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Zhao X, Si H. Exploring the chain mediating roles of frailty and depressive symptoms in the relationship between pain and cognitive function among nursing home older adults. Psychogeriatrics 2024; 24:426-432. [PMID: 38323495 DOI: 10.1111/psyg.13089] [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: 11/22/2023] [Revised: 12/18/2023] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND The prevalence of cognitive decline is high among nursing home older adults. Pain is a vital factor in cognitive function. Furthermore, the current literature lacks the complex association between pain, frailty, depressive symptoms, and cognitive function. The aim of this study was to explore the chain mediating roles of frailty and depressive symptoms in the association between pain and cognitive function among nursing home older adults. METHODS This is a population-based cross-sectional study, conducted in China, of 210 nursing home older adults aged 64-98 years old, who completed the measurements of sociodemographic information, pain, frailty, depressive symptoms, and cognitive function. Mediation analyses tested the indirect effect of frailty and depressive symptoms in the relationship between pain and cognitive function by PROCESS macro. RESULTS Pain, frailty, as well as depressive symptoms, were negatively related to cognitive function. Frailty mediated the association between pain and cognitive function. Importantly, mediation analyses showed that frailty and depressive symptoms acted as sequential mediators of pain and cognitive function. CONCLUSIONS These findings have crucial clinical implications, as they suggest targeting physiological and psychological factors in older adults with chronic pain to alleviate cognitive decline.
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Affiliation(s)
- Xia Zhao
- Department of Health Management, Heze Medical College, Heze, China
| | - Huaxin Si
- School of Public Health, Peking University, Beijing, China
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Palermo S, Stanziano M, Nigri A, Civilotti C, Celeghin A. Parkinson's Disease, SARS-CoV-2, and Frailty: Is There a Vicious Cycle Related to Hypovitaminosis D? Brain Sci 2023; 13:brainsci13040528. [PMID: 37190492 DOI: 10.3390/brainsci13040528] [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: 02/27/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 05/17/2023] Open
Abstract
The literature has long established the association between aging and frailty, with emerging evidence pointing to a relationship between frailty and SARS-CoV-2 contagion. The possible neurological consequences of SARS-CoV-2 infection, associated with physical and cognitive frailty, could lead to a worsening of Parkinson's disease (PD) in infected patients or-more rarely-to an increase in the Parkinsonian symptomatology. A possible link between those clinical pictures could be identified in vitamin D deficiency, while the whole process would appear to be associated with alterations in the microbiota-intestine-brain axis that fall within the α-Synuclein Origin site and Connectome (SOC) model, and allow for the identification of a body-first PD and a brain-first PD. The model of care for this condition must consider intrinsic and extrinsic variables so that care by a multidisciplinary team can be successfully predicted. A multidimensional screening protocol specifically designed to identify people at risk or in the early stages of the disease should begin with the investigation of indices of frailty and microbiota-intestine-brain axis alterations, with a new focus on cases of hypovitaminosis D.
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Affiliation(s)
- Sara Palermo
- Department of Psychology, University of Turin, 10124 Turin, Italy
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Mario Stanziano
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, 20133 Milan, Italy
- Neurosciences Department "Rita Levi Montalcini", University of Turin, 10126 Turin, Italy
| | - Anna Nigri
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | | | - Alessia Celeghin
- Department of Psychology, University of Turin, 10124 Turin, Italy
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da Silva ABJ, Barros WMA, da Silva ML, Silva JML, Souza APDS, da Silva KG, de Sousa Fernandes MS, Carneiro ACBDF, Souza VDON, Lagranha CJ. Impact of vitamin D on cognitive functions in healthy individuals: A systematic review in randomized controlled clinical trials. Front Psychol 2022; 13:987203. [PMID: 36524160 PMCID: PMC9745323 DOI: 10.3389/fpsyg.2022.987203] [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: 08/13/2022] [Accepted: 10/07/2022] [Indexed: 11/30/2022] Open
Abstract
Various functions in the central nervous system, such as growth, development, and cognition can be influenced by vitamins and minerals, which are capable of helping to maintain brain health and function throughout life. Cognition is understood as the aspects related to knowledge, learning, and understanding, as well as the ability to develop these functions. A possible association between low levels of vit D and deficit in the performance of cognitive functions in healthy humans or with some pathological condition is discussed. Because of this, the present systematic review analyzed only randomized clinical trials carried out in healthy non-athlete adults about intellectual and/or mental processes involving cognitive functions to identify whether these individuals with different levels of vit D are capable of interfering with the performance of the cognitive function. To do so, we adopted the PRISMA method criteria and registered it in the PROSPERO database. The search was performed in PubMed (MEDLINE), PsycINFO, Science Direct, Scopus, and Web of Science databases, 2,167 records were identified. The 5 most frequent cognitive domains in the selected studies were: processing speed, attention, verbal learning/memory, executive function, and general cognitive functions. We found that there are positive changes in the following domains: verbal memory and verbal working memory, learning memory, attention, executive function, and also cognitive function in general. We highlight the following suggestions for improvements that vitamin D supplementation may promote in the cognitive domains of healthy adults: a) low doses between 400 and 600 IU/d seem to be more effective when compared to doses between 2,400 and 5,000 IU/d and b) food fortification and enrichment with vit D, need further studies, as they seem to be more or as effective as synthetic supplementation. We evident that there is a need for trials that evaluate the control of vit D levels for healthy adult individuals is important, as they have the potential to minimize health problems, especially those involved in the reduction of cognitive abilities. Thus, the development of more clinical trials to obtain satisfactory answers on this topic needs to be encouraged. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021262413.
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Affiliation(s)
- Ana Beatriz Januário da Silva
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Waleska Maria Almeida Barros
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Mayara Luclécia da Silva
- Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil.,Programa de Pós-graduação Multicêntrico em Ciências Fisiológicas, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Brazil
| | - José Maurício Lucas Silva
- Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil.,Programa de Pós-graduação Multicêntrico em Ciências Fisiológicas, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Brazil
| | - Ana Patrícia da Silva Souza
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Karollainy Gomes da Silva
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Centro Integrado de Tecnologias em Neurociência (CITENC), Centro Universitário Osman Lins (UNIFACOL), Vitória de Santo Antão, PE, Brazil
| | - Matheus Santos de Sousa Fernandes
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | | | | | - Cláudia Jacques Lagranha
- Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil.,Laboratorio de Bioquimica Geral, Molecular e do Exercicio-Universidade Federal de Pernambuco, Centro Acadêmico de Vitória (CAV)-UFPE, Vitória de Santo Antão, PE, Brazil
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