1
|
Rosenberg DE, Wu Y, Idu A, Greenwood-Hickman MA, McCurry SM, LaCroix AZ, Shaw PA. Historic Cognitive Function Trajectories as Predictors of Sedentary Behavior and Physical Activity in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae125. [PMID: 38747395 PMCID: PMC11176976 DOI: 10.1093/gerona/glae125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND We examined whether trajectories of cognitive function over 10 years predict later-life physical activity (PA), sedentary time (ST), and sleep. METHODS Participants were from the Adult Changes in Thought (ACT) cohort study. We included 611 ACT participants who wore accelerometers and had 3+ measures of cognition in the 10 years prior to accelerometer wear. The Cognitive Assessment Screening Instrument (CASI) measured cognition and was scored using item-response theory (IRT). activPAL and ActiGraph accelerometers worn over 7 days measured ST and PA outcomes. Self-reported time in bed and sleep quality measured sleep outcomes. Analyses used growth mixture modeling to classify CASI-IRT scores into latent groups and examine associations with PA, ST, and sleep including demographic and health covariates. RESULTS Participants (Mean age = 80.3 (6.5) years, 90.3% White, 57.1% female, 29.3% had less than 16 years of education) fell into 3 latent trajectory groups: average stable CASI (56.1%), high stable CASI (34.0%), and declining CASI (9.8%). The declining group had 16 minutes less stepping time (95% confidence interval [95% CI]: 0.6, 31.4), 1 517 fewer steps per day (95% CI: 138, 2 896), and 16.3 minutes per day less moderate-to-vigorous PA (95% CI: 1.3, 31.3) compared to the average stable group. There were no associations between CASI trajectory and sedentary or sleep outcomes. CONCLUSIONS Declining cognition predicted lower PA providing some evidence of a reverse relationship between PA and cognition in older adults. However, this conclusion is limited by having outcomes at only one time point, a nonrepresentative sample, self-reported sleep outcomes, and using a global cognition measure.
Collapse
Affiliation(s)
- Dori E Rosenberg
- Investigative Sciences Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Yinxiang Wu
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Abisola Idu
- Biostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | | | - Susan M McCurry
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Andrea Z LaCroix
- Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Pamela A Shaw
- Biostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| |
Collapse
|
2
|
Zhao X, Jin L, Sun SB. Bidirectional Association Between Internet Use and Episodic Memory Among Older Adults: A Longitudinal Mediation Study. J Appl Gerontol 2024; 43:829-840. [PMID: 38016114 DOI: 10.1177/07334648231214944] [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: 11/30/2023] Open
Abstract
Using nationally representative longitudinal data from three waves of the China Health and Retirement Longitudinal Study (CHARLS), we assessed whether social participation and mental health were channels through which internet use and episodic memory mutually influenced each other. Cross-lagged panel models with multiple mediators were employed for the mediation analysis. The results reveal that social participation and depressive symptoms were mechanisms underlying the internet-cognition interplay. Among men, an increased chance of contacting friends served as a pathway connecting internet use with better episodic memory. Conversely, men with better episodic memory were more likely to use the internet partially due to their higher chances of having contact with friends and engaging in group activities. Among women, engagement in group activities and depressive symptoms were two channels through which internet use and episodic memory positively influenced each other. Our findings provide practical implications for slowing cognitive aging and narrowing the digital divide.
Collapse
Affiliation(s)
- Xiaohang Zhao
- National Institute of Social Development, Chinese Academy of Social Sciences, Beijing, China
| | - Lei Jin
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong, China
| | - Skylar Biyang Sun
- School of International Development and Cooperation, University of International Business and Economics, Beijing, China
| |
Collapse
|
3
|
Liu N, Wang Y, Li Z. Internet use, physical activity and depressive symptoms in older adults: A cross-lagged panel analysis. J Affect Disord 2024; 350:937-945. [PMID: 38278330 DOI: 10.1016/j.jad.2024.01.201] [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: 07/18/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Existing cross-sectional studies suggest a strong positive association between Internet use, physical activity, and mental health in older adults; however, longitudinal studies reporting the relationship between Internet use, physical activity, and levels of depressive symptoms in older adults are lacking. This study aimed to examine the bidirectional relationship between Internet use and depressive symptoms in older adults and its underlying mechanisms. METHODS We used two waves of follow-up data (2016 and 2018) from the China Family Panel Studies, including 5837 participants aged 60 years or above. The bidirectional relationship between Internet usage time and depressive symptoms was examined using a cross-lagged model. The mediating role of physical exercise was examined using a half-longitudinal mediation model. RESULTS The results revealed a bidirectional relationship between Internet use time, frequency of physical activity, and depressive symptoms. Longer Internet use predicted lower levels of depressive symptoms, and the frequency of physical activity mediated the longitudinal relationship between Internet use and depressive symptoms in older adults. LIMITATIONS First, our study used self-report-based variables. Second, our study did not obtain the specific timing of the application of various functions of the Internet and the intensity of physical activity among older adults. Finally, based on the availability of data, our study involved only two waves of data. This may not be sufficient for a full longitudinal mediation effect test. CONCLUSIONS Internet use and depressive symptoms were interrelated over time among older adults. The frequency of physical activity was a mediator of Internet use and depressive symptoms. This underscores the importance of Internet-based technologies to enable healthy living and prevent depression and loneliness in older adults.
Collapse
Affiliation(s)
- Ningning Liu
- School of Public Administration, Central South University, Hunan, Room 22, Shaoshan South Road, 410083 Changsha City, Hunan Prov., China.
| | - Yumeng Wang
- School of Architecture and Art, Central South University, Hunan, New Campus of Central South University, Yuelu District, 410083 Changsha City, Hunan Prov., China
| | - Zhirong Li
- School of Architecture and Art, Central South University, Hunan, New Campus of Central South University, Yuelu District, 410083 Changsha City, Hunan Prov., China.
| |
Collapse
|
4
|
Chai S, Zhao D, Gao T, Wang X, Wang X, Luo J, Li J, Zhou C. The relationship between handgrip strength and cognitive function among older adults in China: Functional limitation plays a mediating role. J Affect Disord 2024; 347:144-149. [PMID: 37992778 DOI: 10.1016/j.jad.2023.11.056] [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: 07/05/2023] [Revised: 11/12/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND The deterioration of cognitive function with age has become a major public health issue. To date, the underlying mechanisms of the association between handgrip strength and cognitive function were poorly understood. This study aimed to examine the mediating effect of functional limitation in the longitudinal relationship between handgrip strength and subsequent cognitive function. METHODS This research recruited 4416 participants aged 60 and above from wave 2015 and 2018 of the China Longitudinal Study of Health and Retirement (CHARLS). We conducted the linear regression model and bootstrap analyses to test the mediating role of functional limitation in the relationship between handgrip strength and cognitive function. RESULTS After adjusting the confounders, handgrip strength was positively associated with subsequent cognitive function (β = 0.12, P < 0.001) and was negatively associated with functional limitation (β = -0.14, P < 0.001). The mediation effect of functional limitation accounted for 23.33 % of the total effect regarding the handgrip strength with cognitive function, and the magnitude of mediation effect was a*b = 0.021 (95%CI: 0.017-0.027). LIMITATIONS The variable of functional limitations was self-reported. And this study did not analyse the severity and duration of handgrip strength loss and functional limitations, which may lose some information. CONCLUSIONS Our findings revealed that handgrip strength not only directly influenced cognitive function among older individuals but also indirectly via functional limitation over 3-year follow-up. Physical exercise targeting handgrip strength and functional limitation may be an effective approach to prevent and delay cognitive decline.
Collapse
Affiliation(s)
- Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xueqing Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xuehong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jingjing Luo
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jiayan Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, Jinan 250012, China.
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Duan L, Xiao R, Liu S, Shi Y, Feng Y. Causality between cognitive performance and cardiovascular disease: A bidirectional Mendelian randomization study. Gene 2024; 891:147822. [PMID: 37758004 DOI: 10.1016/j.gene.2023.147822] [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: 07/01/2023] [Revised: 08/29/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Growing evidence points to a connection between cardiovascular disease and cognitive impairment. These observational study findings, however, were not all uniform, and some did not discover a link like this. Investigating the causal link between cognitive impairment and cardiovascular disease is vital. METHOD Using publicly available genome-wide association study (GWAS) summary datasets and stringent screening instrumental variables, we carried out a bidirectional Mendelian randomization study. To investigate the causality between cardiovascular disease and cognitive impairment, three different MR techniques-inverse variance weighted (IVW), MR-Egger, and weighted median-as well as various sensitivity analyses-Cochran's Q, ivw_radial, leave-one-out (LOO), MR-Egger intercept, and MR-PRESSO-were used. RESULTS The causal impact of genetically predicted cognitive performance on hypertension, atrial fibrillation, heart failure, coronary atherosclerosis, coronary artery disease, and myocardial infarction was detected in the forward MR analysis, but not stroke or any subtypes. We only discover the causal effects of hypertension, any stroke, and its subtypes (ischemic and small vessel stroke) on cognitive performance in the reverse MR analysis. CONCLUSION This MR analysis offers proof of a causal link between cognitive impairment and elevated cardiovascular disease risk. Our research emphasizes the value of cognitively impaired patients being screened for cardiovascular disease, which may offer fresh perspectives on cardiovascular disease prevention.
Collapse
Affiliation(s)
- Lincheng Duan
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rong Xiao
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shupei Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Shi
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Feng
- Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| |
Collapse
|
7
|
Cui K, Meng W, Li Z, Zeng X, Li X, Ge X. Dynamics, association, and temporal sequence of cognitive function and frailty: a longitudinal study among Chinese community-dwelling older adults. BMC Geriatr 2023; 23:658. [PMID: 37833637 PMCID: PMC10571451 DOI: 10.1186/s12877-023-04328-9] [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: 06/28/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Little is known about the association of longitudinal dynamics between cognitive function and frailty in Chinese older adults. The temporal sequences between cognitive function and frailty remains unclear. Our study investigates this directionality association using longitudinal data. METHODS Latent growth and multivariate latent growth models were employed to examine dynamics of cognition and frailty and their association among 2824 older adults in China. Cross-lagged panel analyses were used to assess the temporal sequences between frailty and cognition. The relation between cognitive domains and frailty was also examined using aforementioned methods. RESULTS Cognitive function was negatively associated with frailty status. Higher initial level of cognition indicated lower baseline level (β=-0.175, P < 0.001) and change rate (β=-0.041, P = 0.002) of frailty. We observed a reciprocal association between frailty and cognitive function rather than a unidirectional causal relationship. The initial cognitive performance for all components were negatively associated with baseline (β ranged between - 0.098 to -0.023) and change rate (β ranged between - 0.007 to -0.024) of frail status. No consistent associations between change rate of cognitive components and either initial level or change rate of frailty were detected. CONCLUSIONS Our study detected a reciprocal association between cognition and frailty rather than a unidirectional causal relationship. Our results also revealed different connections between cognitive performance and frailty across diverse cognitive domains.
Collapse
Affiliation(s)
- Kai Cui
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Weihan Meng
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Zhiqiang Li
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Xinning Zeng
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Xiaozhe Li
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Xiaoyan Ge
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China.
| |
Collapse
|
8
|
Du C, Miyazaki Y, Dong X, Li M. Education, Social Engagement, and Cognitive Function: A Cross-Lagged Panel Analysis. J Gerontol B Psychol Sci Soc Sci 2023; 78:1756-1764. [PMID: 37294899 PMCID: PMC10561888 DOI: 10.1093/geronb/gbad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVES Although education and social engagement are considered cognitive reserves, the pathway of both reserves on cognitive function has been rarely studied. This study aimed to examine the underlying mechanism between education, social engagement, and cognitive function. METHODS This study used 2-wave data (2010 and 2014) from Health and Retirement Study in the United States (N = 3,201). Education was measured by years of schooling. Social engagement was evaluated by 20 items including volunteering, physical activities, social activities, and cognitive activities. Cognitive function was assessed by a modified Telephone Interview for Cognitive Status. A cross-lagged panel model was fitted to test the mediating mechanism between education, social engagement, and cognitive function. RESULTS Controlling for covariates, higher education in early life was associated with better cognitive function in old age (b = 0.211, 95% confidence interval [CI] = [0.163, 0.259], p < .01). Late-life social engagement partially mediated the association between education and cognitive function (indirect effect = 0.021, 95% CI = [0.010, 0.033], p < .01). The indirect path between education and social engagement via cognition also existed (b = 0.009, 95% CI = [0.005, 0.012], p < .001). DISCUSSION Education in earlier life stage may exert a lifelong effect on cognitive function as well as an indirect effect via enhancing late-life cognitive reserve such as social engagement. The cross-lagged effect of social engagement on cognitive function is significant and vice versa. Future research may explore other cognitive reserves over the life course and its underlying mechanism to achieve healthy cognitive aging.
Collapse
Affiliation(s)
- Chenguang Du
- School of Medicine, University of North Carolina in Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yasuo Miyazaki
- School of Education, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Mengting Li
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Beijing, China
| |
Collapse
|
9
|
Zhao D, Chai S, Gao T, Li J, Zhou C. Physical Mobility, Social Isolation and Cognitive Function: Are There Really Gender Differences? Am J Geriatr Psychiatry 2023; 31:726-736. [PMID: 37147164 DOI: 10.1016/j.jagp.2023.04.002] [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: 01/05/2023] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE This study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults. METHODS This is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults. RESULTS The total effects of T1 physical mobility limitations on T3 cognitive function (β = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: β = -0.008, bootstrap p = 0.012; female: β = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific. CONCLUSION This study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.
Collapse
Affiliation(s)
- Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China; NHC Key Lab of Health Economics and Policy Research (Shandong University) (CZ), Jinan, China; Institute of Health and Elderly Care, Shandong University (CZ), Jinan, China.
| |
Collapse
|
10
|
Park M, Song R, Ju K, Shin JC, Seo J, Fan X, Gao X, Ryu A, Li Y. Effects of Tai Chi and Qigong on cognitive and physical functions in older adults: systematic review, meta-analysis, and meta-regression of randomized clinical trials. BMC Geriatr 2023; 23:352. [PMID: 37280512 DOI: 10.1186/s12877-023-04070-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways. PURPOSE The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach. METHODS A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software. RESULTS Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011). CONCLUSION This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function. PROSPERO REGISTRATION NUMBER: *PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.
Collapse
Affiliation(s)
- Moonkyoung Park
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Rhayun Song
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea.
| | - Kyoungok Ju
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Jacqueline C Shin
- Indiana State University, Department of Psychology, Terre Haute, IN, 47802, USA
| | - Jisu Seo
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xing Fan
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xianqi Gao
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Ahyun Ryu
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Yuelin Li
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| |
Collapse
|
11
|
Li D, Jia Y, Yu J, Liu Y, Li F, Zhang W, Gao Y, Liao X, Wan Z, Zeng Z, Zeng R. Cognition impairment and risk of subclinical cardiovascular disease in older adults: The atherosclerosis risk in communities study. Front Aging Neurosci 2022; 14:889543. [PMID: 35966771 PMCID: PMC9363767 DOI: 10.3389/fnagi.2022.889543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundClinical cardiovascular disease (CVD) and cognition impairment are common and often coexist in aging populations, and CVD is associated with greater cognition impairment risk; however, the association between cognition impairment and CVD risk is inconsistent. It is unknown if pathways that contribute to CVD are caused by impaired cognition. We hypothesized that cognition impairment would be associated with greater subclinical CVD including subclinical myocardial damage [assessed by high-sensitivity cardiac troponin T (hs-cTnT)] and cardiac strain or dysfunction [assessed by N-terminal pro-B-type natriuretic peptide (NT-proBNP)].MethodsThis analysis included Atherosclerosis Risk in Communities Study (ARIC) participants who underwent global cognition z-score tests between 1991 and 1993. Cardiac biomarkers were measured from stored plasma samples collected between 1996 and 1999. Logistic regression models were used to determine the association of cognitive function with subclinical CVD risk.ResultsThere were 558/9216 (6.1%) and 447/9097 (5.0%) participants with incident elevated hs-CTnT (≥14 ng/L) and NT-proBNP (≥300 pg/mL) levels, respectively. Comparing the lowest and highest quartiles of global cognition z-scores, a higher incidence of elevated hs-CTnT [odds ratio (OR) = 1.511, 95% confidence interval (CI): 1.093–2.088, P = 0.013] and NT-proBNP (OR = 1.929, 95% CI: 1.350–2.755, P < 0.001) were observed, respectively. In structural equation modeling, the indirect effect of global cognition z-score on major adverse cardiac events was 42.1% (P < 0.05).ConclusionImpairments in baseline cognitive function were associated with subclinical myocardial damage or wall strain. Although future studies are warranted to investigate the pathophysiological mechanisms behind these associations, our study suggests common pathways between cognitive and cardiac dysfunction.
Collapse
Affiliation(s)
- Dongze Li
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Jia
- Department of General Practice and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Yu
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Liu
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Fanghui Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Zhang
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yongli Gao
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyang Liao
- Department of General Practice and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Wan
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Zeng
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Zeng
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Rui Zeng,
| |
Collapse
|
12
|
Sha S, Pan Y, Xu Y, Chen L. Associations between loneliness and frailty among older adults: Evidence from the China Health and Retirement Longitudinal Study. BMC Geriatr 2022; 22:537. [PMID: 35773656 PMCID: PMC9247968 DOI: 10.1186/s12877-022-03044-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies have demonstrated the associations between loneliness and frailty in late life. However, there is a lack of consensus on the direction of the relationship. The present study aimed to examine the interdependencies between loneliness and frailty over time. Methods Data on participants aged 60 years old and above were collected from the 2011, 2013, and 2015 samples of the China Health and Retirement Longitudinal Study (CHARLS). Loneliness was measured by a single question from the Centre for Epidemiological Studies Depression scale, and frailty was assessed by the Physical Frailty Phenotype (PFP) scale. Cross-lagged panel models were utilized to examine the potential bidirectional relationship between loneliness and frailty. Results Reciprocal associations were found between loneliness and frailty. Furthermore, we found that baseline frailty and early change in frailty had a significant predictive effect on late change in loneliness. Higher baseline loneliness in older adults may create a potentially vicious cycle that influenced early change in frailty and continued to cause late change in loneliness. Conclusion A bidirectional relationship may exist between loneliness and frailty among older Chinese adults over 60 years old. Lonely older adults should be alerted to the potential self-reinforcing cycle of loneliness that affects their health. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03044-0.
Collapse
Affiliation(s)
- Sha Sha
- School of Sociology and Population Studies, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yao Pan
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Yuebin Xu
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Lin Chen
- Beijing Normal University at Zhuhai, Zhuhai, China.
| |
Collapse
|
13
|
Huang Z, Guo Y, Ruan Y, Sun S, Lin T, Ye J, Li J, He L, Wang S, Shi Y, Wu F. Associations of Lifestyle Factors With Cognition in Community-Dwelling Adults Aged 50 and Older: A Longitudinal Cohort Study. Front Aging Neurosci 2020; 12:601487. [PMID: 33240081 PMCID: PMC7680821 DOI: 10.3389/fnagi.2020.601487] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/23/2020] [Indexed: 11/13/2022] Open
Abstract
In the absence of an effective treatment to alter the progressive course of cognitive decline and dementia, identification of modifiable risk factors that could promote healthy cognitive aging has become a public health research priority. This study seeks to comprehensively determine the contemporaneous associations of a broad spectrum of time-varying modifiable lifestyle factors with age-related cognitive decline in a large population-based cohort of older adults. A total of 5,711 subjects aged 50 and older from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Repeated measures of lifestyle factors and cognitive performance were conducted in 2009-2010 and 2014-2015. Linear random slope models were used to evaluate the contemporaneous associations between time-varying lifestyle factors and cognitive performance. Person-mean centering method was used to disaggregate the between- and within-person effects in the time-varying lifestyle factors in the random slope models. We found that higher vegetable and fruit consumption, as well as higher level of physical activity were positively associated with all cognitive domains. Body mass index (BMI) was negatively associated with all cognitive domains, whereas waist-to-hip ratio (WHR) was negatively associated with verbal fluency score only. Sedentary time was negatively associated with digit span score but positively associated with verbal fluency score. The between-person effects seem to be more dominant than within-person effects. Overall, our findings suggest better management of multiple lifestyle factors may protect against cognitive decline in later life. Higher vegetable and fruit consumption and physical activity are protective, whereas obesity is detrimental to cognitive decline in older adults. This study underpins the development of multi-domain lifestyle recommendations to promote healthy cognitive aging.
Collapse
Affiliation(s)
- Zhezhou Huang
- School of Public Health, Fudan University, Shanghai, China
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yanfei Guo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ye Ruan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shuangyuan Sun
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Tao Lin
- Pudong New District Center for Disease Control and Prevention, Shanghai, China
| | - Jinghong Ye
- Hongkou District Center for Disease Control and Prevention, Shanghai, China
| | - Jun Li
- Minhang District Center for Disease Control and Prevention, Shanghai, China
| | - Lihua He
- Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Sen Wang
- Qingpu District Center for Disease Control and Prevention, Shanghai, China
| | - Yan Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Fan Wu
- School of Public Health, Fudan University, Shanghai, China
| |
Collapse
|