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Ksinan AJ, Dalecká A, Court T, Pikhart H, Bobák M. Pulmonary function and trajectories of cognitive decline in aging population. Exp Gerontol 2024; 189:112386. [PMID: 38428543 DOI: 10.1016/j.exger.2024.112386] [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: 11/17/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The number of older people with cognitive impairment is increasing worldwide. Impaired lung function might be associated with cognitive decline in older age; however, results from large longitudinal studies are lacking. In this study, we examined the longitudinal associations between pulmonary function and the trajectories of cognitive decline using prospective population-based SHARE data from 14 countries. METHODS The analytic sample included N = 32,049 older adults (Mean age at baseline = 64.76 years). The dependent variable was cognitive performance, measured repeatedly across six waves in three domains: verbal fluency, memory, and numeracy. The main predictor of interest was peak expiratory flow (PEF). The data were analyzed in a multilevel accelerated longitudinal design, with models adjusted for a variety of covariates. RESULTS A lower PEF score was associated with lower cognitive performance for each domain as well as a lower global cognitive score. These associations remained statistically significant after adjusting for all covariates Q4 vs Q1 verbal fluency: unstandardized coefficient B = -3.15; numeracy: B = -0.52; memory: B = -0.64; global cognitive score B = -2.65, all p < .001). However, the PEF score was not found to be associated with the rate of decline for either of the cognitive outcomes. CONCLUSIONS In this large multi-national longitudinal study, the PEF score was independently associated with lower levels of cognitive functions, but it did not predict a future decline. The results suggest that pre-existing differences in lung functions are responsible for variability in cognitive functions and that these differences remained stable across aging.
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Affiliation(s)
- Albert J Ksinan
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.
| | - Andrea Dalecká
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Tatyana Court
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic; Department of Epidemiology & Public Health, University College London, Institute of Epidemiology and Health Care, London, UK
| | - Martin Bobák
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic; Department of Epidemiology & Public Health, University College London, Institute of Epidemiology and Health Care, London, UK
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Popiołek AK, Niznikiewicz MA, Borkowska A, Bieliński MK. Evaluation of Event-Related Potentials in Somatic Diseases - Systematic Review. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09642-5. [PMID: 38564137 DOI: 10.1007/s10484-024-09642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Many somatic illnesses (e.g. hypertension, diabetes, pulmonary and cardiac diseases, hepatitis C, kidney and heart failure, HIV infection, Sjogren's disease) may impact central nervous system functions resulting in emotional, sensory, cognitive or even personality impairments. Event-related potential (ERP) methodology allows for monitoring neurocognitive processes and thus can provide a valuable window into these cognitive processes that are influenced, or brought about, by somatic disorders. The current review aims to present published studies on the relationships between somatic illness and brain function as assessed with ERP methodology, with the goal to discuss where this field of study is right now and suggest future directions.
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Affiliation(s)
- Alicja K Popiołek
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland.
| | - Margaret A Niznikiewicz
- Medical Center, Harvard Medical School and Boston VA Healthcare System, Psychiatry 116a C/O R. McCarly 940 Belmont St, Brockton, MA, 02301, USA
| | - Alina Borkowska
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland
| | - Maciej K Bieliński
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland
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Ye Z, Li X, Lang H, Fang Y. Long-Term PM2.5 Exposure, Lung Function, and Cognitive Function Among Middle-Aged and Older Adults in China. J Gerontol A Biol Sci Med Sci 2023; 78:2333-2341. [PMID: 37493944 DOI: 10.1093/gerona/glad180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Long-term exposure to PM2.5 is related to poor lung function and cognitive impairment, but less is known about the pathway involved in this association. We aimed to explore whether the effect of PM2.5 on cognitive function was mediated by lung function. METHODS A total of 7 915 adults older than 45 years old were derived from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2011 and 2015. PM2.5 exposure was estimated using a geographically weighted regression model. Lung function was measured by peak expiratory flow (PEF). Cognitive function was evaluated through a structured questionnaire with 4 dimensions: episodic memory, attention, orientation, and visuoconstruction. Under the counterfactual framework, causal mediation analysis was applied to examine direct and indirect associations. RESULTS An interquartile range (IQR) increase in PM2.5 change was significantly related to an 8.480 (95% confidence interval [CI]: 3.116, 13.845) decrease in PEF change and a 0.301 (95% CI: 0.100, 0.575) decrease in global cognitive score change. The direct and indirect effects of PM2.5 exposure on global cognitive performance were -0.279 (95% CI: -0.551, -0.060) and -0.023 (95% CI: -0.041, -0.010), respectively. The proportion of the indirect effect was 7.48% (p = .010). The same significant association appeared in only 2 dimensions, episodic memory and attention, which were both mediated by PEF. CONCLUSIONS Lung function played a partially mediating role in the association between long-term PM2.5 exposure and cognition. More clean air actions should be undertaken to improve lung function and cognitive function in older adults.
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Affiliation(s)
- Zirong Ye
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Xueru Li
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Haoxiang Lang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
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Shrestha S, Zhu X, London SJ, Sullivan KJ, Lutsey PL, Windham BG, Griswold ME, Mosley TH. Association of Lung Function With Cognitive Decline and Incident Dementia in the Atherosclerosis Risk in Communities Study. Am J Epidemiol 2023; 192:1637-1646. [PMID: 37392093 DOI: 10.1093/aje/kwad140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/28/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023] Open
Abstract
We examined the associations between lung function and incident dementia and cognitive decline in 12,688 participants in the ARIC Study who provided lung function measurements in 1990-1992. Cognitive tests were administered up to 7 times, and dementia was ascertained through 2019. We used shared parameter models to jointly fit proportional hazard models and linear mixed-effect models to estimate lung-function-associated dementia rate and cognitive change, respectively. Higher forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were associated with reduced dementia (n = 2,452 persons developed dementia); hazard ratios per 1-L increase in FEV1 and FVC were 0.79 (95% confidence interval (CI): 0.71, 0.89) and 0.81 (95% CI: 0.74, 0.89), respectively. Each 1-L increase in FEV1 and FVC was associated with a 0.08-standard deviation (SD) (95% CI: 0.05, 0.12) and a 0.05-SD (95% CI: 0.02, 0.07) attenuation of 30-year cognitive decline, respectively. A 1% increase in FEV1/FVC ratio was associated with 0.008-SD (95% CI: 0.004, 0.012) less cognitive decline. We observed statistical interaction between FEV1 and FVC, suggesting that cognitive declines depended on values of specific FEV1 and FVC (as compared with FEV1, FVC, or FEV1/FVC ratio models that suggested linear incremental associations). Our findings may have important implications for reducing the burden of cognitive decline that is attributable to environmental exposures and associated lung function impairment.
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Siraj RA. Comorbid Cognitive Impairment in Chronic Obstructive Pulmonary Disease (COPD): Current Understanding, Risk Factors, Implications for Clinical Practice, and Suggested Interventions. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040732. [PMID: 37109690 PMCID: PMC10146750 DOI: 10.3390/medicina59040732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
Cognitive impairment is a common comorbidity in patients with COPD, significantly impacting health and clinical outcomes. Yet it remains under investigated and is largely overlooked. Although the exact cause of cognitive impairment in patients with COPD is still unclear, factors such as hypoxemia, vascular disease, smoking, exacerbation, and physical inactivity have been suggested. While international guidelines recommend identifying comorbidity in patients with COPD, such as cognitive impairment, cognitive assessment is not yet part of the routine assessment. Unidentified cognitive deficits in patients with COPD may have severe impacts on clinical management, resulting in an inability to maintain functional independence, poor self-management, and a greater dropout from pulmonary rehabilitation programs. There is a need to consider cognitive screening as a part of COPD assessment to promote early detection of cognitive impairment. Recognizing cognitive impairment early in the course of the illness allows the development of individualized interventions to meet patients' needs and improve clinical outcomes. Pulmonary rehabilitation should be tailored to cognitively impaired patients with COPD to maximize the benefits and minimize the incompletion rate.
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Affiliation(s)
- Rayan A Siraj
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
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Handing EP, Jiao Y, Aichele S. Age-Related Trajectories of General Fluid Cognition and Functional Decline in the Health and Retirement Study: A Bivariate Latent Growth Analysis. J Intell 2023; 11:65. [PMID: 37103250 PMCID: PMC10144147 DOI: 10.3390/jintelligence11040065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
There have been few studies on associations between age-related declines in fluid cognition and functional ability in population-representative samples of middle-aged and older adults. We used a two-stage process (longitudinal factor analysis followed by structural growth modeling) to estimate bivariate trajectories of age-related changes in general fluid cognition (numeracy, category fluency, executive functioning, and recall memory) and functional limitation (difficulties in daily activities, instrumental activities, and mobility). Data came from the Health and Retirement Study (Waves 2010-2016; N = 14,489; ages 50-85 years). Cognitive ability declined on average by -0.05 SD between ages 50-70 years, then -0.28 SD from 70-85 years. Functional limitation increased on average by +0.22 SD between ages 50-70 years, then +0.68 SD from 70-85 years. Significant individual variation in cognitive and functional changes was observed across age windows. Importantly, cognitive decline in middle age (pre-age 70 years) was strongly correlated with increasing functional limitation (r = -.49, p < .001). After middle age, cognition declined independently of change in functional limitation. To our knowledge, this is the first study to estimate age-related changes in fluid cognitive measures introduced in the HRS between 2010-2016.
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Affiliation(s)
| | - Yuqin Jiao
- Department of Human Development and Family Studies, Fort Collins, CO 80523, USA
| | - Stephen Aichele
- Department of Human Development and Family Studies, Fort Collins, CO 80523, USA
- Colorado School of Public Health, Fort Collins, CO 80523, USA
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Wiley E, Brooks D, MacDermid JC, Sakakibara B, Stratford PW, Tang A. Does peak expiratory flow moderate trajectories of cognitive function among individuals with lung diseases? A longitudinal analysis of the National Health and Aging Trends Study. Respir Med 2023; 207:107120. [PMID: 36646395 DOI: 10.1016/j.rmed.2023.107120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Impaired cognitive function can co-exist in chronic respiratory diseases. However, it is not clear if peak expiratory flow (PEF) impacts changes in cognitive function. Our objective was to explore whether peak expiratory flow moderates trajectories of memory, visuospatial abilities, and executive function in individuals with chronic respiratory diseases. METHODS This was an analysis of individuals with lung diseases from the National Health and Aging Trends Study. Multivariable-adjusted generalized linear mixed models were used to estimate trajectories of immediate and delayed recall, and clock drawing over a 10-year follow-up. The interaction between PEF and time were plotted using sex-specific values for peak expiratory flow at 10th, 50th and 90th percentiles. RESULTS In females, interactions of time-by-PEF were found for both immediate (n = 489, t = 2.73, p<0.01) and delayed recall (n = 489, t = 3.38, p<0.01). Females in the 10th vs. 90th percentile of PEF declined in immediate recall at 0.14 vs. 0.065 words/year, and 0.17 vs. 0.032 words/year for delayed recall. Among males, recall declined linearly over 10 years (immediate recall: n = 296, t = -3.08, p < 0.01; delayed recall: n = 292, t = -2.46, p = 0.02), with no interaction with PEF. There were no time-by-PEF interactions nor declines over time in clock drawing scores in both sexes (females: n = 484, t = 0.25, p = 0.81; males: n = 291, t = -0.61, p = 0.55). CONCLUSION Females with the lowest PEF values experienced the greatest rates of decline in immediate and delayed recall over 10 years of follow-up, whereas males experienced similar declines in memory outcomes across all levels of PEF. Clock drawing scores remained stable over 10 years in both sexes.
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Affiliation(s)
- Elise Wiley
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, M6M 2J5, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, M5G 1V7, Canada.
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada; School of Physical Therapy, Western University, London, ON, N6A 1H1, Canada.
| | - Brodie Sakakibara
- Department of Occupational Science & Occupational Therapy, Centre for Chronic Disease Prevention and Management, Southern Medical Program, University of British Columbia, Kelowna, BC, V1V 1V7, Canada.
| | - Paul W Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.
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Safran E, Ozer AY, Gurses HN. Do handgrip strength and dexterity predict respiratory function in neuromuscular disease? ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1141-1148. [PMID: 36577413 PMCID: PMC9797284 DOI: 10.1055/s-0042-1758757] [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] [Indexed: 12/29/2022]
Abstract
BACKGROUND Neuromuscular diseases are acquired or inherited diseases that affect the function of the muscles in our body, including respiratory muscles. OBJECTIVE We aimed to discover more cost-effective and practical tools to predict respiratory function status, which causes serious problems with patients with neuromuscular disease. METHODS The Vignos and Brooke Upper Extremity Functional Scales were used to evaluate functional status for patient recruitment. The handgrip strength and dexterity of patients were measured using a dynamometer and nine-hole peg test. Respiratory function parameters: forced vital capacity, forced expiratory volume in one second, and peak expiratory flow were evaluated using spirometry. RESULTS The mean age of the 30 patients was 11.5 ± 3.79 years old. Significant relationships were found between nine-hole-peg-test scores and respiratory function parameters on both sides. Significant correlations were found between both handgrip strength and respiratory function parameters (p < 0.05). In the linear regression analysis, it was seen that the forced expiratory volume in 1 second, and peak expiratory flow values could be explained in different percentages (p < 0.05). CONCLUSIONS Handgrip strength and dexterity measurements can be used as indicators for estimating respiratory function parameters in terms of cost and accessibility, although it is known that they will not replace respiratory function tests.
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Affiliation(s)
- Ertugrul Safran
- Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Aysel Yildiz Ozer
- Marmara University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Department of Cardiopulmonary Physiotherapy Rehabilitation, Istanbul, Turkey.,Address for correspondence Aysel Yildiz Ozer
| | - Hulya Nilgun Gurses
- Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Department of Cardiopulmonary Physiotherapy and Rehabilitation, Istanbul, Turkey.
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Wang J, Dove A, Song R, Qi X, Ma J, Bennett DA, Xu W. Poor pulmonary function is associated with mild cognitive impairment, its progression to dementia, and brain pathologies: A community-based cohort study. Alzheimers Dement 2022; 18:2551-2559. [PMID: 35184372 PMCID: PMC10078691 DOI: 10.1002/alz.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/10/2022] [Accepted: 01/25/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The relationship between pulmonary function (PF) and mild cognitive impairment (MCI), dementia, and brain pathologies remains unclear. METHODS A total of 1312 dementia-free participants, including a cognitively intact group (n = 985) and an MCI group (n = 327), were followed for up to 21 years to detect incident MCI and dementia. PF was assessed at baseline with a composite score and tertiled. Over follow-up, 540 participants underwent autopsies for neuropathological assessment. RESULTS Compared to the highest PF, the hazard ratios (95% confidence intervals [CIs]) of the lowest PF were 1.95 (1.43-2.66) for MCI in the cognitively intact group and 1.55 (1.03-2.33) for dementia in the MCI group. Low PF was further related to Alzheimer's disease pathology (odds ratio [OR] 1.32, 95% CI 1.19-1.47) and vascular pathology (OR 3.05, 95% CI 1.49-6.25). DISCUSSION Low PF increases MCI risk and accelerates MCI progression to dementia. Both neurodegenerative and vascular mechanisms may underlie the PF-dementia association.
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Affiliation(s)
- Jiao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Abigail Dove
- Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
| | - Ruixue Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shangdong University, Qilu Hospital of Shangdong University, Jinan, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Jun Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.,Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
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Richards M. The Power of Birth Cohorts to Study Risk Factors for Cognitive Impairment. Curr Neurol Neurosci Rep 2022; 22:847-854. [PMID: 36350423 PMCID: PMC9643995 DOI: 10.1007/s11910-022-01244-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE OF REVIEW Birth cohorts are studies of people the same time; some of which have continuously followed participants across the life course. These are powerful designs for studying predictors of age-related outcomes, especially when information on predictors is collected before these outcomes are known. This article reviews recent findings from these cohorts for the outcomes of cognitive function, cognitive impairment, and risk of dementia, in relation to prior cognitive function, and social and biological predictors. RECENT FINDINGS Cognitive function and impairment are predicted by a wide range of factors, including childhood cognition, education, occupational status and complexity, and biological factors, including genetic and epigenetic. The particular importance of high and rising blood pressure in midlife is highlighted, with some insight into brain mechanisms involved. Some limitations are noted, including sources of bias in the data. Despite these limitations, birth cohorts have provided valuable insights into factors across the life course associated with cognitive impairment.
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Affiliation(s)
- Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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Wang J, Song R, Dove A, Qi X, Ma J, Laukka EJ, Bennett DA, Xu W. Pulmonary function is associated with cognitive decline and structural brain differences. Alzheimers Dement 2022; 18:1335-1344. [PMID: 34590419 PMCID: PMC10085529 DOI: 10.1002/alz.12479] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 01/16/2023]
Abstract
The association of poor pulmonary function (PF) with cognitive trajectories and structural brain differences remains unclear. Within the Rush Memory and Aging Project, 1377 dementia-free subjects were followed up to 21 years. PF was assessed with a composite score measured at baseline. Global and domain-specific cognitive function was assessed annually constructed from 19 cognitive tests. A subsample of 351 participants underwent brain magnetic resonance imaging to investigate the cross-sectional association between PF and structural brain volumes. We found that low PF was related to faster decline in global cognition, and domain-specific function including episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed. In addition, low PF was associated with smaller volumes of total brain, white matter and gray matter, and larger white matter hyperintensities volume. Our results suggest that low PF is associated with faster cognitive decline, and both neurodegeneration and vascular brain lesions may underlie the association.
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Affiliation(s)
- Jiao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health
- Center for International Collaborative Research on Environment, Nutrition and Public Health
| | - Ruixue Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health
- Center for International Collaborative Research on Environment, Nutrition and Public Health
| | - Abigail Dove
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health
- Center for International Collaborative Research on Environment, Nutrition and Public Health
| | - Jun Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Erika J Laukka
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, 60612
| | - Weili Xu
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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12
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Handgrip Strength and Cognitive Function among Elderly Koreans: Insights from the Korean Longitudinal Study of Ageing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095262. [PMID: 35564655 PMCID: PMC9104585 DOI: 10.3390/ijerph19095262] [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: 03/25/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/21/2022]
Abstract
This study aims to assess handgrip strength as a predictor of cognitive decline within men and women in Korea. A random-intercept logistic regression is fit to estimate the status changes in cognitive function throughout all rounds of the KLoSA, a nationally-representative survey of adults aged 45 years and older. Males in the highest quartile were 71.9% less likely to experience cognitive impairment than those in the lowest quartile. The odds of cognitive impairment for men in the third and second quartiles reduced by 62.6% and 60.4% respectively. Similarly, the odds of cognitive impairment for women declined as 72.7%, 63.0%, and 41.8% for fourth, third, and second quartile, respectively, compared with the lowest quartile. These results imply that assessing and monitoring handgrip strength may enable us to identify subgroups of the elderly with higher likelihood of cognitive impairment in Korea.
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Krishna M, Majgi S, DU B, Krishnaveni GV, Veena SR, Prince M, Kumaran K, Christaprasad Karat S, Kumar M, Padukundru M, Nagaraj S, Fall CH. A lifecourse approach to the relationship between lung function and cognition function in late life: findings from the Mysore studies of Natal effect on Ageing and Health (MYNAH) in South India. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.16981.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Emerging evidence from high income settings indicates that lung function may be an independent determinant of cognitive abilities in late life. Despite a high burden of chronic lung disorders and neurocognitive disorders, there are limited data exploring the relationship between lung and cognitive function in later life in low- and middle-income (LMIC) settings. Methods: Between 2013 and 2016, 721 men and women from the Mysore Birth Records Cohort in South India, aged 55-80 years, were retraced and underwent standardised assessments for sociodemographic characteristics, cardiometabolic risk factors, lung function, cognitive function and mental health. Approximately 20 years earlier, a subset of them had assessments for cardiometabolic risk factors (n=522) and lung function (n=143). Results: Forced Expiratory Volume at one second (FEV1) and six seconds (FEV6) were higher among men than women. Women had higher immediate and delayed recall scores compared to men. Multivariate models indicated that those with lower FEV1 (lts) and FEV1/FEV6 ratio in late life had lower composite cognitive score (SD, standard deviation), independent of growth and environment in early life and childhood, attained education, socioeconomic position, cardiometabolic disorders in mid-and late life and lifestyle factors (0.29 SD per litre 95% confidence interval [CI] (0.10, 0.50) p=0.006 for FEV1 and 1.32 SD (0.20, 2.50) p=0.02 for FEV1/FEV6 ratio). Lung function in midlife was unrelated to cognitive outcomes in late life. Conclusions: Causality cannot be inferred from cross sectional associations. Therefore, causality is best explored in longitudinal studies with serial, but contemporaneous measurements of both lung and cognitive function. Mechanistic studies that examine the role of shared risk factors like environmental pollutants and biomass exposure on this relationship are urgently required in LMICs.
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Lai X, Sun J, He B, Li D, Wang S, Zhan S. Associations between pulmonary function and cognitive decline in the middle-aged and older adults: evidence from the China Health and Retirement Longitudinal Study. Environ Health Prev Med 2022; 27:48. [DOI: 10.1265/ehpm.22-00158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Xuefeng Lai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Jian Sun
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University
| | - Bingjie He
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Daowei Li
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Siyan Zhan
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University
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Poor Cognitive Function Is Associated with Obstructive Lung Diseases in Taiwanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052344. [PMID: 33673619 PMCID: PMC7957805 DOI: 10.3390/ijerph18052344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
Previous studies have reported an association between the impairment of cognitive performance and lung diseases. However, whether obstructive or restrictive lung diseases have an impact on cognitive function is still inconclusive. We aimed to investigate the association between cognitive function and obstructive or restrictive lung diseases in Taiwanese adults using the Mini-Mental State Examination (MMSE). In this study, we used data from the Taiwan Biobank. Cognitive function was evaluated using the MMSE. Spirometry measurements of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were obtained to assess lung function. Participants were classified into three groups according to lung function, namely, normal, restrictive, and obstructive lung function. In total, 683 patients enrolled, of whom 357 participants had normal lung function (52.3%), 95 had restrictive lung function (13.9%), and 231 had obstructive lung function (33.8%). Compared to the normal lung function group, the obstructive lung function group was associated with a higher percentage of cognitive impairment (MMSE < 24). In multivariable analysis, a low MMSE score was significantly associated with low FVC, low FEV1, and low FEV1/FVC. Furthermore, a low MMSE score was significantly associated with low FEV1 in the participants with FEV1/FVC < 70%, whereas MMSE was not significantly associated with FVC in the participants with FEV1/FVC ≥ 70%. Our results showed that a low MMSE score was associated with low FEV1, low FVC and low FEV1/FVC. Furthermore, a low MMSE score was associated with obstructive lung diseases but not with restrictive lung diseases.
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Duggan EC, Graham RB, Piccinin AM, Jenkins ND, Clouston S, Muniz-Terrera G, Hofer SM. Systematic Review of Pulmonary Function and Cognition in Aging. J Gerontol B Psychol Sci Soc Sci 2021; 75:937-952. [PMID: 30380129 DOI: 10.1093/geronb/gby128] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Substantial research is dedicated to understanding the aging-related dynamics among individual differences in level, change, and variation across physical and cognitive abilities. Evaluating replicability and synthesizing findings has been limited by differences in measurements, samples, study design, and statistical analyses that confound between-person differences with within-person changes. Here, we systematically reviewed longitudinal results on the aging-related dynamics linking pulmonary function and cognitive performance. METHODS Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were used to systematically review longitudinal studies of pulmonary function and cognition. RESULTS Only four studies thoroughly investigating cognitive and pulmonary longitudinal associations (three or more measurement occasions) were identified. Expanded review criteria identified three studies reporting two measurement occasions, and seven studies reporting one measurement of pulmonary function or cognition and two or more measurements of the other. We identified numerous methodological quality and risk for bias issues across studies. CONCLUSIONS Despite documented correlational associations between pulmonary function and cognition, these results show there is very limited research thoroughly investigating their longitudinal associations. This highlights the need for longitudinal data, rigorous methodological design including key covariates, and clear communication of methods and analyses to facilitate replication across an array of samples. We recommend systematic study of outcome measures and covariates, inclusion of multiple measures (e.g., peak expiratory flow, forced expiratory volume in 1 s, and forced vital capacity), as well as application of the same analytic approach across multiple datasets.
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Affiliation(s)
- Emily Clare Duggan
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Raquel B Graham
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
| | | | - Sean Clouston
- Department of Family, Population and Preventive Medicine, Stony Brook University, New York
| | | | - Scott M Hofer
- Department of Psychology, University of Victoria, British Columbia, Canada.,Department of Neurology, Oregon Health and Science University, Portland
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Ritchie SJ, Hill WD, Marioni RE, Davies G, Hagenaars SP, Harris SE, Cox SR, Taylor AM, Corley J, Pattie A, Redmond P, Starr JM, Deary IJ. Polygenic predictors of age-related decline in cognitive ability. Mol Psychiatry 2020; 25:2584-2598. [PMID: 30760887 PMCID: PMC7515838 DOI: 10.1038/s41380-019-0372-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/13/2018] [Accepted: 01/11/2019] [Indexed: 12/11/2022]
Abstract
Polygenic scores can be used to distil the knowledge gained in genome-wide association studies for prediction of health, lifestyle, and psychological factors in independent samples. In this preregistered study, we used fourteen polygenic scores to predict variation in cognitive ability level at age 70, and cognitive change from age 70 to age 79, in the longitudinal Lothian Birth Cohort 1936 study. The polygenic scores were created for phenotypes that have been suggested as risk or protective factors for cognitive ageing. Cognitive abilities within older age were indexed using a latent general factor estimated from thirteen varied cognitive tests taken at four waves, each three years apart (initial n = 1091 age 70; final n = 550 age 79). The general factor indexed over two-thirds of the variance in longitudinal cognitive change. We ran additional analyses using an age-11 intelligence test to index cognitive change from age 11 to age 70. Several polygenic scores were associated with the level of cognitive ability at age-70 baseline (range of standardized β-values = -0.178 to 0.302), and the polygenic score for education was associated with cognitive change from childhood to age 70 (standardized β = 0.100). No polygenic scores were statistically significantly associated with variation in cognitive change between ages 70 and 79, and effect sizes were small. However, APOE e4 status made a significant prediction of the rate of cognitive decline from age 70 to 79 (standardized β = -0.319 for carriers vs. non-carriers). The results suggest that the predictive validity for cognitive ageing of polygenic scores derived from genome-wide association study summary statistics is not yet on a par with APOE e4, a better-established predictor.
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Affiliation(s)
- Stuart J Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK.
- Department of Psychology, The University of Edinburgh, Edinburgh, UK.
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK.
| | - W David Hill
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Riccardo E Marioni
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Sarah E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Adele M Taylor
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Janie Corley
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
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18
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Qiao H, Chen M, Li S, Li Y, Sun Y, Wu Y. Poor lung function accelerates cognitive decline in middle-aged and older adults: Evidence from the English Longitudinal Study of Ageing. Arch Gerontol Geriatr 2020; 90:104129. [DOI: 10.1016/j.archger.2020.104129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 12/22/2022]
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19
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Kim Y, Lee H, Son TO, Jang H, Cho SH, Kim SE, Kim SJ, Lee JS, Kim JP, Jung YH, Lockhart SN, Kim HJ, Na DL, Park HY, Seo SW. Reduced forced vital capacity is associated with cerebral small vessel disease burden in cognitively normal individuals. NEUROIMAGE-CLINICAL 2019; 25:102140. [PMID: 31896465 PMCID: PMC6940695 DOI: 10.1016/j.nicl.2019.102140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 12/13/2019] [Accepted: 12/21/2019] [Indexed: 01/18/2023]
Abstract
Decreased FVC (% pred) was associated with increased cerebral small vessel disease burden even in cognitively normal subjects. This reduced lung function was related to low Mini-Mental Status Examination (MMSE) scores in cognitively normal subjects. Path analyses showed that white matter hyperintensities partially mediated the positive relationship between FVC (% pred) and MMSE score. There was no significant association between low FVC (% pred) and cortical thickness in cognitively normal subjects.
Background Pulmonary dysfunction is associated with elevated risk of cognitive decline. However, the mechanism underlying this relationship has not been fully investigated. In this study, we investigate the relationships between pulmonary function, cerebral small vessel disease (CSVD) markers, cortical thickness, and the Mini-Mental Status Examination (MMSE) scores in cognitively normal individuals. Methods We used a cross-sectional study design. We identified 1924 patients who underwent pulmonary function testing, three-dimensional brain magnetic resonance imaging (MRI), and the MMSE. Pulmonary function was analyzed according to the quintiles of percentage predicted values (% pred) for forced vital capacity (FVC) or forced expiratory volume in 1 s (FEV1). Regarding CSVD markers, we visually rated white matter hyperintensities (WMH) and manually counted lacunes and microbleeds. Cortical thickness was measured by surface-based methods. Results Compared with the highest quintile of FVC, the lowest quintile of FVC (% pred) showed a higher risk of WMH (OR 1.98, 95% CI: 1.21–3.24) and lacunes (OR 1.86, 95% CI: 1.12–3.08). There were no associations between FVC or FEV1 and cortical thickness. Low FVC, but not FEV1, was associated with low MMSE scores. Path analyses showed that WMH partially mediated the positive relationship between FVC (% pred) and MMSE score. Conclusions Our findings suggested that decreased pulmonary function was associated with increased CSVD burdens, which in turn wass associated with decreased cognition, even in cognitively normal subjects.
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Affiliation(s)
- Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, South Korea
| | - Tea Ok Son
- Cheongju Samsung Rehabilitation Hospital, Cheongju, South Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Si Eun Kim
- Departments of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeonsang National University Changwon Hospital, Changwon, South Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Seoul, South Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University Medical Center, Republic of Korea
| | - Samuel N Lockhart
- Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Republic of Korea
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Kangnam-ku, Seoul 06351, South Korea.
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
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Lutsey PL, Chen N, Mirabelli MC, Lakshminarayan K, Knopman DS, Vossel KA, Gottesman RF, Mosley TH, Alonso A. Impaired Lung Function, Lung Disease, and Risk of Incident Dementia. Am J Respir Crit Care Med 2019; 199:1385-1396. [PMID: 30433810 PMCID: PMC6543713 DOI: 10.1164/rccm.201807-1220oc] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/14/2018] [Indexed: 12/17/2022] Open
Abstract
Rationale: Growing evidence suggests that compromised lung health may be linked to dementia and worsening cognitive ability. Objectives: To test the hypothesis that impaired lung function or lung disease in midlife is associated with greater risk of incident dementia and mild cognitive impairment (MCI) later in life. Methods: A total of 14,184 Atherosclerosis Risk in Communities study participants who underwent spirometry and were asked about lung health (1987-1989) were followed. Dementia and MCI were defined by hospitalization diagnosis codes (1987-2013) in the whole cohort and with adjudication among 42% who attended a comprehensive neurocognitive examination (2011-2013). Measurements and Main Results: In analysis using adjudicated outcomes, odds of dementia or MCI were higher among participants with restrictive (multivariable-adjusted odds ratio, 1.58; 95% confidence interval, 1.14-2.19) and obstructive lung disease (multivariable-adjusted odds ratio, 1.33; 95% confidence interval, 1.07-1.64), compared with those without disease or respiratory symptoms. Associations were similar in analyses restricted to nonsmokers, and present for both Alzheimer's disease-related dementia and cerebrovascular etiologies. Low FEV1% predicted and FVC% predicted were also associated with increased dementia risk. Conclusions: Midlife lung disease and reduced lung function were associated with modestly increased odds of dementia and MCI later in life. Magnitudes of association were more pronounced for restrictive impairment than for obstructive lung disease. These associations were present in smokers and nonsmokers. If the observed associations are causal, policy and public health efforts to reduce smoking and improve air quality may have the added benefit of preventing the development of dementia and MCI.
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Affiliation(s)
- Pamela L. Lutsey
- Division of Epidemiology & Community Health, School of Public Health, and
| | | | - Maria C. Mirabelli
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kamakshi Lakshminarayan
- Division of Epidemiology & Community Health, School of Public Health, and
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota
| | | | - Keith A. Vossel
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota
| | | | - Thomas H. Mosley
- Department of Geriatrics/Gerontology and
- Department of Neurology, University of Mississippi Medical Center, Jackson, Mississippi
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Xin H, Li H, Yu H, Yu J, Zhang J, Wang W, Peng D. Disrupted resting-state spontaneous neural activity in stable COPD. Int J Chron Obstruct Pulmon Dis 2019; 14:499-508. [PMID: 30880940 PMCID: PMC6398400 DOI: 10.2147/copd.s190671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction and aim Abnormal brain structure and function in COPD has been reported on MRI. However, the deficit in local synchronization of spontaneous activity in patients with stable COPD remains unknown. The main aim of the present study was to explore spontaneous brain activity in patients with COPD compared with normal controls using the regional homogeneity (ReHo) method based on resting-state functional MRI. Methods Nineteen patients with stable COPD and 20 well-matched (including age, sex, and number of years of education) normal controls who were recruited for the present study underwent resting-state functional MRI examinations and a series of neuropsychological and clinical assessments. The ReHo method was used to assess the strength of local brain signal synchrony. The mean ReHo values in brain areas with abnormal ReHo were evaluated with a receiver operating characteristic curve. The relationships between the brain regions with altered ReHo values and the clinical and neuropsychological parameters in COPD patients were assessed using Pearson’s correlation. Results Patients with COPD showed significantly lower ReHo values in the left occipital lobe and the right lingual, bilateral precuneus, and right precentral gyrus. The result of receiver operating characteristic curve analysis showed that the altered average ReHo values have high efficacy for distinguishing function. The mean lower ReHo values in the precuneus gyrus showed a significant positive correlation with FEV1%, FEV1/FVC, and orientation function but a significant negative correlation with arterial partial pressure of carbon dioxide. Conclusion The COPD patients demonstrated abnormal synchrony of regional spontaneous activity, and the regions with abnormal activity were all correlated with visual processing pathways, which might provide us with a new perspective to further understand the underlying pathophysiology of cognitive impairment in patients with COPD.
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Affiliation(s)
- Huizhen Xin
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Haijun Li
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Honghui Yu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Jingjing Yu
- Department of Respiratory, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Juan Zhang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Wenjing Wang
- Department of Respiratory, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Dechang Peng
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
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22
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Bowdish DM. The Aging Lung. Chest 2019; 155:391-400. [DOI: 10.1016/j.chest.2018.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/13/2018] [Accepted: 09/05/2018] [Indexed: 02/07/2023] Open
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23
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Association of chronic obstructive pulmonary disease with mild cognitive impairment and dementia. Curr Opin Pulm Med 2019; 24:173-178. [PMID: 29232279 DOI: 10.1097/mcp.0000000000000458] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW As age expectancy increases, both dementia and chronic obstructive pulmonary disease (COPD) have become more prevalent. Dementia and COPD together, however, occur more commonly than would be predicted from the incidence of either alone, suggesting a link between these two common senescent diseases. The purpose of this article is to review the extant literature and report findings in a clinically meaningful manner. We will look at the level of evidence, the risk factors for co-occurrence of the two diseases and the differential effects upon cognitive domains in the population with dementia and COPD. RECENT FINDINGS Cognitive impairment in patients with COPD may be 'dose-dependent' with the duration of COPD. Patients with COPD appear to develop nonamnestic mild cognitive impairment (MCI) as opposed to amnestic MCI. Newer studies exploring the impact of oxygen therapy and pulmonary rehabilitation upon cognitive function have reported some positive findings. SUMMARY Higher prevalence of MCI/dementia is seen in patients with COPD compared with age-matched controls. Imaging findings and dementia/MCI biomarkers provide preliminary evidence for an indirect association of the two conditions. Although no causality can be drawn with the available data, there is some indication that the severity of hypoxemia correlates with the severity of cognitive dysfunction.
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Cahana-Amitay D, Lee LO, Spiro A, Albert ML. Breathe Easy, Speak Easy: Pulmonary Function and Language Performance in Aging. Exp Aging Res 2018; 44:351-368. [PMID: 30355179 PMCID: PMC6205719 DOI: 10.1080/0361073x.2018.1521374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND This study explored the association between pulmonary function (PF) and older adults' language performance accuracy. Study rationale was anchored in aging research reporting PF as a reliable risk factor affecting cognition among the elderly. METHODS 180 adult English native speakers aged 55 to 84 years participated in the study. PF was measured through forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio (FFR). Language performance was assessed with an action naming test and an object naming test, and two tests of sentence comprehension, one manipulating syntactic complexity and the other, semantic negation. Greater PF was predicted to be positively associated with all tasks. RESULTS Unadjusted models revealed FVC and FEV1 effects on language performance among older adults. Participants with higher FVC showed better naming on both tasks and those with higher FEV1 had better object naming only. In covariate-adjusted models, only a positive FVC-object naming association remained. CONCLUSION Findings were discussed in terms of brain oxygenation mechanisms, whereby good PF may implicate efficient oxygenation, supporting neurotransmitter metabolism that protects against neural effects of cerebrovascular risk. Effects on object naming were linked to putative differential oxygenation demands across language tasks.
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Affiliation(s)
- Dalia Cahana-Amitay
- Veterans Affairs Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118
| | - Lewina O. Lee
- Veterans Affairs Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130
- Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA 02118
| | - Avron Spiro
- Veterans Affairs Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130
- Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA 02118
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118
| | - Martin L. Albert
- Veterans Affairs Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118
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Sorrentino P, Nieboer D, Twisk JWR, Stam CJ, Douw L, Hillebrand A. The Hierarchy of Brain Networks Is Related to Insulin Growth Factor-1 in a Large, Middle-Aged, Healthy Cohort: An Exploratory Magnetoencephalography Study. Brain Connect 2018; 7:321-330. [PMID: 28520468 DOI: 10.1089/brain.2016.0469] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Recently, a large study demonstrated that lower serum levels of insulin growth factor-1 (IGF-1) relate to brain atrophy and to a greater risk for developing Alzheimer's disease in a healthy elderly population. We set out to test if functional brain networks relate to IGF-1 levels in the middle aged. Hence, we studied the association between IGF-1 and magnetoencephalography-based functional network characteristics in a middle-aged population. The functional connections between brain areas were estimated for six frequency bands (delta, theta, alpha1, alpha2, beta, gamma) using the phase lag index. Subsequently, the topology of the frequency-specific functional networks was characterized using the minimum spanning tree. Our results showed that lower levels of serum IGF-1 relate to a globally less integrated functional network in the beta and theta band. The associations remained significant when correcting for gender and systemic effects of IGF-1 that might indirectly affect the brain. The value of this exploratory study is the demonstration that lower levels of IGF-1 are associated with brain network topology in the middle aged.
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Affiliation(s)
- Pierpaolo Sorrentino
- 1 Department of Clinical Neurophysiology and MEG Center, VU University Medical Center , Amsterdam, The Netherlands .,2 Istituto di Diagnosi e Cura Hermitage Capodimonte , Naples, Italy
| | - Dagmar Nieboer
- 3 Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam , Amsterdam, The Netherlands
| | - Jos W R Twisk
- 4 Department of Epidemiology and Biostatistics, VU University Medical Center , Amsterdam, The Netherlands
| | - Cornelis J Stam
- 1 Department of Clinical Neurophysiology and MEG Center, VU University Medical Center , Amsterdam, The Netherlands
| | - Linda Douw
- 5 Department of Anatomy and Neurosciences, VU University Medical Center , Amsterdam, The Netherlands .,6 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging/Massachusetts General Hospital , Boston, Massachusetts
| | - Arjan Hillebrand
- 1 Department of Clinical Neurophysiology and MEG Center, VU University Medical Center , Amsterdam, The Netherlands
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Hüls A, Vierkötter A, Sugiri D, Abramson MJ, Ranft U, Krämer U, Schikowski T. The role of air pollution and lung function in cognitive impairment. Eur Respir J 2018; 51:51/2/1701963. [DOI: 10.1183/13993003.01963-2017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/19/2017] [Indexed: 11/05/2022]
Abstract
Air pollution has been associated with impaired lung and cognitive function, especially impairment in visuo-construction performance (VCP). In this article, we evaluate whether the effect of air pollution on VCP is mediated by lung function.We used data from the SALIA cohort (baseline 1985–1994 and follow-up 2007–2010) including 587 women aged 55 years at baseline. Particulate matter (PM) and nitrogen dioxide (NO2) exposures at baseline were estimated via land-use regression models. Lung function was characterised by averages between baseline and follow-up. We used age- and height-controlled Global Lung Initiative (GLI) z-scores of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC. VCP was assessed at follow-up with the CERAD-Plus neuropsychological test battery and causal mediation analysis was conducted.An increase of one interquartile range in FEV1 and FVC was positively associated with VCP (β=0.18 (95% CI 0.02–0.34) and β=0.23 (95% CI 0.07–0.39), respectively). The proportion of the association between NO2 on VCP mediated by FEV1 was 6.2% and this was higher in never smokers (7.2%) and non-carriers of the APOE-ε4 allele (11.2%). However, none of the mediations were statistically significant.In conclusion, air pollution associated VCP was partially mediated by lung function. Further studies on the mechanisms underlying this pathway are required to develop new strategies to prevent air pollution induced cognitive impairment.
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Aiken-Morgan AT, Gamaldo AA, Wright RS, Allaire JC, Whitfield KE. Stability and Change in Cognitive Status Classification of Black Older Adults. J Am Geriatr Soc 2017; 66:179-183. [PMID: 29194573 DOI: 10.1111/jgs.15225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this study was to determine whether stability and change in cognitive status are associated with sociodemographic characteristics and health function. DESIGN Secondary analysis of data. SETTING Baltimore Study of Black Aging-Patterns of Cognitive Aging. PARTICIPANTS Community-dwelling black adults (N = 407; mean age 68.6 ± 9.1). MEASUREMENTS Baseline (n = 602) and 33-month follow-up (n = 450) assessments of cognition, health, and psychosocial function. RESULTS For the present analyses, participants were grouped as being cognitively normal (n = 249), having stable mild cognitive impairment (MCI) (n = 32), or being MCI converters (n = 72; normal at baseline, MCI at follow-up) or reverters (n = 54; MCI at baseline, normal at follow-up). Multivariate analysis of variance showed that the groups differed significantly in education and lung function (P < .010). Post hoc analyses indicated that converters had fewer years of education than the other groups, whereas those who were cognitively normal had better lung function than converters and reverters (P < .050). CONCLUSION These results suggest that education and lung health are associated with patterns of cognitive status change and stability. Future research should account for sociodemographic and health factors when examining stability of cognitive status classifications.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Department of Psychology, North Carolina A&T State University, Greensboro, North Carolina.,Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina
| | - Alyssa A Gamaldo
- Human Development and Family Studies, Pennsylvania State University, State College, Pennsylvania
| | | | - Jason C Allaire
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
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Sumida K, Kwak L, Grams ME, Yamagata K, Punjabi NM, Kovesdy CP, Coresh J, Matsushita K. Lung Function and Incident Kidney Disease: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis 2017; 70:675-685. [PMID: 28754455 PMCID: PMC5651181 DOI: 10.1053/j.ajkd.2017.05.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/22/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Reduced lung function is associated with clinical outcomes such as cardiovascular disease. However, little is known about its association with incident end-stage renal disease (ESRD) and chronic kidney disease (CKD). STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS 14,946 participants aged 45 to 64 years at baseline (1987-1989) in the Atherosclerosis Risk in Communities (ARIC) Study (45.0% men and 25.2% black), with follow-up through 2012. PREDICTORS Race- and sex-specific quartiles of percent-predicted forced vital capacity (FVC) and the proportion of forced expiratory volume in 1 second of expiration to FVC (FEV1/FVC) at baseline determined with spirometry. OUTCOMES Incident ESRD (defined here as renal replacement therapy or death due to CKD) as the primary outcome and incident CKD (defined here as ESRD, ≥25% decline in estimated glomerular filtration rate to a level <60mL/min/1.73m2, or CKD-related hospitalizations/deaths) as the secondary outcome. RESULTS During a median follow-up of 23.6 years, 526 (3.5%) participants developed ESRD. After adjusting for potential confounders, the cause-specific HR of incident ESRD for the lowest (vs highest) quartile was 1.72 (95% CI, 1.31-2.26) for percent-predicted FVC and 1.33 (95% CI, 1.03-1.73) for FEV1/FVC. Compared to a high-normal lung function pattern, a mixed pattern (ie, percent-predicted FVC<80% and FEV1/FVC<70%; 3.4% of participants) demonstrated the highest adjusted cause-specific HR of ESRD at 2.28 (95% CI, 1.50-3.45), followed by the restrictive pattern (ie, percent-predicted FVC<80% and FEV1/FVC≥70%; 4.8% of participants) at 2.03 (95% CI, 1.47-2.81), obstructive pattern (ie, percent-predicted FVC≥80% and FEV1/FVC<70%; 18.9% of participants) at 1.47 (95% CI, 1.09-1.99), and low-normal pattern (ie, percent-predicted FVC 80%-<100% and FEV1/FVC≥70%, or percent-predicted FVC≥80% and FEV1/FVC 70%-<75%; 44.3% of participants) at 1.21 (95% CI, 0.94-1.55). Similar associations were seen with incident CKD. LIMITATIONS Limited number of participants with moderate/severe lung dysfunction and spirometry only at baseline. CONCLUSIONS Reduced lung function, particularly lower percent-predicted FVC, is independently associated with CKD progression. Our findings suggest a potential pathophysiologic contribution of reduced lung function to the development of CKD and a need for monitoring kidney function in persons with reduced lung function.
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Affiliation(s)
- Keiichi Sumida
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN; Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Lucia Kwak
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Morgan E Grams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Naresh M Punjabi
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Csaba P Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Calvin CM, Batty GD, Der G, Brett CE, Taylor A, Pattie A, Čukić I, Deary IJ. Childhood intelligence in relation to major causes of death in 68 year follow-up: prospective population study. BMJ 2017; 357:j2708. [PMID: 28659274 PMCID: PMC5485432 DOI: 10.1136/bmj.j2708] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 01/02/2023]
Abstract
Objectives To examine the association between intelligence measured in childhood and leading causes of death in men and women over the life course.Design Prospective cohort study based on a whole population of participants born in Scotland in 1936 and linked to mortality data across 68 years of follow-up.Setting Scotland.Participants 33 536 men and 32 229 women who were participants in the Scottish Mental Survey of 1947 (SMS1947) and who could be linked to cause of death data up to December 2015.Main outcome measures Cause specific mortality, including from coronary heart disease, stroke, specific cancer types, respiratory disease, digestive disease, external causes, and dementia.Results Childhood intelligence was inversely associated with all major causes of death. The age and sex adjusted hazard ratios (and 95% confidence intervals) per 1 SD (about 15 points) advantage in intelligence test score were strongest for respiratory disease (0.72, 0.70 to 0.74), coronary heart disease (0.75, 0.73 to 0.77), and stroke (0.76, 0.73 to 0.79). Other notable associations (all P<0.001) were observed for deaths from injury (0.81, 0.75 to 0.86), smoking related cancers (0.82, 0.80 to 0.84), digestive disease (0.82, 0.79 to 0.86), and dementia (0.84, 0.78 to 0.90). Weak associations were apparent for suicide (0.87, 0.74 to 1.02) and deaths from cancer not related to smoking (0.96, 0.93 to 1.00), and their confidence intervals included unity. There was a suggestion that childhood intelligence was somewhat more strongly related to coronary heart disease, smoking related cancers, respiratory disease, and dementia in women than men (P value for interactions <0.001, 0.02, <0.001, and 0.02, respectively).Childhood intelligence was related to selected cancer presentations, including lung (0.75, 0.72 to 0.77), stomach (0.77, 0.69 to 0.85), bladder (0.81, 0.71 to 0.91), oesophageal (0.85, 0.78 to 0.94), liver (0.85, 0.74 to 0.97), colorectal (0.89, 0.83 to 0.95), and haematopoietic (0.91, 0.83 to 0.98). Sensitivity analyses on a representative subsample of the cohort observed only small attenuation of the estimated effect of intelligence (by 10-26%) after adjustment for potential confounders, including three indicators of childhood socioeconomic status. In a replication sample from Scotland, in a similar birth year cohort and follow-up period, smoking and adult socioeconomic status partially attenuated (by 16-58%) the association of intelligence with outcome rates.Conclusions In a whole national population year of birth cohort followed over the life course from age 11 to age 79, higher scores on a well validated childhood intelligence test were associated with lower risk of mortality ascribed to coronary heart disease and stroke, cancers related to smoking (particularly lung and stomach), respiratory diseases, digestive diseases, injury, and dementia.
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Affiliation(s)
- Catherine M Calvin
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - G David Batty
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Department of Epidemiology and Public Health, University College London
| | - Geoff Der
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G2 3QB
| | - Caroline E Brett
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Natural Sciences and Psychology, Liverpool John Moores University, Tom Reilly Building, Liverpool, L3 3AF, UK
| | - Adele Taylor
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Alison Pattie
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Iva Čukić
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Ian J Deary
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
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Lane CA, Parker TD, Cash DM, Macpherson K, Donnachie E, Murray-Smith H, Barnes A, Barker S, Beasley DG, Bras J, Brown D, Burgos N, Byford M, Jorge Cardoso M, Carvalho A, Collins J, De Vita E, Dickson JC, Epie N, Espak M, Henley SMD, Hoskote C, Hutel M, Klimova J, Malone IB, Markiewicz P, Melbourne A, Modat M, Schrag A, Shah S, Sharma N, Sudre CH, Thomas DL, Wong A, Zhang H, Hardy J, Zetterberg H, Ourselin S, Crutch SJ, Kuh D, Richards M, Fox NC, Schott JM. Study protocol: Insight 46 - a neuroscience sub-study of the MRC National Survey of Health and Development. BMC Neurol 2017; 17:75. [PMID: 28420323 PMCID: PMC5395844 DOI: 10.1186/s12883-017-0846-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/21/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Increasing age is the biggest risk factor for dementia, of which Alzheimer's disease is the commonest cause. The pathological changes underpinning Alzheimer's disease are thought to develop at least a decade prior to the onset of symptoms. Molecular positron emission tomography and multi-modal magnetic resonance imaging allow key pathological processes underpinning cognitive impairment - including β-amyloid depostion, vascular disease, network breakdown and atrophy - to be assessed repeatedly and non-invasively. This enables potential determinants of dementia to be delineated earlier, and therefore opens a pre-symptomatic window where intervention may prevent the onset of cognitive symptoms. METHODS/DESIGN This paper outlines the clinical, cognitive and imaging protocol of "Insight 46", a neuroscience sub-study of the MRC National Survey of Health and Development. This is one of the oldest British birth cohort studies and has followed 5362 individuals since their birth in England, Scotland and Wales during one week in March 1946. These individuals have been tracked in 24 waves of data collection incorporating a wide range of health and functional measures, including repeat measures of cognitive function. Now aged 71 years, a small fraction have overt dementia, but estimates suggest that ~1/3 of individuals in this age group may be in the preclinical stages of Alzheimer's disease. Insight 46 is recruiting 500 study members selected at random from those who attended a clinical visit at 60-64 years and on whom relevant lifecourse data are available. We describe the sub-study design and protocol which involves a prospective two time-point (0, 24 month) data collection covering clinical, neuropsychological, β-amyloid positron emission tomography and magnetic resonance imaging, biomarker and genetic information. Data collection started in 2015 (age 69) and aims to be completed in 2019 (age 73). DISCUSSION Through the integration of data on the socioeconomic environment and on physical, psychological and cognitive function from 0 to 69 years, coupled with genetics, structural and molecular imaging, and intensive cognitive and neurological phenotyping, Insight 46 aims to identify lifetime factors which influence brain health and cognitive ageing, with particular focus on Alzheimer's disease and cerebrovascular disease. This will provide an evidence base for the rational design of disease-modifying trials.
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Affiliation(s)
- Christopher A. Lane
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Thomas D. Parker
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Dave M. Cash
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Kirsty Macpherson
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Elizabeth Donnachie
- Leonard Wolfson Experimental Neurology Centre, Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Anna Barnes
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Suzie Barker
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Daniel G. Beasley
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Jose Bras
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - David Brown
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Ninon Burgos
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | | | - M. Jorge Cardoso
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Ana Carvalho
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Jessica Collins
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Enrico De Vita
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - John C. Dickson
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Norah Epie
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Miklos Espak
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Susie M. D. Henley
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Chandrashekar Hoskote
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Michael Hutel
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Jana Klimova
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Ian B. Malone
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Pawel Markiewicz
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Andrew Melbourne
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Marc Modat
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Anette Schrag
- Department of Clinical Neuroscience, Institute of Neurology, University College London, London, UK
| | - Sachit Shah
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - Nikhil Sharma
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Carole H. Sudre
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - David L. Thomas
- Leonard Wolfson Experimental Neurology Centre, Institute of Neurology, University College London, London, UK
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image Computing, University College London, London, UK
| | - John Hardy
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Nick C. Fox
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Jonathan M. Schott
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
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Brunner EJ, Welch CA, Shipley MJ, Ahmadi-Abhari S, Singh-Manoux A, Kivimäki M. Midlife Risk Factors for Impaired Physical and Cognitive Functioning at Older Ages: A Cohort Study. J Gerontol A Biol Sci Med Sci 2017; 72:237-242. [PMID: 27271050 PMCID: PMC5233910 DOI: 10.1093/gerona/glw092] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/28/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Previous studies examined midlife risk factors separately for old-age impaired physical and cognitive functioning. We determined the overlap of risk factors for both domains of functioning within the same setting. METHODS Biological and behavioral risk factors at age 50 years and cognitive and physical functioning were assessed 18 (SD = 5) years later in the Whitehall II study (N = 6,316). Impaired physical functioning was defined as ≥1 limitation on the activities of daily living scale. Impaired cognitive functioning was defined as Mini-Mental State Examination score <27. Two statistical analyses were employed: minimally adjusted analysis (for age, sex, and ethnicity) and mutually adjusted analysis (including all risk factors). Missing data on risk factors were imputed. RESULTS After confounder adjustment, impaired physical and cognitive functioning at older ages were predicted by hypertension (odds ratios [ORs] 1.80 95% confidence interval [CI] 1.39-2.33 and 1.57 95% CI 1.07-2.31, respectively), poor lung function (1.51 95% CI 1.28-1.78 and 1.31 95% CI 1.08-1.59), and physical inactivity, marginally in the case of cognitive function (1.50 95% CI 1.19-1.90 and 1.27 95% CI 0.99-1.62) at age 50 years. Impaired physical functioning but not cognitive functioning was additionally predicted by depression and higher body mass index (1.72 95% CI 1.46-2.03 and 1.29 95% CI 1.16-1.44, respectively). CONCLUSIONS Several midlife risk factors are associated with impaired physical and cognitive functioning in old age, supporting a unified prevention policy. Analysis of 12 risk factors at age 50 suggests that strategies targeting physical inactivity, hypertension, and poor lung function will reduce impairments in both cognitive and physical functioning in old age.
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Affiliation(s)
- Eric J Brunner
- Research Department of Epidemiology and Public Health, University College London, UK.
| | - Catherine A Welch
- Research Department of Epidemiology and Public Health, University College London, UK
| | - Martin J Shipley
- Research Department of Epidemiology and Public Health, University College London, UK
| | - Sara Ahmadi-Abhari
- Research Department of Epidemiology and Public Health, University College London, UK
| | - Archana Singh-Manoux
- Research Department of Epidemiology and Public Health, University College London, UK
- INSERM U1018, Center for Research in Epidemiology and Population Health, Paul Brousse Hospital, Villejuif, France
| | - Mika Kivimäki
- Research Department of Epidemiology and Public Health, University College London, UK
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El Sheikh MM, Awaad MI, El Assal G, Heweidi D, Khalifa A. Frequency and correlates of anxiety, depression, and cognitive dysfunctions in patients with chronic obstructive pulmonary disease. MIDDLE EAST CURRENT PSYCHIATRY 2016. [DOI: 10.1097/01.xme.0000490930.77759.a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Steves CJ, Mehta MM, Jackson SHD, Spector TD. Kicking Back Cognitive Ageing: Leg Power Predicts Cognitive Ageing after Ten Years in Older Female Twins. Gerontology 2015; 62:138-49. [PMID: 26551663 PMCID: PMC4789972 DOI: 10.1159/000441029] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/11/2015] [Indexed: 11/29/2022] Open
Abstract
Background Many observational studies have shown a protective effect of physical activity on cognitive ageing, but interventional studies have been less convincing. This may be due to short time scales of interventions, suboptimal interventional regimes or lack of lasting effect. Confounding through common genetic and developmental causes is also possible. Objectives We aimed to test whether muscle fitness (measured by leg power) could predict cognitive change in a healthy older population over a 10-year time interval, how this performed alongside other predictors of cognitive ageing, and whether this effect was confounded by factors shared by twins. In addition, we investigated whether differences in leg power were predictive of differences in brain structure and function after 12 years of follow-up in identical twin pairs. Methods A total of 324 healthy female twins (average age at baseline 55, range 43-73) performed the Cambridge Neuropsychological Test Automated Battery (CANTAB) at two time points 10 years apart. Linear regression modelling was used to assess the relationships between baseline leg power, physical activity and subsequent cognitive change, adjusting comprehensively for baseline covariates (including heart disease, diabetes, blood pressure, fasting blood glucose, lipids, diet, body habitus, smoking and alcohol habits, reading IQ, socioeconomic status and birthweight). A discordant twin approach was used to adjust for factors shared by twins. A subset of monozygotic pairs then underwent magnetic resonance imaging. The relationship between muscle fitness and brain structure and function was assessed using linear regression modelling and paired t tests. Results A striking protective relationship was found between muscle fitness (leg power) and both 10-year cognitive change [fully adjusted model standardised β-coefficient (Stdβ) = 0.174, p = 0.002] and subsequent total grey matter (Stdβ = 0.362, p = 0.005). These effects were robust in discordant twin analyses, where within-pair difference in physical fitness was also predictive of within-pair difference in lateral ventricle size. There was a weak independent effect of self-reported physical activity. Conclusion Leg power predicts both cognitive ageing and global brain structure, despite controlling for common genetics and early life environment shared by twins. Interventions targeted to improve leg power in the long term may help reach a universal goal of healthy cognitive ageing.
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Affiliation(s)
- Claire J Steves
- Department of Twin Research and Genetic Epidemiology, Kings College London, London, UK
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Abstract
Background The link between intelligence in youth and all-cause mortality in later-life is well established. To better understand this relationship, the current study examines the links between pre-morbid intelligence and a number of specific health outcomes at age 50 using the NLSY-1979 cohort. Methods Participants were the 5793 participants in the NLSY-79 who responded to questions about health outcomes at age 50. Sixteen health outcomes were examined: two were summary measures (physical health and functional limitation), 9 were diagnosed illness conditions, 4 were self-reported conditions, and one was a measure of general health status. Linear and logistic regressions were used, as appropriate, to examine the relationship between intelligence in youth and the health outcomes. Age, sex and both childhood and adult SES, and its sub-components – income, education, & occupational prestige – are all adjusted for separately. Results & conclusion Higher pre-morbid intelligence is linked with better physical health at age 50, and a lower risk for a number of chronic health conditions. For example, a 1 SD higher score in IQ was significantly associated with increased odds of having good, very good, or excellent health, with an odds ratio of 1.70 (C.I. 1.55–1.86). Thirteen of the illness outcomes were significantly and negatively associated with IQ in youth; the odds ratios ranged from 0.85 for diabetes/high blood sugar to 0.65 for stroke, per one standard deviation higher score in IQ. Adjustment for childhood SES led to little attenuation but adult SES partially mediated the relationship for a number of conditions. Mediation by adult SES was not consistently explained by any one of its components—income, education, and occupation status. The current findings contribute to our understanding of lower intelligence as a risk factor for poor health and how this may contribute to health inequalities. We examined links between intelligence in youth and health at age 50 in NLSY-1979. Higher intelligence in youth is linked with better physical health at age 50. Higher intelligence in youth is linked with lower risk for chronic illnesses. Adult but not childhood SES partially mediated the intelligence–health relationship.
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Affiliation(s)
- Christina Wraw
- Center for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, Scotland EH8 9JZ, United Kingdom
- Corresponding author.
| | - Ian J. Deary
- Center for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, Scotland EH8 9JZ, United Kingdom
| | - Catharine R. Gale
- Center for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, Scotland EH8 9JZ, United Kingdom
- MRC Life Course Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom
| | - Geoff Der
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, United Kingdom
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35
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Lahousse L, Tiemeier H, Ikram MA, Brusselle GG. Chronic obstructive pulmonary disease and cerebrovascular disease: A comprehensive review. Respir Med 2015; 109:1371-80. [PMID: 26342840 DOI: 10.1016/j.rmed.2015.07.014] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 06/09/2015] [Accepted: 07/19/2015] [Indexed: 01/23/2023]
Abstract
Along with the aging population, the public health burden of cerebrovascular disease is increasing. Cerebral small vessel disease and accumulation of brain pathology associate with cognitive decline and can lead to clinical outcomes, such as stroke and dementia. Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disease among elderly. The quality of life and prognosis of patients with COPD is greatly determined by the presence of comorbidities including stroke and cognitive impairment. Despite the clinical relevance of cerebral small vessel disease, stroke and (vascular) cognitive impairment in patients with COPD, literature is scarce and underlying mechanisms are unknown. The aim of the present review is therefore to summarize current scientific knowledge, to provide a better understanding of the interplay between COPD and the aging brain and to define remaining knowledge gaps. This narrative review article 1) overviews the epidemiology of cerebral small vessel disease, stroke and cognitive impairment in patients with COPD; 2) discusses potential underlying mechanisms including aging, smoking, systemic inflammation, vasculopathy, hypoxia and genetic susceptibility; and 3) highlights areas requiring further research.
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Affiliation(s)
- Lies Lahousse
- Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Guy G Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Respiratory Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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36
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Schaefer JD, Caspi A, Belsky DW, Harrington H, Houts R, Israel S, Levine ME, Sugden K, Williams B, Poulton R, Moffitt TE. Early-Life Intelligence Predicts Midlife Biological Age. J Gerontol B Psychol Sci Soc Sci 2015; 71:968-977. [PMID: 26014827 DOI: 10.1093/geronb/gbv035] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 04/13/2015] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Early-life intelligence has been shown to predict multiple causes of death in populations around the world. This finding suggests that intelligence might influence mortality through its effects on a general process of physiological deterioration (i.e., individual variation in "biological age"). We examined whether intelligence could predict measures of aging at midlife before the onset of most age-related disease. METHODS We tested whether intelligence assessed in early childhood, middle childhood, and midlife predicted midlife biological age in members of the Dunedin Study, a population-representative birth cohort. RESULTS Lower intelligence predicted more advanced biological age at midlife as captured by perceived facial age, a 10-biomarker algorithm based on data from the National Health and Nutrition Examination Survey (NHANES), and Framingham heart age (r = 0.1-0.2). Correlations between intelligence and telomere length were less consistent. The associations between intelligence and biological age were not explained by differences in childhood health or parental socioeconomic status, and intelligence remained a significant predictor of biological age even when intelligence was assessed before Study members began their formal schooling. DISCUSSION These results suggest that accelerated aging may serve as one of the factors linking low early-life intelligence to increased rates of morbidity and mortality.
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Affiliation(s)
- Jonathan D Schaefer
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK
| | - Daniel W Belsky
- Social Science Research Institute, Duke University, Durham, North Carolina.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Honalee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Renate Houts
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Salomon Israel
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Department of Psychology, Hebrew University, Jerusalem, Israel
| | - Morgan E Levine
- Department of Human Genetics, University of California, Los Angeles, California
| | - Karen Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
| | - Benjamin Williams
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Terrie E Moffitt
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
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37
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Abstract
Almost 40 million people currently live with dementia but this is estimated to double over the next 20 years; despite this, research identifying modifiable risk factors is scarce. There is increasing evidence that cognitive impairment is more frequent in those with chronic lung disease than those without. Chronic obstructive pulmonary disease affects 210 million people, with cognitive impairment present in 60% of certain populations. Co-morbid cognitive dysfunction also appears to impact on important outcomes such as quality of life, hospitalisation and survival. This review summarises the evidence of an association between cognition, impaired lung function and obstructive lung disease. It goes on to examine the contribution of neuro-imaging to our understanding of the underlying pathophysiology. While the mechanisms of brain pathology and cognitive impairment are likely to be complex and multi-factorial, there is evidence to suggest a key role for occult cerebrovascular damage independent of traditional vascular risk factors, including smoking.
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Affiliation(s)
- James W Dodd
- Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning & Research Building, Southmead Hospital, Bristol, BS10 5NB, UK
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38
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Sims RC, Thorpe RJ, Gamaldo AA, Aiken-Morgan AT, Hill LK, Allaire JC, Whitfield KE. Cognition and health in African American men. J Aging Health 2015; 27:195-219. [PMID: 25053802 PMCID: PMC4439206 DOI: 10.1177/0898264314543474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Despite high rates of poor health outcomes, little attention has been focused on associations between prominent health factors and cognitive function in African American men, exclusively. The objective was to examine relationships between cardiovascular and pulmonary health, and cognitive function in African American men. METHOD Data from 257 men were pooled from two studies of African American aging. The mean age of participants was 58.15 and mean educational attainment was 11.78 years. Participants provided self-reported health and demographic information, completed cognitive measures, and had their blood pressure and peak expiratory flow assessed. RESULTS After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures. DISCUSSION Results suggest that lung function is important to consider when examining cognitive function in African American men. Understanding the role of health in cognition and implications for quality of life in this population will be critical as life expectancies increase.
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Affiliation(s)
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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39
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Vasilopoulos T, Kremen WS, Grant MD, Panizzon MS, Xian H, Toomey R, Lyons MJ, Jacobson KC, Franz CE. Individual differences in cognitive ability at age 20 predict pulmonary function 35 years later. J Epidemiol Community Health 2015; 69:261-5. [PMID: 25273357 PMCID: PMC4756634 DOI: 10.1136/jech-2014-204143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Poor pulmonary function is associated with mortality and age-related diseases, and can affect cognitive performance. However, extant longitudinal studies indicate that early cognitive ability also affects later pulmonary function. Despite the multifaceted nature of pulmonary function, most longitudinal studies were limited to a single index of pulmonary function: forced expiratory volume in 1 s (FEV1). In this study, we examined whether early adult cognitive ability predicted five different indices of pulmonary function in mid-life. METHODS Mixed modelling tested the association between young adult general cognitive ability (mean age=20), measured by the Armed Forces Qualification Test (AFQT), and mid-life pulmonary function (mean age=55), in 1019 men from the Vietnam Era Twin Study of Aging. Pulmonary function was indexed by per cent predicted values for forced vital capacity (FVC%p), FEV1%p, maximum forced expiratory flow (FEFmax%p), and maximal voluntary ventilation (MVV%p), and by the ratio of FEV1 to FVC (FEV1/FVC), an index of lung obstruction. RESULTS After adjusting for smoking, pulmonary disease, occupation, income and education, age 20 AFQT was significantly (p<0.05) associated with mid-life FVC%p (β=0.10), FEV1%p (β=0.13), FEFmax%p (β=0.13), and MVV%p (β=0.13), but was not significantly associated with FEV1/FVC (β=0.03, p=0.34). CONCLUSIONS Early adult cognitive ability is a predictor of multiple indices of aging-related pulmonary function 35 years later, including lung volume, airflow and ventilator capacity. Cognitive deficits associated with impaired aging-related lung function may, thus, be partly pre-existing. However, results also highlight that early life risk factors may be differentially related to different metrics of later-life pulmonary health.
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Affiliation(s)
- Terrie Vasilopoulos
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
- Center for Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, California, USA
| | - Michael D Grant
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Matthew S Panizzon
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Hong Xian
- Department of Biostatistics, Saint Louis University, St. Louis, Missouri, USA
- VA St. Louis Healthcare System, St. Louis, Missouri, USA
| | - Rosemary Toomey
- Department of Psychology, Boston University, Boston, Massachusetts, USA
| | - Michael J Lyons
- Department of Psychology, Boston University, Boston, Massachusetts, USA
| | - Kristen C Jacobson
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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40
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Turkeshi E, Vaes B, Andreeva E, Matheï C, Adriaensen W, Van Pottelbergh G, Degryse JM. Short-term prognostic value of forced expiratory volume in 1 second divided by height cubed in a prospective cohort of people 80 years and older. BMC Geriatr 2015; 15:15. [PMID: 25888051 PMCID: PMC4345023 DOI: 10.1186/s12877-015-0013-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 02/11/2015] [Indexed: 11/17/2022] Open
Abstract
Background Spirometry-based parameters of pulmonary function such as forced expiratory volume in 1 second (FEV1) have prognostic value beyond respiratory morbidity and mortality. FEV1 divided by height cubed (FEV1/Ht3) has been found to be better at predicting all-cause mortality than the usual standardization as percentage of predicted "normal values" (FEV1%) and its use is independent of reference equations. Yet, limited data are available on the very old adults (80 years and older) and in association to other adverse health outcomes relevant for this age group. This study aims to investigate the short-term prognostic value of FEV1/Ht3 for all-cause mortality, hospitalization, physical and mental decline in a cohort of very old adults. Methods In a population-based prospective cohort study of 501 very old adults in Belgium, comprehensive geriatric assessment and spirometry were performed at baseline and after 1.7 ± 0.21 years. Kaplan-Meier curves for 3-year all-cause mortality and hospitalization rates and multivariable analysis adjusted for age, sex, smoking status, co-morbidities, anemia, high C reactive protein and creatinine levels examined the association of FEV1/Ht3 with all-cause mortality, unplanned hospitalization and decline in mental and physical functioning. Physical functioning was assessed by activities of daily living, a battery of physical performance tests and grip strength. Mental functioning was assessed with mini mental state examination and 15 items geriatric depression scale. Results Individuals in the lowest quartile of FEV1/Ht3 had a statistically significant increased adjusted risk for all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.10-2.60) and unplanned hospitalization (HR 1.65, 95% CI 1.21-2.25), as well as decline in physical (odds ratio [OR] 1.89, 95% CI 1.05-3.39) and mental functioning (OR 2.39, 95% CI 1.30-4.40) compared to the rest of the study population. Conclusions In a cohort of very old adults, low FEV1 expressed as FEV1/Ht3 was found to be a short-term predictor of all-cause mortality, hospitalization and decline in physical and mental functioning independently of age, smoking status, chronic lung disease and other co-morbidities. Further research is needed on FEV1/Ht3 as a potential risk marker for frailty and adverse health outcomes in this age group.
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Affiliation(s)
- Eralda Turkeshi
- Institute of Health and Society, Université Catholique de Louvain (UCL), Clos Chapelle-aux-Champs 30, bte B1.30.15, 1200, Brussels, Belgium.
| | - Bert Vaes
- Institute of Health and Society, Université Catholique de Louvain (UCL), Clos Chapelle-aux-Champs 30, bte B1.30.15, 1200, Brussels, Belgium. .,Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 33, blok J, PB 7001 3000, Leuven, Belgium.
| | - Elena Andreeva
- Institute of Health and Society, Université Catholique de Louvain (UCL), Clos Chapelle-aux-Champs 30, bte B1.30.15, 1200, Brussels, Belgium.
| | - Catharina Matheï
- Institute of Health and Society, Université Catholique de Louvain (UCL), Clos Chapelle-aux-Champs 30, bte B1.30.15, 1200, Brussels, Belgium. .,Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 33, blok J, PB 7001 3000, Leuven, Belgium.
| | - Wim Adriaensen
- Institute of Health and Society, Université Catholique de Louvain (UCL), Clos Chapelle-aux-Champs 30, bte B1.30.15, 1200, Brussels, Belgium. .,Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 33, blok J, PB 7001 3000, Leuven, Belgium.
| | - Gijs Van Pottelbergh
- Institute of Health and Society, Université Catholique de Louvain (UCL), Clos Chapelle-aux-Champs 30, bte B1.30.15, 1200, Brussels, Belgium. .,Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 33, blok J, PB 7001 3000, Leuven, Belgium.
| | - Jean-Marie Degryse
- Institute of Health and Society, Université Catholique de Louvain (UCL), Clos Chapelle-aux-Champs 30, bte B1.30.15, 1200, Brussels, Belgium. .,Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 33, blok J, PB 7001 3000, Leuven, Belgium.
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41
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Russ TC, Starr JM, Stamatakis E, Kivimäki M, Batty GD. Pulmonary function as a risk factor for dementia death: an individual participant meta-analysis of six UK general population cohort studies. J Epidemiol Community Health 2015; 69:550-6. [DOI: 10.1136/jech-2014-204959] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/30/2014] [Indexed: 01/22/2023]
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42
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Andreou G, Vlachos F, Makanikas K. Effects of chronic obstructive pulmonary disease and obstructive sleep apnea on cognitive functions: evidence for a common nature. SLEEP DISORDERS 2014; 2014:768210. [PMID: 24649370 PMCID: PMC3932644 DOI: 10.1155/2014/768210] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 10/09/2013] [Accepted: 10/31/2013] [Indexed: 12/16/2022]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSAS) show similar neurocognitive impairments. Effects are more apparent in severe cases, whereas in moderate and mild cases the effects are equivocal. The exact mechanism that causes cognitive dysfunctions in both diseases is still unknown and only suggestions have been made for each disease separately. The primary objective of this review is to present COPD and OSAS impact on cognitive functions. Secondly, it aims to examine the potential mechanisms by which COPD and OSAS can be linked and provide evidence for a common nature that affects cognitive functions in both diseases. Patients with COPD and OSAS compared to normal distribution show significant deficits in the cognitive abilities of attention, psychomotor speed, memory and learning, visuospatial and constructional abilities, executive skills, and language. The severity of these deficits in OSAS seems to correlate with the physiological events such as sleep defragmentation, apnea/hypopnea index, and hypoxemia, whereas cognitive impairments in COPD are associated with hypoventilation, hypoxemia, and hypercapnia. These factors as well as vascocerebral diseases and changes in systemic hemodynamic seem to act in an intermingling and synergistic way on the cause of cognitive dysfunctions in both diseases. However, low blood oxygen pressure seems to be the dominant factor that contributes to the presence of cognitive deficits in both COPD and OSAS.
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Affiliation(s)
- Georgia Andreou
- Department of Special Education, University of Thessaly, Argonafton & Filellinon, 38221 Volos, Greece
| | - Filippos Vlachos
- Department of Special Education, University of Thessaly, Argonafton & Filellinon, 38221 Volos, Greece
| | - Konstantinos Makanikas
- Department of Special Education, University of Thessaly, Argonafton & Filellinon, 38221 Volos, Greece
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Finkel D, Reynolds CA, Emery CF, Pedersen NL. Genetic and environmental variation in lung function drives subsequent variation in aging of fluid intelligence. Behav Genet 2013; 43:274-85. [PMID: 23760789 DOI: 10.1007/s10519-013-9600-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 05/31/2013] [Indexed: 11/26/2022]
Abstract
Longitudinal studies document an association of pulmonary function with cognitive function in middle-aged and older adults. Previous analyses have identified a genetic contribution to the relationship between pulmonary function with fluid intelligence. The goal of the current analysis was to apply the biometric dual change score model to consider the possibility of temporal dynamics underlying the genetic covariance between aging trajectories for pulmonary function and fluid intelligence. Longitudinal data from the Swedish Adoption/Twin Study of Aging were available from 808 twins ranging in age from 50 to 88 years at the first wave. Participants completed up to six assessments covering a 19-year period. Measures at each assessment included spatial and speed factors and pulmonary function. Model-fitting indicated that genetic variance for FEV1 was a leading indicator of variation in age changes for spatial and speed factors. Thus, these data indicate a genetic component to the directional relationship from decreased pulmonary function to decreased function of fluid intelligence.
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Affiliation(s)
- Deborah Finkel
- Department of Psychology, Indiana University Southeast, New Albany, IN, USA.
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44
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Clouston SAP, Brewster P, Kuh D, Richards M, Cooper R, Hardy R, Rubin MS, Hofer SM. The dynamic relationship between physical function and cognition in longitudinal aging cohorts. Epidemiol Rev 2013; 35:33-50. [PMID: 23349427 PMCID: PMC3578448 DOI: 10.1093/epirev/mxs004] [Citation(s) in RCA: 264] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 12/19/2022] Open
Abstract
On average, older people remember less and walk more slowly than do younger persons. Some researchers argue that this is due in part to a common biologic process underlying age-related declines in both physical and cognitive functioning. Only recently have longitudinal data become available for analyzing this claim. We conducted a systematic review of English-language research published between 2000 and 2011 to evaluate the relations between rates of change in physical and cognitive functioning in older cohorts. Physical functioning was assessed using objective measures: walking speed, grip strength, chair rise time, flamingo stand time, and summary measures of physical functioning. Cognition was measured using mental state examinations, fluid cognition, and diagnosis of impairment. Results depended on measurement type: Change in grip strength was more strongly correlated with mental state, while change in walking speed was more strongly correlated with change in fluid cognition. Examining physical and cognitive functioning can help clinicians and researchers to better identify individuals and groups that are aging differently and at different rates. In future research, investigators should consider the importance of identifying different patterns and rates of decline, examine relations between more diverse types of measures, and analyze the order in which age-related declines occur.
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Affiliation(s)
- Sean A. P. Clouston
- Correspondence to Dr. Sean A. P. Clouston, Department of Psychology, Faculty of Social Sciences, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia V8P 5C2, Canada (e-mail: )
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45
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Vidal JS, Aspelund T, Jonsdottir MK, Jonsson PV, Harris TB, Lopez OL, Gudnason V, Launer LJ. Pulmonary function impairment may be an early risk factor for late-life cognitive impairment. J Am Geriatr Soc 2013; 61:79-83. [PMID: 23311554 PMCID: PMC3545414 DOI: 10.1111/jgs.12069] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the association between change in pulmonary function (PF) and mid- and late-life cognitive function. DESIGN Prospective population-based cohort study that included measures of pulmonary function in midlife and brain magnetic resonance imaging data acquired in late life. SETTING The Age, Gene/Environment Susceptibility-Reykjavik Study. PARTICIPANTS Three thousand six hundred sixty-five subjects who had at least one measure of forced expiratory volume in 1 second (FEV(1)) and were cognitively tested on average 23 years later. A subset of 1,281 subjects had two or three measures of FEV(1) acquired over a 7.8-year period. MEASUREMENTS Pulmonary function was estimated as FEV(1)/height(2). Rate of PF decline was estimated as the slope of decline over time. Cognitive status was measured with continuous scores of memory, speed of processing, and executive function and as the outcome of mild cognitive impairment (MCI) and dementia. RESULTS Lower PF measured in midlife predicted poorer memory, slower speed of processing, poorer executive function, and greater likelihood of MCI and dementia 23 years later. Decrease in PF over a 7.8-year period in midlife was not associated with MCI or dementia. CONCLUSION Low PF measured in midlife may be an early marker of later cognitive problems. Additional studies characterizing early and late PF changes are needed.
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Affiliation(s)
- Jean-Sébastien Vidal
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
- Hopital Broca, Service Gérontologie 2, 54 rue Pascal, 75013 Paris, France
| | | | - Maria K. Jonsdottir
- The Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Psychology, University of Iceland, Reykjavik, Iceland
| | - Palmi V. Jonsson
- Geriatric Research Center, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tamara B. Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Oscar L. Lopez
- Departments of Psychiatry and Neurology, University of Pittsburgh, Pennsylvania
| | - Vilmundur Gudnason
- The Icelandic Heart Association, Kopavogur, Iceland
- Geriatric Research Center, Landspitali University Hospital, Reykjavik, Iceland
| | - Lenore J. Launer
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
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Abstract
Human aging is associated with decline in cognitive and physical functioning. Although pulmonary function predicts long-term performance (up to 10 years) on measures of cognitive function, recent data suggest the opposite relationship: Cognitive decline predicts self-reported physical limitations. In the study reported here, we utilized dual-change-score models to determine the directional relationship between pulmonary and cognitive function. Our sample consisted of 832 participants (ages 50-85 years at baseline), who were assessed in up to seven waves of testing across 19 years as part of the longitudinal Swedish Adoption/Twin Study of Aging. Changes in pulmonary function led to subsequent changes in fluid cognitive function, specifically, in tasks reflecting psychomotor speed and spatial abilities. There was no evidence that declines in cognitive function led to subsequent declines in pulmonary function. Thus, these data indicate a directional relationship from decreased pulmonary function to decreased cognitive function, a finding that underscores the importance of maintaining pulmonary function to ensure cognitive performance.
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Affiliation(s)
- Charles F Emery
- Department of Psychology, Ohio State University, Columbus 43210, USA.
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47
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Feng L, Lim ML, Collinson S, Ng TP. Pulmonary Function and Cognitive Decline in an Older Chinese Population in Singapore. COPD 2012; 9:555-62. [DOI: 10.3109/15412555.2012.706341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Corley J, Gow AJ, Starr JM, Deary IJ. Smoking, childhood IQ, and cognitive function in old age. J Psychosom Res 2012; 73:132-8. [PMID: 22789417 DOI: 10.1016/j.jpsychores.2012.03.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/29/2012] [Accepted: 03/30/2012] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To examine the association between smoking history and cognitive function in old age, and whether it remains after controlling for childhood cognitive ability (IQ) and adult socioeconomic status (SES). METHODS In the Lothian Birth Cohort 1936 Study, 1080 men and women, who previously participated in a nationwide IQ-type test in childhood, were followed up at age 70. The associations between smoking history and age 70 IQ, general cognitive ability (g), processing speed, memory, and verbal ability were assessed. RESULTS Lower childhood IQ was associated with a higher risk of becoming a smoker and continuing to smoke in late life, and with reduced lung function (FEV1) in late life. Current smokers scored significantly lower than ex-smokers and never smokers on tests of age 70 IQ, general cognitive ability, and processing speed, but not memory or verbal ability. After controlling for childhood IQ and SES, current smoking at age 70 (but not pack years of smoking) was associated with impairments in general cognitive ability and processing speed. CONCLUSION Smoking in old age makes a small, independent contribution to cognitive performance in old age.
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Affiliation(s)
- Janie Corley
- Department of Psychology, University of Edinburgh, UK
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Modig K, Bergman LR. Associations between intelligence in adolescence and indicators of health and health behaviors in midlife in a cohort of Swedish women. INTELLIGENCE 2012. [DOI: 10.1016/j.intell.2012.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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MacDonald SWS, DeCarlo CA, Dixon RA. Linking biological and cognitive aging: toward improving characterizations of developmental time. J Gerontol B Psychol Sci Soc Sci 2011; 66 Suppl 1:i59-70. [PMID: 21743053 DOI: 10.1093/geronb/gbr039] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Chronological age is the most frequently employed predictor in life-span developmental research, despite repeated assertions that it is best conceived as a proxy for true mechanistic changes that influence cognition across time. The present investigation explores the potential that selected functional biomarkers may contribute to the more effective conceptual and operational definitions of developmental time. METHODS We used data from the Victoria Longitudinal Study to explore both static and dynamic biological or physiological markers that arguably influence process-specific mechanisms underlying cognitive changes in late life. Multilevel models were fit to test the dynamic coupling between change in theoretically relevant biomarkers (e.g., grip strength, pulmonary function) and change in select cognitive measures (e.g., executive function, episodic and semantic memory). RESULTS Results showed that, independent of the passage of developmental time (indexed as years in study), significant time-varying covariation was observed linking corresponding declines for select cognitive outcomes and biological markers. DISCUSSION Our findings support the interpretation that cognitive decline is not due to chronological aging per se but rather reflects multiple causal factors from a broad range of biological and physical health domains that operate along the age continuum.
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