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Vance DE, Fazeli PL, Azuero A, Khalidi S, Frank JS, Wadley VG, Raper JL, Pope CN, Jacob AE, Ball KK. Two-year clinical trial examining the effects of speed of processing training on everyday functioning in adults with human immunodeficiency virus-associated neurocognitive disorder (HAND) and borderline HAND in the U.S. Deep South: Findings of the Think Fast Study. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-14. [PMID: 37200482 PMCID: PMC10656361 DOI: 10.1080/23279095.2023.2209900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Many people living with human immunodeficiency virus (HIV) (PLWH) experience cognitive decline that impairs everyday functioning. Cognitive training approaches, such as speed of processing (SOP) training, may reduce the impact of HIV-Associated Neurocognitive Disorder (HAND) on everyday functioning. In this experimental design study called the Think Fast Study, 216 participants age 40 and older with HAND or borderline HAND were randomized to one of three groups: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73); or (3) 10 h of Internet Navigation Control Training (a contact control group; n = 73). Participants completed several everyday functioning measures at baseline, posttest, and year 1 and year 2 follow ups, which included: (a) Modified Lawton and Brody Activities of Daily Living (ADL) Questionnaire; (b) Timed Instrumental Activities of Daily Living (TIADL) Test; (c) Patient's Assessment of Own Functioning (PAOFI); (d) Medication Adherence Questionnaire (MAQ); and (e) Medication Adherence Visual Analog Scale (VAS). Linear mixed-effect models and generalized estimating equation models were fitted to estimate between group differences at all follow-up time points. At follow-up timepoints, those in the 10-h and 20-h training groups had better scores on medication adherence measures (MAQ and VAS) than those in the control group, with effects (Cohen's d) ranging 0.13-0.41 for MAQ and 0.02-0.43 for VAS. In conclusion, SOP training improved some indicators of everyday functioning, specifically medication adherence; however, the therapeutic effects diminished over time. Implications for practice and research are posited.
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Affiliation(s)
- David E. Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L. Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sarah Khalidi
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer S. Frank
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia G. Wadley
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James L. Raper
- The 1917 (HIV/AIDS) Clinic, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Caitlin N. Pope
- Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
| | - Alexandra E. Jacob
- UAB Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Karlene K. Ball
- UAB Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Association of Qi-stagnation Constitution and Subjective Sleep Characteristics with Mild Cognitive Impairment among Elderly in Community: A Cross-Sectional Study. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Liu Z, Zhang L, Wu J, Zheng Z, Gao J, Lin Y, Liu Y, Xu H, Zhou Y. Machine learning-based classification of circadian rhythm characteristics for mild cognitive impairment in the elderly. Front Public Health 2022; 10:1036886. [PMID: 36388285 PMCID: PMC9650188 DOI: 10.3389/fpubh.2022.1036886] [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: 09/05/2022] [Accepted: 10/10/2022] [Indexed: 01/29/2023] Open
Abstract
Introduction Using wrist-wearable sensors to ecological transient assessment may provide a more valid assessment of physical activity, sedentary time, sleep and circadian rhythm than self-reported questionnaires, but has not been used widely to study the association with mild cognitive impairment and their characteristics. Methods 31 normal cognitive ability participants and 68 MCI participants were monitored with tri-axial accelerometer and nocturnal photo volumetric pulse wave signals for 14 days. Two machine learning algorithms: gradient boosting decision tree and eXtreme gradient boosting were constructed using data on daytime physical activity, sedentary time and nighttime physiological functions, including heart rate, heart rate variability, respiratory rate and oxygen saturation, combined with subjective scale features. The accuracy, precision, recall, F1 value, and AUC of the different models are compared, and the training and model effectiveness are validated by the subject-based leave-one-out method. Results The low physical activity state was higher in the MCI group than in the cognitively normal group between 8:00 and 11:00 (P < 0.05), the daily rhythm trend of the high physical activity state was generally lower in the MCI group than in the cognitively normal group (P < 0.05). The peak rhythms in the sedentary state appeared at 12:00-15:00 and 20:00. The peak rhythms of rMSSD, HRV high frequency output power, and HRV low frequency output power in the 6h HRV parameters at night in the MCI group disappeared at 3:00 a.m., and the amplitude of fluctuations decreased; the amplitude of fluctuations of LHratio nocturnal rhythm increased and the phase was disturbed; the oxygen saturation was between 90 and 95% and less than 90% were increased in all time periods (P < 0.05). The F1 value of the two machine learning algorithms for MCI classification of multi-feature data combined with subjective scales were XGBoost (78.02) and GBDT (84.04). Conclusion By collecting PSQI Scale data combined with circadian rhythm characteristics monitored by wrist-wearable sensors, we are able to construct XGBoost and GBDT machine learning models with good discrimination, thus providing an early warning solution for identifying family and community members with high risk of MCI.
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Affiliation(s)
- Zhizhen Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China,Zhizhen Liu
| | - Lin Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jingsong Wu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zhicheng Zheng
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Jiahui Gao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yongsheng Lin
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yinghua Liu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Haihua Xu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China,*Correspondence: Yongjin Zhou
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Hu Y, Zhou F, Kaminga AC, Yan S, Hu Z. Associations of depressive symptoms and chronic diseases with activities of daily living among middle-aged and older population in China: A population-based cohort study. Front Psychiatry 2022; 13:848255. [PMID: 36003971 PMCID: PMC9393545 DOI: 10.3389/fpsyt.2022.848255] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Activities of daily living (ADL) disability is a concern in the aging population and can lead to increased health service demands and lower quality of life. The aim of this longitudinal study was to assess the associations of chronic conditions and depressive symptoms with ADL disability. METHODS This prospective cohort study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study (CHARLS). A total of 10,864 participants aged 45 and older were included for analysis. Chronic diseases were assessed by self-report and depressive symptoms were assessed using the validated 10-item of Center for Epidemiologic Studies Depression Scale at baseline. Incidents of ADL disability during follow-up were assessed using the Katz ADL scales. RESULTS After 4 years of follow-up, there were 704 participants incidents of ADL disability. The incident rate was 17.22 per 1,000 person-years. Having at least one chronic disease was independently associated with a 39% increased risk of incident ADL disability (adjusted HR, 1.39; 95%CI: 1.16, 1.67). The presence of depression symptoms was independently associated with a 54% increased risk of incident ADL disability (adjusted HR, 1.54; 95%CI: 1.30, 1.82). However, there was no significant additive interaction effect between chronic diseases and depressive symptoms on ADL disability. CONCLUSION Chronic diseases and depressive symptoms are associated with an increased risk of ADL disability in middle-aged and older Chinese adults. Improving chronic diseases and depressive symptoms can prevent ADL disability.
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Affiliation(s)
- Yingyun Hu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shipeng Yan
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Perez-Lasierra JL, Casajús JA, Casasnovas JA, Arbones-Mainar JM, Lobo A, Lobo E, Moreno-Franco B, Gonzalez-Agüero A. Can Physical Activity Reduce the Risk of Cognitive Decline in Apolipoprotein e4 Carriers? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7238. [PMID: 34299687 PMCID: PMC8303365 DOI: 10.3390/ijerph18147238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 12/16/2022]
Abstract
Physical activity (PA) reduces the risk of cognitive decline (CD) in the general population. However, little is known about whether the presence of the apolipoprotein E epsilon 4 allele (APOE e4) could modify this beneficial effect. The aim of this systematic review was to analyze and synthetize the scientific evidence related to PA levels and CD risk in cognitively healthy APOE e4 carriers. Four electronic databases were analyzed. Only original articles with longitudinal study design were selected to analyze the relationship between PA and CD in APOE e4 carriers. Five studies were included in the systematic review. All studies except one stated that PA is a protective factor against CD in APOE e4 carriers. Moreover, partial support was found for the hypothesis that a greater amount and intensity of PA are more beneficial in CD prevention. The results support the idea that PA is a protective factor against CD in APOE e4 carriers. Nevertheless, it would be necessary to carry out further studies that would allow these findings to be contrasted.
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Affiliation(s)
- Jose Luis Perez-Lasierra
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Jose Antonio Casajús
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - José Antonio Casasnovas
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERCV Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jose Miguel Arbones-Mainar
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- Adipocyte and Fat Biology Laboratory (AdipoFat), 50009 Zaragoza, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERSAM Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Elena Lobo
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERSAM Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Microbiology, Pediatrics, Radiology and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Belén Moreno-Franco
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERCV Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Microbiology, Pediatrics, Radiology and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Alejandro Gonzalez-Agüero
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Anhedonia as a Potential Risk Factor of Alzheimer's Disease in a Community-Dwelling Elderly Sample: Results from the ZARADEMP Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041370. [PMID: 33546118 PMCID: PMC7913238 DOI: 10.3390/ijerph18041370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/22/2021] [Accepted: 01/30/2021] [Indexed: 12/18/2022]
Abstract
(1) Introduction: Dementia is a major public health problem, and Alzheimer's disease (AD) is the most frequent subtype. Clarifying the potential risk factors is necessary in order to improve dementia-prevention strategies and quality of life. Here, our purpose was to investigate the role of the absence of hedonic tone; anhedonia, understood as the reduction on previous enjoyable daily activities, which occasionally is underdetected and underdiagnosed; and the risk of developing AD in a cognitively unimpaired and non-depressed population sample. (2) Method: We used data from the Zaragoza Dementia and Depression (ZARADEMP) project, a longitudinal epidemiological study on dementia and depression. After excluding subjects with dementia, a sample of 2830 dwellers aged ≥65 years was followed for 4.5 years. The geriatric mental state examination was used to identify cases of anhedonia. AD was diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. A multivariate survival analysis and Cox proportional hazards regression model were performed, and the analysis was controlled by an analysis for the presence of clinically significant depression. (3) Results: We found a significant association between anhedonia cases and AD risk in the univariate analysis (hazard ratio (HR): 2.37; 95% CI: 1.04-5.40). This association persisted more strongly in the fully adjusted model. (4) Conclusions: Identifying cognitively intact individuals with anhedonia is a priority to implement preventive strategies that could delay the progression of cognitive and functional impairment in subjects at risk of AD.
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