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Rusher A, Araka E, Ananthakrishnan AN, Ritchie C, Kochar B. IBD Is Like a Tree: Reflections From Older Adults With Inflammatory Bowel Disease. Inflamm Bowel Dis 2024:izae139. [PMID: 38934627 DOI: 10.1093/ibd/izae139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Despite the growing proportion of older adults with inflammatory bowel disease (IBD), their lived experience is not well understood. IBD literature is generally focused on younger adults, and few studies are qualitative. Older adults may report well-being differently than younger adults, so it is important that we learn about their goals and priorities with a chronic disease. OBJECTIVE The study sought to understand the lived experience of older adults with IBD and explore their perceptions and priorities. METHODS We conducted in-depth interviews with patients ≥60 years of age with IBD to evaluate the impact and perception of IBD in the context their overall health and life. We used a hybrid inductive-deductive thematic analysis of our transcripts to identify underlying patterns. RESULTS We achieved thematic saturation after 22 interviews. We produced 4 major themes: (1) having IBD at an older age, (2) financial ramifications of IBD at an older age, (3) expectations for a meaningful life, and (4) unmet needs. Prominent subthemes included (1) ageism, loss of autonomy, and barriers to healthcare; (2) retirement and insurance issues; (3) redefining quality of life and gratitude; and (4) social isolation and navigating daily life with IBD. CONCLUSIONS Having IBD later in life presents unique challenges. Physicians treating older patients should consider age-sensitive communication, susceptibility to social isolation, and practices for healthy aging in the context of IBD. Patient priorities for further investigation include more representation in the media and educational material tailored for older adults with IBD.
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Affiliation(s)
- Alison Rusher
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth Araka
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Ashwin N Ananthakrishnan
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
- The Mongan Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christine Ritchie
- The Mongan Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Bharati Kochar
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
- The Mongan Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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2
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Abramowitz A, Weber M. Management of MCI in the Outpatient Setting. Curr Psychiatry Rep 2024:10.1007/s11920-024-01514-3. [PMID: 38856858 DOI: 10.1007/s11920-024-01514-3] [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] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE OF REVIEW We review current literature related to the clinical assessment of Mild Cognitive Impairment (MCI). We compile recommendations related to the evaluation of MCI and examine literature regarding the use of clinical biomarkers in this assessment, the role of non-pharmacologic therapy in the prevention of cognitive decline, and recent approval of anti-amyloid therapy in the treatment of MCI. RECENT FINDINGS The role of imaging and plasma biomarkers in the clinical assessment of MCI has expanded. There is data that non-pharmacologic therapy may have a role in the prevention of neurocognitive decline. Anti-amyloid therapies have recently been approved for clinical use. Clinical assessment of MCI remains multifactorial and includes screening and treating for underlying psychiatric and medical co-morbidities. The use of biomarkers in clinical settings is expanding with the rise of anti-amyloid therapies. These new diagnostics and therapeutics require nuanced discussion of risks and benefits. Psychiatrist's skillset is uniquely suited for these complex evaluations.
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Affiliation(s)
- Amy Abramowitz
- UNC School of Medicine and UNC Hospitals, Chapel Hill, NC, USA.
| | - Michael Weber
- UNC School of Medicine and UNC Hospitals, Chapel Hill, NC, USA
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Bhugra D, Liebrenz M, Ventriglio A, Ng R, Javed A, Kar A, Chumakov E, Moura H, Tolentino E, Gupta S, Ruiz R, Okasha T, Chisolm MS, Castaldelli-Maia J, Torales J, Smith A. World Psychiatric Association-Asian Journal of Psychiatry Commission on Public Mental Health. Asian J Psychiatr 2024; 98:104105. [PMID: 38861790 DOI: 10.1016/j.ajp.2024.104105] [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: 11/02/2023] [Revised: 04/22/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
Although there is considerable evidence showing that the prevention of mental illnesses and adverse outcomes and mental health promotion can help people lead better and more functional lives, public mental health remains overlooked in the broader contexts of psychiatry and public health. Likewise, in undergraduate and postgraduate medical curricula, prevention and mental health promotion have often been ignored. However, there has been a recent increase in interest in public mental health, including an emphasis on the prevention of psychiatric disorders and improving individual and community wellbeing to support life trajectories, from childhood through to adulthood and into older age. These lifespan approaches have significant potential to reduce the onset of mental illnesses and the related burdens for the individual and communities, as well as mitigating social, economic, and political costs. Informed by principles of social justice and respect for human rights, this may be especially important for addressing salient problems in communities with distinct vulnerabilities, where prominent disadvantages and barriers for care delivery exist. Therefore, this Commission aims to address these topics, providing a narrative overview of relevant literature and suggesting ways forward. Additionally, proposals for improving mental health and preventing mental illnesses and adverse outcomes are presented, particularly amongst at-risk populations.
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Affiliation(s)
- Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neurosciences, Kings College, London SE5 8AF, United Kingdom.
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | | | - Roger Ng
- World Psychiatric Association, Geneva, Switzerland
| | | | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Egor Chumakov
- Department of Psychiatry & Addiction, St Petersburg State University, St Petersburg, Russia
| | | | | | - Susham Gupta
- East London NHS Foundation Trust, London, United Kingdom
| | - Roxanna Ruiz
- University of Francisco Moaroquin, Guatemala City, Guatemala
| | | | | | | | | | - Alexander Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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Khan N, Malingagio A, Briceño EM, Mehdipanah R, Lewandowski-Romps L, Heeringa SG, Garcia N, Levine DA, Langa KM, Gonzales XF, Morgenstern LB. A Community-Based Study of Cognitive Impairment Caregiving Outcomes Pre- and During the COVID-19 Pandemic. J Appl Gerontol 2024; 43:700-705. [PMID: 37991816 PMCID: PMC11052669 DOI: 10.1177/07334648231215155] [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] [Indexed: 11/23/2023] Open
Abstract
The impact of the COVID-19 pandemic on informal caregiving was examined in a Mexican American (MA) and Non-Hispanic White (NHW) population-based cohort. 395 participants age > 65 years were recruited via door-to-door and phone recruitment as part of the Brain Attack Surveillance in Corpus Christi-Cognitive (BASIC-C) project. Both recipients and caregivers answered questions regarding the recipient's health and the COVID-19 pandemic. 15% of caregivers saw their caregiving recipient less than before the pandemic and 18% saw their recipient more than before. 55% of caregivers reported a slight to severe impact of the pandemic on their caregiving, and 45% reported no impact. For most caregivers, their caregiving role did not change markedly during the pandemic. MA and NHW caregivers had similar survey responses.
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Affiliation(s)
- Noreen Khan
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | | | | | - Steven G Heeringa
- University of Michigan Institute for Social Research, Ann Arbor, MI, USA
| | - Nelda Garcia
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Kenneth M Langa
- University of Michigan Medical School, Ann Arbor, MI, USA
- University of Michigan Institute for Social Research, Ann Arbor, MI, USA
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | | | - Lewis B Morgenstern
- University of Michigan Medical School, Ann Arbor, MI, USA
- University of Michigan School of Public Health, Ann Arbor, MI, USA
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Oken BS, Kaplan J, Klee D, Gallegos AM. Contributions of loneliness to cognitive impairment and dementia in older adults are independent of other risk factors and Alzheimer's pathology: a narrative review. Front Hum Neurosci 2024; 18:1380002. [PMID: 38873650 PMCID: PMC11169707 DOI: 10.3389/fnhum.2024.1380002] [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: 01/31/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Abstract
Loneliness significantly contributes to cognitive impairment and dementia in older adults. Loneliness is a distressing feeling resulting from a perceived lack of social connection (i.e., a discrepancy between desired and actual social relationships), while social isolation is a related term that can be defined by number and type of social relationships. Importantly, loneliness is distinct from social isolation in that it is associated with a distressing self-perception. The primary focus of this narrative review is the impact of chronic loneliness on cognitive impairment and dementia among older adults. Loneliness has a significant association with many factors that are related to worse cognition, and therefore we include discussion on health, mental health, as well as the physiological effects of loneliness, neuropathology, and potential treatments. Loneliness has been shown to be related to development of dementia with a hazard ratio (HR) risk comparable to having a single APOE4 gene. The relationship of dementia to loneliness appears to be at least partially independent of other known dementia risk factors that are possibly associated with loneliness, such as depression, educational status, social isolation, and physical activity. Episodic memory is not consistently impacted by loneliness, which would be more typically impaired if the mild cognitive impairment (MCI) or dementia was due to Alzheimer's disease (AD) pathology. In addition, the several longitudinal studies that included neuropathology showed no evidence for a relationship between loneliness and AD neuropathology. Loneliness may decrease resilience, or produce greater cognitive change associated with the same level of AD neuropathology. Intervention strategies to decrease loneliness in older adults have been developed but need to consider key treatment targets beyond social isolation. Loneliness needs to be assessed in all studies of cognitive decline in elders, since it significantly contributes to the variance of cognitive function. It will be useful to better define the underlying mechanism of loneliness effects on cognition to determine if it is similar to other psychological factors related to excessive stress reactivity, such as neuroticism or even depression, which are also associated with cognitive decline. It is important from a health perspective to develop better strategies to decrease loneliness in older adults.
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Affiliation(s)
- Barry S. Oken
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Josh Kaplan
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Daniel Klee
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Autumn M. Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
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Wang K, Chen XS, Kang SY, Smith BD, Gu D. Older adults' online activities and cognition: Investigating the psychological mechanisms and age and gender differences. Soc Sci Med 2024; 352:116988. [PMID: 38820692 DOI: 10.1016/j.socscimed.2024.116988] [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: 07/17/2023] [Revised: 03/13/2024] [Accepted: 05/15/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES This study aimed to investigate psychological mechanisms underlying the association between older adults' Internet use and cognition and examine potential age and gender group differences. METHODS 2064 older participants were extracted from the Waves 2012, 2013, and 2016 Health and Retirement Study. Internet use was measured by two sets of variables: Internet access and different types of online activities (i.e., informational use, social use, online shopping, and online banking). Path analyses were applied to test the proposed mechanisms via three mediators (i.e., loneliness, depressive symptoms, and perceived control). Multi-group analyses were conducted to examine the potential group differences. RESULTS Internet use was positively associated with cognition. Despite the large direct effect, small but significant indirect effects via depressive symptoms and perceived control were identified across all online activities. Multi-group analyses revealed age-group differences in the mechanisms: depressive symptoms mediated the effects of all online activities on cognition among young-old adults, while perceived control mediated all the effects among old-old adults. Gender group differences were also identified: depressive symptoms mediated the effects of all online activities on cognition among older women and most online activities among older men, whereas perceived control mediated the associations between informational and instrumental (i.e., online shopping and banking) use and cognition among older men. DISCUSSION This study highlights the mediating effect of depressive symptoms and perceived control and age and gender differences regarding the Internet use-cognition association. Internet-based cognitive interventions should consider these psychological mediators and age and gender differences for the best results.
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Affiliation(s)
- Kun Wang
- Department of Social Work, College of Community and Public Affairs, The State University of New York at Binghamton, Binghamton, NY, 13902, USA.
| | - Xiayu Summer Chen
- School of Social Work, University of Illinois at Urbana-Champaign, IL, 61820, USA.
| | - Suk-Young Kang
- Department of Social Work, College of Community and Public Affairs, The State University of New York at Binghamton, Binghamton, NY, 13902, USA.
| | - Brenda D Smith
- School of Social Work, University of Alabama, Tuscaloosa, AL, 35401, USA.
| | - Danan Gu
- Independent Researcher, Suzhou, Jiangsu, China.
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Baciu M, Roger E. Finding the Words: How Does the Aging Brain Process Language? A Focused Review of Brain Connectivity and Compensatory Pathways. Top Cogn Sci 2024. [PMID: 38734967 DOI: 10.1111/tops.12736] [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: 01/16/2023] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
As people age, there is a natural decline in cognitive functioning and brain structure. However, the relationship between brain function and cognition in older adults is neither straightforward nor uniform. Instead, it is complex, influenced by multiple factors, and can vary considerably from one person to another. Reserve, compensation, and maintenance mechanisms may help explain why some older adults can maintain high levels of performance while others struggle. These mechanisms are often studied concerning memory and executive functions that are particularly sensitive to the effects of aging. However, language abilities can also be affected by age, with changes in production fluency. The impact of brain changes on language abilities needs to be further investigated to understand the dynamics and patterns of aging, especially successful aging. We previously modeled several compensatory profiles of language production and lexical access/retrieval in aging within the Lexical Access and Retrieval in Aging (LARA) model. In the present paper, we propose an extended version of the LARA model, called LARA-Connectivity (LARA-C), incorporating recent evidence on brain connectivity. Finally, we discuss factors that may influence the strategies implemented with aging. The LARA-C model can serve as a framework to understand individual performance and open avenues for possible personalized interventions.
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Affiliation(s)
- Monica Baciu
- LPNC, Psychology Department, Grenoble Alps University
- Neurology Department, Grenoble Alps University Hospital
| | - Elise Roger
- LPNC, Psychology Department, Grenoble Alps University
- Communication and Aging Laboratory, Research Center of the University Institute of Geriatrics of Montreal
- Faculty of Medicine, University of Montreal
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Vogel S, Oliva Y Hausmann A, Zank S. Exploring the associations between structural and functional aspects of social relationships and cognition in very old age. Aging Ment Health 2024:1-8. [PMID: 38712590 DOI: 10.1080/13607863.2024.2348616] [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: 06/29/2023] [Accepted: 04/22/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES Few studies have examined the associations between social relationships and cognition in very old adults (80+ years). Moreover, limited research has considered structural and functional aspects of social relationships together when exploring their associations with cognition. Therefore, the present study aimed to investigate the associations between structural and functional social aspects and cognition in very old age. METHOD The sample comprised 518 two-wave participants of the NRW80+ Study, who showed no indication of dementia and an average age of 85 years at baseline (range: 80-97 years). They were assessed twice over an approximate 2-year interval. Multilevel linear growth curve analysis was employed to model cognitive development over very old age and to examine the associations between structural and functional aspects of social relationships and cognitive development. It was controlled for demographic and health characteristics. RESULTS A larger social network size (ß = 0.05, 95% CI [0.02, 0.08], p = 0.002) and frequent compared with occasional, seldom, and no contact with others (ß = 0.16, 95% CI [0.03, 0.28], p = 0.013) were associated with higher global cognition in the fully-controlled model. Model comparisons further revealed that structural aspects better predicted global cognition in very old age compared to functional aspects (χ2(2) = 16.17, p < 0.001). CONCLUSION The findings underline the positive association between structural aspects of social relationships and global cognition in very old age. They also highlight the need for interventions promoting a socially active lifestyle to prevent cognitive decline in this vulnerable age group.
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Affiliation(s)
- Selina Vogel
- Department of Special Education and Rehabilitation Sciences, University of Cologne, Cologne, Germany
| | - Andrés Oliva Y Hausmann
- Department of Special Education and Rehabilitation Sciences, University of Cologne, Cologne, Germany
| | - Susanne Zank
- Department of Special Education and Rehabilitation Sciences, University of Cologne, Cologne, Germany
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
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Jin E, Hwang SSH. A preliminary study on the neurocognitive deficits associated with loneliness in young adults. Front Public Health 2024; 12:1371063. [PMID: 38680939 PMCID: PMC11046705 DOI: 10.3389/fpubh.2024.1371063] [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: 01/15/2024] [Accepted: 03/01/2024] [Indexed: 05/01/2024] Open
Abstract
The experience of loneliness is universal and may have an adverse effect on neurocognitive functioning even at a younger age. Using a comprehensive neurocognitive functioning test (NCFT) battery, we examined the possible negative effects of loneliness on neurocognitive functioning in young adults. The high-loneliness and low-loneliness groups were screened using the UCLA Loneliness Scale v. 3, and measures pertaining to the domains of intelligence, attention, memory, executive function, and psychomotor functioning were tested and compared. As depression and anxiety were significantly higher in the high-loneliness group, an analysis of covariance was conducted. As a result, the high-loneliness group showed significantly poor performance on measures of executive function and attention prior to controlling for depression and anxiety, and executive function retained its significance even after controlling for these variables. Additional analysis showed that depression and anxiety did not significantly mediate the relationship between loneliness and neurocognitive functioning. Such results suggest that loneliness is likely to negatively affect executive functioning and attention in early adulthood and then progressively spread to other domains of cognitive functioning, as reported in the older adult population. The limitations and implications of the present study were considered and addressed.
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Yang JM, Kim JH, Hwang JE. Effect of intensity of persistent social isolation on mental health in the late middle-aged and older population: results of the Korea Longitudinal Study of Ageing (2006-2020). Psychogeriatrics 2024; 24:391-403. [PMID: 38339804 DOI: 10.1111/psyg.13085] [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: 07/15/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Social isolation (SI) was recently identified as a significant public health issue in the United States. Consequently, several studies on the association between SI and mental health were conducted. However, few studies have considered the duration and intensity of SI. In the present study, a longitudinal analysis was conducted to determine the effect of the intensity of persistent SI on the mental health status of late middle-aged and older Koreans. METHODS After excluding missing values, data on 6200 participants were analyzed using the group-based trajectory model (GBTM) from the first to fifth Korean Longitudinal Study of Ageing (KLoSA) to categorise the SI trajectory (SIT). The Chi-square test, t-test, analysis of variance, and time-lagged generalised estimation equations were utilised from the fifth to eighth KLoSA to determine the association between SIT and the incidence of cognitive decline (the group with a Korean version Mini-Mental State Examination score of 23 or lower), cognitive function score, and depression score. RESULTS Four SIT groups were identified in the GBTM analysis. These were the non-SIT (21.7%), mild (46.8%), moderate (21.1%), and severe SIT (10.4%) groups. Compared to the non-SIT group, the severe SIT group experienced a greater incidence of cognitive decline (odds ratio = 1.57, P < 0.0001) as well as poorer cognitive function scores (B = -0.63, P < 0.0001) and depression scores (B = 0.90, P < 0.0001). Furthermore, stratified analysis by sex and age showed that mental health status was inversely proportionate to the intensity of SIT, particularly in males and patients, aged 65 years and above. CONCLUSION A close association was observed between SIT and mental health. This finding highlighted the need for policies and institutional measures to reduce the incidence of mental health deterioration among vulnerable groups due to the intensity of SI.
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Affiliation(s)
- Jeong Min Yang
- Department of Public Health, General Graduate School of Dankook University, Cheonan, Republic of Korea
| | - Jae Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
| | - Ji Eun Hwang
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
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Aljadani R, Carnahan R, Culp K, Souza-Talarico JN. COVID-19 Pandemic Impact on the Trajectories of Cognitive Decline and Depression Symptoms in Long-Term Care Facility Residents. J Am Med Dir Assoc 2024; 25:328-334.e6. [PMID: 38195079 DOI: 10.1016/j.jamda.2023.12.003] [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: 08/17/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES To compare the longitudinal rates of change in cognition and depressive symptoms between 2019 (pre-COVID-19 pandemic) and 2020 (COVID-19 pandemic) among long-term care facility (LTCF) residents in Iowa, which ranked among the top 10 US states that suffered from extreme nursing staff shortages during this crisis. DESIGN A longitudinal cohort study analyzing the Long-Term Care Minimum Data Set (MDS) version 3.0 between January 1, 2019, and December 31, 2020. SETTING AND PARTICIPANTS LTCF residents from the state of Iowa, with a first assessment before March 10 for each year (2019 and 2020), LTCF stay period >60 days, and at least 2 documented assessments with a minimum of 45 days in between. LTCF residents with a Brief Interview for Mental Status score (BIMS) <3 were excluded. METHODS We computed doubly robust estimators by combining regression and propensity score models for BIMS (cognitive decline) and Nine-item Patient Health Questionnaire (PHQ-9; depression symptoms) monthly scores for 2020 vs 2019. RESULTS A total of 24,025 residents from 436 LTCFs were included. Our research revealed a marginally accelerated monthly decline in BIMS scores during 2020 as opposed to 2019, with a rate of -0.012 per month (95% CI -0.022, -0.002; P = .016). Simultaneously, we observed a monthly increment of 0.016 in the PHQ-9 scores among LTCF residents in 2020 (95% CI 0.006, 0.028; P = .003). CONCLUSIONS AND IMPLICATIONS Our study identified a notable yet modest increase in cognitive decline and depressive symptoms among NH residents in Iowa during the COVID-19 pandemic. Although statistically significant, the changes were small and may not have clinical relevance over 1 year. Further research is needed to examine risk factors for cognitive decline during pandemic scenarios such as social isolation, loneliness, inappropriate patient-centered care, and the relationship with staff shortage and facility resources.
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Affiliation(s)
- Rawabi Aljadani
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Ryan Carnahan
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Kennith Culp
- College of Nursing, University of Iowa, Iowa City, IA, USA
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12
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Agyekum MW, Afrifa-Anane GF, Kyei-Arthur F. Prevalence and correlates of disability in older adults, Ghana: evidence from the Ghana 2021 Population and Housing Census. BMC Geriatr 2024; 24:52. [PMID: 38212686 PMCID: PMC10785330 DOI: 10.1186/s12877-023-04587-6] [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: 01/10/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Although there are studies on disabilities in older persons, most of these studies have been carried out in developed countries. Hence, there are limited studies on disability in older adults in sub-Saharan Africa, including Ghana. The few studies that have examined the prevalence and correlates of disability in older adults used survey data for their analyses. To contribute to addressing this knowledge gap that has arisen, this study used a national census, the 2021 Ghana Population and Housing Census, to examine the prevalence and correlates of disability in older adults in Ghana. METHODS The 2021 Ghana Population and Housing Census data was used for this study. A sample size of 197,057 Ghanaians aged 60 years and above was used for this study. The Washington Group questions on disability were used to measure disability by asking older adults about their difficulties in performing the six domains of disability (physical, sight, intellectual, hearing, self-care, and speech). A multinomial logistic regression housed in STATA was used to analyse the correlates of disability in older adults in Ghana. A p-value less than 0.05 was used for statistical significance. RESULTS The results show that slightly more than one-third (38.4%) of the older adults were disabled. In terms of the number of disabilities in older adults, 16.9% had one disability condition, while 2.4% had six disability conditions. Also, 9.4% had two disability conditions. Older adults who were females, aged 70-79 years and 80 years and above, resided in rural areas, with primary, JHS/Middle, SHS, unaffiliated with religion, ever married and never married, unemployed, and belonged to the middle and rich households were more likely to have a disability condition. Also, older adults residing in the Middle and Northern zones, having no health insurance, and using clean cooking fuel were less likely to have a disability condition. CONCLUSIONS The results show that socio-demographic and household factors were associated with disability in older adults in Ghana. Hence, policymakers and researchers should target these factors when designing appropriate policies, programmes, and interventions to improve the wellbeing of older adults.
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Affiliation(s)
- Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education Winneba, Winneba, Ghana.
| | - Grace Frempong Afrifa-Anane
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | - Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
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Khalaila R, Cohn-Schwartz E, Shiovitz-Ezra S, Lawlor B. A prospective association between social isolation and cognitive performance among older adults in Europe: the role of loneliness and poor oral health. Aging Ment Health 2024:1-7. [PMID: 38192062 DOI: 10.1080/13607863.2023.2299968] [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: 08/04/2023] [Accepted: 12/16/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES The relationship between social isolation, loneliness, and tooth loss and cognition in older people is poorly understood. We examine how social isolation and cognitive performance are associated prospectively among older adults, as well as how tooth loss and loneliness are related to this association. METHODS Using data from 26,168 participants aged ≥50 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we explored the association between social isolation, loneliness, tooth loss and cognition. We used bootstrapping with resampling strategies for testing a moderated mediating model. RESULTS Higher social isolation was associated with poorer cognitive performance (B = -0.20, 95% CI = -0.03, -0.01; R2 =0.60), an association mediated by the respondent's number of missing teeth (B = -0.001, 95% CI = -0.002, -0.001). Higher levels of social isolation were associated with a greater number of missing teeth, and a higher number of missing teeth was linked with poorer cognition. We also found that loneliness moderated the relationship between social isolation and both the number of missing teeth (B = -0.11, p = 0.047) and cognitive performance. CONCLUSION In later life, social isolation and loneliness are associated with shoddy oral health and poor cognitive status. Clinicians and policymakers should be aware of both the association between social isolation and feelings of loneliness on dentition and oral health and their relationship to the cognitive status of older adults.
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Affiliation(s)
- Rabia Khalaila
- Nursing department, Zefat Academic College, Zefat, Israel
| | - Ella Cohn-Schwartz
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Sharon Shiovitz-Ezra
- Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Brian Lawlor
- Old Age Psychiatry, Global Brain Health Institute, Trinity College, Dublin, Ireland
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Georgescu MF, Beydoun MA, Ashe J, Maino Vieytes CA, Beydoun HA, Evans MK, Zonderman AB. Loneliness, Dementia Status, and Their Association with All-Cause Mortality Among Older US Adults. J Alzheimers Dis 2024; 99:753-772. [PMID: 38701144 DOI: 10.3233/jad-231359] [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: 05/05/2024]
Abstract
Background Loneliness, dementia, and mortality are interconnected. Objective We aimed at understanding mediating pathways and interactions between loneliness and dementia in relation to mortality risk. Methods The study tested bi-directional relationships between dementia, loneliness, and mortality, by examining both interactions and mediating effects in a large sample of older US adults participating in the nationally representative Health and Retirement Study. Out of≤6,468 older participants selected in 2010, with mean baseline age of 78.3 years and a follow-up time up to the end of 2020, 3,298 died at a rate of 64 per 1,000 person-years (P-Y). Cox proportional hazards and four-way decomposition models were used. Results Algorithmically defined dementia status (yes versus no) was consistently linked with a more than two-fold increase in mortality risk. Dementia status and Ln(odds of dementia) were strongly related with mortality risk across tertiles of loneliness score. Loneliness z-score was also linked to an elevated risk of all-cause mortality regardless of age, sex, or race or ethnicity, and its total effect (TE) on mortality was partially mediated by Ln(odds of dementia), z-scored, (≤40% of the TE was a pure indirect effect). Conversely, a small proportion (<5%) of the TE of Ln(odds of dementia), z-scored, on mortality risk was explained by the loneliness z-score. Conclusions In sum, dementia was positively associated with all-cause mortality risk, in similar fashion across loneliness score tertiles, while loneliness was associated with mortality risk. TE of loneliness on mortality risk was partially mediated by dementia odds in reduced models.
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Affiliation(s)
- Michael F Georgescu
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, NIA/NIH/IRP, Baltimore, MD, USA
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, NIA/NIH/IRP, Baltimore, MD, USA
| | - Jason Ashe
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, NIA/NIH/IRP, Baltimore, MD, USA
| | - Christian A Maino Vieytes
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, NIA/NIH/IRP, Baltimore, MD, USA
| | - Hind A Beydoun
- U.S. Department of Veterans Affairs, VA National Center on Homelessness Among Veterans, Washington, DC, USA
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, NIA/NIH/IRP, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, NIA/NIH/IRP, Baltimore, MD, USA
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15
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Pecchinenda A, Yankouskaya A, Boccia M, Piccardi L, Guariglia C, Giannini AM. Exploring the relationship between perceived loneliness and subjective cognitive decline in older individuals. Aging Ment Health 2024; 28:73-82. [PMID: 37540497 DOI: 10.1080/13607863.2023.2242291] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/12/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE Loneliness has been associated to a greater risk of cognitive decline and dementia in older individuals. However, evidence on whether this association also exists for older individuals who complain of cognitive problems is limited. We conducted a survey to examine the association between subjective cognitive decline in the working memory domain, perceived loneliness, depression, anxiety, and stress in older individuals with different profiles. METHODS A total of 302 healthy, old individuals completed 3 questionnaires to assess subjective cognitive problems in attention, executive functions, storage, depression, anxiety, stress, and perceived loneliness. RESULTS We conducted a cluster analysis and 3 clusters of individuals with different profiles emerged. Individuals with greater subjective cognitive problems (cluster 1) in the attention and storage domains, reported higher perceived loneliness and stress but not depression. In contrast, individuals with the least subjective cognitive problems (cluster 3) in the storage domain, reported lower perceived loneliness. CONCLUSIONS Individuals with higher subjective cognitive decline also report higher levels of perceived loneliness but not more depression than their peers. However, this correlation is present only for individuals with mild subjective cognitive decline (cluster 2). The implications for future research and interventions are discussed.
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Affiliation(s)
- Anna Pecchinenda
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Laura Piccardi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- San Raffaele Cassino Hospital, Cassino, FR, Italy
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Anna Maria Giannini
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
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Lay-Yee R, Hariri AR, Knodt AR, Barrett-Young A, Matthews T, Milne BJ. Social isolation from childhood to mid-adulthood: is there an association with older brain age? Psychol Med 2023; 53:7874-7882. [PMID: 37485695 PMCID: PMC10755222 DOI: 10.1017/s0033291723001964] [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: 02/20/2023] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Older brain age - as estimated from structural MRI data - is known to be associated with detrimental mental and physical health outcomes in older adults. Social isolation, which has similar detrimental effects on health, may be associated with accelerated brain aging though little is known about how different trajectories of social isolation across the life course moderate this association. We examined the associations between social isolation trajectories from age 5 to age 38 and brain age assessed at age 45. METHODS We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and persistent 'child-adult' isolation. A brain age gap estimate (brainAGE) - the difference between predicted age from structural MRI date and chronological age - was derived at age 45. We undertook analyses of brainAGE with trajectory group as the predictor, adjusting for sex, family socio-economic status, and a range of familial and child-behavioral factors. RESULTS Older brain age in mid-adulthood was associated with trajectories of social isolation after adjustment for family and child confounders, particularly for the 'adult-only' group compared to the 'never-isolated' group. CONCLUSIONS Although our findings are associational, they indicate that preventing social isolation, particularly in mid-adulthood, may help to avert accelerated brain aging associated with negative health outcomes later in life.
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Affiliation(s)
- Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences, and School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
| | - Ahmad R. Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Annchen R. Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | | | - Timothy Matthews
- Department of Social Genetic & Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Barry J. Milne
- Centre of Methods and Policy Application in the Social Sciences, and School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
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Li Y, Wang W, Zhu L, Yang L, Wu H, Zhang X, Guo L, Lu C. Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older. JAMA Netw Open 2023; 6:e2349241. [PMID: 38147332 PMCID: PMC10751597 DOI: 10.1001/jamanetworkopen.2023.49241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/09/2023] [Indexed: 12/27/2023] Open
Abstract
Importance It remains unclear whether pet ownership is associated with cognitive decline and to what extent pet ownership mitigates the association between living alone and cognitive decline. Objective To explore the association of pet ownership with cognitive decline, the interaction between pet ownership and living alone, and the extent to which pet ownership mitigates the association between living alone and cognitive decline in older adults. Design, Setting, and Participants This cohort study used data from waves 5 (June 2010 to July 2011) to 9 (from June 2018 to July 2019) in the English Longitudinal Study of Ageing. Participants included adults 50 years and older. Data were analyzed from April 1 to June 30, 2023. Exposures Pet ownership and living alone in wave 5. Main Outcomes and Measures In waves 5 to 9, verbal memory and verbal fluency were assessed, and composite verbal cognition was further calculated. Results Of the 7945 participants included, the mean (SD) age was 66.3 (8.8) years, and 4446 (56.0%) were women. Pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.008 [95% CI, 0.002-0.014] SD/y), verbal memory (β = 0.006 [95% CI, 0.001-0.012] SD/y), and verbal fluency (β = 0.007 [95% CI, 0.001-0.013] SD/y). Three-way interaction tests showed that living alone was a significant modifier in all 3 associations. Stratified analyses showed that pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.023 [95% CI, 0.011-0.035] SD/y), verbal memory (β = 0.021 [95% CI, 0.008-0.034] SD/y), and verbal fluency (β = 0.018 [95% CI, 0.005-0.030] SD/y) among individuals living alone, but not among those living with others. Joint association analyses showed no significant difference in rates of decline in composite verbal cognition, verbal memory, or verbal fluency between pet owners living alone and pet owners living with others. Conclusions and Relevance In this cohort study, pet ownership was associated with slower rates of decline in verbal memory and verbal fluency among older adults living alone, but not among those living with others, and pet ownership offset the associations between living alone and declining rates in verbal memory and verbal fluency. Further studies are needed to assess whether pet ownership slows the rate of cognitive decline in older adults living alone.
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Affiliation(s)
- Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liwan Zhu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liwen Yang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Herui Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaojuan Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Puthran R, Janeslätt G, Acharya V, Ramachandran M, Dsouza SA. Cross-cultural adaptation of assessments for time-related abilities of Indian older adults and evaluation of their reliability and validity. Scand J Occup Ther 2023; 30:1153-1166. [PMID: 37200526 DOI: 10.1080/11038128.2023.2211314] [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: 12/07/2021] [Revised: 04/16/2023] [Accepted: 05/02/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Older adults may have difficulties in daily time management due to age-related or disease-related cognitive impairment. Standardised assessments for time-related abilities are currently unavailable in India. AIM The study aimed to adapt the Kit for Assessing Time-processing Ability-Senior (KaTid-Senior) and Time-Self rating, Senior (Time-S Senior) for daily time management of Indian older adults, translate these into an Indian language, and evaluate the reliability and validity of the adapted assessments. MATERIALS AND METHODS The two Swedish-origin assessments were reviewed, adapted for linguistic and cultural relevance into English, and translated into Kannada language. Older adults (n = 128) were conveniently selected, assessed with the Montreal Cognitive Assessment, and assigned to age and gender-matched groups: cognitively-impaired and cognitively-normal. Data was then collected with the adapted assessments. RESULTS Both adapted assessments demonstrated acceptable reliability (internal consistency) in this sample (α =0.89 - 0.90). The cognitively-impaired group had significantly (p < 0.001) lower scores on the assessments as compared to the cognitively-normal group. There was a strong to moderate correlation between the assessments supporting their convergent validity. CONCLUSIONS The adapted assessments are reliable and valid in the Indian context. SIGNIFICANCE The study would facilitate contextually-relevant assessment and management of time-related abilities in Indian older adults.
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Affiliation(s)
- Reeti Puthran
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Jupiter Hospital, Thane, India
| | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Center for Clinical Research in Dalarna, Uppsala University, Uppsala, Sweden
| | - Vinita Acharya
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Meena Ramachandran
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Bridgepoint Collaboratory for Research and Innovation, Sinai Health, Toronto, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Sebestina Anita Dsouza
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Centre for Studies on Health Aging, Manipal Academy of Higher Education, Manipal, India
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Rai AR, Joy T, Poojari M, Pai MM, Massand A, Murlimanju BV. Role of Acorus calamus in preventing depression, anxiety, and oxidative stress in long-term socially isolated rats. Vet World 2023; 16:1755-1764. [PMID: 37766700 PMCID: PMC10521175 DOI: 10.14202/vetworld.2023.1755-1764] [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: 04/27/2023] [Accepted: 07/22/2023] [Indexed: 09/29/2023] Open
Abstract
Background and Aim Social isolation stress (SIS) and individual housing have been shown to cause abnormal cognitive insufficiencies, altered anxiety levels, and signs of psychiatric diseases. Acorus calamus (AC), commonly known as Sweet Flag, has been widely used in India to treat neurological, metabolic, and respiratory disorders, indicating its potential therapeutic value. This study aimed to determine the antidepressant and antioxidative effects of AC on rats subjected to long-term, social isolation-induced stress. Materials and Methods This study involved 2-month-old male rats (24) weighing approximately 180-200 g bred in-house. The rats were divided into four groups (n = 6): Group 1 received saline, Group 2 received SIS, Group 3 received only 50 mg/kg AC, and Group 4 received 50 mg/kg AC and SIS for 6 weeks. After this, behavioral, biochemical, and neuronal assays were conducted. Results Behavioral experiments showed significantly higher activity levels (p < 0.001) in AC-treated rats than in the SIS group. In addition, rats subjected to SIS with AC treatment exhibited enhanced total antioxidants, superoxide dismutase, and neuronal assays compared to rats subjected to SIS alone. Conclusion Acorus calamus treatment improved the antidepressant and antioxidant potential against SIS in rat brain tissue. Moreover, we proved that AC can effectively reverse the neurotoxicity induced by SIS in animal models. As we battle against the coronavirus disease 2019 pandemic and social isolation, AC could be considered a supplementary treatment to alleviate depressive-like symptoms in our present-day lifestyle.
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Affiliation(s)
- Ashwin Rohan Rai
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Teresa Joy
- Department of Anatomy, American University of Antigua College of Medicine, University Park, Jabberwock Beach Road, Coolidge, St. John’s, Antigua, West Indies
| | - Meghana Poojari
- Department of Anatomy, Basaveshwara Medical College and Hospital, Chitradurga, India
| | - Mangala M. Pai
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Amit Massand
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - B. V. Murlimanju
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Duan Y, Jiang S, Yin Z, Wang S, Gao J, Yang M, Chen C, Fu H, Wang C. Association of social isolation and cognitive performance: a longitudinal study using a four-wave nationwide survey. BMC Public Health 2023; 23:1409. [PMID: 37481576 PMCID: PMC10362697 DOI: 10.1186/s12889-023-16274-7] [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: 01/11/2023] [Accepted: 07/09/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND This study aimed to examine the bidirectional relationship between social isolation and cognitive performance among Chinese middle-aged and older adults. METHODS We used four waves of data from the China Health and Retirement Longitudinal Study. A latent growth model (LGM) was applied to examine the association between social isolation and cognitive performance across different characteristics. RESULTS In the analysis, we ultimately included 9,367 participants after excluding respondents with missing key variables. Social isolation and cognitive performance showed significant differences across time. After adjusting for the confounders, there was a significant association between higher social isolation and poor cognitive performance (β = -1.38, p < 0.001), and higher levels of social isolation resulted in a more pronounced decline in cognition over time (β = 0.17, p < 0.001). Additionally, the path coefficient between the initial level of cognition at baseline and the slope of social isolation was - 0.07 (p < 0.001) and 0.01 (p = 0.021), respectively. For the correlation between slopes, our study found that females' cognition scores were more susceptible to social isolation (β = - 2.78, p < 0.001). Similarly, regarding cognition scores, the influence of social isolation was greater among people with education below the primary level (β = - 2.89, p = 0.002) or a greater number of chronic diseases (β = - 2.56, p = 0.001). CONCLUSION Our findings support the bidirectional association between social isolation and cognition. Specifically, higher baseline social isolation and its rate of increase over time contribute to an intensification of cognitive decline at follow-up. Besides, poorer cognitive performance predicted higher social isolation.
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Affiliation(s)
- Yanran Duan
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Shuai Jiang
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Zhao Yin
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Sufan Wang
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Jinghong Gao
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Mengyu Yang
- Zhengzhou University School of Public Health, Zhengzhou, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Hang Fu
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Chengzeng Wang
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
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