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Gao Q, Chua KC, Mayston R, Prina M. Longitudinal associations of loneliness and social isolation with care dependence among older adults in Latin America and China: A 10/66 dementia research group population-based cohort study. Int J Geriatr Psychiatry 2024; 39:e6115. [PMID: 38923024 DOI: 10.1002/gps.6115] [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: 07/20/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES With increasing life expectancy and rapid ageing, there is an expanding number of older people who have functional declines, greater needs for care and support and who are at increased risk of insufficient social interaction. Longitudinal investigations on the interplay between loneliness, social isolation and care dependence remain limited. This study thus aimed to investigate the longitudinal reciprocal association between social isolation/loneliness and care dependence among older adults in Latin America and China. METHODS We analysed data from the population-based cohorts from the 10/66 Dementia Research Group (DRG) project (baseline 2003-07 and follow-up 2007-2010). The 10/66 DRG study recruited and followed up older adults aged 65 years or above in 11 catchment areas in Latin America and China. A total of 15,027 older adults from Latin America and China (mean age = 73.5, standard deviation = 6.5) were included in our analyses. Cross-lagged panel models were used to investigate potential reciprocal associations. RESULTS Loneliness was positively associated with care dependence at baseline (β = 0.11, p < 0.001 in Latin America; β = 0.16, p < 0.05 in China]. Social isolation consistently had a stronger positive association with care dependence across all study sites in both waves. Longitudinally, care dependence positively predicted loneliness (β = 0.10, p < 0.001) and social isolation (β = 0.05, p < 0.001) in Latin American study sites but not in China. Yet there was no statistical evidence of lagged effects of loneliness and social isolation on care dependence in all study countries. CONCLUSIONS Older people with care dependence are at risk of developing loneliness and social isolation. It is crucial to develop complex care models using a societal approach to address social and care needs holistically, especially for the older group with declining functional capacity. Future longitudinal research is required to explore the causal mechanisms of relationships and cultural differences, in order to inform the development of culturally appropriate care models.
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Affiliation(s)
- Qian Gao
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- School of Public Health, Imperial College London, London, UK
| | - Kia-Chong Chua
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rosie Mayston
- Global Health & Social Medicine & King's Global Health Institute, Social Science & Public Policy, King's College London, London, UK
| | - Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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He CYY, Zhou Z, Kan MMP, Chan DHY, Wong ACT, Mok KHY, Lam FMH, Chan SCC, Cheung CKC, Yeung MKC, Wong AYL. Modifiable risk factors for mild cognitive impairment among cognitively normal community-dwelling older adults: A systematic review and meta-analysis. Ageing Res Rev 2024:102350. [PMID: 38942197 DOI: 10.1016/j.arr.2024.102350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 05/16/2024] [Accepted: 05/26/2024] [Indexed: 06/30/2024]
Abstract
Although numerous studies have investigated modifiable risk factors for mild cognitive impairment (MCI) among community-dwelling seniors, no meta-analysis has summarized these findings. Five databases were searched from January 1, 2000, to December 30, 2023. The protocol was registered with PROSPERO. Data were extracted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant meta-analyses of modifiable risk factors were performed. The evidence of each factor was assessed by the GRADE for cohort studies. Of 16,651 citations, 87 studies involving 225,584 community-dwelling seniors were included. Fourteen meta-analyses involving 20 studies with 44,199 participants were performed. The analyses revealed low-to-moderate-quality evidence supporting that diabetes, 2 or more comorbidities, anxiety, apathy, depressive symptoms, and physical frailty were risk factors for incident MCI in older adults. Conversely, hypertension, agitation, and irritability might not be risk factors. Additionally, moderate-quality evidence supports the protective effect of engaging in cognitive-demanding activities on the onset of MCI. Collectively, this study constitutes the first extensive compilation of evidence regarding the various risk factors for the development of MCI in older adults. Our findings hold significant potential to guide the formulation of prevention and management strategies to either prevent or potentially reverse the onset of MCI.
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Affiliation(s)
- Christo Y Y He
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Zhixing Zhou
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Mandy M P Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Dorothy H Y Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Athena C T Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Kenny H Y Mok
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Freddy M H Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Sam C C Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
| | - Chelsia K C Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077)
| | - Michael K C Yeung
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China (ZIP Code: 999077).
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China (ZIP Code: 999077).
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Bransby L, Yassi N, Rosenich E, Buckley R, Li QX, Maruff P, Pase M, Lim YY. Associations between multidomain modifiable dementia risk factors with AD biomarkers and cognition in middle-aged and older adults. Neurobiol Aging 2024; 138:63-71. [PMID: 38537555 DOI: 10.1016/j.neurobiolaging.2024.02.015] [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: 07/21/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 04/09/2024]
Abstract
This study aimed to determine associations between modifiable dementia risk factors (MDRF), across domains mood symptomatology, lifestyle behaviors, cardiovascular conditions, cognitive/social engagement, sleep disorders/symptomatology, with cognition, beta-amyloid (Aβ) and tau, and brain volume. Middle-aged/older adults (n=82) enrolled in a sub-study of the Healthy Brain Project completed self-report questionnaires and a neuropsychological battery. Cerebrospinal fluid levels of Aβ 1-42, total tau (t-tau), and phosphorylated tau (p-tau181) (Roche Elecsys), and MRI markers of hippocampal volume and total brain volume were obtained. Participants were classified as no/single domain risk (≤1 domains) or multidomain risk (≥2 domains). Compared to the no/single domain risk group, the multidomain risk group performed worse on the Preclinical Alzheimer's Cognitive Composite (d=0.63, p=.005), and Executive Function (d=0.50, p=.016), and had increased p-tau181 (d=0.47, p=.042) and t-tau (d=0.54, p=.021). In middle-aged/older adults, multidomain MDRFs were related to increases in tau and worse cognition, but not Aβ or brain volume. Findings suggest that increases in AD biomarkers are apparent in midlife, particularly for individuals with greater burden, or variety of MDRFs.
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Affiliation(s)
- Lisa Bransby
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Emily Rosenich
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Rachel Buckley
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Qiao-Xin Li
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Paul Maruff
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Cogstate Ltd., Melbourne, Victoria, Australia
| | - Matthew Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
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Wang Z, Sommerlad A, Hassiotis A, Richards M, Livingston G. Mid-life social participation in people with intellectual disability: The 1958 British birth cohort study. PLoS One 2024; 19:e0302411. [PMID: 38768178 PMCID: PMC11104648 DOI: 10.1371/journal.pone.0302411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/03/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Low social participation is a potentially modifiable risk factor for cognitive deterioration in the general population and related to lower quality of life (QoL). We aimed to find out whether social participation is linked to cognitive deterioration and QoL for people with borderline intellectual functioning and mild intellectual disability. METHOD We used data from the National Child Development Study, consisting of people born during one week in 1958, to compare midlife social participation in people with mild intellectual disability, borderline intellectual functioning, and without intellectual impairment. We defined social participation as 1. confiding/emotional support from the closest person and social network contact frequency at age 44, and 2. confiding relationships with anyone at age 50. We then assessed the extent to which social participation mediated the association between childhood intellectual functioning and cognition and QoL at age 50. RESULTS 14,094 participants completed cognitive tests at age 11. People with borderline intellectual functioning and mild intellectual disability had more social contact with relatives and confiding/emotional support from their closest person, but fewer social contacts with friends and confiding relationships with anyone than those without intellectual disability. Having a confiding relationship partially mediated the association at age 50 between IQ and cognition (6.4%) and QoL (27.4%) for people with borderline intellectual functioning. CONCLUSION We found adults with intellectual disability have positive family relationships but fewer other relationships. Even at the age of 50, confiding relationships may protect cognition for people with borderline intellectual functioning and are important for QoL.
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Affiliation(s)
- Zuyu Wang
- Division of Psychiatry, University College London, London, United Kingdom
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Angela Hassiotis
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health & Ageing at UCL, University College London, London, United Kingdom
| | - Gill Livingston
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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2024 Alzheimer's disease facts and figures. Alzheimers Dement 2024; 20:3708-3821. [PMID: 38689398 PMCID: PMC11095490 DOI: 10.1002/alz.13809] [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: 05/02/2024]
Abstract
This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non-physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community-based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community-based workers to provide dementia care. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non-physician health care professionals play in facilitating clinical care and access to community-based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.
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Cao Z, Zhang J, Lu Z, Chen H, Min J, Hou Y, Wang X, Xu C. Physical Activity, Mental Activity, and Risk of Incident Stroke: A Prospective Cohort Study. Stroke 2024; 55:1278-1287. [PMID: 38533647 DOI: 10.1161/strokeaha.123.044322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 02/28/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Cumulative evidence suggests a correlation between physical or mental activity and the risk of stroke. However, the combined impact of these activities on stroke onset remains unexplored. This study identified physical and mental activity patterns using principal component analysis and investigated their associations with risk of incident stroke in the general population. METHODS Our study was sourced from the UK Biobank cohort between 2006 and 2010. Information on physical and mental-related activities were obtained through a touch-screen questionnaire. The incident stroke was diagnosed by physicians and subsequently verified through linkage to Hospital Episode Statistics. Principal component analysis was used to identify potential physical and mental activity patterns. Cox proportional hazard regression models were performed to calculate hazard ratios (HRs) and 95% CIs of incident stroke, adjusting for potential confounders. RESULTS The initial UK Biobank cohort originally consisted of 502 411 individuals, of whom a total of 386 902 participants (aged 38-79 years) without any history of stroke at baseline were included in our study. During a median follow-up of 7.7 years, 6983 (1.8%) cases of stroke were documented. The mean age of the included participants was 55.9 years, and the proportion of women was 55.1%. We found that multiple individual items related to physical and mental activity showed significant associations with risk of stroke. We identified 4 patterns of physical activity and 3 patterns of mental activity using principal component analysis. The adherence to activity patterns of vigorous exercise, housework, and walking predominant patterns were associated with a lower risk of stroke by 17% (HR, 0.83 [95% CI, 0.78-0.89]; 20% (HR, 0.80 [95% CI, 0.75-0.85]; and 20% (HR, 0.80 [95% CI, 0.75-0.86), respectively. Additionally, the transportation predominant pattern (HR, 1.36 [95% CI, 1.28-1.45) and watching TV pattern (HR, 1.43 [95% CI, 1.33-1.53) were found to be significantly associated with a higher risk of stroke. These associations remained consistent across all subtypes of stroke. CONCLUSIONS Activity patterns mainly related to frequent vigorous exercise, housework, and walking were associated with lower risks of stroke and all its subtypes. Our findings provide new insights for promoting suitable patterns of physical and mental activity for primary prevention of stroke.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
- School of Public Health, Zhejiang University, Hangzhou, China (Z.C.)
| | - Jing Zhang
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
| | - Zuolin Lu
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands (Z.L.)
| | - Han Chen
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
| | - Jiahao Min
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
| | - Yabing Hou
- Yanjing Medical College, Capital Medical University, Beijing, China (Y.H.)
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
- Hangzhou International Urbanology Research Center and Center for Urban Governance Studies, China (X.W., C.X.)
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
- Hangzhou International Urbanology Research Center and Center for Urban Governance Studies, China (X.W., C.X.)
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Litkouhi PN, Numbers K, Valenzuela M, Crawford JD, Lam BCP, Litkouhi PN, Sachdev PS, Kochan NA, Brodaty H. Critical periods for cognitive reserve building activities for late life global cognition and cognitive decline: the Sydney memory and aging cohort study. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:387-403. [PMID: 36852741 DOI: 10.1080/13825585.2023.2181941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/14/2023] [Indexed: 03/01/2023]
Abstract
Cognitive, social, and physical activities, collectively linked to cognitive reserve, are associated with better late-life cognitive outcomes. To better understand the building of cognitive reserve, we investigated which of these activities, during which stages of life, had the strongest associations with late-life cognitive performance. From the Sydney Memory and Aging Study, 546 older Australians, who were community-dwelling and without a dementia diagnosis at recruitment (Mage 80.13 years, 52.2% female), were asked about their engagement in social, physical, and cognitive activities throughout young adulthood (YA), midlife (ML), and late-life (LL). Comprehensive neuropsychological testing administered biennially over 6 years measured baseline global cognition and cognitive decline. In our study, YA, but not ML nor LL, cognitive activity was significantly associated with late-life global cognition (β = 0.315, p < .001). A follow-up analysis pointed to the formal education component of the YA cognitive activity measure, rather than YA cognitive leisure activities, as a significant predictor of better late-life global cognition (β = 0.146, p = .003). YA social activity and LL cognitive activity were significantly associated with less cognitive decline (β = 0.023, p < .001, and β = 0.016, p = .022, respectively). Physical activity was not found to be associated with global cognition or cognitive decline. Overall, YA cognitive activity was associated with better late-life cognition, and YA social and LL cognitive activities were associated with less cognitive decline. Formal education emerges as the key contributor in the association between YA cognitive activity and late-life global cognition.
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Affiliation(s)
- Princess Neila Litkouhi
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Katya Numbers
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | | | - John D Crawford
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | | | - Perminder S Sachdev
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Aging (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Australia
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Liu Y, Lu G, Liu L, He Y, Gong W. Cognitive reserve over the life course and risk of dementia: a systematic review and meta-analysis. Front Aging Neurosci 2024; 16:1358992. [PMID: 38681665 PMCID: PMC11047126 DOI: 10.3389/fnagi.2024.1358992] [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: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 05/01/2024] Open
Abstract
Background The number of people with dementia is soaring. Cognitive reserve has been thought to be associated with dementia risk. It is not clear at which period in the life course and which cognitive reserve proxies contribute to the reduced risk of dementia. Methods By scanning four databases (PubMed, Embase, Web of Science, and MEDLINE) up to Jun 3, 2023, longitudinal studies of life-course cognitive reserve and risk of dementia were found. The HRs and 95% CIs for each study were summarized using random effects models. Subgroup analyses and sensitivity analyses were conducted. Utilizing funnel plots, Begg and Egger tests, publication bias was investigated. Results A total of 27 studies were included, containing 10 in early-life, 10 in middle-life, and 13 in late-life. All studies used validated questionnaires to measure cognitive reserve, and dementia diagnosis followed recognized worldwide guidelines. All included studies were of medium or low risk. Cognitive reserve in early-life (Hazard ratio (HR): 0.82; 95% confidence interval (CI): 0.79-0.86), middle-life (HR: 0.91; 95% CI: 0.84-0.98) and late-life (HR: 0.81; 95% CI: 0.75-0.88) all have protective effects on dementia risk. Multiple sensitivity analyses showed consistent results. Conclusion Dementia risk is reduced by the buildup of cognitive reserves during life-course. Accumulation of proxies for cognitive reserve in early and late life had the greatest effect on dementia risk reduction. Social connection may be an effective approach to lower dementia risk.
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Affiliation(s)
| | | | | | | | - Weijuan Gong
- School of Nursing and School of Public Health, Medical College, Yangzhou University, Yangzhou, China
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Castillo-Ordoñez WO, Cajas-Salazar N, Velasco-Reyes MA. Genetic and epigenetic targets of natural dietary compounds as anti-Alzheimer's agents. Neural Regen Res 2024; 19:846-854. [PMID: 37843220 PMCID: PMC10664119 DOI: 10.4103/1673-5374.382232] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/15/2023] [Accepted: 07/18/2023] [Indexed: 10/17/2023] Open
Abstract
Alzheimer's disease is a progressive neurodegenerative disorder and the most common cause of dementia that principally affects older adults. Pathogenic factors, such as oxidative stress, an increase in acetylcholinesterase activity, mitochondrial dysfunction, genotoxicity, and neuroinflammation are present in this syndrome, which leads to neurodegeneration. Neurodegenerative pathologies such as Alzheimer's disease are considered late-onset diseases caused by the complex combination of genetic, epigenetic, and environmental factors. There are two main types of Alzheimer's disease, known as familial Alzheimer's disease (onset < 65 years) and late-onset or sporadic Alzheimer's disease (onset ≥ 65 years). Patients with familial Alzheimer's disease inherit the disease due to rare mutations on the amyloid precursor protein (APP), presenilin 1 and 2 (PSEN1 and PSEN2) genes in an autosomal-dominantly fashion with closely 100% penetrance. In contrast, a different picture seems to emerge for sporadic Alzheimer's disease, which exhibits numerous non-Mendelian anomalies suggesting an epigenetic component in its etiology. Importantly, the fundamental pathophysiological mechanisms driving Alzheimer's disease are interfaced with epigenetic dysregulation. However, the dynamic nature of epigenetics seems to open up new avenues and hope in regenerative neurogenesis to improve brain repair in Alzheimer's disease or following injury or stroke in humans. In recent years, there has been an increase in interest in using natural products for the treatment of neurodegenerative illnesses such as Alzheimer's disease. Through epigenetic mechanisms, such as DNA methylation, non-coding RNAs, histone modification, and chromatin conformation regulation, natural compounds appear to exert neuroprotective effects. While we do not purport to cover every in this work, we do attempt to illustrate how various phytochemical compounds regulate the epigenetic effects of a few Alzheimer's disease-related genes.
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Affiliation(s)
- Willian Orlando Castillo-Ordoñez
- Facultad de Ciencias Naturales-Exactas y de la Educación, Departamento de Biología. Universidad del Cauca, Popayán-Cauca, Colombia
- Departamento de Estudios Psicológicos, Universidad Icesi, Cali, Colombia
| | - Nohelia Cajas-Salazar
- Facultad de Ciencias Naturales-Exactas y de la Educación, Departamento de Biología. Universidad del Cauca, Popayán-Cauca, Colombia
| | - Mayra Alejandra Velasco-Reyes
- Facultad de Ciencias Naturales-Exactas y de la Educación, Departamento de Biología. Universidad del Cauca, Popayán-Cauca, Colombia
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Meng X, Su J, Gao T, Ma D, Zhao Y, Fang S, Zhi S, Li H, Sun J. Multidomain interventions based on a life-course model to prevent dementia in at-risk Chinese older adults: A randomized controlled trial. Int J Nurs Stud 2024; 152:104701. [PMID: 38330865 DOI: 10.1016/j.ijnurstu.2024.104701] [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: 06/06/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Due to the time-dependent effect of specific risk factors for dementia, multidomain interventions based on a life-course model might achieve optimal preventive effects against dementia. OBJECTIVE The purpose of this study was to investigate the effectiveness of multidomain interventions based on a life-course model of modifiable risk factors for dementia in at-risk Chinese older adults. DESIGN This was a two-arm, proof-of-concept, randomized controlled trial. SETTING AND PARTICIPANTS We randomly assigned 96 community-dwelling at-risk adults aged 60 years or older in a 1:1 ratio to either the 6-month multidomain intervention group (dementia literacy, physical activity, cognitive training, social activity and optional modules) or the control group (health education). METHODS The primary outcomes were the dementia risk score and cognitive composite Z score. The secondary outcomes included the individual components of the dementia risk score (protective and risk factors) and cognitive composite Z score (global cognition, memory, executive function and language), social isolation (loneliness, social contact, and social participation), dementia literacy and prevention belief. Linear mixed models with maximum likelihood estimation were used to calculate the outcomes between the groups over time. RESULTS The primary analyses showed that the dementia risk score was significantly lower (p < 0.001) and that the cognitive composite Z score was significantly higher (p = 0.013) in the multidomain intervention group than in the control group. Baseline characteristics did not modify the effects of the multidomain interventions (p value for interaction > 0.05). For secondary outcomes, statistically significant group × time interactions were observed for the protective (p = 0.001) and risk factors (p = 0.049), as well as in executive function (p = 0.020), loneliness (p = 0.029), dementia literacy (p < 0.001) and prevention belief (p < 0.001). CONCLUSIONS Multidomain interventions based on a life-course model are feasible and have the potential to reduce dementia risk and improve cognitive function in at-risk Chinese older adults. REGISTRATION The trial was registered at the Chinese Clinical Trials Registry (ChiCTR2100053417).
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Affiliation(s)
- Xiangfei Meng
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jianping Su
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Xinjiang Medical University, Urumqi Municipality, Xinjiang, China
| | - Tianbao Gao
- Department of Internal Medicine, Beian No.2 People's Hospital, Beian, Heilongjiang, China
| | - Dongfei Ma
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Yanjie Zhao
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Shuyan Fang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Shengze Zhi
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Hongyang Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, Jilin, China.
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11
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Huang HZ, Ai WQ, Wei N, Zhu LS, Liu ZQ, Zhou CW, Deng MF, Zhang WT, Zhang JC, Yang CQ, Hu YZ, Han ZT, Zhang HH, Jia JJ, Wang J, Liu FF, Li K, Xu Q, Yuan M, Man H, Guo Z, Lu Y, Shu K, Zhu LQ, Liu D. Senktide blocks aberrant RTN3 interactome to retard memory decline and tau pathology in social isolated Alzheimer's disease mice. Protein Cell 2024; 15:261-284. [PMID: 38011644 PMCID: PMC10984625 DOI: 10.1093/procel/pwad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
Sporadic or late-onset Alzheimer's disease (LOAD) accounts for more than 95% of Alzheimer's disease (AD) cases without any family history. Although genome-wide association studies have identified associated risk genes and loci for LOAD, numerous studies suggest that many adverse environmental factors, such as social isolation, are associated with an increased risk of dementia. However, the underlying mechanisms of social isolation in AD progression remain elusive. In the current study, we found that 7 days of social isolation could trigger pattern separation impairments and presynaptic abnormalities of the mossy fibre-CA3 circuit in AD mice. We also revealed that social isolation disrupted histone acetylation and resulted in the downregulation of 2 dentate gyrus (DG)-enriched miRNAs, which simultaneously target reticulon 3 (RTN3), an endoplasmic reticulum protein that aggregates in presynaptic regions to disturb the formation of functional mossy fibre boutons (MFBs) by recruiting multiple mitochondrial and vesicle-related proteins. Interestingly, the aggregation of RTN3 also recruits the PP2A B subunits to suppress PP2A activity and induce tau hyperphosphorylation, which, in turn, further elevates RTN3 and forms a vicious cycle. Finally, using an artificial intelligence-assisted molecular docking approach, we determined that senktide, a selective agonist of neurokinin3 receptors (NK3R), could reduce the binding of RTN3 with its partners. Moreover, application of senktide in vivo effectively restored DG circuit disorders in socially isolated AD mice. Taken together, our findings not only demonstrate the epigenetic regulatory mechanism underlying mossy fibre synaptic disorders orchestrated by social isolation and tau pathology but also reveal a novel potential therapeutic strategy for AD.
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Affiliation(s)
- He-Zhou Huang
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wen-Qing Ai
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Na Wei
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
- Department of Pathology, School of Basic Medicine, Zhengzhou University, Zhengzhou 450002, China
| | - Ling-Shuang Zhu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhi-Qiang Liu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chao-Wen Zhou
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Man-Fei Deng
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wen-Tao Zhang
- The Second Affiliated Hospital, Department of Neurology, Hengyang Medical School, University of South China, Hengyang 421001, China
| | - Jia-Chen Zhang
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chun-Qing Yang
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ya-Zhuo Hu
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Institute of Geriatrics, Chinese PLA General Hospital and Chinese PLA Medical Academy, Beijing 100853, China
| | - Zhi-Tao Han
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Institute of Geriatrics, Chinese PLA General Hospital and Chinese PLA Medical Academy, Beijing 100853, China
| | - Hong-Hong Zhang
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Institute of Geriatrics, Chinese PLA General Hospital and Chinese PLA Medical Academy, Beijing 100853, China
| | - Jian-Jun Jia
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Institute of Geriatrics, Chinese PLA General Hospital and Chinese PLA Medical Academy, Beijing 100853, China
| | - Jing Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Fang-Fang Liu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ke Li
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Qi Xu
- Department of Neurology, Union Hospital, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Mei Yuan
- The Second Affiliated Hospital, Department of Neurology, Hengyang Medical School, University of South China, Hengyang 421001, China
| | - Hengye Man
- Department of Biology, Boston University, Boston, MA 02215, USA
| | - Ziyuan Guo
- Center for Stem Cell and Organoid Medicine (CuSTOM), Division of Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Youming Lu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Kai Shu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ling-Qiang Zhu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Dan Liu
- Department of Medical Genetics, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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12
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Ren Q, Wang S, Li J, Cao K, Zhuang M, Wu M, Geng J, Jia Z, Xie W, Liu A. Novel Social Stimulation Ameliorates Memory Deficit in Alzheimer's Disease Model through Activating α-Secretase. J Neurosci 2024; 44:e1689232024. [PMID: 38418221 PMCID: PMC10957211 DOI: 10.1523/jneurosci.1689-23.2024] [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: 09/07/2023] [Revised: 01/24/2024] [Accepted: 02/09/2024] [Indexed: 03/01/2024] Open
Abstract
As the most common form of dementia in the world, Alzheimer's disease (AD) is a progressive neurological disorder marked by cognitive and behavioral impairment. According to previous researches, abundant social connections shield against dementia. However, it is still unclear how exactly social interactions benefit cognitive abilities in people with AD and how this process is used to increase their general cognitive performance. In this study, we found that single novel social (SNS) stimulation promoted c-Fos expression and increased the protein levels of mature ADAM10/17 and sAPPα in the ventral hippocampus (vHPC) of wild-type (WT) mice, which are hippocampal dorsal CA2 (dCA2) neuron activity and vHPC NMDAR dependent. Additionally, we discovered that SNS caused similar changes in an AD model, FAD4T mice, and these alterations could be reversed by α-secretase inhibitor. Furthermore, we also found that multiple novel social (MNS) stimulation improved synaptic plasticity and memory impairments in both male and female FAD4T mice, accompanied by α-secretase activation and Aβ reduction. These findings provide insight into the process underpinning how social interaction helps AD patients who are experiencing cognitive decline, and we also imply that novel social interaction and activation of the α-secretase may be preventative and therapeutic in the early stages of AD.
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Affiliation(s)
- Qiaoyun Ren
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Susu Wang
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Junru Li
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Kun Cao
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Mei Zhuang
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Miao Wu
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Junhua Geng
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Zhengping Jia
- Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Wei Xie
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
- Jiangsu Co-innovation Center of Neuroregeneration, Southeast University, Nanjing 210096, China
| | - An Liu
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
- Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
- Shenzhen Research Institute, Southeast University, Shenzhen 518063, China
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13
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Elovainio M, Komulainen K, Hakulinen C, Pahkala K, Rovio S, Hutri N, Raitakari OT, Pulkki-Råback L. Intergenerational continuity of loneliness and potential mechanisms: Young Finns Multigenerational Study. Sci Rep 2024; 14:5465. [PMID: 38443584 PMCID: PMC10915156 DOI: 10.1038/s41598-024-56147-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/01/2024] [Indexed: 03/07/2024] Open
Abstract
Evidence on the intergenerational continuity of loneliness and on potential mechanisms that connect loneliness across successive generations is limited. We examined the association between loneliness of (G0) parents (859 mothers and 570 fathers, mean age 74 years) and their children (G1) (433 sons and 558 daughters, mean age 47 years) producing 991 parent-offspring pairs and tested whether these associations were mediated through subjective socioeconomic position, temperament characteristics, cognitive performance, and depressive symptoms. Mean loneliness across parents had an independent effect on their adult children's experienced loneliness (OR = 1.72, 95% CI 1.23-2.42). We also found a robust effect of mothers' (OR = 1.64, 95% CI 1.17-2.29), but not of fathers' loneliness (OR = 1.47, 95% CI 0.96-2.25) on offspring's experienced loneliness in adulthood. The associations were partly mediated by offspring depressive (41-54%) and anxiety (29-31%) symptoms. The current findings emphasize the high interdependence of loneliness within families mediated partly by offspring's mental health problems.
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Affiliation(s)
- Marko Elovainio
- Research Program Unit, Faculty of Medicine (Department of Psychology), University of Helsinki, Haartmaninkatu 3, P.O.Box 63, 00014, Helsinki, Finland.
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00300, Helsinki, Finland.
| | - Kaisla Komulainen
- Research Program Unit, Faculty of Medicine (Department of Psychology), University of Helsinki, Haartmaninkatu 3, P.O.Box 63, 00014, Helsinki, Finland
| | - Christian Hakulinen
- Research Program Unit, Faculty of Medicine (Department of Psychology), University of Helsinki, Haartmaninkatu 3, P.O.Box 63, 00014, Helsinki, Finland
| | - Katja Pahkala
- Department of Public Health, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Suvi Rovio
- Department of Public Health, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Nina Hutri
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli T Raitakari
- Department of Public Health, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Laura Pulkki-Råback
- Research Program Unit, Faculty of Medicine (Department of Psychology), University of Helsinki, Haartmaninkatu 3, P.O.Box 63, 00014, Helsinki, Finland
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14
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Dodds L, Brayne C, Siette J. Associations between social networks, cognitive function, and quality of life among older adults in long-term care. BMC Geriatr 2024; 24:221. [PMID: 38438951 PMCID: PMC10910782 DOI: 10.1186/s12877-024-04794-9] [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: 08/15/2023] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Having rich social networks is associated with better physical and cognitive health, however older adults entering long-term care may experience an increased risk of social isolation and consequent negative impacts on cognitive function. Our study aimed to identify if there is an association between accessing specific types of services or activities within long-term care on social networks and cognition. METHODS A cross-sectional study of 96 residents from 2 aged care providers in New South Wales, Australia. Residents were given a battery of assessments measuring social network structure (Lubben Social Network Scale, LSNS-12), quality of life (EuroQol 5D, Eq. 5D5L) and cognitive function (Montreal Cognitive Assessment, MoCA). Demographic factors and service use factors were also collected from aged care providers' electronic records. Independent sample t-test, ANOVA and linear regression analyses were used to explore associated factors for cognition. RESULTS Residents had a mean age of 82.7 ± 9.4 years (median = 81) and 64.6% were women. Most residents had cognitive impairment (70.8%) and reported moderate sized social networks (26.7/60) (Lubben Social Network Scale, LSNS-12). Residents who had larger social networks of both family and friends had significantly better cognitive performance. Service type and frequency of attendance were not associated with cognitive function. CONCLUSIONS Among individuals most at risk of social isolation, having supportive and fulfilling social networks was associated with preserved cognitive function. The relationship between service provision and social interactions that offer psychosocial support within long-term facilities and its impact over time on cognitive function requires further exploration.
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Affiliation(s)
- Laura Dodds
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
| | - Carol Brayne
- Cambridge Public Health, Cambridge University, Cambridge, UK
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia.
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15
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van Gennip ACE, van Sloten TT, Fayosse A, Sabia S, Singh‐Manoux A. Age at cardiovascular disease onset, dementia risk, and the role of lifestyle factors. Alzheimers Dement 2024; 20:1693-1702. [PMID: 38085549 PMCID: PMC10947967 DOI: 10.1002/alz.13562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 01/18/2024]
Abstract
INTRODUCTION We first examined the role of age at cardiovascular disease (CVD) onset for incident dementia, and then examined whether lifestyle factors at guideline-recommended levels in individuals with CVD mitigates dementia risk. METHODS We used population-based data (Whitehall II: n = 10,308/baseline 1985-1988/examinations every 4-5 years). Lifestyle factors (non-smoking, body mass index [BMI], physical activity, diet) were extracted post-CVD. RESULTS Over a median of 31.6 years, 3275 (32.1%) developed CVD. At age 70, risk of dementia was higher in individuals with CVD onset before (hazard ratio [HR] of incident dementia for participants with CVD before age 60, using participants without CVD at age 70 as the reference: 1.56, 95% confidence interal [CI] 1.18-2.08) but not after 60 years. In participants with CVD, a greater number of lifestyle factors at recommended levels post-CVD was associated with a lower dementia risk (per lifestyle factor at recommended level HR: 0.73, 95% CI 0.59-0.92). DISCUSSION Our results suggest that early onset CVD is associated with a higher dementia risk at older ages. In those with CVD, the dementia risk was lower if lifestyle factors are at recommended levels following CVD diagnosis. HIGHLIGHTS CVD in midlife but not in late life is associated with a higher risk of dementia. Dementia risk in CVD patients is lower if their lifestyle factors are at recommended levels. These findings provide evidence to promote CVD prevention in midlife or earlier. Study findings also show the importance of a healthy lifestyle in those with CVD.
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Affiliation(s)
- April C. E. van Gennip
- Epidemiology of Ageing and Neurodegenerative Diseases, Inserm U1153Université Paris CitéParisFrance
- Department of Internal MedicineMaastricht University Medical CentreMaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Thomas T. van Sloten
- Department of Vascular MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Aurore Fayosse
- Epidemiology of Ageing and Neurodegenerative Diseases, Inserm U1153Université Paris CitéParisFrance
| | - Séverine Sabia
- Epidemiology of Ageing and Neurodegenerative Diseases, Inserm U1153Université Paris CitéParisFrance
- Faculty of Brain SciencesUniversity College LondonLondonUK
| | - Archana Singh‐Manoux
- Epidemiology of Ageing and Neurodegenerative Diseases, Inserm U1153Université Paris CitéParisFrance
- Faculty of Brain SciencesUniversity College LondonLondonUK
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16
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Mose A, Chen Y, Tan X, Ren Q, Ren X. Association of social integration with cognitive function trajectories among Chinese older adults: evidence from the China health and retirement longitudinal study (CHARLS). Front Aging Neurosci 2024; 15:1322974. [PMID: 38274988 PMCID: PMC10808469 DOI: 10.3389/fnagi.2023.1322974] [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: 10/17/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background The prevalence of cognitive impairment among older adults remains high. It has been proven that social integration is related to cognitive function. However, limited research has examined the association of social integration and its different dimensions with cognitive function trajectories of older adults. Methods The data were from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2013 (T1) to 2018 (T3). A total of 3,977 older adults were included in the final analysis. Cognitive function was measured with items from an adapted Chinese version of the Mini-Mini-Mental Mental State Examination (MMSE), while the measurement of social integration included three dimensions: economic integration, relational integration and community integration. A group-based trajectory model (GBTM) was used to identify cognitive trajectory groups among participants and an unordered multinomial logistic regression was employed to explore the association of baseline social integration and its three dimensions with cognitive function trajectories. Result Three cognitive function trajectory groups were identified: low-decline group (24.1%), medium-decline group (44.2%) and high-stable group (31.7%). Comparing to the medium-decline trajectory group, older adults with higher social integration scores were more likely to be in the high-stable trajectory group (OR = 1.087, 95%CI: 1.007 ~ 1.174), while less likely to be in the low-decline group (OR = 0.806, 95%CI: 0.736 ~ 0.882). Among the different dimensions of social integration, older adults with higher community integration scores were more likely to be in the high-stable trajectory group (OR = 1.222, 95%CI: 1.026 ~ 1.456); Older adults with higher relational integration scores were less likely to be in the low-decline trajectory group (OR = 0.816, 95%CI: 0.734 ~ 0.906). The economic integration was not found to correlate with the cognitive function trajectories. Stratified analyses revealed that the association between community integration and cognitive trajectories was only significant among older adults aged 60 to 69, and the association between relational integration and cognitive trajectories was only significant among older adults who was agricultural household registration. Conclusion The developmental trajectories of cognitive function among Chinese older adults are heterogeneous. Social integration is significantly related to the trajectories of cognitive function in Chinese older adults. Measures should be taken to promote social integration of Chinese older adults to reduce the decline of cognitive function.
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Affiliation(s)
- Amu Mose
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yanhong Chen
- The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaoshuang Tan
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qingman Ren
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaohui Ren
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Jackman V, Wolverson E, Clarke C, Quinn C. A participatory approach to understand what might be most meaningful to people living with dementia in a positive psychology intervention. Aging Ment Health 2024:1-10. [PMID: 38189283 DOI: 10.1080/13607863.2023.2299967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES This study aimed to understand which character strengths are most important for people living with dementia and therefore which strengths-based psychological interventions could be most meaningful and acceptable. METHODS A participatory design, utilising Delphi methodology, was incorporated into an iterative three stage framework: (1) literature reviewed for Positive Psychology (PP) interventions and patient public involvement to define the character strengths; (2) modified Delphi (N = 10) identified which character strengths are most important for living with dementia; (3) focus groups (N = 14) explored which PP interventions are most acceptable and meaningful. Qualitative data from the focus groups was analysed using thematic analysis. RESULTS Love, kindness and humour were deemed the most important character strengths for living with dementia. Qualitative data from the focus groups was captured in three superordinate themes: (1) lack of opportunity not capacity; (2) key considerations of PP interventions for people living with dementia; and (3) potential benefits of PP interventions. CONCLUSIONS Love, kindness and humour come naturally to people with dementia, but people may lack social opportunities to use these strengths. Therefore, a PP intervention promoting positive emotion, social relationships and connection to one's values appears most meaningful and acceptable as this may provide a social context to use and maintain these strengths.
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Affiliation(s)
| | - Emma Wolverson
- School of Psychology and Social Work, University of Hull, Hull
- Dementia UK, London, UK
| | | | - Catherine Quinn
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
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Bransby L, Rosenich E, Maruff P, Lim YY. How Modifiable Are Modifiable Dementia Risk Factors? A Framework for Considering the Modifiability of Dementia Risk Factors. J Prev Alzheimers Dis 2024; 11:22-37. [PMID: 38230714 PMCID: PMC10995020 DOI: 10.14283/jpad.2023.119] [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: 06/13/2023] [Accepted: 08/06/2023] [Indexed: 01/18/2024]
Abstract
Many risk factors for dementia, identified from observational studies, are potentially modifiable. This raises the possibility that targeting key modifiable dementia risk factors may reduce the prevalence of dementia, which has led to the development of dementia risk reduction and prevention strategies, such as intervention trials or dementia prevention guidelines. However, what has rarely been considered in the studies that inform these strategies is the extent to which modifiable dementia risk factors can (1) be identified by individuals, and (2) be readily modified by individuals. Characteristics of modifiable dementia risk factors such as readiness of identification and targeting, as well as when they should be targeted, can influence the design, or success of strategies for reducing dementia risk. This review aims to develop a framework for classifying the degree of modifiability of dementia risk factors for research studies. The extent to which these modifiable dementia risk factors could be modified by an individual seeking to reduce their dementia risk is determined, as well as the resources that might be needed for both risk factor identification and modification, and whether modification may be optimal in early-life (aged <45 years), midlife (aged 45-65 years) or late-life (aged >65 years). Finally, barriers that could influence the ability of an individual to engage in risk factor modification and, ultimately, dementia risk reduction are discussed.
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Affiliation(s)
- L Bransby
- Lisa Bransby, Turner Institute for Brain and Mental Health, 18 Innovation Walk, Clayton, VIC 3800, Australia;
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M S, E K, N TR, E C, K S, Kaminyoge MS, B M, R W, G L, W K G, S-M P, B M. The role of cognitive reserve in mediating HIV-associated neurocognitive disorders in older adults living with-treated HIV in Mbeya, Tanzania: A cross-sectional observational study. Int J Geriatr Psychiatry 2023; 38:e6042. [PMID: 38141048 DOI: 10.1002/gps.6042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION HIV-associated neurocognitive disorders (HAND) are a spectrum of cognitive impairments in chronic HIV infection. HAND is common in sub-Saharan Africa (SSA), despite combination antiretroviral therapy (cART). Older people appear to be at increased risk. It is unknown if cognitive reserve (CR), which is protective in neurodegenerative dementias, protects against HAND. OBJECTIVE To evaluate the association of CR and risk of HAND in an older cART-treated population in SSA. METHODS Cross-sectional observational study completed in hospital outpatient clinics in Southwest Tanzania. We assessed HIV-positive participants aged ≥50 years established on cART using a neuropsychological test battery, functional assessment, informant history and depression screen. Control participants were HIV-negative individuals attending chronic disease clinics. We used operationalised Frascati criteria for HAND diagnosis. CR was measured using the Cognitive Reserve Index (CRI) and other proxy measures. RESULTS The prevalence of HAND was 64.4% (n = 219/343). Lower CRI score [odds ratio (OR) = 0.971, p = 0.009] and less formal education (OR = 4.364, p = 0.026) were independent risk factors for HAND but HIV-severity measures were not. Unemployment and low-skilled manual work were associated with increased risk of HAND in bivariate analysis but not in multivariable analysis. CONCLUSIONS Higher total CRI score and more formal education appeared to be protective against HAND, in this cohort. Potentially, cognitively and socially stimulating activities and exercise could increase cognitive reserve in later life. Cognitive reserve could possibly be more important than HIV-disease severity in risk of HAND in older people with treated HIV.
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Affiliation(s)
- Sadler M
- Newcastle University, Newcastle Upon Tyne, UK
| | - Kuhoga E
- Department of Epidemiology, Bio-Statistics and Clinical Research, University of Dar es Salaam-Mbeya College of Health and Allied Sciences, UDSM-MCHAS, Mbeya, Tanzania
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
| | | | - Chuma E
- Department of Epidemiology, Bio-Statistics and Clinical Research, University of Dar es Salaam-Mbeya College of Health and Allied Sciences, UDSM-MCHAS, Mbeya, Tanzania
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
| | - Said K
- Mbeya Zonal Referral Hospital (MZRH), Mbeya, Tanzania
| | | | - Mussa B
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
| | - Walker R
- Newcastle University, Newcastle Upon Tyne, UK
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Livingston G
- Division of Psychiatry, University College London, London, UK
| | - Gray W K
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Paddick S-M
- Newcastle University, Newcastle Upon Tyne, UK
- Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - Mbwele B
- Department of Epidemiology, Bio-Statistics and Clinical Research, University of Dar es Salaam-Mbeya College of Health and Allied Sciences, UDSM-MCHAS, Mbeya, Tanzania
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
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Luo MS, Li LW. Trajectories of social isolation and depressive symptoms in mid- and later life: a parallel process latent growth curve analysis. Aging Ment Health 2023; 27:2211-2219. [PMID: 37212635 DOI: 10.1080/13607863.2023.2214099] [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: 06/16/2022] [Accepted: 05/10/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Social isolation has subjective and objective dimensions. This study explored the change trajectories of both dimensions of isolation and depressive symptoms and their interrelationships in terms of levels and changes over time. METHODS Data were drawn from the 2006-2018 Health and Retirement Study, involving a nationally representative sample of middle-aged and older adults (N = 7890). Parallel process latent growth curve models were used. RESULTS Over time, objective isolation displayed a non-linear upward trend, subjective isolation displayed a non-linear downward trend, and depressive symptoms remained relatively stable. More objectively isolated people experienced smaller increases in objective isolation and more subjectively isolated people experienced smaller decreases in subjective isolation. Such negative intercept-slope associations were not observed for depressive symptoms. Net of sociodemographic characteristics, physical disabilities, functional limitations, and chronic diseases, each isolation dimension was associated with the level of depressive symptoms. But only the rate of change in subjective isolation was positively associated with that of depressive symptoms. CONCLUSION The initial level of objective isolation may be one of the common origins of subjective isolation and depressive symptoms. Recognition of such shared origins is important in mitigating the synergistic and deleterious effects of loneliness and depression in middle-aged and older adults.
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Affiliation(s)
- Meng Sha Luo
- Department of Sociology, Zhejiang University, Hangzhou, China
| | - Lydia W Li
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
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21
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Xiong S, Hou N, Tang F, Li J, Deng H. Association of cardiometabolic multimorbidity and adherence to a healthy lifestyle with incident dementia: a large prospective cohort study. Diabetol Metab Syndr 2023; 15:208. [PMID: 37876001 PMCID: PMC10594816 DOI: 10.1186/s13098-023-01186-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND The co-occurrence of cardiometabolic diseases (CMDs) is increasingly prevalent and has been associated with an additive risk of dementia in older adults, but the extent to which this risk can be offset by a healthy lifestyle is unknown. We aimed to examine the associations of cardiometabolic multimorbidity and lifestyle with incident dementia and related brain structural changes. METHODS This prospective study extracted health and lifestyle data from 171 538 UK Biobank participants aged 60 years or older without dementia at baseline between 2006 and 2010 and followed up until July 2021, as well as brain structural data in a nested imaging subsample of 11 972 participants. Cardiometabolic multimorbidity was defined as the presence of two or more CMDs among type 2 diabetes, coronary heart disease, stroke, and hypertension. Lifestyle patterns were determined based on 7 modifiable lifestyle factors including smoking, alcohol consumption, physical activity, diet, sleep duration, sedentary behavior, and social contact. RESULTS Over a median follow-up of 12.3 years, 4479 (2.6%) participants developed dementia. The presence of CMDs was dose-dependently associated with an increased risk of dementia. Compared with participants with no CMDs and a favourable lifestyle, those with ≥ 3 CMDs and an unfavourable lifestyle had a five times greater risk of developing dementia (HR 5.33, 95% CI 4.26-6.66). A significant interaction was found between CMD status and lifestyle (Pinteraction=0.001). The absolute difference in incidence rates of dementia per 1000 person years comparing favourable versus unfavourable lifestyle was - 0.65 (95% CI - 1.02 to - 0.27) among participants with no CMDs and - 5.64 (- 8.11 to - 3.17) among participants with ≥ 3 CMDs, corresponding to a HR of 0.71 (0.58-0.88) and 0.42 (0.28-0.63), respectively. In the imaging subsample, a favourable lifestyle was associated with larger total brain, grey matter, and hippocampus volumes across CMD status. CONCLUSION Our findings suggest that adherence to a healthy lifestyle might substantially attenuate dementia risk and adverse brain structural changes associated with cardiometabolic multimorbidity.
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Affiliation(s)
- Sizheng Xiong
- Department of Vascular Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| | - Ningxin Hou
- Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feifei Tang
- Department of Cardiovascular Surgery, Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Li
- Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongping Deng
- Department of Vascular Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Grigoryan GA. The systemic effects of the enriched environment on the conditioned fear reaction. Front Behav Neurosci 2023; 17:1227575. [PMID: 37674611 PMCID: PMC10477375 DOI: 10.3389/fnbeh.2023.1227575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
In this review, a hypothesis is proposed to explain the beneficial effect of an enriched environment (EE) on the conditioned fear reaction (CFR) from the perspective of a functional system of behavioral control. According to the hypothesis, the EE affects all behavioral act components, including the processing of sensory information, memory, motivational and reinforcing systems, and motor activities, which weakens the CFR. Animals raised in the EE have effects that are comparable to those of context (CTX) and CS pre-exposures at latent inhibition. An abundance of stimuli in the EE and constant contact with them provide the formation of CS-noUS and CTX-noUS connections that later, during CFR learning, slow down and diminish fear. The EE also contributes to faster processing of information and habituation to it. As a result, many stimuli in the context lose their significance, and subjects simply ignore them. And finally, the EE affects the motivational and reinforcing brain mechanisms, induces an impairment of search activity, and worsens memory consolidation, which leads to a reduction of CFR.
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Affiliation(s)
- Grigory A. Grigoryan
- The Laboratory of Conditioned Reflexes and Physiology of Emotions, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
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Lingling, Tsuji T, Ide K, Kondo K. Group leisure activities are associated with a lower risk of dementia than individual leisure activities: A 6-year longitudinal study from the Japan Gerontological Evaluation Study (JAGES). Prev Med 2023; 173:107573. [PMID: 37328035 DOI: 10.1016/j.ypmed.2023.107573] [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: 01/22/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/18/2023]
Abstract
Participating in group leisure activities may lower the risk of dementia compared with doing leisure activities alone. However, only some studies have examined the differences. In this study, we sought to determine whether the incidence of dementia risk differs according to the implementation status of leisure activities (participation in a group or alone). The association between the implementation status of leisure activities and the risk of dementia was examined using Cox proportional hazards models in the 6-year (2010-2016) cohort data of 50,935 participants (23,533 males and 27,402 females) aged 65 years or older of the Japan Gerontological Evaluation Study. Over six years of follow-up, 5395 respondents (10.6%) developed dementia. After adjusting for potential confounders, such as depression and social support, the implementation status of leisure activities was associated with a lower dementia risk in participants who engaged in group leisure activities (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.73-0.85) and a higher dementia risk in those without leisure activity (HR, 1.30; 95% CI, 1.22-1.39), in comparison with those engaging in leisure activities alone. Engagement in group leisure activities may be associated with a reduced risk of dementia.
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Affiliation(s)
- Lingling
- Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Community General Support, Hasegawa Hospital, Yachimata-shi, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan.
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Maddock J, Gallo F, Wolters FJ, Stafford J, Marseglia A, Dekhtyar S, Lenart-Bugla M, Verspoor E, Perry M, Samtani S, Vernooij-Dassen M, Wolf-Ostermann K, Melis R, Brodaty H, Ikram MA, Welmer AK, Davis D, Ploubidis GB, Richards M, Patalay P. Social Health and Change in Cognitive Capability among Older Adults: Findings from Four European Longitudinal Studies. Gerontology 2023; 69:1330-1346. [PMID: 37497894 DOI: 10.1159/000531969] [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: 01/19/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION In this study, we examine whether social health markers measured at baseline are associated with differences in cognitive capability and the rate of cognitive decline over an 11-to-18-year period among older adults and compare results across studies. METHODS We applied an integrated data analysis approach to 16,858 participants (mean age 65 years; 56% female) from the National Survey for Health and Development (NSHD), the English Longitudinal Study of Aging (ELSA), the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), and the Rotterdam Study. We used multilevel models to examine social health in relation to cognitive capability and the rate of cognitive decline. RESULTS Pooled estimates show distinct relationships between markers of social health and cognitive domains, e.g., a large network size (≥6 people vs. none) was associated with higher executive function (0.17 standard deviation [SD] [95% CI: 0.00, 0.34], I2 = 27%) but not with memory (0.08 SD [95% CI: -0.02, 0.18], I2 = 19%). We also observed pooled associations between being married or cohabiting, having a large network size, and participating in social activities with slower decline in cognitive capability. However, estimates were close to zero, e.g., 0.01 SD/year (95% CI: 0.01, 0.02) I2 = 19% for marital status and executive function. There were clear study-specific differences: results for average processing speed were the most homogenous, and results for average memory were the most heterogeneous. CONCLUSION Overall, markers of good social health have a positive association with cognitive capability. However, we found differential associations between specific markers of social health and cognitive domains and differences between studies. These findings highlight the importance of examining between-study differences and considering the context specificity of findings in developing and deploying interventions.
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Affiliation(s)
- Jane Maddock
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health, University College London, London, UK
| | - Federico Gallo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands
| | - Jean Stafford
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health, University College London, London, UK
| | - Anna Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden
| | | | - Eline Verspoor
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marieke Perry
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Suraj Samtani
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Sydney, Australia
| | - Myrra Vernooij-Dassen
- Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Karin Wolf-Ostermann
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Leibniz ScienceCampus Digital Public Health, Bremen, Germany
| | - Rene Melis
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Sydney, Australia
| | | | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health, University College London, London, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health, University College London, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health, University College London, London, UK
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, London, UK
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Ellouze I, Sheffler J, Nagpal R, Arjmandi B. Dietary Patterns and Alzheimer's Disease: An Updated Review Linking Nutrition to Neuroscience. Nutrients 2023; 15:3204. [PMID: 37513622 PMCID: PMC10384681 DOI: 10.3390/nu15143204] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Alzheimer's disease (AD) is a growing concern for the aging population worldwide. With no current cure or reliable treatments available for AD, prevention is an important and growing area of research. A range of lifestyle and dietary patterns have been studied to identify the most effective preventive lifestyle changes against AD and related dementia (ADRD) pathology. Of these, the most studied dietary patterns are the Mediterranean, DASH, MIND, ketogenic, and modified Mediterranean-ketogenic diets. However, there are discrepancies in the reported benefits among studies examining these dietary patterns. We herein compile a narrative/literature review of existing clinical evidence on the association of these patterns with ADRD symptomology and contemplate their preventive/ameliorative effects on ADRD neuropathology in various clinical milieus. By and large, plant-based dietary patterns have been found to be relatively consistently and positively correlated with preventing and reducing the odds of ADRD. These impacts stem not only from the direct impact of specific dietary components within these patterns on the brain but also from indirect effects through decreasing the deleterious effects of ADRD risk factors, such as diabetes, obesity, and cardiovascular diseases. Importantly, other psychosocial factors influence dietary intake, such as the social connection, which may directly influence diet and lifestyle, thereby also impacting ADRD risk. To this end, prospective research on ADRD should include a holistic approach, including psychosocial considerations.
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Affiliation(s)
- Ines Ellouze
- Department of Plant Biotechnology, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja 382, Tunisia;
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA
| | - Julia Sheffler
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32304, USA;
| | - Ravinder Nagpal
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32306, USA
| | - Bahram Arjmandi
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32306, USA
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Lai KY, Kumari S, Webster C, Gallacher JEJ, Sarkar C. Neighbourhood residential density, urbanicity and incident dementia and Alzheimer's disease: A 12-year prospective cohort study from the UK Biobank. ENVIRONMENTAL RESEARCH 2023; 226:115627. [PMID: 36894118 DOI: 10.1016/j.envres.2023.115627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/25/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION An increasing proportion of global population is exposed to urban densification in an aging society. However, little is known of the role of residential density and urbanicity on the risk of developing dementia including Alzheimer's disease. We examined long-term associations between residential density and urbanicity and risks of incident dementia and Alzheimer's disease. METHODS This prospective cohort study included participants from the UK Biobank who lived at the same residential address, had no self-reported neurological conditions and without dementia at baseline. Residential density was measured as the number of dwelling units within 1-km street neighbourhood of participant's home address. A composite index of urbanicity was developed from neighbourhood-level z-standardized densities of housing, retail, public transport and street centrality. Hazard ratios were derived from Cox proportional hazard models adjusted for known risk factors. RESULTS The analytic sample included 239,629 participants aged 38-72 years. During a median follow-up of 12.3 years (interquartile range 11.5-13.0 years), 2,176 participants developed dementia and 1,004 Alzheimer's disease. After adjustments for potential risk factors, each 1,000 units/Km2 increment in residential density was associated with higher risks of dementia (hazard ratio [HR]=1.10, 95% confidence interval [CI]: 1.06-1.15) and Alzheimer's disease (HR=1.10, 95% CI: 1.04-1.16). Consistently, categorical models showed that living in neighbourhoods of higher residential density and urbanicity were associated with higher risks of dementia (HR = 1.30, 95% CI: 1.12-1.51 for the highest density quintile compared to the lowest and HR = 1.21, 95% CI: 1.05-1.39 for the highest urbanicity quintile relative to the lowest). The associations were more pronounced in female, age >65 years, and among participants of the low income and those being frail and having shorter leucocyte telomere length (LTL). CONCLUSIONS Higher residential density and urbanicity was found to be positively associated with elevated risks of dementia and Alzheimer's disease. Optimizing neighbourhood residential density maybe one of the upstream considerations for mitigating against neurodegenerative diseases.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China; Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China
| | - Sarika Kumari
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China; Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China
| | - John E J Gallacher
- UK Dementias Platform, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China; Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China; UK Dementias Platform, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom.
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Sommerlad A, Kivimäki M, Larson EB, Röhr S, Shirai K, Singh-Manoux A, Livingston G. Social participation and risk of developing dementia. NATURE AGING 2023; 3:532-545. [PMID: 37202513 DOI: 10.1038/s43587-023-00387-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/22/2023] [Indexed: 05/20/2023]
Abstract
The increasing number of people with dementia globally illustrates the urgent need to reduce dementia's scale and impact. Lifetime social participation may affect dementia risk by increasing cognitive reserve, and through brain maintenance by reducing stress and improving cerebrovascular health. It may therefore have important implications for individual behavior and public health policy aimed at reducing dementia burden. Observational study evidence indicates that greater social participation in midlife and late life is associated with 30-50% lower subsequent dementia risk, although some of this may not be causal. Social participation interventions have led to improved cognition but, partly due to short follow-up and small numbers of participants, no reduction in risk of dementia. We summarize the evidence linking social participation with dementia, discuss potential mechanisms by which social participation is likely to reduce and mitigate the impact of neuropathology in the brain, and consider the implications for future clinical and policy dementia prevention interventions.
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Affiliation(s)
- Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK.
- Camden and Islington NHS Foundation Trust, London, UK.
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- University of Washington Schools of Medicine and Public Health, Seattle, WA, USA
| | - Susanne Röhr
- School of Psychology, Massey University, Manawatu, New Zealand
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Kokoro Shirai
- Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK
- Université Paris Cité, Inserm, U1153, Paris, France
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Lai KY, Webster C, Kumari S, Gallacher JEJ, Sarkar C. The associations of socioeconomic status with incident dementia and Alzheimer's disease are modified by leucocyte telomere length: a population-based cohort study. Sci Rep 2023; 13:6163. [PMID: 37061546 PMCID: PMC10105714 DOI: 10.1038/s41598-023-32974-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
Socio-economic status (SES) and biological aging are risk factors for dementia, including Alzheimer's disease, however, it is less clear if the associations with SES vary sufficiently across different biological age strata. We used data from 331,066 UK Biobank participants aged 38-73 with mean follow-up of 12 years to examine if associations between SES (assessed by educational attainment, employment status and household income) and dementia and Alzheimer's disease are modified by biological age (assessed by leucocyte telomere length: LTL). Diagnosis of events was ascertained through hospital admissions data. Cox regressions were used to estimate hazard ratios [HRs]. A consistent dose-response relationship was found, with participants in low SES and shorter LTL strata (double-exposed group) reporting 3.28 (95% confidence interval [CI] 2.57-4.20) and 3.44 (95% CI 2.35-5.04) times higher risks of incident dementia and Alzheimer's disease respectively, compared to those of high SES and longer LTL (least-exposed group). Of interest is a synergistic interaction between SES and LTL to increase risk of dementia (RERI 0.57, 95% CI 0.07-1.06) and Alzheimer's disease (RERI 0.79, 95% CI 0.02-1.56). Our findings that SES and biological age (LTL) are synergistic risk factors of dementia and Alzheimer's disease may suggest the need to target interventions among vulnerable sub-groups.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
| | - Sarika Kumari
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
| | - John E J Gallacher
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
- Department of Urban Planning and Design, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK.
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Soofi H, Forlini C. Psychedelic Research for Dementia Risks Perpetuating Structural Failures and Inadequacies in Aged Care. AJOB Neurosci 2023; 14:131-134. [PMID: 37097855 DOI: 10.1080/21507740.2023.2188291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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30
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Li Y, Yang Y, Zhao P, Wang J, Mi B, Zhao Y, Pei L, Yan H, Chen F. Longitudinal associations between specific types/amounts social contact and cognitive function among middle-aged and elderly Chinese: A causal inference and longitudinal targeted maximum likelihood estimation analysis. J Affect Disord 2023; 331:158-166. [PMID: 36963512 DOI: 10.1016/j.jad.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Social contact has demonstrated associations with cognitive function, while the literature on the effect of specific social relationship subdomains on cognitive function is limited. This study aimed to examine the causal effects of specific types/amounts of social contact on cognitive function among middle-aged and elderly Chinese. METHODS A total of 38,883 middle-aged and elderly adults from the China Health and Retirement Longitudinal Study were involved. Social contact in this study included interaction with families, taking care of grandchildren, interaction with friends, and participation in three types of social activities. We performed the linear mixed-effects model analysis with propensity score approach and the longitudinal targeted maximum likelihood-based estimation analysis after adjusting for potential covariates and confounders. RESULTS Interaction with families, caring for grandchildren, interaction with friends and participation in social activities were all associated with cognitive z-scores. Participants who interacted with families "2-3 times a week" and "once a week" versus "almost every day" had higher cognitive z-scores. Those who interacted with friends and participated in social activities "almost every week" versus "almost daily" had higher cognitive z-scores. LIMITATIONS The assessment of cognition was biased against people with poor education due to elements of language and mathematical testing, and against those with visual impairment. CONCLUSIONS Social contact was associated with better cognitive function among middle-aged and elderly Chinese. Social contact "1-3 times a week" was optimal for cognitive function. More social contact in middle-aged and elderly Chinese led to less cognitive decline in later life than in their inactive peers.
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Affiliation(s)
- Yemian Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Yuhui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Peng Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Jingxian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Yaling Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Leilei Pei
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Fangyao Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China; Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
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31
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Chen H, Young A, Oxtoby NP, Barkhof F, Alexander DC, Altmann A. Transferability of Alzheimer's disease progression subtypes to an independent population cohort. Neuroimage 2023; 271:120005. [PMID: 36907283 DOI: 10.1016/j.neuroimage.2023.120005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/22/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023] Open
Abstract
In the past, methods to subtype or biotype patients using brain imaging data have been developed. However, it is unclear whether and how these trained machine learning models can be successfully applied to population cohorts to study the genetic and lifestyle factors underpinning these subtypes. This work, using the Subtype and Stage Inference (SuStaIn) algorithm, examines the generalisability of data-driven Alzheimer's disease (AD) progression models. We first compared SuStaIn models trained separately on Alzheimer's disease neuroimaging initiative (ADNI) data and an AD-at-risk population constructed from the UK Biobank dataset. We further applied data harmonization techniques to remove cohort effects. Next, we built SuStaIn models on the harmonized datasets, which were then used to subtype and stage subjects in the other harmonized dataset. The first key finding is that three consistent atrophy subtypes were found in both datasets, which match the previously identified subtype progression patterns in AD: 'typical', 'cortical' and 'subcortical'. Next, the subtype agreement was further supported by high consistency in individuals' subtypes and stage assignment based on the different models: more than 92% of the subjects, with reliable subtype assignment in both ADNI and UK Biobank dataset, were assigned to an identical subtype under the model built on the different datasets. The successful transferability of AD atrophy progression subtypes across cohorts capturing different phases of disease development enabled further investigations of associations between AD atrophy subtypes and risk factors. Our study showed that (1) the average age is highest in the typical subtype and lowest in the subcortical subtype; (2) the typical subtype is associated with statistically more-AD-like cerebrospinal fluid biomarkers values in comparison to the other two subtypes; and (3) in comparison to the subcortical subtype, the cortical subtype subjects are more likely to associate with prescription of cholesterol and high blood pressure medications. In summary, we presented cross-cohort consistent recovery of AD atrophy subtypes, showing how the same subtypes arise even in cohorts capturing substantially different disease phases. Our study opened opportunities for future detailed investigations of atrophy subtypes with a broad range of early risk factors, which will potentially lead to a better understanding of the disease aetiology and the role of lifestyle and behaviour on AD.
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Affiliation(s)
- Hanyi Chen
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering and Department of Computer Science, University College London, UK
| | - Alexandra Young
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Neil P Oxtoby
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering and Department of Computer Science, University College London, UK
| | - Frederik Barkhof
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering and Department of Computer Science, University College London, UK; Queen Square Institute of Neurology, University College London, UK; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, The Netherlands
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering and Department of Computer Science, University College London, UK
| | - Andre Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering and Department of Computer Science, University College London, UK.
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32
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Luo M, Li LW. Within-Person Dynamics of Objective and Subjective Social Isolation in Midlife and Later Life. J Aging Health 2023; 35:182-190. [PMID: 35945654 DOI: 10.1177/08982643221118449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ObjectivesTo investigate the within-person dynamics of objective and subjective social isolation among U.S. middle-aged and older adults and to explore gender differences in this relationship. Methods: Four waves of data from the Health and Retirement Study (HRS, 2006-2018, N = 5437) and the multiple group random intercept cross-lagged panel model were used. Results: Within-person deviation in expected subjective isolation predicted deviation in expected objective isolation years later. No corresponding cross-lagged effect of objective isolation on subjective isolation was found. Gender differences were detected: the within-person cross-lagged positive effect of subjective isolation on objective isolation was significant for men but not for women. Discussion: This study provides evidence for a unidirectional relationship between subjective and objective isolation at the within-person level: higher than expected increase in subjective isolation predicts higher than expected increase in subsequent objective isolation. This within-person process is more salient in men than in women.
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Affiliation(s)
- Mengsha Luo
- Department of Sociology, 12377Zhejiang University, Hangzhou, China
| | - Lydia W Li
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
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33
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Ren Y, Savadlou A, Park S, Siska P, Epp JR, Sargin D. The impact of loneliness and social isolation on the development of cognitive decline and Alzheimer's Disease. Front Neuroendocrinol 2023; 69:101061. [PMID: 36758770 DOI: 10.1016/j.yfrne.2023.101061] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/19/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023]
Abstract
Alzheimer's Disease (AD) is the leading cause of dementia, observed at a higher incidence in women compared with men. Treatments aimed at improving pathology in AD remain ineffective to stop disease progression. This makes the detection of the early intervention strategies to reduce future disease risk extremely important. Isolation and loneliness have been identified among the major risk factors for AD. The increasing prevalence of both loneliness and AD emphasizes the urgent need to understand this association to inform treatment. Here we present a comprehensive review of both clinical and preclinical studies that investigated loneliness and social isolation as risk factors for AD. We discuss that understanding the mechanisms of how loneliness exacerbates cognitive impairment and AD with a focus on sex differences will shed the light for the underlying mechanisms regarding loneliness as a risk factor for AD and to develop effective prevention or treatment strategies.
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Affiliation(s)
- Yi Ren
- Department of Cell Biology and Anatomy, University of Calgary, Canada; Cumming School of Medicine, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada
| | - Aisouda Savadlou
- Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada
| | - Soobin Park
- Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada
| | - Paul Siska
- Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada
| | - Jonathan R Epp
- Department of Cell Biology and Anatomy, University of Calgary, Canada; Cumming School of Medicine, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada
| | - Derya Sargin
- Department of Psychology, University of Calgary, Canada; Department of Physiology & Pharmacology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada.
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34
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Feng L, Wang Y, Zeng D, Wang M, Duan X. Predictors of cognitive decline in older individuals without dementia: An updated meta-analysis. Ann Clin Transl Neurol 2023; 10:497-506. [PMID: 36705073 PMCID: PMC10109353 DOI: 10.1002/acn3.51740] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To evaluate the effect of overall peripheral inflammatory levels on cognitive function, we explored the relationship between established biomarkers of peripheral inflammation (circulating C-reactive protein [CRP], interleukin-6 [IL-6], and tumor necrosis factor-α [TNF-α]) and cognitive decline by performing a review of observational studies and creating an updated summary. METHODS We included literatures exploring the relationship between peripheral levels of CRP, IL-6, and TNF-α and subsequent cognitive decline, published until July 2022, by searching the following databases: PubMed, Embase, Web of Science, the Cochrane Library, ClinicalTrials, CNKI, and VIP databases. We used random-effects models to pool the odds ratios (ORs) for the risks of subsequent cognitive decline in older adults with high levels of peripheral inflammation. We initially screened out 501 literatures, of which only 17 were ultimately eligible. Overall, there were 19,516 older individuals included in our meta-analysis, and 2134 of them experienced subsequent cognitive change. RESULTS Individuals with high levels of peripheral inflammation may have 14% more chance to develop subsequent cognitive decline than those with low levels (OR = 1.14, 95% CI: 1.03-1.27; p < 0.00001). In the subgroup analysis, the incidence of cognitive decline was higher in individuals with high levels of IL-6. This study further demonstrates the link between systemic inflammation and cognitive status. INTERPRETATION Detecting CRP, IL-6, and TNF-α in peripheral blood is necessary, as they may become effective indicators for forthcoming cognitive performance.
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Affiliation(s)
- Lan Feng
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China.,Department of Anesthesiology, Southwest Medical University, Luzhou, China
| | - Yuhao Wang
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China.,Department of Anesthesiology, Southwest Medical University, Luzhou, China
| | - Daojun Zeng
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China.,Department of Anesthesiology, Southwest Medical University, Luzhou, China
| | - Maohua Wang
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China.,Department of Anesthesiology, Southwest Medical University, Luzhou, China
| | - Xiaoxia Duan
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China.,Department of Anesthesiology, Southwest Medical University, Luzhou, China
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35
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Fedurek P, Lacroix L, Aktipis A, Cronk L, Makambi J, Mabulla I, Lehmann J, Berbesque JC. Relationship between proximity and physiological stress levels in hunter-gatherers: The Hadza. Horm Behav 2023; 147:105294. [PMID: 36521419 DOI: 10.1016/j.yhbeh.2022.105294] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 11/02/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
In recent years there has been a great deal of documentation on how social relationships are related to various aspects of human wellbeing. However, until recently most studies investigating the effects of social relationships on wellbeing have applied social network measures to reported social contacts. Recent advances in the application of bio-loggers in biological studies have now made it possible to quantify social relationships based on in-person, rather than self-reported, social interactions. We used GPS-derived in-camp and out-of-camp proximity data to analyse how in-person proximity is related to Hair Cortisol Concentration (HCC) among Hadza hunter-gatherers. Time spent in close proximity to other camp members was associated with higher HCC, especially in women. In contrast, individuals who spent more time in close out-of-camp proximity to their best friend experienced lower HCC. Our study suggests that physiological costs related to group living might be mitigated by in-person interactions with close friends. We also find that the location (i.e., in-camp vs out-of-camp) of proximity to others and self-perceived friends is associated with HCC among the Hadza.
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Affiliation(s)
- Piotr Fedurek
- Anthropology Programme, University of Roehampton, London, UK; Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland.
| | - Laurent Lacroix
- Health Sciences Research Centre, University of Roehampton, London, UK
| | - Athena Aktipis
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Lee Cronk
- Department of Anthropology, Rutgers University, New Brunswick, NJ, USA
| | - Jerryson Makambi
- Mount Meru Tour Guide and International Language School, Arusha, Tanzania
| | | | - Julia Lehmann
- Anthropology Programme, University of Roehampton, London, UK
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36
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Bielak AAM, Gow AJ. A Decade Later on How to "Use It" So We Don't "Lose It": An Update on the Unanswered Questions about the Influence of Activity Participation on Cognitive Performance in Older Age. Gerontology 2023; 69:336-355. [PMID: 35709704 DOI: 10.1159/000524666] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 04/19/2022] [Indexed: 01/13/2023] Open
Abstract
Activity engagement is a modifiable factor that has been widely-cited as being good for the aging brain and cognition and represents a valuable target for reducing dementia risk. However, specific issues about activity engagement (mental, social, and physical) and cognition in older adulthood remain, and Bielak [Gerontology 2010;56: 507-519] reviewed seven major methodological and theoretical questions about this relationship. We present an updated reflection on these key questions, focusing on research published in the last 10 years. For some questions, a significant amount of work has been done and conclusions have become clearer; for others, there have been few additions to the literature and our knowledge remains much the same as it was a decade ago. We review the issues identified in the 2010 paper including the directionality and temporal nature of the relationship; whether specific activity domains offer different benefits to cognition and what domain(s) of cognition are affected; variation in the relation by age, gender, or education; potential mechanisms involved; and how activity engagement is assessed. For each, we present the most up-to-date research, discuss remaining challenges and possible future directions. This formal unifying of the information in the field is intended as a guide to support continued progress by spurring on studies addressing specific questions while reminding researchers of critical issues. We conclude with recommendations that future studies investigating the link between activity engagement and cognitive performance in adulthood should consider.
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Affiliation(s)
- Allison A M Bielak
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Alan J Gow
- Centre for Applied Behavioural Sciences and Department of Psychology, Heriot-Watt University, Edinburgh, UK
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37
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Marseglia A, Kalpouzos G, Laukka EJ, Maddock J, Patalay P, Wang HX, Bäckman L, Westman E, Welmer AK, Dekhtyar S. Social Health and Cognitive Change in Old Age: Role of Brain Reserve. Ann Neurol 2022; 93:844-855. [PMID: 36579809 DOI: 10.1002/ana.26591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Individual aspects of social health (SH; eg, network, engagement, support) have been linked to cognitive health. However, their combined effect and the role of the structural properties of the brain (brain reserve [BR]) remain unclear. We investigated the interplay of SH and BR on cognitive change in older adults. METHODS Within the Swedish National Study on Aging and Care-Kungsholmen, 368 dementia-free adults aged ≥60 years with baseline brain magnetic resonance imaging were followed over 12 years to assess cognitive change. A measure of global cognition was computed at each of the 5 waves of assessment by averaging domain-specific Z scores for episodic memory, perceptual speed, semantic memory, and letter and category fluency. An SH composite score was computed at baseline by combining leisure activities and social network. BR was proxied by total brain tissue volume (TBTV). Linear mixed models (adjusted for sociodemographic, vascular, and genetic factors) were used to estimate cognitive trajectories in relation to SH and TBTV. Interaction analysis and stratification were used to examine the interplay between SH and TBTV. RESULTS Moderate-good SH (n = 245; vs poor, β-slope = 0.01, 95% confidence interval [CI] = 0.002-0.02, p = 0.018) and moderate-to-large TBTV (n = 245; vs small, β-slope = 0.03, 95% CI = 0.02-0.04, p < 0.001) were separately associated with slower cognitive decline. In stratified analysis, moderate-good SH was associated with higher cognitive levels (but not change) only in participants with moderate-to-large TBTV (β-intercept = 0.21, 95% CI = 0.06-0.37, p < 0.01; interaction SH * TBTV, p < 0.05). INTERPRETATION Our findings highlight the interplay between SH and BR that likely unfolds throughout the entire life course to shape old-age cognitive outcomes. ANN NEUROL 2023.
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Affiliation(s)
- Anna Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Grégoria Kalpouzos
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Jane Maddock
- Medical Research Council Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London, UK
| | - Praveetha Patalay
- Medical Research Council Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London, UK.,Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Hui-Xin Wang
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
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Tsai FJ, Shen SW. Concepts of dementia prevention in the health promotion among older adults: A narrative review. Medicine (Baltimore) 2022; 101:e32172. [PMID: 36550862 PMCID: PMC9771271 DOI: 10.1097/md.0000000000032172] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The number of older adults with dementia is predicted to markedly increase in the coming decades. A person suffers from dementia every 3 seconds globally, and one out of every 7 people suffers from dementia in Taiwan. The purpose of this narrative review is to integrate existing concepts of dementia prevention into health promotion and improve older adults' quality of life. This narrative review was performed using the PubMed database by searching for basic research and systematic reviews on dementia prevention and health promotion among older adults. We established a framework for dementia prevention and health promotion with regard to the physical, mental, spiritual, and social health aspects. We identified the following strategies related to older adults towards dementia prevention and health promotion in follows: Physical health promotion: cognitive activities, physical activities, body mass index, balanced diet, rainbow diet, Mediterranean diet, dietary approaches to stop hypertension diet, mind diet, no smoking and drinking, avoiding the "three highs" (i.e., hyperglycemia, hyperlipidemia, and hypertension), and head trauma; Mental health promotion: Positive thinking, Brief Symptom Rating Scale (BSRS-5), depression scale, and ascertained dementia 8 questionnaire (AD8) screening; Spiritual health promotion: religious beliefs, spiritual music, meditative activities, mindfulness, yoga, Qi-gong, Tai-chi, and Baduanjin; and Social health promotion: A supportive family system, socialization, social support, social networks, social interaction, and social participation. The conclusion of this narrative review was to integrate the concepts of dementia prevention and health promotion among older adults.
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Affiliation(s)
- Fu-Ju Tsai
- Department of Nursing, Fooyin University, Taiwan R.O.C
| | - Sheng-Wei Shen
- Department of Neurology, Pingtung Hospital, Ministry of Health and Welfare, Taiwan, R.O.C
- * Correspondence: Sheng-Wei Shen, 270, Ziyou Rd., Pingtung City, Pingtung County 900, Taiwan R.O.C. (e-mail: )
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Li X, Zhang J, Hou R, Zheng M, Singh M, Li H, Li C, Zhang X, Yang X, Wu L, Wang Y, Zheng D. Bidirectional associations of intellectual and social activities with cognitive function among middle-aged and elderly adults in China. J Affect Disord 2022; 319:83-89. [PMID: 36116603 DOI: 10.1016/j.jad.2022.09.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies evaluating the association between leisure activities and cognitive function produced conflicting results. Different types of leisure activities may have different effects on cognition, and very few studies have explored their bidirectional associations. Our study aimed to explore whether intellectual and social activities had bidirectional associations with cognitive function among the middle-aged and elderly adults in China. METHODS Data was derived from the China Health and Retirement Longitudinal Study. The data in this study were based on 11,549 participants aged 45 or older whose intellectual and social activities and cognitive function were assessed at baseline. Cross-lagged panel model was used to examine the temporal relationship of intellectual and social activities with cognitive function. RESULTS Totally, 5624 participants completed the third follow-up in 2018. The results showed that the better the cognitive function they had at baseline, the more intellectual activities they were engage in (β = 0.044, P < 0.001) and vice versa (β = 0.042, P = 0.001). Additionally, better cognitive function at baseline was significantly associated with more engagement in social activities (β = 0.028, P = 0.030); in contrast, higher engagement in social activities at baseline was not related to better cognitive function (β = -0.008, P = 0.523). LIMITATIONS Engagement in social and intellectual activities was assessed via questionnaire. CONCLUSIONS Our findings indicated that there was a bidirectional relationship between intellectual activities and cognitive function. However, participation in social activities did not slow down the decline in cognitive function. Participating in intellectual activities, compared to social activities, is especially beneficial for cognitive function.
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Affiliation(s)
- Xiaochun Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jiajia Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Rui Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Manqi Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Manjot Singh
- Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, University of Western Australia, Crawley, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Haibin Li
- Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Xiaoyu Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Xinghua Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Lijuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
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Association between loneliness and its components and cognitive function among older Chinese adults living in nursing homes: A mediation of depressive symptoms, anxiety symptoms, and sleep disturbances. BMC Geriatr 2022; 22:959. [PMID: 36514018 PMCID: PMC9746079 DOI: 10.1186/s12877-022-03661-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the associations between loneliness and its components and cognitive function among older Chinese adults living in nursing homes and to test whether depressive symptoms, anxiety symptoms, and sleep disturbances mediate these associations. METHODS The sample comprised 228 Chinese individuals aged ≥ 65 years living in nursing homes who were free of dementia and psychiatric or serious somatic diseases. Loneliness was evaluated using the UCLA Loneliness Scale. Global cognitive function was assessed using the Beijing version of the Montreal Cognitive Assessment. Multivariable linear regression analyses were performed to examine the associations between loneliness and its components and global cognitive function. A mediation analysis was used to test the potential mediating effects of depressive symptoms, anxiety symptoms, and sleep disturbances. RESULTS The mean (SD) age of the participants was 80.8 (6.3) years, and 58.3% were women. Compared with the lowest quartile of loneliness degree, the multivariable-adjusted beta coefficient (95% confidence interval [95% CI]) for the highest quartile was -1.32 (-2.61 to -0.02) (P for trend = 0.03). Loneliness components, personal feelings of isolation and the lack of relational connectedness but not the lack of collective connectedness, were also inversely associated with cognitive function. Significant indirect effects on cognitive function were observed for loneliness and its two components (personal feelings of isolation and the lack of relational connectedness) in mediating pathways via depressive symptoms, anxiety symptoms, and sleep disturbances (all p < 0.05). CONCLUSIONS A higher degree of loneliness and its two components, personal feelings of isolation and the lack of relational connectedness, are associated with worse cognitive function among Chinese residents in nursing homes. Depressive symptoms, anxiety symptoms, and sleep disturbances may at least partially mediate these associations.
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The Molecular Effects of Environmental Enrichment on Alzheimer's Disease. Mol Neurobiol 2022; 59:7095-7118. [PMID: 36083518 PMCID: PMC9616781 DOI: 10.1007/s12035-022-03016-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022]
Abstract
Environmental enrichment (EE) is an environmental paradigm encompassing sensory, cognitive, and physical stimulation at a heightened level. Previous studies have reported the beneficial effects of EE in the brain, particularly in the hippocampus. EE improves cognitive function as well as ameliorates depressive and anxiety-like behaviors, making it a potentially effective neuroprotective strategy against neurodegenerative diseases such as Alzheimer's disease (AD). Here, we summarize the current evidence for EE as a neuroprotective strategy as well as the potential molecular pathways that can explain the effects of EE from a biochemical perspective using animal models. The effectiveness of EE in enhancing brain activity against neurodegeneration is explored with a view to differences present in early and late life EE exposure, with its potential application in human being discussed. We discuss EE as one of the non pharmacological approaches in preventing or delaying the onset of AD for future research.
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Wang B, Wang N, Sun Y, Tan X, Zhang J, Lu Y. Association of Combined Healthy Lifestyle Factors With Incident Dementia in Patients With Type 2 Diabetes. Neurology 2022; 99:e2336-e2345. [PMID: 36104282 DOI: 10.1212/wnl.0000000000201231] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Type 2 diabetes and lifestyle factors have been associated with dementia risk, but the effect of a healthy lifestyle on diabetes-related dementia remains largely unknown. We aimed to investigate whether the increased risk of dementia among individuals with diabetes can be offset by a broad combination of healthy lifestyle factors. METHODS This prospective study used data from the UK Biobank cohort. An overall lifestyle score ranging from 0 to 7 was created, with 1 point for each of the 7 healthy lifestyle factors: no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, adequate sleep duration, less sedentary behavior, and frequent social contact. Incident dementia was ascertained using linkage with electronic health records. Cox proportional hazards models were used to examine the associations between diabetes, healthy lifestyle score, and dementia incidence. RESULTS We included 167,946 participants aged 60 years or older without dementia at baseline (mean age 64.1 [SD 2.8] years, 51.7% female). During a median follow-up of 12.3 years, 4,351 developed all-cause dementia. Participants with diabetes, but not those with prediabetes, showed a higher risk of dementia than those with normoglycemia. Compared with diabetes-free participants who had a lifestyle score of 7, the hazard ratios (HRs) for dementia were 4.01 (95% CI 3.06-5.25) and 1.74 (95% CI 1.11-2.72) for those with diabetes who had a lifestyle score of 0-2 and 7, respectively. Among participants with diabetes, the HR for dementia comparing a lifestyle score of 7 vs 0-2 was 0.46 (95% CI 0.28-0.75). This finding corresponded to a reduction in the 10-year absolute risk of dementia from 5.22% (95% CI 3.94%-6.73%) to 1.72% (95% CI 0.92%-2.97%). The association between higher lifestyle score and lower dementia risk was independent of glycemic control and diabetes medication. DISCUSSION Adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of dementia among participants with diabetes. Behavioral lifestyle modification through multifactorial approaches should be a priority for prevention and delayed onset of dementia in patients with diabetes.
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Affiliation(s)
- Bin Wang
- From the Institute and Department of Endocrinology and Metabolism (B.W., Y.S., N.W., Y.L.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Neuroscience (X.T.), Uppsala University, Sweden; Department of Clinical Neuroscience (X.T.), Karolinska Institutet, Sweden; and Guangdong Mental Health Center (J.Z.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ningjian Wang
- From the Institute and Department of Endocrinology and Metabolism (B.W., Y.S., N.W., Y.L.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Neuroscience (X.T.), Uppsala University, Sweden; Department of Clinical Neuroscience (X.T.), Karolinska Institutet, Sweden; and Guangdong Mental Health Center (J.Z.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying Sun
- From the Institute and Department of Endocrinology and Metabolism (B.W., Y.S., N.W., Y.L.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Neuroscience (X.T.), Uppsala University, Sweden; Department of Clinical Neuroscience (X.T.), Karolinska Institutet, Sweden; and Guangdong Mental Health Center (J.Z.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiao Tan
- From the Institute and Department of Endocrinology and Metabolism (B.W., Y.S., N.W., Y.L.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Neuroscience (X.T.), Uppsala University, Sweden; Department of Clinical Neuroscience (X.T.), Karolinska Institutet, Sweden; and Guangdong Mental Health Center (J.Z.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jihui Zhang
- From the Institute and Department of Endocrinology and Metabolism (B.W., Y.S., N.W., Y.L.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Neuroscience (X.T.), Uppsala University, Sweden; Department of Clinical Neuroscience (X.T.), Karolinska Institutet, Sweden; and Guangdong Mental Health Center (J.Z.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yingli Lu
- From the Institute and Department of Endocrinology and Metabolism (B.W., Y.S., N.W., Y.L.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Neuroscience (X.T.), Uppsala University, Sweden; Department of Clinical Neuroscience (X.T.), Karolinska Institutet, Sweden; and Guangdong Mental Health Center (J.Z.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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Drinkwater E, Davies C, Spires-Jones TL. Potential neurobiological links between social isolation and Alzheimer's disease risk. Eur J Neurosci 2022; 56:5397-5412. [PMID: 34184343 DOI: 10.1111/ejn.15373] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022]
Abstract
It is estimated that 40% of dementia cases could be prevented by modification of lifestyle factors that associate with disease risk. One of these potentially modifiable lifestyle factors is social isolation. In this review, we discuss what is known about associations between social isolation and Alzheimer's disease, the most common cause of dementia. This is particularly relevant in the time of the COVID-19 pandemic when social isolation has been enforced with potential emerging negative impacts on cognition. While there are neurobiological mechanisms emerging that may account for the observed epidemiological associations between social isolation and Alzheimer's disease, more fundamental research is needed to fully understand the brain changes induced by isolation that may make people vulnerable to disease.
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Affiliation(s)
| | - Caitlin Davies
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, UK.,Translational Neuroscience PhD Programme, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Tara L Spires-Jones
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
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Comon M, Rouch I, Edjolo A, Padovan C, Krolak-Salmon P, Dorey JM. Impaired Facial Emotion Recognition and Gaze Direction Detection in Mild Alzheimer's Disease: Results from the PACO Study. J Alzheimers Dis 2022; 89:1427-1437. [PMID: 36057821 DOI: 10.3233/jad-220401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Facial emotion recognition (FER) and gaze direction (GD) identification are core components of social cognition, possibly impaired in many psychiatric or neurological conditions. Regarding Alzheimer's disease (AD), current knowledge is controversial. OBJECTIVE The aim of this study was to explore FER and GD identification in mild AD compared to healthy controls. METHODS 180 participants with mild AD drawn from the PACO study and 74 healthy elderly controls were enrolled. Participants were asked to complete three socio-cognitive tasks: face sex identification, recognition of facial emotions (fear, happiness, anger, disgust) expressed at different intensities, and GD discrimination. Multivariate analyses were conducted to compare AD participants and healthy controls. RESULTS Sex recognition was preserved. GD determination for subtle deviations was impaired in AD. Recognition of prototypically expressed facial emotions was preserved while recognition of degraded facial emotions was impacted in AD participants compared to controls. Use of multivariate analysis suggested significant alteration of low-expressed fear and disgust recognition in the AD group. CONCLUSION Our results showed emotion recognition and GD identification in patients with early-stage AD compared to elderly controls. These impairments could be the object of specific therapeutic interventions such as social cognition remediation or raising awareness of primary caregivers to improve the quality of life of patients with early AD.
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Affiliation(s)
- Martin Comon
- Aging Psychiatry Unit, University Hospital Le Vinatier, Bron, France
| | - Isabelle Rouch
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, University Hospital of Saint Etienne, Saint-Etienne, France.,INSERM U 1219, Bordeaux Population Health Center, University of Bordeaux, France
| | - Arlette Edjolo
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, University Hospital of Saint Etienne, Saint-Etienne, France.,INSERM U 1219, Bordeaux Population Health Center, University of Bordeaux, France
| | - Catherine Padovan
- Aging Psychiatry Unit, University Hospital Le Vinatier, Bron, France
| | - Pierre Krolak-Salmon
- Memory Clinical and Research Center of Lyon (CMRR), Aging Institute I-Vie, University Hospital of Lyon, Villeurbanne, France.,Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France
| | - Jean-Michel Dorey
- Aging Psychiatry Unit, University Hospital Le Vinatier, Bron, France.,Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France
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Zhu J, Ge F, Zeng Y, Qu Y, Chen W, Yang H, Yang L, Fang F, Song H. Physical and Mental Activity, Disease Susceptibility, and Risk of Dementia: A Prospective Cohort Study Based on UK Biobank. Neurology 2022; 99:e799-e813. [PMID: 35896434 PMCID: PMC9484730 DOI: 10.1212/wnl.0000000000200701] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The association between patterns of physical/mental activity and dementia and how it is affected by disease susceptibility remains unknown. We aimed to examine the association between patterns of physical and mental activity and dementia and whether it can be modified by disease susceptibility to dementia. METHODS In a prospective cohort study based on UK Biobank, 501,376 dementia-free participants were recruited in 2006-2010 and followed from 1 year after the recruitment date until the end of 2019 for ascertainment of dementia. Data on physical (i.e., physical activity at leisure time, housework-related activity, and transportation) and mental (i.e., intelligence, social contact, and use of electronic device) activity were collected using questionnaires at recruitment. Cox models were used to estimate the associations of physical and mental activity-related items, as well as major activity patterns identified by principal component analysis, with the risk of dementia, adjusted for multiple confounders. The modification role of disease susceptibility on such associations was assessed through stratified analyses by the polygenic risk score (PRS) of dementia generated based on summary statistics of independent genome-wide association studies, by the APOE genotype, and by the self-reported family history of dementia. RESULTS The mean age at recruitment was 56.53, and 45.60% of the participants were male. During a mean follow-up of 10.66 years, 5,185 dementia cases were identified. When analyzed separately, multiple studied items related to physical and mental activity showed significant associations with the risk of dementia. The pattern analyses revealed that a higher level of adherence to activity patterns related to frequent vigorous and other exercises (hazard ratio 0.65, 95% CI 0.59-0.71), housework-related activity (0.79, 0.72-0.85), and friend/family visit (0.85, 0.75-0.96) was associated with a lower risk of dementia. We obtained comparable results for vascular dementia and Alzheimer disease as well as in the stratified analyses by the PRS for dementia, APOE genotype, or family history of dementia. DISCUSSION Activity patterns more adherent to frequent vigorous and other exercises, housework-related activity, and friend/family visit were associated with a reduced risk of multiple types of dementia. Such associations are independent of disease susceptibility, highlighting the potential of these physical and mental activity patterns, as effective interventions, in the primary prevention of dementia.
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Affiliation(s)
- Jianwei Zhu
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Fenfen Ge
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Yu Zeng
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Yuanyuan Qu
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Wenwen Chen
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Huazhen Yang
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Lei Yang
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Fang Fang
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Huan Song
- Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
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Chang YK, Erickson KI, Aghjayan SL, Chen FT, Li RH, Shih JR, Chang SH, Huang CM, Chu CH. The multi-domain exercise intervention for memory and brain function in late middle-aged and older adults at risk for Alzheimer's disease: A protocol for Western-Eastern Brain Fitness Integration Training trial. Front Aging Neurosci 2022; 14:929789. [PMID: 36062144 PMCID: PMC9435311 DOI: 10.3389/fnagi.2022.929789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Aging is associated with cognitive decline, increased risk for dementia, and deterioration of brain function. Modifiable lifestyle factors (e.g., exercise, meditation, and social interaction) have been proposed to benefit memory and brain function. However, previous studies have focused on a single exercise modality or a single lifestyle factor. Consequently, the effect of a more comprehensive exercise program that combines multiple exercise modalities and lifestyle factors, as well as examines potential mediators and moderators, on cognitive function and brain health in late middle-aged and older adults remains understudied. This study's primary aim is to examine the effect of a multi-domain exercise intervention on memory and brain function in cognitively healthy late middle-aged and older adults. In addition, we will examine whether apolipoprotein E (ApoE) genotypes, physical fitness (i.e., cardiovascular fitness, body composition, muscular fitness, flexibility, balance, and power), and brain-derived neurotrophic factor (BDNF) moderate and mediate the exercise intervention effects on memory and brain function. Methods The Western-Eastern Brain Fitness Integration Training (WE-BFit) is a single-blinded, double-arm, 6-month randomized controlled trial. One hundred cognitively healthy adults, aged 45-70 years, with different risks for Alzheimer's disease (i.e., ApoE genotype) will be recruited and randomized into either a multi-domain exercise group or an online educational course control group. The exercise intervention consists of one 90-min on-site and several online sessions up to 60 min per week for 6 months. Working memory, episodic memory, physical fitness, and BDNF will be assessed before and after the 6-month intervention. The effects of the WE-BFit on memory and brain function will be described and analyzed. We will further examine how ApoE genotype and changes in physical fitness and BDNF affect the effects of the intervention. Discussion WE-BFit is designed to improve memory and brain function using a multi-domain exercise intervention. The results will provide insight into the implementation of an exercise intervention with multiple domains to preserve memory and brain function in adults with genetic risk levels for Alzheimer's disease. Clinical trial registration ClinicalTrials.gov, identifier: NCT05068271.
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Affiliation(s)
- Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Sarah L. Aghjayan
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Feng-Tzu Chen
- Department of Sport Medicine, China Medical University, Taichung, Taiwan
| | - Ruei-Hong Li
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Jia-Ru Shih
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Shao-Hsi Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chien-Heng Chu
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
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Amelianchik A, Sweetland-Martin L, Norris EH. The effect of dietary fat consumption on Alzheimer's disease pathogenesis in mouse models. Transl Psychiatry 2022; 12:293. [PMID: 35869065 PMCID: PMC9307654 DOI: 10.1038/s41398-022-02067-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Alzheimer's disease (AD) is a fatal cognitive disorder with proteinaceous brain deposits, neuroinflammation, cerebrovascular dysfunction, and extensive neuronal loss over time. AD is a multifactorial disease, and lifestyle factors, including diet, are likely associated with the development of AD pathology. Since obesity and diabetes are recognized as risk factors for AD, it might be predicted that a high-fat diet (HFD) would worsen AD pathology. However, modeling HFD-induced obesity in AD animal models has yielded inconclusive results. Some studies report a deleterious effect of HFD on Aβ accumulation, neuroinflammation, and cognitive function, while others report that HFD worsens memory without affecting AD brain pathology. Moreover, several studies report no major effect of HFD on AD-related phenotypes in mice, while other studies show that HFD might, in fact, be protective. The lack of a clear association between dietary fat consumption and AD-related pathology and cognitive function in AD mouse models might be explained by experimental variations, including AD mouse model, sex and age of the animals, composition of the HFD, and timeline of HFD consumption. In this review, we summarize recent studies that aimed at elucidating the effect of HFD-induced obesity on AD-related pathology in mice and provide an overview of the factors that may have contributed to the results reported in these studies. Based on the heterogeneity of these animal model studies and given that the human population itself is quite disparate, it is likely that people will benefit most from individualized nutritional plans based on their medical history and clinical profiles.
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Affiliation(s)
- Anna Amelianchik
- Patricia and John Rosenwald Laboratory of Neurobiology & Genetics, The Rockefeller University, 1230 York Avenue, New York, NY, USA
| | - Lauren Sweetland-Martin
- Patricia and John Rosenwald Laboratory of Neurobiology & Genetics, The Rockefeller University, 1230 York Avenue, New York, NY, USA
| | - Erin H Norris
- Patricia and John Rosenwald Laboratory of Neurobiology & Genetics, The Rockefeller University, 1230 York Avenue, New York, NY, USA.
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Shen C, Rolls ET, Cheng W, Kang J, Dong G, Xie C, Zhao XM, Sahakian BJ, Feng J. Associations of Social Isolation and Loneliness With Later Dementia. Neurology 2022; 99:e164-e175. [PMID: 35676089 DOI: 10.1212/wnl.0000000000200583] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/08/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the independent associations of social isolation and loneliness with incident dementia and to explore the potential neurobiological mechanisms. METHODS We utilized the UK Biobank cohort to establish Cox proportional hazard models with social isolation and loneliness as separate exposures. Demographic (sex, age, and ethnicity), socioeconomic (education level, household income, and Townsend deprivation index), biological (body mass index, APOE genotype, diabetes, cancer, cardiovascular disease, and other), cognitive (speed of processing and visual memory), behavioral (current smoker, alcohol intake, and physical activity), and psychological (social isolation or loneliness, depressive symptoms, and neuroticism) factors measured at baseline were adjusted. Then, voxel-wise brainwide association analyses were used to identify gray matter volumes (GMVs) associated with social isolation and with loneliness. Partial least squares regression was performed to test the spatial correlation of GMV differences and gene expression using the Allen Human Brain Atlas. RESULTS We included 462,619 participants (mean age at baseline 57.0 years [SD 8.1]). With a mean follow-up of 11.7 years (SD 1.7), 4,998 developed all-cause dementia. Social isolation was associated with a 1.26-fold increased risk of dementia (95% CI, 1.15-1.37) independently of various risk factors including loneliness and depression (i.e., full adjustment). However, the fully adjusted hazard ratio for dementia related to loneliness was 1.04 (95% CI, 0.94-1.16) and 75% of this relationship was attributable to depressive symptoms. Structural MRI data were obtained from 32,263 participants (mean age 63.5 years [SD 7.5]). Socially isolated individuals had lower GMVs in temporal, frontal, and other (e.g., hippocampal) regions. Mediation analysis showed that the identified GMVs partly mediated the association between social isolation at baseline and cognitive function at follow-up. Social isolation-related lower GMVs were related to underexpression of genes that are downregulated in Alzheimer disease and to genes that are involved in mitochondrial dysfunction and oxidative phosphorylation. DISCUSSION Social isolation is a risk factor for dementia that is independent of loneliness and many other covariates. Social isolation-related brain structural differences coupled with different molecular functions also support the associations of social isolation with cognition and dementia. Social isolation may thus be an early indicator of an increased risk of dementia.
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Affiliation(s)
- Chun Shen
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Edmund T Rolls
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Wei Cheng
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Jujiao Kang
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Guiying Dong
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Chao Xie
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Xing-Ming Zhao
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Barbara J Sahakian
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China
| | - Jianfeng Feng
- From the Institute of Science and Technology for Brain-Inspired Intelligence (C.S., W.C., J.K., G.D., C.X., X.-M.Z., B.S., J.F.), Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education (C.S., G.D., C.X., X.-M.Z., J.F.), Shanghai Center for Mathematical Sciences (J.K.), and MOE Frontiers Center for Brain Science (X.-M.Z., J.F.), Fudan University, Shanghai, China; Department of Computer Science (E.R., J.F.), University of Warwick, Coventry; Oxford Centre for Computational Neuroscience (E.R.); Behavioural and Clinical Neuroscience Institute (B.S.) and Department of Psychiatry (B.S.), University of Cambridge, UK; and Zhangjiang Fudan International Innovation Center (J.F.), Shanghai, China.
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Wang Y, Shirai K, Ohira T, Hirosaki M, Kondo N, Takeuchi K, Yamaguchi C, Tamada Y, Kondo K, Cadar D, Iso H. Occasions for laughter and dementia risk: Findings from a six-year cohort study. Geriatr Gerontol Int 2022; 22:392-398. [PMID: 35289045 DOI: 10.1111/ggi.14371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/10/2022] [Accepted: 02/19/2022] [Indexed: 11/28/2022]
Abstract
AIM Currently, there is little evidence on the relationship between laughter and the risk of dementia, and since laughter is mainly a social behavior, we aimed to examine the association between various occasions for laughter and the risk of dementia in Japanese older adults. METHODS We draw upon 6-year follow-up data from the Japan Gerontological Evaluation Study, including 12 165 independent older adults aged 65 years or over. Occasions for laughter were assessed using a questionnaire, while dementia was diagnosed using the standardized dementia scale of the long-term care insurance system in Japan. Cox proportional hazards models were estimated, yielding hazard ratios and 95% confidence intervals (CIs). RESULTS The multivariable hazard ratio of dementia incidence for all participants in the groups for high versus low variety of occasions for laughter was 0.84 (95% CI: 0.72-0.98, P for trend <0.001). A greater variety of occasions for laughter was associated with a lower risk of dementia 0.78 (95% CI: 0.63-0.96, P for trend <0.001) among women, but was less pronounced for men, with significant associations only for the medium group. Laughing during conversations with friends, communicating with children or grandchildren, and listening to the radio were primarily associated with decreased risk. CONCLUSION A greater variety of laughter occasions in individual and social settings was associated with a reduced risk of dementia. Geriatr Gerontol Int 2022; 22: 392-398.
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Affiliation(s)
- Yu Wang
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mayumi Hirosaki
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Division of Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Chikae Yamaguchi
- Department of Community Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Dorina Cadar
- Department of Behavioural Science and Health, University College London, London, UK.,Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
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50
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Levene T, Livingston G, Banerjee S, Sommerlad A. Minimum clinically important difference of the Social Functioning in Dementia Scale (SF-DEM): cross-sectional study and Delphi survey. BMJ Open 2022; 12:e058252. [PMID: 35351729 PMCID: PMC8966522 DOI: 10.1136/bmjopen-2021-058252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Good social functioning is important for people living with dementia and their families. The Social Functioning in Dementia Scale (SF-DEM) is a valid and reliable instrument measuring social functioning in dementia. However the minimum clinically important difference (MCID) has not yet been derived for SF-DEM. This study aims to define the MCID for the SF-DEM. DESIGN We used triangulation, incorporating data from a cross-sectional study to calculate the MCID using distribution-based and anchor-based methods, and a Delphi survey. SETTING AND PARTICIPANTS The cross-sectional survey comprised 299 family carers of people with dementia. Twenty dementia experts (researchers, clinicians, family carers) rated whether changes on clinical vignettes represented a meaningful change in the Delphi survey. PRIMARY OUTCOME MEASURES We calculated the distribution-based MCID as 0.5 of an SD for each of the three SF-DEM domains (1-spending time with others, 2-communicating with others, 3-sensitivity to others). We used the carers' rating of social functioning to calculate the anchor-based MCID. For the Delphi survey, we defined consensus as ≥75% agreement. Where there was lack of consensus, experts were asked to complete a further survey round. RESULTS We found that 0.5 SD of SF-DEM was 1.9 points, 2.2 and 1.4 points in domains 1, 2 and 3, respectively. Using the anchoring analysis, the MCIDs were 1.7 points, 1.7 points, and 0.9 points in domains 1, 2 and 3, respectively. The Delphi method required two rounds. In the second round, a consensus was reached that a 2-point change was considered significant in all three domains, but no consensus was reached on a 1-point change. CONCLUSIONS By triangulating all three methods, the SF-DEM's MCIDs were 1.9, 2.0 and 1.4 points for domains 1, 2 and 3, respectively. For individuals, these values should be rounded to a 2-point change for each domain.
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Affiliation(s)
- Tamara Levene
- Division of Psychiatry, University College London, London, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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