured biennially from 1998 to 2016. We calculated BWC and BWV as the slope and root-mean-square error by regressing body weight on time for each individual. BWC was categorized by quintiles (Q): stable weight (Q2 to Q4), weight loss (Q1), and weight gain (Q5). BWV was categorized by tertiles. We used linear mixed regression models to assess associations with cognitive change. RESULTS Compared with stable weight (median: 0 kg/y), weight loss (median: -1.3 kg/y) predicted faster cognitive decline as demonstrated by mean difference of -0.023 (95% CI: -0.027 to -0.019) in cognitive change z score per year, whereas weight gain (median: 1 kg/y) was related to slower cognitive decline (β = 0.006; 95% CI: 0.003 to 0.009). Larger BWV was also associated with faster cognitive decline (β comparing the top with bottom tertile = -0.003; 95% CI: -0.006 to -0.0002). Similar associations were observed for episodic and working memory. CONCLUSIONS Weight loss and large BWV over a long time independently predicted faster cognitive decline in middle-aged and older adults, underscoring the importance of long-term dynamic body weight monitoring.
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Affiliation(s)
- Tianjing Zhou
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Chen
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuhui Huang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Binghan Wang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Zheng
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
| | - Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Shuang Rong
- Department of Nutrition, School of Public Health, Wuhan University, Wuhan, China
- Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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17
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Anaika G, Regalla SS, Reddy BM, Ganguly E, Sharma PK. Association of Obesity with Cognitive Impairment and Depression among Oldest Old Population having Frailty syndrome. J Frailty Sarcopenia Falls 2022; 7:207-221. [PMID: 36531515 PMCID: PMC9729753 DOI: 10.22540/jfsf-07-207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 06/26/2024] Open
Abstract
Objectives The objectives were to estimate prevalence of obesity among frail individuals aged ≥80 years and examine the association of obesity with cognitive impairment and depression among frail individuals aged ≥80 years. Methods Two-hundred community-dwelling participants aged ≥80 years, were enrolled; 166 frail participants were further analyzed. Obesity and adiposity were determined by Body Mass Index (BMI), Waist Circumference (WC) and Body Fat Percentage (BF%). Cognitive impairment and Depression were assessed using Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15). Frailty was assessed by Fried criteria. Chi-Square, t-test, trend-analysis and Logistic Regression (LR) were done. Results Obesity among Frail individuals aged ≥80 years was 40% using BMI and 73.2% using WC. Obesity was inversely associated with cognitive impairment and depression among frail individuals. Severity of cognitive impairment and depression was lower among obese frail than non-obese frail. Trend-analysis showed decreasing cognitive impairment and depression with increasing BF%. On LR, obesity among frail individuals had inverse association with cognitive impairment and depression. Conclusion Obesity among frail individuals aged ≥80 years was associated with lower odds of cognitive impairment and depression in our population. Positive effects of weight gain in oldest old frail individuals and development of cognitive impairment and dementia should be explored in further researches.
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Affiliation(s)
| | | | | | - Enakshi Ganguly
- Epidemiology, Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- SHARE INDIA, Fogarty International, NIH (USA) and Department of Epidemiology, University of Pittsburgh, USA
| | - Pawan Kumar Sharma
- Epidemiology, Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- SHARE INDIA, Fogarty International, NIH (USA) and Department of Epidemiology, University of Pittsburgh, USA
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18
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Chen H, Zhou T, Guo J, Ji JS, Huang L, Xu W, Zuo G, Lv X, Zheng Y, Hofman A, Ma Y, Yuan C. Association of Long-Term Body Weight Variability With Dementia: A Prospective Study. J Gerontol A Biol Sci Med Sci 2022; 77:2116-2122. [PMID: 34908120 PMCID: PMC9536437 DOI: 10.1093/gerona/glab372] [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: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Body weight variability (BWV) refers to intraindividual weight loss and gain over a period. The association of long-term BWV with dementia remains unclear and whether this association is beyond body weight change is undetermined. METHODS In the Health and Retirement Study, a total of 5 547 dementia-free participants (56.7% women; mean [SD] age, 71.1 [3.2] years) at baseline (2008) were followed up to 8 years (mean = 6.8 years) to detect incident dementia. Body weight was self-reported biennially from 1992 to 2008. BWV was measured as the coefficient of variation utilizing the body weight reported 9 times across 16 years before baseline. Cox-proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS Among the 5 547 participants, a total of 427 incident dementia cases were identified during follow-up. Greater long-term BWV was significantly associated with a higher risk of dementia (HR comparing extreme quartiles: 2.01, 95% CI: 1.48-2.72; HR of each SD increment: 1.21, 95% CI: 1.10-1.32; p-trend < .001) independent of mean body weight and body weight change. This significant association was even observed for BWV estimated approximately 15 years preceding dementia diagnosis (HR of each SD increment: 1.13, 95% CI: 1.03-1.23) and was more pronounced for that closer to diagnosis. CONCLUSION Our prospective study suggested that greater BWV may be a novel risk factor for dementia.
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Affiliation(s)
- Hui Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Tianjing Zhou
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Guo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Liyan Huang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guangmin Zuo
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaozhen Lv
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Yan Zheng
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
| | - Albert Hofman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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19
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Association of life course adiposity with risk of incident dementia: a prospective cohort study of 322,336 participants. Mol Psychiatry 2022; 27:3385-3395. [PMID: 35538193 DOI: 10.1038/s41380-022-01604-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 01/08/2023]
Abstract
Cohort studies report inconsistent associations between body mass index (BMI) and all-cause incident dementia. Furthermore, evidence on fat distribution and body composition measures are scarce and few studies estimated the association between early life adiposity and dementia risk. Here, we included 322,336 participants from UK biobank to investigate the longitudinal association between life course adiposity and risk of all-cause incident dementia and to explore the underlying mechanisms driven by metabolites, inflammatory cells and brain structures. Among the 322,336 individuals (mean (SD) age, 62.24 (5.41) years; 53.9% women) in the study, during a median 8.74 years of follow-up, 5083 all-cause incident dementia events occurred. The risk of dementia was 22% higher with plumper childhood body size (p < 0.001). A strong U-shaped association was observed between adult BMI and dementia. More fat and less fat-free mass distribution on arms were associated with a higher risk of dementia. Interestingly, similar U-shaped associations were found between BMI and four metabolites (i.e., 3-hydroxybutrate, acetone, citrate and polyunsaturated fatty acids), four inflammatory cells (i.e., neutrophil, lymphocyte, monocyte and leukocyte) and abnormalities in brain structure that were also related to dementia. The findings that adiposity is associated with metabolites, inflammatory cells and abnormalities in brain structure that were related to dementia risk might provide clues to underlying biological mechanisms. Interventions to prevent dementia should begin early in life and include not only BMI control but fat distribution and body composition.
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20
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Daou T, Abi Kharma J, Daccache A, Bassil M, Naja F, Rahi B. Association between Lebanese Mediterranean Diet and Frailty in Community-Dwelling Lebanese Older Adults-A Preliminary Study. Nutrients 2022; 14:nu14153084. [PMID: 35956260 PMCID: PMC9370448 DOI: 10.3390/nu14153084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023] Open
Abstract
Discrepancies in the characteristics of the food components of a Mediterranean diet exist based on the country of origin. In Lebanon, a traditional Mediterranean diet emphasizes the high intakes of fruits (including dried), vegetables, burghol, and dairy products. Therefore, this cross-sectional study aimed to explore the association between adherence to the Lebanese Mediterranean diet (LMD) and frailty among older adults in Lebanon. A total of 112 community-dwelling older adults aged ≥65 years were recruited. Demographic and clinical characteristics were collected through face-to-face interviews. A 61-item food frequency questionnaire (FFQ) was used to collect dietary intake data, and adherence to LMD was calculated. Physical frailty was defined by the presence of three out of the five criterion: weight loss, weakness, exhaustion, slowness, and low activity. Binary logistic regression was used to examine the relationship between LMD adherence and frailty while adjusting for several confounders. The participants’ mean age was 73 ± 12.8 and 65% were females. Sixteen (14.3%) individuals were identified as frail. Frail individuals were significantly older (p = 0.001), depressed (p < 0.001), at risk of cognitive impairment (p = 0.006), and reported polypharmacy (p = 0.003). No significant association was found between LMD adherence and frailty in fully adjusted models (OR = 0.195; 95% CI: 0.033−1.154; p = 0.071 when categorical and OR = 0.856; 95% CI: 0.668−1.097; p = 0.218 when continuous). We also performed additional analyses with a modified frailty index where house chores were not considered as part of leisure activities of the physical activity criterion. The results showed that a higher LMD adherence was associated with a significantly decreased frailty prevalence (OR = 0.123, 95% CI: 0.022−0.676, p = 0.016 when categorical and OR = 0.773, 95% CI 0.608−0.983, p = 0.036). Larger, longitudinal studies are needed to clarify the relationship between the adherence to the Lebanese Mediterranean diet and frailty in Lebanese older adults.
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Affiliation(s)
- Tracy Daou
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box 13-5053, Chouran, Beirut 1102 2801, Lebanon; (T.D.); (J.A.K.); (A.D.)
| | - Joelle Abi Kharma
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box 13-5053, Chouran, Beirut 1102 2801, Lebanon; (T.D.); (J.A.K.); (A.D.)
| | - Alexandra Daccache
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box 13-5053, Chouran, Beirut 1102 2801, Lebanon; (T.D.); (J.A.K.); (A.D.)
| | - Maya Bassil
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha P.O. Box 2713, Qatar;
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, Research Institute of Medical & Health Sciences (RIMHS), College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates;
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Berna Rahi
- Department of Family and Consumer Sciences, College of Health Sciences, Sam Houston State University, Huntsville, TX 77304, USA
- Correspondence: ; Tel.: +1-936-294-1986
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21
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Marrie RA, Patel R, Figley CR, Kornelsen J, Bolton JM, Graff LA, Mazerolle EL, Helmick C, Uddin MN, Figley TD, Marriott JJ, Bernstein CN, Fisk JD. Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure. Front Neurol 2022; 13:910014. [PMID: 35685743 PMCID: PMC9170886 DOI: 10.3389/fneur.2022.910014] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/03/2022] [Indexed: 01/09/2023] Open
Abstract
ObjectiveVascular comorbidities are associated with reduced cognitive performance and with changes in brain structure in people with multiple sclerosis (MS). Understanding causal pathways is necessary to support the design of interventions to mitigate the impacts of comorbidities, and to monitor their effectiveness. We assessed the inter-relationships among vascular comorbidity, cognition and brain structure in people with MS.MethodsAdults with neurologist-confirmed MS reported comorbidities, and underwent assessment of their blood pressure, HbA1c, and cognitive functioning (i.e., Symbol Digit Modalities Test, California Verbal Learning Test, Brief Visuospatial Memory Test-Revised, and verbal fluency). Test scores were converted to age-, sex-, and education-adjusted z-scores. Whole brain magnetic resonance imaging (MRI) was completed, from which measures of thalamic and hippocampal volumes, and mean diffusivity of gray matter and normal-appearing white matter were converted to age and sex-adjusted z-scores. Canonical correlation analysis was used to identify linear combinations of cognitive measures (cognitive variate) and MRI measures (MRI variate) that accounted for the most correlation between the cognitive and MRI measures. Regression analyses were used to test whether MRI measures mediated the relationships between the number of vascular comorbidities and cognition measures.ResultsOf 105 participants, most were women (84.8%) with a mean (SD) age of 51.8 (12.8) years and age of symptom onset of 29.4 (10.5) years. Vascular comorbidity was common, with 35.2% of participants reporting one, 15.2% reporting two, and 8.6% reporting three or more. Canonical correlation analysis of the cognitive and MRI variables identified one pair of variates (Pillai's trace = 0.45, p = 0.0035). The biggest contributors to the cognitive variate were the SDMT and CVLT-II, and to the MRI variate were gray matter MD and thalamic volume. The correlation between cognitive and MRI variates was 0.50; these variates were used in regression analyses. On regression analysis, vascular comorbidity was associated with the MRI variate, and with the cognitive variate. After adjusting for the MRI variate, vascular comorbidity was not associated with the cognitive variate.ConclusionVascular comorbidity is associated with lower cognitive function in people with MS and this association is partially mediated via changes in brain macrostructure and microstructure.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- *Correspondence: Ruth Ann Marrie
| | - Ronak Patel
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Chase R. Figley
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Division of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Division of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
| | - James M. Bolton
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lesley A. Graff
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Erin L. Mazerolle
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Carl Helmick
- Department of Psychiatry and Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Md Nasir Uddin
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Neurology, University of Rochester, Rochester, New York, NY, United States
| | - Teresa D. Figley
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - James J. Marriott
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Charles N. Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - John D. Fisk
- Nova Scotia Health and the Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, NS, Canada
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22
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Relationship Between Vitamin D Status and Brain Perfusion in Neuropsychiatric Lupus. Nucl Med Mol Imaging 2022; 56:158-168. [DOI: 10.1007/s13139-022-00741-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/20/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022] Open
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23
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Moorman SM, Kobielski S. Body Mass Index and Memory Across 18 Years in the Wisconsin Longitudinal Study. J Gerontol A Biol Sci Med Sci 2022; 78:129-133. [PMID: 35147678 PMCID: PMC9879747 DOI: 10.1093/gerona/glac037] [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: 08/31/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Body weight is a modifiable risk factor for dementia, but results have been mixed as to the ages at which normal body weight is markedly preferable to overweight or obesity. This study assessed the association between change in body mass index (BMI) over 2 periods of the life course with change in memory between the ages of 65 and 72 for males and females. METHODS Participants were 3 637 White high school graduates, born in 1939, from the Wisconsin Longitudinal Study. The statistical analyses were fixed-effects regression models, with moderation terms to test for sex differences. One set of models examined change in BMI between ages 54 and 65, and the other set examined change in BMI between ages 65 and 72. In both cases, cognitive change occurred between ages 65 and 72. RESULTS Greater increases in BMI were associated with a greater decline in immediate recall for females only, both contemporaneously and following a lag. Increases in BMI were associated with greater contemporaneous-but not lagged-declines in both delayed recall and digit ordering for both males and females. CONCLUSIONS The present study adds to the evidence that for White, high school educated Americans, weight gain in midlife and young-old age is a risk factor for memory decline. Results vary according to the timing of the weight gain, the aspect of memory measured, and participant sex.
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Affiliation(s)
- Sara M Moorman
- Address correspondence to: Sara M. Moorman, PhD, Department of Sociology, Boston College, McGuinn Hall 426, 140 Commonwealth Avenue, Chestnut Hill, MA 02467-3807, USA. E-mail:
| | - Sara Kobielski
- Department of Sociology, Boston College, Chestnut Hill, Massachusetts, USA
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24
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Drouin SM, McFall GP, Potvin O, Bellec P, Masellis M, Duchesne S, Dixon RA. Data-Driven Analyses of Longitudinal Hippocampal Imaging Trajectories: Discrimination and Biomarker Prediction of Change Classes. J Alzheimers Dis 2022; 88:97-115. [PMID: 35570482 PMCID: PMC9277685 DOI: 10.3233/jad-215289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hippocampal atrophy is a well-known biomarker of neurodegeneration, such as that observed in Alzheimer's disease (AD). Although distributions of hippocampal volume trajectories for asymptomatic individuals often reveal substantial heterogeneity, it is unclear whether interpretable trajectory classes can be objectively detected and used for prediction analyses. OBJECTIVE To detect and predict hippocampal trajectory classes in a computationally competitive context using established AD-related risk factors/biomarkers. METHODS We used biomarker/risk factor and longitudinal MRI data in asymptomatic adults from the AD Neuroimaging Initiative (n = 351; Mean = 75 years; 48.7% female). First, we applied latent class growth analyses to left (LHC) and right (RHC) hippocampal trajectory distributions to identify distinct classes. Second, using random forest analyses, we tested 38 multi-modal biomarkers/risk factors for their relative importance in discriminating the lower (potentially elevated atrophy risk) from the higher (potentially reduced risk) class. RESULTS For both LHC and RHC trajectory distribution analyses, we observed three distinct trajectory classes. Three biomarkers/risk factors predicted membership in LHC and RHC lower classes: male sex, higher education, and lower plasma Aβ1-42. Four additional factors selectively predicted membership in the lower LHC class: lower plasma tau and Aβ1-40, higher depressive symptomology, and lower body mass index. CONCLUSION Data-driven analyses of LHC and RHC trajectories detected three classes underlying the heterogeneous distributions. Machine learning analyses determined three common and four unique biomarkers/risk factors discriminating the higher and lower LHC/RHC classes. Our sequential analytic approach produced evidence that the dynamics of preclinical hippocampal trajectories can be predicted by AD-related biomarkers/risk factors from multiple modalities.
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Affiliation(s)
- Shannon M. Drouin
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
| | - G. Peggy McFall
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | | | - Pierre Bellec
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
| | - Simon Duchesne
- CERVO Brain Research Centre, Quebec, QC, Canada
- Radiology and Nuclear Medicine Department, Université Laval, Quebec, QC, Canada
| | - Roger A. Dixon
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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25
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Association Between Body Mass Index and Cognitive Function in Mild Cognitive Impairment Regardless of APOE ε4 Status. Dement Neurocogn Disord 2022; 21:30-41. [PMID: 35154338 PMCID: PMC8811203 DOI: 10.12779/dnd.2022.21.1.30] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022] Open
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26
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Brenowitz WD. Invited Commentary: Body Mass Index and Risk of Dementia-Potential Explanations for Life-Course Differences in Risk Estimates and Future Research Directions. Am J Epidemiol 2021; 190:2511-2514. [PMID: 33831175 DOI: 10.1093/aje/kwab095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
The relationship between body mass index (BMI) and health outcomes of older adults, including dementia, remains controversial. Many studies find inverse associations between BMI and dementia among older adults, while in other studies high BMI in midlife is associated with increased dementia risk. In this issue, Li et al. (Am J Epidemiol. 2021;190(12):2503-2510) examine BMI from mid- to late life and risk of dementia using the extensive follow-up of the Framingham Offspring Study. They found changing trends in the association between BMI and dementia from a positive association for midlife (ages 40-49) to an inverse trend in late life. Their work demonstrates the importance of studying dementia risk factors across the life course. Midlife obesity might be an important modifiable risk factor for dementia. However, because incipient dementia can lead to weight loss, reverse causation remains a key source of bias that could explain an inverse trend between BMI and dementia in older ages. The extent of other biases, including unmeasured confounding, inaccuracy of BMI as a measure for adiposity, or selective survival, are also unclear. Triangulating evidence on body composition and dementia risk could lead to better targets for dementia intervention, but future work will need to evaluate specific pathways.
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27
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Zeki Al Hazzouri A, Vittinghoff E, Hoang T, Golden SH, Fitzpatrick AL, Zhang A, Grasset L, Yaffe K. Body mass index in early adulthood and dementia in late life: Findings from a pooled cohort. Alzheimers Dement 2021; 17:1798-1807. [PMID: 33984188 PMCID: PMC8809510 DOI: 10.1002/alz.12367] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION To examine the independent association of body mass index (BMI) in early adulthood with dementia incidence among men and women. METHODS We studied 5104 older adults from the Cardiovascular Health Study (CHS) and the Health, Aging, and Body Composition (Health ABC) study. We imputed early adulthood and midlife BMI using a pooled parent cohort with complete adult lifespan coverage and previously established methods. Dementia was ascertained using criteria such as neuropsychological test battery, medical records, and dementia-related drug use. Pooled logistic regression (PLR) models were used. RESULTS Compared to women with normal BMI in early adulthood, the odds of dementia were higher among both overweight (odds ratio [OR] = 1.8; 95% confidence interval [CI] = 1.31 to 2.54) and obese (OR = 2.45; 95% CI = 1.47 to 4.06) women, independent of mid- and late-life BMI. Similar relationship was observed in men. CONCLUSIONS With the growing obesity epidemic among US adults, efforts aimed at reducing dementia may need to begin obesity prevention and treatment early in the life course.
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Affiliation(s)
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California San Francisco, CA
| | - Tina Hoang
- Departments of Psychiatry, University of California San Francisco, CA
| | - Sherita H. Golden
- Department of Medicine Johns Hopkins University School of Medicine and Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Annette L. Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, School of Public Health, University of Washington, WA
| | - Adina Zhang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY
| | - Leslie Grasset
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team VINTAGE, UMR 1219, F-33000 Bordeaux, France; Inserm, CIC1401-EC, F-33000 Bordeaux, France
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco, CA
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28
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Speh A, Wang R, Winblad B, Kramberger MG, Bäckman L, Qiu C, Laukka EJ. The Relationship Between Cardiovascular Health and Rate of Cognitive Decline in Young-Old and Old-Old Adults: A Population-Based Study. J Alzheimers Dis 2021; 84:1523-1537. [PMID: 34690136 PMCID: PMC8764601 DOI: 10.3233/jad-210280] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Modifiable vascular risk factors have been associated with late-life cognitive impairment. The Life Simple 7 (LS7) score comprises seven cardiovascular health metrics: smoking, diet, physical activity, body mass index, plasma glucose, total serum cholesterol, and blood pressure. Objective: To investigate the association between individual and composite LS7 metrics and rate of cognitive decline, and potential differences in these associations between young-old and old-old individuals. Methods: This cohort study included 1,950 participants aged≥60 years (M = 70.7 years) from the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K), who underwent repeated neuropsychological testing (episodic and semantic memory, verbal fluency, processing speed, global cognition) across 12 years. The LS7 score was assessed at baseline and categorized as poor, intermediate, or optimal. Level and change in cognitive performance as a function of LS7 categories were estimated using linear mixed-effects models. Results: Having an optimal LS7 total score was associated with better performance (expressed in standard deviation units) at baseline for perceptual speed (β= 0.21, 95%CI 0.12–0.29), verbal fluency (β= 0.08, 0.00–0.16), and global cognition (β= 0.06, 0.00–0.12) compared to the poor group. Age-stratified analyses revealed associations for cognitive level and change only in the young-old (< 78 years) group. For the specific metrics, diverging patterns were observed for young-old and old-old individuals. Conclusion: Meeting the LS7 criteria for ideal cardiovascular health in younger old age is associated with slower rate of cognitive decline. However, the LS7 criteria may have a different meaning for cognitive function in very old adults.
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Affiliation(s)
- Andreja Speh
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden.,Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.,Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Rui Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden.,The Swedish School of Sport and Health Science, GIH, Stockholm, Sweden.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bengt Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Milica G Kramberger
- Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
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29
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Aliberti MJR, Szlejf C, Lima-Costa MF, de Andrade FB, Alexandre TS, Ferri CP, Suemoto CK. Frailty Modifies the Association of Hypertension With Cognition in Older Adults: Evidence From the ELSI-Brazil. J Gerontol A Biol Sci Med Sci 2021; 76:1134-1143. [PMID: 33420508 DOI: 10.1093/gerona/glaa303] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The relationship between hypertension and cognition in later life is controversial. We investigated whether the association of hypertension with cognition differs in older adults according to the frailty status using cross-sectional data from the Brazilian Longitudinal Study of Aging, a nationally representative sample of adults aged ≥50 years. METHOD Hypertension was defined by a medical diagnosis or measured blood pressure ≥140/90 mm Hg. Frailty status was assessed using the Cardiovascular Health Study criteria. We estimated the association of hypertension and systolic and diastolic blood pressure with global cognition, orientation, memory, and verbal fluency z-scores, using multiple linear regression models. We also investigated interactions between hypertension and frailty on cognitive performance and impairment. RESULTS We evaluated 8609 participants (mean age = 61.9 ± 9.6 years, 53% women). Participants with hypertension (59% of adults aged 50-64 and 77% of those aged ≥65 years) had poorer scores for global cognitive performance than those without hypertension, especially among adults aged 50-64 years (β = -0.09; 95% confidence interval = -0.15, -0.04; p = .001). However, frailty modified the associations of hypertension with cognitive performance and impairment in those aged ≥65 years (p-values for interaction = .01 and .02, respectively). Among nonfrail older adults, hypertension was associated with cognitive impairment. In contrast, among frail older adults, hypertension was related to better global and memory cognitive z-scores. CONCLUSIONS Hypertension was associated with worse cognitive performance. Among older adults, hypertension was related to cognitive impairment only in nonfrail participants. Frailty evaluation may help clinicians offer personalized hypertension management in older adults.
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Affiliation(s)
- Márlon J R Aliberti
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Brazil.,Research Institute, Hospital Sirio-Libanes, Sao Paulo, Brazil
| | - Claudia Szlejf
- Department of Diagnostic and Ambulatory Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | | | - Fabíola B de Andrade
- Rene Rachou Research Institute, Oswaldo Cruz Foundation (FIOCRUZ), Minas Gerais, Brazil
| | - Tiago S Alexandre
- Department of Gerontology, Federal University of Sao Carlos, Sao Paulo, Brazil
| | - Cleusa P Ferri
- Department of Psychiatry, Universidade Federal de Sao Paulo, Brazil
| | - Claudia K Suemoto
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Brazil
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30
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Tang X, Zhao W, Lu M, Zhang X, Zhang P, Xin Z, Sun R, Tian W, Cardoso MA, Yang J, Simó R, Zhou JB, Stehouwer CDA. Relationship between Central Obesity and the incidence of Cognitive Impairment and Dementia from Cohort Studies Involving 5,060,687 Participants. Neurosci Biobehav Rev 2021; 130:301-313. [PMID: 34464646 DOI: 10.1016/j.neubiorev.2021.08.028] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 01/11/2023]
Abstract
Central obesity, measured by the waist circumference (WC) or waist-to-hip ratio, has been linked with metabolic dysfunction and structural abnormalities in the brain, two risk factors for cognitive impairment and dementia. The current analysis was performed to understand the influence of central obesity on the incidence of cognitive impairment and dementia. It included 21 studies involving 5,060,687 participants and showed that a high WC was associated with a greater risk of cognitive impairment and dementia (HR = 1.10, 95 % CI: 1.05-1.15), compared with a low WC. Sub-group analysis showed that a high WC increased the likelihood of developing cognitive impairment and dementia in individuals older than 65 years of age (HR = 1.13, 95 % CI: 1.08-1.19), whereas no association was observed in individuals younger than 65 years of age (HR = 1.04, 95 % CI: 0.93-1.16). Furthermore, dose-response meta-analysis confirmed that a high WC was a risk factor for cognitive impairment and dementia. In conclusion, central obesity, as measured by WC, was associated with a risk of cognitive impairment and dementia.
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Affiliation(s)
- Xingyao Tang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Zhao
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ming Lu
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xin Zhang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ping Zhang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhong Xin
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ran Sun
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Tian
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Jinkui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rafael Simó
- Endocrinology and Nutrition Department, Hospital Universitari Vall d'Hebron. Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Jian-Bo Zhou
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
| | - Coen D A Stehouwer
- Department of Internal Medicine and CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, the Netherlands
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Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study. Eur J Epidemiol 2021; 36:1043-1054. [PMID: 34370136 DOI: 10.1007/s10654-021-00792-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002 to 2018. Baseline BMI and BMI change were available for 12,027 adults aged older than 65 years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score lower than 18. Multivariable Cox proportional hazard model was used. Among 12,027 participants (mean age was 81.23 years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9 years' follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75-0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94-1.10) in underweight and 1.01 (95% CI 0.80-1.28) in obese participants. Large weight loss (< -10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29-1.56), compared to stable weight status group (-5% ~ 5%). In the restricted cubic spline models, BMI change showed a reverse J-shaped association with cognitive impairment. BMI-defined overweight, but not obesity, was associated with a lower risk of cognitive impairment among elderly Chinese adults, while large weight loss was associated with an increased risk. These findings are consistent with weight loss in the prodromal phase of dementia.
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Gaulton TG, Neuman MD, Brown RT, Betz ME. Association of hospitalization with driving reduction and cessation in older adults. J Am Geriatr Soc 2021; 69:2231-2239. [PMID: 33864381 PMCID: PMC8751345 DOI: 10.1111/jgs.17178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Driving has not been considered as part of the social cost of acute illness and may go unnoticed in the post-hospital care of older adults. Decreases in driving after hospitalization and at-risk populations have not been investigated. OBJECTIVE To determine the association between driving reduction and cessation and hospitalization in older adults by using nationally representative data. DESIGN Retrospective cohort analysis. SETTING Health and Retirement Study survey from 2004 to 2014. PARTICIPANTS Adults aged 65 years and older who were able to drive and had an available car (n = 12,110; 40,364 interviews). MEASUREMENTS Self-report of a hospitalization requiring an overnight stay, changes in driving patterns including driving cessation or limitations over a 2-year period, comorbid conditions, health utilization, and behaviors. RESULTS Of hospitalizations in adults aged 65 years and older, 22% were associated with a decrease in driving patterns within 2 years. The relative risk of a reduction or cessation in driving was 1.62 (95% CI: 1.54, 1.70, p < 0.001) when there was a hospitalization compared with when a hospitalization did not occur. Baseline functional, cognitive, and visual impairment, fair or poor self-rated health, and diabetes were identified as independent risk factors for decreased driving patterns after hospitalization. CONCLUSIONS Changes in driving patterns are common after a hospitalization in older adults. The findings suggest that driving, although not a current goal of post-hospital care, is important to the continued autonomy and community mobility of older adults and needs to be addressed as part of discharge planning and their recovery.
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Affiliation(s)
- Timothy G Gaulton
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia PA
| | - Mark D Neuman
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia PA
| | - Rebecca T Brown
- Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
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Morledge MD, Pories WJ. Bariatric surgery and cognitive impairment. Obesity (Silver Spring) 2021; 29:1239-1241. [PMID: 34128341 DOI: 10.1002/oby.23187] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/23/2021] [Accepted: 03/09/2021] [Indexed: 12/15/2022]
Abstract
Bariatric surgery has been shown to improve cognition in patients with severe obesity. Bariatric surgery may improve mental function in patient populations with obesity and with cognitive impairment, including nonacquired, dementia, and traumatic brain injury, although studies have been limited. Bariatric surgery provides an opportunity to explore the effects of obesity, type 2 diabetes, dyslipidemias, and other expressions of metabolic syndrome on cognition. It offers the unusual opportunity to study patients with these chronic diseases and, later, those without them. This suggests the need for further studies into the effects of bariatric surgery on patient populations with obesity and with cognitive impairment to look at the effects of the continuing metabolic brain damage in people with severe obesity when earlier intervention could be considered.
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Affiliation(s)
- Michael D Morledge
- Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Walter J Pories
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
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Lee M, Oh MS, Jung S, Lee JH, Kim CH, Jang MU, Kim YE, Bae HJ, Park J, Kang Y, Lee BC, Lim JS, Yu KH. Differential effects of body mass index on domain-specific cognitive outcomes after stroke. Sci Rep 2021; 11:14168. [PMID: 34239011 PMCID: PMC8266804 DOI: 10.1038/s41598-021-93714-7] [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: 03/02/2021] [Accepted: 06/29/2021] [Indexed: 11/12/2022] Open
Abstract
Although the obesity paradox is an important modifiable factor in cardiovascular diseases, little research has been conducted to determine how it affects post-stroke cognitive function. We aimed to investigate the association between body mass index (BMI) and domain-specific cognitive outcomes, focusing on the subdivision of each frontal domain function in post-ischemic stroke survivors. A total of 335 ischemic stroke patients were included in the study after completion of the Korean-Mini Mental Status Examination (K-MMSE) and the vascular cognitive impairment harmonization standards neuropsychological protocol at 3 months after stroke. Frontal lobe functions were analyzed using semantic/phonemic fluency, processing speed, and mental set shifting. Our study participants were categorized into four groups according to BMI quartiles. The z-scores of K-MMSE at 3 months differed significantly between the groups after adjustment for initial stroke severity (p = 0.014). Global cognitive function in stroke survivors in the Q1 (the lowest quartile) BMI group was significantly lower than those in Q2 and Q4 (the highest quartile) BMI groups (K-MMSE z-scores, Q1: − 2.10 ± 3.40 vs. Q2: 0.71 ± 1.95 and Q4: − 1.21 ± 1.65). Controlled oral word association test findings indicated that phonemic and semantic word fluency was lower in Q4 BMI group participants than in Q2 BMI group participants (p = 0.016 and p = 0.023 respectively). BMI might differentially affect cognitive domains after ischemic stroke. Although being underweight may negatively affect global cognition post-stroke, obesity could induce frontal lobe dysfunctions, specifically phonemic and semantic word fluency.
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Affiliation(s)
- Minwoo Lee
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - San Jung
- Department of Neurology, Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Ju-Hun Lee
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Chul-Ho Kim
- Department of Neurology, Chunchon Sacred Heart Hospital, Chunchon, South Korea
| | - Min Uk Jang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Young Eun Kim
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jaeseol Park
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chunchon, South Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine , 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Kyung-Ho Yu
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea.
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The risk of Alzheimer's disease according to dynamic changes in metabolic health and obesity: a nationwide population-based cohort study. Aging (Albany NY) 2021; 13:16974-16989. [PMID: 34237705 PMCID: PMC8312469 DOI: 10.18632/aging.203255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/18/2021] [Indexed: 12/29/2022]
Abstract
We evaluated the association of metabolic health and obesity phenotypes with the risk of Alzheimer's disease (AD). This study enrolled 136,847 elderly participants aged 60 or above from the Korean National Health Insurance System. At baseline examinations in 2009 and 2010, subjects were categorized into four groups: the metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO) groups. Based on the phenotypic transition after 2 years, the subjects were further categorized into 16 subgroups. They were followed from 2009 to 2015 to monitor for AD development. The MHO phenotype protected subjects from AD, relative to the MHNO phenotype (HR, 0.73; 95% CI, 0.65-0.81). Among subjects initially classified as MHO, 41.8% remained MHO, with a significantly lower risk of AD compared with the stable MHNO group (HR, 0.62; 95% CI, 0.50-0.77). Among MUO subjects at baseline, those who changed phenotype to MUNO were at higher risk of AD (HR, 1.47; 95% CI, 1.28-1.70), and the transition to the MHO phenotype protected subjects from AD (HR, 0.62; 95% CI, 0.50-0.78). The MHO phenotype conferred a decreased risk of AD. Maintenance or recovery of metabolic health might mitigate AD risk among obese individuals.
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Wang C, Fu W, Cao S, Jiang H, Guo Y, Xv H, Liu J, Gan Y, Lu Z. Weight Loss and the Risk of Dementia: A Meta-analysis of Cohort Studies. Curr Alzheimer Res 2021; 18:125-135. [PMID: 33855945 DOI: 10.2174/1567205018666210414112723] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/18/2021] [Accepted: 04/06/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Weight loss is a common phenomenon among the elderly and is identified as an important indicator of health status. Many epidemiology studies have investigated the association between weight loss and dementia, but the results were inconsistent. OBJECTIVE To examine and determine the association between weight loss and the risk of dementia. METHODS Eligible cohort studies involving weight loss and dementia were searched from PubMed, Embase, and Ovid databases through October 2018. Pooled relative risks (RRs) with its 95% confidence intervals (CIs) were used to estimate the effects of weight loss on the risk of dementia. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity. The Begg's test and Egger's test were used to assess the publication bias. RESULTS A total of 20 cohort studies with 38,141 participants were included in this meta-analysis. Weight loss was significantly associated with the risk of dementia (RR=1.26, 95% CI=1.15-1.38). BMI decline ≥0.8 units (RR=1.31, 95% CI=1.10-1.56) and ≥4% (RR=1.19, 95% CI=1.03-1.38) could increase the risk of dementia. The risk of all-cause dementia for people with weight loss increased by 31% (RR=1.31, 95% CI=1.15-1.49), and 25% higher for incident Alzheimer's disease (RR=1.25, 95% CI=1.07-1.46). Weight loss in participants with normal weight had a similar dementia risk (RR=1.21, 95% CI=1.06-1.38) with the overweight individuals (RR=1.22, 95% CI=1.11-1.34). CONCLUSION Weight loss may be associated with an increased risk of dementia, especially for Alzheimer's disease. Maintaining weight stability may help prevent dementia.
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Affiliation(s)
- Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenning Fu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Yingying Guo
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongbin Xv
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianxin Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Ciciliati AMM, Adriazola IO, Souza Farias-Itao D, Pasqualucci CA, Leite REP, Nitrini R, Grinberg LT, Jacob-Filho W, Suemoto CK. Severe Dementia Predicts Weight Loss by the Time of Death. Front Neurol 2021; 12:610302. [PMID: 34054683 PMCID: PMC8160379 DOI: 10.3389/fneur.2021.610302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/30/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Body mass index (BMI) in midlife is associated with dementia. However, the association between BMI and late-life obesity is controversial. Few studies have investigated the association between BMI and cognitive performance near the time of death using data from autopsy examination. We aimed to investigate the association between BMI and dementia in deceased individuals who underwent a full-body autopsy examination. Methods: Weight and height were measured before the autopsy exam. Cognitive function before death was investigated using the Clinical Dementia Rating (CDR) scale. The cross-sectional association between BMI and dementia was investigated using linear regression models adjusted for sociodemographic and clinical variables. Results: We included 1,090 individuals (mean age 69.5 ± 13.5 years old, 46% women). Most participants (56%) had a normal BMI (18.5–24.9 kg/m2), and the prevalence of dementia was 16%. Twenty-four percent of the sample had cancer, including 76 cases diagnosed only by the autopsy examination. Moderate and severe dementia were associated with lower BMI compared with participants with normal cognition in fully adjusted models (moderate: β = −1.92, 95% CI = −3.77 to −0.06, p = 0.042; severe: β = −2.91, 95% CI = −3.97 to −1.86, p < 0.001). Conclusion: BMI was associated with moderate and severe dementia in late life, but we did not find associations of BMI with less advanced dementia stages.
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Affiliation(s)
| | | | | | | | | | - Ricardo Nitrini
- Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Lea T Grinberg
- Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil.,Department of Neurology and Pathology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Wilson Jacob-Filho
- Discipline of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
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Yaffe K, Vittinghoff E, Hoang T, Matthews K, Golden SH, Zeki Al Hazzouri A. Cardiovascular Risk Factors Across the Life Course and Cognitive Decline: A Pooled Cohort Study. Neurology 2021; 96:e2212-e2219. [PMID: 33731482 PMCID: PMC8166431 DOI: 10.1212/wnl.0000000000011747] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/28/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Cardiovascular risk factors (CVRFs) are associated with increased risk of cognitive decline, but little is known about how early adult CVRFs and those across the life course might influence late-life cognition. To test the hypothesis that CVRFs across the adult life course are associated with late-life cognitive changes, we pooled data from 4 prospective cohorts (n = 15,001, ages 18-95). METHODS We imputed trajectories of body mass index (BMI), fasting glucose (FG), systolic blood pressure (SBP), and total cholesterol (TC) for older adults. We used linear mixed models to determine the association of early adult, midlife, and late-life CVRFs with late-life decline on global cognition (Modified Mini-Mental State Examination [3MS]) and processing speed (Digit Symbol Substitution Test [DSST]), adjusting for demographics, education, and cohort. RESULTS Elevated BMI, FG, and SBP (but not TC) at each time period were associated with greater late-life decline. Early life CVRFs were associated with the greatest change, an approximate doubling of mean 10-year decline (an additional 3-4 points for 3MS or DSST). Late-life CVRFs were associated with declines in early late life (<80 years) but with gains in very late life (≥80 years). After adjusting for CVRF exposures at all time periods, the associations for early adult and late-life CVRFs persisted. CONCLUSIONS We found that imputed CVRFs across the life course, especially in early adulthood, were associated with greater late-life cognitive decline. Our results suggest that CVRF treatment in early adulthood could benefit late-life cognition, but that treatment in very late life may not be as helpful for these outcomes.
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Affiliation(s)
- Kristine Yaffe
- From the Departments of Psychiatry and Neurology (K.Y.) and Epidemiology & Biostatistics (K.Y., E.V.), University of California San Francisco; San Francisco Veterans Affairs Medical Center (K.Y.); Northern California Institute Research for Research and Education (T.H.), San Francisco; Department of Psychiatry (K.M.), University of Pittsburgh, PA; Department of Medicine (S.H.G.), Johns Hopkins University School of Medicine; Department of Epidemiology (S.H.G.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY.
| | - Eric Vittinghoff
- From the Departments of Psychiatry and Neurology (K.Y.) and Epidemiology & Biostatistics (K.Y., E.V.), University of California San Francisco; San Francisco Veterans Affairs Medical Center (K.Y.); Northern California Institute Research for Research and Education (T.H.), San Francisco; Department of Psychiatry (K.M.), University of Pittsburgh, PA; Department of Medicine (S.H.G.), Johns Hopkins University School of Medicine; Department of Epidemiology (S.H.G.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY
| | - Tina Hoang
- From the Departments of Psychiatry and Neurology (K.Y.) and Epidemiology & Biostatistics (K.Y., E.V.), University of California San Francisco; San Francisco Veterans Affairs Medical Center (K.Y.); Northern California Institute Research for Research and Education (T.H.), San Francisco; Department of Psychiatry (K.M.), University of Pittsburgh, PA; Department of Medicine (S.H.G.), Johns Hopkins University School of Medicine; Department of Epidemiology (S.H.G.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY
| | - Karen Matthews
- From the Departments of Psychiatry and Neurology (K.Y.) and Epidemiology & Biostatistics (K.Y., E.V.), University of California San Francisco; San Francisco Veterans Affairs Medical Center (K.Y.); Northern California Institute Research for Research and Education (T.H.), San Francisco; Department of Psychiatry (K.M.), University of Pittsburgh, PA; Department of Medicine (S.H.G.), Johns Hopkins University School of Medicine; Department of Epidemiology (S.H.G.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY
| | - Sherita H Golden
- From the Departments of Psychiatry and Neurology (K.Y.) and Epidemiology & Biostatistics (K.Y., E.V.), University of California San Francisco; San Francisco Veterans Affairs Medical Center (K.Y.); Northern California Institute Research for Research and Education (T.H.), San Francisco; Department of Psychiatry (K.M.), University of Pittsburgh, PA; Department of Medicine (S.H.G.), Johns Hopkins University School of Medicine; Department of Epidemiology (S.H.G.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY
| | - Adina Zeki Al Hazzouri
- From the Departments of Psychiatry and Neurology (K.Y.) and Epidemiology & Biostatistics (K.Y., E.V.), University of California San Francisco; San Francisco Veterans Affairs Medical Center (K.Y.); Northern California Institute Research for Research and Education (T.H.), San Francisco; Department of Psychiatry (K.M.), University of Pittsburgh, PA; Department of Medicine (S.H.G.), Johns Hopkins University School of Medicine; Department of Epidemiology (S.H.G.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; and Department of Epidemiology (A.Z.A.H.), Mailman School of Public Health, Columbia University, New York, NY
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Balter LJ, Raymond JE, Aldred S, Higgs S, Bosch JA. Age, BMI, and inflammation: Associations with emotion recognition. Physiol Behav 2021; 232:113324. [PMID: 33482194 DOI: 10.1016/j.physbeh.2021.113324] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 11/18/2022]
Abstract
Experimental studies show that inflammation impairs the ability to interpret the mental state of another person, denoted theory of mind (ToM). The current study attempted a conceptual replication in states associated with elevated low-grade inflammation, i.e., high body weight and advanced age. Ninety young (M = 26.3 years, SD = 4.1) or older (M = 70.7 years, SD = 4.0) participants with either a normal body mass index (BMI) (M = 22.4, SD = 2.2) or high BMI (M = 33.1, SD = 3.8) completed the Reading the Mind in the Eyes Test (RMET) to assess emotion recognition. Plasma interleukin-6 (IL-6) level was measured to index low-grade inflammation. As anticipated, elevated IL-6 levels were found with higher BMI, although not with increased age. IL-6 was associated with poorer task performance, independent of potential demographic and health confounders (e.g., sex, education, smoking status, alcohol intake, presence of medical conditions, and medication intake). Analyses also revealed an interaction whereby young individuals with a high BMI showed worse RMET performance compared to their normal BMI counterparts, whereas the opposite pattern was found in older individuals. The present observational study replicated experimental results showing that elevated low-grade inflammation is correlated with a lower ability to infer the mental states of others. These findings suggest that also naturalistic conditions of (protracted) low-grade inflammation may alter emotion recognition.
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Affiliation(s)
- Leonie Jt Balter
- Stress Research Institute, Stockholm University, Stockholm, SE-10691.
| | - Jane E Raymond
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Sarah Aldred
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Jos A Bosch
- Psychology Department, Clinical Psychology, University of Amsterdam, Amsterdam, 1018 WT, NL
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Karlsson IK, Gatz M, Arpawong TE, Dahl Aslan AK, Reynolds CA. The dynamic association between body mass index and cognition from midlife through late-life, and the effect of sex and genetic influences. Sci Rep 2021; 11:7206. [PMID: 33785811 PMCID: PMC8010114 DOI: 10.1038/s41598-021-86667-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/18/2021] [Indexed: 11/30/2022] Open
Abstract
Body mass index (BMI) is associated with cognitive abilities, but the nature of the relationship remains largely unexplored. We aimed to investigate the bidirectional relationship from midlife through late-life, while considering sex differences and genetic predisposition to higher BMI. We used data from 23,892 individuals of European ancestry from the Health and Retirement Study, with longitudinal data on BMI and three established cognitive indices: mental status, episodic memory, and their sum, called total cognition. To investigate the dynamic relationship between BMI and cognitive abilities, we applied dual change score models of change from age 50 through 89, with a breakpoint at age 65 or 70. Models were further stratified by sex and genetic predisposition to higher BMI using tertiles of a polygenic score for BMI (PGSBMI). We demonstrated bidirectional effects between BMI and all three cognitive indices, with higher BMI contributing to steeper decline in cognitive abilities in both midlife and late-life, and higher cognitive abilities contributing to less decline in BMI in late-life. The effects of BMI on change in cognitive abilities were more evident in men compared to women, and among those in the lowest tertile of the PGSBMI compared to those in the highest tertile, while the effects of cognition on BMI were similar across groups. In conclusion, these findings highlight a reciprocal relationship between BMI and cognitive abilities, indicating that the negative effects of a higher BMI persist from midlife through late-life, and that weight-loss in late-life may be driven by cognitive decline.
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Affiliation(s)
- Ida K Karlsson
- Institute of Gerontology and Aging Research Network-Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Margaret Gatz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Thalida Em Arpawong
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Anna K Dahl Aslan
- Institute of Gerontology and Aging Research Network-Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Health Sciences, School of Health Sciences, University of Skövde, Skövde, Sweden
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Nissankara Rao LS, Kilari EK, Kola PK. Protective effect of Curcuma amada acetone extract against high-fat and high-sugar diet-induced obesity and memory impairment. Nutr Neurosci 2021; 24:212-225. [PMID: 31149894 DOI: 10.1080/1028415x.2019.1616436] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: Curcuma amada Roxb. (Mango ginger) was evaluated for anti-obesity, anti-amnesic and neuroprotection using high-fat and high-sugar diet (HFHS)-induced obesity and cognitive impairment in rats. Methods: Animals were exposed to HFHS diet to evaluate lipid parameters and subjected to Y maze test and Pole climbing test to evaluate the memory. In addition, oxidative stress parameters, acetyl cholinesterase activity (AChE), neurochemicals and histopathology were assessed in the brain. Results: HFHS diet led to increased body weight and lipid parameters (total cholesterol, low-density lipoprotein [LDL], and very low-density lipoprotein [VLDL], triglycerides [TG]) but not high-density lipoprotein (HDL). Elevated serum glutamate oxalate transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT), oxidative biomarker, decreased enzymatic and non-enzymatic antioxidants, Acetylcholinesterase (AChE) activity and reduced percentage of spontaneous alternation behaviour (% SAB in Y-maze test) as well as reduced serotonin and dopamine levels and neurodegeneration were observed in HFHS diet-fed rats. Curcuma amada (CAAE1, 100 mg/kg and CAAE2, 300 mg/kg) treatment to HFHS diet-fed rats (21 days after HFHS diet feeding alone) showed dose-dependent activity and ameliorated the HFHS diet-induced alterations in lipid parameters related to obesity, hepatological parameters, memory, oxidative stress, neurochemicals and neurodegeneration. Furthermore, 300 mg/kg of C. amada (CAAE2) augmented the memory by inhibiting acetylcholinesterase (AChE) activity; it also ameliorated the effect of antioxidants such as glutathione, superoxide dismutase (SOD), and total thiol and mitigated the effect of malondialdehyde (MDA). CAAE2 also controlled the level of dopamine and serotonin and reduced the neurodegeneration in the hippocampus CA1 region. Discussion: The results of the present study indicated that treatment with C. amada 300 mg/kg (CAAE2) attenuated the HFHS diet-induced obesity, memory loss, oxidative stress, and neurodegeneration. These study results indicated that the administration of C. amada offers a potential treatment option for obesity and memory loss, and it requires further preclinical and clinical evaluations.
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Affiliation(s)
| | - Eswar Kumar Kilari
- Department of Pharmacology, University College of Pharmaceutical Sciences, Andhra University, Visakhapatnam, Andhra Pradesh, India
| | - Phani Kumar Kola
- Department of Pharmacology, University College of Pharmaceutical Sciences, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India
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Consumption of Oleic Acid on the Preservation of Cognitive Functions in Japanese Elderly Individuals. Nutrients 2021; 13:nu13020284. [PMID: 33498506 PMCID: PMC7909548 DOI: 10.3390/nu13020284] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 02/07/2023] Open
Abstract
We recruited 154 community-dwelling elderly individuals and conducted a cohort study to find out the nutrient intake that is suitable for maintaining cognitive function in Japanese elders. Cognitive function was evaluated by the two functional tests, the Montreal Cognitive Assessment (MoCA) and Wechsler Memory Scale-Delayed Recall (WMS-DR), and daily nutrient intake was estimated from a Brief-type Self-administered Diet History Questionnaire (BDHQ). By a multiple regression analysis, among the four major nutrients (protein, fat, carbohydrate and ash), we detected a significant correlation between the score of cognitive functions assessed by both MoCA and WMS-DR and daily consumption of fat (p = 0.0317 and p = 0.0111, respectively). Among categories of fatty acid, we found a significant correlation between the score of both MoCA and WMS-DR and consumption of monounsaturated fatty acid (MUFA) (p = 0.0157 and p = 0.0136, respectively). Finally, among MUFAs, we observed a significant correlation between the score of both MoCA and WMS-DR and consumption of oleic acid (p = 0.0405 and p = 0.0165, respectively). From these observations, we can propose that daily consumption of fat, especially in oleic acid, has a beneficial effect against cognitive decline in community-dwelling Japanese elderly individuals.
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Lu Y, Sugawara Y, Matsuyama S, Tsuji I. Association between Long-term Weight Change since Midlife and Risk of Incident Disabling Dementia among Elderly Japanese: the Ohsaki Cohort 2006 Study. J Epidemiol 2020; 32:237-243. [PMID: 33390463 PMCID: PMC8979918 DOI: 10.2188/jea.je20200260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Both weight loss and cognitive impairment are common in late-life, but it remains unknown whether weight change is associated with risk of incident dementia among elderly Japanese. Our study aimed to investigate the association between long-term weight change since midlife and risk of incident disabling dementia using a community-based cohort study of elderly Japanese. Methods In 2006, we conducted a cohort study of 6,672 disability-free Japanese adults aged ≥65 years. In both 1994 and 2006, the participants reported their weight using a self-reported questionnaire. Based on weight obtained at these two time points, participants were classified into: stable weight (−1.4 to +1.4 kg), weight gain (≥+1.5 kg), and weight loss of −2.4 to −1.5 kg, −3.4 to −2.5 kg, −4.4 to −3.5 kg, −5.4 to −4.5 kg, and ≥−5.5 kg. Incident disabling dementia was retrieved from the public Long-term Care Insurance database. Participants were followed-up for 5.7 years (between April 2007 and November 2012). Cox proportional hazards model was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident disabling dementia. Results During 32,865 person-years of follow-up, 564 participants were ascertained as having incident disabling dementia. Compared with stable weight, the multivariable-adjusted HRs were 0.97 (95% CI, 0.70–1.34) for weight loss of −2.4 to −1.5 kg, 0.98 (95% CI, 0.70–1.38) for −3.4 to −2.5 kg, 1.28 (95% CI, 0.91–1.81) for −4.4 to −3.5 kg, 1.27 (95% CI, 0.92–1.77) for −5.4 to −4.5 kg, and 1.64 (95% CI, 1.29–2.09) for ≥−5.5 kg. Conclusion Our study suggested that a ≥−3.5 kg weight loss over 12 years might be associated with higher risk of incident disabling dementia among elderly Japanese.
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Affiliation(s)
- Yukai Lu
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Sanae Matsuyama
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
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Fu J, Liu Q, Du Y, Zhu Y, Sun C, Lin H, Jin M, Ma F, Li W, Liu H, Zhang X, Chen Y, Sun Z, Wang G, Huang G. Age- and Sex-Specific Prevalence and Modifiable Risk Factors of Mild Cognitive Impairment Among Older Adults in China: A Population-Based Observational Study. Front Aging Neurosci 2020; 12:578742. [PMID: 33192471 PMCID: PMC7662098 DOI: 10.3389/fnagi.2020.578742] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background Minimal data are available on the prevalence of mild cognitive impairment (MCI) in older Chinese adults. Moreover, the current information on MCI shows important geographical variations. Objective We aimed to assess the prevalence and risk factors for MCI by age and sex among older adults in a North Chinese population. Methods In this population-based cross-sectional study, we enrolled a random sample of 4,943 adults aged ≥ 60 years between March 2018 and June 2019 in Tianjin, China. Of these, 312 individuals were excluded due to a lack of data (e.g., fasting blood test). As a result, 4,631 subjects were assessed. Individuals with MCI were identified using neuropsychological assessments, including the Mini-Mental State Examination and Activities of Daily Living scale, based on a modified version of the Petersen’s criteria. Results The mean (SD) age of the 4,631 participants was 67.6 (4.89) years, and 2,579 (55.7%) were female. The overall age- and sex-standardized prevalence of MCI in our study population was 10.7%. There were significant associations of MCI with age [65–69 vs. 60–64 years, OR = 0.74; 95% confidence interval (CI): 0.58, 0.96], physical activity (≥23.0 vs. <23.0 MET-hours/week, OR = 0.79; 95% CI: 0.64, 0.96), body mass index (BMI) (OR = 0.92; 95% CI: 0.89, 0.95), grip strength (OR = 0.50; 95% CI: 0.38, 0.67), hypertension (yes vs. no, OR = 1.44; 95% CI: 1.18, 1.77), higher levels of sleepiness (OR = 1.80; 95% CI: 1.36, 2.37), and longer sleep duration (OR = 1.40; 95% CI: 1.14, 1.72). The inverse association between BMI and MCI was stronger in older age groups (P for heterogeneity = 0.003). Moreover, the magnitude of association between triglycerides and MCI was different between the sexes (P for heterogeneity = 0.029). Conclusion The age- and sex-standardized prevalence of MCI was 10.7% in the study sample. Physical activity, BMI, grip strength, sleepiness, sleep duration, and hypertension were associated with the prevalence of MCI. Additionally, triglycerides and BMI might be differently associated with the presence of MCI for different sexes and age stages, respectively.
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Affiliation(s)
- Jingzhu Fu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Qian Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yue Du
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yun Zhu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Changqing Sun
- Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Hongyan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Mengdi Jin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Fei Ma
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Huan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yongjie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhuoyu Sun
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guangshun Wang
- Department of Tumor, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
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Weiss J, Puterman E, Prather AA, Ware EB, Rehkopf DH. A data-driven prospective study of dementia among older adults in the United States. PLoS One 2020; 15:e0239994. [PMID: 33027275 PMCID: PMC7540891 DOI: 10.1371/journal.pone.0239994] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/16/2020] [Indexed: 11/18/2022] Open
Abstract
Background Studies examining risk factors for dementia have typically focused on testing a priori hypotheses within specific risk factor domains, leaving unanswered the question of what risk factors across broad and diverse research fields may be most important to predicting dementia. We examined the relative importance of 65 sociodemographic, early-life, economic, health and behavioral, social, and genetic risk factors across the life course in predicting incident dementia and how these rankings may vary across racial/ethnic (non-Hispanic white and black) and gender (men and women) groups. Methods and findings We conducted a prospective analysis of dementia and its association with 65 risk factors in a sample of 7,908 adults aged 51 years and older from the nationally representative US-based Health and Retirement Study. We used traditional survival analysis methods (Fine and Gray models) and a data-driven approach (random survival forests for competing risks) which allowed us to account for the semi-competing risk of death with up to 14 years of follow-up. Overall, the top five predictors across all groups were lower education, loneliness, lower wealth and income, and lower self-reported health. However, we observed variation in the leading predictors of dementia across racial/ethnic and gender groups such that at most four risk factors were consistently observed in the top ten predictors across the four demographic strata (non-Hispanic white men, non-Hispanic white women, non-Hispanic black men, non-Hispanic black women). Conclusions We identified leading risk factors across racial/ethnic and gender groups that predict incident dementia over a 14-year period among a nationally representative sample of US aged 51 years and older. Our ranked lists may be useful for guiding future observational and quasi-experimental research that investigates understudied domains of risk and emphasizes life course economic and health conditions as well as disparities therein.
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Affiliation(s)
- Jordan Weiss
- Population Studies Center and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail: (DHR); (JW)
| | - Eli Puterman
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Aric A. Prather
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, United States of America
| | - Erin B. Ware
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, United States of America
| | - David H. Rehkopf
- School of Medicine, Stanford University, Palo Alto, California, United States of America
- * E-mail: (DHR); (JW)
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Fung AWT. Effect of physical exercise and medication on enhancing cognitive function in older adults with vascular risk. Geriatr Gerontol Int 2020; 20:1067-1071. [PMID: 32989840 DOI: 10.1111/ggi.14048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/21/2020] [Accepted: 09/11/2020] [Indexed: 01/14/2023]
Abstract
AIM To examine the association of physical exercise (PE) and medication on cognitive function in older adults with vascular risk. METHODS This was a cross-sectional study of 478 non-demented participants aged ≥60 years with vascular risk. Management strategy included PE (mind-body exercise and/or strenuous exercise), medication, PE combined with medication and no management at all. Participation of PE was determined by self-reporting exercise engagement in the past year. Cognitive preservation was defined as a global composite z-score that was equal to or above the age and educational adjusted mean of cognitively normal older adults. Binary logistic regression was carried out to examine the association between management strategy and cognitive preservation in each exercise modality adjusted by sociodemographic, physical, mental and genetic factors. RESULTS An association was found in preserved cognitive function for those who managed their vascular risk through PE (OR 2.5, 95% CI 1.2-5.3, P = 0.015) and in combination with medication (OR 2.1, 95% CI 1.0-4.6, P = 0.05). A similar pattern was also found in each exercise subtype. A significant short-term (OR 3.6, 95% CI 1.0-12.4, P = 0.042) to lifelong (OR 3.5, 95% CI 1.4-8.5, P = 0.006) cognitive benefit was found in MB exercise. CONCLUSION Medication alone may be insufficient to preserve cognitive function in older adults with vascular risk. In our sample, medication in combined with PE is found to have significant impact on cognitive improvement. Mind-body exercise might be better than strenuous exercise, as a more sustainable cognitive effect is observed. Geriatr Gerontol Int 2020; 20: 1067-1071..
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Affiliation(s)
- Ada Wai-Tung Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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The Tendency of Modified Electroconvulsive Therapy-Related Working Memory and Subjective Memory Deficits in Depression: A Prospective Follow-up Study. J ECT 2020; 36:198-204. [PMID: 32118689 DOI: 10.1097/yct.0000000000000668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aim of the study was to explore the tendency of modified electroconvulsive therapy (MECT)-related working memory and subjective memory deficits in depressed patients. METHODS Sixty patients with unipolar/bipolar depression were prepared and enrolled for MECT and 56 subjects were enrolled as healthy controls (HCs). Their demographics (sex, age, body mass index, years of schooling, etc) and clinical characteristics (dosage and number of MECT, etc) were compared. Depression severity, working memory, and subjective memory were measured using the Hamilton Depression Rating Scale 17 (HAMD17), a Digit Span Backwards (DSB), and self-reported assessments, respectively. Measurements were taken at baseline, within 24 hours after each MECT session, and in every month for a 6-month follow-up period. RESULTS (a) The patients had poorer performance than the HCs on DSB and HAMD17 at baseline, and the DSB score and HAMD17 total scores were negatively correlated. However, after the second MECT session, the patients' HAMD17 score was significantly improved compared with that at the baseline (P < 0.05), whereas the DSB score showed no significant difference compared with the HCs (P > 0.05). (b) After the first MECT session, 62% of the patients reported subjective memory deficits, which were exacerbated over the subsequent sessions and relieved with antidepressant treatment during the follow-up period. (c) The risk factors for prolonged subjective memory deficits were overweight and the maximum MECT dosage/age (dosage/age = the percentage of output part of total dosage × 100/age, unit: 1/year) ≥ 1.5/year (odds ratio [OR] = 15.36 and 7.98). CONCLUSIONS Depressed patients showed poorer working memory than the HCs. Such memory deficit may be aggravated by MECT, although it may improve with the relief of depression. Although subjective memory deficits can occur after the first MECT session and gradually recover after the treatment, they may last for 6 months or longer. Persistent deficits may be related to being overweight and having a high MECT dosage.
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Li J, Jiao M, Wen J, Fan D, Xia Y, Cao Y, Shi R, Xiao C. Association of body mass index and blood lipid profile with cognitive function in Chinese elderly population based on data from the China Health and Nutrition Survey, 2009-2015. Psychogeriatrics 2020; 20:663-672. [PMID: 32339333 DOI: 10.1111/psyg.12559] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 11/28/2022]
Abstract
AIM The associations of body mass index (BMI) and serum lipids with cognitive function are inconsistent and remain unclear, especially in the elderly population. This discrepancy triggered our interest in exploring the impact of BMI and serum lipids on memory status among the elderly Chinese population. METHODS Data were collected from the China Health and Nutrition Survey database. We used data from the survey's 2015 wave to examine the association between BMI and memory status and from the 2009-2015 surveys to examine the association between serum lipids and cognitive function. We performed multivariable logistic regression analyses and multivariable linear regression analyses to examine these associations. RESULTS Being underweight, normal weight, and severely obese were associated with an increased risk of bad self-reported memory status, with overweight as the reference. After adjustment for confounding factors, BMI was positively associated with cognitive function score in the low BMI group (≤24.5 kg/m2 ) (β ± SE: 0.02 ± 0.01, P = 0.013) and negatively associated with cognitive function score in the high BMI group (>24.5 kg/m2 ) (β ± SE: -0.04 ± 0.01, P = 0.009) in multivariable linear regression analysis. In men, higher levels of serum triglycerides and apolipoprotein B were associated with a decreased risk of cognitive impairment. In women, a higher level of high-density lipoprotein cholesterol was associated with a decreased risk of cognitive impairment. CONCLUSION We found inverse U-shaped relationships between BMI and cognitive function and for the gender-specific association of serum lipids with cognitive function. This result indicated that among the elderly population, better nutritional status suggests superior memory status and cognitive function performance.
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Affiliation(s)
- Jiang Li
- Department of Laboratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Mingyuan Jiao
- Department of Laboratory Medicine, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Jiangping Wen
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Danping Fan
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Ya Xia
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yongtong Cao
- Department of Laboratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Rongxing Shi
- Department of Acupuncture and Moxibustion, China-Japan Friendship Hospital, Beijing, China
| | - Cheng Xiao
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
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Duan Q, Fan R, Lei R, Ma W, Ding B. Plasma fatty acid profile is related to cognitive function in obese Chinese populations (35-64 years): A cross-sectional study. Food Sci Nutr 2020; 8:4773-4781. [PMID: 32994939 PMCID: PMC7500792 DOI: 10.1002/fsn3.1738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/02/2020] [Accepted: 06/06/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A fast-growing body of evidence suggests that dietary lipids influence cognition, but the effects of dietary fatty acid (FA) intake and plasma FA profile on cognitive function in obese populations are currently unclear. The present study aimed to investigate the dietary FA intakes and plasma FA composition and their association with cognitive functions in obese and overweight populations aged 35-64 years. METHODS A total of 672 subjects were recruited and divided into normal-weight, overweight, and obese groups based on their body mass index (BMI). Dietary information was collected using a semiquantified food frequency questionnaire. Plasma FAs composition was examined using gas chromatography. The mini-mental state examination and Montreal Cognitive Assessment scales were carried out to assess the cognitive performance of each participant. Dietary FA intake and plasma FA composition were compared with rank transformation followed by one-way ANOVA analysis across different BMI groups. Spearman rank correlation analysis was used to investigate the correlation between dietary FA intake and plasma FA composition and cognitive functions in normal-weight, overweight, and obese subjects, respectively. RESULTS Overweight and obese subjects consumed larger amounts of saturated fatty acids (SFAs) compared to normal-weight participants (p < .05). Obese populations also had higher plasma levels of total SFAs and total monounsaturated fatty acid (MUFAs) than normal-weight subjects (both p < .05). In addition, plasma levels of SFAs, polyunsaturated fatty acids (PUFAs), and MUFAs were negatively correlated with cognitive functions in obese subjects but showed no correlation in normal-weight and overweight subjects. CONCLUSIONS From current data, we found higher plasma levels of SFA, PUFA, and MUFA in obese populations, which were associated with declined cognition. Lowering plasma FA levels may help maintaining normal cognitive functions in obese people.
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Affiliation(s)
- Qi Duan
- Department of EndocrinologyBeijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Rong Fan
- School of Public HealthBeijing Key Laboratory of Environmental ToxicologyCapital Medical UniversityBeijingChina
| | - Ruqing Lei
- School of Public HealthBeijing Key Laboratory of Environmental ToxicologyCapital Medical UniversityBeijingChina
| | - Weiwei Ma
- School of Public HealthBeijing Key Laboratory of Environmental ToxicologyCapital Medical UniversityBeijingChina
| | - Bingjie Ding
- Department of Clinical NutritionBeijing Friendship HospitalCapital Medical UniversityBeijingChina
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Liu Z, Yang H, Chen S, Cai J, Huang Z. The association between body mass index, waist circumference, waist-hip ratio and cognitive disorder in older adults. J Public Health (Oxf) 2020; 41:305-312. [PMID: 30020483 DOI: 10.1093/pubmed/fdy121] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 05/23/2018] [Accepted: 06/20/2018] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To examine the association between body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and cognitive disorder in older adults. METHODS Cross-sectional data from the mini-mental state examination questionnaire and physical examination of older adults (≥65, n = 1037) were collected and analyzed. Logistic regression examined the odds ratios (ORs) of cognitive performance according to BMI, WC and WHR. RESULTS The prevalence of cognitive dysfunction in older adults was 13.0%. The BMI-based overweight rate, obesity rate and central obesity rate calculated by either WC or WHR were 39.6, 11.4% and 66.5, 65.6%, respectively. The risk of cognitive impairment was increased in elderly individuals ≥70 years old than in those <70 years old (OR = 1.738). In addition, gender, WHR and smoking habit were also significantly different between the two age groups (P < 0.05). We examined the effects of different BMI values and WC/WHR central obesity on cognition impairment in ≥70-year-old adults and found that BMI obesity and WC/WHR central obesity had a combined effect on the incidence of cognition impairment (OR = 3.076 and OR = 3.584). CONCLUSIONS BMI obesity and WC/WHR central obesity have a combined effect on cognitive impairment and WHR has a stronger association with cognitive impairment than WC.
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Affiliation(s)
- Zhizhen Liu
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hongqing Yang
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Luoxing Street Community Health Service Center, Mawei District, Fuzhou, China
| | - Shiya Chen
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Cai
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zijie Huang
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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