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Zhang Y, Yuan X, Jiang Z, Hu R, Liang H, Mao Q, Xiong Y, Zhang J, Liu M. The relationship between multimorbidity and cognitive function in older Chinese adults: based on propensity score matching. Front Public Health 2024; 12:1422000. [PMID: 39328989 PMCID: PMC11425792 DOI: 10.3389/fpubh.2024.1422000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 08/30/2024] [Indexed: 09/28/2024] Open
Abstract
Objective The goal of this study was to further validate the effect of multimorbidity on cognitive performance in older adults after controlling for confounders using propensity score matching (PSM). Methods A cross-sectional survey of older adult people aged 60 years or older selected by convenience sampling was conducted in seven medical institutions, three communities, and five nursing homes in Zunyi City, Guizhou Province. The data collected included general information, health-related information, and Mini-Mental State Examination (MMSE) scores. Variables were controlled for confounders by PSM to analyze differences in cognitive ability between multimorbidity and nonmultimorbidity older adults. Logistic regression and multivariate-adjusted restricted cubic spline (RCS) curves for matched samples were used to assess the relationship between multimorbidity and cognitive decline. Results A total of 14,175 respondents were enrolled, and the mean age of the participants included in this study was 71.26 ± 7.1 years, including 7,170 (50. 58%) of the participants were males, 7,005 (49.42%) were females, and 5,482 participants (38.67%) were screened for cognitive decline. After PSM, logistic regression analysis revealed that multimorbidity was a risk factor for cognitive decline (OR = 1.392, 95% CI = 1.271-1.525, p < 0.001). The RCS show that the risk of cognitive decline is always greater in older adults with multimorbidity than in older adults without multimorbidity at the same age. Age, sex, marital status, educational level, monthly income, drinking status, participation in social activities, and exercise were influential factors for cognitive decline in older adults (p < 0.05). The incidence of cognitive decline in older adults with multimorbidity was also greater than that in older adults with one chronic disease (p < 0.001). Conclusion The risk of cognitive decline in older adults with multimorbidity is greater than that in older adults without multimorbidity; therefore, the government should strengthen the prevention and treatment of multimorbidity in older adults to further protect their cognitive abilities.
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Affiliation(s)
- Yumeng Zhang
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Faculty of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiaoli Yuan
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Zhixia Jiang
- College Office, Guizhou Nursing Vocational College, Guiyang, Guizhou, China
| | - Rujun Hu
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Heting Liang
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Qingyun Mao
- Faculty of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Yan Xiong
- Faculty of Nursing, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jiabi Zhang
- Kweichow Moutai Hospital, Renhuai, Guizhou, China
| | - Mi Liu
- Kweichow Moutai Hospital, Renhuai, Guizhou, China
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Li Y, Xiang Q, Song Q, Liang R, Deng L, Dong B, Yue J. Longitudinal associations between social support and sarcopenia: findings from a 5-year cohort study in Chinese aged ≥50 years. J Nutr Health Aging 2024; 28:100014. [PMID: 38267150 DOI: 10.1016/j.jnha.2023.100014] [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: 10/31/2023] [Revised: 12/01/2023] [Accepted: 12/15/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES We aimed to investigate longitudinal associations of overall social support and its sub-domains with risk of sarcopenia and its related traits in community-dwelling Chinese aged ≥ 50 years. We also explored interaction effects of potential factors on such associations. DESIGN A prospective cohort study. SETTING Community-based setting in western China. PARTICIPANTS We included participants aged ≥50 years with complete information necessary for analysis from the WCHAT study who did not have sarcopenia at baseline (2018) and had sufficient data for sarcopenia assessment during 2021-2023. MEASUREMENTS Exposures included overall social support, subjective support, objective support and support utilization, which were assessed with the Social Support Rating Scale. Outcomes included sarcopenia, low muscle mass (LMM), low muscle strength and low physical performance, which were diagnosed with the 2019 AWGS consensus. Longitudinal associations between the exposures and outcomes were estimated by logistic regression, with generalized estimating equations (GEE) as sensitivity analyses. Subgroup analyses by potential covariates were conducted to detect interaction effects. RESULTS A total of 1905 participants were finally included in the analytic sample, of whom 326 (17.1%) developed incident sarcopenia during 5-year follow-up. After controlling for confounders, higher degree of overall social support (OR = 0.87, 95%CI 0.76-0.99), subjective support (OR = 0.88, 95%CI 0.77-0.99) and support utilization (OR = 0.87, 95%CI 0.77-0.99) correlated with lower sarcopenia risk, among which higher support utilization degree was indicative of lower risk for LMM (OR = 0.88, 95%CI 0.79-0.98). GEE further revealed that overall support degree was negatively associated with risk for sarcopenia (OR = 0.86, 95%CI 0.76-0.98) and LMM (OR = 0.87, 95%CI 0.77-0.99). Objective support was neither significantly associated with sarcopenia nor its traits. No significant interaction effect was observed between overall support and the concerned confounders on sarcopenia (interaction P-value > 0.05). CONCLUSION Overall social support degree was negatively associated with sarcopenia risk, possibly primarily through affecting muscle mass rather than muscle strength or physical performance, and such an association remained robust across subgroups with distinct characteristics. This holds implications for policymakers to conduct population-based risk assessment, and supportive strategies against sarcopenia should focus on enhancing subjective support and support utilization rather than objective support alone.
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Affiliation(s)
- Yuxiao Li
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiao Xiang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Rui Liang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Linghui Deng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Birong Dong
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Zhang H, Ye C, Zhang S, Yang D, Gong X, Li S, Xue W, Su J, Zhao L, Qiu Y, He X, Zhang Y, Tang M. Association between health literacy and dysphagia in the community-dwelling older population: a cross-sectional study. Aging Clin Exp Res 2023; 35:2165-2172. [PMID: 37505395 PMCID: PMC10520086 DOI: 10.1007/s40520-023-02499-4] [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: 03/21/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Dysphagia, or swallowing disorders, has become a growing concern due to the aging population, and health literacy plays a crucial role in active aging. However, the relationship between them remains unclear. AIMS To investigate the association between health literacy and dysphagia among community-dwelling older adults in China. METHODS A survey was conducted on 4462 older adults aged 65 and above in a community in Yiwu City, China, from May 2021 to January 2022. Swallowing problems were assessed using a 30 ml water swallowing test (WST) and the Eating Assessment Tool-10 questionnaire (EAT-10). The participants' health literacy was evaluated using the Chinese Health Literacy Scale (CHLS). Logistic regression and t tests were employed to measure the association between them. RESULTS The prevalence of dysphagia was 5.70% and 7.85% as determined by EAT-10 and 30 ml-WST, respectively. The health literacy level of community-dwelling older adults was 24.4 ± 4.93 (9-45). Participants with dysphagia exhibited lower levels of health literacy (p < 0.05). The logistic regression model demonstrated an inverse association between health literacy and dysphagia (OR = 0.94, 95%CI = 0.91-0.96 for EAT-10, and OR = 0.93, 95%CI = 0.92-0.95 for WST). Moreover, this association remained significant even after adjusting for covariates. DISCUSSION Older adults with dysphagia have lower levels of health literacy, particularly in terms of their ability to seek medical advice, acquire and evaluate medical information, and access social support resources. CONCLUSIONS Health literacy is associated with dysphagia among community-dwelling older adults. Effective interventions should be implemented to provide support in terms of both medical services and social support for this population.
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Affiliation(s)
- Huafang Zhang
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Chenxi Ye
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Simei Zhang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Dan Yang
- Zhejiang Nursing Association, Hangzhou, 310003, China
| | - Xiaolan Gong
- Futian Community Health Service Center, Yiwu, 322000, China
| | - Sihan Li
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Wenfeng Xue
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Jie Su
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Lancai Zhao
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Yufeng Qiu
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Xiaona He
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Yongming Zhang
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China.
| | - Mengling Tang
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China.
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Wei P. Ultra-Early Screening of Cognitive Decline Due to Alzheimer's Pathology. Biomedicines 2023; 11:biomedicines11051423. [PMID: 37239094 DOI: 10.3390/biomedicines11051423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Alzheimer's pathology can be assessed and defined via Aβ and tau biomarkers. The preclinical period of Alzheimer's disease is long and lasts several decades. Although effective therapies to block pathological processes of Alzheimer's disease are still lacking, downward trends in the incidence and prevalence of dementia have occurred in developed countries. Accumulating findings support that education, cognitive training, physical exercise/activities, and a healthy lifestyle can protect cognitive function and promote healthy aging. Many studies focus on detecting mild cognitive impairment (MCI) and take a variety of interventions in this stage to protect cognitive function. However, when Alzheimer's pathology advances to the stage of MCI, interventions may not be successful in blocking the development of the pathological process. MCI individuals reverting to normal cognitive function exhibited a high probability to progress to dementia. Therefore, it is necessary to take effective measures before the MCI stage. Compared with MCI, an earlier stage, transitional cognitive decline, may be a better time window in which effective interventions are adopted for at-risk individuals. Detecting this stage in large populations relies on rapid screening of cognitive function; given that many cognitive tests focus on MCI detection, new tools need to be developed.
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Affiliation(s)
- Pengxu Wei
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Neuro-Functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
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Bian D, Li X, Xiao Y, Song K, Wang L, Shen J, Aimaiti M, Ma X, Shi C, Li G. Relationship between Social Support, Sarcopenia, and Cognitive Impairment in Chinese Community-Dwelling Older Adults. J Nutr Health Aging 2023; 27:726-733. [PMID: 37754212 DOI: 10.1007/s12603-023-1973-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/24/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Cognitive impairment and sarcopenia have become important challenges for the growing aging population. Social support has been shown to protect against cognitive impairment, but its impact on sarcopenia remains unknown. The purpose of this study was to explore the correlation between social support, sarcopenia, and cognitive impairment in Chinese older adults. METHOD A multi-stage whole group sampling method was used to conduct a cross-sectional survey of 720 community-dwelling older people in Shanghai. The definition of sarcopenia was in accordance with the criteria of the Asian Working Group for Sarcopenia (AWGS) 2019. Cognitive impairment was evaluated using a computerized neuropsychological assessment device that had been previously validated. Social support was assessed using the Social Support Rate Scale. Logistic regression analyses were conducted to explore the relationship between social support cognitive impairment and sarcopenia, fully adjusting for all potential confounding factors. RESULTS Our study found that 230 (31.94%) of the participants had cognitive impairment and 97 (13.47%) of the participants had sarcopenia. The mean social support score was 35.10 ± 7.54. Besides, the results showed that cognitive impairment was associated with sarcopenia (OR:1.650, 95% CI: 1.048, 2.596, P=0.030) after adjusting for confounding factors. Older adults with high level social support had the lowest risk of cognitive impairment (OR: 0.297, 95% CI: 0.115, 0.680, P=0.021) and sarcopenia (OR: 0.113, 95% CI: 0.031, 0.407, P=0.001), respectively. CONCLUSION Our analysis revealed that high level social support was negatively associated with sarcopenia and cognitive impairment. These findings provide strong support for the health promotion effect of social networks against sarcopenia and cognitive impairment in Chinese community-dwelling older adults, with important implications for healthcare policy makers.
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Affiliation(s)
- D Bian
- C. Shi, Center for Health Technology Assessment, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China, ; G. Li, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
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