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Hedberg L, Kumar A, Skott P, Smedberg JI, Seiger Å, Sandborgh-Englund G, Nordin LE, Kåreholt I, Tzortzakakis A, Westman E, Trulsson M, Ekman U. White matter abnormalities mediate the association between masticatory dysfunction and cognition among older adults. J Oral Rehabil 2023; 50:1422-1431. [PMID: 37710915 DOI: 10.1111/joor.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 06/30/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Masticatory parameters, such as reduced number of teeth and posterior contacts, have been shown to be associated with reduced cognitive status. The underlying mechanisms that affect these associations, are however, not well understood. OBJECTIVES The study aims to investigate the association between masticatory dysfunction and cognition and explore the mediating effect of brain structure. METHODS In this cross-sectional study, 45 older adults with subjective masticatory dysfunction (mean age 72.3 ± 4.0 years) were included. Mini-Mental State Examination score <25, brain trauma, neurological disease, neurodegenerative disorders, depression or poor Swedish language skills were criteria for exclusion. Cognitive functions (executive function and episodic memory) and masticatory dysfunction defined by functional occluding status (FOS; the number of occluding units and number of remaining teeth) were analysed with partial correlation models. Structural magnetic resonance imaging was performed on 28 feasible participants. Multiple regression analyses were performed to evaluate the predictive value of brain structure and white matter hypointensities (WM-hypo) on cognitive functions. A mediation analysis was applied to assess significant predictor/s of the association between FOS and cognition. RESULTS Both episodic memory and executive functions were positively correlated with FOS. WM-hypo predicted cognitive status (executive function, p ≤ .01). WM-hypo mediated 66.6% (p = 0.06) of the association between FOS and executive functions. CONCLUSION Associations between FOS and cognitive functions are reported, where FOS, a potential modifiable risk factor, was related to both episodic memory and executive functions. The mediating effect of WM-hypo on the association between FOS and executive functions highlights the impact of the vascularisation of the brain on the link between mastication and cognition. The present study provides increased knowledge that bridges the gap between masticatory dysfunction and cognition.
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Affiliation(s)
- Linn Hedberg
- Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Abhishek Kumar
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Pia Skott
- Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Jan-Ivan Smedberg
- Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Åke Seiger
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Sandborgh-Englund
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Love Engström Nordin
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Department of Diagnostic Medical Physics, Karolinska University Hospital, Stockholm, Sweden
| | - Ingemar Kåreholt
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Antonios Tzortzakakis
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mats Trulsson
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Urban Ekman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit, Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
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Pająk A, Polak M, Kozela M, Doryńska A, Bobak M. Trajectories in physical functioning at older age in relation to childhood and adulthood SES and social mobility: a population-based cohort study. Front Public Health 2023; 11:1228920. [PMID: 37744505 PMCID: PMC10513394 DOI: 10.3389/fpubh.2023.1228920] [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: 05/25/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Older age is associated with the deterioration of physical functioning (PF), and low PF is strongly related to poor quality of life among older people. We conducted a study to examine the trajectories of PF between middle and old age, considering sex differences as well as the association between socioeconomic status (SES) at different life stages and changes in PF. Methods We analyzed data from the Polish arm of the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study, including 1,116 men and 1,178 women aged 45-64 years at baseline. Adult and childhood SES and social mobility were assessed using a retrospectively focused questionnaire. PF was assessed using the 10-question SF-36 scale at baseline examination, face-to-face re-examination, and three postal surveys, covering up to 20 years (on average, 18 years). We employed Generalized Estimating Equations models to assess changes in PF scores over time and compare PF trajectories across different SES categories. Results After adjusting for age and other covariates, we found that, in both sexes, participants with always middle or high SES, as well as those who reported upward mobility, had higher PF scores at baseline compared to those with always low SES. A decline in PF between middle and old age was observed in all SES groups; however, the decline was slower in participants with always middle or high SES compared to those with always low SES. Conclusion This cohort study revealed that lower SES and downward social mobility were cross-sectionally associated with poorer PF, while upward social mobility seemed to largely reverse the effect of low childhood SES. In addition to the cross-sectional associations observed at baseline, advantaged SES was also significantly associated with a slower decline in PF over an 18-year follow-up period.
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Affiliation(s)
- Andrzej Pająk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Kozela
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Doryńska
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
| | - Martin Bobak
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czechia
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Sindi S, Kiasat S, Kåreholt I, Nilsen C. Psychosocial working conditions and cognitive and physical impairment in older age. Arch Gerontol Geriatr 2023; 104:104802. [PMID: 36084608 DOI: 10.1016/j.archger.2022.104802] [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: 05/21/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Psychosocial working conditions are associated with cognitive and physical impairments. The aim of this study was to investigate the associations between mid-late life psychosocial working conditions and the combination of physical and cognitive impairment among older adults, and the potential sex differences in these associations. METHODS Data were derived from two Swedish nationally representative surveys (n = 839; follow-up: 20-24 years). Multinomial and binary logistic regressions assessed the associations between work stressors (job demand-control model), and a combination of cognitive and physical impairment. RESULTS Low control jobs were significantly associated with higher odds of cognitive (OR: 1.41, CI: 1.15-1.72) and physical impairment (OR: 1.23, CI: 1.02-1.47), and cognitive and physical impairment combined (OR: 1.50, CI: 1.19-1.89). Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment (OR: 1.57, CI: 1.12-2.20), and combined cognitive and physical impairment (OR: 1.59, CI: 1.07-2.36). Active jobs (high control, high demand) were associated with lower odds of cognitive impairment (OR: 0.48, CI: 0.29-0.80). Sex-stratified analyses showed stronger associations among men; passive jobs were associated with both cognitive (OR: 2.18, CI: 1.31-3.63) and physical impairment (OR: 1.78, CI: 1.13-2.81), while low strain jobs were associated with less physical impairment (OR: 0.55, CI: 0.33-0.89). No significant associations between work stressors and impairment were found for women. CONCLUSIONS These results highlight the importance of psychosocial working conditions for late-life physical and cognitive impairment, especially among men. Jobs characterised by low control and low demands are associated with higher risk for impairments.
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Affiliation(s)
- Shireen Sindi
- Division of Clinical Geriatrics, Center for Alzheimer's Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Karolinska University Hospital, Karolinska Vägen 37 A, QA32, Stockholm, Solna 171 64, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom.
| | - Shadi Kiasat
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet/Stockholm University, Stockholm, Sweden
| | - Ingemar Kåreholt
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet/Stockholm University, Stockholm, Sweden; Institute of Gerontology, School of Health and Welfare, Aging Research Network - Jönköping (ARN-J), Jönköping University, Jönköping, Sweden
| | - Charlotta Nilsen
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet/Stockholm University, Stockholm, Sweden; Institute of Gerontology, School of Health and Welfare, Aging Research Network - Jönköping (ARN-J), Jönköping University, Jönköping, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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The Role of Job Control and Job Demands in Becoming Physically Active during the COVID-19 Pandemic: A Three-Wave Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042168. [PMID: 35206362 PMCID: PMC8871569 DOI: 10.3390/ijerph19042168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 02/04/2023]
Abstract
Organizational studies suggest that certain psychosocial working conditions are liable to foster positive health outcomes, such as engaging in leisure-time physical activities. However, the psychosocial factors contributing to this improvement remain unexplored, particularly in the workplace and in the context of the decline observed in the physical activity level of the population worldwide. The objective of the study was to examine whether exposure to different combinations of psychosocial working conditions during the COVID-19 pandemic predicts the probability of becoming physically active among Quebec workers. Job demands, job control, and physical activity were assessed three times during the first year of the pandemic via an online questionnaire among physically inactive workers (n = 440). Logistic regression analyses were conducted to examine the associations between various combinations of psychosocial risks and physical activity. A total of 117 participants became physically active during the study. After controlling for covariates, active jobs increased the odds of becoming physically active, compared to high-strain jobs (OR = 2.57 (95% CI 1.13 to 5.87)). Having a highly demanding job may not negatively impact physical activity if workers have enough job control to achieve the required tasks.
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