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Noale M, Prinelli F, Conti S, Sergi G, Maggi S, Brennan L, de Groot LC, Volkert D, McEvoy CT, Trevisan C. Undernutrition, cognitive decline and dementia: The collaborative PROMED-COG pooled cohorts study. Clin Nutr 2024; 43:2372-2380. [PMID: 39265298 DOI: 10.1016/j.clnu.2024.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 09/02/2024] [Accepted: 09/02/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND & AIMS Undernutrition may negatively impact cognitive function, but evidence of this relationship is not yet consolidated. Under the "PROtein enriched MEDiterranean diet to combat undernutrition and promote healthy neuroCOGnitive ageing" (PROMED-COG) project, we evaluated the association between undernutrition, and cognitive decline and incident dementia in older adults. METHODS Retrospective data harmonization was performed on three Italian population-based studies: the Italian Longitudinal Study of Ageing (ILSA), the Progetto Veneto Anziani (Pro.V.A.), and the Bollate Eye Study-Follow-Up (BEST-FU). The associations between undernutrition, operationalized using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and decline on the Mini-Mental State Examination (MMSE) or dementia incidence follow-up were evaluated with Cox proportional hazard regression models. RESULTS The pooled cohort comprised 9071 individuals (52% females) aged between 42 and 101 years. The prevalence of undernutrition at the baseline was 14.3%, significantly higher among females (15.4% vs 13%) and in older age, ranging from 3.5% in those aged <60 years to 28.8% in those 85+ years. Undernutrition was associated with both cognitive decline over a median 8.3-year follow-up (Hazard Ratio (HR) 1.20, 95% Confidence Interval (CI) 1.02-1.41, p = 0.028) and incidence of dementia over a median 8.6-year follow-up (HR = 1.57, 95%CI 1.01-2.43, p = 0.046). For cognitive decline, the association with undernutrition was more marked in males than females (HR = 1.36, 95%CI 1.05-1.77, p = 0.019 vs HR = 1.10, 95% CI 0.89-1.36, p = 0.375). CONCLUSION Undernutrition is prevalent among older people and is associated with an increased risk of experiencing cognitive decline and dementia. The prevention and early identification of undernutrition could be an important nonpharmacologic strategy to counteract neurodegeneration.
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Affiliation(s)
- Marianna Noale
- Neuroscience Institute, Aging Branch, National Research Council (CNR), Viale Giuseppe Colombo 3, 35121 Padova, Italy
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate (MI), Italy.
| | - Silvia Conti
- Institute of Biomedical Technologies, National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate (MI), Italy
| | - Giuseppe Sergi
- Geriatric Unit, Department of Medicine, University of Padova (UNIPD), Via Giustiniani 2, 35128 Padova, Italy
| | - Stefania Maggi
- Neuroscience Institute, Aging Branch, National Research Council (CNR), Viale Giuseppe Colombo 3, 35121 Padova, Italy
| | - Lorraine Brennan
- School of Agriculture and Food Science, Institute of Food and Health and Conway Institute, University College Dublin, Belfield, Dublin, Ireland
| | | | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander Universität of Erlangen-Nümberg, Nuremberg, Germany
| | - Claire T McEvoy
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK; The Global Brain Institute, Trinity College Dublin, Ireland & University of California San Francisco, USA
| | - Caterina Trevisan
- Geriatric Unit, Department of Medicine, University of Padova (UNIPD), Via Giustiniani 2, 35128 Padova, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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Ohta T, Kojima N, Osuka Y, Sasai H. Physical frailty predicts cognitive decline among community-dwelling older Japanese women: A prospective cohort study from the Otassha study. Arch Gerontol Geriatr 2024; 124:105453. [PMID: 38704920 DOI: 10.1016/j.archger.2024.105453] [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: 03/11/2024] [Revised: 04/11/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Physical frailty and cognitive decline are common issues in geriatrics within an aging society, yet the association between them remains controversial. This study aims to evaluate the association between physical frailty and cognitive decline among community-dwelling older Japanese women. METHODS A prospective cohort study was conducted in an urban area of Tokyo, Japan, involving community-dwelling older adults 65 years or older. Physical frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria, consisting of five components: shrinking, weakness, exhaustion, slowness, and low activity. Participants were classified as robust, pre-frail, or frail based on the presence of one or more criteria. Cognitive decline was defined as at least a three-point decrease in the Mini-Mental State Examination score from baseline. The association between physical frailty and cognitive decline was examined using binomial logistic regression, adjusting for potential confounders. The analysis yielded multivariable odds ratios (ORs) and 95 % confidence intervals (CIs), with robust participants using as the reference group. RESULTS A total of 2,122 individuals participated in the baseline survey, with 805 included in the analysis (mean age: 72.9 ± 5.1 years). At baseline, 363 participants were classified as pre-frail, while 32 were classified as frail. During the two-year follow-up period, 68 participants experienced cognitive decline. The multivariable OR (95 % CI) for frailty, using robust as the reference, was 3.50 (1.13, 10.80). Furthermore, a linear relationship was observed between physical frailty and cognitive decline. CONCLUSION Among older Japanese women, there exists a dose-response relationship between physical frailty status and cognitive decline.
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Affiliation(s)
- Takahisa Ohta
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Wang LY, Hu ZY, Chen HX, Zhou CF, Hu XY. Prevalence of mild cognitive impairment and its association with malnutrition in older Chinese adults in the community. Front Public Health 2024; 12:1407694. [PMID: 39206002 PMCID: PMC11353079 DOI: 10.3389/fpubh.2024.1407694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Objective This study aims to characterize the prevalence and associated factors of cognitive impairment in older adults within Chinese community settings. Background Research exploring the interrelation between malnutrition and cognitive impairment in the older adult community-dwelling population is scarce. The impact of nutritional status on cognitive function in aging adults has not been definitively established. Methods A cross-sectional survey was conducted in one urban and one rural community in Chengdu, China, from October 2022 to March 2023. The sample included 706 older adults. Logistic regression was utilized to determine independent risk factors for mild cognitive impairment (MCI). Results The study found a significant prevalence of MCI at 32.0% among the older adult population. Among those suffering from malnutrition, 55.6% were affected by MCI. The logistic regression analysis indicated that malnutrition risk (OR = 2.192, 95% CI 1.431 to 3.357, p < 0.001), rural residence (OR = 1.475, 95% CI 1.003 to 2.170, p = 0.048), age (70-79 years old; OR = 2.425, 95% CI 1.611 to 3.651, p < 0.001; ≥80 years old: OR = 4.773, 95% CI 2.571 to 8.859, p < 0.001), male (OR = 1.584, 95% CI 1.085 to 2.313, p = 0.017), middle education level (OR = 0.986, 95% CI 1.627 to 5.482, p < 0.001), and ADL dependence (OR = 1.810, 95% CI 1.158 to 2.827, p = 0.009) were significantly associated with the occurrence of MCI. Conclusion The findings indicate a widespread occurrence of MCI in community-dwelling older Chinese adults. The association between malnutrition, as measured by the Mini Nutritional Assessment-Short Form (MNA-SF), and cognitive decline is evident. Older adult individuals with nutritional risk, advancing age, rural residence, male gender, moderate education, and ADL dependency are at increased likelihood of developing MCI. Longitudinal research is needed to clarify the temporal relationships between MCI, demographic factors, and whether improvements in nutritional status or ADL can reduce the incidence of MCI in this population.
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Affiliation(s)
- Ling-ying Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Zi-yi Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hong-xiu Chen
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Chun-fen Zhou
- Mental Health Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiu-ying Hu
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Shi Y, Yu C, Zhou W, Wang T, Zhu L, Cheng X, Bao H. The Association of Malnutrition With Chronic Kidney Disease in the Older Chinese Population With Hypertension: Evidence From the China H-type Hypertension Registry Study. J Ren Nutr 2024; 34:209-215. [PMID: 37116627 DOI: 10.1053/j.jrn.2023.04.005] [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: 10/11/2022] [Revised: 03/02/2023] [Accepted: 04/09/2023] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVE Current evidence of the dose-response association between the geriatric nutritional risk index (GNRI) and chronic kidney disease (CKD) is limited. Hence, this study aimed to determine the association between GNRI and CKD in the elderly Chinese population with hypertension. METHODS Data were derived from the China H-type Hypertension Registry. A total of 9,897 elderly patients with hypertension were included in the cross-sectional analysis. GNRI was calculated using the serum albumin and weight loss and the specific formula was as follows: GNRI = [1.489 × serum albumin (g/L)] + [41.7 × (actual weight/ideal weight)]. The outcome of our study was CKD, which was defined as an estimated glomerular filtration rate value of <60 mL/minute/1.73 m2. The association between the GNRI and CKD was analyzed using multivariate logistic regression. RESULTS The present study population was composed of 9,897 participants with an average age of 68.67 (6.10) years. In particular, it was consisted of 4,683 (47.32%) male and 5,214 (52.68%) female participants. Overall, there was a significantly negative association between GNRI and CKD prevalence (per 1 increment; adjusted odds ratio [OR], 0.96; 95% confidence interval [CI]: 0.95-0.97). In a fully adjusted model, compared with the participants in the highest group tertiles 3 (GNRI ≥112), the participants in group tertiles 1 (GNRI <106) and group tertiles 2 (GNRI ≥106 ≤ 112) increased the prevalence of CKD by 57% (OR 1.57, 95% CI: 1.28-1.93) and 5% (OR 1.05, 95% CI: 0.86-1.28), respectively. Moreover, similar results were observed when the GNRI was assessed as a categorical variable based on the clinical cutoff values. CONCLUSION This cross-sectional analysis found a significant negative association between GNRI and CKD among the elderly Chinese adults with hypertension.
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Affiliation(s)
- Yumeng Shi
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lingjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
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Wang X, Yin Z, Yang Y, Fu X, Guo C, Pu K, Zang S. Association of plant-based dietary patterns with depression and anxiety symptoms in Chinese older adults: A nationwide study. J Affect Disord 2024; 350:838-846. [PMID: 38278327 DOI: 10.1016/j.jad.2024.01.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/26/2023] [Accepted: 01/14/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND The associations of plant-based dietary patterns with depression and anxiety symptoms among older adults have not been extensively studied. Therefore, the purpose of this study was to examine these associations in Chinese older adults. METHODS Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was employed in the present study. The simplified food frequency questionnaire was used to assess the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). The Center for Epidemiologic Studies Depression Scale-10 (CES-D-10) was used to evaluate depression symptoms, and the Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess anxiety symptoms. This study employed logistic regression and linear regression to examine the associations between plant-based dietary patterns and symptoms of depression and anxiety. RESULTS This study included 11,971 older adults, with a mean age of 83.23 ± 11.10 years. The results indicated that PDI and hPDI were negative associated with depression symptoms (adjusted β -0.09, 95 % CI -0.11, -0.07) (adjusted β -0.09, 95 % CI -0.11, -0.07) and anxiety symptoms (adjusted β -0.03, 95 % CI -0.04, -0.02) (adjusted β -0.04, 95 % CI -0.05, -0.02), while uPDI was positive associated with depression symptoms (adjusted β 0.09, 95 % CI 0.07, 0.11) and anxiety symptoms (adjusted β 0.04, 95 % CI 0.03, 0.05). CONCLUSIONS The findings from this study have the potential to promote healthy dietary patterns in older adults, and may have implications for the prevention and management of depression and anxiety in this population.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Zhihua Yin
- Department of Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Ying Yang
- Library of China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Xiao Fu
- Department of Gastroenterology, Qingdao Huangdao District Central Hospital, No. 9 Huangpujiang Road, Huangdao District, Qingdao, Shandong Province 266555, China
| | - Chaowei Guo
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Keping Pu
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China.
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Liu Y, Yuan Y, Yang Y, Gao T, Cai J, Wen H, Wu X, Zhou Y, Ma A, Ma Y, Zhong F. Effect of dietary supplementation with multinutrient soy flour on body composition and cognitive function in elderly individuals at the risk of low protein: a randomized, double-blind, placebo-controlled study. Food Funct 2023; 14:9734-9742. [PMID: 37818605 DOI: 10.1039/d3fo02905k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Insufficient protein intake and cognitive decline are common in older adults; however, there have been few studies on low protein risk screening and complex nutrient interventions for elderly individuals in rural communities. This study aimed to evaluate the effect of dietary multinutrient soy flour (MNSF) on body composition and cognitive function in elderly individuals who are at risk of protein deficiency in a randomized, double-blind, placebo-controlled clinical trial. Nutritional interventions were given to those found to have low protein levels using bioelectrical impedance analysis (BIA). Among 733 older adults screened, 62 participants were included and randomly assigned into two groups, one taking soy flour and the other taking MNSF for 12 weeks. A previous cross-sectional survey found that 35.1% of the elderly people with an average age of 71.61 ± 5.94 years had an inadequate body protein mass proportion. After the intervention, the MNSF group demonstrated a significant improvement in protein mass, muscle mass, mineral levels, skeletal muscle mass, and fat-free mass compared with baseline (all P < 0.05), as well as a better upward trend compared with the soy flour group (P = 0.08; P = 0.07; P = 0.05; P = 0.08; P = 0.07). Regarding the mini-mental state examination (MMSE) scores, the MNSF group showed a significant decrease after 12 weeks (P < 0.05), which were significantly different compared with the soy flour group (P < 0.05). In the future, the application of MNSF as a food-based supplement to improve nutrition and delay cognitive decline in older adults at the risk of protein deficiency may be considered.
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Affiliation(s)
- Yajun Liu
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Yanlei Yuan
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Yingcai Yang
- Chronic disease control Department, Qingdao Municipal Center For Disease Control & Prevention, Qingdao 266071, China
| | - Tianlin Gao
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Jing Cai
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Haichao Wen
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Xiaoqing Wu
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Ying Zhou
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Aiguo Ma
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
| | - Yan Ma
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Feng Zhong
- Institute of Nutrition & Health, Qingdao University, Qingdao 266071, China.
- School of Public Health, Qingdao University, Qingdao 266071, China
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Ferdous KA, Knol LL, Park HA. Response to the Letter to the Editor on the association between selenium intake and cognitive function among older adults in the US: National Health and Nutrition Examination Surveys 2011-2014. J Nutr Sci 2023; 12:e106. [PMID: 37900055 PMCID: PMC10600565 DOI: 10.1017/jns.2023.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Khondoker Adeba Ferdous
- Department of Human Nutrition and Hospitality Management, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Linda L. Knol
- Department of Human Nutrition and Hospitality Management, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Han-A. Park
- Department of Human Nutrition and Hospitality Management, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL 35487, USA
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Namgung HG, Hong S, Choi YA. Association of Temporalis Muscle Mass with Early Cognitive Impairment in Older Patients with Acute Ischemic Stroke. J Clin Med 2023; 12:4071. [PMID: 37373767 DOI: 10.3390/jcm12124071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
The prognostic value of temporal muscle mass has been studied in various neurological disorders. Herein, we investigated the association between temporal muscle mass and early cognitive function in patients with acute ischemic stroke. This study included 126 patients with acute cerebral infarction aged ≥65 years. Temporal muscle thickness (TMT) was measured using T2-weighted brain magnetic resonance imaging at admission for acute stroke. Within 2 weeks of stroke onset, skeletal mass index (SMI) and cognitive function were assessed using bioelectrical impedance analysis and the Korean version of the Montreal Cognitive Assessment (MoCA), respectively. Pearson's correlation analyzed the correlation between TMT and SMI, and multiple linear regression analyzed independent predictors of early post-stroke cognitive function. TMT and SMI were significantly positively correlated (R = 0.36, p < 0.001). After adjusting for covariates, TMT was an independent predictor of early post-stroke cognitive function, stratified by the MoCA score (β = 1.040, p = 0.017), age (β = -0.27, p = 0.006), stroke severity (β = -0.298, p = 0.007), and education level (β = 0.38, p = 0.008). TMT may be used as a surrogate marker for evaluating skeletal muscle mass because it is significantly associated with post-stroke cognitive function during the acute phase of ischemic stroke; therefore, TMT may help detect older patients at a high risk of early post-stroke cognitive impairment.
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Affiliation(s)
- Ho-Geon Namgung
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seungho Hong
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Young-Ah Choi
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Intrinsic Capacity to Predict Future Adverse Health Outcomes in Older Adults: A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11040450. [PMID: 36832984 PMCID: PMC9957180 DOI: 10.3390/healthcare11040450] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/24/2022] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE Intrinsic capacity is recognized as an important determinant of healthy aging and well-being of older adults; however, relatively little is known about the intrinsic capacity of older adults to predict adverse health outcomes. The study aimed to examine which adverse health outcomes of older adults can be predicted by intrinsic capacity. METHODS The study was conducted using the scoping review methodological framework of Arksey and O'Malley. A systematic literature search of nine electronic databases (i.e., Pubmed, Embase, Cochrane library, Web of science, CINAHL, China National Knowledge Infrastructure, VIP, Wanfang, and the Chinese Biological Medical Literature Database) were performed from the database's inception to 1 March 2022. RESULTS Fifteen longitudinal studies were included. A series of adverse health outcomes were assessed, including physical function (n = 12), frailty (n = 3), falls (n = 3), mortality (n = 6), quality of life (n = 2) and other adverse health outcomes (n = 4). CONCLUSIONS Intrinsic capacity could predict some adverse health outcomes of different follow-up times for older adults; however, due to the small number of studies and sample size, more high-quality studies are necessary to explore the longitudinal relationships between intrinsic capacity and adverse health outcomes in the future.
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Krzysztoforska K, Piechal A, Wojnar E, Blecharz-Klin K, Pyrzanowska J, Joniec-Maciejak I, Krzysztoforski J, Widy-Tyszkiewicz E. Protocatechuic Acid Prevents Some of the Memory-Related Behavioural and Neurotransmitter Changes in a Pyrithiamine-Induced Thiamine Deficiency Model of Wernicke-Korsakoff Syndrome in Rats. Nutrients 2023; 15:nu15030625. [PMID: 36771332 PMCID: PMC9921060 DOI: 10.3390/nu15030625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
The purpose of this research was to investigate the effects of protocatechuic acid (PCA) at doses of 50 and 100 mg/kg on the development of unfavourable changes in cognitive processes in a pyrithiamine-induced thiamine deficiency (PTD) model of the Wernicke-Korsakoff syndrome (WKS) in rats. The effects of PCA were assessed at the behavioural and biochemical levels. Behavioural analysis was conducted using the Foot Fault test (FF), Bar test, Open Field test, Novel Object Recognition test (NOR), Hole-Board test and Morris Water Maze test (MWM). Biochemical analysis consisting of determination of concentration and turnover of neurotransmitters in selected structures of the rat CNS was carried out using high-performance liquid chromatography. PTD caused catalepsy (Bar test) and significantly impaired motor functions, leading to increased ladder crossing time and multiplied errors due to foot misplacement (FF). Rats with experimentally induced WKS showed impaired consolidation and recall of spatial reference memory in the MWM test, while episodic memory related to object recognition in the NOR was unimpaired. Compared to the control group, rats with WKS showed reduced serotonin levels in the prefrontal cortex and changes in dopamine and/or norepinephrine metabolites in the prefrontal cortex, medulla oblongata and spinal cord. PTD was also found to affect alanine, serine, glutamate, and threonine levels in certain areas of the rat brain. PCA alleviated PTD-induced cataleptic symptoms in rats, also improving their performance in the Foot Fault test. In the MWM, PCA at 50 and 100 mg/kg b.w. improved memory consolidation and the ability to retrieve acquired information in rats, thereby preventing unfavourable changes caused by PTD. PCA at both tested doses was also shown to have a beneficial effect on normalising PTD-disrupted alanine and glutamate concentrations in the medulla oblongata. These findings demonstrate that certain cognitive deficits in spatial memory and abnormalities in neurotransmitter levels persist in rats that have experienced an acute episode of PTD, despite restoration of thiamine supply and long-term recovery. PCA supplementation largely had a preventive effect on the development of these deficits, to some extent also normalising neurotransmitter concentrations in the brain.
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Affiliation(s)
- Kinga Krzysztoforska
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
- Correspondence:
| | - Agnieszka Piechal
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Ewa Wojnar
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Kamilla Blecharz-Klin
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Justyna Pyrzanowska
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Ilona Joniec-Maciejak
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Jan Krzysztoforski
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Waryńskiego 1, 00-645 Warsaw, Poland
| | - Ewa Widy-Tyszkiewicz
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
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Gait Indicators Contribute to Screening Cognitive Impairment: A Single- and Dual-Task Gait Study. Brain Sci 2023; 13:brainsci13010154. [PMID: 36672137 PMCID: PMC9856295 DOI: 10.3390/brainsci13010154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/23/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Screening cognitive impairment is complex and not an appliance for early screening. Gait performance is strongly associated with cognitive impairment. Objectives: We aimed to explore gait indicators that could potentially screen cognitive dysfunction. Methods: A total of 235 subjects were recruited from June 2021 to June 2022. Four gait tasks, including the walking test, the timed “Up & Go” test (TUG), foot pressure balance (FPB), and one-legged standing with eyes closed test (OLS-EC), were performed. Moreover, in the walking test, participants were instructed to walk at their usual pace for the single-gait test. For the dual-task tests, participants walked at their usual pace while counting backward from 100 by 1s. The data were analyzed by the independent sample t-test, univariate and multivariate logistic regression, a linear trend, stratified and interaction analysis, the receiver operating characteristic (ROC) curve, and Pearson’s correlations. Results: Among the 235 participants, 81 (34.5%) were men and 154 (65.5%) were women. The mean age of participants was 72 ± 7.836 years. The control, MCI, mild AD, and severe AD groups had means of 71, 63, 71, and 30, respectively. After adjusting for age, sex, education, and body mass index (BMI), the dual-task toe-off-ground angle (TOA) (odds ratio (OR) = 0.911, 95% confidence interval (CI): 0.847, 0.979), single-task TOA (OR = 0.904, 95% CI: 0.841−0.971), and the timed “Up & Go” time (TUGT) (OR = 1.515, 95% CI: 1.243−1.846) were significantly associated with an increased risk of cognitive impairment. In addition, the trend test and stratified analysis results had no significant differences (all p > 0.05). The area under the roc curve (AUC) values of TOA in the dual-task and TUGT were 0.812 and 0.847, respectively. Additionally, TOA < 36.75° in the dual-task, TOA < 38.90° in the single-task, and TUGT > 9.83 seconds (s) are likely to indicate cognitive impairment. The cognitive assessment scale scores were significantly correlated with TOA (all r > 0.3, p < 0.001) and TUGT (all r > 0.2), respectively. Conclusion: TOA and TUGT scores are, in some circumstances, associated with cognitive impairment; therefore, they can be used as simple initial screenings to identify patients at risk.
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Sánchez-Sánchez JL, Rolland Y, Cesari M, de Souto Barreto P. Impact of nursing home-acquired pneumonia on the domains of the novel construct of intrinsic capacity: The INCUR study. J Am Geriatr Soc 2022; 70:3436-3446. [PMID: 36054223 PMCID: PMC10087686 DOI: 10.1111/jgs.17991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Nursing home-acquired pneumonia (NHAP) and related hospitalizations might lead to abrupt functional declines, especially among nursing home residents. Intrinsic capacity is a novel construct proposed by the World Health Organization specifically designed to capture the physical and cognitive capacities of the aging individual to design personalized interventions. This study aimed to investigate the associations of NHAP and related hospitalizations with several intrinsic capacity domains among nursing home residents. METHODS We used data from the INCUR study (n = 754; mean age = 86.1 ± 7.4; 75.2% female). Four intrinsic capacity domains were assessed through the Short Physical Performance Battery (SPPB, locomotion), Abbreviated Mental Test (cognition), 10-items Geriatric Depression scale (GDS-10, mood), the Mini-Nutritional Assessment Short-Form (vitality) at three time-points along 1-year. Linear mixed models were used to analyze longitudinal evolution in the intrinsic capacity domains according to NHAP diagnosis and hospitalization. RESULTS A total of 161 (21.4%) were diagnosed with NHAP, and 46 of them (28.6%) required hospitalization. NHAP was significantly associated with declines in the intrinsic capacity vitality domain (β = -0.51; 95% CI -0.84; -0.18). The association was also found for NHAP-related hospitalization (β = -0.97; 95% CI -1.46; -0.48). NHAP-related hospitalization was also associated with worsening in the psychological domain (β = 0.56; 95% CI 0.08; 1.04). No other significant associations were found. CONCLUSIONS NHAP and related hospitalization are associated with the deterioration of intrinsic capacity vitality and psychology domains. Prevention of pneumonia may result in better functional evolution in very old and vulnerable nursing home residents.
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Affiliation(s)
- Juan Luis Sánchez-Sánchez
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Yves Rolland
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR1295, Université de Toulouse, Toulouse, France
| | - Matteo Cesari
- IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Milan, Italy
| | - Philipe de Souto Barreto
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR1295, Université de Toulouse, Toulouse, France
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13
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Salis F, Loddo S, Zanda F, Peralta MM, Serchisu L, Mandas A. Comprehensive Geriatric Assessment: Application and correlations in a real-life cross-sectional study. Front Med (Lausanne) 2022; 9:984046. [PMID: 36177326 PMCID: PMC9513036 DOI: 10.3389/fmed.2022.984046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background The assessment process of elderly people considers all aspects of an individual's life, including physical, mental, and social aspects. Frailty refers to a decline in physiological functions or strengths leading to increased vulnerability to stressors and decreased ability to cope with them. Comprehensive Geriatric Assessment (CGA) is a validated and useful tool in this context to holistically study elderly people. The primary aim of this study was to determine the prevalence of impaired health status in a large geriatric population turning to outpatient service, based on the components of the CGA, and thus to describe its usefulness in real-life clinical practice. The secondary aim of this study was the evaluation of the association between nutritional status, assessed with Mini Nutritional Assessment (MNA)-within the CGA-and cognitive-affective and functional capacities, and multimorbidity. Materials and methods This real-life, retrospective cross-sectional study included subjects consecutively evaluated from January 2009 to December 2020 at the Geriatric Outpatient Service, University Hospital of Monserrato, Cagliari, Italy. A sum of 3,260 patients were subjected to CGA. Results Only a small proportion of the sample (2.24%) showed an absence of impairment in cognitive-affective, functional, and nutritional domains. Moderate correlations were found between MNA and several other CGA variables, namely, Geriatric Depression Scale (GDS; ϱ = -0.41, p < 0.0001), Barthel Index of Independence in Activities of Daily Living (ADL) (ϱ = 0.51, p < 0.0001), Instrumental Activities of Daily Living (IADL) (ϱ = 0.43, p < 0.0001), and Performance-Oriented Mobility Assessment (ϱ = 0.44, p < 0.0001). A multiple regression also highlighted these variables as significant regressors of MNA. Finally, malnutrition showed a significant association with depression (odds ratio [OR]: 4.97), dependence on ADL (OR: 19.8) and IADL (OR: 7.04), and falling risk (OR: 5.16). Conclusion This study has figured out the complex situation in which geriatric care finds itself the complexity and severe impairment of elderly people. The possibilities of intervention are often limited, but the literature confirms the benefits of good nutritional status on the general health status. The data that emerged from our study fit into this assumption, highlighting the close association between the nutritional domain and the other CGA domains.
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Affiliation(s)
- Francesco Salis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Simona Loddo
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Zanda
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Monica Peralta
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, Cagliari, Italy
| | - Luca Serchisu
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, Cagliari, Italy
| | - Antonella Mandas
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, Cagliari, Italy
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Mateen FJ. Progress towards the 2030 sustainable development goals: direct and indirect impacts on neurological disorders. J Neurol 2022; 269:4623-4634. [PMID: 35583660 DOI: 10.1007/s00415-022-11180-1] [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: 03/18/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
The United Nations' Sustainable Development Goals (SDGs) were set forth in 2015 as a blueprint for all nations to create a more sustainable future together. These 17 social, environmental, and economic goals have established targets to meet globally by the year 2030, with a focus on pro-poor initiatives, gender equality, and ending hunger. The relationship of the SDGs with neurological disorders and how the achievement of the SDGs intersects with the future of neurological practice have not been comprehensively examined. However, the incidence of neurological disorders, the outcomes of people living with neurological disorders, and the training of future neurologists can be interlinked, directly or indirectly, with programming for the SDGs and their eventual achievement. Each SDG is reviewed in the context of neurology. This lens can inform programming and policy, enhance research and training, and improve inter-sectoral action for neurological disorders worldwide.
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Affiliation(s)
- Farrah J Mateen
- Department of Neurology, Neurological Clinical Research Institute, Massachusetts General Hospital, 165 Cambridge Street, #627, Boston, MA, 02114, USA.
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15
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Cavalli A, Lelli D, Pedone C, Boccardi V, Mecocci P, Antonelli Incalzi R. Attention, Praxis, and Reasoning Are Associated with Risk of Undernutrition in Older People with Cognitive Impairment. J Alzheimers Dis 2022; 89:1017-1024. [PMID: 35964176 DOI: 10.3233/jad-215732] [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: 11/15/2022]
Abstract
BACKGROUND Dementia is a risk factor for undernutrition. However, it is not clear if specific cognitive deficits have a higher risk of undernutrition and how much appetite/nutritional problems and caregiver stress mediate this association. OBJECTIVE To evaluate the relationship between nutritional status and severity of global and function-specific scores of cognitive dysfunctions, and to which extent this association is mediated by appetite/nutritional problems and caregiver stress. METHODS Cross-sectional analysis of the ReGAl study data, including 761 older adults attending a Memory Clinic. Nutritional status was evaluated with Mini Nutritional Assessment (MNA). The relationship between scores at neuro-cognitive tests and risk of undernutrition was evaluated using logistic regression models adjusted for potential confounders. To allow comparison between different tests, all scores were standardized. Mediation analysis was used to evaluate how much appetite/nutritional problems and caregiver stress mediate this association. RESULTS Mean age was 77 years (SD: 9), 37.3% were women. Exploring different cognitive domains, a stronger association was documented for attentive matrices (OR:0.49, 95% CI: 0.34-0.72), the figure copy test (OR:0.63, 95% CI: 0.45-0.88), and the verbal judgement test (OR:0.61, 95% CI: 0.42-0.91). The proportion of the effect of cognition (MMSE) on nutritional status mediated by caregiver distress was 9.5% (95% CI: 0.002-0.27), the proportion mediated by appetite/nutritional problems was 11% (95% CI: -4.8-3.18). CONCLUSION Risk of undernutrition is associated to cognitive decline; a stronger association was observed for attention, praxis, and reasoning. Caregiver distress is a mediator of this association. This information should be considered in the management plans of this population.
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Affiliation(s)
- Andrea Cavalli
- Unit of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
| | - Diana Lelli
- Unit of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
| | - Claudio Pedone
- Unit of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
| | - Virginia Boccardi
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia-SantaMaria della Misericordia Hospital, Perugia, Italy
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia-SantaMaria della Misericordia Hospital, Perugia, Italy
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Prado CM, Landi F, Chew STH, Atherton PJ, Molinger J, Ruck T, Gonzalez MC. Advances in Muscle Health and Nutrition: A Toolkit for Healthcare Professionals. Clin Nutr 2022; 41:2244-2263. [DOI: 10.1016/j.clnu.2022.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 11/03/2022]
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Xu Q, Shao L, Zhao S, Cai J, Lu L, Wang B, Liu P. Social support and nutritional status: Positive psychological capital as a mediator. SOCIAL BEHAVIOR AND PERSONALITY 2022. [DOI: 10.2224/sbp.11384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Nutrition is a critical public health concern for older adults and could be influenced by psychosocial factors. We explored the relationships of social support, positive psychological capital, and nutritional status among older adults from the perspective of positive psychology. We
used random sampling to recruit 151 community-dwelling older adults aged 60 and over, and they took part in face-to-face or telephone interviews using a standardized questionnaire. Hierarchical linear regression and bootstrapping analyses were applied to examine mediation effects. The results
show that there were significant positive correlations between the participants' social support, positive psychological capital, and nutritional status. Furthermore, we found a significant mediating effect of positive psychological capital in the relationship between social support and nutritional
status. These findings are of significance for adopting positive psychology interventions to maintain and improve older adults' nutritional status.
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Affiliation(s)
- Qian Xu
- Department of Clinical Nutrition, Peking University People's Hospital, and Institute of Medical Technology, Peking University Health Science Center, People's Republic of China
| | - Lin Shao
- Department of Clinical Nutrition, Peking University People's Hospital, People's Republic of China
| | - Shilong Zhao
- Department of Clinical Nutrition, Peking University People's Hospital, People's Republic of China
| | - Jingjing Cai
- Department of Clinical Nutrition, Peking University People's Hospital, People's Republic of China
| | - Lulu Lu
- Department of Clinical Nutrition, Peking University People's Hospital, People's Republic of China
| | - Boshi Wang
- Department of Clinical Nutrition, Peking University People's Hospital, People's Republic of China
| | - Peng Liu
- Department of Clinical Nutrition, Peking University People's Hospital, and Institute of Medical Technology, Peking University Health Science Center, People's Republic of China
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Gomez G, Botero-Rodríguez F, Misas JD, Garcia-Cifuentes E, Sulo S, Brunton C, Venegas-Sanabria LC, Gracia DA, Cano Gutierrez CA. A Nutritionally Focused Program for Community-living Older Adults Resulted in Improved Health and Well-being. Clin Nutr 2022; 41:1549-1556. [DOI: 10.1016/j.clnu.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 11/03/2022]
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Patterns of intrinsic capacity among community-dwelling older adults: Identification by latent class analysis and association with one-year adverse outcomes. Geriatr Nurs 2022; 45:223-229. [DOI: 10.1016/j.gerinurse.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/04/2022]
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Analysis of the Relationship among Cognitive Impairment, Nutritional Indexes and the Clinical Course among COVID-19 Patients Discharged from Hospital—Preliminary Report. Nutrients 2022; 14:nu14081580. [PMID: 35458142 PMCID: PMC9033019 DOI: 10.3390/nu14081580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Numerous data indicate the presence of cognitive impairment in people who have undergone COVID-19, often called COVID Fog (CF). This phenomenon persists even 6 months after infection, and its etiology and pathogenesis are not fully known. The aim of this article was to analyze the relationship among cognitive functioning, clinical data and nutrition indexes in patients discharged from the COVID-19 hospital of the Military Institute of Medicine, Warsaw, Poland. The sample comprised 17 individuals—10 women and 7 men, with ages of 65 ± 14 years. Cognitive impairment was measured with the use of the Montreal Cognitive Assessment (MoCA). The nutrition parameters included: hemoglobin, red blood cells, total cholesterol and its fractions, triglycerides, total protein, albumin, urea, creatinine, phosphates, calcium and sodium. The analysis showed that albumin concentration significantly correlated with the total MoCA score and especially with the short-term memory test score. Conversely, total cholesterol, and especially LDL concentrations, were highly and negatively associated with the MoCA score. In conclusion: markers of nutritional status are correlated with the severity of CF. Individuals with malnutrition or risk of malnutrition should be screened for CF. Further studies need to be performed in this area.
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Sun B, Zhao Y, Lu W, Chen Y. The Relationship of Malnutrition With Cognitive Function in the Older Chinese Population: Evidence From the Chinese Longitudinal Healthy Longevity Survey Study. Front Aging Neurosci 2021; 13:766159. [PMID: 34880747 PMCID: PMC8645828 DOI: 10.3389/fnagi.2021.766159] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/13/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objective: Few studies have explored the relationship between malnutrition measured by the Geriatric Nutritional Risk Index (GNRI) and cognitive performance. This study aimed to investigate the association of malnutrition with cognitive function in the Chinese population. Methods: It was a prospective longitudinal study and used three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2011–2012, 2014, and 2017–2018. Participants aged 60 years or older without mental illness and cerebrovascular diseases were eligible. The GNRI was used to assess nutritional status as follows: normal nutrition (a GNRI > 98), mild malnutrition (92 ≤ a GNRI ≤ 98), and moderate-to-severe malnutrition (a GNRI < 92). Cognitive performance was evaluated by the Mini-Mental State Examination (MMSE) scores. The relationship between the GNRI and cognitive function was analyzed using a linear mixed-effects model. Results: A total of 1,632 subjects were analyzed, including 741 males and 891 females. Of these, 65.0, 19.4, and 15.6% of subjects were at normal nutritional status, mild, and moderate-to-severe malnutrition, respectively. After adjusting for potential confounders, participants under mild and moderate-to-severe malnutrition status have a lower MMSE score [β (95% CI): –0.95 (–1.60, –0.25) and –1.39 (–2.21, –0.57), respectively], compared with those having normal nutrition. Also, there was a linear trend in the association of malnutrition risk with cognitive function in the total population [β (95% CI): –0.74 (–1.13, –0.35)]. However, a significant association of malnutrition with cognitive function was observed only among illiterate females aged above 90 years. Conclusion: This study suggested that there was a significant relationship between the GNRI and cognitive function in the Chinese elderly. Furthermore, subjects with more serious malnutrition have a worse cognitive function, especially in the oldest illiterate females. Clinicians should put more emphasis on assessing the nutritional and cognitive status of the elderly to timely intervene and prevent cognitive impairment.
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Affiliation(s)
- Boran Sun
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yihao Zhao
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Unusual Bioactive Compounds with Antioxidant Properties in Adjuvant Therapy Supporting Cognition Impairment in Age-Related Neurodegenerative Disorders. Int J Mol Sci 2021; 22:ijms221910707. [PMID: 34639048 PMCID: PMC8509433 DOI: 10.3390/ijms221910707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/29/2022] Open
Abstract
Cognitive function decline is strictly related to age, resulting in the loss of the ability to perform daily behaviors and is a fundamental clinical neurodegeneration symptom. It has been proven that an adequate diet, comprehensive nutrition, and a healthy lifestyle may significantly inhibit neurodegenerative processes, improving cognitive functions. Therefore, intensive research has been conducted on cognitive-enhancing treatment for many years, especially with substances of natural origin. There are several intervention programs aimed at improving cognitive functions in elderly adults. Cognitive functions depend on body weight, food consumed daily, the quality of the intestinal microflora, and the supplements used. The effectiveness in the prevention of dementia is particularly high before the onset of the first symptoms. The impact of diet and nutrition on age-associated cognitive decline is becoming a growing field as a vital factor that may be easily modified, and the effects may be observed on an ongoing basis. The paper presents a review of the latest preclinical and clinical studies on the influence of natural antioxidants on cognitive functions, with particular emphasis on neurodegenerative diseases. Nevertheless, despite the promising research results in animal models, the clinical application of natural compounds will only be possible after solving a few challenges.
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Malnutrition in Older Adults-Recent Advances and Remaining Challenges. Nutrients 2021; 13:nu13082764. [PMID: 34444924 PMCID: PMC8399049 DOI: 10.3390/nu13082764] [Citation(s) in RCA: 241] [Impact Index Per Article: 80.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/04/2021] [Accepted: 08/10/2021] [Indexed: 12/12/2022] Open
Abstract
Malnutrition in older adults has been recognised as a challenging health concern associated with not only increased mortality and morbidity, but also with physical decline, which has wide ranging acute implications for activities of daily living and quality of life in general. Malnutrition is common and may also contribute to the development of the geriatric syndromes in older adults. Malnutrition in the old is reflected by either involuntary weight loss or low body mass index, but hidden deficiencies such as micronutrient deficiencies are more difficult to assess and therefore frequently overlooked in the community-dwelling old. In developed countries, the most cited cause of malnutrition is disease, as both acute and chronic disorders have the potential to result in or aggravate malnutrition. Therefore, as higher age is one risk factor for developing disease, older adults have the highest risk of being at nutritional risk or becoming malnourished. However, the aetiology of malnutrition is complex and multifactorial, and the development of malnutrition in the old is most likely also facilitated by ageing processes. This comprehensive narrative review summarizes current evidence on the prevalence and determinants of malnutrition in old adults spanning from age-related changes to disease-associated risk factors, and outlines remaining challenges in the understanding, identification as well as treatment of malnutrition, which in some cases may include targeted supplementation of macro- and/or micronutrients, when diet alone is not sufficient to meet age-specific requirements.
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Koyanagi A, Smith L, Shin JI, Oh H, Kostev K, Jacob L, Abduljabbar AS, Haro JM. Multimorbidity and Subjective Cognitive Complaints: Findings from 48 Low- and Middle-Income Countries of the World Health Survey 2002-2004. J Alzheimers Dis 2021; 81:1737-1747. [PMID: 33998540 DOI: 10.3233/jad-201592] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Data on the association between multimorbidity and subjective cognitive complaints (SCC) are lacking from low- and middle-income countries (LMICs). OBJECTIVE To assess the association between multimorbidity and SCC among adults from 48 LMICs. METHODS Cross-sectional, community-based data were analyzed from the World Health Survey 2002-2004. Ten chronic conditions (angina, arthritis, asthma, chronic back pain, depression, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Multivariable linear regression and mediation analyses were conducted to explore the associations. RESULTS A total of 224,842 individuals aged≥18 years [mean (SD) age 38.3 (16.0) years; 49.3% males] constituted the final sample. Compared to no chronic conditions, the mean SCC score was higher by 7.13 (95% CI = 6.57-7.69), 14.84 (95% CI = 13.91-15.77), 21.10 (95% CI = 19.49-22.70), 27.48 (95% CI = 25.20-29.76), and 33.99 (95% CI = 31.45-36.53) points for 1, 2, 3, 4, and≥5 chronic conditions. Estimates by sex and age groups (18-44, 45-64,≥65 years) were similar. Nearly 30% of the association between multimorbidity (i.e.,≥2 chronic conditions) and SCC was explained by psychological factors (i.e., perceived stress, sleep problems, anxiety symptoms). CONCLUSION Multimorbidity is associated with SCC among adults in LMICs. Future studies should investigate whether addressing psychological factors in people with multimorbidity can improve cognitive function, and whether screening for SCC in individuals with multimorbidity can be a useful tool to identify individuals at particularly high risk for future cognitive decline.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Barcelona, Spain.,ICREA, Barcelona, Spain
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Karel Kostev
- Philipps University of Marburg, Marburg, Germany
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | | | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Barcelona, Spain.,King Saud University, Riyadh, Saudi Arabia
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