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Bai W, An S, Jia H, Xu J, Qin L. Relationship between triglyceride-glucose index and cognitive function among community-dwelling older adults: a population-based cohort study. Front Endocrinol (Lausanne) 2024; 15:1398235. [PMID: 39104819 PMCID: PMC11298491 DOI: 10.3389/fendo.2024.1398235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/08/2024] [Indexed: 08/07/2024] Open
Abstract
Background The global increase in the aging population presents considerable challenges, particularly regarding cognitive impairment, a major concern for public health. This study investigates the association between the triglyceride-glucose (TyG) index, a measure of insulin resistance, and the risk of cognitive impairment in the elderly. Methods This prospective cohort study enrolled 2,959 participants aged 65 and above from the 2015 and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). The analysis employed a logistic regression model to assess the correlation between the TyG index and cognitive impairment. Results The study included 2,959 participants, with a mean age of 71.2 ± 5.4 years, 49.8% of whom were female. The follow-up in 2020 showed a decrease in average cognitive function scores from 8.63 ± 4.61 in 2015 to 6.86 ± 5.45. After adjusting for confounding factors, a significant association was observed between TyG index quartiles and cognitive impairment. Participants in the highest quartile (Q4) of baseline TyG had a higher risk of cognitive impairment compared to those in the lowest quartile (Q1) (odds ratio [OR]: 1.97, 95% confidence intervals [CI]: 1.28-2.62, P<0.001). Conclusion The study highlights a significant connection between elevated TyG index levels and cognitive impairment among older adults in China. These findings suggest that targeted interventions to reduce the TyG index could mitigate cognitive impairment and potentially lower the incidence of dementia.
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Affiliation(s)
- Weimin Bai
- Department of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, China
| | - Shuang An
- Department of Pediatric Rehabilitation, Henan Children’s Hospital Zhengzhou Children’s Hospital, Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Hui Jia
- Department of Convalescent Four Areas Nine Departments, Navy Qingdao Special Service Recuperation Center, Qingdao, China
| | - Juan Xu
- Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Lijie Qin
- Department of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, China
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Miao F, Tian A, Wang B, Li J. Cognitive impairment in young and middle-aged patients with acute heart failure. ESC Heart Fail 2024. [PMID: 38816208 DOI: 10.1002/ehf2.14885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/15/2024] [Accepted: 05/11/2024] [Indexed: 06/01/2024] Open
Abstract
AIMS This study aimed to investigate the prevalence, risk factors and prognostic implications of cognitive impairment in young and middle-aged patients with acute heart failure (HF). METHODS In a prospective cohort of patients with acute HF, we assessed cognitive function by the Mini-Cog, predictors of the cognitive impairment and its associations with 30 day and 1 year cardiovascular death or HF rehospitalization among young and middle-aged patients (<65 years old). RESULTS Among 1958 young and middle-aged patients, the prevalence of cognitive impairment was 19.6%. Predictors of cognitive impairment included older age, females, lower education levels and prior strokes. Compared with patients having normal cognitive function, cognitive impairment was associated with a higher risk of 30 day cardiovascular death or HF rehospitalization [hazard ratio (HR), 1.52, 95% confidence interval (CI), 1.07-2.17, P = 0.02], but not for 1 year cardiovascular death or HF rehospitalization (HR, 1.06, 95% CI, 0.87-1.30, P = 0.55). CONCLUSIONS Cognitive impairment is present in a notable proportion of young and middle-aged patients with acute HF and is associated with an increased risk of short-term adverse outcomes. Strategies for screening and intervention for cognitive impairment at a younger age are necessary, particularly for those at high risk.
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Affiliation(s)
- Fengyu Miao
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People's Republic of China
- Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China
- Beijing Municipal Health Big Data and Policy Research Center, Beijing Institute of Hospital Management, Beijing, People's Republic of China
| | - Aoxi Tian
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People's Republic of China
- Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China
| | - Bin Wang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People's Republic of China
- Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China
| | - Jing Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People's Republic of China
- Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China
- Central-China Branch of National Center for Cardiovascular Diseases, Central-China Hospital, Zhengzhou, People's Republic of China
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Wang L, Xian X, Zhou M, Xu K, Cao S, Cheng J, Dai W, Zhang W, Ye M. Anti-Inflammatory Diet and Protein-Enriched Diet Can Reduce the Risk of Cognitive Impairment among Older Adults: A Nationwide Cross-Sectional Research. Nutrients 2024; 16:1333. [PMID: 38732579 PMCID: PMC11085298 DOI: 10.3390/nu16091333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Cognitive impairment (CI) is a common mental health disorder among older adults, and dietary patterns have an impact on cognitive function. However, no systematic researches have constructed anti-inflammatory diet (AID) and protein-enriched diet (PED) to explore their association with CI among older adults in China. METHODS The data used in this study were obtained from the 2018 waves of the China Longitudinal Health and Longevity Survey (CLHLS). We construct AID, PED, and calculate scores for CI. We use binary logistic regression to explore the relationship between them, and use restrictive cubic splines to determine whether the relationships are non-linear. Subgroup analysis and sensitivity analysis were used to demonstrate the robustness of the results. RESULTS A total of 8692 participants (mean age is 83.53 years) were included in the analysis. We found that participants with a higher AID (OR = 0.789, 95% confidence interval: 0.740-0.842, p < 0.001) and PED (OR = 0.910, 95% confidence interval: 0.866-0.956, p < 0.001) score showed lower odds of suffering from CI. Besides, the relationship between the two dietary patterns and CI is linear, and the results of subgroup analysis and sensitivity analysis are also significant. CONCLUSION Higher intakes of AID and PED are associated with a lower risk of CI among older adults, which has important implications for future prevention and control of CI from a dietary and nutritional perspective.
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Affiliation(s)
- Liang Wang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Xiaobing Xian
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Mengting Zhou
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Ke Xu
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Shiwei Cao
- School of the Second Clinical, Chongqing Medical University, Chongqing 400016, China;
| | - Jingyu Cheng
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Weizhi Dai
- School of the First Clinical, Chongqing Medical University, Chongqing 400016, China;
| | - Wenjia Zhang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Mengliang Ye
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
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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.
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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.
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Yuan Y, Peng C, Burr JA, Lapane KL. Frailty, cognitive impairment, and depressive symptoms in Chinese older adults: an eight-year multi-trajectory analysis. BMC Geriatr 2023; 23:843. [PMID: 38087208 PMCID: PMC10717397 DOI: 10.1186/s12877-023-04554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
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.
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Affiliation(s)
- Yiyang Yuan
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, 01605, Worcester, MA, USA.
| | - Changmin Peng
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Jeffrey A Burr
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Kate L Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, 01605, Worcester, MA, USA
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Tao L, Wang X, Gao S, Nie Z, Chen L, Liang W, Ding Y, Yang R. Longitudinal relationships between grip strength, subjective memory complaints and cognitive function among middle-aged and older adults in China. Aging Clin Exp Res 2023; 35:2101-2108. [PMID: 37603266 DOI: 10.1007/s40520-023-02507-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Subjective memory complaints are considered an early sign of cognitive decline. Recent evidence shows that grip strength is an important predictor of cognitive function. However, few studies have compared whether one condition is uniquely associated with cognitive function when another condition is controlled for. AIMS To explore the longitudinal associations of cognitive function with subjective memory complaints and grip strength in middle-aged and older adults, with a particular focus on whether one condition is uniquely associated with cognitive function when another condition is considered. METHODS A total of 3,877 middle-aged and older adults (aged 45-92 years) from the China Health and Retirement Longitudinal Study reported on their demographic and health status and completed measures of grip strength and subjective memory complaints, as well as a series of cognitive tests, every two years between 2011 and 2015. Generalized estimating equation models were used to assess the relationships between grip strength, subjective memory complaints, and cognitive function. RESULTS Grip strength was longitudinally associated with cognitive function (β = 0.021, 95% confidence interval [CI]: 0.011, 0.030, P < 0.001) independent of subjective memory complaints. In contrast, changes in the subjective memory complaints were not related to cognitive function over time (β = 0.107, 95% CI: - 0.025, 0.238, P = 0.112). Only at baseline subjective memory complaints were associated with poorer cognitive function (β = - 1.142, 95% CI: - 1.309, - 0.975, P < 0.001). CONCLUSIONS Grip strength might be a more important clinical correlate of cognitive function decline over time than subjective memory complaints. DISCUSSION Regular assessment and close monitoring of grip strength might help identify individuals who might be at high risk for cognitive impairment.
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Affiliation(s)
- Lu Tao
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Xiaoxiao Wang
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Shiying Gao
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Zuoting Nie
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Long Chen
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Wei Liang
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China.
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China.
| | - Rumei Yang
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China.
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Wu W, Pu L, Hu X, Chen Q, Wang G, Wang Y. Moderate-to-high risk of obstructive sleep apnea with excessive daytime sleepiness is associated with postoperative neurocognitive disorders: a prospective one-year follow-up cohort study. Front Neurosci 2023; 17:1161279. [PMID: 37325036 PMCID: PMC10266218 DOI: 10.3389/fnins.2023.1161279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/08/2023] [Indexed: 06/17/2023] Open
Abstract
Background Few studies found that obstructive sleep apnea (OSA) may be related to postoperative neurocognitive disorders (PND) including postoperative delirium (POD) and cognitive decline (POCD) in the early postoperative period. However, the results are controversial and need further verification, and no research has explored the effect of OSA on the incidence of PND during the 1-year follow-up periods. Furthermore, OSA patients with excessive daytime sleepiness (EDS) as a severe phenotype have more significant neurocognitive impairments, but the relationship between OSA with EDS and PND within 1 year after surgery has not been studied. Objectives To explore the effect of moderate-to-high risk of OSA and the moderate-to-high risk of OSA with EDS on PND within 1 year after surgery. Methods In this prospective cohort study, including 227 older patients, moderate-to-high risk of OSA (using STOP-BANG), subjective EDS (using Epworth Sleepiness Scale), and objective EDS (using Actigraphy) were selected as exposures. Key outcomes included POD during hospitalization (using Confusion Assessment Method-Severity), POCD at discharge, 1-month and 1-year after surgery (using Mini-Mental State Examination and Telephone Interview for Cognitive Status-40). We applied multiple logistic regression models to estimate the effect of moderate-to-high risk of OSA and moderate-to-high risk of OSA with EDS on PND. Results In the multivariate analysis, moderate-to-high risk of OSA was not associated with POD during hospitalization and POCD at discharge, 1-month, and 1-year after surgery (p > 0.05). However, the moderate-to-high risk of OSA with subjective EDS was related to POCD at discharge compared to the moderate-to-high risk of OSA or normal group (no moderate-to-high risk of OSA and no EDS) (p < 0.05). In addition, moderate-to-high risk of OSA with objective EDS was associated with POCD at discharge, 1-month, and 1-year postoperatively compared to the moderate-to-high risk of OSA or normal group (p < 0.05). Conclusion Moderate-to-high risk of OSA with EDS, not moderate-to-high risk of OSA alone, was a clinically helpful predictor for POCD within 1-year after surgery and should be routinely assessed before surgery.
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Affiliation(s)
- Wenwen Wu
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lihui Pu
- Menzies Health Institute Queensland & School of Nursing and Midwifery, Griffith University, Brisbane, QL, Australia
| | - Xiuying Hu
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qian Chen
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guan Wang
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanyan Wang
- Science and Technology Department, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Xiao S, Shi L, Zhang J, Li X, Lin H, Xue Y, Xue B, Chen Y, Zhou G, Zhang C. The role of anxiety and depressive symptoms in mediating the relationship between subjective sleep quality and cognitive function among older adults in China. J Affect Disord 2023; 325:640-646. [PMID: 36657496 DOI: 10.1016/j.jad.2023.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 12/28/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Deterioration of cognitive function has a significant impact on the unavoidable burden on individuals, families, and society. This study aimed to examine the serial multiple mediating effects of anxiety and depressive symptoms on the relationship between subjective sleep quality and cognitive function among older adults in China. METHODS We selected 6442 Chinese older adults aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey. The SPSS PROCESS macro was employed to perform simple and serial multiple mediation analyses. RESULTS Subjective sleep quality, depressive symptoms, anxiety symptoms, and cognitive function were significantly related (P < 0.01). Poor sleep quality can have a direct negative influence on cognitive function among older adults (effect = -0.110; 95 % CI = [-0.166, -0.053]), but it can also have an indirect negative impact via three pathways: the independent mediation of anxiety symptoms (effect = -0.028; 95 % CI = [-0.048, -0.011]), the independent mediation of depressive symptoms (effect = -0.014; 95 % CI = [-0.026, -0.002]), and the serial mediation of anxiety and depressive symptoms (effect = -0.009; 95 % CI = [-0.017, -0.001]). LIMITATIONS This study used a cross-sectional design, which restricts the ability to infer causal relationships. CONCLUSIONS The effect of subjective sleep quality on cognitive function was serially mediated by anxiety and depressive symptoms among older adults. Diverse therapies targeted at improving sleep quality in older adults may improve mood and cognitive functioning.
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Affiliation(s)
- Shujuan Xiao
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinru Li
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yiming Chen
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Guangqing Zhou
- Health Management Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; Health Management Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
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Richard’s MM, Zamora EV, Aydmune Y, Comesaña A, Krzemien D, Introzzi IM, Lopez-Ramón MF, Navarro-Pardo E. Age-related switching costs in adulthood: “All or None Hypothesis” corollaries. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04340-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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10
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Zhang Q, Sun MA, Sun Q, Mei H, Rao H, Liu J. Mental Fatigue Is Associated with Subjective Cognitive Decline among Older Adults. Brain Sci 2023; 13:376. [PMID: 36979186 PMCID: PMC10046332 DOI: 10.3390/brainsci13030376] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Both Subjective Cognitive Decline (SCD) and mental fatigue are becoming increasingly prevalent as global demographics shifts indicate our aging populations. SCD is a reversible precursor for Alzheimer's disease, and early identification is important for effective intervention strategies. We aim to investigate the association between mental fatigue-as well as other factors-and SCD. A total of 707 old adults (aged from 60 to 99) from Shanghai, China, participated in this study and completed self-reported instruments covering their cognitive and mental status as well as demographic information. Mental fatigue status was assessed by using four items derived from the functional impairment syndrome of the Old Adult Self Report (OASR). SCD was assessed by using the Memory/Cognition syndrome of OASR. A total of 681 old adults were included in the current study. The means of SCD significantly differed between each group of factors (age, gender, and mental fatigue). The general linear regression models showed that SCD increased with age, females scored higher than males, and SCD was positively associated with mental fatigue factors including difficulty getting things done, poor task performance, sleeping more, and a lack of energy among old adults. The study also found that SCD is negatively associated with the high-income group among young-old (aged from 60 to 75) males and associated with good marital/living status with the companion of spouses/partners among young-old females. These results suggest that gender, income level, marital/living status, and mental fatigue are crucial factors in preventing SCD among old adults and are pivotal in developing early intervention strategies to preserve the mental health of an increasingly aging population.
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Affiliation(s)
- Qianqian Zhang
- School of Nursing and Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - McKenna Angela Sun
- School of Nursing and Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Qiuzi Sun
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hua Mei
- Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Hengyi Rao
- School of Nursing and Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jianghong Liu
- School of Nursing and Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Lin L, Cao B, Chen W, Li J, Zhang Y, Guo VY. Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China. JAMA Netw Open 2022; 5:e2241714. [PMID: 36367722 PMCID: PMC9652754 DOI: 10.1001/jamanetworkopen.2022.41714] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
IMPORTANCE Studies investigating the association of threat-related and deprivation-related adverse childhood experiences (ACEs) with later-life cognitive decline are lacking. OBJECTIVES To evaluate the independent association of threat-related and deprivation-related ACEs with cognitive decline over time among middle-aged and older Chinese adults and to examine the modifying role of social isolation in such associations. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study used cognitive data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey that was administered between June 1, 2011, and March 31, 2012, and the CHARLS follow-up survey administered between July 1 and September 30, 2015. The life history survey with information of ACEs was additionally administered between June 1 and December 31, 2014. Statistical analysis was performed from March 1 to July 31, 2022. The study population consisted of middle-aged and older adults (age range, 45-97 years) with complete data on ACEs and 2 cognitive assessments and without cognitive impairment at baseline. EXPOSURES Five threat-related ACEs (ie, physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and 5 deprivation-related ACEs (ie, emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death) before 17 years of age were queried by questionnaires. The cumulative scores of the 2 ACE dimensions were calculated and grouped into 3 categories as 0, 1, and 2 or more in main analyses. MAIN OUTCOMES AND MEASURES Cognitive function was measured by episodic memory and executive function. Global cognition was further calculated as the total score of these 2 dimensions. The raw scores of each cognitive test were standardized to z scores using baseline means and SDs. Linear mixed-effects models were constructed to examine the association between 2 dimensions of ACEs and the rate of annual cognitive decline. The modifying role of baseline social isolation in such associations was assessed with 3-way interaction tests. RESULTS Of the 6466 participants included in main analyses, 3301 (51.1%) were men and the mean (SD) age was 57.2 (8.3) years. Compared with no exposures, experience of 1 deprivation-related ACE was associated with faster cognitive decline in global cognition (β = -0.012 [95% CI, -0.022 to -0.002] SD/y) and executive function (β = -0.010 [95% CI, -0.020 to -0.00002] SD/y), whereas individuals with at least 2 childhood deprivations had faster cognitive declines in all cognitive tests (β = -0.035 [95% CI, -0.050 to -0.019] SD/y for global cognition; β = -0.047 [95% CI, -0.068 to -0.025] SD/y for episodic memory; β = -0.019 [95% CI, -0.034 to -0.004] SD/y for executive function). However, such an association was not observed for threat-related ACEs. In addition, baseline social isolation was a significant modifier in the associations between deprivation-related ACEs and cognitive declines in global cognition (β = -0.033 [95% CI, -0.061 to -0.005] SD/y; P = .02 for 3-way interaction) and executive function (β = -0.032 [95% CI, -0.059 to -0.005] SD/y; P = .02 for 3-way interaction). CONCLUSIONS AND RELEVANCE Deprivation-related ACEs, but not threat-related ACEs, were associated with faster decline in later-life cognitive function, whereas social isolation could modify such detrimental impact. These findings highlight the potential benefits of promoting social integration in maintaining later-life cognitive function among individuals who have experienced childhood deprivation.
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Affiliation(s)
- Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bing Cao
- Department of Neurosurgery, Wu Tsai Neuroscience Institute, Stanford University School of Medicine, Stanford, California
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinghua Li
- Department of Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuying Zhang
- Department of Child Healthcare, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Abstract
AIMS To clarify the risk factors for frailty to help doctors prevent diseases that cause weakness, through early interventions. METHODS We searched the PubMed, EMBASE, and Cochrane Library databases to identify all relevant studies using the items "frailty," "weak," "risk factors," and "predictive factors" and compared their results. The aging population (≥65 years old) was divided into 2 groups, a "frailty group" and a "robust control group," and then the characteristics, lifestyles, and comorbidities were compared. RESULTS We compared the influence of baseline and concomitant diseases on frailty in the elderly respectively, and the analysis of the influence of baseline on frailty found that increasing age, lower weight, female sex, living alone, low levels of exercise, polypharmacy, higher education level, smoking, drinking, malnutrition, and lower vitamin D levels were associated with aging individuals being more likely to experience frailty. The data about concomitant diseases had shown that diabetes, hearing dysfunction, cognitive impairment, poor sleep, a history of falls, pain, and depression can increase the risk of frailty among the elderly population. CONCLUSION Characteristics, comorbidities, and lifestyle factors can impact the occurrence of frailty, and relevant influencing factors should be considered.
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Affiliation(s)
- Xinrui Wang
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
| | - Jiji Hu
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
| | - Diping Wu
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
- *Correspondence: Diping Wu, Department of Nursery, Gulin people’s Hospital, Sichuan 646500, China (e-mail: )
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Vargas-Torres-Young DA, Salazar-Talla L, Cuba-Ruiz S, Urrunaga-Pastor D, Runzer-Colmenares FM, Parodi JF. Cognitive Frailty as a Predictor of Mortality in Older Adults: A Longitudinal Study in Peru. Front Med (Lausanne) 2022; 9:910005. [PMID: 35814770 PMCID: PMC9256954 DOI: 10.3389/fmed.2022.910005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate the role of cognitive frailty and its components as risk factors of mortality in older adults of the Centro Médico Naval (CEMENA) in Callao, Peru during 2010-2015. Methods We performed a secondary analysis of data from a prospective cohort that included older adults (60 years and older) treated at the CEMENA Geriatrics service between 2010–2015. Frailty was defined as the presence of three or more criteria of the modified Fried Phenotype. Cognitive impairment was assessed using the Peruvian version of the Mini Mental State Examination (MMSE), considering a score <21 as cognitive impairment. Cognitive frailty was defined as the coexistence of both. In addition, we included sociodemographic characteristics, medical and personal history, as well as the functional evaluation of each participant. Results We included 1,390 older adults (mean follow-up: 2.2 years), with a mean age of 78.5 ± 8.6 years and 59.6% (n = 828) were male. Cognitive frailty was identified in 11.3% (n = 157) and 9.9% (n = 138) died during follow-up. We found that cognitive frailty in older adults (aHR = 3.57; 95%CI: 2.33–5.49), as well as its components, such as sedentary behavior and cognitive impairment (aHR = 7.05; 95%CI: 4.46–11.13), weakness and cognitive impairment (aHR = 6.99; 95%CI: 4.41–11.06), and exhaustion and cognitive impairment (aHR = 4.51; 95%CI: 3.11–6.54) were associated with a higher risk of mortality. Conclusion Cognitive frailty and its components were associated with a higher risk of mortality in older adults. It is necessary to develop longitudinal studies with a longer follow-up and that allow evaluating the effect of interventions in this vulnerable group of patients to limit adverse health outcomes, including increased mortality.
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Affiliation(s)
| | - Leslie Salazar-Talla
- Grupo Estudiantil de Investigación en Salud Mental (GISAM), Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martin de Porres, Lima, Peru
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Lima, Peru
| | - Sofia Cuba-Ruiz
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Lima, Peru
| | - Diego Urrunaga-Pastor
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Peru
- *Correspondence: Diego Urrunaga-Pastor
| | | | - Jose F. Parodi
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru
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