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Gao Y, Zhang Z, Song J, Gan T, Lin Y, Hu M, Wu IX. Combined healthy lifestyle behaviours and incident dementia: A systematic review and dose-response meta-analysis of cohort studies. Int J Nurs Stud 2024; 156:104781. [PMID: 38744152 DOI: 10.1016/j.ijnurstu.2024.104781] [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: 10/04/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND The associations of combined healthy lifestyle behaviours and incident dementia have not been systematically reviewed and the dose-response relationship was uncertain. OBJECTIVES To evaluate the associations of combined healthy lifestyle behaviours with incident dementia and other cognitive outcomes, assess the dose-response relationship between the number of lifestyle behaviours and incident dementia, and summarise the adherence to healthy lifestyle behaviours. DESIGN Systematic review and meta-analysis. METHODS PubMed, EMBASE, Web of Science and PsycINFO were searched from inception to 20 Jan 2024. Cohort studies reporting associations of combined healthy lifestyle behaviours with incident dementia or other cognitive outcomes were included. We used the random-effects meta-analysis to pool the risk estimates and the robust error meta-regression method to examine the dose-response relationship. The methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 22 articles including 25 cohort studies mostly from high-income economics were included, with all assessed as high methodological quality. Adherence to a healthy lifestyle was associated with a decreased risk of incident dementia, either per healthy lifestyle behaviour increase (pooled hazard ratio 0.89, 95 % confidence interval 0.85-0.94) or the highest level versus the lowest level (pooled hazard ratio 0.61, 95 % confidence interval 0.49-0.76). An inverse, linear dose-response relationship (Pnon-linear = 0.845) between the number of healthy lifestyle behaviours and incident dementia was observed, with an 11 % risk reduction for each healthy behaviour increase. A relatively limited number of included studies indicated that adherence to a healthy lifestyle combination could yield benefits for cognitive decline, global cognition, memory and executive function. In addition, the adherence rates typically decreased as the number of healthy lifestyle behaviours increased. CONCLUSIONS Adherence to a healthy lifestyle was associated with a lower risk of incident dementia and other cognitive outcomes. It is important to find a subtle balance between the benefits and adherence. Further large cohort studies for combined lifestyle behaviours with specific cognitive outcomes and dose-response relationships are required, especially based on middle- and low-income populations. REGISTRATION The study was registered in PROSPERO (CRD42023418509). TWEETABLE ABSTRACT Engaging in a greater number of healthy lifestyle behaviours yields increased benefits in preventing dementia, albeit with lower adherence rates as a trade-off. Finding a delicate balance between the benefits and adherence is crucial.
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Affiliation(s)
- Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Zixuan Zhang
- Changsha Center for Disease Control and Prevention, Changsha, China
| | - Jinlu Song
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Ting Gan
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
| | - Yali Lin
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Irene Xinyin Wu
- Xiangya School of Public Health, Central South University, Changsha, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, China.
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Jiang X, Chen M, Cui L, Guo Q, Huang L. Study on the relationship between berry, grape, red wine consumption and cognitive impairment in middle-aged and elderly people in China. Front Nutr 2024; 11:1403427. [PMID: 39050136 PMCID: PMC11267986 DOI: 10.3389/fnut.2024.1403427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction Some evidence suggests that fruit and alcohol consumption may be related to cognitive impairment. Methods This study conducted a cross-sectional study on the "correlation between eating habits and cognitive function of the middle-aged and elderly population in China." The purpose of this study is to explore the relationship between fruit consumption, drinking habits and cognitive impairment in Chinese people over 50 years old. Results The results show that the protective factors of cognitive impairment are the preference for berries and the daily intake of 100-200 grams grapes in Chinese middle-aged and elderly people with objective cognitive unimpaired. The habit of drinking red wine is a protective factor for cognitive impairment in Chinese middle-aged and elderly people with mild cognitive impairment (MCI). However, this study did not find the relationship between white wine, beer, yellow rice wine, liquor and cognitive impairment. Discussion Therefore, we believe that berries, grapes and red wine consumption can protect the cognitive function of the middle-aged and elderly people in China, and the protective function is related to the basic cognitive state.
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Affiliation(s)
- Xinting Jiang
- Department of Gerontology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Meirong Chen
- Department of Neurorehabilitation High Dependency Unit, Jiangwan Hospital, Shanghai, China
| | - Liang Cui
- Department of Gerontology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Huang
- Department of Gerontology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Bloomberg M, Muniz-Terrera G, Brocklebank L, Steptoe A. Healthy lifestyle and cognitive decline in middle-aged and older adults residing in 14 European countries. Nat Commun 2024; 15:5003. [PMID: 38937442 PMCID: PMC11211489 DOI: 10.1038/s41467-024-49262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
Studies examining lifestyle and cognitive decline often use healthy lifestyle indices, making it difficult to understand implications for interventions. We examined associations of 16 lifestyles with cognitive decline. Data from 32,033 cognitively-healthy adults aged 50-104 years participating in prospective cohort studies of aging from 14 European countries were used to examine associations of lifestyle with memory and fluency decline over 10 years. The reference lifestyle comprised not smoking, no-to-moderate alcohol consumption, weekly moderate-plus-vigorous physical activity, and weekly social contact. We found that memory and fluency decline was generally similar for non-smoking lifestyles. By contrast, memory scores declined up to 0.17 standard deviations (95% confidence interval= 0.08 - 0.27) and fluency scores up to 0.16 standard deviations (0.07 - 0.25) more over 10 years for those reporting smoking lifestyles compared with the reference lifestyle. We thus show that differences in cognitive decline between lifestyles were primarily dependent on smoking status.
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Affiliation(s)
- Mikaela Bloomberg
- Department of Behavioural Science and Health, University College London, London, UK.
| | | | - Laura Brocklebank
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Li Y, Wang K, Jigeer G, Jensen G, Tucker KL, Lv Y, Shi X, Gao X. Healthy Lifestyle and the Likelihood of Becoming a Centenarian. JAMA Netw Open 2024; 7:e2417931. [PMID: 38900423 PMCID: PMC11190803 DOI: 10.1001/jamanetworkopen.2024.17931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 04/18/2024] [Indexed: 06/21/2024] Open
Abstract
Importance Previous studies have reported that lifestyle factors were associated with life expectancy and/or mortality, but most of them studied the middle-aged or older age groups (aged ≥60 years), and few focused on people aged 80 years or older. Objectives To examine healthy lifestyle and the likelihood of becoming centenarians among people aged 80 years or older in China. Design, Settings, and Participants Using data from the Chinese Longitudinal Healthy Longevity Survey, a nationally representative and one of the largest prospective cohorts targeting people aged 80 years or older established in 1998, a community-based, prospective nested case-control study was performed. Data were analyzed from December 1, 2022, to April 15, 2024. Exposures A healthy lifestyle score for 100 (HLS-100, ranging from 0 to 6), including smoking, exercise, and dietary diversity, was constructed, with higher scores indicating potentially better health outcomes. Main Outcomes and Measures The primary outcome was survivorship to becoming a centenarian by 2018 (the end of follow-up). Information on sociodemographic characteristics, lifestyle factors, and other covariates was collected. Results The sample comprised 5222 individuals (61.7% women, mean [SD] age, 94.3 [3.3] years), including 1454 identified centenarians and 3768 controls (died before becoming centenarians) matched by age, sex, and year of entry. During a median follow-up of 5 (IQR, 3-7) years, 373 of 1486 individuals among the lowest HLS-100 (0-2) group and 276 of 851 individuals among the highest HLS-100 (5-6) group became centenarians. The adjusted odds ratio (AOR) comparing the highest vs the lowest HLS-100 groups was 1.61 (95% CI, 1.32-1.96; P < .001 for trend). An association was noted when we further treated centenarians with relatively healthy status as the outcome, as evaluated by self-reported chronic conditions, physical and cognitive function, and mental wellness (AOR, 1.54; 95% CI, 1.05-2.26). Similar results were observed in other sensitivity analyses. Conclusions and Relevance In this case-control study of Chinese older adults, adhering to a healthy lifestyle appears to be important even at late ages, suggesting that constructing strategic plans to improve lifestyle behaviors among all older adults may play a key role in promoting healthy aging and longevity.
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Affiliation(s)
- Yaqi Li
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Kaiyue Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Guliyeerke Jigeer
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Gordon Jensen
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell
| | - Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
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Li H, Zheng Y, Li Q, Wang M. Cognitive Function, Healthy Lifestyle, and All-Cause Mortality among Chinese Older Adults: A Longitudinal Prospective Study. Nutrients 2024; 16:1297. [PMID: 38732544 PMCID: PMC11085585 DOI: 10.3390/nu16091297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Both cognitive decline and unhealthy lifestyles have been linked to an elevated risk of mortality in older people. We aimed to investigate whether a healthy lifestyle might modify the association between cognitive function and all-cause mortality in Chinese older populations. METHODS The final analysis included 5124 individuals free of dementia, selected from the Chinese Longitudinal Healthy Longevity Survey from 2011 to 2018. Cognitive function was assessed in 2011 using the Mini-Mental State Examination (MMSE). A lifestyle score was calculated based on five lifestyle factors, including smoking, alcohol consumption, physical activity, diet, and body mass index. Cox proportional hazards models were performed to evaluate the association between baseline cognitive function and the risk of all-cause mortality, with an interaction term of cognitive function and lifestyle score being added to the models. RESULTS The average age of participants was 81.87 years old at baseline. During a median follow-up of 6.4 years, 1461 deaths were documented. Both higher cognitive function (HR: 0.96; 95% CI: 0.96-0.97) and a healthier lifestyle (HR: 0.92; 95% CI: 0.87-0.97) were significantly associated with a reduced risk of mortality. We found that lifestyle significantly modified the association of cognitive function with mortality (p for interaction = 0.004). The inverse relation between cognitive function and mortality was found to be more pronounced among participants with a healthier lifestyle. Of note, among the lifestyle scores component, diet showed a significant interaction with mortality (p for interaction = 0.003), and the protective HR of the all-cause mortality associated with higher MMSE scores was more prominent among participants with healthy diets compared with unhealthy diets. CONCLUSIONS Our study indicates that cognitive decline is associated with a higher risk of mortality, and such associations are attenuated by maintaining a healthy lifestyle, with a particular emphasis on healthy diet.
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Affiliation(s)
- Huiwen Li
- China Population and Development Research Center, Beijing 100081, China;
| | - Yi Zheng
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Qi Li
- Institute of Social Development, Chinese Academy of Macroeconomic Research, Beijing 100038, China;
| | - Mengying Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education, Peking University, Beijing 100191, China
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Yang J, Zhou C, Li H. Effects of lifestyle and its interaction with anemia on cognitive function in older adults: A longitudinal study. Psych J 2024; 13:242-251. [PMID: 38105563 PMCID: PMC10990814 DOI: 10.1002/pchj.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/22/2023] [Indexed: 12/19/2023]
Abstract
A better understanding of the impact of lifestyle factors on cognitive function in older adults is critical for developing intervention strategies to achieve successful aging. Moreover, older adults who fulfill the World Health Organization criteria for anemia have a significantly higher risk of developing dementia. In the current study, we aimed to assess the buffering effects of lifestyle on cognitive function in older Chinese adults through a nationally representative survey. The sample consisted of 1201 participants (mean age: 82.39 ± 12.08 years, 52.1% female) from the 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Multiple linear regression analyses were used to explore the relationship between changes in lifestyle factors and the rate of cognitive function changes, as well as the effects of the interaction between lifestyle factors and anemia on cognitive function changes. Increased levels of participation in leisure activities, social activities, and dietary diversity delayed cognitive decline. Persistent anemia accelerated cognitive decline, while frequent participation in leisure activities delayed cognitive decline due to anemia. The increased levels of participation in leisure activities, social activities, and dietary diversity can alleviate the cognitive decline caused by aging itself, and more frequently participation in leisure activities can also alleviate the adverse effects of anemia on cognitive function in older adults.
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Affiliation(s)
- Jia Yang
- CAS Key Laboratory of Behavioral ScienceInstitute of PsychologyBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
- Zhejiang Museum of Natural HistoryHangzhouChina
| | - Chen Zhou
- CAS Key Laboratory of Behavioral ScienceInstitute of PsychologyBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Hui‐Jie Li
- CAS Key Laboratory of Behavioral ScienceInstitute of PsychologyBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
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Murugan Y, Parmar A, Hirani MM, Babaria DL, Damor NC. Self-Care Practices and Health-Seeking Behaviors Among Older Adults in Urban Indian Slums: A Mixed Methods Study. Cureus 2024; 16:e58800. [PMID: 38784325 PMCID: PMC11112451 DOI: 10.7759/cureus.58800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Background Effective self-care is crucial for maintaining health among older adults in resource-constrained communities. This study examined self-care practices, health-seeking behaviors, and associated factors among older adults in urban slums in India. Materials and methods A mixed methods study was conducted among 432 adults aged ≥65 years. Participants were selected through multistage random sampling from five slum areas. Self-care practices, health-seeking behaviors, demographic information, chronic conditions, self-efficacy, and health literacy were assessed through interviews. The qualitative data was explored through in-depth interviews with 30 participants. Results Inadequate health literacy (194, 45%) and low self-efficacy (162, 37.5%) were common. While 324 (75%) had an adequate diet and 378 (87.5%) took medications properly, only 86 (20%) monitored diabetes complications. Only 194 (45%) of the patients underwent recommended cancer screening, and 324 (75%) of the patients saw doctors ≥twice a year. Age, sex, education, income, comorbidities, self-efficacy, and health literacy had significant associations. Alongside facilitators such as social support, barriers such as limited healthcare access and suboptimal prevention orientation emerged. Conclusion Suboptimal prevention orientation and overreliance on secondary care instead of self-care among elderly people are problematic given the limited use of geriatric services. Grassroots health workers can improve health literacy and self-efficacy through home visits to enable self-care. Healthcare access inequities for vulnerable groups merit policy attention.
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Affiliation(s)
- Yogesh Murugan
- Family Medicine, Guru Gobind Singh Government Hospital, Jamnagar, IND
| | - Alpesh Parmar
- Public Health, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Mehjabin M Hirani
- General Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Dhruvam L Babaria
- Internal Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Naresh C Damor
- Community Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
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Xian G, Chai Y, Gong Y, He W, Ma C, Zhang X, Zhang J, Ma Y. The relationship between healthy lifestyles and cognitive function in Chinese older adults: the mediating effect of depressive symptoms. BMC Geriatr 2024; 24:299. [PMID: 38549104 PMCID: PMC10979595 DOI: 10.1186/s12877-024-04922-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Previous studies have proven the positive relationship between healthy lifestyles and cognitive function in older adults. However, the specific impacts and mechanisms require further investigation. Therefore, this study aimed to investigate whether healthy lifestyles and cognitive function were associated with Chinese older adults and whether depressive symptoms mediated their association. METHODS 8272 valid samples were included using the latest data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Pearson's test was applied to investigate the relationship between the key variables. Regression models were employed to examine the mediating effects of healthy lifestyles, using Sobel's test and the bootstrap method to confirm path effects. RESULTS There was a significant correlation between healthy lifestyles, depressive symptoms, and cognitive function (p < 0.01). Healthy lifestyles directly impact cognitive function (β = 0.162, p < 0.01). Healthy lifestyles had a significant effect on depressive symptoms (β=-0.301, p < 0.01), while depressive symptoms have a significant impact on cognitive function (β=-0.108, p < 0.01). Depressive symptoms partially mediated the effect of healthy lifestyles on cognitive function (β = 0.032, p < 0.01). The Sobel and bootstrap tests confirmed the robustness of the regression analysis results. CONCLUSION Depressive symptoms mediate the relationship between healthy lifestyles and cognitive function. Our findings suggest that prevention strategies for cognitive impairment in older adults should focus on healthy lifestyles and mental health.
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Affiliation(s)
- Guowei Xian
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yulin Chai
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yunna Gong
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Wenfeng He
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Chunxiao Ma
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Xiaolin Zhang
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Jing Zhang
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yong Ma
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China.
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Zheng X, Leng J, Ma H, Hu P. Physical "lying flat": The negative effect of personal relative deprivation on health-promoting lifestyles. J Affect Disord 2024; 349:414-419. [PMID: 38190854 DOI: 10.1016/j.jad.2024.01.006] [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: 10/20/2023] [Revised: 11/23/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND Social comparison is an inevitable aspect of human life, often leading to personal relative deprivation, wherein individuals experience a sense of unfair treatment when they perceive themselves as being at a disadvantage in comparison to others. Earlier research has observed a phenomenon called "lying flat" associated with personal relative deprivation, characterized by a lack of motivation for self-improvement. The purpose of this study is to investigate whether this pattern is suitable for the domains of health-promoting lifestyles given that health-promoting is driven by self-improvement motivation. METHODS In three studies conducted in China, an understudied non-Western society, we investigated the association between personal relative deprivation and health-promoting lifestyles by utilizing diverse measures and samples. RESULTS Findings from Study 1 (N = 12,465) indicated a negative relationship between personal relative deprivation and health-promoting behavior. This effect was particularly prominent among older individuals (Study 2, N = 11,378). Study 3 (N = 234) indirectly explored the possibility that a decreased priority given to health goals explains the reduced adoption of health-promoting behaviors when experiencing personal relative deprivation. LIMITATIONS First, all health-promoting lifestyles are self-reported. Second, the mechanism between PRD and health-promoting lifestyles was not directly examined. CONCLUSION Overall, this research confirms the physical "lying flat" phenomenon, highlighting that personal relative deprivation contributes to unhealthy diets and physical inactivity. Moreover, our findings also suggest that the lower significance placed on health goals relative to other life goals may serve as an underlying reason for this phenomenon.
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Affiliation(s)
- Xuegang Zheng
- Department of Psychology, Renmin University of China, China.
| | - Jie Leng
- Department of Psychology, Renmin University of China, China.
| | - Hang Ma
- Department of Psychology, Renmin University of China, China
| | - Ping Hu
- Department of Psychology, Renmin University of China, China.
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Hou J, Jiang H, Han Y, Huang R, Gao X, Feng W, Guo Z. Lifestyle Influence on Mild Cognitive Impairment Progression: A Decision Tree Prediction Model Study. Neuropsychiatr Dis Treat 2024; 20:271-280. [PMID: 38371917 PMCID: PMC10871141 DOI: 10.2147/ndt.s435464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 02/20/2024] Open
Abstract
Purpose This study assessed the influences of different lifestyle on mild cognitive impairment (MCI) progression and established a decision tree prediction model to analyse their predictive significance on MCI progression incidence. Patients and Methods From October 2015 to February 2020,330 patients with MCI were recruited, and demographic and lifestyle information collected. They were followed up for 19.04 ± 10.227 months. Cognitive function was assessed using the Mini-Mental State Examination Scale every 6 months, and they were divided into MCI stable group and MCI progression group. Results The Kaplan Meier survival analysis showed an overall cohort survival rate of 33.2%; the annual conversion rate of MCI progression was 20%. Physical exercise, social engagement, high-fat diet, age, napping, and tea drinking were decision tree prediction model nodes. Hobbies were the most important factor for predicting MCI progression. The MCI progression probability rates were: with hobbies 26.829% (44 cases), without hobbies 57.831% (96 cases); for those withot hobbies, with physical exercise 43.077% (28 cases) without physical exercise 72.340% (68 cases); for those without hobbies with physical exercise and social engagement 20.000% (4 cases), without social engagement 53.333% (24 cases); for those without hobbies, physical exercises and social engagement and with nap habits 48.485% (16 cases), without nap habits 66.667% (8 cases). The decision tree prediction model AUC for predicting the MCI progression receiver operating characteristic curve was 0.737 (95% confidence interval: 0.685-0.785) (75.71% sensitivity, 71.75% specificity, P < 0.001. Conclusion Hobbies, physical exercise, social engagement, napping, and drinking tea can help prevent MCI progression, while a high-fat diet may exacerbate MCI progression. In this study the rule with the lowest MCI progress probability for those who had hobbies, high-fat diet, and social engagement. And the decision tree model had good prediction efficiency.
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Affiliation(s)
- Jiwen Hou
- Department of Geriatrics, Affiliated Hospital of Chengdu University, Chengdu, People’s Republic of China
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Hua Jiang
- Department of Geriatrics, Affiliated Hospital of Chengdu University, Chengdu, People’s Republic of China
| | - Yan Han
- Department of Geriatrics, Affiliated Hospital of Chengdu University, Chengdu, People’s Republic of China
| | - Rong Huang
- Department of Geriatrics, Affiliated Hospital of Chengdu University, Chengdu, People’s Republic of China
| | - Xiang Gao
- Department of Geriatrics, Affiliated Hospital of Chengdu University, Chengdu, People’s Republic of China
| | - Wei Feng
- Department of Geriatrics, Affiliated Hospital of Chengdu University, Chengdu, People’s Republic of China
| | - Zongjun Guo
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
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Li K, Wu J, Zhou Q, Zhao J, Li Y, Yang M, Yang Y, Hu Y, Xu J, Zhao M, Xu Q. The mediating role of accelerated biological aging in the association between blood metals and cognitive function. JOURNAL OF HAZARDOUS MATERIALS 2024; 462:132779. [PMID: 37879277 DOI: 10.1016/j.jhazmat.2023.132779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
Aging is a key risk factor in cognitive diseases. Recently, metal exposures were found associated with both biological aging and cognitive function. Here, we aim to evaluate the associations of blood metals with cognitive function and the mediated effect of biological aging. Fourteen metals were detected and biological age was calculated through Klemera and Doubal method among 514 adults in Beijing, China. The generalized linear models indicated that the copper (Cu), molybdenum (Mo), and strontium (Sr) were positively associated with biological aging [βCu (95% CI): 12.76 (9.26, 16.27); βMo (95% CI): 1.50 (0.15, 2.85)], and βSr (95% CI): 1.86 (0.68, 3.03)], while vanadium (V) was inversely related to biological aging [βV (95% CI): -0.76 (-1.48, -0.05)]. Subsequently, Cu, lead (Pb), selenium (Se), and biological aging were associated with cognitive function and further mediation analyses confirmed that biological aging partially mediated (33.98%, P = 0.019) the association of Cu and cognitive function. Additionally, we constructed a lifestyle index that implied the modifiable healthy lifestyle could slow aging to attenuate the detrimental effect of metals on cognition. Our findings provide insights into the potential pathways linking multiple metals exposure to aging and cognition and underscore the importance of adopting healthy lifestyles.
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Affiliation(s)
- Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
| | - Jingtao Wu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jiaxin Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Ming Yang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yisen Yang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yaoyu Hu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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12
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Bai A, Xu W, Liang Y, Jiang Y, Lin Z. Dietary patterns from mid-through later-life in relation to sarcopenia risk over 20 years among Chinese community-dwelling oldest old individuals. Clin Nutr 2023; 42:2569-2577. [PMID: 37967504 DOI: 10.1016/j.clnu.2023.10.020] [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: 08/01/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Evidence regarding how dietary patterns (DPs) from mid- (60 years old) to later-life (over 80 years old) affect sarcopenia risk in old age is scarce. METHODS We included 7267 participants aged ≥80 years from the Chinese Longitudinal Healthy Longevity Survey in 2018. The Simplified Healthy Eating Index (SHE index) based on nine dietary variables was used to measured DPs and changes in DPs, with a higher score indicating better diet quality. The term "Mid-life" DPs denoted dietary habits at the age of 60 whereas "Later-life" DPs referred to dietary habits acquired over 80 years old. Sarcopenia risk was evaluated using the SARC-CalF questionnaire. We applied multivariable adjusted logistic regression models to investigate the cross-sectional association between DPs in a life course and sarcopenia risk in 2018 after adjusting for potential confounders including sociodemographic characteristics, lifestyle risk factors, and unfavorable health conditions. Several sensitivity analyses were conducted to verify the robustness of the results. RESULTS We found that healthier DPs during both mid- and later-life were associated with a decreased odds of sarcopenia risk, with adjusted odds ratios (ORs) of 0.69 (95 % confidence interval [CI]: 0.54-0.88) and 0.84 (95 % CI: 0.71-0.99), respectively. The odds of sarcopenia risk were also decreased among those with healthier DPs over a period of 20 years (OR = 0.80, 95 % CI: 0.69-0.93). For each nutrient consumption, participants who had high-quality fish consumption both in mid- and later-life had a 23 % decreased odds of sarcopenia risk (OR = 0.77, 95 % CI: 0.67-0.88) compared with those who had low-quality fish consumption all the time. The results were largely unchanged in sensitivity analyses. CONCLUSIONS Our findings highlight the importance of maintaining healthy dietary habits throughout life to reduce the risk of sarcopenia in old age.
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Affiliation(s)
- Anying Bai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Weihao Xu
- Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, PR China; Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, PR China.
| | - Yuanfeng Liang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, PR China
| | - Yu Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China; School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, PR China.
| | - Zhanyi Lin
- Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, PR China; Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, PR China.
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13
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Wang J, Chen C, Zhou J, Ye L, Li Y, Xu L, Xu Z, Li X, Wei Y, Liu J, Lv Y, Shi X. Healthy lifestyle in late-life, longevity genes, and life expectancy among older adults: a 20-year, population-based, prospective cohort study. THE LANCET. HEALTHY LONGEVITY 2023; 4:e535-e543. [PMID: 37804845 DOI: 10.1016/s2666-7568(23)00140-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Lifestyle and longevity genes have different and important roles in the human lifespan; however, the association between a healthy lifestyle in late-life and life expectancy mediated by genetic risk is yet to be elucidated. We aimed to investigate the associations of healthy lifestyle in late-life and genetic risk with life expectancy among older adults. METHODS A weighted healthy lifestyle score was constructed from the following variables: current non-smoking, non-harmful alcohol consumption, regular physical activity, and a healthy diet. Participants were recruited from the Chinese Longitudinal Healthy Longevity Survey, a prospective community-based cohort study that took place between 1998 and 2018. Eligible participants were aged 65 years and older with available information on lifestyle factors at baseline, and then were categorised into unhealthy (bottom tertile of the weighted healthy lifestyle score), intermediate (middle tertile), and healthy (top tertile) lifestyle groups. A genetic risk score was constructed based on 11 lifespan loci among 9633 participants, divided by the median and classified into low and high genetic risk groups. Stratified Cox proportional hazard regression was used to estimate the interaction between genetic and lifestyle factors on all-cause mortality risk. FINDINGS Between Jan 13, 1998, and Dec 31, 2018, 36 164 adults aged 65 years and older were recruited, among whom a total of 27 462 deaths were documented during a median follow-up of 3·12 years (IQR 1·62-5·94) and included in the lifestyle association analysis. Compared with the unhealthy lifestyle category, participants in the healthy lifestyle group had a lower all-cause mortality risk (hazard ratio [HR] 0·56 [95% CI 0·54-0·57]; p<0·0001). The highest mortality risk was observed in individuals in the high genetic risk and unhealthy lifestyle group (HR 1·80 [95% CI 1·63-1·98]; p<0·0001). The absolute risk reduction was greater for participants in the high genetic risk group. A healthy lifestyle was associated with a gain of 3·84 years (95% CI 3·05-4·64) at the age of 65 years in the low genetic risk group, and 4·35 years (3·70-5·06) in the high genetic risk group. INTERPRETATION A healthy lifestyle, even in late-life, was associated with lower mortality risk and longer life expectancy among Chinese older adults, highlighting the importance of a healthy lifestyle in extending the lifespan, especially for individuals with high genetic risk. FUNDING National Natural Science Foundation of China. TRANSLATION For the Mandarin translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jun Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinhui Zhou
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lihong Ye
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lanjing Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Zinan Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xinwei Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yuan Wei
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Hygienic Inspection, School of Public Health, Jilin University, Changchun, China
| | - Junxin Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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Kong D, Lu P, Lee YH, Wu B, Shelley M. Health Behavior Patterns and Associated Risk of Memory-Related Disorders Among Middle-Aged and Older Chinese Couples. Res Aging 2023; 45:666-677. [PMID: 36800501 DOI: 10.1177/01640275231157784] [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: 02/19/2023]
Abstract
Objectives: Studies on the interdependence of couples' health behaviors and subsequent cognitive outcomes remain limited. Methods: Longitudinal data from the China Health and Retirement Longitudinal Study (2011-2018) were used (N = 1869 heterosexual couples). Latent class analysis identified the dyadic pattern of health behaviors in 2011 (i.e., alcohol consumption, smoking, and physical inactivity). Stratified Cox models examined the association of latent classes with risk of developing memory-related disorders in 2013-2018. Results: Three classes were identified: class 1 (21.25%, only husband smoke, and both active), class 2 (47.55%, both inactive, neither drink nor smoke), and class 3 (31.20%, both drink and smoke, and both active). Couples' sedentary lifestyle was associated with an increased risk of memory-related disorders among both husbands and wives. Conclusion: Couples were moderately concordant in their physical activity but weakly in smoking and drinking. Couple-based interventions, especially promoting physical activity, may reduce cognitive aging among middle-aged and older Chinese couples.
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Affiliation(s)
- Dexia Kong
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Peiyi Lu
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Yen-Han Lee
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Mack Shelley
- Department of Political Science, Statistics, and School of Education, Iowa State University, Ames, IA, USA
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Zhou YF, Song XY, Pan A, Koh WP. Nutrition and Healthy Ageing in Asia: A Systematic Review. Nutrients 2023; 15:3153. [PMID: 37513571 PMCID: PMC10383719 DOI: 10.3390/nu15143153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/05/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Nutrition plays a key role in modulating the likelihood of healthy ageing. In the present study, we aimed to conduct a systematic review to assess the impact of nutrition on healthy ageing in Asia. METHODS The systematic review was registered in the International Prospective Register of Systematic Reviews database (CRD42023408936) and conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Web of Science, and Embase databases were searched up to February 2023 without language restrictions. We included prospective cohort studies that evaluated the associations of intake of a single food or consumption of a single nutrient at midlife; adherence to various dietary patterns at midlife; and improved adherence to dietary patterns from mid- to late life with the likelihood of healthy ageing and its components. RESULTS Out of 16,373 records, we included 71 papers comprising 24 cohorts from Singapore, China, Japan, and Thailand. The healthy ageing components included cognitive function, physical function, and depression. The majority of studies supported the observation that the likelihood of healthy ageing and its components in late life was positively increased by a higher consumption of healthy foods, such as vegetables, fruits, fish, nuts, legumes, tea, milk, and dairy, at midlife, and also by greater adherence to dietary patterns with high diversity scores or high total antioxidant capacities. Furthermore, improved adherence to healthy dietary patterns from mid- to late life also increased the likelihood of healthy ageing in late life. CONCLUSION Consuming healthy foods and adhering to healthy dietary patterns at midlife can promote the likelihood of healthy ageing. Moreover, improving diet quality from mid- to late life can still be beneficial.
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Affiliation(s)
- Yan-Feng Zhou
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Xing-Yue Song
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430032, China
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore 138632, Singapore
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16
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Orte S, Migliorelli C, Sistach-Bosch L, Gómez-Martínez M, Boqué N. A Tailored and Engaging mHealth Gamified Framework for Nutritional Behaviour Change. Nutrients 2023; 15:nu15081950. [PMID: 37111168 PMCID: PMC10142076 DOI: 10.3390/nu15081950] [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: 02/28/2023] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Mobile health applications (apps) have been shown to be effective for improving eating habits. However, most of the existing apps rely on calorie and nutrient counting which have several limitations including the difficulty in sustaining long-term use, inaccuracy, and the risk of developing eating disorders. We designed and developed a mHealth framework for nutritional behaviour change, integrated into the CarpeDiem app, that focuses on the intake of key food groups which are known to have a higher impact on health indicators instead of the intake of nutrients. This framework is mainly based on a gamified system that delivers personalized dietary missions to the user and provides motivational recommendations that help the user to achieve these missions. Its design was guided by an evidenced-based theory of behavioural change, the HAPA model, and it is also characterized by the personalization of the system and the use of a recommender system based on advanced artificial intelligence techniques. Overall, the approach used in the present app could foster a sustained improvement of eating habits among the general population, which is the main challenge of dietary interventions, decreasing the risk of developing the chronic diseases associated with unhealthy dietary habits.
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Affiliation(s)
- Silvia Orte
- Unitat de Salut Digital, Centre Tecnològic de Catalunya, Eurecat, 08005 Barcelona, Spain
| | - Carolina Migliorelli
- Unitat de Salut Digital, Centre Tecnològic de Catalunya, Eurecat, 08005 Barcelona, Spain
| | - Laura Sistach-Bosch
- Unitat de Salut Digital, Centre Tecnològic de Catalunya, Eurecat, 08005 Barcelona, Spain
| | | | - Noemi Boqué
- Unitat de Nutrició i Salut, Centre Tecnològic de Catalunya, Eurecat, 43204 Reus, Spain
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17
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Yao KR, Luo Q, Tang X, Wang ZH, Li L, Zhao L, Zhou L, Li L, Huang L, Yin XH. Effects of traditional Chinese mind–body exercises on older adults with cognitive impairment: A systematic review and meta-analysis. Front Neurol 2023; 14:1086417. [PMID: 37077563 PMCID: PMC10106716 DOI: 10.3389/fneur.2023.1086417] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/03/2023] [Indexed: 04/05/2023] Open
Abstract
ObjectiveTo determine the effectiveness of traditional Chinese mind–body exercises in improving cognition, memory, and executive function in older adults with cognitive impairment.Data sourcesRelevant English and Chinese language studies published until September 14th, 2022 were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINAHL, WAN FANG DATA, VIP Information, CNKI, and SinoMed databases.Review methodsRandomized controlled trials assessing traditional Chinese mind–body exercises (Tai Chi, Baduanjin, Qigong, Mind–Body Therapies, and Yijinjing) in older adults with cognitive impairment were included. Two researchers independently identified eligible studies and extracted data. A risk-of-bias assessment was performed using the Cochrane Risk of Bias Tool.ResultsThis study included 15 randomized controlled trials (1,127 participants) from China, Thailand and American. Most studies had a high risk of bias in the blinding of participants and researchers, one study had a high risk of bias in the random sequence generation and two studies had a high risk of bias in the incomplete outcome data. Compared with conventional therapy alone, traditional Chinese mind–body exercises significantly improved global cognitive function (p < 0.00001), and Baduanjin could improve the global cognitive function (p < 0.00001), memory function (p < 0.0001), and executive function (p < 0.0001) outcomes after treatment, and significantly improved some dimensional scores on the auditory verbal learning test after treatment (p = 0.04).ConclusionCompared with conventional therapy, traditional Chinese mind–body exercises (Tai Chi, Baduanjin, and Qigong) significantly improved global cognitive function, and Baduanjin could improve global cognitive function, memory function, and executive function in older adults with cognitive impairment.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#searchadvanced, CRD42022327563.
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Affiliation(s)
- Ke-ru Yao
- School of Nursing, University of South China, Hengyan, China
| | - Qin Luo
- School of Nursing, University of South China, Hengyan, China
| | - Xi Tang
- School of Nursing, University of South China, Hengyan, China
| | - Zhi-han Wang
- School of Nursing, University of South China, Hengyan, China
| | - Lu Li
- School of Nursing, University of South China, Hengyan, China
| | - Lu Zhao
- School of Nursing, University of South China, Hengyan, China
| | - Li Zhou
- Second Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Ling Li
- Second Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Li Huang
- Second Affiliated Hospital of University of South China, Hengyang, Hunan, China
- *Correspondence: Li Huang,
| | - Xin-hong Yin
- School of Nursing, University of South China, Hengyan, China
- Xin-hong Yin,
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18
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Mai S, Cai J, Zheng W, Li L. Path analysis of social engagement, loneliness and cognitive function among Chinese older adults. PSYCHOL HEALTH MED 2023; 28:1087-1099. [PMID: 36424712 DOI: 10.1080/13548506.2022.2151635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study established a research model to fully understand the relationship of social engagement, loneliness and cognitive function among Chinese older adults. In the latest wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a total of 12,852 participants aged 65 years and older were included in the study. Path analysis was performed to examine our hypotheses. The social engagement had a positive relationship with normal cognitive function while loneliness had a negative one, and the standardized regression weights were 0.618 (p < 0.01) and -0.046 (p < 0.01), respectively. Watching TV or listening to the radio had the greatest association with cognitive function, followed by housework, outdoor activities, reading newspapers or books, playing cards or mahjong, and raising domestic animals or pets. Loneliness played a mediating role between social engagement and cognitive function. Social engagement could be considered as one of the interventions to improve older adults' health.
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Affiliation(s)
- Shumin Mai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Jingjing Cai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Weijun Zheng
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, P.R.China
| | - Lu Li
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, P.R.China
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19
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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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20
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Chen Y, Sun B, Wang C, Zhang K, Lu W, Huang G. Associations of types of grains and lifestyle with all-cause mortality among Chinese adults aged 65 years or older: a prospective cohort study. J Transl Med 2023; 21:88. [PMID: 36747298 PMCID: PMC9903469 DOI: 10.1186/s12967-023-03927-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 01/25/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Little is known on the association of types of grains with mortality and the moderating effect of lifestyle on this association. This study aims to evaluate the single or joint associations of types of grains and lifestyle with all-cause mortality among Chinese older adults. METHODS Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018. Subjects aged ≥ 65 years were eligible. The types of grains included wheat, total rice, and coarse cereals. Lifestyle was derived using smoking, alcohol consumption, physical activity, and dietary pattern. All-cause mortality was the primary outcome. RESULTS This study included 30275 participants with a mean age 87 ± 11 years and documented 19261 deaths during a mean follow-up of 4.8 years. Compared to wheat, in those with healthy and intermediate lifestyle, total rice was associated with a 13% (HR: 0.87, 95% CI 0.80, 0.93) and 6% (HR: 0.94, 95% CI 0.90, 1.00) lower risk of mortality, respectively, and coarse cereals were associated with a 14% (HR: 0.86, 95% CI 0.74, 1.00) and 12% (HR: 0.88, 95% CI 0.79, 0.97) lower risk of mortality, respectively. Meanwhile, an increase per SD in intakes of wheat and coarse cereals was associated with a 10% (HR: 1.10, 95% CI 1.03, 1.18) and 25% (HR: 1.25, 95% CI 1.08, 1.44) higher mortality rate in those with healthy lifestyle, and a 13% (HR: 1.13, 95% CI 1.08, 1.19) and 29% (HR: 1.29, 95% CI 1.17, 1.44) higher mortality in females but not males. In addition, a U-shaped association of intake of total grains with all- cause mortality was observed (P for non-linearity = 0.002), and a J-shaped association of intake of total rice with all- cause mortality was observed (P for non-linearity = 0.003). CONCLUSIONS Specific types of grains and lifestyle were separately or jointly associated with all-cause mortality. Compared to wheat, total rice and coarse cereals were advanced grains for participants with a relatively healthy lifestyle. Intake of total rice was related to all-cause mortality in a dose-response manner. Therefore, a combination of intermediate intake of total rice and healthy lifestyle should be encouraged in older adults.
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Affiliation(s)
- Yongjie Chen
- grid.265021.20000 0000 9792 1228Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, No 22 Qixiangtai Road, Tianjin, 300070 China ,grid.265021.20000 0000 9792 1228Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Boran Sun
- grid.265021.20000 0000 9792 1228Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, No 22 Qixiangtai Road, Tianjin, 300070 China
| | - Caihong Wang
- grid.265021.20000 0000 9792 1228Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, No 22 Qixiangtai Road, Tianjin, 300070 China
| | - Keming Zhang
- grid.410648.f0000 0001 1816 6218Department of Nutrition, First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, No 22 Qixiangtai Road, Tianjin, 300070, China. .,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
| | - Guowei Huang
- Department of Nutrition & Food Science, School of Public Health, Tianjin Medical University, No 22 Qixiangtai Road, Tianjin, 300070, China. .,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
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Cao X, Liu Q, Liu J, Yang B, Zhou J. The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships. Front Public Health 2023; 11:1149769. [PMID: 37089498 PMCID: PMC10116415 DOI: 10.3389/fpubh.2023.1149769] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/16/2023] [Indexed: 04/25/2023] Open
Abstract
Background Given the potentially negative effects of hearing loss on mental health and cognitive function, it is critical to gain a better understanding of the mechanisms underlying the link between hearing loss and cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their components in the role of depressive symptoms as a mediator between hearing loss and cognitive impairment. Methods Cross-sectional analyses were conducted with 8,094 Chinese older adults (aged ≥65 years) from the Chinese Longitudinal Healthy Longevity Survey in 2018. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of depressive symptoms and social relationships in the association between hearing loss and cognitive impairment. Results There is a significant correlation between hearing loss, depressive symptoms, social relationships, and cognitive function. Depressive symptoms partially mediated the association between hearing loss and cognitive function [standardized regression B-coefficient (B) = -0.114; 95% confidence interval (CI): (-0.158, -0.076)]. Social relationships moderated the effect of hearing loss on cognitive function through both path b (depressive symptoms - cognitive function) [B = 0.021; 95% CI: (0.008, 0.034)], and path c' (hearing loss-cognitive function) [B = 0.597; 95% CI: (0.463, 0.730)]. Furthermore, social activities and social networks moderated both the direct and indirect effects of moderated mediation. However, there appeared to be no moderated effect of social support for both the direct and indirect paths. Conclusion Social relationships moderated both the direct and indirect effects of depressive symptoms on the association between hearing loss and cognitive impairment. These findings shed light on the mechanisms underlying the relationship between hearing loss and cognitive impairment in Chinese older adults. It might be worthwhile to recommend multidimensional health and social interventions aimed at improving mental health and social inclusion among older adults with hearing loss.
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qian Liu
- Department of Psychology, Hunan Normal University, Changsha, China
| | - Jiali Liu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bingfang Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiansong Zhou
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jiansong Zhou,
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Cao X, Yang B, Zhou J. Waist-to-calf circumstance ratio and cognitive function among Chinese older adults: Mediating roles of physical performance and social activity. Front Aging Neurosci 2023; 15:1166341. [PMID: 37139093 PMCID: PMC10150408 DOI: 10.3389/fnagi.2023.1166341] [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: 02/15/2023] [Accepted: 03/23/2023] [Indexed: 05/05/2023] Open
Abstract
Background In light of the potentially detrimental effects of central fat and decreased muscle mass on cognitive function, it would be beneficial to learn more about the mediating mechanisms underpinning the association between the two. The purpose of this study is to determine the association between waist-to-calf circumstance ratio (WCR) and cognitive function, as well as to investigate whether physical performance and social activity mediate the relationship between WCR and cognitive function among older Chinese adults. Methods An analysis of 9,652 older Chinese adults was conducted during the 2018 wave of the Chinese Longitudinal Health Longevity Survey (CLHLS). The Mini-Mental State Examination (MMSE) and a self-reported scale were used to measure cognitive function, physical performance, and social activity, respectively. Multiple linear regression and mediation analyses were conducted. Results The findings suggest that a high WCR had a significant negative association with cognitive function (B = -0.535, 95% CI: -0.754, -0.317). Mediation analysis revealed that a high WCR influenced old adults' cognitive function in three ways: first, through the partial mediating effect of physical performance (B = -0.270; 95% CI: -0.340, -0.203); second, through the partial mediating effect of social activity (B = -0.035; 95% CI: -0.055, -0.017); and third, through the serial mediating effects of physical performance and social activity (B = -0.021, 95% CI: -0.029, -0.015). Conclusion The study results suggest the adverse impact of a high WCR on older adults' cognitive function, and the possible mechanisms of physical performance and social activity by which the association takes place. Multidimensional health and social interventions aimed at improving physical, social, and cognitive functioning among older adults with sarcopenic obesity are recommended.
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Chronic Disease Health Management Medical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Binfang Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Chronic Disease Health Management Medical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiansong Zhou
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental and Mental Diseases, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jiansong Zhou
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Zhao D, Han X, Huan J, Gao D, Wang T, Song J, Wang L, Zhang H, Luo T, Pan B, Niu Q, Lu X. Forecasting and analysis of the effect of lifestyle on cognitive dysfunction induced by occupational aluminum exposure based on Bayesian networks. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2023; 97:104035. [PMID: 36496184 DOI: 10.1016/j.etap.2022.104035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/24/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To evaluate the risk of cognitive impairment in workers with plasma aluminum concentrations and lifestyles using a Bayesian network (BN). METHODS In 2019, 476 male workers in the Shanxi Aluminum factory were investigated. We measured plasma aluminum concentrations in workers by inductive coupled plasma mass spectrometry (ICPMS) and tested workers' cognitive function by the MoCA scale. We collected the data of lifestyle by the occupational Workers' Health questionnaire and express the influence of lifestyle on cognition by the OR value (95 %CI) of logistic regression. A Bayesian network model was used to predict the risk of cognitive dysfunction. RESULTS The subjects were divided into a cognitively normal group and cognitively impaired group according to MoCA scores. There were statistically significant differences in age, education level, alcohol consumption, physical exercise, reading, aluminum length of service and blood aluminum concentration between the two groups (P < 0.05). The plasma aluminum concentration in the cognitive impairment group was 1.68 times higher than that in the cognitive normal group. Four groups were established according to the quartile of blood aluminum concentration of the subjects, namely, Group Q1 (<14.95 μg/L), Q2 group (14.95-32.96 μg/L), Q3 group (32.96-56.62 μg/L), and Q4 group (>56.62 μg/L). Binary logistic regression analysis showed that in the adjustment variable Model2, drinking, short sleep, long sleep, and mobile phone use increased the risk of cognitive impairment by 1.505(0.99,2.289), 1.269(0.702,2.295), 1.125(0.711,1.781) and 1.19(0.779,1.82), respectively, compared with their reference values. The risk of cognitive impairment from reading and exercise was 0.7(0.398,1.232) and 0.787(0.51,1.217), respectively, compared with those of no reading and no exercise. The risk of cognitive impairment of blood aluminum concentration in the Q2, Q3, and Q4 groups was 2.103(1.092,4.051), 1.866(0.955,3.644) and 3.679(1.928,7.020), respectively, compared with that in the Q1 group. Compared with age <40 , the risk of cognitive impairment of age ≥40 was 2.515(1.508,4.193) (P < 0.05). Bayesian network model results showed that if all participants had plasma aluminum concentrations higher than Q4, the prevalence of cognitive impairment was 54.5 %. The prevalence of cognitive impairment was 75.0 % if all participants had plasma aluminum levels above Q4, were older than 40, smoked, drank alcohol, used a cell phone for more than 2 h, slept for more than 8 h, did not exercise, and did not read. CONCLUSIONS Our findings suggest that both poor lifestyle and occupational aluminum exposure may affect cognitive function. Workers must maintain a reasonable lifestyle and reduce aluminum exposure, which can control the occurrence of cognitive impairment.
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Affiliation(s)
- Dan Zhao
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xiao Han
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jiaping Huan
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Dan Gao
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Tianshu Wang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jing Song
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Linping Wang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Huifang Zhang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Tiane Luo
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Shanxi 030001, China
| | - Baolong Pan
- Sixth Hospital of Shanxi Medical University (General Hospital of Tisco), China
| | - Qiao Niu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xiaoting Lu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
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Cardelo MP, Corina A, Leon-Acuña A, Quintana-Navarro GM, Alcala-Diaz JF, Rangel-Zuñiga OA, Camargo A, Conde-Gavilan C, Carmona-Medialdea C, Vallejo-Casas JA, Carmona-Asenjo E, Ochoa-Sepulveda JJ, Aguera-Morales E, Delgado-Lista J, Katsiki N, Lopez-Miranda J, Perez-Jimenez F, Yubero-Serrano EM, Perez-Martínez P. Effect of the Mediterranean diet and probiotic supplementation in the management of mild cognitive impairment: Rationale, methods, and baseline characteristics. Front Nutr 2022; 9:1037842. [PMID: 36570150 PMCID: PMC9773830 DOI: 10.3389/fnut.2022.1037842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Mild cognitive impairment (MCI) can progress to Alzheimer's disease (AD). When MCI is not properly controlled, the speed of deterioration can dramatically increase. Reduction of oxidative stress/inflammation and the modulation of the gut-brain axis could be new potential therapeutic targets for the prevention and treatment of AD. Consumption of specific nutrients, diets and probiotic supplementation have been evaluated for neurodegenerative disorders. We focus on a detailed description of the study methods and baseline characteristics of a clinical trial aiming to evaluate the efficacy of a combined nutritional intervention, i.e., a Mediterranean diet with probiotics, on cognitive capacity in a population with MCI. Methods In this randomized, latin-square crossover, double-blind, and controlled dietary intervention trial (clinicaltrials.gov NCT05029765), 47 MCI patients were randomized to consume three dietary interventions for 24-weeks each: (1) A Mediterranean diet supplemented with probiotics (109 colony-forming units of Lactobacillus rhamnosus and Bifidobacterium longum); (2) A Mediterranean diet + placebo; and (3) A Healthy diet according to the World Health Organization (WHO) recommendations. Participants will be evaluated before and after each of the three intervention periods (each 24-weeks, with a total of 72-weeks) for adherence to the assigned diet, blood tests, cognitive performance, gut microbiota analysis and functional neuroimaging studies. Results Fifty patients, ≥60 years-old and diagnosed with MCI, underwent randomization. A total of 47 patients completed follow-up dietary interventions (57.4% males), with a good glycemic control (HbA1c 5.8 ± 0.1%, fasting glucose and insulin 99.7 ± 3.3 mg/dL and 10.4 ± 0.9 mU/L, respectively), elevated systolic blood pressure (136.9 ± 2.1 mmHg) and increased degree of inflammation (high-sensitivity C-reactive protein, 8.8 ± 0.9 mg/dL). Baseline adherence to the Mediterranean diet was medium (7.5 ± 0.3 points on the score that ranged from 0 to 14 points). Conclusion The results of this clinical study would provide more evidence on the need for dietary therapeutic strategies, for clinical and individual practice, in the management of MCI patients to reduce the risk of AD development. Targeting lifestyle modifications in high-risk populations could prevent substantial cases of cognitive decline. Clinical trial registration [ClinicalTrials.gov], identifier [NCT05029765].
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Affiliation(s)
- Magdalena P. Cardelo
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Andreea Corina
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Ana Leon-Acuña
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Gracia M. Quintana-Navarro
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Juan F. Alcala-Diaz
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Oriol Alberto Rangel-Zuñiga
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Antonio Camargo
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Cristina Conde-Gavilan
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Claudia Carmona-Medialdea
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Juan A. Vallejo-Casas
- Unidad de Gestión Clinica de Medicina Nuclear, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Elvira Carmona-Asenjo
- Unidad de Gestión Clinica de Medicina Nuclear, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Juan J. Ochoa-Sepulveda
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Eduardo Aguera-Morales
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Javier Delgado-Lista
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Niki Katsiki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece,School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - José Lopez-Miranda
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Francisco Perez-Jimenez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Elena M. Yubero-Serrano
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Pablo Perez-Martínez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain,*Correspondence: Pablo Perez-Martínez,
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Zhang W, Wang T, Wang A. Impact of physical activity intensity on longitudinal trajectories of cognitive function and depressive symptoms in middle-aged and older Chinese adults: Eight-year prospective study. J Affect Disord 2022; 315:64-69. [PMID: 35839942 DOI: 10.1016/j.jad.2022.07.012] [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: 04/11/2022] [Revised: 06/22/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Little is known about how longitudinal trajectories of cognitive function and depressive symptoms are impacted by varying levels of physical activity (PA) intensity. METHOD The data were from the China Health and Retirement Longitudinal Study, a nationally representative household study of the Chinese population aged 45 years and older. The sample included 5025 middle-aged and older adults (mean age = 57) who self-reported their cognitive function, depressive symptoms, and PA intensity (vigorous PA, moderate PA, and light PA) every two years from 2011 to 2018. RESULT On average, every 2 years, cognitive function decreased by 0.17 points (95 % CI: [-0.22, -0.12], P < 0.05), while depressive symptoms increased by 0.23 points (95 % CI: [0.19,0.27], P < 0.001). Middle-aged and older adults who reported a minimum of 6 days/week frequency of moderate PA (β = 0.14, 95 % CI:[0.01,0.27]) had lower reduction of cognitive function compared to people with none moderate PA but not vigorous PA (β = 0.04, 95 % CI:[-0.11,0.19]) and light PA (β = 0.06, 95 % CI:[-0.09,0.22]). The increase in depressive symptoms was significantly slower among middle-aged and older adults with a minimum of 6 days/week light PA (β = -0.02, 95 % CI:[-0.03,-0.002]). CONCLUSION A minimum of 6 days of moderate PA a week was associated with a slower reduction in cognitive function and a minimum of 6 days of light PA a week was linked to a delayed increase in depressive symptoms. In middle-aged and older adults, a tailored PA intensity may be more beneficial in achieving the maximum improvement in cognitive function and mental health.
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Affiliation(s)
- Wen Zhang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Tingxuan Wang
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Anni Wang
- School of Nursing, Fudan University, China.
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Gao R, Yang Z, Yan W, Du W, Zhou Y, Zhu F. Protein intake from different sources and cognitive decline over 9 years in community-dwelling older adults. Front Public Health 2022; 10:1016016. [PMID: 36311592 PMCID: PMC9614310 DOI: 10.3389/fpubh.2022.1016016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/29/2022] [Indexed: 01/28/2023] Open
Abstract
Objectives To examine the association of protein intake from different sources with cognitive decline. Methods Our analysis included 3,083 participants aged 55-93 years from the China Health and Nutrition Survey. Cognition was assessed in 1997, 2000, 2004, 2006, and 2015. Diet intake was assessed using weighing methods in combination with 24-h dietary recalls for three consecutive days at each survey. Results Participants consumed 13.94% of energy intake from total protein, with 11.47 and 2.47% from plant and animal sources, respectively. During a follow-up of 9 years, participants in quintile 5 of plant protein intake (% energy) had a higher risk [odds ratio (95% CI): 3.03 (1.22-7.53)] of cognitive decline compared with those in quintile 1. Higher animal protein intake (% total protein) was associated with a lower risk of cognitive decline [odds ratio (95% CI) for quintile 5 vs. quintile 1: 0.22 (0.07-0.71)]. Grains (plant source) protein intake was inversely but fish/shrimp and poultry (animal source) protein intake were positively associated with change in cognitive Z-score. Conclusion Increasing animal protein consumption in a population with plant dominant diets may help to prevent cognitive decline.
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Affiliation(s)
- Rongtao Gao
- Department of Chronic Disease Control and Prevention, Tai'an Center for Disease Control and Prevention, Tai'an, China
| | - Zhan Yang
- Tai'an Maternal and Child Health Care Hospital, Tai'an, China
| | - Wenju Yan
- Department of Vascular Cardiology, Tai'an Central Hospital, Tai'an, China
| | - Weiping Du
- Department of Chronic Disease Control and Prevention, Tai'an Center for Disease Control and Prevention, Tai'an, China
| | - Yuan Zhou
- Department of Chronic Disease Control and Prevention, Tai'an Center for Disease Control and Prevention, Tai'an, China
| | - Feng Zhu
- Department of Hematology, Second Affiliated Hospital of Shandong First Medical University, Tai'an, China,*Correspondence: Feng Zhu
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Liang F, Fu J, Turner-McGrievy G, Wang Y, Qiu N, Ding K, Zeng J, Moore JB, Li R. Association of Body Mass Index and Plant-Based Diet with Cognitive Impairment among Older Chinese Adults: A Prospective, Nationwide Cohort Study. Nutrients 2022; 14:3132. [PMID: 35956314 PMCID: PMC9370436 DOI: 10.3390/nu14153132] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 12/10/2022] Open
Abstract
To examine the association of body mass index (BMI) and a plant-based diet (PBD) with cognitive impairment in older adults, this cohort study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a national, community-based, longitudinal, prospective study in China. Cognitive function was evaluated via the Mini-Mental State Examination (MMSE). Diet was assessed using a simplified food frequency questionnaire (FFQ), and PBD patterns were estimated using the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). BMI was measured objectively during the physical examination. Cox proportional hazard models and restricted cubic spline analyses were used. A total of 4792 participants with normal cognition at baseline were included, and 1077 participants were identified as having developed cognitive impairment during the 24,156 person-years of follow-up. A reverse J-shaped association was observed between BMI and cognitive impairment (p = 0.005 for nonlinearity). Participants who were overweight (HR = 0.79; 95% CI 0.66-0.95) and obese (HR = 0.72; 95% CI 0.54-0.96) had a decreased risk of cognitive impairment, while those who were underweight (HR = 1.42; 95% CI 1.21-1.66) had an increased risk. Lower PDI, lower hPDI, and higher uPDI were associated with an increased risk of cognitive impairment (HR = 1.32; 95% CI 1.16-1.50 for PDI; HR = 1.46; 95% CI 1.29-1.66 for hPDI; HR = 1.21; 95% CI 1.06-1.38 for uPDI). The protective effect of being overweight on cognitive impairment was more pronounced among participants with a higher PDI (HR = 0.74; 95% CI 0.57-0.95) than those with a lower PDI (HR = 0.87; 95% CI 0.67-1.12), among participants with a higher hPDI (HR = 0.73; 95% CI 0.57-0.94) than those with a lower hPDI (HR = 0.93; 95% CI 0.72-1.10), and among participants with a lower uPDI (HR = 0.61; 95% CI 0.46-0.80) than those with a higher uPDI (HR = 1.01; 95% CI 0.80-1.27). Our results support the positive associations of overweight status, obesity, an overall PBD, and a healthful PBD with cognitive function in older adults. A lower adherence to an overall PBD, a healthful PBD, and a higher adherence to an unhealthful PBD may attenuate the protective effect of being overweight on cognitive function.
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Affiliation(s)
- Fang Liang
- School of Public Health, Wuhan University, Wuhan 430071, China; (F.L.); (J.F.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Jialin Fu
- School of Public Health, Wuhan University, Wuhan 430071, China; (F.L.); (J.F.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - Yechuang Wang
- School of Public Health, Wuhan University, Wuhan 430071, China; (F.L.); (J.F.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Nan Qiu
- School of Public Health, Wuhan University, Wuhan 430071, China; (F.L.); (J.F.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Kai Ding
- School of Public Health, Wuhan University, Wuhan 430071, China; (F.L.); (J.F.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Jing Zeng
- School of Public Health, Wuhan University, Wuhan 430071, China; (F.L.); (J.F.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
| | - Justin B. Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA;
| | - Rui Li
- School of Public Health, Wuhan University, Wuhan 430071, China; (F.L.); (J.F.); (Y.W.); (N.Q.); (K.D.); (J.Z.)
- School of Nursing, Wuhan University, Wuhan 430071, China
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Zhou Y, Wang J, Cao L, Shi M, Liu H, Zhao Y, Xia Y. Fruit and Vegetable Consumption and Cognitive Disorders in Older Adults: A Meta-Analysis of Observational Studies. Front Nutr 2022; 9:871061. [PMID: 35795585 PMCID: PMC9251442 DOI: 10.3389/fnut.2022.871061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesThe aim of this meta-analysis was to assess the quantitative associations between fruit and vegetable intake and cognitive disorders in older adults.DesignA meta-analysis.Setting and ParticipantsWe used the PubMed, Web of Science and Scopus databases for a literature search to 12 April 2022. We preliminarily retrieved 11,759 studies, 16 of which met the inclusion criteria including six cross-sectional studies, nine cohort studies and one case-control study, incorporating 64,348 participants and 9,879 cases.MethodsUsing the three databases, we identified observational studies exploring the association. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effects model.ResultsSixteen studies were included in the meta-analysis, and the results showed that increased fruit and vegetable consumption in older adults was associated with a decline in the prevalence of cognitive disorders (OR: 0.79, 95% CI: 0.76–0.83). Moreover, intake of fruits (OR: 0.83, 95% CI: 0.77–0.89) and vegetables (OR: 0.75, 95% CI: 0.70–0.80) alone were both associated with a lower prevalence of cognitive disorders. Subgroup analyses indicated that the intake of fruits and vegetables was associated with the prevalence of cognitive impairment (OR: 0.72, 95% CI: 0.76–0.80) and dementia (OR: 0.84, 95% CI: 0.78–0.91) but not Alzheimer’s disease (OR: 0.88, 95% CI: 0.76–1.01).Conclusion and ImplicationsOur meta-analysis provides evidence that the intake of fruits and vegetables is inversely proportional and linearly associated with the prevalence of cognitive disorders in older adults. Future research is required to further investigate the preventive effects of the frequency, quantity, and duration of eating vegetables and fruits on cognitive disorders in older adults.
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Affiliation(s)
- Yuhan Zhou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jieyuan Wang
- Tibet Military Region Centers for Disease Control and Prevention of PLA, Tibet, China
| | - Limin Cao
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Mengyuan Shi
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Huiyuan Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Yang Xia, ;
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Yan LL, Li C, Zou S, Li Y, Gong E, He Z, Shao S, Jin X, Hua Y, Gallis JA, Turner EL. Healthy eating and all-cause mortality among Chinese aged 80 years or older. Int J Behav Nutr Phys Act 2022; 19:60. [PMID: 35619133 PMCID: PMC9137098 DOI: 10.1186/s12966-022-01280-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background There is little evidence of the influence of dietary patterns on mortality risk among adults 80 years or older (“oldest-old”). We evaluated the association between the Simplified Healthy Eating index (SHE-index) and mortality among Chinese oldest-old. Methods Population-based cohort study from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 1998–2014, n = 35 927), conducted in 22 Chinese provinces, were pooled for analysis. The first seven waves of the CLHLS (1998, 2000, 2002, 2005, 2008–09, 2011–12, and 2013–2014) were utilized, with follow-up to the last wave (2018) (range 0–21 years). The SHE-index was collected in each wave, and was constructed from intake frequency of nine dietary variables, with a higher score indicating better diet quality. Cox proportional hazards model with dietary patterns as a time-varying exposure was employed to analyze the relationship between SHE-index and mortality. Results At baseline, the median age of all participants was 92 years (25th percentile, 85 years; 75th percentile, 100 years). In multivariable models, the hazard ratios (95% confidence intervals) for SHE-index quartile 2, quartile 3 and quartile 4 versus quartile1 were 0.91 (0.88, 0.93), 0.89 (0.86, 0.92) and 0.82 (0.78, 0.85), respectively. Results were generally consistent for men and women and in a large number of sensitivity analyses. Conclusions Healthier eating patterns were associated with a significant reduction in the risk of all-cause mortality among Chinese oldest-old, lending support to the importance of life-long adherence to healthy diet into advanced old age. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01280-6.
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Affiliation(s)
- Lijing L Yan
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China. .,School of Public Health, Wuhan University, Wuhan, Hubei Province, 430072, China. .,The George Institute for Global Health, Chaoyang District, Beijing, 100600, China. .,Ningbo Eye Hospital (affiliated with Wenzhou Medical University), Yinzhou District, 315040, Ningbo, China.
| | - Chaoyun Li
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China
| | - Siyu Zou
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaxi Li
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China.,Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 3210 Humin Rd, Shanghai, 201108, China
| | - Enying Gong
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China.,Department of Population Medicine and Public Health, Peking Union Medical College, Beijing, China
| | - Zhengting He
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China.,Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Shuai Shao
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, 3004, Australia
| | - Xurui Jin
- MindRank AI Ltd, Hangzhou, Zhejiang, 311113, China
| | - Yechu Hua
- Department of Public Health Sciences, University of Rochester, Rochester, NY, 14623, USA
| | - John A Gallis
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.,Department of Biostatistics and Bioinformatics, Duke University, Hock Plaza, 2424 Erwin Road, Durham, NC, 27710, USA
| | - Elizabeth L Turner
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.,Department of Biostatistics and Bioinformatics, Duke University, Hock Plaza, 2424 Erwin Road, Durham, NC, 27710, USA
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Zhou T, Zhang X, Fan S, Deng Z, Jiao C. The Impact of Early Neighborhood Cohesion, and Its Mechanism, on Cognitive Function in Later Life. Front Psychiatry 2022; 13:848911. [PMID: 35573370 PMCID: PMC9091595 DOI: 10.3389/fpsyt.2022.848911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/06/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives This study aimed to explore the impact of early neighborhood cohesion, and its mechanism, on cognitive function in later life. Methods In total, 10,727 Chinese elderly, aged 60-90, forming two datasets (2014 and 2018) from the China Health and Retirement Longitudinal Study (CHARLS) were used as a sample. Childhood neighborhood cohesion was measured by the extent of how much neighbors were willing to help and how close-knit neighbors were. Mini-Mental State Examination (MMSE) and Center for Epidemiologic Studies Depression Scale (CESD-10) were used to assess the cognitive functions and depression of the elderly. We used a structural equation model to examine the relationship between early neighborhood cohesion and late-life cognitive function and conducted bootstrapping analyses to assess the mechanism. Results Cognitive function was positively predicted by childhood neighborhood cohesion (β = 0.06, p < 0.001), and cognitive function of the elderly were also positively predicted through the mediating effects of childhood friendships, which included depression and social activity participation as two chain paths. Conclusion The findings suggest that childhood neighborhood cohesion positively predicts cognitive function among elderly people through the mediating roles of childhood friendship, depression, and social activity engagement. Childhood neighborhood cohesion is correlated with better childhood friendships, then to fewer depression symptoms and greater elderly social activity participation, and finally to better cognitive functions in the elderly.
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Affiliation(s)
- Tao Zhou
- School of Psychology Shenzhen University, Shenzhen, China
| | - Xiaoyi Zhang
- School of Psychology Shenzhen University, Shenzhen, China
| | - Shuming Fan
- Faculty of Education, Department of Educational Psychology, East China Normal University, Shanghai, China
| | - Zeming Deng
- School of Psychology Shenzhen University, Shenzhen, China
| | - Can Jiao
- School of Psychology Shenzhen University, Shenzhen, China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, China
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Yuan L, Zhao Z, Wang J, Du M, Xiao Y, Liu L, Sun J. Decomposition and Comparative Analysis of the Prevalence of and Factors Associated With Smoking Between the Rural and Urban Elderly Population in China: A National Cross-Sectional Study. Front Public Health 2022; 10:824587. [PMID: 35372230 PMCID: PMC8968864 DOI: 10.3389/fpubh.2022.824587] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/31/2022] [Indexed: 11/21/2022] Open
Abstract
This study aimed to compare and analyse the differences in smoking prevalence, and knowledge, attitudes, and factors associated with smoking between the rural and urban elderly population in China. In total, 6,966 participants aged 60 and above were included in this study, which assessed their smoking-related knowledge, attitudes, and perceptions toward tobacco control. The Chi-square test and logistic regression model were used for statistical analysis, and the Fairlie model was used for decomposition analysis. The overall prevalence of smoking was 25.6%; the rate was much higher in men than in women (overall: OR = 26.234; urban: OR = 31.260; rural: OR = 23.889). The rate of correct responses to all questions on smoking problems was significantly higher among the urban elderly than the rural elderly. Further, 64.18% of the participants supported printing photos of the health hazards of smoking on the cover of cigarette packs, and the rural elderly were more supportive of this. Moreover, only 36.52% of the participants supported increasing taxation and retail price of cigarettes; the urban elderly showed more support for this. Rules about smoking at home also played an important role, especially for families where smoking was not allowed at home, but with exceptions to the rule; however, this factor was only meaningful in urban families (urban: OR = 0.117). Through the Fairlie decomposition analysis, gender (-1.62%), age (-2.03%), region (13.68%), knowing about e-cigarettes (5.17%), rules about smoking at home (3.95%), and smoking-related knowledge scores (42.85%) were found to be associated with rural-urban disparities. This study focused on the differences in smoking between urban and rural areas in China. Smoking among the urban elderly was significantly less prevalent compared with the rural population. Factors including education, region, and smoking-related knowledge need to be addressed to reduce the gap between urban and rural health hazards in China.
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Affiliation(s)
- Lei Yuan
- Department of Health Management, Second Military Medical University, Shanghai, China
- *Correspondence: Lei Yuan
| | - Zhe Zhao
- Department of Health Management, Second Military Medical University, Shanghai, China
| | - Jin Wang
- Department of Obstetrics and Gynecology, Beijing Aerospace General Hospital, Beijing, China
| | - Maolin Du
- Department of Office, Second Military Medical University, Shanghai, China
| | - Yan Xiao
- Department of Health Management, Second Military Medical University, Shanghai, China
- Department of Medical and Research, Naval Medical Center, Second Military Medical University, Shanghai, China
| | - Lijuan Liu
- Department of Health Management, Second Military Medical University, Shanghai, China
- Lijuan Liu
| | - Jinhai Sun
- Department of Health Management, Second Military Medical University, Shanghai, China
- Jinhai Sun
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32
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Chen H, Shen J, Xuan J, Zhu A, Ji JS, Liu X, Cao Y, Zong G, Zeng Y, Wang X, Yuan C. Plant-based dietary patterns in relation to mortality among older adults in China. NATURE AGING 2022; 2:224-230. [PMID: 37118372 DOI: 10.1038/s43587-022-00180-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/19/2022] [Indexed: 04/30/2023]
Abstract
A plant-based dietary pattern has been recommended for its potential health and environmental benefits, but its relation to mortality warrants further exploration1. We examined this association among 13,154 adults aged 65 years and older (57.4% female) in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The overall plant-based diet index (PDI), healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI) were calculated using dietary data collected by a simplified food frequency questionnaire (FFQ). Compared with the lowest quintile, participants in the highest quintile of PDI and hPDI had a decreased risk of all-cause mortality (hazard ratio (HR) = 0.92; 95% confidence interval (CI) 0.86, 0.98 for PDI; HR = 0.81, 95% CI, 0.76, 0.87 for hPDI), whereas participants with the highest uPDI scores had a 17% (95% CI, 9%, 26%) increased risk. Among plant foods, fresh fruits, fresh vegetables, legumes, garlic, nuts and tea were the main protective contributors, whereas preserved vegetables and sugar were associated with a higher risk of mortality. These findings support the beneficial roles of overall and healthful plant-based dietary patterns. The quality, and not only quantity, of plant foods should be emphasized in relevant public health recommendations.
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Affiliation(s)
- Hui Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Shen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Xuan
- China Academy for Rural Development, Department of Agricultural Economics and Management, Zhejiang University, Hangzhou, China
| | - Anna Zhu
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
| | - Yaying Cao
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Geng Zong
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, National School of Development, Peking University, Beijing, China
- Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, USA
| | - Xiaoxi Wang
- China Academy for Rural Development, Department of Agricultural Economics and Management, Zhejiang University, Hangzhou, China.
- Potsdam Institute for Climate Impact Research, Potsdam, Germany.
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Bonyadi N, Dolatkhah N, Salekzamani Y, Hashemian M. Effect of berry-based supplements and foods on cognitive function: a systematic review. Sci Rep 2022; 12:3239. [PMID: 35217779 PMCID: PMC8881511 DOI: 10.1038/s41598-022-07302-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 02/08/2022] [Indexed: 11/08/2022] Open
Abstract
In the current decade, a growing body of evidence has proposed the correlation between diet and cognitive function or dementia in the ageing population. This study was designed to appraise discoveries from the randomized controlled trials to confirm the effects of berry-based supplements or foods on cognitive function in older adults. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, EMBASE, Google Scholar, and ProQuest as well as SID, Magiran, and Iranmedex electronic databases were explored for human interventional studies up to March 2021. In total, eleven articles were identified using frozen blueberry (n = 4 studies), blueberry concentrate (n = 2), beverage (n = 3), capsule (n = 1), extract and powder (n = 1). These studies had been performed among older people with no recognized cognitive impairment or mild cognitive impairment (MCI). The primary outcomes included global cognitive function, psychomotor function, learning and memory, working memory capacity, executive functions, and brain perfusion/activity. To our knowledge, this is the first systematic review of available clinical trials on the effects of berry-based supplements and foods on cognitive performances as well as brain perfusion parameters among the elderly with normal cognition or MCI. Existing evidence concludes that berry-based supplements and foods have beneficial effects on resting brain perfusion, cognitive function, memory performance, executive functioning, processing speed, and attention indices.
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Affiliation(s)
- Negar Bonyadi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Yaghoub Salekzamani
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Hashemian
- Department of Biology, School of Arts and Sciences, Utica College, Utica, USA
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Guan M. Associations of fruit & vegetable intake and physical activity with poor self-rated health among Chinese older adults. BMC Geriatr 2022; 22:10. [PMID: 34979973 PMCID: PMC8722069 DOI: 10.1186/s12877-021-02709-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the existing literature highlights the central roles of sociodemographic factors, fruit & vegetable (F&V) intake, and physical activities for maintaining good health, less is known about the associations in the Chinese context. This study attempted to explore the associations of servings of F&V intake and levels of physical activities with poor self-rated health (SRH) among Chinese older adults. METHODS Data were drawn from the Study on Global Ageing and Adult Health-China (SAGE-China) issued by the World Health Organization and included 7560 respondents aged ≥60 years in China. After screening out the potential confounding factors, multiple logistic regression models were adopted to explore the associations of sociodemographic factors, servings of F&V intake, and levels of physical activities with poor SRH. RESULTS Among the sample, nearly a quarter reported poor health status. There were significant gender differences in the case of servings of F&V intake and levels of physical activities. Logistic regressions indicated that higher fruit intake was associated with lower likelihood of vigorous level of physical activity as compared to zero intake. Likewise, higher vegetable intake (≥10 servings) was associated with a higher likelihood of vigorous & moderate level of physical activity when compared to lower intake (≤ 4 servings). Higher fruit intake was associated with a lower likelihood of poor SRH. Similarly, vegetable intake (5 servings: AOR = 0.69, 95%CI: 0.58-0.83; 6-9 servings: AOR = 0.72, 95%CI: 0.59-0.87) was significantly associated with poor SRH. Additionally, vigorous level of physical activity (AOR = 0.79, 95%CI: 0.65-0.97) and vigorous fitness/leisure (AOR = 0.57, 95%CI: 0.39-0.84) were significantly associated with poor SRH. CONCLUSION This study suggested that older adults with high fruit intake had lower probability of performing vigorous & moderate level of physical activity, while those with high vegetable intake had higher probability of performing vigorous & moderate level of physical activity. Likewise, the older adults with high F&V intake and higher probability of performing vigorous level of physical activity, walk/bike activity, and vigorous/moderate fitness/leisure had less likelihood to face the risk for poor SRH outcomes. The appropriate servings of F&V intake and levels of physical activity should be highlighted.
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Affiliation(s)
- Ming Guan
- Family Issues Center, Xuchang University, Road Bayi 88, Xuchang, Henan, China. .,International Issues Center, Xuchang University, Road Bayi 88, Xuchang, Henan, China. .,School of Business, Xuchang University, Road Bayi 88, Xuchang, Henan, China.
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Zhang Q, Zhang M, Chen Y, Zhu S, Zhou W, Zhang L, Dong G, Cao Y. Smoking Status and Cognitive Function in a National Sample of Older Adults. Front Psychiatry 2022; 13:926708. [PMID: 35873239 PMCID: PMC9301276 DOI: 10.3389/fpsyt.2022.926708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022] Open
Abstract
AIMS To examine the correlation between smoking status and different domains of cognitive function in elderly Americans. METHODS We used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). Participants over 60 years with available smoking history and cognitive function data were enrolled in our analysis. The NHANES study included the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST) to assess cognition. Multivariate regression analyses were used to estimate the association between cigarette smoking and cognitive function. RESULTS A total of 2,932 participants were enrolled in the analysis, including 372 (12.7%) current smokers, 1,115 (38%) former smokers, and 1,445 (49.3%) never smokers. Never smokers had in average 3.82 (95% CI, 2.21 to 5.43) points more than current smokers in the DSST, whereas former smokers had 3.12 (95% CI, 1.51 to 4.73) points more than current smokers. Besides, smoking was not associated with the results of the AFT or the CERAD test. CONCLUSIONS This study suggests that cigarette smoking is associated with processing speed among the American elderly.
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Affiliation(s)
- Qiaoyang Zhang
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Min Zhang
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Yun Chen
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Shumin Zhu
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Wang Zhou
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Lihao Zhang
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Guanzhong Dong
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Yin Cao
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
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Nunes CF, Carvalho TRD, Duarte RDS, Barboza YACO, Lemos MCCD, Pinho CPS. Prevalence of sarcopenia and associated factors in patients in hemodialysis. REVISTA CIÊNCIAS EM SAÚDE 2021. [DOI: 10.21876/rcshci.v11i4.1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To assess the prevalence of sarcopenia and associated factors in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD). Methods: This cross-sectional study evaluated patients with CKD undergoing HD from January to October 2016 in two dialysis centers located in Recife, Pernambuco. For the diagnosis of sarcopenia, the criteria proposed by the 2019 European Consensus on Sarcopenia, which advocates low muscle strength as the main criterion, were considered. Demographic, clinical, anthropometric, and behavioral covariates were evaluated. Results: 108 patients were included, with a mean age of 51.4 ± 17.0 years and homogeneous distribution between the sexes.Sarcopenia was present in 38.9% of the population, of which 69% had severe sarcopenia. A higher prevalence of sarcopenia was observed among men (60% vs. 17%; p < 0.001), in those without a partner (48.1% vs. 30.4%; p < 0.045), in smokers (50% vs. 30%; p < 0.034), with low weight (underweight 73.3%, eutrophic 33.9%, overweight 32.4%; p = 0.001) and those with normal albumin levels (47.5% vs. 28.6%; p = 0.045). Conclusion: Approximately one in three nephropathic patients on hemodialysis presented sarcopenia and, among these, most had the severe form of this condition.Uremic sarcopenia was more prevalent in males, in individuals without partners, underweight, in smokers, and among those with normal albumin levels.
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Wang Y, Li Z, Ma L, Li G, Han K, Liu Z, Wang H, Xu B. The Native Dietary Habits of the Two Sympatric Bee Species and Their Effects on Shaping Midgut Microorganisms. Front Microbiol 2021; 12:738226. [PMID: 34690980 PMCID: PMC8529121 DOI: 10.3389/fmicb.2021.738226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/14/2021] [Indexed: 12/27/2022] Open
Abstract
The intestinal microbial community composition of different bee species typically has host specificity, yet little is known about the underlying formation mechanism. There are signs that dietary habits vary in different bee species, suggesting that there may be close relationships between dietary habits and intestinal microorganisms. We explored this hypothesis by comparing the dietary habits and gut microbiota of two common bee species (Apis mellifera L. and Apis cerana cerana) in China. Bee bread and midgut samples from wild and laboratory-reared bees were collected, and the differences in intestinal microbial community composition and growth and development before and after the change in dietary habits of different bee species were compared. We found that the two sympatric species had different dietary specializations and similar metagenomic diversities. The microbiota composition differed between the two species. Moreover, we revealed that changes in native dietary habits destroyed the intestinal microbiota community composition, negatively affecting the growth and development of honeybees.
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Affiliation(s)
- Ying Wang
- Department of Science and Technology, Shandong Agricultural University, Taian, China
| | - Zhenfang Li
- College of Plant Protection, China Agricultural University, Beijing, China
| | - Lanting Ma
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China
| | - Guilin Li
- College of Life Sciences, Qufu Normal University, Jining, China
| | - Kai Han
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China
| | - Zhenguo Liu
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China
| | - Hongfang Wang
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China
| | - Baohua Xu
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China
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Shen S, Luo M, Meng X, Deng Y, Cheng S. All-Cause Mortality Risk Associated With Solid Fuel Use Among Chinese Elderly People: A National Retrospective Longitudinal Study. Front Public Health 2021; 9:741637. [PMID: 34722448 PMCID: PMC8551618 DOI: 10.3389/fpubh.2021.741637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/15/2021] [Indexed: 02/05/2023] Open
Abstract
Background: The adverse health effects of air pollutants are widely reported, and the elderly are susceptible to toxic environments. This study aimed to evaluate the association between use of solid fuels for cooking and mortality among the elderly. Methods: A total of 5,732 and 3,869 participants from the Chinese Longitudinal Healthy Longevity Survey were enrolled in two (2014 and 2018) and three surveys (2011, 2014, and 2018) of survey. Cooking fuel was divided into clean and solid fuel. Cox proportional hazards models were used to estimate the mortality hazard ratio (HR). Subgroup analyses were performed to assess the potential interaction effect. Results: Among the participants in the 2011-2018 survey, 53% reported using solid fuel. Such group was associated with a 9% increase in mortality risk relative to clean fuel users (HR = 1.09, 95% CI = 1.01-1.18). Among participants in the 2014-2018 survey, 339 reported a switch from solid to clean fuels and they were not at increased mortality risk relative to the 488 people that reported a stable use of clean fuels (HR = 1.14, 95% CI = 0.99-1.31) although the estimated HR was similar to the one for stable solid fuel users (HR = 1.19, 95%CI = 1.04-1.36 n = 509). Interaction and stratified analyses showed that solid fuel use had an impact on mortality in participants who were non-current smokers, had low dietary diversity scores, and were living in areas with high PM2.5 concentrations (>50 μg/m3) and city population below 8 million (P for interaction < 0.05). The association was robust in the three sensitivity analyses. Conclusion: The finding showed a clear association between solid fuel use and mortality among older Chinese, and an even stronger association between risk of mortality and solid fuel use among individuals exposed to high levels of PM2.5.
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Affiliation(s)
- Shisi Shen
- The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Min Luo
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xuchen Meng
- The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Ying Deng
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Shuwen Cheng
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
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Martín MA, Goya L, de Pascual-Teresa S. Effect of Cocoa and Cocoa Products on Cognitive Performance in Young Adults. Nutrients 2020; 12:nu12123691. [PMID: 33265948 PMCID: PMC7760676 DOI: 10.3390/nu12123691] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/18/2020] [Accepted: 11/28/2020] [Indexed: 12/14/2022] Open
Abstract
Increasing evidence support a beneficial role of cocoa and cocoa products on human cognition, particularly in aging populations and patients at risk. However, thorough reviews on the efficacy of cocoa on brain processes in young adults do not exist precisely due to the limited number of studies in the matter. Thus, the aim of this study was to summarize the findings on the acute and chronic effects of cocoa administration on cognitive functions and brain health in young adults. Web of Science and PubMed databases were used to search for relevant trials. Human randomized controlled studies were selected according to PRISMA guidelines. Eleven intervention studies that involved a total of 366 participants investigating the role of cocoa on cognitive performance in children and young adults (average age ≤ 25 years old) were finally selected. Findings from individual studies confirm that acute and chronic cocoa intake have a positive effect on several cognitive outcomes. After acute consumption, these beneficial effects seem to be accompanied with an increase in cerebral blood flow or cerebral blood oxygenation. After chronic intake of cocoa flavanols in young adults, a better cognitive performance was found together with increased levels of neurotrophins. This systematic review further supports the beneficial effect of cocoa flavanols on cognitive function and neuroplasticity and indicates that such benefits are possible in early adulthood.
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