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Wei Y, Zhou YF, Xiao L, Qin J, Cheng H, Cai H, Chen X, Zou Y, Yang L, Zhang H, Zhang Z, Yang X. Associations of Heavy Metals with Cognitive Function: An Epigenome-Wide View of DNA Methylation and Mediation Analysis. Ann Neurol 2024; 96:87-98. [PMID: 38661228 DOI: 10.1002/ana.26942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Exposure to heavy metals has been reported to be associated with impaired cognitive function, but the underlying mechanisms remain unclear. This pilot study aimed to identify key heavy metal elements associated with cognitive function and further explore the potential mediating role of metal-related DNA methylation. METHODS Blood levels of arsenic, cadmium, lead, copper, manganese, and zinc and genome-wide DNA methylations were separately detected in peripheral blood in 155 older adults. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Least absolute shrinkage and selection operator penalized regression and Bayesian kernel machine regression were used to identify metals associated with cognitive function. An epigenome-wide association study examined the DNA methylation profile of the identified metal, and mediation analysis investigated its mediating role. RESULTS The MMSE scores showed a significant decrease of 1.61 (95% confidence interval [CI]: -2.64, -0.59) with each 1 standard deviation increase in ln-transformed arsenic level; this association was significant in multiple-metal models and dominated the overall negative effect of 6 heavy metal mixture on cognitive function. Seventy-three differentially methylated positions were associated with blood arsenic (p < 1.0 × 10-5). The methylation levels at cg05226051 (annotated to TDRD3) and cg18886932 (annotated to GAL3ST3) mediated 24.8% and 25.5% of the association between blood arsenic and cognitive function, respectively (all p < 0.05). INTERPRETATION Blood arsenic levels displayed a negative association with the cognitive function of older adults. This finding shows that arsenic-related DNA methylation alterations are critical partial mediators that may serve as potential biomarkers for further mechanism-related studies. ANN NEUROL 2024;96:87-98.
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Affiliation(s)
- Yue Wei
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yan-Feng Zhou
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China
| | - Lili Xiao
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Jian Qin
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Hong Cheng
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Haiqing Cai
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Xing Chen
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yunfeng Zou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Li Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Haiying Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Zhiyong Zhang
- Department of Environmental Health and Occupational Medicine, Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath Research, Guilin Medical University, Guilin, China
| | - Xiaobo Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
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Li Y, Wang L, Wang H, Leng X, Gao J, Huang D. Polysaccharides from Eucommia ulmoides Oliv. leaves alleviates alcohol-induced mouse brain injury and BV-2 microglial dysfunction. Int J Biol Macromol 2024; 273:132887. [PMID: 38851621 DOI: 10.1016/j.ijbiomac.2024.132887] [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: 04/25/2024] [Revised: 05/25/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
Acute alcohol intoxication is a harmful clinical condition characterized by behavioral and neurological symptoms, for which few effective therapies are available at present. Dysfunction of microglial BV-2 cells has been reported to be associated with acute alcohol-induced brain injuries. In the present study, the protective effects of Eucommia ulmoides Oliv. leaves polysaccharides (EULP) on acute alcoholic brain injury and microglial dysfunction were investigated. 14-day pretreatment of EULP significantly attenuated neurobehavioral deficit and neurotransmitter damage in the brain tissue of mice caused by acute alcohol exposure. Additionally, EULP regulated the metabolic disorder of brain tissue. Consistently, it was shown that EULP pretreatment significantly improved alcohol-induced phagocytosis decrease, oxidative stress and inflammation in BV-2 cells. Therefore, EULP may be proposed and employed as a potential therapeutic agent for alcohol-induced brain damage.
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Affiliation(s)
- Yingzhi Li
- State Key Laboratory of Food Science and Resources, International Institute of Food Innovation Co., Ltd., China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China
| | - Luchen Wang
- State Key Laboratory of Food Science and Resources, International Institute of Food Innovation Co., Ltd., China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China
| | - Huimei Wang
- State Key Laboratory of Food Science and Resources, International Institute of Food Innovation Co., Ltd., China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China
| | - Xueping Leng
- State Key Laboratory of Food Science and Resources, International Institute of Food Innovation Co., Ltd., China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China
| | - Jiaming Gao
- State Key Laboratory of Food Science and Resources, International Institute of Food Innovation Co., Ltd., China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China
| | - Danfei Huang
- State Key Laboratory of Food Science and Resources, International Institute of Food Innovation Co., Ltd., China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China.
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Wei X, Chen Y, Qin J, Yang Y, Yang T, Yan F, Zhang Z, Han L, Ma Y. Factors associated with the intrinsic capacity in older adults: A scoping review. J Clin Nurs 2024; 33:1739-1750. [PMID: 38345142 DOI: 10.1111/jocn.17017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION In 2015, the term 'intrinsic capacity' (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain. AIM We aim to synthesise the factors connected with IC. METHODS This scoping review followed the five-stage framework of Arksey and O'Malley and was reported using PRISMA-ScR guidelines. RESULTS In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults. CONCLUSIONS This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults. RELEVANCE TO CLINICAL PRACTICE The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well-being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline. NO PATIENT OR PUBLIC CONTRIBUTION As this is a scoping review, no patient or public contributions are required.
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Affiliation(s)
- Xiaoqin Wei
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yajing Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Jiangxia Qin
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yiyi Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Tingting Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Fanghong Yan
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Ziyao Zhang
- Lanzhou University of Arts and Science, Lanzhou, Gansu Province, China
| | - Lin Han
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
- Nursing Department, Gansu Provincial Hospital, Lanzhou, Gansu Province, China
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
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Xu T, Bu G, Yuan L, Zhou L, Yang Q, Zhu Y, Zhang S, Liu Q, Ouyang Z, Yang X, Tang B, Jiao B, Bei Y, Shen L. The prevalence and risk factors study of cognitive impairment: Analysis of the elderly population of Han nationality in Hunan province, China. CNS Neurosci Ther 2024; 30:e14478. [PMID: 37736696 PMCID: PMC11017419 DOI: 10.1111/cns.14478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/31/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE A large number of studies have found that the prevalence of cognitive impairment varies in different regions. However, data on cognitive impairment in the Chinese population is still lacking. The goal of this study was to assess the prevalence of cognitive impairment among the elderly in a region of China and explore the associated risk factors. METHODS We performed a population-based cross-sectional survey from April to June 2022. Residents come from three villages and six urban communities in the county-level city of Liuyang in southern China (N = 3233) and the coverage rate of our study population reached 73%. Participants were assessed with a series of clinical examinations and neuropsychological measures. A total of 2598 participants were selected after filtering out those under 60 years old or with incomplete data. Patients with cognitive impairment included those with mild cognitive impairment (MCI) or dementia who met standard diagnostic criteria. RESULTS The prevalence of cognitive impairment, MCI, and dementia among participants aged 60 years and older were 21.48% (95% CI, 19.90-23.10), 15.70% (95% CI, 14.30-17.10), and 5.77 (95% CI, 4.90-6.70), respectively. And residents in villagers were more likely to have cognitive impairment than in urban communities (p < 0.001). Age growth and education level were independent influencing factors for cognitive impairment in all populations (p < 0.001). For lifestyles factors, both smoking and drinking reduced the risk of cognitive impairment (p < 0.05), but when further quantified, the link disappeared. Moreover, having cerebrovascular disease and severe vision impairment were risk factors (p < 0.05). CONCLUSION A representative prevalence of cognitive impairment, MCI, and dementia was found in the elderly Han Chinese population in Southern China. And we further explored the role of known risk factors, particularly in physical activity, smoking, and alcohol consumption.
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Affiliation(s)
- Tianyan Xu
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Guiwen Bu
- Department of NeurologyLiuyang Jili HospitalChangshaChina
| | - Li Yuan
- Department of NeurologyLiuyang Jili HospitalChangshaChina
| | - Lu Zhou
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Qijie Yang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Yuan Zhu
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Sizhe Zhang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Qianqian Liu
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Ziyu Ouyang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Xuan Yang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Beisha Tang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
- National Clinical Research Center for Geriatric DisordersCentral South UniversityChangshaChina
- Engineering Research Center of Hunan Province in Cognitive Impairment DisordersCentral South UniversityChangshaChina
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic DiseasesChangshaChina
- Key Laboratory of Hunan Province in Neurodegenerative DisordersCentral South UniversityChangshaChina
| | - Bin Jiao
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
- National Clinical Research Center for Geriatric DisordersCentral South UniversityChangshaChina
- Engineering Research Center of Hunan Province in Cognitive Impairment DisordersCentral South UniversityChangshaChina
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic DiseasesChangshaChina
- Key Laboratory of Hunan Province in Neurodegenerative DisordersCentral South UniversityChangshaChina
| | - Yuzhang Bei
- Department of NeurologyLiuyang Jili HospitalChangshaChina
| | - Lu Shen
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
- National Clinical Research Center for Geriatric DisordersCentral South UniversityChangshaChina
- Engineering Research Center of Hunan Province in Cognitive Impairment DisordersCentral South UniversityChangshaChina
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic DiseasesChangshaChina
- Key Laboratory of Hunan Province in Neurodegenerative DisordersCentral South UniversityChangshaChina
- Key Laboratory of Organ InjuryAging and Regenerative Medicine of Hunan ProvinceChangshaChina
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Komninou MA, Egli S, Rossi A, Ernst J, Krauthammer M, Schuepbach RA, Delgado M, Bartussek J. Former smoking, but not active smoking, is associated with delirium in postoperative ICU patients: a matched case-control study. Front Psychiatry 2024; 15:1347071. [PMID: 38559401 PMCID: PMC10979642 DOI: 10.3389/fpsyt.2024.1347071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Objective To examine the relationship between current and former smoking and the occurrence of delirium in surgical Intensive Care Unit (ICU) patients. Methods We conducted a single center, case-control study involving 244 delirious and 251 non-delirious patients that were admitted to our ICU between 2018 and 2022. Using propensity score analysis, we obtained 115 pairs of delirious and non-delirious patients matched for age and Simplified Acute Physiology Score II (SAPS II). Both groups of patients were further stratified into non-smokers, active smokers and former smokers, and logistic regression was performed to further investigate potential confounders. Results Our study revealed a significant association between former smoking and the incidence of delirium in ICU patients, both in unmatched (adjusted odds ratio (OR): 1.82, 95% confidence interval (CI): 1.17-2.83) and matched cohorts (OR: 3.0, CI: 1.53-5.89). Active smoking did not demonstrate a significant difference in delirium incidence compared to non-smokers (unmatched OR = 0.98, CI: 0.62-1.53, matched OR = 1.05, CI: 0.55-2.0). Logistic regression analysis of the matched group confirmed former smoking as an independent risk factor for delirium, irrespective of other variables like surgical history (p = 0.010). Notably, also respiratory and vascular surgeries were associated with increased odds of delirium (respiratory: OR: 4.13, CI: 1.73-9.83; vascular: OR: 2.18, CI: 1.03-4.59). Medication analysis showed that while Ketamine and Midazolam usage did not significantly correlate with delirium, Morphine use was linked to a decreased likelihood (OR: 0.27, 95% CI: 0.13-0.55). Discussion Nicotine's complex neuropharmacological impact on the brain is still not fully understood, especially its short-term and long-term implications for critically ill patients. Although our retrospective study cannot establish causality, our findings suggest that smoking may induce structural changes in the brain, potentially heightening the risk of postoperative delirium. Intriguingly, this effect seems to be obscured in active smokers, potentially due to the recognized neuroprotective properties of nicotine. Our results motivate future prospective studies, the results of which hold the potential to substantially impact risk assessment procedures for surgeries.
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Affiliation(s)
- Maria Angeliki Komninou
- Institute of Intensive Care Medicine, University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | - Simon Egli
- Institute of Intensive Care Medicine, University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | - Aurelio Rossi
- Institute of Intensive Care Medicine, University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | - Jutta Ernst
- Center of Clinical Nursing Sciences, University Hospital Zurich, Zurich, Switzerland
| | - Michael Krauthammer
- Department for Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Reto A. Schuepbach
- Institute of Intensive Care Medicine, University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | - Marcos Delgado
- Institute of Intensive Care Medicine, University Hospital Zurich & University of Zurich, Zurich, Switzerland
- Department of Anesthesia and Intensive Care Medicine, Tiefenau Hospital, Insel Group. University of Bern, Bern, Switzerland
| | - Jan Bartussek
- Institute of Intensive Care Medicine, University Hospital Zurich & University of Zurich, Zurich, Switzerland
- Department for Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
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Mazumder AH, Barnett JH, Halt AH, Taivalantti M, Kerkelä M, Järvelin MR, Veijola J. Visual memory and alcohol use in a middle-aged birth cohort. BMC Public Health 2024; 24:788. [PMID: 38481169 PMCID: PMC10935933 DOI: 10.1186/s12889-024-18153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Light and moderate alcohol use has been reported to be associated with both impaired and enhanced cognition. The purpose of this study was to explore whether there was a linear relationship between visual memory and alcohol consumption in males and females in a large middle-aged birth cohort population in cross-sectional and longitudinal settings. Data were collected from 5585 participants completing 31-year (1997-1998) and 46-year (2012-2014) follow-ups including Paired Associate Learning (PAL) test at 46-years follow-up. The participants were originally from 12,231 study population of the Northern Finland Birth Cohort 1966 (NFBC1966). The PAL test was conducted to assess visual memory. Reported alcohol use was measured as total daily use of alcohol, beer, wine, and spirits converted into grams and as frequency and amount of use of beer, wine, and spirits. The total daily alcohol use was not associated with reduced visual memory. The frequency of use of beer and wine in males was associated with better visual memory in cross-sectional and longitudinal settings. Using six or more servings of spirits was associated with worse visual memory in males in cross-sectional and longitudinal settings. Using six or more servings of spirits was associated with worse visual memory in males in cross-sectional and longitudinal setting. The study suggested a lack of a linear association between drinking and visual memory in the middle-aged population.
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Affiliation(s)
- Atiqul Haq Mazumder
- Department of Psychiatry, Research Unit of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Department of Psychiatry, Turku Psychosis and Substance Use (TuPSU), University of Turku, Turku, Finland.
| | | | - Anu-Helmi Halt
- Department of Psychiatry, Research Unit of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, University Hospital of Oulu and University of Oulu, and Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - Marjo Taivalantti
- Department of Psychiatry, Research Unit of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, University Hospital of Oulu and University of Oulu, and Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - Martta Kerkelä
- Department of Psychiatry, Research Unit of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, University Hospital of Oulu and University of Oulu, and Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
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Ekem-Ferguson G, Tetteh J, Malm K, Yawson AO, Biritwum R, Mensah G, Yawson AE. Determinants of semantic and episodic memory decline among older adults in Ghana: Evidence from the WHO study on global AGEing and adult health Ghana wave 2. DIALOGUES IN HEALTH 2023; 2:100118. [PMID: 38515495 PMCID: PMC10953951 DOI: 10.1016/j.dialog.2023.100118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/14/2023] [Accepted: 02/20/2023] [Indexed: 03/23/2024]
Abstract
Objective Determined factors associated with semantic (SM) and episodic memory (EM) among older adults aged 50 years and older in Ghana. Methods Data from WHO Study on Global AGEing and Adult Health (SAGE) Ghana Wave 2 was used for this study. Semantic memory (SM) and Episodic memory (EM) were the main study outcomes separately. The study employed Nested Ordinary Least Square regression analysis by sequentially adding 6 blocks of variables and comparison tests between the nested models. Results The study involved 3575 adult Ghanaians aged 50 years and older with a mean ± standard deviation of 62.6 ± 18.4 years. The overall mean ± SD of EM and SM were 5.86 ± 2.51 and 11.69 ± 8.59 respectively. Overall, analysis from block 6 showed a significant variation in SM by approximately 16.9%(ΔR2 = 1.17%) where increasing age, never married (β = -1.55; 95% CI = -2.41-0.69), being resident in Greater Accra (regional disparity) (β = -3.45; 95% CI = -4.73-2.20), underweight (β = -0.81;95% CI = -1.34-0.27), and moderate self-rated health (SRH) (β = -0.98; 95% CI = -1.52-0.45) significantly decreased SM. Similarly, increasing age, separated/divorced (β = -0.22; 95% CI = -0.35-0.87), being resident in Greater Accra (β = -0.53; 95% CI = -0.80-0.26), and moderate SRH (β = -0.20; 95% CI = -0.36--0.04) significantly decrease EM with an overall significant variation of approximately 22.9%(ΔR2 = 2.7%). Conclusions Increasing age, sex, marital status, regional disparity, and poor SRH significantly decreased both Semantic memory and Episodic memory. Higher educational attainment and life satisfaction significantly influenced SM and EM. These provide pointers to important socio-demographic determinants of SM and EM with implications for the implementation of the Ghana national ageing policy 2010, 'ageing with security and dignity', and as a key consideration for healthy ageing towards 2030.
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Affiliation(s)
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Keziah Malm
- National Malaria Control Programme, Ghana Health Service, Ghana
| | - Anita Ohenewa Yawson
- Ground Floor Surgical Intensive Care Unit, Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Richard Biritwum
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - George Mensah
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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Tan LF, Li H, Pan A, Teng GG, Koh WP. Association between gout at midlife and cognitive impairment at late life - The Singapore Chinese Health Study. Arch Gerontol Geriatr 2023; 111:104996. [PMID: 36958148 DOI: 10.1016/j.archger.2023.104996] [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: 11/14/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES The association between gout and risk of cognitive impairment or dementia is not well established. We examined the relationship between having gout at midlife and the risk of developing cognitive impairment later on. METHODS We used data of 16,948 participants from the population-based Singapore Chinese Health Study cohort. Participants were recruited from 1993 to 1998 at mean age of 53 years and re-contacted for three follow-up interviews: 1999 to 2004 for follow-up 1, 2006 to 2010 for follow-up 2, and 2014 to 2016 for follow-up 3. History of physician-diagnosed gout was self-reported at follow-up 1 and follow-up 2, while cognitive function was assessed with the Singapore modified Mini-Mental State Examination during follow-up 3, when participants had a mean age of 73.2 years. RESULTS Gout was reported by 1281 (7.6%) participants at either follow-up 1 or 2, and 2243 (14.4%) had cognitive impairment at follow-up 3. A history of gout was associated with reduced risk of cognitive impairment (OR 0.78, 95% CI 0.65-0.93). This risk was reduced in a stepwise manner with either increased duration of gout or lower age at first diagnosis of gout (Ptrend <0.001). Compared to those without gout, those with gout for ≥20 years (OR 0.56, 95% CI 0.39-0.80) and those with age of onset of gout <50 years old (OR 0.59, 95% CI 0.37-0.94) had a lower risk of developing cognitive impairment. CONCLUSION A young age of onset or a long history of gout was associated with reduced risk of cognitive impairment in late life.
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Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, National University Health System, Singapore
| | - Huiqi Li
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gim Gee Teng
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore; Division of Rheumatology, Department of Medicine, National University Hospital, National University Health System, Singapore.
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
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Factors Associated With Social Isolation in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:322-330.e6. [PMID: 36549651 DOI: 10.1016/j.jamda.2022.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Social isolation is a global health issue that affects older adults throughout their lives. This study aimed to identify the factors associated with social isolation in older adults. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Adults aged 60 years and older. METHODS We searched for observational studies without language restrictions in 11 databases from inception to August 2022. Pooled odds ratio (OR) and 95% CI were calculated using the R software (version 4.2.1). The modified Newcastle-Ottawa Scale was used to evaluate the risk of bias. RESULTS Eighteen factors were grouped into 5 themes. The following 13 factors were statistically significant: (1) demographics theme: aged 80 years and older (OR: 2.41; 95% CI: 1.20-4.85), less than or equal to a high school degree (OR: 1.68; 95% CI: 1.44-1.97), smoking (OR: 1.43; 95% CI: 1.18-1.73), and male (OR: 1.38; 95% CI: 1.01-1.89); (2) environment theme: low social support (OR: 7.77; 95% CI: 3.45-17.50) and no homeownership (OR: 1.38; 95% CI: 1.25-1.51); (3) role theme: no social participation (OR: 3.18; 95% CI: 1.30-7.80) and no spouse (OR: 2.61; 95% CI: 1.37-4.99); (4) physical health: hearing loss (OR: 2.78; 95% CI: 1.54-5.01), activities of daily living impairment (OR: 2.38; 95% CI: 1.57-3.61), and poor health status (OR: 1.52; 95% CI: 1.32-1.74); and (5) mental health: cognitive decline (OR: 1.85; 95% CI: 1.40-2.45) and depression (OR: 1.72; 95% CI: 1.21-2.44). CONCLUSIONS AND IMPLICATIONS Social isolation in older adults is associated with various factors. Hence, focused intervention should be adopted for older adults. In addition, further longitudinal studies are required to confirm a direct link between multiple factors and social isolation.
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Guan T, Zhang C, Zou X, Chen C, Zhou L, Wu X, Hao J. The Influence of Alcohol Consumption, Depressive Symptoms and Sleep Duration on Cognition: Results from the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12574. [PMID: 36231874 PMCID: PMC9566793 DOI: 10.3390/ijerph191912574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
AIM Healthy cognition-related factors include alcohol consumption, depressive symptoms, and sleep duration. However, less is known about the role of these factors in the dyad or tripartite relationships. In this study, we examined whether there were potential mediation effects, moderation effects, and interactions between these factors in the longitudinal study. METHODS Both cross-sectional data analysis and a longitudinal study were performed using baseline and 2018 data from the China Health and Retirement Longitudinal Study (CHARLS) cohort. CHARLS is a nationwide survey program covering 450 villages and 150 counties in 28 provinces that aims to investigate comprehensive demographic information. After selecting participants from the CHARLS cohort, 15,414 were included in the study. Non-drinkers, those who drink more than once a month, and those who drink less than once a month were defined by their alcohol consumption. Depressive symptoms were defined as nondepressed (less than or equal to 12) and depressed (more than 12). Sleep duration was defined as 7-8 h per night, ≤6 h per night, and ≥9 h per night. The total cognitive scores were calculated from memory, orientation, and executive tests. The PROCESS macro in SPSS was used to analyze all mediations and moderating mediations. RESULTS Alcohol consumption has a positive correlation with cognition. The global cognition z scores of participants with depressive symptoms were significantly lower than those of the control (all p's < 0.001), in different models. The memory score (β: -0.148; 95% CI: -0.240 to -0.056; p = 0.002), the executive score (β: -0.082; 95% CI: -0.157 to -0.006; p = 0.033), and the global cognition score (β: -0.105; 95% CI: -0.187 to -0.023; p = 0.012) of participants defined as ≤6 h per night were, obviously, less than the control (7-8 h per night). An association between depression and alcohol consumption has been found, and the protective effects have been reversed by depression, which caused the cognition decline. Sleep duration was identified as a moderator, influencing the relationship between depressive symptoms and cognitive function. Besides, there was an interaction causing cognition decline among alcohol consumption, depressive symptoms, and sleep duration. Cognitive function showed a marked downward trend with increasing age. CONCLUSIONS In this model, depression primarily mediates the relationship between alcohol consumption and cognition, and sleep duration changes the mediation effect. Furthermore, there is a significant interaction between alcohol consumption, depressive symptoms, and sleep duration, which are significantly associated with cognitive function.
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Affiliation(s)
- Tianyue Guan
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Chao Zhang
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Xuanmin Zou
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Chen Chen
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Li Zhou
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Xiaochang Wu
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Jiahu Hao
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei 230032, China
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11
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Lung function impairment in relation to cognition and vascular brain lesions: the Rotterdam Study. J Neurol 2022; 269:4141-4153. [PMID: 35267082 DOI: 10.1007/s00415-022-11027-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate the association of chronic obstructive pulmonary disease (COPD) and Preserved Ratio Impaired Spirometry (PRISm) with cognitive performance and presence of vascular brain lesions (VBL). METHODS We determined both cross-sectional and longitudinal association of lung function impairment with cognition, as well as cross-sectional association of lung function impairment with VBL, in the general population. Between 2009 and 2014 we included 3,941 participants from the Rotterdam Study with spirometry tests, brain MRI scans and cognition tests, of whom 1815 had follow-up data on cognition. RESULTS Our finding indicated that cross-sectionally, participants with PRISm or COPD GOLD2-4 had a worse global cognitive performance. We did not find differences in cognition over time between those with normal spirometry versus those with lung function impairment. In addition, PRISm and COPD GOLD2-4 were associated with a higher prevalence of lacunar infarcts compared to normal spirometry. CONCLUSIONS This study suggests that persons with COPD GOLD2-4 or restrictive lung function, defined as PRISm, are characterized by poorer global cognitive function and a higher prevalence of lacunar infarcts.
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Zhang Q, Zhang M, Chen Y, Zhu S, Zhou W, Zhang L, Dong G, Cao Y. Smoking Status and Cognitive Function in a National Sample of Older Adults. Front Psychiatry 2022; 13:926708. [PMID: 35873239 PMCID: PMC9301276 DOI: 10.3389/fpsyt.2022.926708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022] Open
Abstract
AIMS To examine the correlation between smoking status and different domains of cognitive function in elderly Americans. METHODS We used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). Participants over 60 years with available smoking history and cognitive function data were enrolled in our analysis. The NHANES study included the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST) to assess cognition. Multivariate regression analyses were used to estimate the association between cigarette smoking and cognitive function. RESULTS A total of 2,932 participants were enrolled in the analysis, including 372 (12.7%) current smokers, 1,115 (38%) former smokers, and 1,445 (49.3%) never smokers. Never smokers had in average 3.82 (95% CI, 2.21 to 5.43) points more than current smokers in the DSST, whereas former smokers had 3.12 (95% CI, 1.51 to 4.73) points more than current smokers. Besides, smoking was not associated with the results of the AFT or the CERAD test. CONCLUSIONS This study suggests that cigarette smoking is associated with processing speed among the American elderly.
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Affiliation(s)
- Qiaoyang Zhang
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Min Zhang
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Yun Chen
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Shumin Zhu
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Wang Zhou
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Lihao Zhang
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Guanzhong Dong
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Yin Cao
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
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Ren Z, Li Y, Li X, Shi H, Zhao H, He M, Zha S, Qiao S, Pu Y, Liu H, Zhang X. Associations of body mass index, waist circumference and waist-to-height ratio with cognitive impairment among Chinese older adults: Based on the CLHLS. J Affect Disord 2021; 295:463-470. [PMID: 34507227 DOI: 10.1016/j.jad.2021.08.093] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Few studies have been conducted on the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cognitive impairment among Chinese older adults through a prospective design. OBJECTIVE This study was aimed to evaluate the associations of BMI, WC, and WHtR with cognitive impairment. METHODS We included participants aged 65 years and older in 2014 at baseline and 2018 follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). BMI, WC, and WHtR were calculated from measured weight, height, and waist circumference. Mini-Mental State Examination was utilized to assess cognitive impairment. Modified Poisson regression was used for calculating prevalence ratios, risk ratios, and 95% confidence intervals. RESULTS A total of 5156 participants were included in 2014 at baseline. The prevalence of cognitive impairment was 42.5%, 26.7%, and 21.2% in underweight, normal-weight, and overweight/obesity participants defined by BMI categories, respectively, and 24.1% and 26.8% in central obesity participants defined by WC and WHtR cutoffs, respectively. Prospectively, participants with underweight were more likely to suffer from cognitive impairment (RR = 1.258, 95% CI: [1.016, 1.559]), but no risk was found among participants with overweight/obesity after adjustment. Regardless of whether covariates were adjusted or not, no effect on cognitive impairment was found in participants with WC and WHtR groups in the follow-up survey. CONCLUSIONS Underweight may be a significant risk factor for the cognitive impairment of Chinese older adults. Weight management programs targeting older adults should attach importance to achieving and maintaining optimal body weight and improving cognitive function.
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Affiliation(s)
- Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yuyu Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuyin Qiao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yajiao Pu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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Sharifi F, Khoiee MA, Aminroaya R, Ebrahimpur M, Shafiee G, Heshmat R, Payab M, Shadman Z, Fakhrzadeh H, Arzaghi SM, Mehrdad N, Ostovar A, Sheidaei A, Fahimfar N, Nabipour I, Larijani B. Studying the relationship between cognitive impairment and frailty phenotype: a cross-sectional analysis of the Bushehr Elderly Health (BEH) program. J Diabetes Metab Disord 2021; 20:1229-1237. [PMID: 34900774 PMCID: PMC8630203 DOI: 10.1007/s40200-021-00847-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Some pathophysiological effects of physical frailty and cognitive impairment might be similar; therefore, finding the associations in epidemiologic studies could guide clinicians and researchers to recognize effective strategies for each type of frailty such as frailty phenotype and frailty index, which in turn will result in a preventive approach. The study aimed to reveal which components of frailty phenotype are more associated with cognitive impairment. The findings of this study may help other researchers clarify the related pathways. METHODS This is a cross-sectional analysis of the results of the second phase of Bushehr Elderly Health Program; a community-based elderly prospective cohort study conducted in 2015-2016. The participants were selected through a multistage stratified cluster random sampling method. Frailty was assessed based on the Fried frailty phenotype criteria. Cognitive impairment was assessed by the Mini-Mental State Examination (MMSE), the Mini-Cog, and the Category Fluency Test (CFT). Multiple logistic regression models were applied to determine the association between frailty and cognitive impairment. Depression trait was assessed using the Patient Health Questionnaire-9 (PHQ-9). Activities of daily living were assessed using the Barthel Index and Instrumental Activities of Daily Living (IADLs) using Lawton's IADL. RESULTS The studyp conducted among people ≥ 60 years old (N = 2336) with women consisting 51.44% of the sample group. The mean age of the participants was 69.26 years old. The prevalence of pre-frailty and frailty were 42.59% and 7.66%, respectively. In the fully adjusted model, the odds ratio of the association between pre-frailty and frailty with cognitive impairment was 1.239, 95% CI: 1.011 - 1.519 and 1.765, 95% CI: 1.071 - 2.908, respectively (adjusted for age, sex, education, body mass index, smoking, diabetes mellitus, PHQ- 9, Barthel Index, and IADLs). In the fully adjusted multiple logistic regression models, all of the components of Fried frailty phenotype were significantly related to cognitive impairment except weight loss. CONCLUSION Cognitive impairment may be associated with frailty phenotype. Moreover, low strength and function of muscles had a stronger association with cognitive impairment. It seems that a consideration of cognitive impairment assessment in older people along with frailty and vice versa in clinical settings is reasonable.
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Affiliation(s)
- Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Alizadeh Khoiee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reihane Aminroaya
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhaleh Shadman
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, NO. 10, Jalale-Al- Ahmad Ave, Chamran Highway, Tehran, Iran
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Zhang L, Hou Y, Cao B, Wei QQ, Ou R, Liu K, Lin J, Yang T, Xiao Y, Zhao B, Shang H. Vascular Risk Factors and Cognition in Multiple System Atrophy. Front Neurosci 2021; 15:749949. [PMID: 34764851 PMCID: PMC8576549 DOI: 10.3389/fnins.2021.749949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/06/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: Vascular risk factors have been reported to be associated with cognitive impairment (CI) in the general population, but their role on CI in multiple system atrophy (MSA) is unclear. This study aimed to explore the relationship between vascular risk factors and CI in patients with MSA. Methods: The clinical data and vascular risk factors were collected. The Montreal Cognitive Assessment tool was used to test the cognitive function of patients with MSA. Binary logistic regression was used to analyze the correlation between vascular risk factors and CI. Results: A total of 658 patients with MSA with a mean disease duration of 2.55 ± 1.47 years were enrolled. In MSA patients, hypertension was recorded in 20.2%, diabetes mellitus in 10.3%, hyperlipidemia in 10.2%, smoking in 41.2%, drinking in 34.8%, and obesity in 9.6%. The prevalence of CI in patients with MSA, MSA with predominant parkinsonism (MSA-P), and MSA with predominant cerebellar ataxia (MSA-C) was 45.0, 45.1, and 44.9%, respectively. In the binary logistic regression model, patients with more than one vascular risk factors were significantly more likely to have CI in MSA (OR = 4.298, 95% CI 1.456-12.691, P = 0.008) and MSA-P (OR = 6.952, 95% CI 1.390-34.774, P = 0.018), after adjusting for age, sex, educational years, disease duration, and total Unified multiple system atrophy rating scale scores. Conclusion: Multiple vascular risk factors had a cumulative impact on CI in MSA. Therefore, the comprehensive management of vascular risk factors in MSA should not be neglected.
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Affiliation(s)
- Lingyu Zhang
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yanbing Hou
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Bei Cao
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qian-Qian Wei
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ruwei Ou
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Kuncheng Liu
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Junyu Lin
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Tianmi Yang
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Xiao
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Zhao
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - HuiFang Shang
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Zhang Y, Li Y, Zheng X, Zhu L, Xu B. Association between alcohol consumption in midlife and cognitive function in old age: Findings from the China health and Nutrition Survey. Nutr Metab Cardiovasc Dis 2021; 31:3044-3053. [PMID: 34642057 DOI: 10.1016/j.numecd.2021.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Alcohol consumption has been reported to impair the physical and mental health of the elderly. This study aimed to explore the association between alcohol consumption patterns in midlife and cognition in the elderly among the Chinese population. METHODS AND RESULTS Study subjects were individuals aged ≥45 years in the shared database of the China Health and Nutrition Survey in 1997, who were followed up in 2006. A questionnaire was used to collect information about alcohol consumption (frequency, amount and type). Alcohol consumption (grams/week) was classified into none, light (≤84), light-to-moderate (84.01-168), moderate-to-heavy (168.01-336) and heavy (≥336.01) categories in men, and none, light (<42) and moderate (≥42) categories in women. Cognitive function was measured in 2006 using a subset of items from the modified Telephone Interview for Cognitive Status. The lowest quintile was used as the cut-off point for cognitive impairment. A multivariate logistic regression model was applied. The study involved 1926 participants with a mean age of 56.91 years, and men accounted for 51.66% of the total participants. Drinking behaviours and cognitive scores had significant sexual difference (P < 0.001). Cognitive impairment was identified in 135 men and 237 women. Compared with light drinking, heavy drinking and non-drinking were associated with cognitive impairment in men [adjusted odds ratio (aOR) and 95% CI were 2.19 (1.59-3.00), 1.54 (1.21-1.96), respectively; P < 0.001]. Compared with light drinkers, female non-drinkers and moderate drinkers were associated with cognitive impairment [aOR and 95% CI were 1.54 (1.16-2.03) and 1.75 (1.08-2.85), respectively; P < 0.001]. CONCLUSIONS Scientific evidence on the adverse effects of heavy drinking on elderly cognition and the possibly protective effects of light drinking could influence policy decisions on alcohol consumption in China.
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Affiliation(s)
- Yuge Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xubin Zheng
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Liping Zhu
- Shanghai Center for Women and Children's Health, Shanghai, China
| | - Biao Xu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
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Wu J, Cheng GHL, Sheng LT, Feng L, Yuan JM, Chee M, Pan A, Koh WP. Prospective associations between change in sleep duration and cognitive impairment: Findings from the Singapore Chinese Health Study. J Affect Disord 2021; 281:125-130. [PMID: 33316717 DOI: 10.1016/j.jad.2020.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The relation of changes in sleep duration with risk of cognitive impairment are inconclusive. This study evaluated the prospective relationships of changes in sleep duration with risk of cognitive impairment in Singapore Chinese. METHODS We used data from 16,948 Chinese men and women who were aged 45-74 years at baseline (1993-1998) during recruitment into the Singapore Chinese Health Study cohort. Daily sleep duration was assessed at baseline, follow-up 2 (2006 to 2010) and follow-up 3 interviews (2014-2016). Cognitive function was evaluated with a Singapore-Modified Mini-Mental State Examination at follow-up 3 interviews when participants were 61-96 years old. Multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence intervals (95% CIs) for cognitive impairment. RESULTS Of the 16,948 participants, 14.4% were defined to have cognitive impairment. Compared with 7 h/day sleep at both baseline and follow-up 2, the OR (95% CI) for cognitive impairment was 1.50 (1.04-2.16) for those who maintained long sleep duration (≥9 h/day), 2.18 (1.37-3.45) for those who prolonged sleep from short duration (≤5 h/day) to long duration (≥9 h/day), and 1.55 (1.20-2.02) for those who prolonged sleep from recommended duration (7 h/day) to long duration. The highest risk was observed in those who shortened sleep from long to short duration (2.93, 1.35-6.34). LIMITATIONS Measures of sleep were self-reported. CONCLUSIONS Substantial changes in sleep duration over time were associated with higher risks of cognitive impairment. The findings underscore the importance of maintaining optimal sleep duration for the prevention of cognitive impairment.
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Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Grand H-L Cheng
- School of Arts and Social Sciences, The Open University of Hong Kong, Hong Kong, China
| | - Li-Ting Sheng
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Chee
- Centre for Cognitive Neuroscience, Duke-NUS Medical School Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
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Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101826. [PMID: 31126049 PMCID: PMC6572418 DOI: 10.3390/ijerph16101826] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/11/2019] [Accepted: 05/17/2019] [Indexed: 12/17/2022]
Abstract
Purpose. This study investigated the effects of objective and subjective socioeconomic status (SES) indicators on two health behaviors, cigarette smoking and alcohol drinking, among African American older adults. Methods. This community-based study recruited 619 economically disadvantaged African American older adults (age ≥ 65 years) residing in South Los Angeles. Structured face-to-face interviews were conducted to collect data. Data on demographic factors (age and gender), subjective SES (financial difficulties), objective SES (educational attainment), living arrangement, marital status, healthcare access (insurance), and health (number of chronic medical conditions, self-rated health, sick days, depression, and chronic pain) and health behaviors (cigarette smoking and alcohol drinking) were collected from participants. Logistic regressions were used to analyze the data. Results. High financial difficulties were associated with higher odds of smoking cigarettes and drinking alcohol, independent of covariates. Educational attainment did not correlate with our outcomes. Similar patterns emerged for cigarette smoking and alcohol drinking. Conclusion. Subjective SES indicators such as financial difficulties may be more relevant than objective SES indicators such as educational attainment to health risk behaviors such as cigarette smoking and alcohol drinking among African American older adults in economically constrain urban environments. Smoking and drinking may serve as coping mechanisms with financial difficulty, especially among African American older adults. In line with the minorities' diminished returns (MDR) theory, and probably due to discrimination against racial minorities, educational attainment has a smaller protective effect among economically disadvantaged African American individuals against health risk behaviors.
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