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Xu C, Cao Z, Lu Z, Hou Y, Wang Y, Zhang X. Associations between Recreational Screen Time and Brain Health in Middle-Aged and Older Adults: A Large Prospective Cohort Study. J Am Med Dir Assoc 2024; 25:104990. [PMID: 38642587 DOI: 10.1016/j.jamda.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES To investigate the associations of recreational screen time with risks of brain-related disorders (dementia, stroke, and Parkinson's disease) and neuroimaging features. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS A total of 407,792 participants from the UK Biobank who were free of dementia, stroke, or Parkinson's disease at enrollment (2006-2010). METHODS TV viewing and time spent using the computer were self-reported at baseline. Among a subsample of 40,692 participants, neuroimaging features were measured by magnetic resonance imaging in 2014. Data were analyzed using Cox proportional hazard models, restricted cubic spline models, and general linear regression models. RESULTS During a median follow-up of 12.6 years, 5227 incident dementia, 6822 stroke, and 2308 Parkinson's disease cases were identified. Compared with TV viewing >0-1 h/day, watching TV ≥5 h/day was associated with higher risks of dementia [hazard ratio (HR), 1.44; 95% confidence interval (CI), 1.28-1.62], stroke (HR, 1.12; 95% CI, 1.01-1.25), and Parkinson's disease (HR, 1.28; 95% CI, 1.06-1.54). Moreover, we observed inverse associations between TV viewing time and both gray matter volume and hippocampus volume (Ptrend <.001). However, we did not observe the significant associations between discretional computer use and brain-related disorders or neuroimaging features. CONCLUSIONS AND IMPLICATIONS Our findings suggest that high TV viewing time is associated with increased risk of various brain-related disorders, highlighting recreational TV viewing could have an important impact on brain-related health.
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Affiliation(s)
- Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhi Cao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Zuolin Lu
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Yabing Hou
- Yanjing Medical College, Capital Medical University, Beijing, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin, China.
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Chengkai L, Junhong L, Zhengya Z, Jiaxiang Z, Fuan W, Fuxin W, Zhiyu Z, Liu S. Association between grip strength and walking pace with incidence of degenerative cervical myelopathy: a UK biobank observational study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024:10.1007/s00586-024-08374-8. [PMID: 38980365 DOI: 10.1007/s00586-024-08374-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/17/2024] [Accepted: 06/14/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE This study investigates the association between handgrip strength, walking pace, and the incidence of degenerative cervical myelopathy (DCM) using the UK Biobank dataset. METHODS We analyzed data from 364,716 UK Biobank participants without prior neurological conditions. Handgrip strength was measured with a dynamometer, and walking pace was self-reported. Cox proportional hazards models assessed hazard ratios (HRs) and 95% confidence intervals (CIs) for DCM development. RESULTS The cohort, with an average age of 56.2 years (SD, 8.1) and 47.4% male, was followed for a median of 12.6 years. During this period, 3,993 participants (1.1%) developed DCM. A significant inverse correlation was found between handgrip strength and DCM incidence (P for trend < 0.001), with decreasing HRs for DCM across quartiles of increasing grip strength: HRs were 0.70 (95% CI: 0.64-0.76), 0.62 (95% CI: 0.57-0.68), and 0.59 (95% CI: 0.54-0.66) for the second, third, and fourth quartiles, respectively. Participants with average or brisk walking paces had a lower DCM risk (HR, 0.55; 95% CI: 0.50-0.61 and HR, 0.48; 95% CI: 0.43-0.54) compared to slow walkers. The greatest risk reduction was in those with both higher handgrip strength and faster pace (HR, 0.39; 95% CI: 0.34-0.44). CONCLUSIONS Handgrip strength and walking pace are inversely associated with DCM incidence, suggesting their potential as cost-effective screening tools for identifying individuals at risk for DCM.
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Affiliation(s)
- Lin Chengkai
- Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Shenzhen Key Laboratory of Bone Tissue Repair and Translational Research, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Sun Yat-sen University, China
| | - Li Junhong
- Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zhu Zhengya
- Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zhou Jiaxiang
- Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Wang Fuan
- Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Wei Fuxin
- Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
- Shenzhen Key Laboratory of Bone Tissue Repair and Translational Research, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Sun Yat-sen University, China.
| | - Zhou Zhiyu
- Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
| | - Shaoyu Liu
- Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, Department of Spinal Surgery, Orthopaedic Research Institute, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Wang Z, Li X, Wang J, Yang W, Dove A, Lu W, Qi X, Sindi S, Xu W. Association of past and current sleep duration with structural brain differences: A large population-based study from the UK Biobank. Sleep Med 2024; 119:179-186. [PMID: 38692219 DOI: 10.1016/j.sleep.2024.04.033] [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: 12/24/2023] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE This study aimed to examine the association between past/current sleep duration and macro-/micro-structural brain outcomes and explore whether hypertension or social activity plays a role in such association. METHODS Within the UK Biobank, 40 436 dementia-free participants (age 40-70 years) underwent a baseline assessment followed by a brain magnetic resonance imaging (MRI) scan 9 years later. Past (baseline) and current (MRI scans) sleep duration (hours/day) were recorded and classified as short (≤5), intermediate (6-8), and long (≥9). Brain structural volumes and diffusion markers were assessed by MRI scans. RESULTS Compared with past intermediate sleep, past short sleep was related to smaller cortex volumes (standardized β [95 % CI]: -0.04 [-0.07, -0.02]) and lower regional fractional anisotropy (FA) (-0.08 [-0.13, -0.03]), while past long sleep was related to smaller regional subcortical volumes (standardized β: -0.04 to -0.07 for thalamus, accumbens, and hippocampus). Compared to current intermediate sleep, current short sleep was associated with smaller cortex volumes (-0.03 [-0.05, -0.01]), greater white matter hyperintensities (WMH) volumes (0.04 [0.01, 0.08]), and lower regional FA (-0.07 [-0.11, -0.02]). However, current long sleep was related to smaller total brain (-0.03 [-0.05, -0.02]), grey matter (-0.05 [-0.07, -0.03]), cortex (-0.05 [-0.07, -0.03]), regional subcortical volumes [standardized β: -0.05 to -0.09 for putamen, thalamus, hippocampus, and accumbens]), greater WMH volumes (0.06 [0.03, 0.09]), as well as lower regional FA (-0.05 [-0.09, -0.02]). The association between current long sleep duration and poor brain health was stronger among people with hypertension or low frequency of social activity (all Pinteraction <0.05). CONCLUSIONS Both past and current short/long sleep are associated with smaller brain volume and poorer white matter health in the brain, especially in individuals with hypertension and low frequency of social activity. Our findings highlight the need to maintain 6-8 h' sleep duration for healthy brain aging.
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Affiliation(s)
- Zhiyu Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xuerui Li
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China
| | - Jiao Wang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenzhe Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Wenli Lu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiuying Qi
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
| | - Weili Xu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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Wang J, Liu D, Guo C, Duan Y, Hu Z, Tian M, Xu Q, Niu Y, Yan G. Association between garden work and risk of incident dementia in an older population in China: a national cohort study. Public Health 2024; 232:74-81. [PMID: 38749151 DOI: 10.1016/j.puhe.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/07/2024] [Accepted: 04/09/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Evidence on the association between garden work and risk of incident dementia in the older Chinese population is limited. This study aimed to explore the association between the frequency of garden work and risk of incident dementia in an older population in China. STUDY DESIGN This was a national cohort study. METHODS This study analysed data from 8676 participants (median age: 86 years) from the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazard models were used to assess the association between the frequency of garden work and risk of incident dementia using hazard ratios (HRs) and 95% confidence intervals (CIs). Multiplicative and additive interaction effects were calculated between the frequency of garden work and age, sex or residence on incident dementia; subgroup analyses of the association were also conducted by age, sex and residence. In addition, sensitivity analyses were performed to assess the robustness of the results. RESULTS During 4.31 years (median) of follow-up, 633 participants developed dementia. Compared with participants who did not engage in garden work, the adjusted risk of incident dementia for those who regularly or almost daily engaged in garden work decreased by 28% (HR = 0.72, 95% CI: 0.57-0.93). An additive interaction effect between frequency of garden work and age on incident dementia was observed, with subgroup analyses demonstrating similar statistically significant associations among participants aged ≥85 years, women and city or town residents. Sensitivity analyses were consistent with the primary analysis in the present study. CONCLUSIONS Frequent engagement in garden work may be associated with a reduced risk of dementia and may be an effective measure to prevent incident dementia in the older population in China.
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Affiliation(s)
- J Wang
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - D Liu
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - C Guo
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - Y Duan
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - Z Hu
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - M Tian
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - Q Xu
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - Y Niu
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - G Yan
- School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China.
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Callow DD, Spira AP, Zipunnikov V, Lu H, Wanigatunga SK, Rabinowitz JA, Albert M, Bakker A, Soldan A. Sleep and physical activity measures are associated with resting-state network segregation in non-demented older adults. Neuroimage Clin 2024; 43:103621. [PMID: 38823249 PMCID: PMC11179421 DOI: 10.1016/j.nicl.2024.103621] [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: 02/14/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
Greater physical activity and better sleep are associated with reduced risk of cognitive decline and dementia among older adults, but little is known about their combined associations with measures of brain function and neuropathology. This study investigated potential independent and interactive cross-sectional relationships between actigraphy-estimated total volume of physical activity (TVPA) and sleep patterns [i.e., total sleep time (TST), sleep efficiency (SE)] with resting-state functional magnetic resonance imaging (rs-fMRI) measures of large scale network connectivity and positron emission tomography (PET) measures of amyloid-β. Participants were 135 non-demented older adults from the BIOCARD study (116 cognitively normal and 19 with mild cognitive impairment; mean age = 70.0 years). Using multiple linear regression analyses, we assessed the association between TVPA, TST, and SE with connectivity within the default-mode, salience, and fronto-parietal control networks, and with network modularity, a measure of network segregation. Higher TVPA and SE were independently associated with greater network modularity, although the positive relationship of SE with modularity was only present in amyloid-negative individuals. Additionally, higher TVPA was associated with greater connectivity within the default-mode network, while greater SE was related to greater connectivity within the salience network. In contrast, longer TST was associated with lower network modularity, particularly among amyloid-positive individuals, suggesting a relationship between longer sleep duration and greater network disorganization. Physical activity and sleep measures were not associated with amyloid positivity. These data suggest that greater physical activity levels and more efficient sleep may promote more segregated and potentially resilient functional networks and increase functional connectivity within specific large-scale networks and that the relationship between sleep and functional networks connectivity may depend on amyloid status.
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Affiliation(s)
- Daniel D Callow
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Adam P Spira
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America; Johns Hopkins Center on Aging and Health, Baltimore, MD, the United States of America
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America
| | - Jill A Rabinowitz
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ US
| | - Marilyn Albert
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Arnold Bakker
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Anja Soldan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
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Zhang Y, Zhu Y, Zhang X, Li C, Fu H, Lin L, Yang Z, Zhang B. The association of sleep duration and leukocyte telomere length in middle-aged and young-old adults: A cross-sectional study of UK Biobank. Sleep Med 2024; 117:18-24. [PMID: 38493659 DOI: 10.1016/j.sleep.2024.02.043] [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: 01/08/2024] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND The relationships between sleep duration and aging-associated diseases are intricate. Leukocyte telomere length (LTL) is a biomarker of aging, while the association of sleep duration and LTL is unclear. METHODS The 310,091 study participants from UK Biobank were enrolled in this cross-sectional study. Restricted cubic splines (RCS) analysis was firstly performed to assess the nonlinear relationship between sleep duration and LTL. Sleep duration was then categorized into three groups: <7 h (short sleep duration), 7-8 h (reference group), and >8 h (long sleep duration) and multiple linear regression was applied to analyze the association of short sleep and long sleep duration with LTL. We further performed subgroup analyses stratified by sex, age, chronotype and snoring. RESULTS RCS showed an inverted J-shaped relationship between sleep duration and LTL. Compared with the reference group, the inverse association of long sleep duration and LTL was statistically significant in fully-adjusted model (P = 0.001). Subgroup analyses showed that this association was more apparent in people over 50 years (51-60 y: P = 0.002; >60 y: P = 0.005), in men (P = 0.022), and in people preferred evening chronotype (P = 0.001). CONCLUSION Compared with participants sleeping 7-8 h, those sleep longer than 8 h had shorter LTL in middle-aged and young-old adults. The negative association between long sleep duration and LTL was more apparent in older people, in men, and in people preferred evening chronotype.
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Affiliation(s)
- Yuchun Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, 510515, PR China
| | - Yuanting Zhu
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China; NHC Key Laboratory on Assisted Circulation (Sun Yat-sen University), Guangzhou, 510080, PR China
| | - Xiaojun Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, 510515, PR China
| | - Chunhao Li
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, 510515, PR China
| | - Hongna Fu
- NHC Key Laboratory on Assisted Circulation (Sun Yat-sen University), Guangzhou, 510080, PR China; Department of Emergency, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Luyang Lin
- NHC Key Laboratory on Assisted Circulation (Sun Yat-sen University), Guangzhou, 510080, PR China; Department of Emergency, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Zhen Yang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China; NHC Key Laboratory on Assisted Circulation (Sun Yat-sen University), Guangzhou, 510080, PR China; Department of Emergency, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Bo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, 510515, PR China.
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Ding Q. Editorial: The 3 S's: sex, stress, and sleep as risk factors for dementias. Front Aging Neurosci 2024; 16:1410797. [PMID: 38711598 PMCID: PMC11070573 DOI: 10.3389/fnagi.2024.1410797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/10/2024] [Indexed: 05/08/2024] Open
Affiliation(s)
- Qunxing Ding
- Kent State University, East Liverpool, OH, United States
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Liu YJ, Li FR, Han WW, Liu Y, Liu Y, Wang JM, Miao MY, Lyu JQ, Wan ZX, Qin LQ, Chen GC. Relationship of microvascular complications and healthy lifestyle with all-cause and cardiovascular mortality in women compared with men with type 2 diabetes. Clin Nutr 2024; 43:1033-1040. [PMID: 38527395 DOI: 10.1016/j.clnu.2024.03.005] [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: 10/11/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Sex differences exist in the prevalence of microvascular disease (MVD) and healthy-lifestyle adherence. Whether MVD and healthy lifestyles are associated with mortality risk similarly for women and men who have type 2 diabetes mellitus (T2DM) remains unknown. METHODS The present study included 9992 women and 15,860 men with T2DM from the UK Biobank. MVDs included retinopathy, peripheral neuropathy, and chronic kidney disease. Healthy lifestyle factors consisted of ideal BMI, nonsmoking, healthy diet, regular exercise, and appropriate sleep duration. Sex-specific hazard ratios (HRs) of mortality associated with the MVDs or healthy lifestyles were calculated and women-to-men ratio of HRs (RHR) were further estimated, after multivariable adjustment for potential confounders. RESULTS During a median of 12.7 years of follow-up, 4346 (1202 in women) all-cause and 1207 (254 in women) CVD deaths were recorded. The adjusted HRs (95% CI) of all-cause mortality for 1 additional increment of the MVDs were 1.71 (1.55, 1.88) for women and 1.48 (1.39, 1.57) for men, with an RHR of 1.16 (1.03, 1.30). The corresponding RHR was 1.36 (1.09, 1.69) for cardiovascular mortality. Adhering to a healthy lifestyle (≥4 vs. ≤1 lifestyle factor) was associated with an approximately 60%-70% lower risk of all-cause and cardiovascular mortality without sex differences (P-interaction >0.70). Furthermore, as compared with having no MVD and an unfavorable lifestyle, having ≥2 MVDs but a favorable lifestyle was not associated with a higher risk of all-cause mortality either in women (HR = 0.88; 95% CI: 0.49, 1.60) or in men (HR = 0.95; 95% CI: 0.64, 1.40), similarly when considering cardiovascular mortality. CONCLUSIONS In T2DM, while MVDs are more strongly associated with mortality risk in women than in men, adhering to a favorable lifestyle is associated with a substantially lower risk of mortality and may eliminate the detrimental impact of MVDs in both sexes.
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Affiliation(s)
- Yu-Jie Liu
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Fu-Rong Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Wen-Wen Han
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yan Liu
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yu Liu
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jia-Min Wang
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Meng-Yuan Miao
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jie-Qiong Lyu
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Zhong-Xiao Wan
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
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Fjell AM, Walhovd KB. Individual sleep need is flexible and dynamically related to cognitive function. Nat Hum Behav 2024; 8:422-430. [PMID: 38379065 DOI: 10.1038/s41562-024-01827-6] [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: 05/25/2023] [Accepted: 01/15/2024] [Indexed: 02/22/2024]
Abstract
Given that sleep deprivation studies consistently show that short sleep causes neurocognitive deficits, the effects of insufficient sleep on brain health and cognition are of great interest and concern. Here we argue that experimentally restricted sleep is not a good model for understanding the normal functions of sleep in naturalistic settings. Cross-disciplinary research suggests that human sleep is remarkably dependent on environmental conditions and social norms, thus escaping universally applicable rules. Sleep need varies over time and differs between individuals, showing a complex relationship with neurocognitive function. This aspect of sleep is rarely addressed in experimental work and is not reflected in expert recommendations about sleep duration. We recommend focusing on the role of individual and environmental factors to improve our understanding of the relationship between human sleep and cognition.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway.
- Center for Computational Radiology and Artificial Intelligence, Oslo University Hospital, Oslo, Norway.
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Center for Computational Radiology and Artificial Intelligence, Oslo University Hospital, Oslo, Norway
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Du Z, Sato K, Tsuji T, Kondo K, Kondo N. Sedentary behavior and the combination of physical activity associated with dementia, functional disability, and mortality: A cohort study of 90,471 older adults in Japan. Prev Med 2024; 180:107879. [PMID: 38272270 DOI: 10.1016/j.ypmed.2024.107879] [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: 09/29/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE To examine the associations of sedentary behavior (SB) and the combination of moderate-to-vigorous intensity physical activity (MVPA) with dementia, functional disability, and mortality in older adults, and the heterogeneity in different subpopulations. METHODS Nation-wide cohort with 90,471 individuals aged ≥65 years in Japan. SB (<3, 3-<8, and ≥ 8 h per day [h/d]) and MVPA (0, 0 < MVPA<1, and ≥ 1 h/d) were measured in 2016. Long-term care registry-based incidence of outcomes was ascertained through 2021. Cox proportional hazard models were performed. RESULTS Compared with SB < 3 h/d group, SB ≥ 8 h/d was associated with higher risks of dementia, functional disability, and mortality with hazard ratios (95% confidence interval) of 1.36 (1.22-1.52), 1.32 (1.19-1.48), and 1.31 (1.18-1.45). The combination of MVPA and SB demonstrated a dose-respond trend of increasing risks of dementia, functional disability, and mortality with increased SB and decreased MVPA, where participants who spent no MVPA with SB ≥ 8 h/d had the highest risks. High MVPA attenuated but didn't eliminate the risks. Participants who spent MVPA≥1 h/d with SB ≥ 8 h/d had comparable risks to those who spent no MVPA with SB < 3 h/d. No heterogeneity was found by MVPA levels, sex, education, comorbidity, and depression conditions. CONCLUSIONS Prolonged daily SB was associated with higher risks of dementia, functional disability, and mortality in older adults, regardless of MVPA, sex, education, and chronic conditions. Individuals with high MVPA also face considerable risks when engaging in high SB. High MVPA with high SB revealed a comparable risk to no MVPA with low SB.
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Affiliation(s)
- Zhen Du
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Koryu Sato
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
| | - Taishi Tsuji
- Institute of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan; Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
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Lam A, Kong S, Naismith SL. Recent advances in understanding of sleep disorders and disturbances for dementia risk and prevention. Curr Opin Psychiatry 2024; 37:94-100. [PMID: 38226546 DOI: 10.1097/yco.0000000000000921] [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] [Indexed: 01/17/2024]
Abstract
PURPOSE OF REVIEW To synthesise the recent work examining the relationship between sleep disturbances and dementia, emphasising studies involving individuals with mild cognitive impairment (MCI) or Alzheimer's disease (AD) and/or those investigating AD biomarkers. Additionally, we provide an update on recent interventions targeting sleep-related issues in older adults with MCI or AD. RECENT FINDINGS Various studies have examined obstructive sleep apnoea, sleep duration, and circadian alterations in relation to Alzheimer's pathology and dementia risk, with an emerging body of evidence suggesting that cardiovascular disease, hypertension, glymphatic function, and inflammation might serve as plausible pathophysiological mechanisms contributing to dementia during critical brain periods. Conversely, recent studies investigating insomnia have produced disparate results. Regarding intervention studies, the scarcity of prospective randomised control trials poses a challenge in establishing the benefits of addressing sleep disorders and disturbances. SUMMARY Recent work examining the pathophysiological links between sleep and dementia is strongest for obstructive sleep apnoea and sleep duration, while findings in insomnia studies exhibit inconsistency, possibly due to varied associations with dementia among different insomnia subtypes. It is apparent that more longitudinal studies examining the underlying pathophysiological mechanisms are necessary, alongside more rigorous clinical trials. Although some trials are underway in this field, there is still scarcity in trials examining interventions for circadian disturbances.
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Affiliation(s)
- Aaron Lam
- Healthy Brain Ageing Program, Brain and Mind Centre
- School of Psychology, Faculty of Science
- Charles Perkins Centre, The University of Sydney, Camperdown
- The Woolcock Institute of Medical Research, Sydney, NSW, Australia
| | - Shawn Kong
- Healthy Brain Ageing Program, Brain and Mind Centre
- School of Psychology, Faculty of Science
- Charles Perkins Centre, The University of Sydney, Camperdown
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre
- School of Psychology, Faculty of Science
- Charles Perkins Centre, The University of Sydney, Camperdown
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12
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Yiallourou SR, Cribb L, Cavuoto MG, Rowsthorn E, Nicolazzo J, Gibson M, Baril AA, Pase MP. Association of the Sleep Regularity Index With Incident Dementia and Brain Volume. Neurology 2024; 102:e208029. [PMID: 38165323 DOI: 10.1212/wnl.0000000000208029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Irregular sleep may increase the risk of cardiometabolic conditions, but its association with incident dementia is unclear. The aim of this study was to assess the association between sleep regularity, that is, the day-to-day consistency in sleep-wake patterns and the risk of incident dementia and related brain MRI endophenotypes. METHODS We used Cox proportional hazard models to investigate the relationships between sleep regularity and incident dementia in 88,094 UK Biobank participants. The sleep regularity index (SRI) was calculated as the probability of being in the same state (asleep/awake) at any 2 time points 24 hours apart, averaged over 7 days of accelerometry. RESULTS The mean age of the sample was 62 years (SD = 8), 56% were women, and the median SRI was 60 (SD = 10). There were 480 cases of incident dementia over a median 7.2 years of follow-up. Following adjustments for demographic, clinical, and genetic confounders (APOE ε4), there was a nonlinear association between the SRI and dementia hazard (p [global test of spline term] < 0.001) with hazard ratios (HRs) following a U-shape pattern. HRs, relative to the median SRI, were 1.53 (95% CI 1.24-1.89) for participants with SRI at the 5th percentile (SRI = 41) and 1.16 (95% CI 0.89-1.50) for those with SRI at the 95th percentile (SRI = 71). In a subset with brain MRI (n = 15,263), gray matter and hippocampal volume tended to be lowest at the extremes of the SRI. DISCUSSION Sleep regularity displayed a U-shaped association with risk of incident dementia. Irregular sleep may represent a novel dementia risk factor.
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Affiliation(s)
- Stephanie R Yiallourou
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Lachlan Cribb
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Marina G Cavuoto
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Ella Rowsthorn
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Jessica Nicolazzo
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Madeline Gibson
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Andrée-Ann Baril
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Matthew P Pase
- From the Turner Institute for Brain and Mental Health (S.R.Y., L.C., M.G.C., E.R., J.N., M.G., M.P.P.), School of Psychological Science, Monash University; National Ageing Research Institute (M.G.C.), Melbourne, Australia; Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
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13
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Liu X, Xu P, Wei R, Cheng B, Sun L, Yang L, Chen G. Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China. Front Public Health 2024; 11:1047025. [PMID: 38249381 PMCID: PMC10796606 DOI: 10.3389/fpubh.2023.1047025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Objective To examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations. Methods This community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored. Results The age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7-7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6-6.9, 8-8.9, and ≥ 9 h were 1.280 (1.053-1.557), 1.425 (1.175-1.728), 1.294 (1.068-1.566), and 1.360 (1.109-1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60-80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108-1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055-1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080-1.534) and those aged 81-97 years (OR: 2.128, 95%CI: 1.152-3.934). For cognitive impairment, the group aged 81-97 years with daytime dysfunction was associated with a higher odds ratio than other age groups. Conclusion The present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81-97 years exhibiting the strongest association.
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Affiliation(s)
- Xuechun Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, China
| | - Peiru Xu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Rong Wei
- Outpatient Department of the Second Hospital of Anhui Medical University, Hefei, China
| | - Beijing Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Liang Sun
- Fuyang Center of Disease Control and Prevention, Fuyang, China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Guihai Chen
- Department of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, China
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14
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Bulycheva I, Watanabe Y, Kitamura K, Kabasawa K, Saito T, Takahashi A, Kobayashi R, Oshiki R, Takachi R, Tsugane S, Yamazaki O, Watanabe K, Nakamura K. Self-Reported Sleep Duration and Bedtime Are Associated with Dementia Risk in Community-Dwelling People Aged 40-74 Years: The Murakami Cohort Study. J Alzheimers Dis 2024; 99:535-547. [PMID: 38669530 DOI: 10.3233/jad-231104] [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: 04/28/2024]
Abstract
Background Sleep is a potentially modifiable factor associated with dementia, including Alzheimer's disease, but current evidence supporting this is insufficient. Objective This study aimed to determine whether sleep duration and bedtime patterns are associated with the risk of dementia among middle-aged and older people. Methods This cohort study had an eight-year follow-up period. Participants were 13,601 community-dwelling people aged 40-74 years living in Murakami (Niigata, Japan). Data were collected using a self-administered questionnaire. Predictors were self-reported sleep duration and bedtime, and the outcome was newly-diagnosed dementia determined using the long-term care insurance database. Covariates were demographic characteristics, body mass index, smoking, alcohol consumption, total physical activity, insomnia symptoms, disease history, and either bedtime or sleep duration. Cox proportional hazard models were used to calculate hazard ratios (HRs). Results The mean age of participants at baseline was 59.2 years. Over a mean follow-up period of 8.0 years, 319 cases of dementia were observed. A long self-reported sleep duration relative to the reference sleep duration (7 hours) was associated with increased dementia risk, with the "8 hours" group (adjusted HR = 1.30, 95% CI:0.99-1.73) and "≥9 hours" group (adjusted HR = 1.46, 95% CI:1.00-2.15) having an increased risk (marginally significant) relative to the reference group. Early bedtime was associated with increased dementia risk (adjusted p for trend = 0.0010), with the "21 : 00 or earlier" group (adjusted HR = 1.61, 95% CI:1.14-2.28) having an increased risk relative to the reference ("23 : 00"). Conclusions A long self-reported sleep duration and early bedtime are both associated with increased dementia risk in middle-aged and older people.
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Affiliation(s)
- Irina Bulycheva
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshiko Saito
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akemi Takahashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Rieko Oshiki
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Nara, Japan
| | - Shoichiro Tsugane
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | | | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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15
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Gan X, Zhou C, He P, Ye Z, Liu M, Yang S, Zhang Y, Zhang Y, Huang Y, Xiang H, Qin X. Inverse association of glucosamine use and risk of new-onset kidney stones in UK adults with less sedentary time. Prev Med 2023; 177:107738. [PMID: 37866696 DOI: 10.1016/j.ypmed.2023.107738] [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: 07/16/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To assess the association of different sedentary behaviors and glucosamine use with the risk of kidney stones and examine the modification of genetic risk of kidney stones on this association. METHODS 473,225 participants free of kidney stones at baseline from the UK Biobank were included. Total sedentary time was calculated as the sum of the duration of TV-watching, driving, and non-occupational computer using. The primary outcome was new-onset kidney stones. RESULTS During a median follow-up of 12.0 years, 5528 cases of kidney stones were documented. All major sedentary behaviors and total sedentary time were significantly positively related to the risk of kidney stones (All P for trend<0.05). Participants with total sedentary time ≥ 3.5 h/day had a significantly higher risk of new-onset kidney stones (vs. <3.5 h/day [tertile 1]; HR, 1.18; 95%CI,1.10-1.27). Compared with non-users, participants who regularly used glucosamine had a significantly lower risk of new-onset kidney stones in those with total sedentary time < 3.5 h/day (HR, 0.72; 95%CI,0.59-0.86), but not in those with total sedentary time ≥ 3.5 h/day (HR, 0.99; 95%CI,0.91-1.08; P-interaction = 0.001). Among participants with total sedentary time < 3.5 h/day, there was a dose-response relationship of glucosamine use with new-onset kidney stones (P for trend<0.001). Genetic risks of kidney stones did not significantly modify the association. CONCLUSIONS TV-watching, driving and non-occupational computer using were all positively associated with the risk of new-onset kidney stones. Glucosamine use was associated with a lower risk of new-onset kidney stones in participants with total sedentary time < 3.5 h/day, following a dose-response relationship.
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Affiliation(s)
- Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Yu Huang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Hao Xiang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China.
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Li JX, Zhong QQ, Yuan SX, Zhu F. Trends in deaths and disability-adjusted life-years of stroke attributable to low physical activity worldwide, 1990-2019. BMC Public Health 2023; 23:2242. [PMID: 37964255 PMCID: PMC10644476 DOI: 10.1186/s12889-023-17162-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/05/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Low physical activity (LPA) is linked to the risk of stroke, but the disease burden of stroke attributable to LPA needs to be understood to develop effective preventive strategies. We aim to assess spatiotemporal trends in the global burden of stroke attributable to LPA from 1990 to 2019. METHODS Based on the Global Burden of Disease, Injuries, and Risk Factors Study, our research examined deaths, the Disability-Adjusted Life Years (DALYs), the Age-Standardized Mortality Rate (ASMR), the Age-Standardized DALY Rate (ASDR), and the Estimated Annual Percentage Change (EAPC) for stroke attributable to LPA. RESULTS Deaths and DALYs were on the rise worldwide from 1990 to 2019, with increases of 72.72% for the former and 67.41% for the latter; ASMR and ASDR decreased, with the ASMR-related EAPC of -1.61 (95% CI:-1.71--1.5) and ASDR-related EAPC of -1.35 (95% CI:-1.43--1.27); females had more numbers of deaths and DALYs, and the majorities of deaths and DALYs were shared by those aged ≥ 70. The highest burden rates were shared by North Africa, the Middle East, and Tropical Latin America; the ASMR-related EAPC was associated with the ASMR in 1990 (R = -0.26, P < 0.001) and the Socio-Demographic Index (SDI) across different countries in 2019 (R = -0.61, P < 0.001), respectively, and such patterns were similar to what ASDR and the ASDR-related EAPC had; the Human Development Index (HDI) in 2019 was associated with the ASMR-related EAPC (R = 0.63, P < 0.001) and the ASDR-related EAPC across different countries (R = -0.62, P < 0.001), respectively. CONCLUSIONS Globally, deaths and DALYs of stroke attributable to LPA were on the rise, although their age-standardized rates presented downward over the past three decades; the burden of stroke attributable to LPA showed upward trends especially in those aged ≥ 70 and females in the regions of East Asia, North Africa, and the Middle East, which need more attention to the effects of physical activity on health interventions.
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Affiliation(s)
- Jun-Xiao Li
- Central Laboratory, Guangzhou Twelfth People's Hospital, Guangzhou, China
- Departments of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Qiong-Qiong Zhong
- Central Laboratory, Guangzhou Twelfth People's Hospital, Guangzhou, China
- Departments of Public Health and Preventive Medicine, Jinan University, Guangzhou, China
| | - Shi-Xiang Yuan
- Department of Neurosurgery, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Feng Zhu
- Central Laboratory, Guangzhou Twelfth People's Hospital, Guangzhou, China.
- Departments of Public Health and Preventive Medicine, Jinan University, Guangzhou, China.
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17
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Wu H, Gu Y, Du W, Meng G, Wu H, Zhang S, Wang X, Zhang J, Wang Y, Huang T, Niu K. Different types of screen time, physical activity, and incident dementia, Parkinson's disease, depression and multimorbidity status. Int J Behav Nutr Phys Act 2023; 20:130. [PMID: 37924067 PMCID: PMC10625186 DOI: 10.1186/s12966-023-01531-0] [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: 05/15/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Several previous studies have shown that excessive screen time is associated with an increased prevalence of dementia, Parkinson's disease (PD), and depression. However, the results have been inconsistent. This study aimed to prospectively investigate the association between different types of screen time and brain structure, as well as the incidence of dementia, Parkinson's disease, depression, and their multimorbidity status. METHODS We included 473,184 participants initially free of dementia, PD, and depression from UK Biobank, as well as 39,652 participants who had magnetic resonance imaging (MRI) data. Screen time exposure variables including TV viewing and computer using were self-reported by participants. Cox proportional hazards regression models were used to estimate the association between different types of screen time and the incidence of dementia, Parkinson's disease, depression, and their multimorbidity status. Multiple linear regression models were used to assess the linear relationship between different types of screen time and MRI biomarkers in a subgroup of participants. RESULTS During the follow up, 6,096, 3,061, and 23,700 participants first incident cases of dementia, PD, and depression respectively. For moderate versus the lowest computer uses, the adjusted HRs (95% CIs) were 0.68 (0.64, 0.72) for dementia, 0.86 (0.79, 0.93) for PD, 0.85 (0.83, 0.88) for depression, 0.64 (0.55, 0.74) for dementia and depression multimorbidity, and 0.59 (0.47, 0.74) for PD and depression multimorbidity. The multivariable HRs (95% CIs) for the highest versus the lowest group of TV viewing time were 1.28 (1.17, 1.39) for dementia, 1.16 (1.03, 1.29) for PD, 1.35 (1.29, 1.40) for depression, 1.49 (1.21, 1.84) for dementia and depression multimorbidity, and 1.44 (1.05, 1.97) for PD and depression multimorbidity. Moderate computer using time was negatively associated with white matter hyperintensity volume (β = -0.042; 95% CI -0.067, -0.017), and positively associated with hippocampal volume (β = 0.059; 95% CI 0.034, 0.084). Participants with the highest TV viewing time were negatively associated with hippocampal volume (β = -0.067; 95% CI -0.094, -0.041). In isotemporal substitution analyses, substitution of TV viewing or computer using by equal time of different types of PA was associated with a lower risk of all three diseases, with strenuous sports showing the strongest benefit. CONCLUSION We found that moderate computer use was associated with a reduced risk of dementia, PD, depression and their multimorbidity status, while increased TV watching was associated with a higher risk of these disease. Notably, different screen time may affect the risk of developing diseases by influencing brain structures. Replacing different types of screen time with daily-life PA or structured exercise is associated with lower dementia, PD, and depression risk.
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Affiliation(s)
- Hanzhang Wu
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Baidi Road 238, Tianjin, 300192, China.
| | - Wenxiu Du
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ge Meng
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongmei Wu
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuena Wang
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Juanjuan Zhang
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yaogang Wang
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Tianjin, 300070, China.
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
| | - Kaijun Niu
- School of Public Health of Tianjin, University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Baidi Road 238, Tianjin, 300192, China.
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
- Center for International Collaborative Research On Environment, Nutrition and Public Health, Tianjin, China.
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18
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Fjell AM, Sørensen Ø, Wang Y, Amlien IK, Baaré WFC, Bartrés-Faz D, Bertram L, Boraxbekk CJ, Brandmaier AM, Demuth I, Drevon CA, Ebmeier KP, Ghisletta P, Kievit R, Kühn S, Madsen KS, Mowinckel AM, Nyberg L, Sexton CE, Solé-Padullés C, Vidal-Piñeiro D, Wagner G, Watne LO, Walhovd KB. No phenotypic or genotypic evidence for a link between sleep duration and brain atrophy. Nat Hum Behav 2023; 7:2008-2022. [PMID: 37798367 PMCID: PMC10663160 DOI: 10.1038/s41562-023-01707-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/31/2023] [Indexed: 10/07/2023]
Abstract
Short sleep is held to cause poorer brain health, but is short sleep associated with higher rates of brain structural decline? Analysing 8,153 longitudinal MRIs from 3,893 healthy adults, we found no evidence for an association between sleep duration and brain atrophy. In contrast, cross-sectional analyses (51,295 observations) showed inverse U-shaped relationships, where a duration of 6.5 (95% confidence interval, (5.7, 7.3)) hours was associated with the thickest cortex and largest volumes relative to intracranial volume. This fits converging evidence from research on mortality, health and cognition that points to roughly seven hours being associated with good health. Genome-wide association analyses suggested that genes associated with longer sleep for below-average sleepers were linked to shorter sleep for above-average sleepers. Mendelian randomization did not yield evidence for causal impacts of sleep on brain structure. The combined results challenge the notion that habitual short sleep causes brain atrophy, suggesting that normal brains promote adequate sleep duration-which is shorter than current recommendations.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway.
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
| | - Øystein Sørensen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Yunpeng Wang
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Inge K Amlien
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
| | - David Bartrés-Faz
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pii Sunyer, Barcelona, Spain
| | - Lars Bertram
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Lübeck Interdisciplinary Platform for Genome Analytics, University of Lübeck, Lübeck, Germany
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
- Institute of Sports Medicine Copenhagen, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Andreas M Brandmaier
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Ilja Demuth
- Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Biology of Aging Working Group, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christian A Drevon
- Vitas AS, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- UniDistance Suisse, Brig, Switzerland
- Swiss National Centre of Competence in Research LIVES, University of Geneva, Geneva, Switzerland
| | - Rogier Kievit
- Cognitive Neuroscience Department, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Simone Kühn
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
- Radiography, Department of Technology, University College Copenhagen, Copenhagen, Denmark
| | - Athanasia M Mowinckel
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Lars Nyberg
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Claire E Sexton
- Department of Psychiatry, University of Oxford, Oxford, UK
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Alzheimer's Association, Chicago, IL, USA
| | - Cristina Solé-Padullés
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pii Sunyer, Barcelona, Spain
| | - Didac Vidal-Piñeiro
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Leiv Otto Watne
- Oslo Delirium Research Group, Department of Geriatric Medicine, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
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Wong ATY, Reeves GK, Floud S. Total sleep duration and daytime napping in relation to dementia detection risk: Results from the Million Women Study. Alzheimers Dement 2023; 19:4978-4986. [PMID: 37083147 PMCID: PMC10955772 DOI: 10.1002/alz.13009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION There is inconsistent evidence on the associations of sleep duration and daytime napping with dementia risk. METHODS In the Million Women Study, a total of 830,716 women (mean age, 60 years) were asked about sleep duration (<7, 7-8, >8 hours) and daytime napping (rarely/never, sometimes, usually) in median year 2001, and were followed for the first hospital record with any mention of dementia. Cox regression estimated dementia detection risk ratios (RRs) during 17-year follow-up in 5-year intervals. RESULTS With 34,576 dementia cases, there was strong attenuation over follow-up in the RRs related to long sleep duration (>8 vs 7-8 hours) and usually napping (vs rarely/never). Short sleep duration was modestly, positively associated with dementia in the long term (RR = 1.08, 95% confidence interval [CI] 1.04-1.12). DISCUSSION There was little evidence to suggest that long sleep duration and regular napping are associated with long-term dementia risk. Short sleep duration was modestly associated with dementia risk, but residual confounding cannot be excluded. HIGHLIGHTS Long sleep duration was not associated with long-term dementia risk. Daytime napping was not associated with long-term dementia risk. There is some evidence for a small higher risk of dementia related to short sleep.
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Affiliation(s)
- Angel T. Y. Wong
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Gillian K. Reeves
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Sarah Floud
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
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20
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Yang S, Ye Z, Liu M, Zhang Y, Gan X, Wu Q, Zhou C, He P, Zhang Y, Qin X. Variety and Duration of Different Sedentary Behaviors, Inflammation, Genetic Susceptibility, and New-Onset Dementia in the Older Population. J Am Med Dir Assoc 2023; 24:1396-1404. [PMID: 37451311 DOI: 10.1016/j.jamda.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/13/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES We aimed to evaluate the relationship of the variety and duration of different sedentary behaviors (TV-watching, driving, and nonoccupational computer use) with the risk of dementia in older participants, and examine whether inflammation and genetic susceptibility may modify the relationship. DESIGN A prospective cohort study. SETTING AND PARTICIPANTS 173,829 older participants (≥60 years) without prior dementia in the UK Biobank were enrolled. METHODS A healthy sedentary behavior score was calculated as the number of the 3 major sedentary behaviors with a duration associated with the lowest risk of dementia. The primary outcome was new-onset all-cause dementia. RESULTS During a median follow-up of 12.4 years, 4965 (2.9%) participants developed new-onset dementia. There were U-shaped associations for TV-watching and driving time, and a reversed J-shaped association for nonoccupational computer use time with new-onset all-cause dementia, with the lowest dementia risk at >0-<2 hours/day for all the 3 sedentary behaviors. Moreover, a higher healthy sedentary behavior score was significantly associated with a lower risk of all-cause dementia (per 1 score increment: hazard ratio 0.78, 95% CI 0.75-0.81), with a stronger inverse association in those with higher levels of high-sensitivity C-reactive protein and monocytes (both P-interactions <.05). Genetic risks of dementia did not significantly modify the association. Similar trends were found for new-onset Alzheimer's disease and vascular dementia. CONCLUSIONS AND IMPLICATIONS The associations between the duration of different sedentary behaviors and new-onset dementia were different in the older population. Moreover, the variety of sedentary behavior was inversely associated with new-onset dementia, especially among those with higher levels of inflammation.
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Affiliation(s)
- Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
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21
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Wang Y, Luo X, Long X, Shao Y, Zhang S, Zhang Y, Wang Y. Association between housework and the risk of dementia among older Chinese adults: a prospective cohort study. Front Psychol 2023; 14:1228059. [PMID: 37554140 PMCID: PMC10406521 DOI: 10.3389/fpsyg.2023.1228059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/11/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES Physical activity (PA) is known to improve physical functioning and mental health and to reduce the incidence of dementia. However, studies of the effects of non-recreational PA on the incidence of dementia, especially in East Asian populations, remain limited. In this study, we evaluate the association of doing housework with the risk of dementia among participants in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS The analysis was conducted with data from 7,237 CLHLS participants age over 65 obtained in 2008/2009, 2011/2012, 2014, and 2018. The frequency of housework performance was classified into four groups. A Cox proportional-hazards model was used to examine the association of the baseline housework frequency with the incidence of dementia, with adjustment for demographic and socioeconomic characteristics and lifestyle and health conditions. RESULTS The adjusted multivariate model showed that the incidence of dementia was lower among participants who did housework almost every day than among those who rarely or never did housework (hazard ratio = 0.49; 95% confidence interval, 0.39-0.61). The subgroup and sensitivity analyses yielded similar results. CONCLUSION A high frequency of housework performance was associated with a reduced incidence of dementia among older Chinese adults, especially those who did not exercise regularly. The encouragement of engagement in housework would be a cost-effective measure promoting healthy aging in the Chinese population.
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Affiliation(s)
- Yuanlong Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Xinxin Luo
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Xiangyun Long
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yuan Shao
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Song Zhang
- Anning Mental Rehabilitation Hospital, Changchun, China
| | - Yingli Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yongjun Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
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22
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Zhang Y, Chen SD, Deng YT, You J, He XY, Wu XR, Wu BS, Yang L, Zhang YR, Kuo K, Feng JF, Cheng W, Suckling J, David Smith A, Yu JT. Identifying modifiable factors and their joint effect on dementia risk in the UK Biobank. Nat Hum Behav 2023; 7:1185-1195. [PMID: 37024724 DOI: 10.1038/s41562-023-01585-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/10/2023] [Indexed: 04/08/2023]
Abstract
Previous hypothesis-driven research has identified many risk factors linked to dementia. However, the multiplicity and co-occurrence of risk factors have been underestimated. Here we analysed data of 344,324 participants from the UK Biobank with 15 yr of follow-up data for 210 modifiable risk factors. We first conducted an exposure-wide association study and then combined factors associated with dementia to generate composite scores for different domains. We then evaluated their joint associations with dementia in a multivariate Cox model. We estimated the potential impact of eliminating the unfavourable profiles of risk domains on dementia using population attributable fraction. The associations varied by domain, with lifestyle (16.6%), medical history (14.0%) and socioeconomic status (13.5%) contributing to the majority of dementia cases. Overall, we estimated that up to 47.0%-72.6% of dementia cases could be prevented.
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Affiliation(s)
- Yi Zhang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Shi-Dong Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Yue-Ting Deng
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Jia You
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China
| | - Xiao-Yu He
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Xin-Rui Wu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Bang-Sheng Wu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Liu Yang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Ya-Ru Zhang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Kevin Kuo
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Wei Cheng
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - A David Smith
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China.
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23
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Zhong Q, Zhou R, Huang YN, Chen HW, Liu HM, Huang Z, Yuan Z, Wu K, Cao BF, Liu K, Fan WD, Liang YQ, Wu XB. The independent and joint association of accelerometer-measured physical activity and sedentary time with dementia: a cohort study in the UK Biobank. Int J Behav Nutr Phys Act 2023; 20:59. [PMID: 37198574 DOI: 10.1186/s12966-023-01464-8] [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: 11/04/2022] [Accepted: 05/06/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Research on the association of physical activity and sedentary time with dementia is accumulating, though elusive, and the interaction effects of the two remain unclear. We analysed the joint associations of accelerometer-measured physical activity and sedentary time with risk of incident dementia (all-cause dementia, Alzheimer's disease and vascular dementia). METHODS A total of 90,320 individuals from the UK Biobank were included. Accelerometer-measured total volume of physical activity (TPA) and sedentary time were measured at baseline and dichotomised by median (low TPA [< 27 milli-gravity (milli-g)], high TPA [≥ 27 milli-g]; low sedentary time [< 10.7 h/day], high sedentary time [≥ 10.7 h/day]). Cox proportional hazards models were used to evaluate the joint associations with incident dementia on both additive and multiplicative scales. RESULTS During a median follow-up of 6.9 years, 501 cases of all-cause dementia were identified. Higher TPA was associated with a lower risk of all-cause dementia, Alzheimer's disease and vascular dementia; the multivariate adjusted hazard ratios (HRs) (95% CI) per 10 milli-g increase were 0.63 (0.55-0.71), 0.74 (0.60-0.90) and 0.69 (0.51-0.93), respectively. Sedentary time was only found to be linked to all-cause dementia, and the HR for high sedentary time was 1.03 (1.01-1.06) compared with that for low sedentary time. No additive and multiplicative relationship of TPA and sedentary time to incident dementia was found (all P values > 0.05). CONCLUSION Higher TPA level was related to a lower risk of incident dementia irrespective of sedentary time, which highlighted the implication of promoting physical activity participation to counteract the potential detrimental effect of sedentary time on dementia.
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Affiliation(s)
- Qi Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Yi-Ning Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Hao-Wen Chen
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Hua-Min Liu
- Department of Anaesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiwei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Zelin Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Keyi Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Bi-Fei Cao
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Kuan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Wei-Dong Fan
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Yong-Qi Liang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1063-No.1023 of Shatai South Road, Baiyun District, Guangzhou, 510515, China.
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Feter N, de Paula D, dos Reis RCP, Alvim Matos SM, Barreto SM, Duncan BB, Schmidt MI. Association Between 24-Hour Movement Behavior and Cognitive Function in Brazilian Middle-Aged and Older Adults: Findings From the ELSA-Brasil. Innov Aging 2023; 7:igad030. [PMID: 37197282 PMCID: PMC10184510 DOI: 10.1093/geroni/igad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Indexed: 05/19/2023] Open
Abstract
Background and Objectives The relationship between 24-hr movement behavior and specific domains of cognitive function is unclear. The purpose of this study was to identify the joint association of daily time spent in light (light-intensity physical activity [LPA]) and moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and sleep with cognitive function in middle-aged and older adults. Research Design and Methods Cross-sectional data from Wave 3 (2017-2019) of the Brazilian Longitudinal Study of Adult Health were analyzed. The study included adults aged 41-84 years old. Physical activity was assessed using a waist-worn accelerometer. Cognitive function was examined using standardized tests to assess memory, language, and Trail-Making test. Global cognitive function score was calculated by averaging domain-specific scores. Compositional isotemporal substitution models were performed to identify the association between the reallocation of time spent in LPA, MVPA, sleep, and SB with cognitive function. Results Participants (n = 8,608) were 55.9% female (mean age 58.9 [8.6] years). Reallocating time from SB to MVPA was associated with higher cognitive function: Reallocating 15 min to MVPA by reducing 5 min from each other behavior was associated with increased odds of better cognitive function in both insufficient (<7 hr/day; odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.54-0.77) and sufficient (≥7 hr/day; OR: 0.62; 95% CI: 0.58-0.67) sleep groups. Among those with insufficient sleep, reallocating time to MVPA and sleep from SB was associated with higher global cognitive performance. Discussion and Implications Small reductions in SB and increments in MVPA were associated with higher cognitive function in middle-aged and older adults.
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Affiliation(s)
- Natan Feter
- Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Danilo de Paula
- Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Citton P dos Reis
- Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Statistics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sheila Maria Alvim Matos
- Post Graduate Program in Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Sandhi Maria Barreto
- Faculdade de Medicina & Hospital das Clinicas/EBSERH, Universidade Federal de Minas Gerais, Brazil
| | - Bruce Bartholow Duncan
- Post Graduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | - Maria Inês Schmidt
- Post Graduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
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25
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Rolls ET, Feng R, Feng J. Lifestyle risks associated with brain functional connectivity and structure. Hum Brain Mapp 2023; 44:2479-2492. [PMID: 36799566 PMCID: PMC10028639 DOI: 10.1002/hbm.26225] [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: 10/05/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 02/18/2023] Open
Abstract
Some lifestyle factors are related to health and brain function and structure, but the brain systems involved are incompletely understood. A general linear model was used to test the associations of the combined and separate lifestyle risk measures of alcohol use, smoking, diet, amounts of physical activity, leisure activity, and mobile phone use, with brain functional connectivity with the high resolution Human Connectome Project (HCP) atlas in 19,415 participants aged 45-78 from the UK Biobank, with replication with HCP data. Higher combined lifestyle risk scores were associated with lower functional connectivity across the whole brain, but especially of three brain systems. Low physical, and leisure and social, activity were associated with low connectivities of the somatosensory/motor cortical regions and of hippocampal memory-related regions. Low mobile phone use, perhaps indicative of poor social communication channels, was associated with low functional connectivity of brain regions in and related to the superior temporal sulcus that are involved in social behavior and face processing. Smoking was associated with lower functional connectivity of especially frontal regions involved in attention. Lower cortical thickness in some of these regions, and also lower subcortical volume of the hippocampus, amygdala, and globus pallidus, were also associated with the sum of the poor lifestyle scores. This very large scale analysis emphasizes how the lifestyle of humans relates to their brain structure and function, and provides a foundation for understanding the causalities that relate to the differences found here in the brains of different individuals.
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Affiliation(s)
- Edmund T Rolls
- Department of Computer Science, University of Warwick, Coventry, UK
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
- Oxford Centre for Computational Neuroscience, Oxford, UK
| | - Ruiqing Feng
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Jianfeng Feng
- Department of Computer Science, University of Warwick, Coventry, UK
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
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26
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Hamrouni M, Bishop N. Effect of replacing television viewing with different intensities of physical activity on COVID-19 mortality risk: Short communication from UK Biobank. Scand J Public Health 2023:14034948231158441. [PMID: 36883751 PMCID: PMC9996135 DOI: 10.1177/14034948231158441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
AIMS This study aimed to examine the theoretical effects of replacing television (TV) viewing with different intensities of physical activity on COVID-19 mortality risk using isotemporal substitution models. METHODS The analytical sample was composed of 359,756 UK Biobank participants. TV viewing and physical activity were assessed by self-report. Logistic regressions adjusted for covariates were used to model the effects of substituting an hour a day of TV viewing with an hour of walking, moderate-intensity physical activity (MPA) or vigorous-intensity physical activity (VPA) on COVID-19 mortality risk. RESULTS From 16 March 2020 to 12 November 2021, there were 879 COVID-19 deaths in the analytical sample. Substituting an hour a day of TV viewing with an hour of walking was associated with a 17% lower risk of COVID-19 mortality (odds ratio (OR)=0.83, 95% confidence interval (CI) 0.74-0.92). In sex-stratified analyses, the same substitution was associated with a lower risk in both men (OR=0.85, 95% CI 0.74-0.96) and women (OR=0.78, 95% CI 0.65-0.95). However, replacing an hour a day of TV viewing with an hour of MPA was only associated with a lower risk in women (OR=0.80, 95% CI 0.65-0.98). CONCLUSIONS
Replacing TV viewing with walking was associated with a significant reduction in COVID-19 mortality risk. Public health authorities should consider promoting the replacement of TV viewing with walking as a protective strategy against COVID-19 mortality.
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Affiliation(s)
- Malik Hamrouni
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Nicolette Bishop
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, UK
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27
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Dingle SE, Bujtor MS, Milte CM, Bowe SJ, Daly RM, Torres SJ. Statistical Approaches for the Analysis of Combined Health-Related Factors in Association with Adult Cognitive Outcomes: A Scoping Review. J Alzheimers Dis 2023; 92:1147-1171. [PMID: 36872778 DOI: 10.3233/jad-221034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUND Dementia prevention is a global health priority, and there is emerging evidence to support associations between individual modifiable health behaviors and cognitive function and dementia risk. However, a key property of these behaviors is they often co-occur or cluster, highlighting the importance of examining them in combination. OBJECTIVE To identify and characterize the statistical approaches used to aggregate multiple health-related behaviors/modifiable risk factors and assess associations with cognitive outcomes in adults. METHODS Eight electronic databases were searched to identify observational studies exploring the association between two or more aggregated health-related behaviors and cognitive outcomes in adults. RESULTS Sixty-two articles were included in this review. Fifty articles employed co-occurrence approaches alone to aggregate health behaviors/other modifiable risk factors, eight studies used solely clustering-based approaches, and four studies used a combination of both. Co-occurrence methods include additive index-based approaches and presenting specific health combinations, and whilst simple to construct and interpret, do not consider the underlying associations between co-occurring behaviors/risk factors. Clustering-based approaches do focus on underlying associations, and further work in this area may aid in identifying at-risk subgroups and understanding specific combinations of health-related behaviors/risk factors of particular importance in the scope of cognitive function and neurocognitive decline. CONCLUSION A co-occurrence approach to aggregating health-related behaviors/risk factors and exploring associations with adult cognitive outcomes has been the predominant statistic approach used to date, with a lack of research employing more advanced statistical methods to explore clustering-based approaches.
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Affiliation(s)
- Sara E Dingle
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Melissa S Bujtor
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia.,Department of Psychological Medicine, Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Steven J Bowe
- Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.,Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Robin M Daly
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
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28
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Mavragani A, Sanchez T, Yang H, Zhao F, Qin Y, Wu J, Yan H, Xu Y, Zhang L. Caregiver Perceptions of Children's and Adolescents' Psychosocial Functioning During the Stringent COVID-19 Lockdown Restrictions in Shanghai: Cross-sectional Study. JMIR Public Health Surveill 2023; 9:e43689. [PMID: 36749625 PMCID: PMC9907570 DOI: 10.2196/43689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic represents a global health crisis. The Shanghai municipal government in China implemented strict and comprehensive pandemic control strategies in the first half of 2022 to eliminate a wave of COVID-19 infection. The pandemic and the resulting government responses have led to abrupt changes to families' daily lives, including the mental health of children and adolescents. OBJECTIVE The aim of this paper is to examine the impact of COVID-19 exposure and the stringent lockdown measures on the daily life and mental health of children and adolescents and to provide suggestions on maintaining their mental health when similar public health emergencies occur in the future. METHODS In this cross-sectional study, an anonymous survey was distributed online in May 1-15, 2022, in Shanghai. Individuals were eligible to participate if they were currently the caregiver of a child or adolescent (aged 4-17 years). Outcomes were psychosocial functioning of children and adolescents, as reported by parents, using the Pediatric Symptom Checklist-17. COVID-19 exposure and life changes were also reported. Multivariate logistic regression was used to analyze risk factors for poor psychosocial functioning. RESULTS In total, 2493 valid questionnaires were analyzed. The rate of positive scores on the global Pediatric Symptom Checklist-17 scale was 16.5% (n=411). Internalizing, attention, and externalizing problem subscale positivity rates were 17.3% (n=431), 10.9% (n=272), and 8.9% (n=221), respectively. Caregivers reported that 64.2% (n=1601) and 20.7% (n=516) of the children's interactions with friends or peers and parents deteriorated, respectively. Compared with male caregivers, female caregivers were less likely to report psychosocial problems in children and adolescents (adjusted odds ratio [aOR] 0.68; 95% CI 0.53-0.88). Older children and those with lower COVID-19 Exposure and Family Impact Scales scores were less likely to have psychological problems (aOR 1.15; 95% CI 1.10-1.21). Compared with children with screen times <1 hour per day for recreation, those using screens for >3 hours had higher odds of psychological distress (aOR 2.09; 95% CI 1.47-1.97). Children who spent 1-2 hours exercising and had better interactions with friends or peers and parents showed a trend toward lower odds of psychological problems. Children and adolescents with worse sleep compared with preclosure were more likely to have psychological problems. CONCLUSIONS The prevalence of psychosocial problems among children and adolescents is relatively high. Being young, having more COVID-19 exposure, and having more screen times (>3 h/day), less exercise time (<30 min), worse sleep, and deteriorated interactions with friends or peers and parents were risk factors for poor psychosocial functioning. It is necessary for governments, communities, schools, and families to take appropriate countermeasures to reduce the negative impact of the stringent control measures on caregivers' parenting and psychosocial functioning of children and adolescents.
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Affiliation(s)
| | | | - Hongyang Yang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Fangjie Zhao
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Yuchen Qin
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Jiali Wu
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Hongli Yan
- School of Nursing, Second Military Medical University, Shanghai, China
| | - Yan Xu
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Lulu Zhang
- College of Health Service, Second Military Medical University, Shanghai, China
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29
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Liang H, Yin X, Chen T, Zhang Y, Zhang Q, Lin J, Yin H, Tang J, He Y, Xia P, Zhu Y, Li H, Mo Y, Li Y, Wang Y, Yang X, Hu Z. Excessive Sedentary Time Is Associated with Cognitive Decline in Older Patients with Minor Ischemic Stroke. J Alzheimers Dis 2023; 96:173-181. [PMID: 37742637 DOI: 10.3233/jad-230008] [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: 09/26/2023]
Abstract
BACKGROUND Cognitive impairment is commonly seen after acute ischemic stroke (AIS). Sedentary behaviors increase the risk of dementia among community dwelling population. OBJECTIVE This study aims to investigate the association of sedentary behaviors with poststroke cognitive impairment among older adults with minor AIS. METHODS This cohort study recruited 594 older subjects with minor AIS from three hospitals in China during February 1, 2016, and December 31, 2018. Participants were followed up for two years and the sedentary time per day was self-reported at the end of follow-up. Cognitive functions were assessed by Mini-Mental State Examination (MMSE). Participants were categorized into the high and low sedentary time group according to the median sedentary time of the participants. RESULTS At two years of follow-up, the long sedentary time group had significantly lower MMSE scores than the short sedentary time group [median, (IQR): 21 (18 to 25) versus 22 (18 to 25), p = 0.368]. The long sedentary time group had a higher speed of cognitive decline than the short sedentary time group. Excessive sedentary time was associated with a higher risk of longitudinal cognitive decline (OR: 2.267, 95% CI: 1.594 to 3.225), adjusting for age, sex, education, body mass index, APOE genotype, comorbidities, symptoms of depression, anxiety, and insomnia, baseline MMSE scores and National Institute of Health Stroke Scale scores, cognitive therapy, and TOAST ischemic stroke subtypes. CONCLUSIONS This study identified a possible link between sedentary behaviors and longitudinal cognitive decline among older patients with minor AIS, suggesting that reducing sedentary time might be helpful for preventing poststroke dementia.
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Affiliation(s)
- Hongtao Liang
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | | | - Tian Chen
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Yan Zhang
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Qin Zhang
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Jie Lin
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Huan Yin
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Jinghua Tang
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Yingyi He
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Ping Xia
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Yongping Zhu
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Haihua Li
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Yongbiao Mo
- Department of Emergency, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Yongyong Li
- Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Yang
- Neuroscience Center, General Hospital of Ningxia Medical University, Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, China
| | - Zicheng Hu
- Department of Neurology, People's Hospital of Chongqing Hechuan, Chongqing, China
- Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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30
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Wood TR, Turknett J. Is the lack of appropriate cognitive demand the primary driver of dementia risk? LIFESTYLE MEDICINE 2022. [DOI: 10.1002/lim2.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Thomas R. Wood
- Department of Pediatrics University of Washington Seattle Washington USA
- Institute for Human and Machine Cognition Pensacola Florida USA
| | - Josh Turknett
- Brainjo Center for Neurology and Cognitive Enhancement Atlanta Georgia USA
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31
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Turknett J, Wood TR. Demand Coupling Drives Neurodegeneration: A Model of Age-Related Cognitive Decline and Dementia. Cells 2022; 11:2789. [PMID: 36139364 PMCID: PMC9496827 DOI: 10.3390/cells11182789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/27/2022] [Accepted: 09/05/2022] [Indexed: 12/12/2022] Open
Abstract
The societal burden of Alzheimer's Disease (AD) and other major forms of dementia continues to grow, and multiple pharmacological agents directed towards modifying the pathological "hallmarks" of AD have yielded disappointing results. Though efforts continue towards broadening and deepening our knowledge and understanding of the mechanistic and neuropathological underpinnings of AD, our previous failures motivate a re-examination of how we conceptualize AD pathology and progression. In addition to not yielding effective treatments, the phenotypically heterogeneous biological processes that have been the primary area of focus to date have not been adequately shown to be necessary or sufficient to explain the risk and progression of AD. On the other hand, a growing body of evidence indicates that lifestyle and environment represent the ultimate level of causation for AD and age-related cognitive decline. Specifically, the decline in cognitive demands over the lifespan plays a central role in driving the structural and functional deteriorations of the brain. In the absence of adequate cognitive stimulus, physiological demand-function coupling leads to downregulation of growth, repair, and homeostatic processes, resulting in deteriorating brain tissue health, function, and capacity. In this setting, the heterogeneity of associated neuropathological tissue hallmarks then occurs as a consequence of an individual's genetic and environmental background and are best considered downstream markers of the disease process rather than specific targets for direct intervention. In this manuscript we outline the evidence for a demand-driven model of age-related cognitive decline and dementia and why it mandates a holistic approach to dementia treatment and prevention that incorporates the primary upstream role of cognitive demand.
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Affiliation(s)
- Josh Turknett
- Brainjo Center for Neurology and Cognitive Enhancement, Atlanta, GA 30076, USA
| | - Thomas R. Wood
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
- Institute for Human and Machine Cognition, Pensacola, FL 32502, USA
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