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Wragg E, Skirrow C, Dente P, Cotter J, Annas P, Lowther M, Backx R, Barnett J, Cree F, Kroll J, Cormack F. Generating normative data from web-based administration of the Cambridge Neuropsychological Test Automated Battery using a Bayesian framework. Front Digit Health 2024; 6:1294222. [PMID: 39371313 PMCID: PMC11451437 DOI: 10.3389/fdgth.2024.1294222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 07/12/2024] [Indexed: 10/08/2024] Open
Abstract
Introduction Normative cognitive data can distinguish impairment from healthy cognitive function and pathological decline from normal ageing. Traditional methods for deriving normative data typically require extremely large samples of healthy participants, stratifying test variation by pre-specified age groups and key demographic features (age, sex, education). Linear regression approaches can provide normative data from more sparsely sampled datasets, but non-normal distributions of many cognitive test results may lead to violation of model assumptions, limiting generalisability. Method The current study proposes a novel Bayesian framework for normative data generation. Participants (n = 728; 368 male and 360 female, age 18-75 years), completed the Cambridge Neuropsychological Test Automated Battery via the research crowdsourcing website Prolific.ac. Participants completed tests of visuospatial recognition memory (Spatial Working Memory test), visual episodic memory (Paired Associate Learning test) and sustained attention (Rapid Visual Information Processing test). Test outcomes were modelled as a function of age using Bayesian Generalised Linear Models, which were able to derive posterior distributions of the authentic data, drawing from a wide family of distributions. Markov Chain Monte Carlo algorithms generated a large synthetic dataset from posterior distributions for each outcome measure, capturing normative distributions of cognition as a function of age, sex and education. Results Comparison with stratified and linear regression methods showed converging results, with the Bayesian approach producing similar age, sex and education trends in the data, and similar categorisation of individual performance levels. Conclusion This study documents a novel, reproducible and robust method for describing normative cognitive performance with ageing using a large dataset.
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Affiliation(s)
- Elizabeth Wragg
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
| | - Caroline Skirrow
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Pasquale Dente
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
| | - Jack Cotter
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
| | - Peter Annas
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
- Research & Development, Lundbaek, Copenhagen, Denmark
| | - Milly Lowther
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Rosa Backx
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
| | - Jenny Barnett
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Fiona Cree
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
| | - Jasmin Kroll
- Clinical Science, Cambridge Cognition, Cambridge, United Kingdom
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Chen SM, Wu CJJ. Sex-based factors influencing perceived relocation stress and glycemic control among older adults with diabetes. Nurs Health Sci 2024; 26:e13150. [PMID: 39103223 DOI: 10.1111/nhs.13150] [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: 09/04/2023] [Revised: 06/06/2024] [Accepted: 07/18/2024] [Indexed: 08/07/2024]
Abstract
This study investigated sex differences perceived relocation stress and glycemic control among older adults with type 2 diabetes in long-term care facilities. A cross-sectional correlation design was used to recruit 120 residents during their first year after moving into the facilities in southern Taiwan. The results showed that almost two-thirds of the participants (64.2%) were women. The mean age was 79.62 (SD = 1.71). Older women with diabetes were reported to have significantly lower levels of education and poor glycemic control but higher levels of perceived relocation stress than men; however, functional independence was significantly higher in men. Although perceived relocation stress significantly predicted HbA1c levels in both women and men, length of stay was also significant in predicting HbA1c levels in women. These findings indicate the need for effective physical and psychological measures to improve glycemic control during the first year of stay in long-term care facilities.
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Affiliation(s)
- Shu-Ming Chen
- School of Nursing, Fooyin University, Kaohsiung City, Taiwan
| | - Chiung-Jung Jo Wu
- School of Health, University of the Sunshine Coast, Petrie, Queensland, Australia
- Royal Brisbane and Women's Hospital (RBWH), Herston, Queensland, Australia
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Argiris G, Stern Y, Habeck C. Cross-sectional and Longitudinal Age-related Disintegration in Functional Connectivity: Reference Ability Neural Network Cohort. J Cogn Neurosci 2024; 36:2045-2066. [PMID: 38739573 DOI: 10.1162/jocn_a_02188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Some theories of aging have linked age-related cognitive decline to a reduction in distinctiveness of neural processing. Observed age-related correlation increases among disparate cognitive tasks have supported the dedifferentiation hypothesis. We previously showed cross-sectional evidence for age-related correlation decreases instead, supporting an alternative disintegration hypothesis. In the current study, we extended our previous research to a longitudinal sample. We tested 135 participants (20-80 years) at two time points-baseline and 5-year follow-up-on a battery of 12 in-scanner tests, each tapping one of four reference abilities. We performed between-tasks correlations within domain (convergent) and between domain (discriminant) at both the behavioral and neural level, calculating a single measure of construct validity (convergent - discriminant). Cross-sectionally, behavioral construct validity was significantly different from chance at each time point, but longitudinal change was not significant. Analysis by median age split revealed that older adults showed higher behavioral validity, driven by higher discriminant validity (lower between-tasks correlations). Participant-level neural validity decreased over time, with convergent validity consistently greater than discriminant validity; this finding was also observed at the cross-sectional level. In addition, a disproportionate decrease in neural validity with age remained significant after controlling for demographic factors. Factors predicting longitudinal changes in global cognition (mean performance across all 12 tasks) included age, change in neural validity, education, and National Adult Reading Test (premorbid intelligence). Change in neural validity partially mediated the effect of age on change in global cognition. Our findings support the theory of age-related disintegration, linking cognitive decline to changes in neural representations over time.
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Matsuyama Y. Complete Loss of Natural Teeth and Loneliness: A Fixed-Effect Analysis. J Dent Res 2024; 103:973-979. [PMID: 39101655 DOI: 10.1177/00220345241263265] [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] [Indexed: 08/06/2024] Open
Abstract
Psychosocial properties of oral health have been reported. The present study aimed to investigate the causal effect of complete loss of natural teeth on loneliness by using fixed-effects analysis to control for confounding factors, including unmeasured time-invariant factors. Data from older adults participating in at least 2 consecutive waves of the English Longitudinal Study of Ageing in waves 3 (2006/2007), 5 (2010/2011), and 7 (2014/2015) were analyzed (N = 18,682 observations from 7,298 individuals). The association between complete loss of natural teeth and loneliness score (ranging from 3 to 9) was examined using fixed-effect linear regression analysis adjusting for time-varying confounders, including sociodemographic and health characteristics. The prevalence of complete tooth loss was 12.7%, 12.8%, and 10.6% in waves 3, 5, and 7, respectively. Individuals who transitioned to complete tooth loss during any 2 consecutive waves had an increase in loneliness score by 0.27 (95% confidence interval [CI] 0.03, 0.52), which was greater than those who maintained natural teeth (-0.03; 95% CI -0.05, -0.01). Fixed-effects analysis adjusting for time-varying confounders revealed a significant association between complete loss of natural teeth and an increase in loneliness score by 0.31 (95% CI 0.17, 0.46). Complete loss of natural teeth among older adults in England was associated with loneliness, even after accounting for measured time-varying and (un)measured time-invariant confounders. Retaining natural teeth may reduce the risk of loneliness.
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Affiliation(s)
- Y Matsuyama
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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5
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Cerin E, Soloveva MV, Molina MA, Schroers RD, Knibbs LD, Akram M, Wu YT, Mavoa S, Prina M, Sachdev PS, Sorensen Catts V, Jalaludin B, Poudel G, Symmons M, Barnett A, Hamidul Huque M, Leung Y, Cherbuin N, Anstey KJ. Neighbourhood environments and cognitive health in the longitudinal Personality and Total Health (PATH) through life study: A 12-year follow-up of older Australians. ENVIRONMENT INTERNATIONAL 2024; 191:108984. [PMID: 39208561 DOI: 10.1016/j.envint.2024.108984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/17/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Urban neighbourhood environments may impact older adults' cognitive health. However, longitudinal studies examining key environmental correlates of cognitive health are lacking. We estimated cross-sectional and longitudinal associations of neighbourhood built and natural environments and ambient air pollution with multiple cognitive health outcomes in Australian urban dwellers aged 60+ years. METHODS The study included 1160 participants of the PATH Through Life study (60+ cohort) who were followed up for 12 years (four assessments; 2001/02 to 2013/15) and with data on socio-demographics, health, cognitive functions and diagnoses, and full residential address. Neighbourhood environmental features encompassed population and street-intersection densities, non-commercial land use mix, transit points, presence of blue space, percentages of commercial land, parkland and tree cover, and annual average PM2.5 and NO2 concentrations. All exposures except for tree cover were assessed at two time points. Generalised additive mixed models estimated associations of person-level average, and within-person changes in, exposures with cognitive functions. Multi-state hidden Markov models estimated the associations of neighbourhood attributes with transitions to/from mild cognitive impairment (MCI). RESULTS Dense, destination-rich neighbourhoods were associated with a lower likelihood of transition to MCI and reversal to no MCI. Positive cross-sectional and longitudinal associations of non-commercial land use mix, street intersection density and percentage of commercial land were observed especially with global cognition and processing speed. While access to parkland and blue spaces were associated with a lower risk of transition to MCI, the findings related to cognitive functions were mixed and supportive of an effect of parkland on verbal memory only. Higher levels of PM2.5 and NO2 were consistently associated with steeper declines and/or decreases in cognitive functions and worse cognitive states across time. CONCLUSION To support cognitive health in ageing populations, neighbourhoods need to provide an optimal mix of environmental complexity, destinations and access to the natural environment and, at the same time, minimise ambient air pollution.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.
| | - Maria V Soloveva
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Miguel A Molina
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Ralf-Dieter Schroers
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, New South Wales, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia.
| | - Muhammad Akram
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Yu-Tzu Wu
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Suzanne Mavoa
- Population Health, Murdoch Children's Research Institute, Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia.
| | - Matthew Prina
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Vibeke Sorensen Catts
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW, Sydney, Australia.
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Randwick, New South Wales, Australia.
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Mark Symmons
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Md Hamidul Huque
- School of Psychology, University of New South Wales, Randwick, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia.
| | - Yvonne Leung
- School of Psychology, University of New South Wales, Randwick, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia; UNSW Ageing Futures Institute, Sydney, Australia.
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Canberra, Australian Capital Territory, Australia.
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Randwick, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia; UNSW Ageing Futures Institute, Sydney, Australia.
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Lai TF, Chang CC, Hsueh MC, Koohsari MJ, Shibata A, Liao Y, Oka K. Association of 24-Hour movement behavior and cognitive function in older Taiwanese adults. Geriatr Nurs 2024; 59:60-66. [PMID: 38986430 DOI: 10.1016/j.gerinurse.2024.06.028] [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: 05/31/2024] [Accepted: 06/21/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVES This study investigates how 24-hour movement behaviors (physical activity, sedentary time, sleep) relate to cognitive performance in older adults. METHODS 213 adults (aged 65+) wore accelerometers to track activity. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Isotemporal substitution analysis examined how replacing one behavior with another affected cognition. RESULTS Increased light physical activity was linked to better cognitive function, whereas longer sleep had a negative impact. Replacing 30 min of sedentary behavior or sleep with light physical activity improved orientation, attention, language, and short-term memory. Substituting moderate-to-vigorous physical activity did not have the same cognitive benefit. CONCLUSION Encouraging older adults to replace sedentary time or excess sleep with light physical activity could support cognitive health and potentially help prevent dementia. These findings have implications for public health strategies promoting cognitive well-being in aging populations.
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Affiliation(s)
- Ting-Fu Lai
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
| | - Chih-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Mohammad Javad Koohsari
- School of Advanced Science and Technology, Japan Advanced Institute of Science and Technology, Nomi, Japan; Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan; School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan; Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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7
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Ho NCW, Bethlehem RAI, Seidlitz J, Nogovitsyn N, Metzak P, Ballester PL, Hassel S, Rotzinger S, Poppenk J, Lam RW, Taylor VH, Milev R, Bullmore ET, Alexander-Bloch AF, Frey BN, Harkness KL, Addington J, Kennedy SH, Dunlop K. Atypical Brain Aging and Its Association With Working Memory Performance in Major Depressive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:786-799. [PMID: 38679324 DOI: 10.1016/j.bpsc.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) can present with altered brain structure and deficits in cognitive function similar to those seen in aging. However, the interaction between age-related brain changes and brain development in MDD remains understudied. In a cohort of adolescents and adults with and without MDD, we assessed brain aging differences and associations through a newly developed tool that quantifies normative neurodevelopmental trajectories. METHODS A total of 304 participants with MDD and 236 control participants without depression were recruited and scanned from 3 studies under the Canadian Biomarker Integration Network for Depression. Volumetric data were used to generate brain centile scores, which were examined for 1) differences between participants with MDD and control participants; 2) differences between individuals with versus without severe childhood maltreatment; and 3) correlations with depressive symptom severity, neurocognitive assessment domains, and escitalopram treatment response. RESULTS Brain centiles were significantly lower in the MDD group than in the control group. Brain centile was also significantly correlated with working memory in the control group but not the MDD group. No significant associations were observed between depression severity or antidepressant treatment response and brain centiles. Likewise, childhood maltreatment history did not significantly affect brain centiles. CONCLUSIONS Consistent with previous work on machine learning models that predict brain age, brain centile scores differed in people diagnosed with MDD, and MDD was associated with differential relationships between centile scores and working memory. The results support the notion of atypical development and aging in MDD, with implications for neurocognitive deficits associated with aging-related cognitive function.
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Affiliation(s)
- Natalie C W Ho
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Ontario, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Ontario, Canada; Faculty of Arts and Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Lifespan Brain Institute, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Institute of Translational Medicine & Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Nikita Nogovitsyn
- Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Ontario, Canada
| | - Paul Metzak
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Pedro L Ballester
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stefanie Hassel
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Susan Rotzinger
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Ontario, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Mood Disorders Treatment and Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jordan Poppenk
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada; Department of Psychology, Queen's University, Kingston, Ontario, Canada; School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Roumen Milev
- Department of Psychology, Queen's University, Kingston, Ontario, Canada; Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Providence Care Hospital, Kingston, Ontario, Canada
| | - Edward T Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Aaron F Alexander-Bloch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Lifespan Brain Institute, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Institute of Translational Medicine & Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Benicio N Frey
- Mood Disorders Treatment and Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, Ontario, Canada; Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Sidney H Kennedy
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Ontario, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Katharine Dunlop
- Keenan Research Centre for Biomedical Research, Unity Health Toronto, Toronto, Ontario, Canada; Centre for Depression & Suicide Studies, Unity Health Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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8
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Sri Lekha PP, Abdul Azeez EP, Singh A, Irshad CV. Association of nature of work and work-related characteristics with cognitive functioning, life satisfaction and depression among Indian ageing adults. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02089-5. [PMID: 39042116 DOI: 10.1007/s00420-024-02089-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/28/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Most individuals spend a significant amount of their time at work, and the dynamics at work can potentially influence their overall life, especially health and mental health. The present study tried to understand the association of the nature of work categorized as physically demanding, psychologically demanding, and environmentally hazardous on life satisfaction, cognitive functioning, and depressive symptoms among working middle-aged and older adults in India. METHOD We used data from the Longitudinal Ageing Study in India (LASI), Wave 1, collected between 2017 and 2018. The study sample consists of 28,653 working adults aged between 45 and 70. The study measures were assessed using standard tools. Linear regression analysis was employed. RESULTS The results indicate that individuals working in less physically demanding (β = 0.06, 99% CI = 0.02-0.09) and not hazardous environments (β = 0.15, 99% CI = 0.09-0.20) had better life satisfaction. Also, not being involved in hazardous work environments increased the likelihood of good cognitive functioning and reduced depressive symptoms (β= -0.17, 99% CI= -0.20- -0.15). However, samples involved in works requiring less psychological demand had an increased likelihood of reduced life satisfaction and increased depressive symptoms. CONCLUSION This study's results highlight the importance of creating a conducive working environment for the ageing adults.
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Affiliation(s)
- P Padma Sri Lekha
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
| | - Arti Singh
- Jindal School of Counselling and Psychology, O.P. Jindal Global University, Haryana, India
| | - C V Irshad
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
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9
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Rabin EE, Huang J, Kim M, Mozny A, Lauing KL, Penco-Campillo M, Zhai L, Bommi P, Mi X, Power EA, Prabhu VC, Anderson DE, Barton KP, Walunas TL, Schiltz GE, Amidei C, Sanchez-Gomez P, Thakkar JP, Lukas RV, Wainwright DA. Age-stratified comorbid and pharmacologic analysis of patients with glioblastoma. Brain Behav Immun Health 2024; 38:100753. [PMID: 38600951 PMCID: PMC11004500 DOI: 10.1016/j.bbih.2024.100753] [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: 10/06/2023] [Revised: 02/13/2024] [Accepted: 03/08/2024] [Indexed: 04/12/2024] Open
Abstract
Background Increased age is a strong and unfavorable prognostic factor for patients with glioblastoma (GBM). However, the relationships between stratified patient age, comorbidities, and medications have yet to be explored in GBM patient survival analyses. Objective To evaluate co-morbid conditions, tumor-related symptoms, medication prescriptions, and subject age for patients with GBM and to establish potential targets for prospective studies. Methods Electronic health records for 565 patients with IDHwt GBM were evaluated at a single center between January 1, 2000 and August 9, 2021 were retrospectively assessed. Data were stratified by MGMT promoter methylation status when available and were used to construct multivariable time-dependent cox models and intra-cohort hazards. Results Younger (<65 years of age) but not older (≥65 years) GBM patients demonstrated a worse prognosis with movement related disabilities (P < 0.0001), gait/balance difficulty (P = 0.04) and weakness (P = 0.007), as well as psychiatric conditions, mental health disorders (P = 0.002) and anxiety (P = 0.001). In contrast, older but not younger GBM patients demonstrated a worse prognosis with epilepsy (P = 0.039). Both groups had worse survival with confusion/altered mental status (P = 0.023 vs < 0.000) and an improved survival with a Temozolomide prescription. Older but not younger GBM patients experienced an improved hazard with a prescription of ace-inhibitor medications (P = 0.048). Conclusion Age-dependent novel associations between clinical symptoms and medications prescribed for co-morbid conditions were demonstrated in patients with GBM. The results of the current work support future mechanistic studies that investigate the negative relationship(s) between increased age, comorbidities, and drug therapies for differential clinical decision-making across the lifespan of patients with GBM.
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Affiliation(s)
- Erik E. Rabin
- Department of Neurological Surgery at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jonathan Huang
- Department of Neurological Surgery at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Miri Kim
- Department of Neurological Surgery at Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Andreas Mozny
- Department of Neurological Surgery at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kristen L. Lauing
- Department of Cancer Biology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Manon Penco-Campillo
- Department of Cancer Biology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Lijie Zhai
- Department of Cancer Biology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Prashant Bommi
- Department of Cancer Biology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Xinlei Mi
- Department of Preventive Medicine-Division of Biostatistics at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Erica A. Power
- Department of Cancer Biology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Vikram C. Prabhu
- Department of Neurological Surgery at Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Douglas E. Anderson
- Department of Neurological Surgery at Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Kevin P. Barton
- Department of Medicine - Hematology/Oncology at Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Theresa L. Walunas
- Department of Medicine - Division of General Internal Medicine and Geriatrics at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine-Division of Health and Biomedical Informatics at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gary E. Schiltz
- Department of Chemistry at Northwestern University, Evanston, IL, USA
| | - Christina Amidei
- Department of Neurological Surgery at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pilar Sanchez-Gomez
- Neurooncology Unit, Unidad Funcional de Investigación en Enfermedades Crónicas (UFIEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Jigisha P. Thakkar
- Department of Neurology at Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Rimas V. Lukas
- Department of Neurology at Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Derek A. Wainwright
- Department of Neurological Surgery at Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
- Department of Cancer Biology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
- Cardinal Bernardin Cancer Center, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
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10
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Cochar-Soares N, de Oliveira DC, Luiz MM, Aliberti MJR, Suemoto CK, Steptoe A, de Oliveira C, Alexandre T. Sex Differences in the Trajectories of Cognitive Decline and Affected Cognitive Domains Among Older Adults With Controlled and Uncontrolled Glycemia. J Gerontol A Biol Sci Med Sci 2024; 79:glae136. [PMID: 38775400 PMCID: PMC11181940 DOI: 10.1093/gerona/glae136] [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: 11/21/2023] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND We aimed to analyze the trajectories of cognitive decline as a function of the presence of type 2 diabetes and glycemic control in analyzes stratified by sex in an 8-year follow-up period. METHODS A total of 1 752 men and 2 232 women aged ≥50 years who participated in the English Longitudinal Study of Ageing (ELSA), conducted from 2004 to 2012, were analyzed. The outcomes of interest were performance on the cognitive domains of memory, executive function, and temporal orientation as well as the global cognition score. Cognitive performance was standardized in z-scores in strata based on schooling and age. The participants were classified as without diabetes, with controlled glycemia, and with uncontrolled glycemia, according to medical diagnosis, glucose-lowering medications use and HbA1c levels. Generalized linear mixed models controlled by sociodemographic, behavioral, and health-related characteristics were used for the trajectory analyses. RESULTS No differences in z-scores were found for global cognition or cognitive domains based on diabetes classification in men and women at baseline. More than 8 years of follow up, women with uncontrolled glycemia had a greater decline in z-scores for global cognition (-0.037 SD/year [95% CI: -0.073; -0.001]) and executive function (-0.049 SD/year [95% CI: -0.092; -0.007]) compared with those without diabetes. No significant difference in trajectories of global cognition or any cognitive domain was found in men as a function of diabetes classification. CONCLUSIONS Women with uncontrolled glycemia are at greater risk of a decline in global cognition and executive function than those without diabetes.
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Affiliation(s)
| | - Dayane C de Oliveira
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Mariane M Luiz
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Márlon J R Aliberti
- Laboratory of Medical Research in Aging (LIM-66), Servico de Geriatria, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Claudia K Suemoto
- Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Andrew Steptoe
- Department of Behavioral Science and Health, University College London, London, UK
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago S Alexandre
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
- Department of Epidemiology and Public Health, University College London, London, UK
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11
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Ojijieme NG, Feng T, Chui CM, Qi X, Liu Y. Physical activity dynamically moderates the impact of multimorbidity on the trajectory of healthy aging over sixteen years. BMC Geriatr 2024; 24:565. [PMID: 38943080 PMCID: PMC11212370 DOI: 10.1186/s12877-024-05067-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/13/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Research examining the healthy aging trajectory of retired older adults with multimorbidity is limited, leaving uncertainties regarding the optimal physical activity (PA) intensity and frequency necessary to sustain healthy aging during retirement. METHODS Our study investigated the moderating effects of PA on the healthy aging trajectories of retired older adults living with multimorbidity in the United States (US). We utilized data from 1,238 retired individuals aged 50 to 102 who contributed 11,142 observations over 16 years from the Health and Retirement Study (HRS). We employed mixed effects modeling to assess the impact of various classes of multimorbidity on this group and examine how different PA, PA intensities, and PA frequencies influence the disability, physical, and cognitive functioning domains of healthy aging. RESULTS The results reveal that while outcomes differed significantly, retired older adults in the US attained healthy aging at baseline. However, their ability to maintain healthy aging declined over time, with multimorbidity, especially musculoskeletal and neurological conditions, accelerating this decline. Fortunately, PA, especially light to moderate intensities, is associated with improving healthy aging and moderating the impact of multimorbidity on the disability and cognitive functioning domains of healthy aging. However, the specific moderating effects of PA depend on its frequency, intensity, and chronic conditions. CONCLUSIONS The significant variability in healthy aging attainment among retired older adults underlies the need to consider these differences when addressing healthy aging issues in the US. Accounting for these variations would aid in evaluating the potential impact of future interventions and contribute to achieving health equity. Fortunately, our dynamic findings facilitate this objective by identifying specific frequencies and intensities of PA tailored to different aspects of multimorbidity and healthy aging. This highlights PA, especially light-to-moderate intensity, as an essential, cost-effective, and amenable strategy for alleviating the impact of multimorbidity on healthy aging.
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Affiliation(s)
- Nnaelue Godfrey Ojijieme
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xingqing Road, Xi'an, Shaanxi, 710049, China
| | - Tieying Feng
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xingqing Road, Xi'an, Shaanxi, 710049, China.
| | - Chin Man Chui
- School of Business, Macau University of Science and Technology, Taipa, Macau, 999078, China.
- Institute of Development Economics, Macau University of Science and Technology, Taipa, China.
| | - Xinzhu Qi
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xingqing Road, Xi'an, Shaanxi, 710049, China
| | - Yuan Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xingqing Road, Xi'an, Shaanxi, 710049, China
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12
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Cardoso MJF, Alvarenga KDF, Tabaquim MDLM, Lopes TDA, Costa OA, Jacob LCB. Elderly people with hearing loss and cognitive decline: speech perception performance in noise. Codas 2024; 36:e20230094. [PMID: 38896743 PMCID: PMC466999 DOI: 10.1590/2317-1782/20242023094pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/14/2023] [Indexed: 06/21/2024] Open
Abstract
PURPOSE To verify the influence of verbal intellectual-cognitive skills on speech perception in noise, in elderly with sensorineural hearing loss, considering education, age, and degree of hearing loss. METHODS 36 elderly between 60 and 89 years old with bilateral sensorineural hearing loss participated in the study. After psychological assessment using the Wechsler Intelligence Scale for Adults (WAIS-III), they were grouped into (GI) 24 elderly without cognitive alteration and (GII) 12 elderly with risk of cognitive alteration. They underwent otorhinolaryngological assessment, audiological interview, pure tone audiometry, and assessment of speech perception in noise using the Hearing in Noise Test (HINT-Brazil). The Mann-Whitney U statistical test compared the results between the groups, and the Spearman correlation verified the variable's age, degree of hearing loss, and level of education. RESULTS There was no difference between the groups in the ability to perceive speech in noise, except in the noise on the left condition, in which GII showed better performance in HINT-Brazil. The degree of hearing loss and level of education influenced the perception of speech in noise. The level of education was correlated with the WAIS-III results. CONCLUSION The decline in verbal intellectual-cognitive skills did not affect speech perception of noise in the elderly with hearing loss. The degree of hearing loss and level of education influenced the performance of the elderly in the speech perception test in noise. Performance in verbal cognitive skills varied according to the level of education.
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Affiliation(s)
- Maria Julia Ferreira Cardoso
- Programa de Pós-graduação em Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.
| | - Kátia de Freitas Alvarenga
- Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.
| | | | - Tatiana de Andrade Lopes
- Programa de Pós-graduação em Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.
| | - Orozimbo Alves Costa
- Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.
| | - Lilian Cássia Bórnia Jacob
- Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.
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13
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Prince JB, Davis HL, Tan J, Muller-Townsend K, Markovic S, Lewis DMG, Hastie B, Thompson MB, Drummond PD, Fujiyama H, Sohrabi HR. Cognitive and neuroscientific perspectives of healthy ageing. Neurosci Biobehav Rev 2024; 161:105649. [PMID: 38579902 DOI: 10.1016/j.neubiorev.2024.105649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/17/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.
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Affiliation(s)
- Jon B Prince
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia.
| | - Helen L Davis
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Jane Tan
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Katrina Muller-Townsend
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Shaun Markovic
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; Discipline of Psychology, Counselling and Criminology, Edith Cowan University, WA, Australia
| | - David M G Lewis
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | | | - Matthew B Thompson
- School of Psychology, Murdoch University, WA, Australia; Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, WA, Australia
| | - Peter D Drummond
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Hakuei Fujiyama
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, WA, Australia
| | - Hamid R Sohrabi
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Department of Biomedical Sciences, Macquarie University, NSW, Australia.
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14
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Yang Z, Hotterbeex P, Marent PJ, Cerin E, Thomis M, van Uffelen J. Physical activity, sedentary behaviour, and cognitive function among older adults: A bibliometric analysis from 2004 to 2024. Ageing Res Rev 2024; 97:102283. [PMID: 38552882 DOI: 10.1016/j.arr.2024.102283] [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: 11/29/2023] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/20/2024]
Abstract
Because of population ageing, there will be a vast increase in the prevalence of cognitive decline and dementia. Physical activity and sedentary behaviour have been identified as modifiable lifestyle behaviours associated with these cognitive conditions. Therefore, the aim of this bibliometric analysis is to reveal the knowledge structure of the field of physical activity, sedentary behaviour, and cognitive function among older adults from 2004 to 2024, and to predict emerging research trends. A total of 1290 publications were retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer were applied to conduct performance analysis, science mapping, and enrichment. T. Liu-Ambrose was the most prolific author (39 publications), and the University of British Columbia was the most prolific institution (48 publications). The USA, China, and Canada were the three most productive countries with 392, 174, and 136 publications respectively. Two research trends revealed the knowledge structure of this field, including the shift from evaluating the effectiveness of interventions on cognitive function to evaluating the effectiveness of interventions on other health-related outcomes, as well as an expansion of research on the role of physical activity and sedentary behaviour in the context of healthy ageing. Sleep, sedentary behaviour, and virtual reality may be emerging research trends and may predict directions for future research. Collectively, this bibliometric analysis provides a one-step overview of the knowledge structure in this field for researchers and other stakeholders, as well as a reference for future research.
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Affiliation(s)
- Zhen Yang
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Pauline Hotterbeex
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Leuven Brain Institute, KU Leuven, Leuven, Belgium; Department of Movement and Sports Sciences, Ghent University Research Centre for Aging Young, Ghent University, Ghent, Belgium
| | - Pieter-Jan Marent
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Department of Movement and Sports Sciences, Ghent University Research Centre for Aging Young, Ghent University, Ghent, Belgium
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Martine Thomis
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Jannique van Uffelen
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Leuven Brain Institute, KU Leuven, Leuven, Belgium.
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15
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Martins VF, Peyré-Tartaruga LA, Haas AN, Kanitz AC, Martinez FG, Gonçalves AK. Observational evidence of the association between physical and psychological determinants of aging with cognition in older adults. Sci Rep 2024; 14:12574. [PMID: 38821915 PMCID: PMC11143211 DOI: 10.1038/s41598-024-58497-7] [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: 09/11/2023] [Accepted: 03/29/2024] [Indexed: 06/02/2024] Open
Abstract
Aging involves physical and cognitive deterioration in older adults. Detecting predictors of dementia early is crucial to identify its onset. This study aimed to associate physical and psychological determinants with cognitive performance in older adults. Observational study with 221 older adults, classified according to cognitive impairment. We evaluated cognitive function by Mini-Mental State Examination. Physical determinants encompassed muscle strength, functional mobility, and cardiorespiratory fitness, while psychological consisted of quality of life and activities of daily living. Multiple linear regression was performed to investigate this relationship. Physical and psychological determinants were significantly linked to cognitive impairment, including lower muscle strength, reduced functional mobility and of cardiorespiratory fitness. The influence of environment, autonomy, and engagement in daily activities on cognitive impairment was also observed. The analysis of physical and psychological determinants could help to aid in distinguishing individuals with cognitive impairment.
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Affiliation(s)
- Valéria Feijó Martins
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Alexandre Peyré-Tartaruga
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Human Locomotion Laboratory (LocoLab), Department of Public Health, Experimental Medicine and Forensic Sciences, University of Pavia, Pavia, Italy.
| | - Aline Nogueira Haas
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Global Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Ana Carolina Kanitz
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávia Gomes Martinez
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andréa Kruger Gonçalves
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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16
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Chen S, Ling Y, Zhou F, Qiao X, Reinhardt JD. Trajectories of cognitive function among people aged 45 years and older living with diabetes in China: Results from a nationally representative longitudinal study (2011~2018). PLoS One 2024; 19:e0299316. [PMID: 38787866 PMCID: PMC11125531 DOI: 10.1371/journal.pone.0299316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/08/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVES Diabetes is associated with decline of cognitive function. Exploring different trajectories of cognitive function occurring in people with diabetes is important to improved prognosis. This study aimed to investigate differential patterns of trajectories of cognitive function and baseline determinants of trajectory group membership utilizing data from middle-aged and older Chinese adults with diabetes. METHODS Participants of the Chinese Health And Retirement Longitudinal Study (CHARLS) aged 45 years and above received biennial assessments between 2011 and 2018. The primary outcome was overall cognitive function score operationalized as sum of mental intactness and episodic memory scores derived from the Telephone Interview of Cognitive Status (TICS). A weighted growth mixture model was used to estimate cognitive function trajectories of CHARLS participants with diabetes, and baseline factors associated with trajectory group membership were investigated with weighted multinomial logistic regression. RESULTS Data from 1,463 participants with diabetes aged 45 years and above were analyzed, a three-group trajectory model showed the best fit for overall cognitive scores: low baseline, linear declining (22.1%); moderate baseline, linear declining (37.5%) and high-stable (40.3%). Older participants, females, participants with low education, with nighttime sleep <6 h, without daytime napping habits, and with depressive symptoms were at a higher risk of unfavorable cognitive function trajectories. CONCLUSIONS We identified heterogeneous trajectories of cognitive function among middle-aged and older people living with diabetes in China. Socially vulnerable groups including females, rural residents, and those with low education were at a higher risk for unfavorable trajectories. In health programs aimed at preventing and mitigating cognitive decline in individuals with diabetes more attention should be given to vulnerable groups. Reduced nighttime sleep, lack of daytime napping, and depressive symptoms appear to be modifiable risk factors.
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Affiliation(s)
- Shi Chen
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuewei Ling
- Department of Management Science and Engineering, Stanford University, Stanford, CA, United States of America
| | - Faquan Zhou
- Department of Vascular Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xu Qiao
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Rehabilitation Medicine Centre, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, China
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17
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Miri A, Araújo H, Gil A, de Oliveira M, Volpe R, Angelo E, Mahmoud Smaili S. Analysis of handgrip strength, pulling force using the upper limbs, and ground reaction forces in the task of boarding a bus between healthy elderly individuals and those with Parkinson's disease. Physiother Theory Pract 2024; 40:909-918. [PMID: 36377318 DOI: 10.1080/09593985.2022.2144781] [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: 12/02/2021] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Elderly individuals with neurodegenerative diseases, such as Parkinson's disease (PD), may experience difficulties when performing functional tasks. OBJECTIVE To analyze the handgrip strength, pulling force, and ground reaction forces (GRF) of individuals with and without PD when boarding a bus while performing both simple (ST) and dual tasks (DT). METHOD This case-control study addressed 31 individuals with PD (GPD) and 30 healthy individuals (GHI). Assessments were performed in ST and DT situations using a bus model (prototype). Handgrip strength and pulling force were measured in both upper limbs using a dynamometer, and GRF was measured using a force platform. The GPD's and GHI's performances were compared in both ST and DT, and the individuals were classified as fallers according to the Falls Efficacy Scale. RESULTS In the inter-group comparison, the GPD presented significantly lower maximum force using their right hand, in handgrip strength (30.43 vs. 36.62, P = .022), and pulling force (10.77 vs 12.81, P = .037). The left hand's pulling force proved to be the most demanding for the GPD, during ST (6.35 vs. 4.76, P = .006) and DT (6.32 vs 4.74, P = .008). The GPD also took longer to perform ST (6.14 vs. 4.67, P < .001) and DT (6.08 vs. 4.81, P = .002). Additionally, the GPD was more afraid of falling compared to the GHI (34.74 vs. 24.77, P < .001). CONCLUSION Boarding a bus is a complex task for individuals with PD because they present lower maximum strength in the upper limbs and more significant functional expenditure than their healthy counterparts.
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Affiliation(s)
- Andressa Miri
- Post-Graduation Program in Rehabilitation Sciences, State University of Londrina (UEL), Avenida Robert Koch, n 60, Vila Operária, Londrina, Brazil
| | - Hayslenne Araújo
- Post-Graduation Program in Rehabilitation Sciences, State University of Londrina (UEL), Avenida Robert Koch, n 60, Vila Operária, Londrina, Brazil
| | - André Gil
- Post-Graduation Program in Rehabilitation Sciences, Northern Paraná University (UNOPAR), Londrina, Brazil
| | - Marcio de Oliveira
- Post-Graduation Program in Rehabilitation Sciences, Northern Paraná University (UNOPAR), Londrina, Brazil
| | - Renata Volpe
- Post-Graduation Program in Rehabilitation Sciences, State University of Londrina (UEL), Avenida Robert Koch, n 60, Vila Operária, Londrina, Brazil
| | - Edylaine Angelo
- Undergraduate Student at the Physiotherapy Program, State University of Londrina (UEL), Londrina, Brazil
| | - Suhaila Mahmoud Smaili
- Post-Graduation Program in Rehabilitation Sciences, Physiotherapy Department, State University of Londrina (UEL), Londrina, Brazil
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18
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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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19
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Wasserman JS, Holtzer R. Depressive Symptoms are Associated with Decline Over Time in Verbal Fluency Performance in Female but Not Male Community-Dwelling Older Adults. Exp Aging Res 2024; 50:360-375. [PMID: 36989442 PMCID: PMC10539484 DOI: 10.1080/0361073x.2023.2195295] [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: 09/01/2022] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE The current study was designed to examine associations between depressive symptoms and longitudinal declines in category and letter fluency performance in a gender-stratified sample of older adults. METHOD Participants were community-residing older adults (females: n = 289; males: n = 233) followed annually (2011-2018) as part of a cohort study conducted at Albert Einstein College of Medicine in New York. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Standard forms assessed category and letter fluency performance. Participants were dementia-free during study enrollment. RESULTS The presence of baseline depressive symptoms suggestive of subclinical depression was associated with a worse longitudinal decline in category fluency performance in female but not male participants. These associations remained significant when excluding participants with prevalent and incident mild cognitive impairment and incident dementia. Irrespective of gender, letter fluency performance did not decline over time and was not influenced by the presence of depressive symptoms. DISCUSSION The present study's results can aid in identification of older adults who may be at greater risk for cognitive decline, and add to the limited literature examining the influence of gender on longitudinal associations between depressive symptoms and verbal fluency performance.
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Affiliation(s)
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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20
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Yang C, Mao Z, Wu S, Yin S, Sun Y, Cui D. Influencing factors, gender differences and the decomposition of inequalities in cognitive function in Chinese older adults: a population-based cohort study. BMC Geriatr 2024; 24:371. [PMID: 38664618 PMCID: PMC11045435 DOI: 10.1186/s12877-024-04857-x] [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: 05/07/2023] [Accepted: 10/04/2023] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Evidence remains limited and inconsistent for assessing cognitive function in Chinese older adults (CFCOA) and inequalities in cognitive function in Chinese older adults (ICFCOA) and exploring their influencing factors and gender differences. This study aimed to identify influencing factors and inequality in CFCOA to empirically explore the existence and sources of gender differences in such inequality and analyse their heterogeneous effects. METHODS Based on data from the China Health and Retirement Longitudinal Study (CHARLS) for three periods from 2011 to 2015, recentered influence function unconditional quantile regression (RIF-UQR) and recentered influence function ordinary least squares (RIF-OLS) regression were applied to assess influencing factors of CFCOA, while grouped treatment effect estimation, Oaxaca-Blinder decomposition, and propensity score matching (PSM) methods were conducted to identify gender differences in ICFCOA and influencing factors, respectively. RESULTS The results showed heterogeneous effects of gender, age, low BMI, subjective health, smoking, education, social interactions, physical activity, and household registration on CFCOA. Additionally, on average, ICFCOA was about 19.2-36.0% higher among elderly females than among elderly males, mainly due to differences in characteristic effects and coefficient effects of factors such as marital status and education. CONCLUSIONS Different factors have heterogeneous and gender-differenced effects on CFCOA and ICFCOA, while the formation and exacerbation of ICFCOA were allied to marital status and education. Considering the severe ageing and the increasing incidence of cognitive decline, there is an urgent need for the government and society to adopt a comprehensive approach to practically work for promoting CFCOA and reducing ICFCOA.
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Affiliation(s)
- Ciran Yang
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Zongfu Mao
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Shaotang Wu
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Shicheng Yin
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Yu Sun
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Dan Cui
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China.
- Global Health Institute, Wuhan University, Wuhan, China.
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21
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Yoon KN, Cui Y, Quan QL, Lee DH, Oh JH, Chung JH. Tomato and lemon extracts synergistically improve cognitive function by increasing brain-derived neurotrophic factor levels in aged mice. Br J Nutr 2024; 131:1105-1114. [PMID: 38016800 PMCID: PMC10918522 DOI: 10.1017/s0007114523002301] [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: 07/28/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 11/30/2023]
Abstract
Brain ageing, the primary risk factor for cognitive impairment, occurs because of the accumulation of age-related neuropathologies. Identifying effective nutrients that increase cognitive function may help maintain brain health. Tomatoes and lemons have various bioactive functions and exert protective effects against oxidative stress, ageing and cancer. Moreover, they have been shown to enhance cognitive function. In the present study, we aimed to investigate the effects of tomato and lemon ethanolic extracts (TEE and LEE, respectively) and their possible synergistic effects on the enhancement of cognitive function and neurogenesis in aged mice. The molecular mechanisms underlying the synergistic effect of TEE and LEE were investigated. For the in vivo experiment, TEE, LEE or their mixture was orally administered to 12-month-old mice for 9 weeks. A single administration of either TEE or LEE improved cognitive function and neurogenesis in aged mice to some extent, as determined using the novel object recognition test and doublecortin immunohistochemical staining, respectively. However, a significant enhancement of cognitive function and neurogenesis in aged mice was observed after the administration of the TEE + LEE mixture, which had a synergistic effect. N-methyl-d-aspartate receptor 2B, postsynaptic density protein 95, and brain-derived neurotrophic factor (BDNF) levels and tropomyosin receptor kinase B (TrkB)/extracellular signal-regulated kinase (ERK) phosphorylation also synergistically increased after the administration of the mixture compared with those in the individual treatments. In conclusion, compared with their separate treatments, treatment with the TEE + LEE mixture synergistically improved the cognitive function, neurogenesis and synaptic plasticity in aged mice via the BDNF/TrkB/ERK signalling pathway.
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Affiliation(s)
- Kyeong-No Yoon
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Yidan Cui
- Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Qing-Ling Quan
- Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Hun Lee
- Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jang-Hee Oh
- Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Ho Chung
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- Laboratory of Cutaneous Aging Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute on Aging, Seoul National University, Seoul, Republic of Korea
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22
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Zarringhadam M, Hasanvand S, Birjandi M, Beiranvand A. Associations between cognitive function and lifestyle in community-living older people: a correlational study. BMC Res Notes 2024; 17:101. [PMID: 38594711 PMCID: PMC11003163 DOI: 10.1186/s13104-024-06766-z] [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: 11/08/2023] [Accepted: 04/03/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Previous studies have examined relationship between cognitive function and lifestyle; however, the nature of this relationship is expected to vary in diverse cultural and low-income setting where lifestyle practices differ from those in high-income countries. AIM This study aims to investigate the correlation between lifestyle factors and cognitive function among individuals aged 60 years and older in 2021. METHODS This cross-sectional, Community-based study involved 300 older adults from comprehensive urban health centers in Khorramabad, Iran, selected through stratified cluster sampling. Data were collected using the demographic information questionnaire, Mini-Mental State Examination, and Lifestyle Questionnaire. Data management and analysis were performed using SPSS (version 22) and independent t-tests, Pearson's correlation coefficient, ANOVA, and multiple linear regression analysis were used. A p value < 0.05 was considered significant. RESULTS The study included 156 males (52%) and 144 females (48%). Findings revealed a significant correlation between cognitive function and lifestyle (P < 0.001). Multiple linear regression analysis indicated that physical health, environmental health, exercise, accident prevention, and avoidance of medication exerted the most significant positive effect on cognitive function. Conversely, social health exhibited a notable negative influence on cognitive function. (P < 0.001). CONCLUSION The results suggest that specific aspects of lifestyle, such as physical health, accident prevention, and avoidance of medication are associated with cognitive function in older adults. Consequently, lifestyle promotion programs may enhance cognitive function and improve the quality of life among older adults.
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Affiliation(s)
- Maryam Zarringhadam
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Shirin Hasanvand
- Social Determinants of Health Research Center, School of Nursing & Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mehdi Birjandi
- Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Afsaneh Beiranvand
- Social Determinants of Health Research Center, School of Nursing & Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
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23
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Wood D, Evangelopoulos D, Beevers S, Kitwiroon N, Demakakos P, Katsouyanni K. Exposure to ambient air pollution and cognitive function: an analysis of the English Longitudinal Study of Ageing cohort. Environ Health 2024; 23:35. [PMID: 38575976 PMCID: PMC10996194 DOI: 10.1186/s12940-024-01075-1] [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: 09/12/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND An increasing number of studies suggest adverse effects of exposure to ambient air pollution on cognitive function, but the evidence is still limited. We investigated the associations between long-term exposure to air pollutants and cognitive function in the English Longitudinal Study of Ageing (ELSA) cohort of older adults. METHODS Our sample included 8,883 individuals from ELSA, based on a nationally representative study of people aged ≥ 50 years, followed-up from 2002 until 2017. Exposure to air pollutants was modelled by the CMAQ-urban dispersion model and assigned to the participants' residential postcodes. Cognitive test scores of memory and executive function were collected biennially. The associations between these cognitive measures and exposure to ambient concentrations of NO2, PM10, PM2.5 and ozone were investigated using mixed-effects models adjusted for time-varying age, physical activity and smoking status, as well as baseline gender and level of education. RESULTS Increasing long-term exposure per interquartile range (IQR) of NO2 (IQR: 13.05 μg/m3), PM10 (IQR: 3.35 μg/m3) and PM2.5 (IQR: 2.7 μg/m3) were associated with decreases in test scores of composite memory by -0.10 (95% confidence interval [CI]: -0.14, -0.07), -0.02 [-0.04, -0.01] and -0.08 [-0.11, -0.05], respectively. The same increases in NO2, PM10 and PM2.5 were associated with decreases in executive function score of -0.31 [-0.38, -0.23], -0.05 [-0.08, -0.02] and -0.16 [-0.22, -0.10], respectively. The association with ozone was inverse across both tests. Similar results were reported for the London-dwelling sub-sample of participants. CONCLUSIONS The present study was based on a long follow-up with several repeated measurements per cohort participant and long-term air pollution exposure assessment at a fine spatial scale. Increasing long-term exposure to NO2, PM10 and PM2.5 was associated with a decrease in cognitive function in older adults in England. This evidence can inform policies related to modifiable environmental exposures linked to cognitive decline.
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Affiliation(s)
- Dylan Wood
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK.
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK.
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK.
| | - Dimitris Evangelopoulos
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
| | - Sean Beevers
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
| | - Nutthida Kitwiroon
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
| | - Panayotes Demakakos
- Department of Epidemiology and Public Health, University College London (UCL), London, UK
| | - Klea Katsouyanni
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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24
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Reuter-Lorenz PA, Park DC. Cognitive aging and the life course: A new look at the Scaffolding theory. Curr Opin Psychol 2024; 56:101781. [PMID: 38278087 DOI: 10.1016/j.copsyc.2023.101781] [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: 09/16/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 01/28/2024]
Abstract
Our understanding of human neurocognitive aging, its developmental roots, and life course influences has been transformed by brain imaging technologies, increasing availability of longitudinal data sets, and analytic advances. The Scaffolding Theory of Aging and Cognition is a life course model, proposed originally in 2009, featuring adaptivity and compensatory potential as lifelong mechanisms for meeting neurocognitive challenges posed by the environment and by developing or declining brain circuitry. Here, we review the scaffolding theory in relation to new evidence addressing when during the life course potentially enriching and depleting factors exert their effects on brain health and scaffolding, and we consider the implications for separable, and potentially reciprocal, influences on the level of cognitive function and the rate of decline in later life.
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25
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Wolfova K, Frycova B, Seblova D, Tom S, Skirbekk VF, Brennan Kearns P. Sex differences in cognitive decline among middle-aged and older adults: a cohort study in Europe. Age Ageing 2024; 53:afae078. [PMID: 38640127 PMCID: PMC11028402 DOI: 10.1093/ageing/afae078] [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: 11/22/2023] [Indexed: 04/21/2024] Open
Abstract
OBJECTIVES Previous studies on sex differences in cognitive decline provide inconsistent findings, with many European countries being underrepresented. We determined the association between sex and cognitive decline in a sample of Europeans and explored differences across birth cohorts and regions. METHODS Participants 50+ years old enrolled in the Survey of Health, Ageing and Retirement in Europe had their cognition measured by tests of immediate recall, delayed recall and verbal fluency biennially up to 17 years of follow-up (median 6, interquartile range 3-9 years). We used linear mixed-effects models to assess the relationship between sex and the rate of cognitive decline, adjusting for sociodemographic and health-related characteristics. RESULTS Of 66,670 participants (mean baseline age 63.5 ± standard deviation 9.4), 55% were female. Males and females had similar rates of decline in the whole sample in immediate recall (beta for interaction sex × time B = 0.002, 95% CI -0.001 to 0.006), delayed recall (B = 0.000, 95% CI -0.004 to 0.004), and verbal fluency (B = 0.008, 95% CI -0.005 to 0.020). Females born before World War II had a faster rate of decline in immediate recall and delayed recall compared to males, while females born during or after World War II had a slower rate of decline in immediate recall. Females in Central and Eastern Europe had a slower rate of cognitive decline in delayed recall compared to males. DISCUSSION Our study does not provide strong evidence of sex differences in cognitive decline among older Europeans. However, we identified heterogeneity across birth cohorts and regions.
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Affiliation(s)
- Katrin Wolfova
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague 150 06, Czech Republic
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague 100 00, Czech Republic
| | - Barbora Frycova
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague 150 06, Czech Republic
| | - Dominika Seblova
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague 150 06, Czech Republic
| | - Sarah Tom
- Department of Neurology, Columbia University, New York 10032, NY, USA
- Department of Epidemiology, Columbia University, 10032 New York, NY, USA
| | - Vegard Fykse Skirbekk
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo 0473, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg 60512, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Columbia Aging Center, Columbia University, New York 10032, NY, USA
| | - Pavla Brennan Kearns
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague 150 06, Czech Republic
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26
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Chen Q, Zhou T, Zhang C, Zhong X. Exploring relevant factors of cognitive impairment in the elderly Chinese population using Lasso regression and Bayesian networks. Heliyon 2024; 10:e27069. [PMID: 38449590 PMCID: PMC10915566 DOI: 10.1016/j.heliyon.2024.e27069] [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: 08/23/2023] [Revised: 02/12/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
Older adults are highly susceptible to developing cognitive impairment(CI). Various factors contribute to the prevalence of CI, but the potential relationships among these factors remain unclear. This study aims to explore the relevant factors associated with CI in Chinese older adults and analyze the potential relationships between CI and these factors.We analyzed the data on 6886 older adults aged≥60 from the China Health and Retirement Longitudinal Study (CHARLS) 2018. Lasso regression was initially used to screening variables. Bayesian Networks(BNs) were used to identify the correlates of CI and potential associations between factors. After screening with Lasso regression, 11 variables were finally included in the BNs. The BNs, by establishing a complex network relationship, revealed that age, education, and indoor air pollution were the direct correlates affecting the occurrence of CI in older adults. It also indicated that marital status indirectly influenced CI through age, and residence indirectly linked to CI through two pathways: indoor air pollution and education.Our findings underscore the effectiveness of BNs in unveiling the intricate network linkages among CI and its associated factors, holding promising applications. It can serve as a reference for public health departments to address the prevention of CI in the elderly.
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Affiliation(s)
- Qiao Chen
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Tianyi Zhou
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Cong Zhang
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Xiaoni Zhong
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
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27
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Huan G, Heyong S. Longitudinal Invariance and Construct Validity of the Chinese Version of the Mini-Mental State Examination Across 10 Years in the Elderly Population. J Nurs Meas 2024; 32:4-17. [PMID: 37348896 DOI: 10.1891/jnm-2021-0102] [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] [Indexed: 06/24/2023]
Abstract
Background and Purpose: In this study, we investigate the longitudinal measurement invariance of the Chinese version of the mini-mental state examination (CMMSE). Methods: The factor structure and longitudinal equivalence of the CMMSE were examined by confirmatory factor analysis. Four CMMSE measurements of 13,132 participants from the China Longitudinal Health and Longevity Study between 2008 and 2018 were included. The nested model of longitudinal invariance proves the existence of strict longitudinal invariance. Results: It showed that the factor structure, factor loadings, intercept error variance, and latent factor means of the CMMSE were invariant across four measurements. Conclusion: These findings indicate that the changes in CMMSE scores can be attributed to real structural change, indicating that the CMMSE is a reliable measurement tool for the study of cognitive aging.
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Affiliation(s)
- Guo Huan
- School of Human Resources, Guangdong University of Finance and Economics, Guangzhou, China
| | - Shen Heyong
- Institute of Analytical Psychology, City University of Macau, Macau, China
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28
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Vyas CM, Manson JE, Sesso HD, Cook NR, Rist PM, Weinberg A, Moorthy MV, Baker LD, Espeland MA, Yeung LK, Brickman AM, Okereke OI. Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS. Am J Clin Nutr 2024; 119:692-701. [PMID: 38244989 PMCID: PMC11103094 DOI: 10.1016/j.ajcnut.2023.12.011] [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: 10/13/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Longer effects of multivitamin-mineral (MVM) supplementation on late-life cognitive function remain untested using in-person, detailed neuropsychological assessments. Furthermore, insufficient evidence exists for healthcare providers to recommend daily MVM supplements to prevent cognitive decline. OBJECTIVES This study aimed to test MVM effects on cognitive change using in-person, detailed neuropsychological assessments and conduct a meta-analysis within COSMOS (COcoa Supplement and Multivitamin Outcomes Study) cognitive substudies for a robust evaluation of MVM effects on cognition. METHODS COSMOS is a 2 × 2 factorial trial of cocoa extract (500 mg flavanols/d) and/or a daily MVM supplement for cardiovascular disease and cancer prevention among 21,442 United States adults aged ≥60 y. There were 573 participants in the clinic subcohort of COSMOS (that is, COSMOS-Clinic) who completed all cognitive tests administered at baseline. For the meta-analysis, we included nonoverlapping participants across 3 COSMOS cognitive substudies: COSMOS-Clinic (n = 573); COSMOS-Mind (n = 2158); COSMOS-Web (n = 2472). RESULTS In COSMOS-Clinic, we observed a modest benefit of MVM compared with placebo on global cognition over 2 y {mean difference [95% confidence interval (CI)] = 0.06 SD units (SU) (-0.003, 0.13)}, with a significantly more favorable change in episodic memory [mean difference (95% CI) = 0.12 SU (0.002, 0.23)] but not in executive function or attention [mean difference (95% CI) = 0.04 SU (-0.04, 0.11)]. The meta-analysis of COSMOS substudies showed clear evidence of MVM benefits on global cognition [mean difference (95% CI) = 0.07 SU (0.03, 0.11); P = 0.0009] and episodic memory [mean difference (95% CI) = 0.06 SU (0.03, 0.10); P = 0.0007]; the magnitude of effect on global cognition was equivalent to reducing cognitive aging by 2 y. CONCLUSIONS In COSMOS-Clinic, daily MVM supplementation leads to a significantly more favorable 2-y change in episodic memory. The meta-analysis within COSMOS cognitive substudies indicates that daily MVM significantly benefits both global cognition and episodic memory. These findings within the COSMOS trial support the benefits of a daily MVM in preventing cognitive decline among older adults. This trial was registered at COSMOS-clinicaltrials.gov as NCT02422745, at COSMOS-Mind-clinicaltrials.gov as NCT03035201, and at COSMOS-Web-clinicaltrials.gov as NCT04582617.
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Affiliation(s)
- Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Nancy R Cook
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Alison Weinberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - M Vinayaga Moorthy
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Laura D Baker
- Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Mark A Espeland
- Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Lok-Kin Yeung
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
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Novotný JS, Srt L, Stokin GB. Emotion regulation shows an age- and sex-specific moderating effect on the relationship between chronic stress and cognitive performance. Sci Rep 2024; 14:3028. [PMID: 38321166 PMCID: PMC10847168 DOI: 10.1038/s41598-024-52756-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Despite the extensive knowledge about the effects of chronic stress on cognition, the underlying mechanisms remain unclear. We conducted a cross-sectional moderation analysis on a population-based sample of 596 adults to examine the age- and sex-specific role of emotion regulation (ER) in the relationship between chronic stress and cognitive performance using validated self-report questionnaires. While women showed no direct or moderated relationship between stress and cognition, men displayed a distinct age-related pattern where stress was negatively associated with poorer cognitive performance at older ages, and the onset of this relationship was detected earlier in men with ER problems. These results showed that suppression of emotions and lack of executive control of ER amplify the negative consequences of chronic stress and suggest that there are sex-specific differences in the decline of ability to cope with long-term exposure to stressors.
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Affiliation(s)
- Jan S Novotný
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 1333/5, 779 00, Olomouc, Czech Republic
| | - Luka Srt
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Gorazd B Stokin
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 1333/5, 779 00, Olomouc, Czech Republic.
- Department of Neurology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
- Translational Neuroscience and Aging Program, Center for Translational Medicine, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czech Republic.
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Iso-Markku P, Aaltonen S, Kujala UM, Halme HL, Phipps D, Knittle K, Vuoksimaa E, Waller K. Physical Activity and Cognitive Decline Among Older Adults: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e2354285. [PMID: 38300618 PMCID: PMC10835510 DOI: 10.1001/jamanetworkopen.2023.54285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
Importance Physical activity is associated with the risk for cognitive decline, but much of the evidence in this domain comes from studies with short follow-ups, which is prone to reverse causation bias. Objective To examine how length of follow-up, baseline age, physical activity amount, and study quality modify the longitudinal associations of physical activity with cognition. Data Sources Observational studies of adults with a prospective follow-up of at least 1 year, a valid baseline cognitive measure or midlife cohort, and an estimate of the association of baseline physical activity and follow-up cognition were sought from PsycInfo, Scopus, CINAHL, Web of Science, SPORTDiscus, and PubMed, with the final search conducted on November 2, 2022. Study Selection Two independent researchers screened titles with abstracts and full-text reports. Data Extraction and Synthesis Two reviewers independently assessed study quality and extracted data. Pooled estimates of association were calculated with random-effects meta-analyses. An extensive set of moderators, funnel plots, and scatter plots of physical activity amount were examined. This study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures Pooled estimates of the associations between physical activity and global cognition, as well as specific cognitive domains, were examined. Results A total of 104 studies with 341 471 participants were assessed. Analysis of binary outcomes included 45 studies with 102 452 individuals, analysis of follow-up global cognition included 14 studies with 41 045 individuals, and analysis of change in global cognition included 25 studies with 67 463 individuals. Physical activity was associated with a decreased incidence of cognitive impairment or decline after correction for funnel plot asymmetry (pooled risk ratio, 0.97; 95% CI, 0.97-0.99), but there was no significant association in follow-ups longer than 10 years. Physical activity was associated with follow-up global cognition (standardized regression coefficient, 0.03; 95% CI, 0.02-0.03) and change in global cognition (standardized regression coefficient, 0.01; 95% CI, 0.01 to 0.02) from trim-and-fill analyses, with no clear dose-response or moderation by follow-up length, baseline age, study quality or adjustment for baseline cognition. The specific cognitive domains associated with physical activity were episodic memory (standardized regression coefficient, 0.03; 95% CI, 0.02-0.04) and verbal fluency (standardized regression coefficient, 0.05; 95% CI, 0.03-0.08). Conclusions and Relevance In this meta-analysis of the association of physical activity with cognitive decline, physical activity was associated with better late-life cognition, but the association was weak. However, even a weak association is important from a population health perspective.
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Affiliation(s)
- Paula Iso-Markku
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hanna-Leena Halme
- Helsinki University Hospital Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Daniel Phipps
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Keegan Knittle
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Katja Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Valsdóttir V, Jónsdóttir MK, Magnúsdóttir BB, Chang M, Hu YH, Gudnason V, Launer LJ, Stefánsson H. Comparative study of machine learning methods for modeling associations between risk factors and future dementia cases. GeroScience 2024; 46:737-750. [PMID: 38135769 PMCID: PMC10828447 DOI: 10.1007/s11357-023-01040-9] [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: 09/16/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
A substantial portion of dementia risk can be attributed to modifiable risk factors that can be affected by lifestyle changes. Identifying the contributors to dementia risk could prove valuable. Recently, machine learning methods have been increasingly applied to healthcare data. Several studies have attempted to predict dementia progression by using such techniques. This study aimed to compare the performance of different machine-learning methods in modeling associations between known cognitive risk factors and future dementia cases. A subset of the AGES-Reykjavik Study dataset was analyzed using three machine-learning methods: logistic regression, random forest, and neural networks. Data were collected twice, approximately five years apart. The dataset included information from 1,491 older adults who underwent a cognitive screening process and were considered to have healthy cognition at baseline. Cognitive risk factors included in the models were based on demographics, MRI data, and other health-related data. At follow-up, participants were re-evaluated for dementia using the same cognitive screening process. Various performance metrics for all three machine learning algorithms were assessed. The study results indicate that a random forest algorithm performed better than neural networks and logistic regression in predicting the association between cognitive risk factors and dementia. Compared to more traditional statistical analyses, machine-learning methods have the potential to provide more accurate predictions about which individuals are more likely to develop dementia than others.
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Affiliation(s)
- Vaka Valsdóttir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.
- RHLÖ - Icelandic Gerontological Research Center, Landspítali University Hospital, Reykjavik, Iceland.
| | - María K Jónsdóttir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
| | - Brynja Björk Magnúsdóttir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
| | - Milan Chang
- RHLÖ - Icelandic Gerontological Research Center, Landspítali University Hospital, Reykjavik, Iceland
| | - Yi-Han Hu
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- The Icelandic Heart Association, Kopavogur, Iceland
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, National Institutes of Health (NIH), Bethesda, MD, USA
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Hao W, Shan YF, Kimura T, Ukawa S, Ohira H, Okabayashi S, Wakai K, Ando M, Tamakoshi A. Dual decline in subjective gait speed and domain-specific cognition is associated with higher risk of incident dementia in older Japanese adults: A 15-year age-specific cohort study. Arch Gerontol Geriatr 2024; 117:105254. [PMID: 37952420 DOI: 10.1016/j.archger.2023.105254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Dual decline in gait speed and cognition has been found to have higher dementia risk than no decline or pure decline. However, evidence from the Asian population is lacking. Therefore, we aimed to investigate the association of dual decline from age 65 to 70 years with late-life dementia in older Japanese adults with different personal characteristics. METHODS Data were collected from an age-specific cohort study conducted in 482 Japanese 65-year-old adults. We investigated participant demographics, medical histories, lifestyles, subjective gait speed, and cognition at both 64/65 and 70/71 years old, and confirmed dementia until age of 85 years. Cox proportion hazard models were used to estimate the risk of dementia, with adjustments for covariates, and death was treated as a competing risk. RESULTS After a mean follow-up period of 12.5-years, 111 participants developed dementia. Older adults with dual decline are more likely to have hyperlipidemia, diabetes, and smoking habits. And we found that dual decline in gait speed and domain-specific cognition was associated with a higher risk of dementia compared with no decline in most cognitive tests, with the highest risk observed for gait speed combined with memory (sub-distribution hazard ratio:3.89, 95 %, confidence intervals: [1.68-9.01]). However, significant differences only existed in men after stratification by sex. CONCLUSIONS A dual decline in subjective gait speed and cognition may serve as a robust predictor of dementia over a decade prior to its onset, particularly in men. These findings highlighted the importance of screening for dual decline at an early age.
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Affiliation(s)
- Wen Hao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yi-Fan Shan
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shigekazu Ukawa
- Department of Social Welfare Science and Clinical Psychology, Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka, Japan
| | - Hideki Ohira
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | - Satoe Okabayashi
- Agency for Health, Safety and Environment, Kyoto University, Kyoto, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
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Wig GS, Klausner S, Chan MY, Sullins C, Rayanki A, Seale M. Participant diversity is necessary to advance brain aging research. Trends Cogn Sci 2024; 28:92-96. [PMID: 38280836 PMCID: PMC10922549 DOI: 10.1016/j.tics.2023.12.004] [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: 08/11/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/29/2024]
Abstract
An absence of population-representative participant samples has limited research in healthy brain aging. We highlight examples of what can be gained by enrolling more diverse participant cohorts, and propose recommendations for specific reforms, both in terms of how researchers accomplish this goal and how institutions support and benchmark these efforts.
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Affiliation(s)
- Gagan S Wig
- Center for Vital Longevity, The University of Texas at Dallas, Dallas, TX 75235, USA; Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75080, USA; Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Sarah Klausner
- Center for Vital Longevity, The University of Texas at Dallas, Dallas, TX 75235, USA
| | - Micaela Y Chan
- Center for Vital Longevity, The University of Texas at Dallas, Dallas, TX 75235, USA
| | - Cameron Sullins
- Center for Vital Longevity, The University of Texas at Dallas, Dallas, TX 75235, USA
| | - Anirudh Rayanki
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75080, USA
| | - Maya Seale
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75080, USA
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Zhu Y, Shi Y, Bartell SM, Corrada MM, Manson SM, O’Connell J, Jiang L. Potential Effects of Long-Term Exposure to Air Pollution on Dementia: A Longitudinal Analysis in American Indians Aged 55 Years and Older. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:128. [PMID: 38397619 PMCID: PMC10888275 DOI: 10.3390/ijerph21020128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
(1) Background: American Indians are disproportionately affected by air pollution, an important risk factor for dementia. However, few studies have investigated the effects of air pollution on the risk of dementia among American Indians. (2) Methods: This retrospective cohort study included a total of 26,871 American Indians who were 55+ years old in 2007, with an average follow-up of 3.67 years. County-level average air pollution data were downloaded from land-use regression models. All-cause dementia was identified using ICD-9 diagnostic codes from the Indian Health Service's (IHS) National Data Warehouse and related administrative databases. Cox models were employed to examine the association of air pollution with dementia incidence, adjusting for co-exposures and potential confounders. (3) Results: The average PM2.5 levels in the IHS counties were lower than those in all US counties, while the mean O3 levels in the IHS counties were higher than the US counties. Multivariable Cox regressions revealed a positive association between dementia and county-level O3 with a hazard ratio of 1.24 (95% CI: 1.02-1.50) per 1 ppb standardized O3. PM2.5 and NO2 were not associated with dementia risk after adjusting for all covariates. (4) Conclusions: O3 is associated with a higher risk of dementia among American Indians.
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Affiliation(s)
- Yachen Zhu
- Program in Public Health, University of California, Irvine, CA 92697, USA
| | - Yuxi Shi
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA 92697, USA (M.M.C.)
| | - Scott M. Bartell
- Program in Public Health, University of California, Irvine, CA 92697, USA
- Department of Environmental and Occupational Health, University of California, Irvine, CA 92697, USA
| | - Maria M. Corrada
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA 92697, USA (M.M.C.)
- Department of Neurology, School of Medicine, University of California, Irvine, CA 92697, USA
| | - Spero M. Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.M.M.); (J.O.)
| | - Joan O’Connell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.M.M.); (J.O.)
| | - Luohua Jiang
- Program in Public Health, University of California, Irvine, CA 92697, USA
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA 92697, USA (M.M.C.)
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Parker RMA, Tilling K, Terrera GM, Barrett JK. Modeling Risk Factors for Intraindividual Variability: A Mixed-Effects Beta-Binomial Model Applied to Cognitive Function in Older People in the English Longitudinal Study of Ageing. Am J Epidemiol 2024; 193:159-169. [PMID: 37579319 PMCID: PMC10773480 DOI: 10.1093/aje/kwad169] [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: 08/10/2022] [Revised: 04/14/2023] [Accepted: 08/04/2023] [Indexed: 08/16/2023] Open
Abstract
Cognitive functioning in older age profoundly impacts quality of life and health. While most research on cognition in older age has focused on mean levels, intraindividual variability (IIV) around this may have risk factors and outcomes independent of the mean value. Investigating risk factors associated with IIV has typically involved deriving a summary statistic for each person from residual error around a fitted mean. However, this ignores uncertainty in the estimates, prohibits exploring associations with time-varying factors, and is biased by floor/ceiling effects. To address this, we propose a mixed-effects location scale beta-binomial model for estimating average probability and IIV in a word recall test in the English Longitudinal Study of Ageing. After adjusting for mean performance, an analysis of 9,873 individuals across 7 (mean = 3.4) waves (2002-2015) found IIV to be greater at older ages, with lower education, in females, with more difficulties in activities of daily living, in later birth cohorts, and when interviewers recorded issues potentially affecting test performance. Our study introduces a novel method for identifying groups with greater IIV in bounded discrete outcomes. Our findings have implications for daily functioning and care, and further work is needed to identify the impact for future health outcomes.
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Affiliation(s)
- Richard M A Parker
- Correspondence to Dr. Richard M. A. Parker, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom (e-mail: )
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Vyas CM, Manson JE, Sesso HD, Rist PM, Weinberg A, Kim E, Moorthy MV, Cook NR, Okereke OI. Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial. Am J Clin Nutr 2024; 119:39-48. [PMID: 38070683 PMCID: PMC11347806 DOI: 10.1016/j.ajcnut.2023.10.031] [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: 09/06/2023] [Revised: 10/21/2023] [Accepted: 10/31/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Some prior randomized clinical trials (RCTs) that tested the effects of cocoa extract (CE), a source of flavanols, on late-life cognition have yielded promising findings. A long-term RCT using in-person neuropsychological tests covering multiple cognitive domains may clarify the cognitive effects of CE. OBJECTIVES To test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y. METHODS The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a 2 × 2 factorial RCT of CE [500 mg flavanols/d, including 80 mg (-)-epicatechin] and/or a daily multivitamin-mineral supplement for cardiovascular disease and cancer prevention among 21,442 United States adults aged ≥60 y. There were 573 participants in the clinic subcohort of COSMOS (that is, COSMOS-Clinic) who completed all cognitive tests at baseline; of these, 492 completed 2-y follow-up assessments. The primary outcome was global cognition (averaging z-scores across 11 tests). Secondary outcomes were episodic memory and executive function/attention. Repeated measures models were used to compare randomized groups. RESULTS Participants' mean age (standard deviation) was 69.6 (5.3); 49.2% were females. Daily supplementation with CE, compared with placebo, had no significant effect on 2-y change in global cognition {mean difference [95% confidence interval (CI)]: -0.01 (-0.08, 0.05) standard deviation units (SU)}. CE, compared with placebo, had no significant effects on 2-y change in episodic memory [mean difference (95% CI): -0.01 (-0.13, 0.10) SU] or executive function/attention [mean difference (95% CI): 0.003 (-0.07, 0.08) SU]. Subgroup analyses uncorrected for multiple-testing suggested cognitive benefits of CE supplementation, compared with placebo among those with poorer baseline diet quality. CONCLUSIONS Among 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study. TRIAL REGISTRATION This trial was registered at clinicaltrials.gov with identifier - NCT02422745.
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Affiliation(s)
- Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Alison Weinberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Eunjung Kim
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - M Vinayaga Moorthy
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Nancy R Cook
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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Jaarsma E, Nooyens A, Kok AAL, Köhler S, van Boxtel M, Verschuren WMM, Huisman M. Modifiable Risk Factors for Accelerated Decline in Processing Speed: Results from Three Dutch Population Cohorts. J Prev Alzheimers Dis 2024; 11:108-116. [PMID: 38230723 PMCID: PMC10994989 DOI: 10.14283/jpad.2023.64] [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: 02/06/2023] [Accepted: 04/20/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Several lifestyle, cardiovascular and psychosocial factors are associated with risk of cognitive decline and dementia. We studied the independent associations of a broad set of modifiable risk factors with decline in processing speed in three large population-based cohorts with up to 23 years of follow-up. METHODS We used data of 9,666 participants from the Doetinchem Cohort Study, the Longitudinal Aging Study Amsterdam, and the Maastricht Aging Study. Decline in processing speed was measured with the letter digit substitution task or the alphabet coding task and modeled using quadratic latent growth curves. Associations of modifiable risk factors with level and rate of decline in processing speed were investigated by estimating associations with level of processing speed at different centering ages. RESULTS Latent growth curves showed that decline in processing speed accelerated with age. Smoking, not drinking alcohol and depressive symptoms were associated with a lower level of processing speed in all cohorts. In two of the cohorts, more physical activity, drinking more than two glasses of alcohol per day, higher BMI and diabetes were associated with a lower level of processing speed. Depressive symptoms and diabetes were also associated with faster decline in processing speed. CONCLUSION Several modifiable risk factors are associated with the level of processing speed in older age, while few are also related to the rate of decline.
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Affiliation(s)
- E Jaarsma
- Almar Kok Amsterdam UMC Locatie De Boelelaan: Amsterdam UMC Locatie VUmc, The Netherlands,
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Min SH, Schnall R, Lee C, Topaz M. An Examination of the Non-linear Relationship Between Cognition and Total Hemoglobin Among the Cognitively Normal Older Adults by Gender. J Aging Health 2024; 36:85-97. [PMID: 37116081 PMCID: PMC11134421 DOI: 10.1177/08982643231172230] [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] [Indexed: 04/30/2023]
Abstract
Objectives: This exploratory study aimed to identify the potential non-linear relationship between hemoglobin (Hgb) and cognition among cognitively normal older adults and how this relationship differs in terms of gender in generalized additive models (GAM). Methods: This is a secondary data analysis using Wave II (2010-2011) data from the National Social Life, Health, and Aging Project. A generalized additive model was used to understand the non-linear relationship between Hgb and cognition, and to identify critical Hgb point related to cognition. Results: While both genders had a non-linear association between Hgb and cognition, the degree of non-linearity was more pronounced in male older adults with EDF value close to 2. The inflection point of 15.10 g/dL for male older adults and inflection point of 11.72 g/dL for female older adults were obtained. Conclusion: Further studies are needed to validate these results and develop precision medicine approaches to integrate these results into clinical practice.
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Affiliation(s)
| | | | - Chiyoung Lee
- University of Washington Bothell School of Nursing & Health Studies, Bothell, WA, USA
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Liu W, Yu L, Deng Q, Li Y, Lu P, Yang J, Chen F, Li F, Zhou X, Bergeron MF, Ashford JW, Xu Q. Toward digitally screening and profiling AD: A GAMLSS approach of MemTrax in China. Alzheimers Dement 2024; 20:399-409. [PMID: 37654085 PMCID: PMC10916970 DOI: 10.1002/alz.13430] [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: 12/26/2022] [Revised: 06/27/2023] [Accepted: 07/23/2023] [Indexed: 09/02/2023]
Abstract
PURPOSES To establish a normative range of MemTrax (MTx) metrics in the Chinese population. METHODS The correct response percentage (MTx-%C) and mean response time (MTx-RT) were obtained and the composite scores (MTx-Cp) calculated. Generalized additive models for location, shape and scale (GAMLSS) were applied to create percentile curves and evaluate goodness of fit, and the speed-accuracy trade-off was investigated. RESULTS 26,633 subjects, including 13,771 (51.71%) men participated in this study. Age- and education-specific percentiles of the metrics were generated. Q tests and worm plots indicated adequate fit for models of MTx-RT and MTx-Cp. Models of MTx-%C for the low and intermediate education fit acceptably, but not well enough for a high level of education. A significant speed-accuracy trade-off was observed for MTx-%C from 72 to 94. CONCLUSIONS GAMLSS is a reliable method to generate smoothed age- and education-specific percentile curves of MTx metrics, which may be adopted for mass screening and follow-ups addressing Alzheimer's disease or other cognitive diseases. HIGHLIGHTS GAMLSS was applied to establish nonlinear percentile curves of cognitive decline. Subjects with a high level of education demonstrate a later onset and slower decline of cognition. Speed-accuracy trade-off effects were observed in a subgroup with moderate accuracy. MemTrax can be used as a mass-screen instrument for active cognition health management advice.
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Affiliation(s)
- Wanwan Liu
- Health Management CenterRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
| | - Ling Yu
- Health Management CenterRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
| | - Qiuqiong Deng
- Health Management CenterRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
| | - Yunrong Li
- Health Management CenterRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
| | - Peiwen Lu
- Department of NeurologyRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
| | - Jie Yang
- Department of NeurologyRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
| | - Fei Chen
- Health Management CenterRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
| | - Feng Li
- Kunming Escher Technology Co. LtdKunmingYunnanChina
| | - Xianbo Zhou
- Center for Alzheimer's ResearchWashington Institute of Clinical ResearchViennaVirginiaUSA
- AstraNeura Co. LtdShanghaiChina
| | - Michael F. Bergeron
- Visiting ScholarDepartment of Health SciencesUniversity of HartfordWest HartfordConnecticutUSA
| | - John Wesson Ashford
- War Related Illness and Injury Study CenterVA Palo Alto HCSPalo AltoCaliforniaUSA
| | - Qun Xu
- Health Management CenterRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
- Department of NeurologyRenji Hospital of Medical School of Shanghai Jiaotong UniversityShanghaiChina
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Sala G, Nishita Y, Tange C, Zhang S, Ando F, Shimokata H, Otsuka R, Arai H. Differential Longitudinal Associations Between Domains of Cognitive Function and Physical Function: A 20-Year Follow-Up Study. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad156. [PMID: 37850300 PMCID: PMC10745265 DOI: 10.1093/geronb/gbad156] [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: 12/21/2022] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVES Cognitive and physical functions are both associated with disability and death. Recent studies have addressed the relationship between cognitive declines and physical declines; however, whether various facets of cognition are diversely associated with specific physical functions is yet to be ascertained. The present work examines the longitudinal associations between fluid and crystallized cognitive functions (Gf and Gc) and physical functions. METHODS The sample consisted of 863 community-dwelling older adults (baseline age 60-79 years) from the National Institute for Longevity Sciences-Longitudinal Study of Aging. The participants were tested on a set of Gf and Gc tests and physical tests (grip strength and gait speed). We ran a series of Multivariate Latent Growth Curve models. Specifically, we tested the relationship between cognitive and physical functions in terms of baseline performance (intercept) and rate of change (slope). RESULTS The slope-slope correlations between Gf and physical function were large (grip strength r = 0.64 and gait speed r = 0.68, ps < .001). By contrast, the slope correlations between Gc and physical functions were weak (rs ≤ 0.31) and barely or marginally significant (ps ≤ .06). DISCUSSION The results show that distinct domains of cognitive functions have different associations with physical functions. Namely, the aging-associated declines in the tested physical functions are robustly correlated with the declines in Gf, but are only weakly correlated with the declines in Gc. Therefore, Gc measures may be poor proxies for the patient's frailty and should be considered with caution in clinical assessment.
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Affiliation(s)
- Giovanni Sala
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Chikako Tange
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Shu Zhang
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Fujiko Ando
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Faculty of Health and Medical Sciences, Aichi Shukutoku University, Nagakute, Aichi, Japan
| | - Hiroshi Shimokata
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Cao N, Zeng X, Wang P. Decomposing the change in the cognitive function gap between older men and women over time in China: The Chinese Longitudinal Healthy Longevity Survey. J Glob Health 2023; 13:04143. [PMID: 37988354 PMCID: PMC10662781 DOI: 10.7189/jogh.13.04143] [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: 11/23/2023] Open
Abstract
Background This study explored how modifiable social determinants of cognitive function can influence these gender gaps. Methods We utilized six waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 56,127 individuals aged 65+. The Kitagawa-Oaxaca-Blinder decomposition approach was used for the analysis. Results Older women consistently had lower average levels of cognitive function than men in each period, but the gap is narrowing. From 2002 to 2018, the gender gap in cognitive function decreased by 1.45 (95% confidence interval (CI) = -1.843, -1.097) points. The coefficients for the endowment effects decreased from 0.387 (95% CI = -0.563, -0.211) to 1.789 (95% CI = -2.471, -1.107) from 2005 to 2018. Lifestyle changes, social participation, and physical health factors significantly contributed to explaining the changes in gender gaps in cognitive function. Conclusions Among these contributing factors, lifestyle, social participation, and physical health have emerged as pivotal elements in reducing the gender gap in cognitive function. Targeted interventions for these variables are essential among older women to narrow the cognitive gender gaps effectively.
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Huber M, Reuter L, Weitgasser L, Pletzer B, Rösch S, Illg A. Hearing loss, depression, and cognition in younger and older adult CI candidates. Front Neurol 2023; 14:1272210. [PMID: 37900591 PMCID: PMC10613094 DOI: 10.3389/fneur.2023.1272210] [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: 08/03/2023] [Accepted: 09/04/2023] [Indexed: 10/31/2023] Open
Abstract
Background and Aim Hearing loss in old age is associated with cognitive decline and with depression. Our study aimed to investigate the relationship between hearing loss, cognitive decline, and secondary depressive symptoms in a sample of younger and older cochlear implant candidates with profound to severe hearing loss. Methods This study is part of a larger cohort study designated to provide information on baseline data before CI. Sixty-one cochlear implant candidates with hearing loss from adulthood onwards (>18 years) were enrolled in this study. All had symmetrical sensorineural hearing loss in both ears (four-frequency hearing threshold difference of no more than 20 dB, PTA). Individuals with primary affective disorders, psychosis, below-average intelligence, poor German language skills, visual impairment, and a medical diagnosis with potential impact on cognition (e.g., neurodegenerative diseases,) were excluded. Four-frequency hearing thresholds (dB, PTA, better ear) were collected. Using the Abbreviated Profile of Hearing Aid Benefit, we assessed subjective hearing in noise. Clinical and subclinical depressive symptoms were assessed with the Beck Depression Inventory (BDI II). Cognitive status was assessed with a neurocognitive test battery. Results Our findings revealed a significant negative association between subjective hearing in noise (APHAB subscale "Background Noise") and BDII. However, we did not observe any link between hearing thresholds, depression, and cognition. Additionally, no differences emerged between younger (25-54 years) and older subjects (55-75 years). Unexpectedly, further unplanned analyses unveiled correlations between subjective hearing in quiet environments (APHAB) and cognitive performance [phonemic fluency (Regensburg Word Fluency), cognitive flexibility (TMTB), and nonverbal episodic memory (Nonverbal Learning Test), as well as subjective hearing of aversive/loud sounds (APHAB)], cognitive performance [semantic word fluency (RWT), and inhibition (Go/Nogo) and depression]. Duration of hearing loss and speech recognition at quiet (Freiburg Monosyllables) were not related to depression and cognitive performance. Conclusion Impact of hearing loss on mood and cognition appears to be independent, suggesting a relationship with distinct aspects of hearing loss. These results underscore the importance of considering not only conventional audiometric measures like hearing thresholds but also variables related to hearing abilities during verbal communication in everyday life, both in quiet and noisy settings.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Lisa Reuter
- Clinic for Otorhinolaryngology, Medical University of Hannover, Hannover, Germany
| | - Lennart Weitgasser
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Belinda Pletzer
- Department of Psychology, Center for Neurocognitive Research, University of Salzburg, Salzburg, Austria
| | - Sebastian Rösch
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Angelika Illg
- Clinic for Otorhinolaryngology, Medical University of Hannover, Hannover, Germany
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Gireesh A, Sacker A, McMunn A, Cadar D. Role of inflammation in the socioeconomic inequalities of neurocognitive disorders. Brain Behav Immun 2023; 113:203-211. [PMID: 37494983 DOI: 10.1016/j.bbi.2023.07.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/20/2023] [Accepted: 07/22/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Socioeconomic position has been shown to be associated with inflammation. However, little is known about the role of inflammation in socioeconomic inequalities in relation to neurocognitive disorders in later life and the potential underlying inflammatory mechanisms. This study has used longitudinal data to investigate the mediation effects of inflammation in the relationship between socioeconomic position and neurocognitive disorders in older adults. METHODS Using data from the English Longitudinal Study of Ageing (ELSA, n = 4,815), we ascertained neurocognitive disorders using a recognised consensus criterion and included the following categories: (1) No Cognitive Impairment (NOCI) (2) Cognitive Impairment No Dementia (CIND) and (3) Dementia. We examined whether socioeconomic position (education, occupation, and wealth) measured in 2008/09 was associated with neurocognitive disorders measured in 2018/19. Mediation analyses were carried out to investigate the role of inflammatory markers [C-Reactive Protein (CRP), plasma fibrinogen and white blood cells (WBC)] in the association between socioeconomic inequalities and subsequent neurocognitive disorders. Sensitivity analyses were conducted to assess the mediating role of lifestyle behaviours and body mass index (BMI). RESULTS Higher education, occupation and wealth were longitudinally associated with a lower likelihood of cognitive impairment and dementia. WBC mediated the association between latent socioeconomic position and CIND [β = -0.037 (CI: -0.06 to -0.01)], but not the association with dementia. Indirect effects were attenuated but remained significant when other mediators, such as lifestyle behaviours and BMI were considered. In a separate analysis accounting for main confounders, CRP and fibrinogen mediated the association between education and CIND, all three inflammatory biomarkers mediated the association of occupation and CIND, while WBC mediated the association between wealth and CIND. CONCLUSION These findings emphasise that socioeconomic inequalities in mid and later life could contribute to the prevalence of neurocognitive disorders in later life. Our results provide some evidence for the biological embedding of WBC in the association between socioeconomic inequalities and cognitive impairment via elevated inflammation. Future studies should explore other plausible biological mechanisms.
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Affiliation(s)
- Aswathikutty Gireesh
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB, London, United Kingdom; Department of Behavioural Science and Health, Institute of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB, London, United Kingdom.
| | - Amanda Sacker
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB, London, United Kingdom.
| | - Anne McMunn
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB, London, United Kingdom.
| | - Dorina Cadar
- Department of Behavioural Science and Health, Institute of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB, London, United Kingdom; Centre for Dementia Studies, Department of Neuroscience, Brighton and Sussex Medical School, Trafford Centre, BN1 9RY, United Kingdom; Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom.
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Lobo E, Lobo A, Gracia-García P, López-Antón R, Saz P, De la Cámara C. Sex Differences in Longitudinal Trajectories of Cognitive Aging in Zaragoza, Spain. Am J Geriatr Psychiatry 2023; 31:796-807. [PMID: 37169710 DOI: 10.1016/j.jagp.2023.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES The objective of this study was to document the longitudinal trajectories of cognitive aging in a sample of cognitively healthy subjects of 55 years or older. The following differences between men and women were hypothesized: 1) in the cognitive loss through aging, 2) in the distinct trajectories identified; and 3) in the predictors associated with the identified trajectories. DESIGN AND SETTING A 4-wave, population-based study in Zaragoza, Spain (1994-2006). PARTICIPANTS A total of 2,403 individuals aged 55+ years, cognitively healthy at baseline. MEASUREMENTS All participants had at least three measurements with the Mini-Mental State Examination (MMSE). Validated Spanish versions of international instruments were used for assessment. Random effects linear panel regression model for analyzing differences by sex in MMSE scores through aging were performed, and growth mixture models (GMM) applied independently for each sex for modeling the longitudinal cognitive trajectories. RESULTS Women showed lower mean MMSE scores in all phases and significantly higher loss in the MMSE from phases 2 to 3 and 3 to 4. The best fitting age-adjusted model of the cognitive trajectories was a 4-class GMM in men and a 3-class in women. Education was a predictor of cognitive trajectories in both men and women. Dependence on iADLs and alcohol status were predictors only for men, and depression and diabetes only for women. CONCLUSIONS The identified differences by sex in cognitive trajectories and their associated factors suggest that men and women may require a different strategy when addressing cognitive aging.
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Affiliation(s)
- Elena Lobo
- Department of Preventive Medicine and Public Health (EL), Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain.
| | - Patricia Gracia-García
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain; Psychiatry Service (PGG), Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Raúl López-Antón
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain; Department of Sociology and Psychology (RLA), Universidad de Zaragoza, Zaragoza, Spain
| | - Pedro Saz
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain
| | - Concepción De la Cámara
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain; Psychiatry Service (CDC), Hospital Clínico Universitario, Zaragoza, Spain
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Moustaka K, Nega C, Beratis IN. Exploring the Impact of Age of Onset of Mild Cognitive Impairment on the Profile of Cognitive and Psychiatric Symptoms. Geriatrics (Basel) 2023; 8:96. [PMID: 37887969 PMCID: PMC10606206 DOI: 10.3390/geriatrics8050096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
The present study aims to explore the differences in the manifestation of cognitive decline and psychiatric symptoms across the different ages of MCI onset: early onset (EOMCI: <65 years old), middle onset (MOMCI: 65-75 years old), and late onset (LOMCI: >75 years old). It was hypothesized that individuals with EOMCI will preserve their cognitive functions to a greater extent as compared to individuals with LOMCI, even after adjusting the cognitive performance for age and education through the use of published Greek norms. The level of cognitive decline concerning MOMCI was evaluated for extracting more precise conclusions regarding the impact of the age of onset on the patterns of MCI symptomatology. The analyses of data were conducted in a Greek population of individuals with MCI, who were consecutive visitors of the Outpatient Memory Clinic of Nestor Alzheimer's Centre in Athens, Greece. The sample consisted of 297 participants who fulfilled the following inclusion criteria: MCI diagnosis based on Petersen's criteria, Greek mother language, and absence of a psychiatric history or chronic and incurable organic disease. The overall results support the presence of a cognitive advantage of the EOMCI group compared to the LOMCI group. In the MOMCI group, cognitive performance displayed a tendency to remain intermediate compared to the other two groups. Nonetheless, significant differences were observed when this group was compared with the LOMCI group. The current findings indicate that the age of onset should be taken under consideration in the neuropsychological assessment of individuals with MCI. The specific parameters could have implications in terms of prognosis as well as the design and implementation of tailored interventions.
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Affiliation(s)
- Kleio Moustaka
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece; (K.M.); (C.N.)
- Alzheimer’s Center, “Nestor” Greek Psychogeriatric Association, 22, Ioannou Drosopoulou Street, 112 57 Athens, Greece
| | - Chrysanthi Nega
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece; (K.M.); (C.N.)
| | - Ion N. Beratis
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece; (K.M.); (C.N.)
- Alzheimer’s Center, “Nestor” Greek Psychogeriatric Association, 22, Ioannou Drosopoulou Street, 112 57 Athens, Greece
- 1st Department of Neurology, Aiginiteio University Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece
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Völter C, Götze L, Dazert S, Thomas JP, Kamin ST. Longitudinal trajectories of memory among middle-aged and older people with hearing loss: the influence of cochlear implant use on cognitive functioning. Front Aging Neurosci 2023; 15:1220184. [PMID: 37781104 PMCID: PMC10537213 DOI: 10.3389/fnagi.2023.1220184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/15/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Cochlear implants (CI) are the gold standard intervention for severe to profound hearing loss, a known modifiable risk factor for dementia. However, it remains unknown whether CI use might prevent the age-related cognitive decline. Recent studies are encouraging but are limited, mainly by short follow-up periods and, for ethical reasons, lack of appropriate control groups. Further, as age-related cognitive decline is multifaceted and not linear, other statistical approaches have to be evaluated. Materials and methods Immediate and delayed recall as measures of cognitive function were assessed in 75 newly implanted CI users (mean age 65.41 years ± 9.19) for up to 5 years (mean 4.5 ± 0.5) of CI use and compared to 8,077 subjects of the same age range from two longitudinal cohort studies, the Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA). Linear and quadratic changes in cognitive trajectories were analyzed in detail using mixed growth models, considering possible confounders. Results For CI users, the linear time slope showed a significant improvement in the specific domains (recall and delayed recall) over time. The quadratic time slope clearly indicated that the predicted change after CI provision followed an inverted U-shape with a predicted decline 2 years after CI provision. In the hearing-impaired group, a significant decline over time was found, with steeper declines early on and the tendency to flatten out in the follow-up. Conclusion Cochlear implant use seems to boost cognitive trajectories in the first years after implantation. However, long-term prevention of dementia seems to need far more than restoration of hearing loss.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr-University, Bochum, Germany
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr-University, Bochum, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr-University, Bochum, Germany
| | - Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, St. Johannes Hospital, Dortmund, Germany
| | - Stefan Thomas Kamin
- Fraunhofer Institute for Integrated Circuits IIS, Fraunhofer Center for Applied Research on Supply Chain Services SCS, Nuremberg, Germany
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Jimenez MP, Gause EL, Hayes-Larson E, Morris EP, Fletcher E, Manly J, Gilsanz P, Soh Y, Corrada M, Whitmer RA, Glymour MM. Racial and Ethnic Differences in the Association between Depressive Symptoms and Cognitive Outcomes in Older Adults: Findings from KHANDLE and STAR. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.07.23295205. [PMID: 37732261 PMCID: PMC10508807 DOI: 10.1101/2023.09.07.23295205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Depressive symptoms are associated with higher risk of dementia but how they impact cognition in diverse populations is unclear. METHODS Asian, Black, LatinX, or White participants (n=2,227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over four years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity. RESULTS Higher depressive symptoms were associated with lower baseline verbal episodic memory scores (-0.06, 95%CI: -0.12, -0.01; -0.15, 95%CI: -0.25, -0.04), and faster decline annually in semantic memory (-0.04, 95%CI: -0.07, -0.01; -0.10, 95%CI: -0.15, -0.05) for Black and LatinX participants. Depressive symptoms were associated with lower baseline but not decline in executive function. DISCUSSION Depressive symptoms were associated with worse cognitive domains, with some evidence of heterogeneity across racial/ethnic groups.
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Affiliation(s)
- Marcia P Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Emma L Gause
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Evan Fletcher
- Department of Neurology, University of California, Davis, CA, USA
| | - Jennifer Manly
- Department of Neurology, Columbia University, New York, NY, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Yenee Soh
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Maria Corrada
- Department of Epidemiology, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Rachel A Whitmer
- Department of Public Health Sciences and Neurology, University of California Davis School of Medicine, Davis, CA, USA
| | - M Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Weddell J, Naismith SL, Bauman A, Tofler G, Zhao E, Redfern J, Buckley T, Gallagher R. Age and Marital Status Predict Mild Cognitive Impairment During Acute Coronary Syndrome Admission: An Observational Study of Acute Coronary Syndrome Inpatients. J Cardiovasc Nurs 2023; 38:462-471. [PMID: 36729065 DOI: 10.1097/jcn.0000000000000964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) has been reported after acute coronary syndrome (ACS), but it is uncertain who is at risk, particularly during inpatient admission. OBJECTIVE In this study, we aimed to explore the prevalence and cognitive domains affected in MCI during ACS admission and determine factors that identify patients most at risk of MCI. METHODS Inpatients with ACS were consecutively recruited from 2 tertiary hospital cardiac wards and screened with the Montreal Cognitive Assessment and the Hopkins Verbal Learning Test. Screening included health literacy (Newest Vital Sign), depressive symptoms (Patient Health Questionnaire-9), and physical activity (Physical Activity Scale for the Elderly). Factors associated with MCI were determined using logistic regression. RESULTS Participants (n = 81) had a mean (SD) age of 63.5 (10.9) years, and 82.7% were male. In total, MCI was identified in 52.5%, 42.5% with 1 screen and 10% with both. Individually, the Montreal Cognitive Assessment identified MCI in 48.1%, and the Hopkins Verbal Learning Test identified MCI in 13.8%. In Montreal Cognitive Assessment screening, the cognitive domains in which participants most frequently did not achieve the maximum points available were delayed recall (81.5%), visuospatial executive function (48.1%), and attention (30.9%). Accounting for education, depression, physical activity, and ACS diagnosis, the likelihood of an MCI positive screen increased by 11% per year of age (odds ratio, 1.11; 95% confidence interval, 1.04-1.18) and by 3.6 times for those who are unmarried/unpartnered (odds ratio, 3.61; 95% confidence interval, 1.09-11.89). CONCLUSION An estimated half of patients with ACS screen positive for MCI during admission, with single and older patients most at risk. Multiple areas of thinking were affected with potential impact on capacity for learning heart disease management.
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Hoang CT, Amin V, Behrman JR, Kohler HP, Kohler IV. Heterogenous trajectories in physical, mental and cognitive health among older Americans: Roles of genetics and life course contextual factors. SSM Popul Health 2023; 23:101448. [PMID: 37520306 PMCID: PMC10372459 DOI: 10.1016/j.ssmph.2023.101448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/13/2023] [Accepted: 06/08/2023] [Indexed: 08/01/2023] Open
Abstract
We investigate the roles of genetic predispositions, childhood SES and adult educational attainment in shaping trajectories for three important components of the overall health of older adults -- BMI, depressive symptoms and cognition. We use the Health & Retirement Study (HRS) and group-based trajectory modeling (GBTM) to identify subgroups of people who share the same underlying trajectories ages 51-94 years. After identifying common underlying health trajectories, we use fractional multinomial logit models to estimate associations of (1) polygenic scores for BMI, depression, ever-smoked, education, cognition and subjective wellbeing, (2) childhood SES and (3) educational attainment with the probabilities of trajectory group memberships. While genetic predispositions do play a part in predicting trajectory group memberships, our results highlight the long arm of socioeconomic factors. Educational attainment is the most robust predictor-it predicts increased probabilities of belonging to trajectories with BMI in the normal range, low depressive symptoms and very-high initial cognition. Childhood circumstances are manifested in trajectories to a lesser extent, with childhood SES predicting higher likelihood of being on the low depressive symptoms and very-high initial cognition trajectories. We also find suggestive evidence that associations of educational attainment on the probabilities of being on trajectories with BMI in the normal range, low depressive symptoms and very-high initial cognition vary with genetic predispositions. Our results suggest that policies to increase educational attainment may improve population health by increasing the likelihood of belonging to "good" aging trajectories.
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Affiliation(s)
| | | | - Jere R. Behrman
- William R. Kenan, Economics and Sociology, University of Pennsylvania, USA
| | - Hans-Peter Kohler
- Fredrick J. Warren Professor of Demography, University of Pennsylvania, USA
| | - Illiana V. Kohler
- Population Studies Center and Department of Sociology, University of Pennsylvania, USA
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Roy A. Food insecurity and cognitive function in older adults: findings from the longitudinal aging study in India. BMC Psychiatry 2023; 23:640. [PMID: 37653393 PMCID: PMC10472592 DOI: 10.1186/s12888-023-05118-8] [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: 01/25/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND As we grow older, food insecurity (FI) may have an impact on our cognitive abilities. The study examines the association of FI with the cognitive function of older adults in India. METHODS We have used the data from the first wave of the Longitudinal Ageing Study of India (LASI), with a sample of 27,032 older adults aged 60 years and older. Bivariate analysis and linear regression models with clusters were applied to show the association. The cognitive performance tests include episodic memory, orientation, arithmetic function, executive function, and object naming. RESULTS The mean cognition was 24.2 (range 0-43), while 36.4%, 2.1%, and 6.4% experienced mild, moderate, and severe FI, respectively. After adjustment for potential confounders, mild (β = -0.18, 95% CI: -0.32, - 0.04) and severe (β = -0.52, 95% CI: -0.82, - 0.22) food insecurity was associated with poor overall cognitive performance. Domain-specific differences in cognition, such as memory, orientation, arithmetic function, executive function, and object naming, were also validated by the level of FI. CONCLUSION The finding suggests that FI is associated with a poor level of cognition among older adults, highlighting the need for increasing the coverage and intervention strategies to address FI in India.
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Affiliation(s)
- Alok Roy
- Department of Geography, Krishnagar Government College, Krishnanagar, West Bengal, 741101, India.
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