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Coelho-Júnior HJ, Araújo EM, Uchida MC, Marzetti E, Aguiar SDS. Effects of resistance training associated with a verbal fluency task on physical performance and cognitive function in frail nursing home residents. Arch Gerontol Geriatr 2024; 121:105353. [PMID: 38340589 DOI: 10.1016/j.archger.2024.105353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/17/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES Studies examining the effects of dual-task resistance training (RT) on nursing-home residents are still scarce. To add knowledge to this field, the present study compared the effects of 12-week RT and RT plus cognitive task (COG) programs on physical performance and cognitive function in a sample of frail nursing home residents. METHODS This is an experimental study that combined data from two studies that examined older adults living in nursing home residences in Brazil. Exercise groups performed a 12-week RT protocol that included four exercises, with 3-4 times (sets) of 8-10 repetitions at 70 %-75 % of 1-repetition maximum (1RM), twice a week. The RT+COG group evoked as many words was possible for specific categories during concentric actions of the squat on the chair (until 90° knee flexion) and seated unilateral knee extension exercises. Global cognitive function and physical performance were evaluated using the Mini-Mental State Examination (MMSE) and Short Physical Performance Battery (SPPB) tests, respectively. RESULTS After interventions, participants in the RT+COG and RT groups had significantly greater lower-limb muscle strength compared with the control group (CG). Those in the RT+COG group had greater tandem performance in comparison to RT and CG groups. CONCLUSIONS Our findings indicate that RT preserves lower-limb muscle strength in frail nursing home residents, regardless of performance of cognitive tasks. Better balance was exclusively observed in the RT+COG, whereas significant improvements in mobility status were only found in the RT group. The present investigation was based on a small sample of nursing home residents. Larger and more structured studies are necessary to confirm our results.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | | | - Marco Carlos Uchida
- Applied Kinesiology Laboratory-AKL, School of Physical Education, University of Campinas, Campinas, SP 13083-851, Brazil
| | - Emanuele Marzetti
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, 00168, Italy; Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, 00168, Italy.
| | - Samuel da Silva Aguiar
- Federal University of Mato Grosso, Mato Grosso, Brazil; University Centre UDF, Faculty of Physical Education, Brasília, Brazil.
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Nakagawa K, Kanai S, Kitakaze S, Okamura H. Discriminant Accuracy of Standing Balance Tests for the Level of Gait Dependency in Hospitalized Patients with Alzheimer's Disease. Dement Geriatr Cogn Disord 2024; 53:135-142. [PMID: 38599186 DOI: 10.1159/000538541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/23/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION When determining the level of gait independence in patients with Alzheimer's disease (AD), detailed functional assessment is difficult in some patients. The previous literature has suggested simple standing balance tests for patients with AD due to their ease of implementation in clinical practice and relevance to gait. However, their usefulness for discriminating the level of gait independence remains unclear. This study aimed to investigate the discrimination accuracy of a simple standing balance test in the level of gait independence among hospitalized patients with AD. METHODS This cross-sectional study was a post hoc analysis of a study conducted on 63 inpatients with AD in a single hospital. Participants were divided into three groups according to their level of gait independence: independent, modified independent (independent, walking with walking aids), and dependent groups (supervision). Gait independence was determined using the Functional Independence Measure. Four standing balance tests were used - closed-leg, semi-tandem, tandem, and one-leg standings - and the discrimination accuracy of each test was calculated by receiver operating characteristic analysis. RESULTS One-leg standing was best at discriminating between the independent and modified independent groups (positive predictive value = 80.0%, negative predictive value = 94.1%). Tandem standing was best at discriminating between the modified independent and dependent groups (positive predictive value = 74.1%, negative predictive value = 93.3%). CONCLUSION A simple standing balance test may assist in the determining level of gait independence in patients with AD when it is difficult to perform a mobility assessment.
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Affiliation(s)
- Keita Nakagawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Sosuke Kitakaze
- Department of Rehabilitation, Maple-Hill Hospital, Hiroshima, Japan
| | - Hitoshi Okamura
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Liang K, Zhang X. Association between Life's Essential 8 and cognitive function: insights from NHANES 2011-2014. Front Aging Neurosci 2024; 16:1386498. [PMID: 38650867 PMCID: PMC11034366 DOI: 10.3389/fnagi.2024.1386498] [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: 02/17/2024] [Accepted: 03/15/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Life's Essential 8 (LE8) is prompted by the American Heart Association (AHA) to assess cardiovascular health. The association between LE8 and cognitive function in America is unknown. Our study was to investigate the association of LE8 with cognitive function in general adults. Materials and methods A total of 2,301 participants were enrolled in the National Health and Nutrition Examination Surveys (NHANES). LE8 scores (range 0-100) were obtained from measurements based on American Heart Association definitions, divided into health behavior and health factor scores. Cognitive function was assessed by three tests including the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal fluency test (AFT), and Digit Symbol Substitution test (DSST). The multivariable linear regression analysis explored the associations between LE8 and cognitive function. Smooth curve fitting was explored using restricted cubic splines. The inflection point was determined by the two-piecewise linear regression. Results In the multivariable linear regression model with full adjustment for confounding variables, AFT scores were 1.2 points higher in participants with LE8 scores >80 than in those with LE8 scores <50 (high LE8 score group: β = 1.20, 95% CI 0.37, 2.03), and 3.32 points higher in DSST (high LE8 score group: β = 3.32, 95% CI 1.24, 5.39). Although high LE8 scores show a Negative association with high CERAD, we found a significant association between higher LE8 scores and higher CERAD when LE8 scores were higher than 82.5 (β = 0.21 95%CI 0.04, 0.39, p-value = 0.0179). Conclusion Our study highlighted a positive association between Life's Essential 8 and cognitive function in older adults.
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Affiliation(s)
- Kangni Liang
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoling Zhang
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
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Suprawesta L, Chen SJ, Liang HY, Hwang HF, Yu WY, Lin MR. Factors affecting cognitive frailty improvement and progression in Taiwanese older adults. BMC Geriatr 2024; 24:105. [PMID: 38287238 PMCID: PMC10823623 DOI: 10.1186/s12877-024-04700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Knowledge of predictors of cognitive frailty (CF) trajectories is required to develop preventive strategies to delay or reverse the progression from CF to dementia and other adverse outcomes. This 2-year prospective study aimed to investigate factors affecting the progression and improvement of CF in older Taiwanese adults. METHODS In total, 832 community-dwelling people aged ≥ 65 years were eligible. Fried's five frailty criteria were used to measure prefrailty and frailty, while cognitive performance was assessed by the Clinical Dementia Rating and Mini-Mental State Examination. Each component of reversible CF and potentially reversible CF was assigned a score, with a total score ranging 0 to 5 points. Two annual follow-up CF assessments were conducted. The group-based trajectory model was applied to identify latent CF trajectory groups, and a multinomial logistic regression was used to examine relationships of explanatory variables with CF trajectories. RESULTS According to data on 482 subjects who completed the two annual follow-ups, three CF trajectories of robust, improvement, and progression were identified. After adjusting for the baseline CF state, CF progression was significantly associated with an older age (odds ratio [OR] = 1.08; 95% confidence interval [CI], 1.02 ~ 1.14), a lower Tinetti balance score (OR = 0.72; 95% CI, 0.54 ~ 0.96), a slower gait (OR = 0.98; 95% CI, 0.97 ~ 0.99), and four or more comorbidities (OR = 2.65; 95% CI, 1.19 ~ 5.90), while CF improvement was not significantly associated with any variable except the baseline CF state. In contrast, without adjusting for the baseline CF state, CF progression was significantly associated with an older age, female sex, balance scores, gait velocity, regular exercise, the number of comorbidities, and depression, while CF improvement was significantly associated with female sex, balance scores, and the number of comorbidities. CONCLUSIONS The baseline CF state, an older age, poorer balance, slower gait, and a high number of comorbidities may contribute to CF progression, while the baseline CF state may account for associations of engaging in regular exercise and depression with CF development.
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Affiliation(s)
- Lalu Suprawesta
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan, ROC
- Department of Sport and Health Education, Faculty of Sport Science and Public Health, Universitas Pendidikan Mandalika, Mataram, West Nusa Tenggara, Indonesia
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Hui-Yu Liang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Hei-Fen Hwang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Wen-Yu Yu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC
| | - Mau-Roung Lin
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan, ROC.
- Programs in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC.
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Wang J, Chen XX, Liu D, Tian E, Guo ZQ, Chen JY, Kong WJ, Zhang SL. Association of Hearing Status and Cognition With Fall Among the Oldest-Old Chinese: A Nationally Representative Cohort Study. Ear Hear 2023; 44:1212-1220. [PMID: 37046369 DOI: 10.1097/aud.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVES The oldest-old (aged ≥80 years) are the most rapidly growing population and age is related to hearing impairment (HI) and cognitive decline. We aimed to estimate the association between HI and fall, and the effect of different cognitive states on this association among the oldest-old Chinese population. DESIGN A total of 6931 Chinese oldest-old were included in the 2018 cross-cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The presence of HI was identified by using a dichotomized metric of self-reported hearing status. Cognitive function was evaluated by using the modified Mini-Mental State Examination (MMSE). Cognitive impairment was defined as the MMSE score below 24 points. Data on fall history were collected by questionnaires survey from the participants or their relatives. We studied the association of hearing status and cognitive function with fall by using multivariable logistic regressions, upon adjustment of sociodemographic characteristics, lifestyles, and health conditions. RESULTS Our participants were aged 92 (range 80 to 117) on average, with 60.1% being women. In total, 39.1% of the participants had reported HI, 50.1% had cognitive impairment, and 26.2% had a history of falling. Participants with HI had a higher incidence of cognitive impairment (79.4%), as compared with their counterparts without HI (31.3%). Compared with those without HI, HI patients had a higher risk of falling after full adjustment for potential confounders (OR = 1.16 [95% confidence interval, CI, 1.01, 1.32], p = 0.031). In comparison with HI participants without cognitive impairment, HI patients with cognitive impairment had a higher fall risk (OR = 1.45 [95% CI = 1.23, 1.72], p < 0.001). CONCLUSIONS Association of hearing status and cognition with fall was, for the first time, examined on the basis of a nationally-representative oldest-old Chinese population. Poor cognitive performance was common in individuals with HI, and those with HI and cognitive impairment further increased the risk of falling.
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Affiliation(s)
- Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- School of Public Health, Wuhan University, Hubei, China
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Dan Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - E Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhao-Qi Guo
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing-Yu Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei-Jia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Su-Lin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Suo J, Shen X, He J, Sun H, Shi Y, He R, Zhang X, Wang X, Xi Y, Liang W. Exploring cognitive trajectories and their association with physical performance: evidence from the China Health and Retirement Longitudinal Study. Epidemiol Health 2023; 45:e2023064. [PMID: 37448124 PMCID: PMC10667582 DOI: 10.4178/epih.e2023064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/13/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES The long-term trends of cognitive function and its associations with physical performance remain unclear, particularly in Asian populations. The study objectives were to determine cognitive trajectories in middle-aged and elderly Chinese individuals, as well as to examine differences in physical performance across cognitive trajectory groups. METHODS Data were extracted from the China Health and Retirement Longitudinal Study. A total of 5,701 participants (47.7% male) with a mean age of 57.8 (standard deviation, 8.4) years at enrollment were included. A group-based trajectory model was used to identify cognitive trajectory groups for each sex. Grip strength, repeated chair stand, and standing balance tests were used to evaluate physical performance. An ordered logistic regression model was employed to analyze differences in physical performance across cognitive trajectory groups. RESULTS Three cognitive trajectory groups were identified for each sex: low, middle, and high. For both sexes, higher cognitive trajectory groups exhibited smaller declines with age. In the fully adjusted model, relative to the low trajectory group, the odds ratios (ORs) of better physical performance in the middle cognitive group were 1.37 (95% confidence interval [CI], 1.17 to 1.59; p<0.001) during follow-up and 1.40 (95% CI, 1.20 to 1.64; p<0.001) at the endpoint. The ORs in the high trajectory group were 1.94 (95% CI, 1.61 to 2.32; p<0.001) during follow-up and 2.04 (95% CI, 1.69 to 2.45; p<0.001) at the endpoint. CONCLUSIONS Cognitive function was better preserved in male participants and individuals with higher baseline cognitive function. A higher cognitive trajectory was associated with better physical performance over time.
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Affiliation(s)
- Jingdong Suo
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xianlei Shen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Jinyu He
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Haoran Sun
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yu Shi
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xiao Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xijie Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yuandi Xi
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Wickramarachchi B, Torabi MR, Perera B. Effects of Physical Activity on Physical Fitness and Functional Ability in Older Adults. Gerontol Geriatr Med 2023; 9:23337214231158476. [PMID: 36860700 PMCID: PMC9969476 DOI: 10.1177/23337214231158476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/22/2023] [Accepted: 02/02/2023] [Indexed: 02/26/2023] Open
Abstract
A cross-sectional survey was done to investigate the pathways the physical activity acts in improving physical fitness and functional outcomes of older adults (60 years and above) using 880 community-dwelling older adults in Sri Lanka. Structural Equation Modeling (SEM) was used. The final SEM model included five latent factors and 14 co-variances. Goodness of Fit Index (GFI), Comparative fit index (CFI) and Root Mean Square Error of Approximation (RMSEA) values of the model were 0.95, 0.93, 0.91, and 0.05 respectively, indicating a good model fit. Strength enhances balance (β = .52, p < .01) and reduces the time required to complete physical functions (β = -.65, p < .01). Since strength declines with advancing age, muscle-strengthening activity programs should be promoted to enhance balance and functional performances in older adults in advanced ages. Strength test (hand grip and leg strength) can be used as a screening test to predict potential risk of falls and functional disabilities in older adults.
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Affiliation(s)
- Bimba Wickramarachchi
- University of Ruhuna, Galle, Sri
Lanka,Universiti Malaysia Sarawak, Kota
Samarahan, Malaysia
| | | | - Bilesha Perera
- University of Ruhuna, Galle, Sri
Lanka,Bilesha Perera, Department of Community
Medicine, Faculty of Medicine, University of Ruhuna, P.O.Box 70, Galle 80000,
Sri Lanka.
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Thompson AC, Miller ME, Handing EP, Chen H, Hugenschmidt CE, Laurienti PJ, Kritchevsky SB. Examining the intersection of cognitive and physical function measures: Results from the brain networks and mobility (B-NET) study. Front Aging Neurosci 2023; 15:1090641. [PMID: 36819728 PMCID: PMC9932333 DOI: 10.3389/fnagi.2023.1090641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023] Open
Abstract
Background and objectives Although evidence exists that measures of mobility and cognition are correlated, it is not known to what extent they overlap, especially across various domains. This study aimed to investigate the intersection of 18 different objective cognitive and physical function measures from a sample of unimpaired adults aged 70 years and older. Research design and methods Canonical correlation analysis was utilized to explore the joint cross-sectional relationship between 13 cognitive and 6 physical function measures in the baseline visit of the Brain Networks and Mobility Function (B-NET) Study (n = 192). Results Mean age of participants was 76.4 years. Two synthetic functions were identified. Function 1 explained 26.3% of the shared variability between the cognition and physical function variables, whereas Function 2 explained 19.5%. Function 1 termed "cognitive and physical speed" related the expanded Short Physical Performance Battery (eSPPB), 400-m walk speed, and Dual Task gait speed measures of physical function to semantic fluency animals scores, Digit Symbol Coding (DSC), and Trail Making Test B. Function 2 termed "complex motor tasks and cognitive tasks" related the Force Plate Postural Sway Foam Task and Dual Task to the following cognitive variables: MoCA Adjusted Score, Verbal Fluency L words, Craft story immediate and delayed recall, and Trail Making Test B. Discussion and implications We identified groups of cognitive and physical functional abilities that were linked in cross-sectional analyses, which may suggest shared underlying neural network pathway(s) related to speed (Function 1) or complexity (Function 2). Translational significance Whether such neural processes decline before measurable functional losses or may be important targets for future interventions that aim to prevent disability also remains to be determined.
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Affiliation(s)
- Atalie C Thompson
- Department of Surgical Ophthalmology, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Michael E Miller
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Elizabeth P Handing
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Haiying Chen
- Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Christina E Hugenschmidt
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Paul J Laurienti
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Stephen B Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States
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Xie K, Han X, Lu J, Xu X, Hu X. Prediction model of all-cause death based on balance ability among middle-aged and older Chinese adults of overweight and obesity. Front Public Health 2022; 10:1039718. [PMID: 36620250 PMCID: PMC9815467 DOI: 10.3389/fpubh.2022.1039718] [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: 09/08/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Advances in studies using body indicators to predict death risk. Estimating the balance ability of death risk in middle-aged and older Chinese adults with overweight and obesity is still challenging. Methods A retrospective analysis of the data from the China Health and Retirement Study from January 2011 to December 2018. A total of 8,632 participants were randomly divided into 7:3 a training group and a verification group, respectively. Univariable Cox analysis was used to prescreen 17 potential predictors for incorporation in the subsequent multivariable Cox analysis. Nine variables were included in the nomogram finally and validated with concordance index (C-index), calibration plots, Hosmer-Lemeshow test, and internal validation population. Results 287 participants were death in the training group. One hundred and thirteen participants were death in the verification group. A total of nine indicators were included in the modeling group, including gender, age, marriage, hypertension, diabetes, stroke, ADL, IADL, and balance ability to establish a prediction model. The nomogram predicted death with a validated concordance index of (C-index = 0.77, 95% CI: 0.74-0.80). The inclusion of balance ability variables in the nomogram maintained predictive accuracy (C-index = 0.77, 95% CI: 0.73-0.82). The calibration curve graph and Hosmer-Lemeshow test (P > 0.05 for both the modeling group and the verification group) showed the model has a good model consistency. Conclusion In the present study, we provide a basis for developing a prediction model for middle-aged and older people with overweight and obesity. In most cases, balance ability is more reversible than other predictors.
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Affiliation(s)
- Kaihong Xie
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Han
- School of Health Humanities, Peking University Health Science Center, Beijing, China
| | - Jia Lu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China,Xiao Xu ✉
| | - Xuanhan Hu
- The Second School of Clinical, Zhejiang Chinese Medical University, Hangzhou, China,*Correspondence: Xuanhan Hu ✉
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Tu R, Wang S, He H, Ding J, Zeng Q, Guo L, Li Y, Xu T, Lu G. Association between subjective cognitive complaints, balance impairment and disability among middle‐aged and older adults: Evidence from a population‐based cohort study. Geriatr Gerontol Int 2022; 22:1025-1031. [DOI: 10.1111/ggi.14501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Raoping Tu
- School of Nursing & School of Public Health Yangzhou University Yangzhou China
- School of Health Management Fujian Medical University Fuzhou China
| | - Suhang Wang
- School of Nursing & School of Public Health Yangzhou University Yangzhou China
| | - Huihui He
- School of Nursing & School of Public Health Yangzhou University Yangzhou China
| | - Jiali Ding
- School of Nursing & School of Public Health Yangzhou University Yangzhou China
| | - Qingping Zeng
- School of Nursing & School of Public Health Yangzhou University Yangzhou China
| | - Lu Guo
- School of Nursing & School of Public Health Yangzhou University Yangzhou China
| | - Yueping Li
- Director of Library Fujian Medical University Library Fuzhou China
| | - Tianwei Xu
- Department of Psychology Stockholm University Stockholm Sweden
| | - Guangyu Lu
- School of Nursing & School of Public Health Yangzhou University Yangzhou China
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11
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Yan J, Luan F, Wang M, Dong W, Zhang X, Li M, Cao Y. Prospective association between standing balance and cognitive function in middle-aged and older Chinese adults. Front Psychol 2022; 13:931216. [PMID: 36225682 PMCID: PMC9549916 DOI: 10.3389/fpsyg.2022.931216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the association of standing balance with cognitive functions and the rate of cognitive decline among middle-aged and older Chinese adults. Methods Participants were selected from China’s Health and Retirement Longitudinal Study. A total of 8,499 subjects aged ≥45 years who participated in wave 1 to wave 3 surveys were included in the final analysis. Standing balance was measured using the tandem test, and participants were categorized into two groups according to their ability to maintain standing balance. Cognitive functions were assessed in three domains: episodic memory, mental status, and global cognition. The associations between standing balance scores, cognitive scores, and the rate of cognitive decline were evaluated using linear regression and linear mixed models. Results Compared with participants who successfully completed the standing balance test, those who were unable to complete the test had lower scores on episodic memory [β = −0.18; 95% confidence interval (CI): −0.24, −0.11], mental status (β = −0.28; 95% CI: −0.37, −0.19), and global cognition (β = −0.51; 95% CI: −0.65, −0.38) after 4 years of follow-up. In addition, the rate of decline in mental status and global cognition increased by 0.10 (β = 0.10; 95% CI: 0.07, 0.13) and 0.08 (β = 0.08; 95% CI: 0.04, 0.12) units, respectively, in participants who were unable to complete the test compared with their counterparts. Conclusion Good standing balance was significantly associated with higher cognitive function and a lower decline in mental status and global cognition in middle-aged and older Chinese adults.
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Affiliation(s)
- Jingzheng Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fangyun Luan
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, China
| | - Meijuan Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wenshuo Dong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xinyue Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mengli Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yingjuan Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Nursing, Qilu Hospital, Shandong University, Jinan, China
- *Correspondence: Yingjuan Cao,
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Cai YH, Wang Z, Feng LY, Ni GX. Effect of Exercise on the Cognitive Function of Older Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2022; 16:876935. [PMID: 35572003 PMCID: PMC9096085 DOI: 10.3389/fnhum.2022.876935] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/01/2022] [Indexed: 01/13/2023] Open
Abstract
Background Aging and type 2 diabetes mellitus (T2DM) are important risk factors for the development of cognitive deterioration and dementia. The objective of this research was to investigate the effects of an exercise intervention on cognitive function in older T2DM patients. Methods Eight literature databases (PubMed, EBSCO, Scopus, Embase, The Cochrane Library, Web of Science, Ovid, and ProQuest) were searched from inception to 20 January 2022. The researchers examined randomized controlled trials (RCTs) that evaluated the impact of exercise on the cognitive performance of older T2DM patients. The Cochrane risk-of-bias tool (ROB 2) for RCTs was used to assess each study. The quality of evidence was assessed using the GRADE (grading of recommendations, assessment, development, and evaluations) approach. The mini-mental state examination (MMSE), Modified MMSE (3MSE), and Montreal cognitive assessment (MoCA) were used to evaluate the cognitive outcomes. We performed a subgroup analysis with stratification according to exercise intervention modality, duration, and cognitive impairment. Results Five trials were eligible, with a total of 738 T2DM patients. The combined findings revealed that exercise improved global cognitive function significantly (standardized mean difference: 1.34, 95% confidence interval: 0.23–2.44, p < 0.01). The effect of exercise on global cognitive performance was not significantly influenced by intervention modality, intervention duration, or cognitive impairment in the sub-group analysis (p > 0.05). In the studies that were included, no relevant adverse events were reported. Conclusion Exercise is beneficial in improving global cognitive function in older adults with T2DM. Studies with bigger sample sizes and higher quality are additionally expected to draw more definite conclusions. Systematic Review Registration [https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42022296049].
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Affiliation(s)
- Yi-Hui Cai
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Zi Wang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Le-Yi Feng
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Guo-Xin Ni
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
- *Correspondence: Guo-Xin Ni,
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