The Prevalence of Mild Cognitive Impairment among Chinese People: A Meta-Analysis

Mild Cognitive Impairment, Religiosity, Spirituality and all-Cause Mortality Among Chinese Older Adults in Ethnic Minority Communities

The relationship between mild cognitive impairment (MCI), religiosity and/or spirituality (R/S), and all-cause mortality among older adults has yet to be clarified. The current study aims to examine this relationship using a longitudinal cohort from ethnic minority communities in mainland China. The Cox proportional hazards regression modeling revealed that MCI predicted an increased risk of all-cause mortality, and high R/S buffered this association. Those findings suggest that a religious-spiritual integrated community intervention program may reduce the mortality risk in older adults with MCI in ethnically disadvantaged populations.

Systematic review and meta-analysis of transcranial direct current stimulation (tDCS) for global cognition in mild cognitive impairment and Alzheimer's disease

OBJECTIVE

To systematically assess the effectiveness of transcranial direct current stimulation (tDCS) on global cognition in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD).

DATA SOURCES

Ten databases were retrieved for pertinent Chinese and English studies published up until February 2023.

DATA EXTRACTION

Two researchers independently selected the literature, extracted the data, evaluated using the Cochrane Collaboration's quality criteria, and then cross-checked. Meta-analysis was performed using RevMan 5.4.

RESULTS

22 studies involving 1074 patients were included. Compared with the control group received the interventions such as pharmacotherapy, cognitive stimulation, et al., with/without sham-tDCS, while the experiment group received tDCS added to the interventions of the control group. The meta-analysis found that tDCS increased MMSE, MoCA, MODA scores and reduced the P300 latency scores (all P < 0.05).

CONCLUSION

The tDCS can ameliorate the global cognition of patients with MCI and AD, and it has a better rehabilitation effect than non-tDCS or sham-tDCS.

Prevalence of mild cognitive impairment and its association with malnutrition in older Chinese adults in the community

Objective

This study aims to characterize the prevalence and associated factors of cognitive impairment in older adults within Chinese community settings.

Background

Research exploring the interrelation between malnutrition and cognitive impairment in the older adult community-dwelling population is scarce. The impact of nutritional status on cognitive function in aging adults has not been definitively established.

Methods

A cross-sectional survey was conducted in one urban and one rural community in Chengdu, China, from October 2022 to March 2023. The sample included 706 older adults. Logistic regression was utilized to determine independent risk factors for mild cognitive impairment (MCI).

Results

The study found a significant prevalence of MCI at 32.0% among the older adult population. Among those suffering from malnutrition, 55.6% were affected by MCI. The logistic regression analysis indicated that malnutrition risk (OR = 2.192, 95% CI 1.431 to 3.357, p < 0.001), rural residence (OR = 1.475, 95% CI 1.003 to 2.170, p = 0.048), age (70-79 years old; OR = 2.425, 95% CI 1.611 to 3.651, p < 0.001; ≥80 years old: OR = 4.773, 95% CI 2.571 to 8.859, p < 0.001), male (OR = 1.584, 95% CI 1.085 to 2.313, p = 0.017), middle education level (OR = 0.986, 95% CI 1.627 to 5.482, p < 0.001), and ADL dependence (OR = 1.810, 95% CI 1.158 to 2.827, p = 0.009) were significantly associated with the occurrence of MCI.

Conclusion

The findings indicate a widespread occurrence of MCI in community-dwelling older Chinese adults. The association between malnutrition, as measured by the Mini Nutritional Assessment-Short Form (MNA-SF), and cognitive decline is evident. Older adult individuals with nutritional risk, advancing age, rural residence, male gender, moderate education, and ADL dependency are at increased likelihood of developing MCI. Longitudinal research is needed to clarify the temporal relationships between MCI, demographic factors, and whether improvements in nutritional status or ADL can reduce the incidence of MCI in this population.

Modifiable risk factors for mild cognitive impairment among cognitively normal community-dwelling older adults: A systematic review and meta-analysis

Although numerous studies have investigated modifiable risk factors for mild cognitive impairment (MCI) among community-dwelling seniors, no meta-analysis has summarized these findings. Five databases were searched from January 1, 2000, to December 30, 2023. The protocol was registered with PROSPERO. Data were extracted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant meta-analyses of modifiable risk factors were performed. The evidence of each factor was assessed by the GRADE for cohort studies. Of 16,651 citations, 87 studies involving 225,584 community-dwelling seniors were included. Fourteen meta-analyses involving 20 studies with 44,199 participants were performed. The analyses revealed low-to-moderate-quality evidence supporting that diabetes, 2 or more comorbidities, anxiety, apathy, depressive symptoms, and physical frailty were risk factors for incident MCI in older adults. Conversely, hypertension, agitation, and irritability might not be risk factors. Additionally, moderate-quality evidence supports the protective effect of engaging in cognitive-demanding activities on the onset of MCI. Collectively, this study constitutes the first extensive compilation of evidence regarding the various risk factors for the development of MCI in older adults. Our findings hold significant potential to guide the formulation of prevention and management strategies to either prevent or potentially reverse the onset of MCI.

Hukou Status and Cognitive Function Among Older Chinese Adults: Does Support from Friends Matter?

OBJECTIVES

This study examined whether older Chinese adults with different types of hukou status (government household registration system) exhibited different cognitive outcomes and whether receiving support from friends, an under-appreciated resource, helped mitigate the negative impacts of agricultural hukou status on cognitive health disparities.

METHODS

Using nationally representative data from the China Longitudinal Aging Social Survey, this study tested these relationships with well-validated measures.

RESULTS

Our results showed that older Chinese adults with agricultural hukou were more likely to have worse cognitive function than those with non-agricultural hukou. Further, friend support characteristics moderated the association between hukou status and cognitive function, whereby having better friend support was related to a weaker negative effect of agricultural hukou status on cognitive function.

DISCUSSION

The findings suggested that agricultural hukou status reflects the effects of accumulated disadvantage across the life course with negative consequences for late-life cognition. The cognitive health disparities between agricultural and non-agricultural residents may be reduced in the context of a higher level of friend support, supporting a stress buffering hypothesis.

The circadian syndrome is a predictor for cognition impairment in middle-aged adults: Comparison with the metabolic syndrome

AIMS

Circadian syndrome (CircS) is considered a better predictor for cardiovascular disease than the metabolic syndrome (MetS). We aim to examine the associations between CircS and MetS with cognition in Chinese adults.

METHOD

We used the data of 8546 Chinese adults aged ≥40 years from the 2011 China Health and Retirement Longitudinal Study. MetS was defined using harmonised criteria. CircS included the components of MetS plus short sleep and depression. The cut-off for CircS was set as ≥4. Global cognitive function was assessed during the face-to-face interview.

RESULTS

CircS and MetS had opposite associations with the global cognition score and self-reported poor memory. Compared with individuals without the CircS and MetS, the regression coefficients (95%CI) for global cognition score were -1.02 (-1.71 to -0.34) for CircS alone and 0.52 (0.09 to 0.96) for MetS alone in men; -1.36 (-2.00 to -0.72) for CircS alone and 0.60 (0.15 to 1.06) for MetS alone in women. Having CircS alone was 2.53 times more likely to report poor memory in men (95%CI 1.80-3.55) and 2.08 times more likely in women (95%CI 1.54-2.81). In contrast, having MetS alone was less likely to report poor memory (OR 0.64 (0.49-0.84) in men and 0.65 (0.52-0.81) in women). People with CircS and MetS combined were more likely to have self-reported poor memory.

CONCLUSIONS

CircS is a strong and better predictor for cognition impairment than MetS in Chinese middle-aged adults. MetS without short sleep and depression is associated with better cognition.

The Prevalence of Mild Cognitive Impairment in China: Evidence from a Meta-Analysis and Systematic Review of 393,525 Adults

OBJECTIVE

This study aims to precisely determine the prevalence of mild cognitive impairment (MCI) in China, acknowledging its significance as a preclinical stage of dementia and a potential "intervention window." The acceleration of the aging process in China underscores the urgency of this research.

METHODS

A comprehensive search was conducted across PubMed, Embase, Web of Science, CNKI, WFD, VIP, and CBM databases from their inception until March 1, 2023. The Agency for Healthcare Research and Quality (AHRQ) methodology checklist guided our quality assessment. A random-effects model meta-analysis was employed to synthesize the pooled prevalence data of MCI in China.

RESULTS

Our analysis encompassed 139 studies, incorporating data from 393,525 individuals aged 40 years and above. The studies were predominantly rated as moderate-to-high quality. The overall prevalence of MCI was determined to be 19.6% (95% CI: 17.7-21.6%). Subgroup analyses indicated variations in prevalence: 20.8% (95% CI: 18.9-22.7%) for P-MCI compared to 16.2% (95% CI: 11.7-20.7%) for DSM criteria. Geographically, prevalence in Southern China (21.0%, 95% CI: 18.1-23.9%) exceeded that in Northern China (17.6%, 95% CI: 15.9-19.4%). Notably, prevalence in hospitals (61.7%, 95% CI: 27.8-95.7%) was significantly higher than in nursing homes (16.1%, 95% CI: 14.3-17.9%) and communities (25.3%, 95% CI: 17.4-33.2%), especially after the COVID-19 outbreak.

CONCLUSION

The study confirms a 19.6% prevalence rate of MCI in China, influenced by factors such as sample sources, beginning year of survey, and regional differences. It highlights the need for targeted screening and resource allocation to subpopulations at risk, aiming to prevent the progression to dementia.

Development and External Validation of a Gait Test Based Diagnostic Model for Detecting Mild Cognitive Impairment

OBJECTIVE

To address the lack of large-scale screening tools for mild cognitive impairment (MCI), this study aimed to assess the discriminatory ability of several gait tests for MCI and develop a screening tool based on gait test for MCI.

DESIGN

A diagnostic case-control test.

SETTING

The general community.

PARTICIPANTS

We recruited 134 older adults (≥65 years) for the derivation sample, comprising -69 individuals in the cognitively normal group and -65 in the MCI group (N=134). An additional 70 participants were enrolled for the validation sample.

INTERVENTIONS

All participants completed gait tests consisting of a single task (ST) and 3 dual tasks (DTs): counting backwards, serial subtractions 7, and naming animals.

MAIN OUTCOME MEASURES

Binary logistic regression analyses were used to develop models, and the efficacy of each model was assessed using receiver operating characteristic (ROC) curve and area under the curve (AUC). The best effective model was the final diagnostic model and validated using ROC curve and calibration curve.

RESULTS

The DT gait test incorporating serial subtractions 7 as the cognitive task demonstrated the highest efficacy with the AUC of 0.906 and the accuracy of 0.831 in detecting MCI with "years of education" being adjusted. Furthermore, the model exhibited consistent performance across different age and sex groups. In external validation, the model displayed robust discrimination (AUC=0.913) and calibration (calibrated intercept=-0.062, slope=1.039).

CONCLUSIONS

The DT gait test incorporating serial subtractions 7 as the cognitive task demonstrated robust discriminate ability for MCI. This test holds the potential to serve as a large-scale screening tool for MCI, aids in the early detection and intervention of cognitive impairment in older adults.

Impacts of education level on Montreal Cognitive Assessment and saccades in community residents from Western China

OBJECTIVES

This cross-sectional study sought to evaluate the effectiveness of the Montreal Cognitive Assessment (MoCA) and saccade in discerning the cognitive function levels among community populations characterized by diverse educational backgrounds.

METHODS

Data from 665 Western China individuals encompassed MoCA scores and saccade performance. The study examined how education level and age influenced these assessments and highlighted the contrasting abilities of these measures in detecting cognitive abnormalities.

RESULTS

The saccade model revealed a consistent cognitive impairment prevalence (15.5%) compared to previous clinical data (9.7% to 23.3%), while MoCA exhibited variable rates (25.1% to 52.8%). Notably, saccades and MoCA significantly diverged in detecting cognitive dysfunction. Additionally, education level had a greater impact on MoCA (effect size: 0.272) compared to saccades (0.024) affecting all MoCA sub-items, with age exerting a smaller influence on MoCA (0.037) compared to saccades (0.056).

CONCLUSION

Saccades are less susceptible to the influence of education level when compared to MoCA, making saccade a potentially more suitable cognitive screening tool for rural community populations.

SIGNIFICANCE

This study represents a pioneering approach by employing saccade detection within community populations to distinguish cognitive function status.

Association between disability and cognitive function in older Chinese people: a moderated mediation of social relationships and depressive symptoms

Objective

Many previous studies have found that disability leads to cognitive impairment, and in order to better understand the underlying mechanisms between disability and cognitive impairment, the present study aimed to investigate the moderating role of social relationships, including their role as mediators between disability and cognitive impairment in depressive symptoms.

Study design

This is a cross-sectional study.

Methods

A total of 5,699 Chinese older adults from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS) were included in this study, and PROCESS macro was used to perform simple mediator and moderator mediator analyses, which were used to analyze the relationship between depressive symptoms and social relationships between disability and cognitive impairment.

Results

The results of this study showed significant correlations between disability, cognitive impairment, depressive symptoms, and social relationships, and that depressive symptoms mediated the relationship between disability and cognitive functioning [B = -0.232; 95% CI: (-0.304, -0.164)], and that social relationships mediated disability and cognitive functioning through pathway a (Disability-Depressive Symptoms) [B = 0.190; 95% CI: (0.020, 0.036)], path b (depressive symptoms-cognitive impairment) [B = 0.029; 95% CI: (0.015, 0.042)], and path c' (incapacitation-cognitive impairment) [B = 0.492; 95% CI: (0.298, 0.685)] to modulate the effect of incapacitation on cognitive impairment. In addition, social activities and social networks moderated the mediation model directly or indirectly, whereas social support moderated only the direct effect.

Conclusion

This study explains the intrinsic link between incapacitation and cognitive impairment in Chinese older adults, and that social relationships and depressive symptoms can directly or indirectly modulate the effects between them. This provides a basis for healthcare professionals to be able to better develop interventions that can be used to improve the level of cognitive functioning and mental health of older adults.

Combined associations of cognitive impairment and psychological resilience with all-cause mortality in community-dwelling older adults

BACKGROUND

Cognitive impairment and psychological resilience are closely related in older adults, but their combined effect on mortality has not been reported. Using a nationally representative sample from the Chinese Longitudinal Healthy Longevity Study, this study examined the interactions between cognitive impairment and psychological resilience and their associations with overall survival.

METHODS

A total of 32,349 community-dwelling older adults (86.85 ± 11.16 years, 56.06 % female) were enrolled in 1998, 2000, 2002, 2005, 2008, 2011, and 2014; all participants were followed until 2018. Cognitive function and psychological resilience were assessed using the Mini-Mental State Examination (MMSE) and the 7-item psychological resilience questionnaire (PRQ), respectively. Illiterate subjects with an MMSE score <18, or literate subjects with an MMSE score <24 were defined as having cognitive impairment. Cox proportional risk regressions were used to analyze the association of cognitive impairment and psychological resilience with all-cause mortality.

RESULTS

After 146,993.52 person-years of follow-up, 23,349 older adults died. Both MMSE and PRQ scores (as continuous variables) were negatively associated with mortality risk after adjusting for all covariates. The hazard ratio (HR) of all-cause mortality for cognitive impairment was not significantly moderated by levels of psychological resilience (P-interaction = 0.094). In joint analyses, participants with combined cognitive impairment and low resilience (by the median of PRQ: < 25 points) had the highest risk of mortality (adjusted-HR: 1.56, 95%CI: 1.48-1.61), which was higher than that of patients with either condition alone. There was a significant additive interaction effect of cognitive impairment and low resilience on all-cause mortality (relative excess risk due to interaction: 0.11, 95 % CI: 0.09-0.13), and 7 % of the overall mortality risk was attributable to their synergistic effect.

CONCLUSIONS

Cognitive impairment and low resilience are synergistically associated with increased risk of all-cause mortality in community-dwelling older adults. The potential mechanisms underlying this combined effect warrant further exploration.

Effects of movement training based on rhythmic auditory stimulation in cognitive impairment: a meta-analysis of randomized controlled clinical trial

Objective

According to the World Alzheimer's Disease Report in 2015,there were 9.9 million new cases of dementia in the world every year. At present, the number of patients suffering from dementia in China has exceeded 8 million, and it may exceed 26 million by 2040.Mild cognitive impairment (MCI) refers to the pathological state of pre-dementia with the manifestation of the progressive decline of memory or other cognitive functions but without decline of activities of daily life. It is particularly important to prevent or prolong the development of MCI into dementia. Research showing effects of rhythmic auditory stimulation based-movement training(RASMT) interventions on cognitive function is also emerging. Therefore, the present meta-analysis briefly summarize findings regarding the impacts of RASMT programs on cognitive impairment.

Methods

Data from Pubmed, Embase, and Cochrane Library were utilized. The impact of RASMT on cognitive functions was evaluated using indicators such as overall cognitive status, memory, attention, and executive functions. The REVMAN5.3 software was employed to analyze bias risks integrated into the study and the meta-analysis results for each indicator.

Results

A total of 1,596 studies were retrieved, of which 1,385 non-randomized controlled studies and 48 repetitive studies were excluded. After reviewing titles and abstracts of the remaining 163 articles, 133 irrelevant studies were excluded, 30 studies were downloaded and read the full text. Among 30 articles, 18 articles that did not meet the inclusion criteria were excluded, the other 12 studies were included in this meta-analysis. Utilizing the Cochrane Collaborative Network Bias Risk Assessment Scale, it was found that 11 studies explained the method of random sequence generation, nine studies did not describe allocation concealment, four were single-blinded to all researchers, and eight reported single-blinding in the evaluation of experimental results. In the meta-analysis, the main outcomes showed statistically significant differences in overall cognitive status [MD = 1.19, 95%CI (0.09, 2.29), (p < 0.05)], attention [MD = -1.86, 95%CI (-3.53, -0.19), (p < 0.05)], memory [MD = 0.71, 95%CI (0.33, 1.09), (p < 0.01)], and executive function [MD = -0.23, 95% CI (-0.44, -0.02), (p < 0.05)]. Secondary outcomes indicated no statistically significant differences in verbal fluency [MD = -0.51, 95%CI (-1.30, 0.27), (p = 0.20)], while depression [MD = -0.29, 95% CI (-0.42, -0.16), (p < 0.01)] and anxiety [MD = 0.19, 95% CI (0.06, 0.32), (p < 0.01)] exhibited statistically significant differences. The GRADEpro GDT online tool assessed the quality of evidence for the outcome measures, revealing one low-quality outcome, two moderate-quality outcomes, and one high-quality outcome in this review.

Conclusion

This study shows that RASMT can improve the general cognitive status, memory, attention and executive function of patients with cognitive impairment. The quality of evidence revealed that MMSE was low, attention and memory were moderate, and executive function was high. The RAMST program (type of exercise: play percussion instruments; time of exercise: 30-60 min; frequency of exercise: 2-3 times/week; duration of exercise: more than 12 weeks) was proved to be more effective in improving cognitive function. However, the sample size is relatively insufficient, the future needs further study.

Systematic review registration

PROSPERO, identifier: CRD42023483561.

Assessing cognitive impairment in home-dwelling Chinese elders aged 80+: a detailed survey of 13,000 participants focusing on demographic factors, social engagement, and disease prevalence

Introduction

Cognitive Impairment (CI) in the elderly, encompassing conditions ranging from Mild Cognitive Impairment (MCI) to dementia, represents a growing public health concern globally. This study aims to investigate the prevalence and correlates of CI among individuals aged 80 and above.

Methods

The study conducts 13,027 elderly individual's door-to-door surveys, followed by the cross-tabulation of analysis data, logistic regression analysis, and health condition assessments to examine various determinants of CI.

Results

The current study's key findings demonstrate sub-statical correlations between CI and various factors, including educational attainment, marital status, and gender. Pronounced differences are evident between urban and rural demographics. Furthermore, aspects of social engagement, notably communication proficiency and sensory capabilities, exhibit a strong association with CI. Logistic regression analysis highlights that residing in rural areas (Odds Ratio [OR] = 0.637) and being female (OR = 0.71) are linked to a decreased risk of CI. In contrast, behavioral and health-related variables present a complex picture. Specifically, aggressive behavior (Adjusted OR = 1.881) and symptoms of depression (Adjusted OR = 0.549) contrast with conditions such as asthma (OR= 2.857) and cerebral infarction (OR=1.348), which elevate the risk of CI. Intriguingly, hyperlipidemia (OR= 0.671) appears to confer a protective effect against CI.

Conclusion

The study highlights the complexity of factors affecting CI in the elderly, advocating for a comprehensive approach to understanding and managing cognitive health.

Interaction between Aβ and tau on reversion and conversion in mild cognitive impairment patients: After 2-year follow-up

Background

The role of amyloid-β (Aβ) and tau in reversion and conversion in patients with mild cognitive impairment (MCI) remains unclear. This study aimed to investigate the influence of cerebrospinal fluid (CSF) Aβ and tau on reversion and conversion and the temporal sequence of their pathogenicity in MCI patients.

Methods

179 MCI patients were recruited from the Alzheimer's Disease Neuroimaging Initiative database and classified into two groups based on cognitive changes after follow-up: reversal group (MCI to cognitively normal) and conversion group (MCI to Alzheimer's disease). CSF biomarkers and cognitive function were measured at baseline and 2-year follow-up. Partial correlation was used to analyze the association between CSF biomarkers and cognitive function, and multivariable logistic regression to identify independent risk factors for cognitive changes at baseline and 2-year follow-up. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive ability of these risk factors for cognitive changes.

Results

The differences in cognitive function and CSF biomarkers between the two groups remained consistent with baseline after 2-year follow-up. After controlling for confounding variables, there was still a correlation between CSF biomarkers and cognitive function at baseline and 2-year follow-up. Multivariable regression analysis found that at baseline, only Aβ level was independently associated with cognitive changes, while Aβ and tau were both predictive factors after 2-year follow-up. ROC curve analysis revealed that the combination of Aβ and tau [area under the curve (AUC) 0.91, sensitivity 84%, specificity 86%] in predicting cognitive changes after 2-year follow-up had better efficacy than baseline Aβ alone (AUC 0.81).

Conclusion

Aβ may precede Tau in causing cognitive changes, and the interaction between the two mediates cognitive changes in patients. This study provides new clinical evidence to support the view that Aβ pathology precedes tau pathology, which together contribute to the changes in cognitive function.

The prevalence of mild cognitive impairment and dementia among rural dwellers: A systematic review and meta-analysis

The mild cognitive impairment (MCI) and dementia in rural areas are increasingly attracting public attention. However, their prevalence is still unclear. This study aims to reveal the distribution of MCI and dementia in rural areas. We systematically searched PubMed, Web of Science, Embase, and PsycINFO up to June 2023 for cohort and cross-sectional studies. Meta-analysis was conducted using random-effects models to evaluate the prevalence of MCI and dementia. Thirty-five studies with 16,936 participants met the inclusion criteria. The pooled prevalence of MCI and dementia was 27 % (n = 12, 95 %CI = 0.21-0.32, I2 = 99.5 %, P < 0.001) and 7 % (n = 27, 95 %CI = 0.05-0.08, I2 = 99.30 %, P < 0.001), respectively. Subgroup analyses revealed that aged 60 years or older [(MCI: 29 %, 95 %CI = 0.20-0.38, I2 = 99.7 %, P < 0.001), (dementia: 9 % (95 %CI = 0.06-0.12, I2 = 99 %, P < 0.001)], female [(MCI: 29 %, 95 %CI = 0.19-0.40, I2 = 99.3 %, P < 0.001), (dementia: 7 %, 95 % CI = 0.04-0.12, I2 = 98.66 %, P < 0.001)], a-MCI (19 %, 95 %CI = 0.12-0.26, I2 = 97.62 %, P < 0.001) and AD (4 %, 95 %CI = 0.02-0.05, I2 = 98.60 %, P < 0.001) showed higher prevalence. The prevalence of MCI and dementia in rural China was 23 % (95 %CI = 0.18-0.29, I2 = 99.5 %, P < 0.001) and 6 % (95 %CI = 0.04-0.08, I2 = 99.6 %, P < 0.001), respectively. Implementing cognitive impairment screening and intervention measures is necessary to improve the cognitive function of the rural population.

The association between indoor air pollution from solid fuels and cognitive impairment: a systematic review and meta-analysis

This study aimed to comprehensively and methodically evaluate the correlation between cognitive impairment and indoor air pollution from solid fuel used for cooking/heating. PubMed, Web of Science, EMBASE, and Cochrane Library databases were searched up to December January 2023. 13 studies from three countries with a total of 277,001 participants were enrolled. A negative correlation was discovered between solid fuel usage for cooking and total cognitive score (β=-0.73, 95 % CI: -0.90 to -0.55) and episodic memory score (β=-0.23, 95 % CI: -0.30 to -0.17). Household solid fuel usage for cooking was considerably associated with a raised risk of cognitive impairment (HR=1.31, 95 % CI: 1.09-1.57) and cognitive decline (HR=1.24, 95 % CI: 1.18-1.30). Compared to continuous solid fuel use for cooking, sustained use of clean fuel and switching from solid fuel to clean fuel were associated with a lower risk of cognitive decline (OR=0.55, 95 % CI: 0.42-0.73; OR=0.81, 95 % CI: 0.71-0.93). A negative association was found between solid fuel usage for heating and total cognitive score (β=-0.43, 95 % CI: -0.59 to -0.26) and episodic memory score (β=-0.22, 95 % CI: -0.34 to -0.10). Our research provided evidence that exposure to indoor air pollution from solid fuel is a potential cause of cognitive impairment and cognitive decline. Making the switch from solid fuels to cleaner fuels could be an important step in preventing cognitive impairment in the elderly.

Slovenian Memory Clinic Organization with the Introduction of Potential New Alzheimer's Disease Treatment

Slovenia, situated in Central Europe with a population of 2.1 million, has an estimated 44,278 individuals with mild cognitive impairment due to Alzheimer's disease or mild Alzheimer's dementia, rendering them potential candidates for disease-modifying treatment (DMT), such as lecanemab. We identified 114 potential candidates whose real-life expenses for diagnostic process surmount to more than €80,000. Treating all potential candidates nationwide would amount to €1.06 billion, surpassing Slovenia's entire annual medication expenditure for 2022 (€743 million). The introduction of DMTs and the associated logistics, along with potential complications, will significantly change societal, professional, and patient approach to treatment of Alzheimer's disease.

Frailty, cognitive impairment, and depressive symptoms in Chinese older adults: an eight-year multi-trajectory analysis

BACKGROUND

Frailty, cognitive impairment, and depressive symptoms are closely interrelated conditions in the aging population. However, limited research has longitudinally analyzed the concurrent trajectories of these three prominent conditions in older adults in China. This study aimed to explore the eight-year trajectories of frailty, cognitive impairment, and depressive symptoms, and to identify individual-level and structural-level factors associated with the trajectories.

METHODS

Four waves of data from the China Health and Retirement Longitudinal Study (2011-2018) were used to identify 6,106 eligible older adults. The main measures included frailty by the frailty index constructed using 30 indicators, cognitive impairment by the summary score of immediate and delayed word recall, figure drawing, serial subtraction, and orientation, and depressive symptoms by the Center for Epidemiologic Studies Depression Scale. Multi-trajectory models identified the trajectories of frailty, cognitive impairment, and depressive symptoms over time. Multinomial logistic regression was employed to estimate the associations between individual-level capital factors and one structural factor (hukou and geographic residency) with the identified trajectories, adjusting for demographic characteristics.

RESULTS

Four trajectories emerged: (1) worsening frailty, worsening cognitive impairment, depression (14.0%); (2) declining pre-frailty, declining cognition, borderline depression (20.0%); (3) pre-frailty, worsening cognitive impairment, no depression (29.3%); and (4) physically robust, declining cognition, no depression (36.7%). Using the "physically robust, declining cognition, no depression" as the reference, not working, no social activity participant, worse childhood family financial situation, and poorer adult health were most strongly associated with the "worsening frailty, worsening cognitive impairment, depression" trajectory; worse health during childhood had the highest association with the "declining pre-frailty, declining cognition, borderline depression" trajectory; less education, lower household consumption, and rural hukou had the greatest association with the increased likelihood of the "pre-frailty, worsening cognitive impairment, no depression" trajectory.

CONCLUSIONS

Findings could inform the understanding of the interrelationship of frailty, cognitive impairment, and depressive symptoms in older adults in China and may help practitioners detect adults at risk for adverse trajectories to implement strategies for proper care.

Evidence from a meta-analysis and systematic review reveals the global prevalence of mild cognitive impairment

Objective

Mild cognitive impairment (MCI) is a preclinical and transitional stage between healthy ageing and dementia. The purpose of our study was to investigate the recent pooled global prevalence of MCI.

Methods

This meta-analysis was in line with the recommendations of Cochrane's Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. We conducted a comprehensive search using the PubMed, Embase, Web of Science, CNKI, WFD, VIP, and CBM from their inception to March 1, 2023. Quality assessment was guided by the Agency for Healthcare Research and Quality (AHRQ) methodology checklist. The pooled global prevalence of MCI was synthesized using meta-analysis via random effect model. Subgroup analyses were performed to examine considered factors potentially associated with MCI prevalence.

Results

We identified 233 studies involving 676,974 individuals aged above 50 years. All the studies rated as moderated-to-high quality. The overall prevalence of MCI was 19.7% [95% confidence interval (95% CI): 18.3-21.1%]. Subgroup analyses revealed that the global prevalence of MCI increased over time, with a significant rise [32.1% (95% CI: 22.6-41.6%)] after 2019. Additionally, MCI prevalence in hospitals [34.0% (95% CI: 22.2-45.7%)] was higher than in nursing homes [22.6% (95% CI: 15.5-29.8%)] and communities [17.9% (95% CI: 16.6-19.2%)], particularly after the epidemic of coronavirus disease 2019 (COVID-19).

Conclusion

The global prevalence of MCI was 19.7% and mainly correlated with beginning year of survey and sample source. The MCI prevalence increased largely in hospitals after 2019 may be related to the outbreak of COVID-19. Further attention to MCI is necessary in the future to inform allocation of health resources for at-risk populations.

Spatiotemporal gait parameter fluctuations in older adults affected by mild cognitive impairment: comparisons among three cognitive dual-task tests

BACKGROUNDS

Gait disorder is associated with cognitive functional impairment, and this disturbance is more pronouncedly when performing additional cognitive tasks. Our study aimed to characterize gait disorders in mild cognitive impairment (MCI) under three dual tasks and determine the association between gait performance and cognitive function.

METHODS

A total of 260 participants were enrolled in this cross-sectional study and divided into MCI and cognitively normal control. Spatiotemporal and kinematic gait parameters (31 items) in single task and three dual tasks (serial 100-7, naming animals and words recall) were measured using a wearable sensor. Baseline characteristics of the two groups were balanced using propensity score matching. Important gait features were filtered using random forest method and LASSO regression and further described using logistic analysis.

RESULTS

After matching, 106 participants with MCI and 106 normal controls were recruited. Top 5 gait features in random forest and 4 ~ 6 important features in LASSO regression were selected. Robust variables associating with cognitive function were temporal gait parameters. Participants with MCI exhibited decreased swing time and terminal swing, increased mid stance and variability of stride length compared with normal control. Subjects walked slower when performing an extra dual cognitive task. In the three dual tasks, words recall test exhibited more pronounced impact on gait regularity, velocity, and dual task cost than the other two cognitive tests.

CONCLUSION

Gait assessment under dual task conditions, particularly in words recall test, using portable sensors could be useful as a complementary strategy for early detection of MCI.

The Mediating Effects of Nutritional Status on the Relationship between Number of Residual Teeth and Cognitive Function among Older Adults: A Cross-Sectional Multicenter Study

The underlying mechanisms of the relationship between the number of teeth and cognition is still unclear. We aimed to construct a mediation model between the number of residual teeth and cognitive function, using nutritional status as a mediating factor. This study was completed using the West China Health and Aging Trend cohort. A total of 6634 multi-ethnic older adults, aged 50 years or older, were included. This study measured cognitive function using the Short-Portable Mental Status Questionnaire, and nutritional status was assessed using the Mini Nutritional Assessment-Short Form. The mediation analysis examined the potential mediating role of nutritional status. The pathway analysis was supplemented and validated using the structural equation modelling framework. Multiple linear regression demonstrated that a higher number of residual teeth was correlated with enhanced cognitive function (β = -0.15; 95% CI: -0.19 to -0.111). The mediation model, from the number of residual teeth to cognitive impairment, was partially mediated by nutritional status (β = -0.0608; 95% CI: -0.0762 to -0.0461). The proportion of the mediating effect, expressed as a percentage, was 40.66%. Furthermore, the estimated coefficients for the number of residual teeth and nutritional status varied across ethnic groups. This study indicated that enhancing the nutrition of older adults could reduce the adverse effects of the number of residual teeth on cognitive function among older adults.

Donepezil combined with traditional Chinese medicine has promising efficacy on mild cognitive impairment: a systematic review and meta-analysis

Objective

Prior research has shown mixed results regarding the effectiveness of combining donepezil and traditional Chinese medicine (TCM) to treat mild cognitive impairment (MCI). In light of this, our study aims to examine the efficacy and safety of this treatment approach for patients with MCI.

Methods

We conducted a comprehensive search of various databases, including Medline (via PubMed), Cochrane, Embase, Web of Science, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wanfang Database from their inception to November 16, 2022. The selection of studies, risk of bias assessment, and data extraction were carried out independently by two authors. The statistical analysis was performed using STATA.

Results

Our meta-analysis included a total of 35 studies with 2,833 patients, published between 2008 and 2022, with intervention durations ranging from 4 weeks to 12 months. However, most of the studies had a high risk of detection bias. Our findings indicated that the combination of donepezil and TCM significantly improved the Montreal Cognitive Assessment (MoCA) score (weighted mean difference [WMD] = 2.79, 95% confidence interval [CI]: 1.82 to 3.75) and the Barthel Index score (WMD = 9.20, 95% CI: 5.39 to 13.00) compared to donepezil alone. However, subgroup analyses showed that the MoCA score did not increase significantly in patients with MCI resulting from cerebrovascular disease (WMD = 1.47, 95% CI: -0.02 to 2.96).

Conclusion

The combination of donepezil and TCM may have a more positive effect on cognitive function and activities of daily living in patients with MCI compared to the use of donepezil alone. However, due to the limited quality of the studies included in our analysis, these findings should be interpreted with caution.

Predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer: a retrospective analysis

Background

Early detection of cognitive impairment in patients undergoing ileostomy for colorectal cancer may help improve patient outcomes and quality of life. Identifying risk factors and clinically accessible factors is crucial for prevention and treatment.

Objective

This retrospective study aimed to identify risk factors for post-operative cognitive impairment in patients undergoing ileostomy for colorectal cancer and to explore potential factors for its prevention and treatment.

Methods

A total of 108 cases were selected and included in the study. Patient data including general characteristics, disease stage, complications, and chemotherapy status were collected, and sleep quality and cognitive function were assessed using questionnaires and follow-up. Patients were randomly divided into training and validation groups. A random forest model was used to rank clinical features based on their contribution to predicting the prognosis of cancer-related cognitive impairment (CRCI). Nomograms were constructed using the support vector machine-recursive feature elimination (SVM-RFE) method, and the minimal root-mean-square error (RMSE) values were compared to select the best model. Regression analysis was performed to determine independent predictors.

Results

Significant differences were observed in age, body mass index (BMI), alcohol consumption, frequency of physical activity, comorbidity, and cancer-related anemia (CRA) between the CRCI and non-CRCI groups. Random forest analysis revealed that age, BMI, exercise intensity, PSQI scores, and history of hypertension were the most significant predictors of outcome. Univariate logistic regression analysis of 18 variables revealed that age, alcohol consumption, exercise intensity, BMI, and comorbidity were significantly associated with the outcome of CRCI (p < 0.05). Univariate and multivariate models with P-values less than 0.1 and 0.2, respectively, showed better predictive performance for CRCI. The results of univariate analysis were plotted on a nomogram to evaluate the risk of developing CRCI after colorectal cancer surgery. The nomogram was found to have good predictive performance. Finally, regression analysis revealed that age, exercise intensity, BMI, comorbidity, and CRA were independent predictors of CRCI.

Conclusions

This retrospective cohort study revealed that age, exercise intensity, BMI, comorbidity, CRA, and mobility are independent predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer. Identifying these factors and potential factors may have clinical implications in predicting and managing post-operative cognitive impairment in this patient population.

Probiotic intervention benefits multiple neural behaviors in older adults with mild cognitive impairment

Probiotic supplements were shown to improve cognitive function in Alzheimer's disease (AD) patients. However, it is still unclear whether this applies to older individuals with mild cognitive impairment (MCI). We aimed to explore the effects of probiotic supplementation on multiple neural behaviors in older adults with MCI. Forty-two MCI patients (age > 60 years) were randomly divided into two groups and consumed either probiotics (n=21) or placebo (n=21) for 12 weeks. Various scale scores, gut microbiota measures and serological indicators were recorded pre- and posttreatment. After 12 weeks of intervention, cognitive function and sleep quality were improved in the probiotic group compared with those in the control group, and the underlying mechanisms were associated with changes in the intestinal microbiota. In conclusion, our study demonstrated that probiotic treatment enhanced cognitive function and sleep quality in older MCI patients, thus providing important insights into the clinical prevention and treatment of MCI.

Psychosocial profiles within community-dwelling older adults with Mild Cognitive Impairment: A prevalence and latent profile analysis study

OBJECTIVES

Mild Cognitive Impairment (MCI) is an at-risk stage for dementia and accurate prevalence studies are lacking in Singapore. From the literature, it is evident that psychosocial factors increase the risk of conversion to dementia. In this study, we sought to establish the prevalence of MCI in Singapore and study the associated psychosocial factors using latent profile analysis.

METHOD

902 community-dwelling older adults, aged between 60 and 99 years old (Mage = 70.48 years), were recruited as part of the Community Health and Intergenerational Study (CHI). They completed neurocognitive assessments and questionnaires on depression and anxiety symptoms, quality of life, social support, satisfaction with life, and social connectivity. Petersen's criteria was used to diagnose MCI. Within the MCI sample, 166 subjects' psychosocial scores were entered into a latent profile analysis to identify profiles of psychosocial functioning.

RESULTS

The prevalence of MCI in our sample was 21.5%. They had significantly lower years of education and perceived social support and higher depressive symptoms than the normal ageing group. Three distinct profiles emerged within the MCI group corresponding to a positive (45.2%), neutral (38.5%), and negative (16.3%) pattern of psychosocial scores. These profiles did not differ significantly in terms of demographic or cognitive variables.

DISCUSSION

The three psychosocial profiles might reflect the differing implications of MCI on a person's well-being and the negative psychosocial profile might likely be most at risk of conversion to dementia. Future longitudinal studies are required to confirm these implications.

Global prevalence of mild cognitive impairment among older adults living in nursing homes: a meta-analysis and systematic review of epidemiological surveys

Mild cognitive impairment (MCI) is the early stage of cognitive impairment between the expected cognitive decline of normal aging and the more serious decline of dementia. This meta-analysis and systematic review explored the pooled global prevalence of MCI among older adults living in nursing homes and its relevant factors. The review protocol was registered in INPLASY (INPLASY202250098). PubMed, Web of Science, Embase, PsycINFO, and CINAHL databases were systematically searched from their respective inception dates to 8 January 2022. The inclusion criteria were made based on the PICOS acronym, as follows: Participants (P): Older adults living in nursing homes; Intervention (I): not applicable; Comparison (C): not applicable; Outcome (O): prevalence of MCI or the data can generate the prevalence of MCI according to study-defined criteria; Study design (S): cohort studies (only baseline data were extracted) and cross-sectional studies with accessible data published in a peer-reviewed journal. Studies involving mixed resources, reviews, systematic reviews, meta-analyses, case studies, and commentaries were excluded. Data analyses were performed using Stata Version 15.0. Random effects model was used to synthesize the overall prevalence of MCI. An 8-item instrument for epidemiological studies was used to assess the quality of included studies. A total of 53 articles were included involving 376,039 participants with a mean age ranging from 64.42 to 86.90 years from 17 countries. The pooled prevalence of MCI in older adults in nursing homes was 21.2% (95% CI: 18.7-23.6%). Subgroup and meta-regression analyses revealed that the screening tools used were significantly associated with MCI prevalence. Studies using the Montreal Cognitive Assessment (49.8%) had a higher prevalence of MCI than those using other instruments. No significant publication bias was found. Several limitations warrant attention in this study; for example, significant heterogeneity between studies remained and some factors associated with the prevalence of MCI were not examined due to insufficient data. Adequate screening measures and allocation of resources are needed to address the high global prevalence of MCI among older adults living in nursing homes.

Interaction between the animal-based dietary pattern and green space on cognitive function among Chinese older adults: A prospective cohort study

Green space is associated with better cognition, while the animal-based dietary pattern can be a risk factor. We aimed to verify the associations and explore their interaction among the elderly. The China Longitudinal Healthy Longevity Survey (CLHLS) cohort including 17,827 participants was used. The average green space coverage rate was used to measure green space exposure. The animal-based diet index (ADI) was scored based on the non-quantitative frequency questionnaire of ten types of food intake (three types of animal foods and seven types of plant foods). We used the Mini-Mental State Examination (MMSE) to assess cognitive function. The Cox proportional hazard regression was applied to explore the correlations and interactions. In the models, we gradually adjusted for the potential risk factors. Compared with participants living in the area with the lowest green space, those living with the highest were associated with a 20% decrease in the risk of cognitive impairment (hazard ratio (HR): 0.80, 95% CI: 0.73, 0.89). As for ADI, the highest group was related to a 64% increase in the risk of cognitive impairment (HR: 1.64, 95% CI: 1.38, 1.95). The protective effect of the highest green space group on cognitive impairment was more evident among participants with low ADI (HR = 0.72, 95% CI: 0.62, 0.83), compared to those with high ADI. Green space was positively associated with cognition, while the animal-based dietary pattern was a cognitive disadvantage. The animal-based dietary pattern may mitigate the beneficial effects of green space on cognition.

Effects of aerobic exercise on global cognitive function and sleep in older adults with mild cognitive impairment: A systematic review and meta-analysis

We conducted a systematic review and meta-analysis to determine the integrated effect of aerobic exercise on cognitive function and sleep in older adults with mild cognitive impairment (MCI) and to optimize exercise methods for improving cognitive function. We searched multiple databases from January 1, 2011, to August 31, 2022, and analyzed 11 studies. Global cognitive function in older adults with MCI undergoing aerobic exercise training was significantly improved (standardized mean difference [SMD]=0.76, 95% confidence interval [CI]:0.37, 1.14), while sleep improvement was not significant (SMD= -2.07 [95% CI: -6.76, 2.62]). In the moderator analysis, aerobic exercise types with cognitive factors, exercise time of 30-50 min per session, and exercise frequency of 5-7 times per week had statistically significant effects on cognitive function improvement. However, meta-regression identified only exercise frequency as a significant moderator of the mean effect size of cognitive function.

Sensory impairment and cognitive function among older adults in China: The mediating roles of anxiety and depressive symptoms

OBJECTIVES

Through a cross-sectional study, we explored the association between sensory impairment and cognitive function in Chinese older adults, and tested the mediating roles of anxiety and depressive symptoms between this relationship.

METHODS

Based on the 2018 Chinese Longitudinal Healthy Longevity Survey, a total of 10,895 older adults aged 65 and above were selected as samples for research. Anxiety, depressive symptoms and cognitive function were evaluated by the Generalized Anxiety Disorder, the Center for Epidemiologic Studies Depression (CES-D10) and the Chinese version of modified Mini-Mental State Examination scales, respectively. Sensory impairment was assessed from self-reported vision and hearing functions. Multiple linear regression and SPSS Macro PROCESS were used for statistical analysis.

RESULTS

Compared with no sensory impairment, vision impairment (B = -1.012, 95%CI: -1.206, -0.818), hearing impairment (B = -2.683, 95%CI: -2.980, -2.386) and dual sensory impairment (B = -6.302, 95%CI: -6.585, -6.020) have a significant association with cognitive function in older adults, respectively. Anxiety and depressive symptoms not only acted as independent mediators, but also played sequential mediating effects on the relationship between sensory impairment and cognitive function.

CONCLUSIONS

Greater attention should be paid to anxiety and depressive symptoms of older adults with sensory impairment, which might be beneficial to maintain cognitive function.

Inter-relationship between cognitive performance and depressive symptoms and their association with quality of life in older adults: A network analysis based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS)

BACKGROUND

Depressive symptoms and cognitive impairment are common psychiatric conditions and often co-occur in older adults. Network analysis has been widely used in exploring the inter-connections between psychiatric symptoms. The aim of this study was to explore the network model of depressive symptoms and cognitive performance, and their association with quality of life in people aged 65 years or above based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS).

METHOD

Global cognitive performance, depressive symptoms, and global quality of life (QoL) were measured using the validated Chinese version of the Mini Mental State Examination (MMSE), the 10-item Center for Epidemiologic Studies Short Depression Scale (CES-D), and the World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. Central symptoms and bridge symptoms were identified via strength and bridge strength, respectively. The flow network was used to identify symptoms directly related to QoL. Network stability was examined using the case dropping bootstrap method.

RESULTS

A total of 9023 participants were included in the network analysis. CESD3 "Feeling blue/depressed", CESD4 "Everything was an effort", and At_C "Attention and Calculation" were the central (influential) symptoms that had the highest strength value. Three bridge symptoms (i.e., Nam "Naming", CESD2 "Difficulty with concentrating", and Lan "Language") were also identified. CESD10 "Sleep disturbances" had the strongest direct connection to QoL.

CONCLUSIONS

This exploratory study highlights the inter-relationships between cognitive performance and depressive symptoms in older adults in the general population. Interventions targeting bridge symptoms have the potential to alleviate depressive and cognitive symptoms in this population. Furthermore, improving sleep quality in older adults may reduce the negative impact of depression and cognition decline on QoL.

Caregivers' depressive symptom trajectories and risk of cognitive impairment among older adults with functional limitations: A prospective cohort study

OBJECTIVES

Caregiver (CG)'s depression is common and its prevalence is rising. The relationship of CG depression with care recipients (CR)'s subsequent cognitive impairment remains unclear. This study examines the association of CG depressive symptoms trajectories with 6-year cognitive impairment risk among care recipients (CR) who are older adults with functional limitations.

METHODS

Retrospective analysis of prospectively collected data cohorts from 2010 to 2016. The sample included 810 community-dwelling older adults aged ≥75 years, dementia free at baseline, with their primary caregiver dyads. CG's depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. The main outcomes were incident mild, moderate, and severe cognitive impairment of CRs measured using Short Portable Mental Status Questionnaire. Group-based trajectory modeling identified three CG depressive symptom trajectory groups. Competing risks regression analysis modeled the hazards as a function of CG depressive symptom trajectories.

RESULTS

Of 810 CRs, 3% developed severe cognitive impairment, 21% had moderate cognitive impairment, and 37% had mild cognitive impairment. Only CG's "Increasing" trajectory group predicted increased risk of CR's mild and moderate cognitive impairment relative to "persistently low" group (subhazard ratio [SHR] = 1.52, 95% confidence interval [CI], p < 0.05; SHR = 1.87, 95% CI, p < 0.05, respectively).

CONCLUSIONS AND IMPLICATIONS

Finding highlight the intricate and non-linear association between CG depressive trajectory and CR cognitive impairment. This evidence can be used to enlighten policymakers and health providers about the need for risk stratification screening for CG mental health and early treatment for CG depression to prevent or delay CR's cognitive impairment.

Associations Between Abdominal Obesity, Chewing Difficulty and Cognitive Impairment in Dementia-Free Chinese Elderly

OBJECTIVE

To investigate the independent and synergistic associations between abdominal obesity, chewing difficulty and cognitive impairment in a community-dwelling older adults sample in China.

METHODS

Cognitive function was measured by the 5 min- Montreal Cognitive Assessment (5 min-MoCA) and abdominal obesity was measured by A Body Shape Index (ABSI) in 572 participants recruited from local communities. Chewing difficulty was assessed via a self-report questionnaire. Linear regression and general logistic regression were performed to investigate the association of chewing difficulty and abdominal obesity with cognition.

RESULTS

Chewing difficulty score [β (95% CI) = -.30 (-.49, -.11)] and ABSI [β (95%CI) = -.30 (-.55, -.05)] were independently associated with worse performance on the 5 min-MoCA. Whilst ABSI was not associated with cognitive impairment, the co-existence of chewing difficulty and abdominal obesity [OR (95% CI) = 2.22 (1.18, 4.17)] was found associated with the presence of cognitive impairment.

CONCLUSION

Chewing difficulty and abdominal obesity were independently associated with cognition. Abdominal obesity and chewing may have an additive effect on cognitive function.

Body mass index and trajectories of the cognition among Chinese middle and old-aged adults

This study aims to investigate the association between trajectories of the cognition and body mass index (BMI) among Chinese middle and old-aged adults. A total of 5693 adults (age 45 +) whose cognitive score is higher than average at the baseline were included from China Health and Retirement Longitudinal Study (CHARLS:2011–2015). Cognitive function was measured by Mini-mental state examination (MMSE) in Chinese version. The Group-based trajectory modeling (GBTM) was adopted to identify the potential heterogeneity of longitudinal changes over the past 5 years and to investigate the relationship between baseline BMI and trajectories of cognitive function. Three trajectories were identified in results: the slow decline (37.92%), the rapid decline (6.71%) and the stable function (55.37%). After controlling for other variables, underweight (BMI < 18.5 kg/m2) was associated with the rapid and slow decline trajectories. Obesity (BMI > 28 kg/m2) was associated with the slow decline trajectory. High-risk people of cognitive decline can be screened by measuring BMI.

Sarcopenia and mild cognitive impairment among elderly adults: The first longitudinal evidence from CHARLS

BACKGROUND

The association between sarcopenia and mild cognitive impairment (MCI) among elderly adults in China remains unclear. The present study aimed to examine the association based on a nationally representative large-scale survey.

METHODS

The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. All subjects met the inclusion criteria were classified based on Asia Working Group for Sarcopenia 2019 criteria. Aging-associated cognitive decline is used to define MCI, and cognitive function is measured based on four dimensions: orientation, computation, memory, and drawing. OLS and logistic regression model were conducted to analyse the cross-sectional association between sarcopenia and different cognitive functions. Logistic regression model was conducted to analyse the longitudinal association between sarcopenia and MCI.

RESULTS

Totally, 5715 participants aged over 60 years (43.8% women; mean age 67.3 ± 6.0 years) were enrolled in a cross-sectional association study in 2015, and further 2982 elderly adults were followed up in 2018. During the period, sarcopenia and possible sarcopenia increased from 8.5% to 29.6%. Scores of cognitive and four dimensions (orientation, computation, memory, and drawing) exhibited a decreasing trend from non-sarcopenia to sarcopenia (P < 0.001). In the fully adjusted OLS regression model, scores of four dimensions were lower in possible sarcopenia and sarcopenia groups when compared with the non-sarcopenia group (P < 0.05) respectively. The incidence of MCI was 10.1%, 16.5%, and 24.2% for non-sarcopenia, possible sarcopenia, and sarcopenia groups from 2015 to 2018, with a significantly statistical difference (P < 0.001). Logistic regression model revealed an odds ratio of 1.43 [95% confidence interval (CI): 1.06-1.91, P = 0.017] for the possible sarcopenia group and 1.72 (95% CI: 1.04-2.85, P = 0.035) for sarcopenia group when compared with the non-sarcopenia group.

CONCLUSIONS

Sarcopenia is associated with worse cognitive impairment, which provided new evidence for a strong association that warrants further research into mechanistic insights.

Gender differences in the correlation between body mass index and cognitive impairment among the community-dwelling oldest-old in China: a cross-sectional study

OBJECTIVE

This study investigates gender differences in the correlation between body mass index (BMI) and cognitive impairment among Chinese community-dwelling oldest-old.

SETTING

Twenty-three provinces in China. Participants' mini-mental state examination (MMSE) scores <24 were considered cognitive impairment. Furthermore, the assessment standards of BMI status were classified into four categories: obese (BMI >30), overweight (25≤BMI≤30), normal (18.5≤BMI<25) and underweight (BMI <18.5).

PARTICIPANTS

A total of 9218 older adults (age 80+) were included from the 2018 wave of Chinese Longitudinal Healthy Longevity Study.

METHODS

Cognitive impairment, BMI and other covariates consisted of the sociodemographic variables, health behaviours and health status were collected. Cognitive impairment was assessed by the MMSE. Inverse probability weighting procedure was adopted to deal with bias due to dropout.Logistic regression was conducted to examine the correlation between BMI and cognitive impairment.

RESULTS

Among 9218 respondents, 3837 were males. Overall, the percentage of participants with cognitive impairment was 44.7%, with 32.1% among males and 53.7% among females. After controlling for other variables, males who were either overweight or underweight and females who were underweight were found to have higher risk of cognitive impairment among the oldest-old. Age, education, economic status, physical activity, activities of daily living, hypertension as well as heart disease were the predicting factors of cognitive impairment.

CONCLUSIONS

The relationship between BMI and cognitive impairment differs between male and female oldest-old, suggesting that we should pay attention to different BMI groups and adopt precise prevention strategies based on gender.

Association of walking speed with cognitive function in Chinese older adults: A nationally representative cohort study

BACKGROUND

Slow walking speed has been shown to predict cognitive decline in older individuals, but studies conducted among Chinese older adults are scarce. We examined the association of walking speed with cognitive function and the trajectory of cognitive decline among Chinese adults aged 60 years and older.

METHODS

Data was from the China Health and Retirement Longitudinal Study (CHARLS), an ongoing nationally representative prospective cohort study. Walking speed was evaluated over a straight 2.5-meter flat course at baseline and categorized into tertiles (the lowest, middle, and highest). Cognitive function was assessed at each wave in three domains: episodic memory, mental status, and global cognition. Data were analyzed using linear mixed-effects models.

RESULTS

A total of 3,954 older adults (48.6% female; mean age: 67.6 ± 5.55 years) were followed for up to 7 years. Participants with lowest walking speed have poorer episodic memory (β = -0.37; 95% CI: -0.46, -0.28), mental status (β = -0.45; 95% CI: -0.60, -0.29), and global cognition (β = -0.81; 95% CI: -1.03, -0.60) over the follow-up. Compared with the highest tertile of walking speed, the lowest walking speed was associated with a faster decline in episodic memory (β = -0.04; 95% CI: -0.07, -0.02), mental status (β = -0.04; 95% CI: -0.07, -0.01), and global cognition (β = -0.06; 95% CI: -0.11, -0.01).

CONCLUSION

Slower walking speed is associated with subsequent risk of poorer cognitive function and faster cognitive decline in older Chinese adults.

Both Short and Long Sleep Durations Are Associated with Poor Cognition and Memory in Chinese Adults Aged 55+ Years-Results from China Health and Nutrition Survey

We aimed to examine the associations between sleep duration and cognitive functions and memory in older Chinese adults attending the China Health and Nutrition Survey. A total of 7924 participants 55 years and older who reported their sleep duration and had a cognitive screen test in 2004, 2006, and 2015 were included in the analysis. Mixed-effects logistic regression models were used to assess the associations. A short sleep duration (≤6 h/day) and long sleep duration (≥10 h/day) were positively associated with a low global cognitive score (odds ratio-OR: 1.23, 95% CI: 1.01-1.50; OR: 1.47, 95% CI: 1.17-1.79, respectively). Both short sleepers and long sleepers had an increased risk of self-reported poor memory (OR: 1.63, 95% CI: 1.39-1.91; OR: 1.48, 95% CI: 1.25-1.74, respectively). No differences in the above associations were found for income, education, and urbanity. In conclusion, both the short and long sleep duration were associated with declined cognition and memory. Maintaining a normal sleep duration may aid in the prevention of cognitive function decline in older adults.

Interactive Effects of Methionine and Lead Intake on Cognitive Function among Chinese Adults

The association between methionine intake and cognitive function is inconclusive. We aimed to assess the association between methionine intake and cognitive function in Chinese adults and to explore the interaction between methionine and lead intake. Data from 4852 adults aged ≥55 years from the China Health and Nutrition Survey were used. Cognitive function was measured in 1997, 2000, 2004, and 2006. A 3-day, 24-hour recall was used to assess methionine and lead intake from different protein sources. Multivariable mixed linear regression was used in the analyses. Total methionine intake was positively correlated with cognition. There was a significant interaction between animal methionine and lead intakes. In subgroup analyses, across the quartiles of animal methionine intake, the regression coefficients (95% CI) for global cognition were 0.00, 0.57 (0.17 to 0.98), 1.18 (0.73 to 1.62), and 1.80 (1.31 to 2.29), respectively, while they were 0.00, -0.73 (-1.12 to -0.34), -0.83 (-1.26 to -0.41), and -1.72 (-2.22 to -1.22) across the quartiles of plant methionine intake, respectivelyThe association between animal methionine intake and cognition was stronger among adults with a low lead intake. In conclusion, animal methionine and plant methionine intake were positively and inversely associated with cognition, respectively. Lead intake modified the association between animal methionine intake and cognition.

The link between cutaneous inflammation and cognitive impairment

Cognitive impairment is a symptom of neurological disorders, including dementia and Alzheimer's disease; and mild cognitive impairment can be a precursor of both disorders. Aged humans and animal models with other systemic disorders, such as cardiovascular diseases and diabetes, display a higher incidence of cognitive decline. Epidemiological studies have shown that the incidence of cognitive impairment also is higher in subjects with certain inflammatory skin disorders, including psoriasis and chronic eczematous dermatitis. Chronologically aged individuals exhibit increased cutaneous inflammation and elevated circulating cytokine levels, linked to alterations in epidermal function, which itself can induce cutaneous inflammation. Conversely, strategies that improve epidermal function can lower cytokine levels in both the skin and circulation. Thus, it seems likely that epidermal dysfunction could contribute, at least in part, to the development of chronic low-grade inflammation, also termed 'inflammaging', in the elderly. The evidence of cognitive impairment in patients with inflammatory dermatoses suggests a link between cutaneous inflammation and cognitive impairment. Because of the pathogenic role of epidermal dysfunction in ageing-associated cutaneous inflammation, improvements in epidermal function could be an alternative approach for mitigation of the ageing-associated decline in cognitive function.

Economic evaluation of the screening for Alzheimer’s disease in China

Background

We evaluated the cost-effectiveness of the screening in mainland China for Alzheimer’s disease (AD) patients aged over 60.

Methods

Individuals in mainland China, received an initial screening by questionnaire on mental state, and those with scores deemed suspicious for AD were referred to diagnostic tests. A 9-state Markov model was developed to simulate the disease progression of a cohort of 100,000 subjects aging from 60 to 80. In addition, several scenarios were analyzed to assess the robustness under different screening frequency, starting age, the duration of drug effects, and the health status of subjects.

Results

The ICER of AD screening was 26413.77 USD per QALY [quality-adjusted life-year (QALY)] compared with no screening. The number of deaths and severe AD cases who did not receive treatment averted by screening accounted for 0.076 and 0.006% of the total population, respectively, and the net monetary benefit was 128.29 USD per capita. Under the thresholds of one and three times the gross domestic product per capita, the probability of screening being cost-effective was approximately 18 and 77%, respectively. The ICER decreased to 18132.96USD per QALY when the drug effect was prolonged, and increased when the frequency of screening was increased, the starting age was postponed, and patients suffering from comorbidities were more. However, the number of severe AD cases and deaths declined when the screening frequency increased.

Conclusion

Screening for AD in individuals over 60 can reduce the numbers of severe AD cases and deaths and may be cost-effective, depending on factors such as screening frequency, starting age of screening, and duration of drug effects. Additionally, mild cognitive impairment (MCI) is an important stage at which the burden of progression to AD may be reduced and the cost-effectiveness of screening may be improved.

Association of social support with cognition among older adults in China: A cross-sectional study

Objective

This study aimed to examine the relationship between social support and its sub-domains and cognitive performance, and the association with cognitive impairment among older adults in China.

Design

A cross-sectional study.

Setting and participants

We included 865 community-based individuals aged 65 and above from Hubei province, China.

Methods

The level of social support was evaluated using the social support rating scale (SSRC). The Mini-Mental State Examination was adopted to assess cognitive function, and its cut-offs were used to determine cognitive impairment among the participants. Multiple linear regression models and logistic regression models were used to estimate the β and odds ratios (ORs) and their 95% CIs, respectively.

Results

The participants were divided into quartiles 1-4 (Q1-Q4), according to the total scores of SSRC. After adjusting for sociodemographic characteristics, lifestyle factors, and history of diseases, for MMSE scores, compared to these in Q1, the β of Q2-Q4 were -0.22 (-0.88, 0.43), 0.29 (-0.35, 0.94), and 0.86 (0.19, 1.53), respectively; For cognitive impairment, the ORs of Q2-Q4 were 1.21 (0.80, 1.82), 0.62 (0.40, 0.94), and 0.50 (0.32, 0.80), respectively. Considering SSRC scores as the continuous variable, per 1-unit increase, the β was 0.05 (0.02, 0.09) for the cognitive score, and the OR was 0.95 (0.92, 0.98) for cognitive impairment. In addition, higher levels of both subjective support and support utilization were related to better MMSE performance and lower risks of cognitive impairment.

Conclusion and implications

Among the older adults in China, as expected, there is a positive relationship between social support and cognitive performance, and high levels of social support, particularly in support utilization, were related to low risks of cognitive impairment. More social support should be provided in this population to improve cognitive function and reduce the risks of cognitive impairment.

Gender-specific prevalence and risk factors of mild cognitive impairment among older adults in Chongming, Shanghai, China

Objective

This study explores the gender differences in the prevalence of mild cognitive impairment (MCI) and the correlation between multiple influencing factors.

Materials and methods

The sample was comprised of 1325 relatively healthy participants aged ≥ 60 years in a Shanghai community-dwelling (557 males and 768 females). Cognitive function was assessed by Mini-Mental State Examination (MMSE). The Instrumental Activities of Daily Living (IADL) scale was used to assess the activities of daily living.

Results

The overall prevalence of MCI was 15.2%, with 10.2% in men and 18.9% in women. In older male subjects, those with higher the Geriatric Depression Scale (GDS) scores [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.01–1.14] and hypertension (OR = 2.33, 95% CI = 1.15–4.73) had a higher risk of MCI. female subjects who were illiterate (OR = 2.95, 95% CI = 1.82–4.78), had a farming background (OR = 1.69, 95% CI = 1.05–2.72), and a history of stroke (OR = 1.96, 95% CI = 1.07–3.59) had a higher risk of MCI, but this was not true for males. However, Male subjects who never smoked were less likely to have MCI (OR = 0.22, 95% CI = 0.09–0.54). Additionally, the prevalence of MCI was lower in older women with high grip strength (OR = 0.96, 95% CI = 0.92–0.99) and hyperlipidemia (OR = 0.45, 95% CI = 0.22–0.96).

Conclusion

The prevalence of MCI was higher in the population of elderly women compared to men. Moreover, it was found that members with MCI tended to having higher GDS scores, smoking, and hypertension; whereas a history of farming, illiteracy, stroke, grip strength, and hyperlipidemia were correlated with MCI in women.

Medication Rules in Herbal Medicine for Mild Cognitive Impairment: A Network Pharmacology and Data Mining Study

Background

Although traditional Chinese medicine (TCM) has good efficacy in the treatment of mild cognitive impairment (MCI), especially memory improvement and safety, its substance basis and intervention mechanism are particularly complex and unknown. Therefore, based on network pharmacology and data mining, this study aims to explore the rules, active ingredients and mechanism of TCM in the treatment of MCI.

Methods

By searching the GeneCard, OMIM, DisGeNET and DrugBank databases, we obtained the critical targets associated with MCI. We matched the components and herbs corresponding to the important targets in the TCMSP platform. Using Cytoscape 3.7.2 software, we constructed a target-component-herb network and conducted a network topology analysis to obtain the core components and herbs. Molecular docking was used to preliminarily analyze and predict the binding activities and main binding combinations of the core targets and components. Based on the analysis of the properties, flavor and meridian distribution of herbs, the rules of herbal therapy for MCI were summarized.

Results

Twenty-eight critical targets were obtained after the screening. Using the TCMSP platform, 492 components were obtained. After standardization, we obtained 387 herbs. Based on the target-composition-herb network analysis, the core targets were ADRB2, ADRA1B, DPP4, ACHE and ADRA1D. According to the screening, the core ingredients were beta-sitosterol, quercetin, kaempferol, stigmasterol and luteolin. The core herbs were matched to Danshen, Yanhusuo, Gancao, Gouteng and Jiangxiang. It was found that the herbs were mainly warm in nature, pungent in taste and liver and lung in meridian. The molecular docking results showed that most core components exhibited strong binding activity to the target combination regardless of the in or out of network combination.

Conclusion

The results of this study indicate that herbs have great potential in the treatment of MCI. This study provides a reference and basis for clinical application, experimental research and new drug development of herbal therapy for MCI.

The Incidence and Burden of Risk Factors for Mild Cognitive Impairment in Older Rural Chinese Persons

Objective: The study investigated the prevalence of mild cognitive impairment (MCI), a common cognitive disorder in late life, among rural older residents in China. The associated risk factors were also analyzed. Methods: Two thousand one hundred forty-six older adults aged 60 or more in a rural town of Zhejiang Province, China, were recruited and analyzed. Demographic characteristics were collected by a self-designed questionnaire. Diagnosis of MCI was made by well-trained primary care physicians according to the Petersen criteria. Results: 23.16% of the analyzed sample were diagnosed with MCI, while the prevalence was significantly higher in women, those never married, not employed, and with older age, lower education, diabetes, coronary heart disease and stroke. Stepwise logistic regression indicated that age, education, diabetes, coronary heart disease, and stroke were significant predictive factors of MCI. Conclusion: The prevalence of MCI in rural older residents in China is high, and those with specific demographic characteristics like women, never married, not employed, and with older age, lower education and chronic physical conditions should be more concerned in primary care management. Integrated care approaches managing MCI and comorbid chronic conditions are recommended in future management practices.

The Prevalence of Amnestic and Non-Amnestic Mild Cognitive Impairment and Its Association with Different Lifestyle Factors in a South Italian Elderly Population

Mild Cognitive Impairment (MCI) is a transition stage between normal aging and dementia and can be useful to monitor the cognitive status of people at risk of dementias. Our aims were to investigate the prevalence of amnestic and non-amnestic MCI in a South Italian elderly population, and to identify socio-demographic, clinical and lifestyle factors associated with MCI. A cross-sectional retrospective population study on 839 community-dwelling participants over 60 years of age was carried out. Elderly people were administered a brief neuropsychological screening to identify their cognitive and functional status, and a questionnaire to investigate several socio-demographic, clinical, and lifestyle factors. Prevalence estimate for MCI was 12.0% (95% CI: 10.0-14.5%), for amnestic MCI was 7.4% (95% CI: 5.8-9.4%), and for non-amnestic MCI was 4.6% (95% CI: 3.4-6.4%), for people older than 60 years of age. Logistic regression models, corrected for age, sex, and education, revealed a significant association of MCI with the following factors: age, education, intellectual activities, and topographical disorientation. On the other hand, education, clinical factors (e.g., depression level and perceived physical pain), lifestyle factors (e.g., smoking, alcohol, and leisure/productive activities), dietary habits, quality of life, and self-reported topographical disorientation were non-significantly associated with MCI. Prevalence estimates and the association of MCI and its subtypes with risk and protective factors were discussed in comparison with the most recent systematic reviews and meta-analyses.

Cognitive Impairment in Convalescent COVID-19 Patients Undergoing Multidisciplinary Rehabilitation: The Association with the Clinical and Functional Status

BACKGROUND

Cognitive impairment has been reported in the aftermath of severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) infection. We investigated the possible association between cognitive impairment and the main clinical and functional status variables in a cohort of convalescent COVID-19 patients without premorbid diseases potentially affecting cognition.

METHODS

We consecutively screened for inclusion of convalescent COVID-19 patients referring to a post-acute care facility for pulmonary rehabilitation. All the enrolled patients were assessed for cognitive functions. We also investigated features of psychological distress (anxiety, depression, symptoms of posttraumatic stress disorder and quality of life) and cardiac and pulmonary functional status.

RESULTS

The 63 enrolled patients (mean age 59.82 ± 10.78, male gender = 47) showed a high frequency of depressive symptoms (76.2%) and anxiety (55.5%), and a high prevalence of symptoms of posttraumatic stress disorder (PTSD, 44.4%). About half of the total sample showed reduced cognitive efficiency (RCE, 44.4%) in the domains of spatial and verbal long-term memory and executive functions. Patients with RCE more frequently showed alteration of blood pressure (BP) circadian rhythm (p = 0.01), higher levels of D-Dimer (p = 0.03), had experienced a severe illness (p = 0.02), had longer disease duration (p = 0.04), more clinically relevant symptoms of PTSD (p = 0.02), more frequent cognitive complaints (p = 0.002), higher anxiety scores (p = 0.01) and lower quality of life (p = 0.02) than patients with normal cognitive efficiency.

CONCLUSIONS

Our findings indicated a possible association between the RCE after COVID-19 and some cardiological variables, including some indirect measures of a residual autonomic disorder, such as the presence of an altered BP circadian rhythm. Future research studies with large samples are needed to provide valid conclusions.

Cognitive Test Scores and Progressive Cognitive Decline in the Aberdeen 1921 and 1936 Birth Cohorts

The Aberdeen birth cohorts of 1921 and 1936 (ABC21 and ABC36) were subjected to IQ tests in 1932 or 1947 when they were aged about 11y. They were recruited between 1997–2001 among cognitively healthy community residents and comprehensively phenotyped in a long-term study of brain aging and health up to 2017. Here, we report associations between baseline cognitive test scores and long-term cognitive outcomes. On recruitment, significant sex differences within and between the ABC21 and ABC36 cohorts supported advantages in verbal ability and learning among the ABC36 women that were not significant in ABC21. Comorbid physical disorders were self-reported in both ABC21 and ABC36 but did not contribute to differences in terms of performance in cognitive tests. When used alone without other criteria, cognitive tests scores which fell below the −1.5 SD criterion for tests of progressive matrices, namely verbal learning, digit symbol and block design, did not support the concept that Mild Cognitive Impairment (MCI) is a stable class of acquired loss of function with significant links to the later emergence of a clinical dementia syndrome. This is consistent with many previous reports. Furthermore, because childhood IQ-type data were available, we showed that a lower cognitive performance at about 64 or 78 y than that predicted by IQ at 11 ± 0.5 y did not improve the prediction of progress to MCI or greater cognitive loss. We used binary logistic regression to explore how MCI might contribute to the prediction of later progress to a clinical dementia syndrome. In a fully adjusted model using ABC21 data, we found that non-amnestic MCI, along with factors such as female sex and depressive symptoms, contributed to the prediction of later dementia. A comparable model using ABC36 data did not do so. We propose that (1) MCI criteria restricted to cognitive test scores do not improve the temporal stability of MCI classifications; (2) pathways towards dementia may differ according to age at dementia onset and (3) the concept of MCI may require measures (not captured here) that underly self-reported subjective age-related cognitive decline.

The Impact of Rotating Night Shift Work and Daytime Recharge on Cognitive Performance Among Retired Nurses

Introduction

The exact relationship between long-term shift work (SW) and cognitive impairment (CI) has been poorly understood. The effects of the long-term rotating night SW (RNSW) combining daytime recharge (DTR) on cognitive function were investigated.

Methods

A total 920 retired nurses and 656 retired female teachers aged ≥50 years were analyzed. Participants who worked at least once per week for 8 hat night for more than 1 year were defined as the SW group, and those without a regular nighttime shift were defined as the control group. The associations among duration, frequency, and DTR of RNSW, and neuropsychological assessments were ascertained by regression models.

Results

Participants with RNSW had a significantly higher proportion of mild CI (MCI), both amnestic MCI (aMCI) (14.4% in 11–20 years, p &lt; 0.05, and 17.8% in &gt; 20 years, p &lt; 0.001) and non-amnestic MCI (naMCI) (8.1% in 11–20 years, p &lt; 0.05), as well as dementia (1.5% in 1–10 years, and 11.7% in &gt; 20 years, p &lt; 0.05) compared to controls (8.4% with aMCI, 4.4% with naMCI, and 7.0% with dementia, respectively). There were significant negative relationships between general times of night SW and scores of Mini-Mental State Examination (MMSE) (R squared = 0.01, p = 0.0014) and Montreal Cognitive Assessment (MoCA) (R squared = 0.01, p = 0.0054). Participants with ≥1 h of DTR and ≥ 11 years of RNSW were about 2-fold more likely to experience MCI compared with the subjects in the control group, especially with 3–5 h (odds ratio [OR]: 2.35; 95% confidence interval: 1.49–3.68, p &lt; 0.001).

Conclusion

The long-term RNSW was associated with a higher risk of CI, especially aMCI and dementia, and the problem cannot be improved by DTR.

Associations of body mass index, waist circumference and waist-to-height ratio with cognitive impairment among Chinese older adults: Based on the CLHLS

BACKGROUND

Few studies have been conducted on the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cognitive impairment among Chinese older adults through a prospective design.

OBJECTIVE

This study was aimed to evaluate the associations of BMI, WC, and WHtR with cognitive impairment.

METHODS

We included participants aged 65 years and older in 2014 at baseline and 2018 follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). BMI, WC, and WHtR were calculated from measured weight, height, and waist circumference. Mini-Mental State Examination was utilized to assess cognitive impairment. Modified Poisson regression was used for calculating prevalence ratios, risk ratios, and 95% confidence intervals.

RESULTS

A total of 5156 participants were included in 2014 at baseline. The prevalence of cognitive impairment was 42.5%, 26.7%, and 21.2% in underweight, normal-weight, and overweight/obesity participants defined by BMI categories, respectively, and 24.1% and 26.8% in central obesity participants defined by WC and WHtR cutoffs, respectively. Prospectively, participants with underweight were more likely to suffer from cognitive impairment (RR = 1.258, 95% CI: [1.016, 1.559]), but no risk was found among participants with overweight/obesity after adjustment. Regardless of whether covariates were adjusted or not, no effect on cognitive impairment was found in participants with WC and WHtR groups in the follow-up survey.

CONCLUSIONS

Underweight may be a significant risk factor for the cognitive impairment of Chinese older adults. Weight management programs targeting older adults should attach importance to achieving and maintaining optimal body weight and improving cognitive function.

Characteristics of older adult hospitalized patients with bronchial asthma: a retrospective study

Background

Bronchial asthma is a chronic inflammation of the airways. Older adult patients with bronchial asthma are defined as patients older than 65 and with a previous or current clear diagnosis of asthma. The purpose of this study was to determine the characteristics of older adult hospitalized patients with bronchial asthma.

Methods

We retrospectively analyzed the data from patients with bronchial asthma admitted to the General Hospital of the Northern Theater Command from September 2018 to January 2020. We divided them into the older adult (≥ 65 years) and the younger (< 65 years) groups. We compared the clinical and epidemiological characteristics of the two groups.

Results

There were 181 inpatients with bronchial asthma, including 41 older adult patients, accounting for 22.7%. There were significant differences in age, sex, smoking, duration of disease, age at diagnosis of asthma, hospital stays, hospitalization costs, number of acute attacks 1 year before admission, number of hospitalizations in our hospital one year before admission, asthma control test score, forced expiratory volume in 1 s (FEV1), FEV1/FVC, the severity of acute attacks, comorbidities, and inhaled corticosteroid dose between the two groups. There were many older adult patients with asthma (mostly late-onset asthma). The hospitalization costs were high. Most patients had many comorbidities, poor asthma control, severe attack, and heavy economic burdens.

Conclusion

Attention should be focused on achieving asthma control in older adult patients to improve their quality of life and reduce their economic burdens.