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Jung D, Jin G, Choi J, Park S, Park K, Seo DG, Choi KH. Daily vitality fluctuations in older adults with depressive symptoms: A multilevel location-scale model. J Psychiatr Res 2024; 173:80-86. [PMID: 38513369 DOI: 10.1016/j.jpsychires.2024.03.008] [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: 09/14/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Examining the daily experiences of older adults with depression facilitates the development and application of personalized effective treatments for them. In previous clinical research on depression, traditional mean-based approaches have mainly been employed. However, the within-person residual variance as a random effect provides greater insight into the heterogeneity of daily experiences among geriatric samples. OBJECTIVE This study aimed to examine the relationship between depression and daily vitality in older adults. Specifically, it focused on the mean and residual variance of daily vitality measured by the Ecological Momentary Assessment (EMA). METHODS Data from 64 older adults aged 65 years or more, who participated in community welfare centers or retirees' associations, were used. Daily vitality was examined using EMA surveys for seven consecutive days (four random surveys per day). The data were analyzed using a location-scale model. RESULTS The intraclass correlation computed from the empty model for the EMA data was 0.488, indicating significant variances in daily vitality across time between individuals. Older adults with higher levels of depressive symptoms showed low mean levels of daily vitality and a large log-residual variance of daily vitality. CONCLUSIONS The findings from the current study suggest that individuals experiencing depression not only exhibit low vitality in their daily lives but also struggle to maintain stable levels of vitality in their lives. These insights could contribute to the facilitation and advancement of personalized interventions tailored for older adults.
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Affiliation(s)
- Dawoon Jung
- Department of Psychology, Korea University, Seoul, 02841, Republic of Korea
| | - Gihun Jin
- Department of Psychology, Hallym University, Chuncheon, 24252, Republic of Korea
| | - Juhee Choi
- Department of Psychology, Korea University, Seoul, 02841, Republic of Korea
| | - Soohyun Park
- Department of Psychology, Korea University, Seoul, 02841, Republic of Korea
| | - Kiho Park
- Department of Psychology, Korea University, Seoul, 02841, Republic of Korea
| | - Dong Gi Seo
- Department of Psychology, Hallym University, Chuncheon, 24252, Republic of Korea.
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Seoul, 02841, Republic of Korea; KU Mind Health Institute, Korea University, Seoul, 02841, Republic of Korea; Mindeep Cognitive Behavioral Therapy Center, Seoul, 06749, Republic of Korea.
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de Breij S, van Hout HPJ, de Bruin SR, Schuster NA, Deeg DJH, Huisman M, Hoogendijk EO. Predictors of Frailty and Vitality in Older Adults Aged 75 years and Over: Results from the Longitudinal Aging Study Amsterdam. Gerontology 2021; 67:69-77. [PMID: 33429387 DOI: 10.1159/000512049] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/17/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Frailty can be seen as a continuum, from fit to frail. While many recent studies have focused on frailty, much less attention has been paid to the other end of the continuum: the group of older adults that remain (relatively) vital. Moreover, there is a lack of studies on frailty and vitality that investigate predictors from multiple domains of functioning simultaneously. The aim of this study was to identify predictors of frailty as well as vitality among older adults aged 75 years and over. METHODS We used longitudinal data from 569 adults aged ≥75 years who participated in the Longitudinal Aging Study Amsterdam. Predictors from the sociodemographic, social, psychological, lifestyle, and physical domains of functioning were measured at T1 (2008-2009). We used the frailty index (FI) to identify frail (FI ≥ 0.25) and vital (FI ≤ 0.15) respondents at follow-up, 3 years later (T2: 2011-2012). We conducted logistic regression analyses with backward stepwise selection to develop and internally validate our prediction models. RESULTS The prevalence of frailty in our sample at follow-up was 49.4% and the prevalence of vitality was 18.3%. Predictors of frailty and vitality partly overlapped and included age, depressive symptoms, number of chronic diseases, and self-rated health. We also found predictors that did not overlap. Male sex, moderate alcohol use, more emotional support received, and no hearing problems, were predictors of vitality. Lower cognitive functioning, polypharmacy, and pain were predictors of frailty. The final model for vitality explained 42% of the variance and the final model for frailty explained 48%. Both models had a good discriminative value (area under ROC-curve [AUC] vitality: 0.88; AUC frailty: 0.85). CONCLUSION Among older adults aged 75 years and over, predictors of frailty only partially overlap with predictors of vitality. The readily accessible predictors in our models may help to identify older adults who are likely to be vital, or who are at risk of frailty.
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Affiliation(s)
- Sascha de Breij
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,
| | - Hein P J van Hout
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Simone R de Bruin
- RIVM National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| | - Noah A Schuster
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Serre-Miranda C, Roque S, Santos NC, Portugal-Nunes C, Costa P, Palha JA, Sousa N, Correia-Neves M. Effector memory CD4(+) T cells are associated with cognitive performance in a senior population. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2014; 2:e54. [PMID: 25566544 PMCID: PMC4277304 DOI: 10.1212/nxi.0000000000000054] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/18/2014] [Indexed: 01/24/2023]
Abstract
Objective: Immunosenescence and cognitive decline are common markers of the aging process. Taking into consideration the heterogeneity observed in aging processes and the recently described link between lymphocytes and cognition, we herein explored the possibility of an association between alterations in lymphocytic populations and cognitive performance. Methods: In a cohort of cognitively healthy adults (n = 114), previously characterized by diverse neurocognitive/psychological performance patterns, detailed peripheral blood immunophenotyping of both the innate and adaptive immune systems was performed by flow cytometry. Results: Better cognitive performance was associated with lower numbers of effector memory CD4+ T cells and higher numbers of naive CD8+ T cells and B cells. Furthermore, effector memory CD4+ T cells were found to be predictors of general and executive function and memory, even when factors known to influence cognitive performance in older individuals (e.g., age, sex, education, and mood) were taken into account. Conclusions: This is the first study in humans associating specific phenotypes of the immune system with distinct cognitive performance in healthy aging.
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Affiliation(s)
- Cláudia Serre-Miranda
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Susana Roque
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Joana Almeida Palha
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Margarida Correia-Neves
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
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Abstract
BACKGROUND The purpose of this study was to describe the longitudinal trajectories and bidirectional relationships of the physical-social and emotional functioning (EF) dimensions of positive aging and to identify their baseline characteristics. METHODS Women age 65 and older who enrolled in one or more Women's Health Initiative clinical trials (WHI CTs) and who had positive aging indicators measured at baseline and years 1, 3, 6, and 9 were included in these analyses (N = 2281). Analytic strategies included latent class growth modeling to identify longitudinal trajectories and multinomial logistic regression to examine the effects of baseline predictors on these trajectories. RESULTS A five-trajectory model was chosen to best represent the data. For Physical-Social Functioning (PSF), trajectory groups included Low Maintainer (8.3%), Mid-Low Improver (10.4%), Medium Decliner (10.7%), Mid-High Maintainer (31.2%), and High Maintainer (39.4%); for EF, trajectories included Low Maintainer (3%), Mid-Low Improver (9%), Medium Decliner (7.7%), Mid-High Maintainer (22.8%), and High Maintainer (57.5%). Cross-classification of the groups of trajectories demonstrated that the impact of a high and stable EF on PSF might be greater than the reverse. Low depression symptoms, low pain, and high social support were the most consistent predictors of high EF trajectories. CONCLUSION Aging women are heterogeneous in terms of positive aging indicators for up to 9 years of follow-up. Interventions aimed at promoting sustainable EF might have diffused effects on other domains of healthy aging.
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Santos NC, Costa PS, Cunha P, Portugal-Nunes C, Amorim L, Cotter J, Cerqueira JJ, Palha JA, Sousa N. Clinical, physical and lifestyle variables and relationship with cognition and mood in aging: a cross-sectional analysis of distinct educational groups. Front Aging Neurosci 2014; 6:21. [PMID: 24605100 PMCID: PMC3932406 DOI: 10.3389/fnagi.2014.00021] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/04/2014] [Indexed: 12/01/2022] Open
Abstract
It is relevant to unravel the factors that may mediate the cognitive decline observed during aging. Previous reports indicate that education has a positive influence on cognitive performance, while age, female gender and, especially, depressed mood were associated with poorer performances across multiple cognitive dimensions (memory and general executive function). Herein, the present study aimed to characterize the cognitive performance of community-dwelling individuals within distinct educational groups categorized by the number of completed formal school years: “less than 4,” “4, completed primary education,” and “more than 4.” Participants (n = 1051) were randomly selected from local health registries and representative of the Portuguese population for age and gender. Neurocognitive and clinical assessments were conducted in local health care centers. Structural equation modeling was used to derive a cognitive score, and hierarchical linear regressions were conducted for each educational group. Education, age and depressed mood were significant variables in directly explaining the obtained cognitive score, while gender was found to be an indirect variable. In all educational groups, mood was the most significant factor with effect on cognitive performance. Specifically, a depressed mood led to lower cognitive performance. The clinical disease indices cardiac and stroke associated with a more negative mood, while moderate increases in BMI, alcohol consumption and physical activity associated positively with improved mood and thus benefitted cognitive performance. Results warrant further research on the cause-effect (longitudinal) relationship between clinical indices of disease and risk factors and mood and cognition throughout aging.
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Affiliation(s)
- Nadine C Santos
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Patrício S Costa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Pedro Cunha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Centro Hospitalar do Alto Ave - EPE Guimarães, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Jorge Cotter
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Centro Hospitalar do Alto Ave - EPE Guimarães, Portugal
| | - João J Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Joana A Palha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
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Santos NC, Costa PS, Cunha P, Cotter J, Sampaio A, Zihl J, Almeida OFX, Cerqueira JJ, Palha JA, Sousa N. Mood is a key determinant of cognitive performance in community-dwelling older adults: a cross-sectional analysis. AGE (DORDRECHT, NETHERLANDS) 2013; 35:1983-1993. [PMID: 23054829 PMCID: PMC3776101 DOI: 10.1007/s11357-012-9482-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 09/25/2012] [Indexed: 05/27/2023]
Abstract
Identification of predictors of cognitive trajectories through the establishment of composite or single-parameter dimensional categories of cognition and mood may facilitate development of strategies to improve quality of life in the elderly. Participants (n = 487, aged 50+ years) were representative of the Portuguese population in terms of age, gender, and educational status. Cognitive and mood profiles were established using a battery of neurocognitive and psychological tests. Data were subjected to principal component analysis to identify core dimensions of cognition and mood, encompassing multiple test variables. Dimensions were correlated with age and with respect to gender, education, and occupational status. Cluster analysis was applied to isolate distinct patterns of cognitive performance and binary logistic regression models to explore interrelationships between aging, cognition, mood, and socio-demographic characteristics. Four main dimensions were identified: memory, executive function, global cognitive status, and mood. Based on these, strong and weak cognitive performers were distinguishable. Cluster analysis revealed further distinction within these two main categories into very good, good, poor, and very poor performers. Mood was the principal factor contributing to the separation between very good and good, as well as poor and very poor, performers. Clustering was also influenced by gender and education, albeit to a lesser extent; notably, however, female gender × lower educational background predicted significantly poorer cognitive performance with increasing age. Mood has a significant impact on the rate of cognitive decline in the elderly. Gender and educational level are early determinants of cognitive performance in later life.
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Affiliation(s)
- Nadine Correia Santos
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Patrício Soares Costa
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Pedro Cunha
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Centro Hospitalar do Alto Ave–EPE, 4810-055 Guimarães, Portugal
| | - Jorge Cotter
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Centro Hospitalar do Alto Ave–EPE, 4810-055 Guimarães, Portugal
| | - Adriana Sampaio
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal
| | - Joseph Zihl
- />Department of Psychology–Neuropsychology, University of Munich, D80802 Munich, Germany
- />Max-Planck Institute of Psychiatry, D80804 Munich, Germany
| | | | - João J Cerqueira
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Joana Almeida Palha
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Nuno Sousa
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
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Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev 2011; 12:e426-37. [PMID: 21348917 DOI: 10.1111/j.1467-789x.2010.00825.x] [Citation(s) in RCA: 554] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The relationship between body mass index (BMI) (in midlife and late-life) and dementia was investigated in meta-analyses of 16 articles reporting on 15 prospective studies. Follow-ups ranged from 3.2 to 36.0 years. Meta-analyses were conducted on samples including 25 624 participants evaluated for Alzheimer's disease (AD), 15 435 participants evaluated for vascular dementia (VaD) and 30 470 followed for any type of dementia (Any Dementia). Low BMI in midlife was associated with 1.96 [95% confidence interval (CI): 1.32, 2.92] times the risk of developing AD. The pooled relative risks for AD, VaD and Any Dementia for overweight BMI in midlife compared with normal BMI were 1.35 (95% CI:1.19, 1.54), 1.33 (95% CI: 1.02, 1.75) and 1.26 (95% CI: 1.10, 1.44), respectively. The pooled relative risks of AD and Any Dementia for obese BMI in midlife compared to normal BMI were 2.04 (95% CI: 1.59, 2.62) and 1.64 (95% CI: 1.34, 2.00), respectively. Continuous BMI in late-life was not associated with dementia. Small numbers of studies included in pooled analyses reduce generalizability of findings, and emphasize the need for publication of additional findings. We conclude that underweight, overweight and obesity in midlife increase dementia risk. Further research evaluating late-life BMI and dementia is required.
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Affiliation(s)
- K J Anstey
- Ageing Research Unit, Centre for Mental Health Research Medical School, Australian National University, Canberra, ACT, Australia.
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Strijk JE, Proper KI, Klaver L, van der Beek AJ, van Mechelen W. Associations between VO2max and vitality in older workers: a cross-sectional study. BMC Public Health 2010; 10:684. [PMID: 21062484 PMCID: PMC2992516 DOI: 10.1186/1471-2458-10-684] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 11/09/2010] [Indexed: 11/26/2022] Open
Abstract
Background To prevent early exit from work, it is important to study which factors contribute to healthy ageing. One concept that is assumed to be closely related to, and therefore may influence healthy ageing, is vitality. Vitality consists of both a mental and a physical component, and is characterised by a perceived high energy level, decreased feelings of fatigue, and feeling fit. Since VO2max gives an indication of one's aerobic fitness, which can be improved by increased levels of physical activity, and because feeling fit is one of the main characteristics of vitality, it is hypothesised that VO2max is related to vitality. Therefore, the aim of this study was to investigate the associations between VO2max and vitality. Methods In 427 older workers (aged 45 + years) participating in the Vital@Work study, VO2max was estimated at baseline using the 2-km UKK walk test. Vitality was measured by both the UWES Vitality Scale and the RAND-36 Vitality Scale. Associations were analysed using linear regression analyses. Results The linear regression models, adjusted for age, showed a significant association between VO2max and vitality measured with the RAND-36 Vitality Scale (β = 0.446; 95% CI: 0.220-0.673). There was no significant association between VO2max and vitality measured with the UWES (β = -0.006; 95% CI:-0.017 - 0.006), after adjusting for age, gender and chronic disease status. Conclusions VO2max was associated with a general measure of vitality (measured with the RAND-36 Vitality Scale), but not with occupational health related vitality (measured with the UWES Vitality Scale). The idea that physical exercise can be used as an effective tool for improving vitality was supported in this study. Trial registration NTR1240
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Affiliation(s)
- Jorien E Strijk
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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