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Liu C, Wang X, Zhang X, Liu Y, Lin R, Wu Y, Wang D. The impact of family climate on problematic internet use: Findings from one nationwide study in China. J Affect Disord 2024; 367:350-358. [PMID: 39236882 DOI: 10.1016/j.jad.2024.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 07/18/2024] [Accepted: 09/02/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND With the growing attention paid to problematic internet use (PIU), this study aims to i) explore the prevalence of PIU based on a nationally representative sample and ii) propose and validate the theoretical model that correlates family climate with PIU. METHODS One national cross-sectional study was conducted with probability sampling and stratified sampling. Overall, 21,854 sample were included and analyzed. Validated measures of family climate, loneliness, and PIU was distributed and collected from June 2022 to August 2022. RESULTS The overall prevalence of PIU in the sample population is approximately 30.86 %. The model findings showed that family communication and family health had indirect effects of -0.12 and - 0.05 on PIU by the mediating effects of loneliness. The indirect effect explained 80.0 % of the total effect of family communication on PIU and 38.5 % of family health on PIU, highlighting the dominance effects of path family communication and PIU via loneliness. Extended family type (-0.047, p = 0.050), low family income (income≤3000 group, -0.127, p < 0.001) were identified as protective factors against PIU, while not living with family members (0.034, p = 0.021) was identified as risk factors of PIU. LIMITATIONS The nature of cross-sectional data have the limitation of preventing examining the casual relationships of PIU and the loneliness and family climate, in which future longitudinal study design is needed. CONCLUSIONS The high prevalence of PIU should be given adequate attention. Optimizing the family climate or family atmosphere by improving positive communication skills, providing family support and family health external resources can be served as effective strategies for controlling PIU.
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Affiliation(s)
- Chenxi Liu
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road No. 13, Qiaokou District, Wuhan 430030, China
| | - Xi Wang
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road No. 13, Qiaokou District, Wuhan 430030, China
| | - Xinyi Zhang
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road No. 13, Qiaokou District, Wuhan 430030, China
| | - Yushu Liu
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road No. 13, Qiaokou District, Wuhan 430030, China
| | - Rujiao Lin
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road No. 13, Qiaokou District, Wuhan 430030, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing 100000, China.
| | - Dan Wang
- School of Management, Hubei University of Chinese Medicine, Huangjiahu West Road No.16, Hongshan District, Wuhan, 430000, China; Hubei Shizhen Laboratory, Hubei University of Chinese Medicine, Huangjiahu West Road No.16, Hongshan District, Wuhan, 430000, China; Research Center for Traditional Chinese Medicine Development, Hubei University of Chinese Medicine, Huangjiahu West Road No.16, Hongshan District, Wuhan, 430000, China.
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Cho G, Betensky RA, Chang VW. Internet usage and the prospective risk of dementia: A population-based cohort study. J Am Geriatr Soc 2023; 71:2419-2429. [PMID: 37132331 DOI: 10.1111/jgs.18394] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 03/08/2023] [Accepted: 03/12/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Little is known about the long-term cognitive impact of internet usage among older adults. This research characterized the association between various measures of internet usage and dementia. METHODS We followed dementia-free adults aged 50-64.9 for a maximum of 17.1 (median = 7.9) years using the Health and Retirement Study. The association between time-to-dementia and baseline internet usage was examined using cause-specific Cox models, adjusting for delayed entry and covariates. We also examined the interaction between internet usage and education, race-ethnicity, sex, and generation. Furthermore, we examined whether the risk of dementia varies by the cumulative period of regular internet usage to see if starting or continuing usage in old age modulates subsequent risk. Finally, we examined the association between the risk of dementia and daily hours of usage. Analyses were conducted from September 2021 to November 2022. RESULTS In 18,154 adults, regular internet usage was associated with approximately half the risk of dementia compared to non-regular usage, CHR (cause-specific hazard ratio) = 0.57, 95% CI = 0.46-0.71. The association was maintained after adjustments for self-selection into baseline usage (CHR = 0.54, 95% CI = 0.41-0.72) and signs of cognitive decline at the baseline (CHR = 0.62, 95% CI = 0.46-0.85). The difference in risk between regular and non-regular users did not vary by educational attainment, race-ethnicity, sex, and generation. In addition, additional periods of regular usage were associated with significantly reduced dementia risk, CHR = 0.80, 95% CI = 0.68-0.95. However, estimates for daily hours of usage suggested a U-shaped relationship with dementia incidence. The lowest risk was observed among adults with 0.1-2 h of usage, though estimates were non-significant due to small sample sizes. CONCLUSIONS Regular internet users experienced approximately half the risk of dementia than non-regular users. Being a regular internet user for longer periods in late adulthood was associated with delayed cognitive impairment, although further evidence is needed on potential adverse effects of excessive usage.
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Affiliation(s)
- Gawon Cho
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York, USA
| | - Rebecca A Betensky
- Department of Biostatistics, School of Global Public Health, New York University, New York, New York, USA
| | - Virginia W Chang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, New York, USA
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3
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Woods SP, Thompson JL, Benge JF. Computer use: a protective factor for cognition in aging and HIV disease? Aging Clin Exp Res 2023:10.1007/s40520-023-02449-0. [PMID: 37278938 DOI: 10.1007/s40520-023-02449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Modifiable lifestyle factors such as engagement with technology may be beneficial to cognition in older adults, but we know little about these relationships in older persons with chronic medical conditions. AIMS The current study examined the association between computer use frequency and cognition in younger and older adults with and without HIV disease. METHODS Participants included 110 older persons with HIV (pwHIV; age ≥ 50 years), 84 younger pwHIV (age ≤ 40 years), 76 older HIV-, and 66 younger HIV- adults who completed a comprehensive medical, psychiatric, and cognitive research assessment. Demographically adjusted scores were derived from a well-validated clinical battery of performance-based neuropsychological tests. Participants also completed self-reported measures of cognitive symptoms in daily life and the Brief Computer Use and Anxiety Questionnaire (BCUAQ). RESULTS Older age was associated with less frequent computer use among persons with and without HIV disease. More frequent computer use was strongly and independently related to better cognitive performance, particularly in higher order domains (e.g., episodic memory and executive functions) and among the older seronegative adults. A small, univariable correlation between more frequent computer use and fewer cognitive symptoms in daily life was observed in the full sample, but that relationship was better explained by computer-related anxiety and HIV/age study group. DISCUSSION These findings add to the existing literature that suggests regular engagement with digital technologies may have a beneficial impact on cognitive functioning, consistent with the technological reserve hypothesis.
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Affiliation(s)
- Steven Paul Woods
- Department of Psychology, University of Houston, 3595 Cullen Blvd., 126 Heyne Bldg., Ste. 239d, Houston, TX, 77204, USA
| | - Jennifer L Thompson
- Department of Psychology, University of Houston, 3595 Cullen Blvd., 126 Heyne Bldg., Ste. 239d, Houston, TX, 77204, USA
| | - Jared F Benge
- Department of Neurology, Dell Medical School, University of Texas at Austin, Trinity St Bldg B, Austin, TX, 78712, USA.
- Mulva Clinic for the Neurosciences, University of Texas at Austin, Austin, TX, 78712, USA.
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4
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Guo H, Feng S, Liu Z. The temperature of internet: Internet use and depression of the elderly in China. Front Public Health 2022; 10:1076007. [PMID: 36620285 PMCID: PMC9811204 DOI: 10.3389/fpubh.2022.1076007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Depression has become one of the most prevalent mental illnesses affecting the elderly in aging countries, i. e., in countries of the world whose population is slowly aging. It has become an important topic for scientists and policymakers to analyze how best to improve the elderly's mental health and save them from depression. The aim of this paper was to investigate whether and to what extent internet use may affect depression in the elderly. The heterogeneous effects of internet use on the elderly's depression across age, gender, and occupation were also investigated. Methods The data used in the present study were gathered from the China Health and Retirement Longitudinal Study that was conducted in 2018. The propensity score matching technique and the endogenous switch regression model were employed in this study to address potential endogeneity caused by both observed and unobserved factors. Results The results of the present study show that the elderly who are relatively young, male, well educated, live in an urban area, or have a small family are more likely to use the internet. The elderly who have healthy eyes or good eyesight, those who are not employed in the agricultural sector, or those who are retired, and those who are not eligible to receive any subsistence allowance or drink wine have a higher probability of using the internet. We also find that internet use significantly reduces the elderly's depression status by 3.370 points, which is roughly equivalent to a reduction of 37.19%. Heterogeneity analysis on internet use reveals that the health effect is particularly effective for agricultural workers, female, or the older elderly. Conclusion The results of the present study highlight the significant welfare effects brought about by the development of internet infrastructure. To improve the mental health of the elderly, the government should encourage them to adopt the internet. In particular, the needs of the elderly who are older, female, or have agricultural work should be paid more attention to motivate them to use the internet more to alleviate depression.
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Affiliation(s)
- Hongwang Guo
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Shuyi Feng
- China Resources, Environment and Development Academy, Nanjing Agricultural University, Nanjing, China
| | - Ziming Liu
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China,*Correspondence: Ziming Liu ✉
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Li W, Yue L, Xiao S. Association Between Internet Use, Cognitive Function, and Globus Pallidus Volumes: A Study Among the Elderly in Chinese Communities. Front Public Health 2022; 10:886974. [PMID: 35646776 PMCID: PMC9130581 DOI: 10.3389/fpubh.2022.886974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/21/2022] [Indexed: 01/15/2023] Open
Abstract
Background Previous studies have linked internet use with several beneficial outcomes for brain health, but there is little data on this among older Chinese. Objective The goal of this study was to explore the association between internet use and cognitive impairment and to explore the possible mechanisms by which internet use prevents cognitive decline. Methods The current study consisted of two cohorts: one from the China Longitudinal Aging Study (CLAS), which included 610 older adults with mild cognitive impairment (MCI), 192 with dementia, and 2,218 healthy older adults; the second cohort included 39 healthy adults from the Shanghai brain health foundation (SHBHF2016001), who underwent T1 cranial magnetic resonance imaging at baseline, from which their volumes of the hippocampus, amygdala, and globus pallidus were calculated. Moreover, they were also followed up for 1 year. Through standardized questionnaires, detailed general demographic information and internet use information was obtained. The cognitive diagnosis of each participant was made by attending psychiatrists at baseline, and their overall cognitive function was assessed by the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results In cohort 1, after controlling age, gender, smoker, tea drinker, take exercise, diabetes, and hypertension, we found that internet use was associated with MCI (P = 0.015, OR = 0.478, 95% CI: 0.264~0.867), but not for dementia (P = 0.205, OR = 0.393, 95% CI: 0.093~1.665). In cohort 2, we found that the globus pallidus volume of internet users was significantly larger than that of non-users, and the MMSE change score was lower (P < 0.05). The results of partial correlation analysis (controlled for sex, age and education) showed that the change of MMSE value was positively correlated with the volume of left globus pallidus (r = 0.547, P = 0.004). Conclusions Internet use might be a protective factor for mild cognitive impairment among the Chinese elderly, and it may prevent a decline in cognitive decline by affecting the volume of the globus pallidus.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Kouvonen A, Kemppainen T, Taipale S, Olakivi A, Wrede S, Kemppainen L. Health and self-perceived barriers to internet use among older migrants: a population-based study. BMC Public Health 2022; 22:574. [PMID: 35321678 PMCID: PMC8941300 DOI: 10.1186/s12889-022-12874-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/28/2022] [Indexed: 12/12/2022] Open
Abstract
Background In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific self-perceived barriers to internet use among older migrants with different health conditions. The aim of this study was to investigate the associations between different health conditions and self-perceived barriers to internet use among older migrants. Methods We used the Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) study, which is a nationally representative survey of community-dwelling Russian-speaking adults aged ≥50 years living in Finland (N=1082, 57% men, mean age 63.2 years, standard deviation 8.4 years, response rate 36%). Postal survey data were collected in 2019. Health indicators were self-rated health (SRH), depressive symptoms, cognitive functioning, and doctor-diagnosed conditions. Linear regression analyses were used to investigate the associations between health indicators and a summary scale consisting of the following barriers of internet use: (1) internet use is too complicated and hard to learn; (2) having concerns about safety issues; (3) internet use is too expensive; (4) physical limitations hinder the internet use; (5) memory problems hinder the internet use. In addition, the two most commonly reported barriers (the first two) were examined separately using logistic regression analyses. The analyses were adjusted for age, sex, education, marital status, local language proficiency, and income support, and the health conditions, and were performed with weights accounting for the survey design and non-response. Results After adjustments, spine/back problems (b=0.13; p=0.049), depressive symptoms (b=0.40; p=0.007), and problems in learning new things (b=0.60; p<0.0005) were associated with higher level of overall barriers to internet use. In addition, a number of health conditions were associated with individual barriers, albeit some health conditions appeared protective. Conclusions In general, older migrants with declining health experience more barriers to internet use than their counterparts with better health. To provide better access to healthcare for older adults, including older migrants, rapidly changing devices, software and apps need to be modified and adapted for those with specific health-related needs.
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Affiliation(s)
- Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland. .,Centre for Public Health, Queen's University Belfast, Institute of Clinical Science, Block A, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
| | - Teemu Kemppainen
- Department of Geosciences and Geography, University of Helsinki, PO Box 64, 00014, Helsinki, Finland.,Centre Maurice Halbwachs (CNRS/EHESS/ENS), École Normale Supérieure 48, boulevard Jourdan, 75014, Paris, France
| | - Sakari Taipale
- Department of Social Sciences and Philosophy, University of Jyvaskyla, PO Box 35, 40014, Jyvaskyla, Finland.,Faculty of Social Sciences, University of Ljubljana, Kardeljeva ploščad 5, 1000, Ljubljana, Slovenia
| | - Antero Olakivi
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland
| | - Sirpa Wrede
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland.,Swedish School of Social Science, University of Helsinki, PO Box 16, 00014, Helsinki, Finland
| | - Laura Kemppainen
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland
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Yuan W, Jiang M, Gong S. How to Improve the Cognitive Health of Middle-Aged and Elderly People: Evidence From China Family Panel Studies. Front Public Health 2022; 10:799255. [PMID: 35186840 PMCID: PMC8855359 DOI: 10.3389/fpubh.2022.799255] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/03/2022] [Indexed: 01/07/2023] Open
Abstract
In the context of the rapid development of the internet and the increasing severity of the aging problem, and in order to promote aged health and help construct a healthy society. We use micro survey data from the 2016 China Family Panel Studies (CFPS) to investigate the impact of the internet on the cognitive health of middle-aged and elderly people (those aged 40 and above). The robust results suggest that the internet plays a significant positive role in the cognitive health of middle-aged and elderly people in terms of internet use and internet involvement. This effect does not change significantly with differences in gender, household registration, location, or household composition, but there are heterogeneity effects due to differences in education. Further analysis indicates that the satisfaction of emotional attachment with children is the internal mechanism of the internet's influence on the cognitive health of people in this age group. Our paper both help scholars and the public to better understand the impact of the internet on the cognitive health of middle-aged and elderly people and clarifies different methods of defining the internet.
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Affiliation(s)
- Wei Yuan
- School of Business Administration, Hubei University of Economics, Wuhan, China
| | - Min Jiang
- Shanghai Institute of Tourism, Shanghai Normal University, Shanghai, China
- *Correspondence: Min Jiang
| | - Shuying Gong
- College of Business, Shanghai University of Finance and Economics, Shanghai, China
- Shuying Gong
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Quialheiro A, Figueiró TH, Rech CR, Marques LP, Paiva KMD, Xavier AJ, d'Orsi E. Can internet use reduce the incidence of cognitive impairment? Analysis of the EpiFloripa Aging Cohort Study (2009-2019). Prev Med 2022; 154:106904. [PMID: 34863810 DOI: 10.1016/j.ypmed.2021.106904] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 11/19/2021] [Accepted: 11/28/2021] [Indexed: 02/06/2023]
Abstract
This study aims to estimate the effect of internet use on the incidence of cognitive impairment in older adults. Data are from the EpiFloripa Aging Cohort Study which has been following a population-based sample of older adults (60+) residing in Florianópolis, southern Brazil, for ten years. The outcome was the incidence of cognitive decline in follow-up waves measured by the Mini-Mental State Examination using cutoff points according to education. The exposure was internet use according to wave (yes/no). We excluded individuals with cognitive impairment from Wave 1 (n = 453). We used a longitudinal analysis model (Generalized Estimating Equations) to estimate incidence rate ratios (IRR) with 95% confidence intervals. We estimated the risk of cognitive impairment in Wave 2 or Wave 3 according to internet use in the previous wave. The incidence of cognitive impairment was 13.4% in Wave 2 and 13.3% in Wave 3. Despite the aging of this cohort, the prevalence of internet users increased from 26.4% in Wave 1 to 32.8% in Wave 2 and 46.8% in Wave 3. The risk of cognitive impairment in Wave 2 or Wave 3 was 70% lower for older adults who used the internet in the previous wave, adjusted for sex, age, years of education, household income, and self-reported comorbidities (IRR = 0.30; 95% CI: 0.15-0.61; p = 0.001). Internet use was associated with a decline in the incidence of cognitive impairment among older adults living in the urban areas of southern Brazil after a period of ten years.
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Affiliation(s)
- Anna Quialheiro
- Life and Health Sciences Research Institute, Medical School, University of Minho, Portugal.
| | - Thamara Hubler Figueiró
- Post-Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Cassiano Ricardo Rech
- Post-Graduate Program in Physical Education, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Larissa Pruner Marques
- Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Karina Mary de Paiva
- Department of Speech, Language and Hearing, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - André Junqueira Xavier
- Post-Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, SC, Brazil; Medicine Course, University of Southern Santa Catarina, Palhoça, Brazil
| | - Eleonora d'Orsi
- Post-Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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9
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Lifestyle Variables Such as Daily Internet Use, as Promising Protective Factors against Cognitive Impairment in Patients with Subjective Memory Complaints. Preliminary Results. J Pers Med 2021; 11:jpm11121366. [PMID: 34945838 PMCID: PMC8708750 DOI: 10.3390/jpm11121366] [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: 11/07/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022] Open
Abstract
Subjective memory complaints (SMCs) may be important markers in the prediction of cognitive deterioration. The aim of this study was to find associations between individual lifestyle factors, which may contribute to cognitive impairment (CI) in people with SMCs and to conduct a literature review on the relationship between internet use and CI in subjects over 50 years old, as a related factor. This was a case-controlled study that included 497 subjects aged over 50 years with SMCs who were recruited from 19 community pharmacies. Three screening tests were used to detect possible CIs, and individuals with at least one test result compatible with a CI were referred to primary care for evaluation. Having self-referred SMC increased the odds of obtaining scores compatible with CI and this factor was significantly related to having feelings of depression (OR = 2.24, 95% CI [1.34, 3.90]), taking anxiolytics or antidepressants (OR = 1.93, 95% CI [1.23, 3.05]), and being female (OR = 1.83, 95% CI [1.15, 2.88]). Thirty percent of our sample obtained scores compatible with CI. Age over 70 years increased the odds of obtaining scores compatible with CI. A high-level education, reading, and daily internet use were factors associated with a reduced risk of positive scores compatible with CI (37–91%, 7–18%, and 67–86%, respectively), while one extra hour television per day increased the risk by 8–30%. Among others, modifiable lifestyle factors such as reading, and daily internet usage may slow down cognitive decline in patients over 50 with SMCs. Four longitudinal studies and one quasi-experimental study found internet use to be beneficial against CI in patients over 50 years of age.
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10
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Hogervorst E, Schröder-Butterfill E, Handajani YS, Kreager P, Rahardjo TBW. Dementia and Dependency vs. Proxy Indicators of the Active Ageing Index in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168235. [PMID: 34443985 PMCID: PMC8391311 DOI: 10.3390/ijerph18168235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/15/2021] [Accepted: 07/28/2021] [Indexed: 11/24/2022]
Abstract
Dementia prevalence is increasing worldwide and developing countries are expected to carry the highest burden of this. Dementia has high care needs and no current effective long-term treatment. However, factors associated with active ageing (e.g., longer employment; participation in society; independent, healthy and secure living; and enabling environments to allow people to remain psychosocially and physically active) could help maintain independence in older people for longer. We investigated proxy indicators of the Active Ageing Index (AAI), which were offset against dementia and dependency (assessed by Instrumental Activities of Daily Living or IADL) in multi-ethnic urban (Jakarta) and rural (Sumedang and Borobudur) health care districts on Java, Indonesia. Dementia was assessed using validated cognitive dementia screening tests, the IADL and carer reports. Dementia and dependency prevalence showed large interregional differences and were highest in rural Borobudur. Dementia and dependency were associated with an older age, lower education (for dementia), worse physical health (for dependency) and not engaging in psychosocial activities, such as attending community events, reading (for dementia) and sport activities (for dependency). By supporting active ageing activities in Puskesmas (primary health care centers) and improving access to medical care, rural areas could possibly reduce dementia and dependency risk. Our follow-up study planned in 2021 should illustrate whether recent relevant policies have rendered success in these areas. Using active ageing indicators could focus policies to support regions with targeted interventions to compress care needs in older people.
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Affiliation(s)
- Eef Hogervorst
- School of Sports, Exercise &Health Sciences, National Centre for Sports and Exercise Medicine, Loughborough University, Loughborough LE11 3TU, UK
- Correspondence: ; Tel.: +44-1509-223020
| | - Elisabeth Schröder-Butterfill
- Ageing and Gerontology Group, Department Economic, Social and Political Science, University of Southampton, Southampton SO17 1BJ, UK;
| | - Yvonne Suzy Handajani
- Department of Public Health, Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Daerah Khusus Ibukota Jakarta 12930, Indonesia;
| | - Philip Kreager
- Institute of Human Sciences, University of Oxford, Oxford OX1 2JD, UK; (P.K.); (T.B.W.R.)
| | - Tri Budi W. Rahardjo
- Institute of Human Sciences, University of Oxford, Oxford OX1 2JD, UK; (P.K.); (T.B.W.R.)
- Faculty of Health Sciences, University of Respati, Daerah Istimewa Yogyakarta 55281, Indonesia
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11
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Cadar D, Abell J, Matthews FE, Brayne C, Batty GD, Llewellyn DJ, Steptoe A. Cohort Profile Update: The Harmonised Cognitive Assessment Protocol Sub-study of the English Longitudinal Study of Ageing (ELSA-HCAP). Int J Epidemiol 2021; 50:725-726i. [PMID: 33370436 PMCID: PMC8271185 DOI: 10.1093/ije/dyaa227] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Dorina Cadar
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jessica Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
- School of Biological & Population Health Sciences, Oregon State University, Corvallis, OR, USA
| | - David J Llewellyn
- Medical School, University of Exeter, Exeter, UK
- Alan Turing Institute, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Feasibility and acceptability evaluation of the Promoting Independence in Dementia (PRIDE) intervention for living well with dementia. Int Psychogeriatr 2021; 33:601-614. [PMID: 32847643 DOI: 10.1017/s1041610220001386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Post-diagnostic psychosocial interventions could play an important role in supporting people with mild dementia remain independent. The Promoting Independence in Dementia (PRIDE) intervention was developed to address this. METHOD The mixed methods non-randomized, pre-post feasibility study occurred across England. Facilitators were recruited from the voluntary sector and memory services. Participants and their supporters took part in the three-session intervention. Outcome measures were collected at baseline and follow-up. To evaluate acceptability, focus groups and interviews were conducted with a subsample of participants and facilitators. RESULTS Contextual challenges to delivery including national research governance changes, affected recruitment of study sites. Thirty-four dyads consented, with 14 facilitators providing the intervention. Dyads took part in at least two sessions (79%), and 73% in all three. Outcome measures were completed by 79% without difficulty, with minimal missing data. No significant changes were found on pre and post assessments. Post hoc analysis found moderate effect size improvements for self-management (SMAS instrument) in people with dementia (d = 0.41) and quality of life (EQ5D measure) in carers (d = 0.40). Qualitative data indicated that dyads found PRIDE acceptable, as did intervention facilitators. CONCLUSIONS The three-session intervention was well accepted by participant-dyads and intervention facilitators. A randomized controlled trial of PRIDE would need to carefully consider recruitment potential across geographically varied settings and site stratification according to knowledge of contextual factors, such as the diversity of post-diagnostic services across the country. Letting sites themselves be responsible for identifying suitable intervention facilitators was successful. The self-report measures showed potential to be included in the main trial.
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13
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Neter E, Chachashvili-Bolotin S, Erlich B, Ifrah K. Benefiting From Digital Use: Prospective Association of Internet Use With Knowledge and Preventive Behaviors Related to Alzheimer Disease in the Israeli Survey of Aging. JMIR Aging 2021; 4:e25706. [PMID: 33929331 PMCID: PMC8122300 DOI: 10.2196/25706] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/12/2021] [Accepted: 03/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous work documented the beneficial association between internet use and improved cognition, functional capacity, and less cognitive decline among people in late adulthood. This work focused on potential mechanisms of such an association: knowledge on Alzheimer disease (AD) and preventive behaviors related to AD. OBJECTIVE The aim of this study was to examine prospective associations of internet use and perceived computer skills with knowledge on AD and preventive behaviors related to AD. METHODS The sample included 1232 older adults (mean age 71.12 [SD 9.07]) drawn from the Israeli branch of the Survey of Health, Aging, and Retirement in Europe (SHARE-Israel). The sample is representative of Israeli households of adults aged 50 or older and their spouses. Data analyzed were collected in person during 2015 (Wave 6), and in a drop-off questionnaire following the in-person 2017 data collection (Wave 7). RESULTS Although both internet use and perceived computer skills were prospectively associated with knowledge and behaviors related to AD in bivariate analyses, after controlling for sociodemographics, only internet use was associated with more such knowledge (β=.13, P<.001) and behaviors (β=.22, P<.001). CONCLUSIONS Internet use emerged as a prospective predictor of protective factors against AD. Policymakers should advance digital engagement so as to enhance knowledge on AD and preventive behaviors among older adults.
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Affiliation(s)
- Efrat Neter
- Department Behavioral Sciences, Faculty of Social & Community Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Svetlana Chachashvili-Bolotin
- Institute for Immigration & Social Integration, Faculty of Social & Community Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Bracha Erlich
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.,Gerontological Data Center, The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Kfir Ifrah
- Gerontological Psychology, Faculty of Social & Community Sciences, Ruppin Academic Center, Emeq Hefer, Israel
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Mayer F, Remoli G, Bacigalupo I, Palazzesi I, Piscopo P, Bellomo G, Canevelli M, Corbo M, Vanacore N, Lacorte E. Decreasing trend in the incidence and prevalence of dementia: a systematic review. Minerva Med 2021; 112:430-440. [PMID: 33881282 DOI: 10.23736/s0026-4806.21.07454-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The progressive ageing of the population is one of the main socio-demographic phenomena, taking place at a global level. Several recent population-based studies conducted worldwide suggest that the age-specific risk of dementia may be changing in some countries and areas. EVIDENCE ACQUISITION This systematic review was performed using the methodology proposed by the Cochrane handbook for systematic reviews and reported following the PRISMA statement. A structured bibliographic search was performed on the databases PubMed, ISI Web of Science and the Cochrane Database of Systematic Reviews. All included studies were qualitatively assessed using the Methodological Evaluation of Observational REsearch (MORE). EVIDENCE SYNTHESIS The bibliographic search yielded 2394 records. Three more articles were retrieved from other sources. A total of ten studies were included, five reported data on a possible reduction in the prevalence of dementia, and five reported data on a possible reduction in its incidence. CONCLUSIONS The present systematic review focused on the recent observations of a possible decrease in the frequency of dementia and cognitive impairment in some Western countries (USA, UK, Sweden, the Netherlands, France, Iceland) between 1977 and 2014. The included studies have a high heterogeneity in terms of the clinical criteria used to diagnose dementia, and of the criteria used to define the clinical condition preceding dementia, such as isolated cognitive impairment. Moreover, the methodological quality with which they were conducted was also heterogeneous, with scores ranging from 1 to 7 using the MORE tool.
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Affiliation(s)
- Flavia Mayer
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Giulia Remoli
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Ilaria Bacigalupo
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Ilaria Palazzesi
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Paola Piscopo
- Department of Neurosciences, Italian National Institute of Health, Rome, Italy
| | - Guido Bellomo
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Marco Canevelli
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy.,Sapienza University, Rome, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura Privata del Policlinico, Milan, Italy
| | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Eleonora Lacorte
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy -
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15
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Rafnsson SB, Maharani A, Tampubolon G. Social Contact Mode and 15-Year Episodic Memory Trajectories in Older Adults With and Without Hearing Loss: Findings from the English Longitudinal Study of Ageing. J Gerontol B Psychol Sci Soc Sci 2021; 77:10-17. [PMID: 33606882 DOI: 10.1093/geronb/gbab029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Frequent social contact benefits cognition in later life although evidence is lacking on the potential relevance of the modes chosen by older adults, including those living with hearing loss, for interacting with others in their social network. METHOD 11,418 participants in the English Longitudinal Study of Ageing provided baseline information on hearing status and social contact mode and frequency of use. Multilevel growth curve models compared episodic memory (immediate and delayed recall) at baseline and longitudinally in participants who interacted frequently (offline only or offline and online combined), compared to infrequently, with others in their social network. RESULTS Frequent offline (B=0.23; SE=0.09) and combined offline and online (B=0.71; SE=0.09) social interactions predicted better episodic memory after adjustment for multiple confounders. We observed positive, longitudinal associations between combined offline and online interactions and episodic memory in participants without hearing loss (B=0.50, SE=0.11) but not with strictly offline interactions (B=0.01, SE=0.11). In those with hearing loss, episodic memory was positively related to both modes of engagement (offline only: B=0.79, SE=0.20; combined online and offline: B=1.27, SE=0.20). Sensitivity analyses confirmed the robustness of these findings. DISCUSSION Supplementing conventional social interactions with online communication modes may help older adults, especially those living with hearing loss, sustain, and benefit cognitively from, personal relationships.
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Affiliation(s)
- Snorri Bjorn Rafnsson
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, United Kingdom
| | - Asri Maharani
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom
| | - Gindo Tampubolon
- Global Development Institute and Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, United Kingdom
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16
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Almeida-Meza P, Steptoe A, Cadar D. Is Engagement in Intellectual and Social Leisure Activities Protective Against Dementia Risk? Evidence from the English Longitudinal Study of Ageing. J Alzheimers Dis 2021; 80:555-565. [PMID: 33554903 PMCID: PMC8075407 DOI: 10.3233/jad-200952] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Studies have suggested that mentally stimulating activities and socially engaged lifestyles may reduce dementia risk; however, it is unclear which activities are more beneficial. Objective: We investigated intellectual and social leisure activities in relation to dementia incidence and explored the modifying role of sex and marital status in these associations. Methods: The sample was comprised of 8,030 participants aged 50+ from the English Longitudinal Study of Ageing, who joined at wave 1 (2002-2003), or waves 3 (2006-2007), or 4 (2008-2009). The end of the study period was wave 8 (2016-2017). Subdistribution hazard models investigated the role of leisure activities grouped into intellectual and social domains in relation to dementia while accounting for the risk of death. Subsequent analyses were conducted with individual leisure activities. Results: During the study period of up to 15 years, 412 participants developed dementia, and 2,192 died. We found that increased engagement in the intellectual activities’ domain was associated with a decreased dementia incidence (SHR 0.85, 95% CI 0.76–0.96, p = 0.007), independent of the risk of death in married individuals, but not in those who were single, divorced, or widowed. Individual analyses for each leisure activity showed independent associations for reading newspapers in females (SHR 0.65, 95% CI 0.49–0.84, p = 0.001), mobile phone usage in males (SHR 0.61, 95% CI 0.45–0.84, p = 0.002), and having hobbies for married individuals (SHR 0.70, 95% CI 0.51–0.95, p = 0.02). Conclusion: We found that intellectual leisure activities contribute to lower dementia risk in a representative population of English adults, suggesting intervention opportunities.
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Affiliation(s)
- Pamela Almeida-Meza
- University College London, Department of Behavioral Science and Health, London, UK
| | - Andrew Steptoe
- University College London, Department of Behavioral Science and Health, London, UK
| | - Dorina Cadar
- University College London, Department of Behavioral Science and Health, London, UK
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17
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Rochat L, Wilkosc-Debczynska M, Zajac-Lamparska L, Rothen S, Andryszak P, Gaspoz J, Colombo L, Khazaal Y, Achab S. Internet Use and Problematic Use in Seniors: A Comparative Study in Switzerland and Poland. Front Psychiatry 2021; 12:609190. [PMID: 34177634 PMCID: PMC8219912 DOI: 10.3389/fpsyt.2021.609190] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/01/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Seniors have been only little considered in studies examining problematic internet use and associated health issues, although they may present risk factors that make them particularly vulnerable for the development of problematic internet use. Objectives: (1) To compare Internet use and problematic use among seniors in Switzerland and Poland; (2) To examine the relationships between problematic internet use, impulsivity traits and well-being as previous studies showed that internet can be used to cope with negative emotions or life dissatisfaction. Methods: A cross-sectional survey conducted between June 2016 and April 2017 with 264 older internet users aged above 60 years old recruited in Switzerland (88) and Poland (176) assessing sociodemographic variables, online activities, problematic internet use, impulsivity traits and well-being. Results: The two groups differed in their reported online activities in that Polish participants reported more searching for information and buying, whereas Swiss participants reported significantly greater problematic internet use than Polish participants. Finally, a multiple linear regression analysis performed on the whole sample indicated that lower well-being and being a Swiss participant were both significantly associated with greater problematic internet use, after age, gender, level of education, impulsivity traits have been controlled for. Discussion: Swiss seniors showed a more problematic internet use than Polish participants who focused more in their online activities on utility use of internet. The relationships between problematic internet use and well-being suggest that older adults use internet mainly to cope with negative emotion or life dissatisfaction. Socio-cultural differences that could account for these group differences as well as difference with young adults are discussed.
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Affiliation(s)
- Lucien Rochat
- Specialized Facility in Behavioral Addiction ReConnecte, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
| | | | | | - Stéphane Rothen
- Department of Mental Health and Psychiatry, Addiction Division, University Hospitals of Geneva, Geneva, Switzerland.,Research Center for Statistics, Geneva School of Management and Economics, University Hospitals of Geneva, Geneva, Switzerland
| | - Paulina Andryszak
- Faculty of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
| | - Julie Gaspoz
- Department of Mental Health and Psychiatry, Addiction Division, University Hospitals of Geneva, Geneva, Switzerland
| | - Laura Colombo
- Department of Mental Health and Psychiatry, Addiction Division, University Hospitals of Geneva, Geneva, Switzerland
| | - Yasser Khazaal
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sophia Achab
- Specialized Facility in Behavioral Addiction ReConnecte, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.,Department of Mental Health and Psychiatry, Addiction Division, University Hospitals of Geneva, Geneva, Switzerland.,Faculty of Medicine, WHO Collaborating Centre for Training and Research in Mental Health, University of Geneva, Geneva, Switzerland
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18
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Association of Late Life Depression, (Non-) Modifiable Risk and Protective Factors with Dementia and Alzheimer's Disease: Literature Review on Current Evidences, Preventive Interventions and Possible Future Trends in Prevention and Treatment of Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207475. [PMID: 33066592 PMCID: PMC7602449 DOI: 10.3390/ijerph17207475] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
The number of people living with dementia and Alzheimer’s disease is growing rapidly, making dementia one of the biggest challenges for this century. Many studies have indicated that depression plays an important role in development of dementia, including Alzheimer’s disease; depression, especially, during the late life may either increase the risk of dementia or even being its prodromal stage. Despite a notably large number of carried observational studies and/or clinical trials, the association between the late life depression and dementia remains, due to the complexity of their relationship, still unclear. Moreover, during past two decades multiple other (non-)modifiable risk and possibly protective factors such as the hypertension, social engagement, obesity, level of education or physical (in)activity have been identified and their relationship with the risk for development of dementia and Alzheimer’s disease has been extensively studied. It has been proposed that to understand mechanisms of dementia and Alzheimer’s disease pathogeneses require their multifactorial nature represented by these multiple factors to be considered. In this review, we first summarize the recent literature findings on roles of the late life depression and the other known (non-)modifiable risk and possibly protective factors in development of dementia and Alzheimer’s disease. Then, we provide evidences supporting hypotheses that (i) depressive syndromes in late life may indicate the prodromal stage of dementia (Alzheimer’s disease) and, (ii) the interplay among the multiple (non-)modifiable risk and protective factors should be considered to gain a better understanding of dementia and Alzheimer’s disease pathogeneses. We also discuss the evidences of recently established interventions considered to prevent or delay the prodromes of dementia and provide the prospective future directions in prevention and treatment of dementia and Alzheimer’s disease using both the single-domain and multidomain interventions.
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19
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Williams BD, Pendleton N, Chandola T. Cognitively stimulating activities and risk of probable dementia or cognitive impairment in the English Longitudinal Study of Ageing. SSM Popul Health 2020; 12:100656. [PMID: 32984495 PMCID: PMC7495111 DOI: 10.1016/j.ssmph.2020.100656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 11/09/2022] Open
Abstract
Objectives To examine the association between cognitive stimulating activities (CSA) in later life (internet/email use, employment, volunteering, evening classes, social club membership and newspaper reading) and risk of cognitive impairment or dementia using marginal structural models to account for time-varying confounding affected by prior exposure. Methods Data were used from the English Longitudinal Study of Ageing waves 1 (2002) to 7 (2014), a nationally representative sample of adults in England aged ≥50. Self-reported participation in CSAs were measured as binary exposures from waves 2 (2004) to 6 (2012), with final sample sizes between n = 3937 and n = 2530 for different CSAs. Baseline exposure and covariates were used to create inverse probability of treatment and censoring weights (IPTCW). IPTCW repeated measures Poisson and linear regression were used to estimate each CSAs effect on risk of probable cognitive impairment or dementia at wave 7 (defined as a score of ≤11/27 on a modified telephone interview for cognitive status (TICS-27)). Results were compared to standard regression adjustment. Results Internet use at any wave (Risk ratios between 0.62 and 0.69) and volunteering in waves 3 to 6 (RRs between 0.516 and 0.633) were associated with reduced risk of cognitive impairment in IPTCW models. Standard estimates were similar for both internet use and volunteering. Newspaper reading (RR 95% Confidence interval 0.74–0.99) and social club membership (RR 95% CI 0.54–0.86) at wave 6 were significantly associated with risk of cognitive impairment in standard models, but not in the IPTCW models (RR 95% CI 0.82–1.11 and 0.60–1.08 respectively). Employment and evening classes were not associated with cognitive impairment in either model. Conclusions We found that volunteering and internet use were associated with reduced risk of cognitive impairment. Associations between newspaper reading or social club membership and cognitive impairment may be due to time-varying confounding affected by prior exposure. Confounding affected by past exposure is a problem in studies of cognitive function. We addressed this using inverse probability weighted marginal structural models. Volunteering and internet use were protective against cognitive impairment. Other cognitively stimulating activities were protective with standard regression. But these associations were non-significant in the marginal structural models.
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Affiliation(s)
- Benjamin David Williams
- Cathie Marsh Institute for Social Research, Humanities Bridgeford Street Building, University of Manchester, Manchester, M13 9PL, UK
| | - Neil Pendleton
- Institute of Brain, Behaviour and Mental Health, Stopford Building, University of Manchester, Manchester, M13 9PT, UK
| | - Tarani Chandola
- Cathie Marsh Institute for Social Research, Humanities Bridgeford Street Building, University of Manchester, Manchester, M13 9PL, UK
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20
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Yates L, Csipke E, Moniz-Cook E, Leung P, Walton H, Charlesworth G, Spector A, Hogervorst E, Mountain G, Orrell M. The development of the Promoting Independence in Dementia (PRIDE) intervention to enhance independence in dementia. Clin Interv Aging 2019; 14:1615-1630. [PMID: 31571842 PMCID: PMC6748161 DOI: 10.2147/cia.s214367] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/07/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Support after a diagnosis of dementia may facilitate better adjustment and ongoing management of symptoms. The aim of the Promoting Independence in Dementia (PRIDE) study was to develop a postdiagnostic social intervention to help people live as well and as independently as possible. The intervention facilitates engagement in evidence-based stimulating cognitive, physical and social activities. METHODS Theories to promote adjustment to a dementia diagnosis, including theories of social learning and self-efficacy, were reviewed alongside self-management and the selective optimization model, to form the basis of the intervention. Analyses of two longitudinal databases of older adults, and qualitative analyses of interviews of older people, people with dementia, and their carers about their experiences of dementia, informed the content and focus of the intervention. Consensus expert review involving stakeholders was conducted to synthesize key components. Participants were sourced from the British NHS, voluntary services, and patient and public involvement groups. A tailored manual-based intervention was developed with the aim for this to be delivered by an intervention provider. RESULTS Evidence-based stimulating cognitive, physical, and social activities that have been shown to benefit people were key components of the proposed PRIDE intervention. Thirty-two participants including people with dementia (n=4), carers (n=11), dementia advisers (n=14), and older people (n=3) provided feedback on the drafts of the intervention and manual. Seven topics for activities were included (eg, "making decisions" and "getting your message across"). The manual outlines delivery of the intervention over three sessions where personalized profiles and plans for up to three activities are developed, implemented, and reviewed. CONCLUSION A manualized intervention was constructed based on robust methodology and found to be acceptable to participants. Consultations with stakeholders played a key role in shaping the manualized PRIDE intervention and its delivery. Unlike most social interventions for dementia, the target audience for our intervention is the people with dementia themselves.
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Affiliation(s)
- Lauren Yates
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Emese Csipke
- Division of Psychiatry, University College London, London, UK
| | - Esme Moniz-Cook
- Department of Psychological Health and Well-Being, Faculty of Health Sciences, School of Health and Social Work, University of Hull, Hull, UK
| | - Phuong Leung
- Division of Psychiatry, University College London, London, UK
| | - Holly Walton
- Department of Applied Health Research, University College London, London, UK
| | - Georgina Charlesworth
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Eef Hogervorst
- National Centre for Sports and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Gail Mountain
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
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McDonough IM, Allen RS. Biological markers of aging and mental health: A seed and soil model of neurocognitive disorders. Aging Ment Health 2019; 23:793-799. [PMID: 30449142 DOI: 10.1080/13607863.2018.1531383] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
As the population of the world gets older, cognitive and mental health decline in older adults has become one of the most pressing scientific problems of the 21st century. It has been well-established that multiple pathways exist that can lead to future cognitive decline and the development of age-related mental health conditions. Making matters more complicated is the fact that aging is not a homogenous or simple process; rather, each person brings a diverse set of circumstances to the table, leading to differences in biologically aging. Research is needed to identify how the intersection of environmental and biological factors may protect older adults or put them at future risk for cognitive decline and the development of age-related mental health conditions. Furthermore, each potential factor may impact different domains of cognition and mental health or may impact individuals differentially based on genetic, environmental, social, emotional, and behavioral factors. Neuroimaging is one key tool that can be used to discover and assess markers of cognitive and mental health. The goal of this special issue is to expand the science on how biological markers can aid the understanding of aging and mental health through the lens of the individual from an international perspective, representing Germany, Taiwan, Thailand, the United Kingdom, and the United States. Common themes from these articles are used to support the new Seed and Soil Model of Neurocognitive Disorders.
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Affiliation(s)
- Ian M McDonough
- a Department of Psychology , The University of Alabama , Tuscaloosa , AL , USA.,b Alabama Research Institute on Aging, The University of Alabama , Tuscaloosa , AL , USA
| | - Rebecca S Allen
- b Alabama Research Institute on Aging, The University of Alabama , Tuscaloosa , AL , USA.,c Department of Psychology , The University of Alabama , Tuscaloosa , AL , USA
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22
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Fancourt D, Steptoe A. Television viewing and cognitive decline in older age: findings from the English Longitudinal Study of Ageing. Sci Rep 2019; 9:2851. [PMID: 30820029 PMCID: PMC6395805 DOI: 10.1038/s41598-019-39354-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 01/21/2019] [Indexed: 01/12/2023] Open
Abstract
There has been significant interest in the effects of television on cognition in children, but much less research has been carried out into the effects in older adults. This study aimed to explore whether television viewing behaviours in adults aged 50 or over are associated with a decline in cognition. Using data from the English Longitudinal Study of Aging involving 3,662 adults aged 50+, we used multivariate linear regression models to explore longitudinal associations between baseline television watching (2008/2009) and cognition 6 years later (2014/2015) while controlling for demographic factors, socio-economic status, depression, physical health, health behaviours and a range of other sedentary behaviours. Watching television for more than 3.5 hours per day is associated with a dose-response decline in verbal memory over the following six years, independent of confounding variables. These results are found in particular amongst those with better cognition at baseline and are robust to a range of sensitivity analyses exploring reverse causality, differential non-response and stability of television viewing. Watching television is not longitudinally associated with changes in semantic fluency. Overall our results provide preliminary data to suggest that television viewing for more than 3.5 hours per day is related to cognitive decline.
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Affiliation(s)
- Daisy Fancourt
- Research Department of Behavioural Science and Health, University College London, London, UK.
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, University College London, London, UK
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23
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Cadar D, Lassale C, Davies H, Llewellyn DJ, Batty GD, Steptoe A. Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England: Evidence From a 12-Year Follow-up in the English Longitudinal Study of Ageing. JAMA Psychiatry 2018; 75:723-732. [PMID: 29799983 PMCID: PMC6145673 DOI: 10.1001/jamapsychiatry.2018.1012] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Lower educational attainment is associated with a higher risk of dementia. However, less clear is the extent to which other socioeconomic markers contribute to dementia risk. OBJECTIVE To examine the relationship of education, wealth, and area-based deprivation with the incidence of dementia over the last decade in England and investigate differences between people born in different periods. DESIGN, SETTING, AND PARTICIPANTS Data from the English Longitudinal Study of Ageing, a prospective cohort study that is representative of the English population, were used to investigate the associations between markers of socioeconomic status (wealth quintiles and the index of multiple deprivation) and dementia incidence. To investigate outcomes associated with age cohorts, 2 independent groups were derived using a median split (born between 1902-1925 and 1926-1943). MAIN OUTCOMES AND MEASURES Dementia as determined by physician diagnosis and the Informant Questionnaire on Cognitive Decline in the Elderly. RESULTS A total of 6220 individuals aged 65 years and older enrolled in the study (median [interquartile range] age at baseline, 73.2 [68.1-78.3] years; 3410 [54.8%] female). Of these, 463 individuals (7.4%) had new cases of dementia ascertained in the 12 years between 2002-2003 and 2014-2015. In the cohort born between 1926 and 1943, the hazard of developing dementia was 1.68 times higher (hazard ratio [HR] = 1.68 [95% CI, 1.05-2.86]) for those in the lowest wealth quintile compared with those in the highest quintile, independent of education, index of multiple deprivation, and health indicators. Higher hazards were also observed for those in the second-highest quintile of index of multiple deprivation (HR = 1.62 [95% CI, 1.06-2.46]) compared with those in the lowest (least deprived) quintile. CONCLUSIONS AND RELEVANCE In an English nationally representative sample, the incidence of dementia appeared to be socioeconomically patterned primarily by the level of wealth. This association was somewhat stronger for participants born in later years.
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Affiliation(s)
- Dorina Cadar
- Department of Behavioural Science and Health,
University College London, London, United Kingdom
| | - Camille Lassale
- Department of Behavioural Science and Health,
University College London, London, United Kingdom,Department of Epidemiology and Public Health,
University College London, London, United Kingdom
| | - Hilary Davies
- School of Health Sciences, University of Surrey,
Guildford, United Kingdom
| | - David J. Llewellyn
- Medical School, University of Exeter, Devon, South
West England, United Kingdom
| | - G. David Batty
- Department of Epidemiology and Public Health,
University College London, London, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health,
University College London, London, United Kingdom,Department of Epidemiology and Public Health,
University College London, London, United Kingdom
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Krug RDR, Xavier AJ, d'Orsi E. Factors associated with maintenance of the use of internet, EpiFloripa Idoso longitudinal study. Rev Saude Publica 2018; 52:37. [PMID: 29641661 PMCID: PMC5893268 DOI: 10.11606/s1518-8787.2018052000216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/22/2017] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To describe the use of the internet and to identify the sociodemographic and health factors associated with changes in the use of the internet over four years in older adults participating in the Brazilian EpiFloripa Idoso study. METHODS This is a longitudinal home-based, population-based study with 1,197 older adults who live in the urban area of Florianópolis, State of Santa Catarina, Brazil. We applied a face-to-face interview. We describe the use of internet according to frequency, place, devices, and motives of the use of the internet. To identify factors associated with changes in the use of the internet, we categorized the outcome as: non-use of the internet, stopped using the internet, started using the internet, and kept using the internet. The independent variables were sex, age, family income, education level, family arrangement, marital status, presence of caregiver, paid work, and cognitive impairment screening. We used multinomial logistic regression with risk ratio (RR) estimates and their respective confidence intervals (95%CI). RESULTS The prevalence of the use of internet increased from 22.9% in 2009-2010 to 26.6% in 2013-2014. Of the total number of older adults who participated in the study, 7.5% started using the internet, 3.2% stopped using it, 19.1% kept their use, and 70.2% kept their non-use in the analyzed period. Of the older adults who used the internet, most used it every day or almost every day of the week, in their own home, on desktop or portable computers, mainly to send and receive messages, to search for information to learn or investigate something, to find information about goods and services, and to use news, social networking, and health information websites. The factors associated with the use of internet over four years were: being male (RR = 2.19, 95%CI 1.48-3.26), higher monthly family income (RR = 3.53, 95%CI 1.35-9.23), higher education level (RR = 2.64, 95%CI 1.57-4.43), and no presence of caregiver (RR = 0.08, 95%CI 0.02-0.31). CONCLUSIONS Although the use of the internet is increasing among older adults, most of the population is still digitally excluded, especially women with lower income and education level. Strategies that promote the digital inclusion of older adults should be stimulated, aiming to universalize the use of the internet, and they should take into account socioeconomic and gender inequalities.
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Affiliation(s)
- Rodrigo de Rosso Krug
- Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Ciências Médicas. Florianópolis, SC, Brasil.,Universidade de Cruz Alta. Programa de Pós-Graduação em Atenção Integral em Saúde. Cruz Alta, RS, Brasil
| | - André Junqueira Xavier
- Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil
| | - Eleonora d'Orsi
- Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Ciências Médicas. Florianópolis, SC, Brasil.,Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil
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25
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Kyriazis M, Kiourti E. Video Games and Other Online Activities May Improve Health in Ageing. Front Med (Lausanne) 2018; 5:8. [PMID: 29435449 PMCID: PMC5796895 DOI: 10.3389/fmed.2018.00008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/15/2018] [Indexed: 12/27/2022] Open
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