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Hu C, Jiang K, Sun X, He Y, Li R, Chen Y, Zhang Y, Tao Y, Jin L. Change in Healthy Lifestyle and Subsequent Risk of Cognitive Impairment Among Chinese Older Adults: A National Community-Based Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae148. [PMID: 38836313 DOI: 10.1093/gerona/glae148] [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: 02/08/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND The association between change in lifestyle and cognitive impairment remains uncertain. OBJECTIVES To investigate the association of change in lifestyle with cognitive impairment. METHODS In this study, 4 938 participants aged 65 or older were involved from the Chinese Longitudinal Healthy Longevity Survey for years 2008-2018. A weighted healthy lifestyle score was derived from 4 lifestyle factors (smoking, alcohol consumption, physical activity, and diet). Multivariable Cox proportional hazards regression models were applied to investigate the associations between 3-year changes in healthy lifestyle (2008-2011) and cognitive impairment (2011-2018). RESULTS Researchers documented 833 new-onset of cognitive impairments more than 20 097 person-years of follow up. Compared with those in the persistently unhealthy group, those in the improved and persistently healthy groups had a lower risk of cognitive impairment, with the multivariate-adjusted hazard ratios (HRs) of 0.67 (95% confidence interval (CI): 0.55, 0.83) and 0.53 (95% CI: 0.40, 0.71), respectively. Furthermore, a significant interaction was observed between change in lifestyle and sex (p-interaction = .032); the HRs were 0.48 (95% CI, 0.34, 0.69) for the improved group and 0.41 (95% CI: 0.26, 0.64) for persistently healthy group among male vs 0.81 (95% CI, 0.63, 1.04) and 0.64 (95% CI, 0.44, 0.92) among female, respectively. CONCLUSIONS This study suggests that improving or maintaining a healthy lifestyle can significantly mitigate the risk of cognitive impairment in Chinese older adults. Additionally, researcher's findings emphasize the significance of maintaining a healthy lifestyle and highlights the potential positive impact of improving previous unhealthy habits, especially for older women.
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Affiliation(s)
- Chengxiang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Kexin Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Xiaoyue Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Yue He
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Runhong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Yana Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Yuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Yuchun Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China
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Huang H, Yang B, Yu R, Ouyang W, Tong J, Le Y. Very high high-density lipoprotein cholesterol may be associated with higher risk of cognitive impairment in older adults. Nutr J 2024; 23:79. [PMID: 39020341 PMCID: PMC11253464 DOI: 10.1186/s12937-024-00983-9] [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: 11/26/2023] [Accepted: 07/10/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Previous studies have shown that high-density lipoprotein cholesterol (HDL-C) levels are positively associated with cognitive function across a range of concentrations. However, recent studies have suggested that very high HDL-C levels may lead to poorer outcomes. Therefore, we aimed to investigate the relationship between different concentrations of HDL-C and cognitive impairment risk. METHODS We collected data from 3632 participants aged over 60 years from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014 to assess the relationship between HDL-C and cognitive function. Cognitive function was evaluated with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, the animal fluency test (AFT), and the digit symbol substitution test (DSST). We used restricted cubic spline models and logistic regression to examine the association between HDL-C and cognitive function. RESULTS A U-shaped was observed between HDL-C and cognitive outcomes, individuals with higher risk in those with both low and very high HDL-C levels compared with those with midrange values. Very high HDL-C levels (≥ 2.50 mmol/L) were associated with increased risk of cognitive impairment (OR = 2.19; 95% CI, 1.12-4.28) compared with those with HDL-C levels in the range of 1.50 to 1.99 mmol/L in older adults after adjustment for confounding factors. Interaction test demonstrated that relationship between very high HDL-C and the risk of cognitive impairment was not changed in different sex and race group (P for interaction > 0.05). CONCLUSIONS Very high HDL-C levels were associated with an increased risk of cognitive impairment. HDL-C may not be a protective factor for maintaining brain health in older adults at very high levels.
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Affiliation(s)
- Huifan Huang
- Department of Anesthesiology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Department of Anesthesiology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Bin Yang
- Department of Anesthesiology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Renhe Yu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Wen Ouyang
- Department of Anesthesiology, the Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Province Key Laboratory of Brain Homeostasis, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianbin Tong
- Department of Anesthesiology, the Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Province Key Laboratory of Brain Homeostasis, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Yuan Le
- Department of Anesthesiology, the Third Xiangya Hospital, Central South University, Changsha, China.
- Hunan Province Key Laboratory of Brain Homeostasis, the Third Xiangya Hospital, Central South University, Changsha, China.
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Duval GT, Raud E, Gohier H, Dramé M, Tabue-Teguo M, Annweiler C. Orthostatic hypotension and cognitive impairment: Systematic review and meta-analysis of longitudinal studies. Maturitas 2024; 185:107866. [PMID: 38604094 DOI: 10.1016/j.maturitas.2023.107866] [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: 04/13/2023] [Revised: 07/31/2023] [Accepted: 09/22/2023] [Indexed: 04/13/2024]
Abstract
The association between cognitive disorders and orthostatic hypotension (OH) has been empirically explored, but the results have been divergent, casting doubt on the presence and direction of the association. The objective of this meta-analysis was to systematically review and quantitatively synthesize the association of OH and cognitive function, specifically mean score on the Mini-Mental State Examination (MMSE), cognitive impairment and incident dementia. A Medline search was conducted in May 2022 with no date limit, using the MeSH terms "orthostatic hypotension" OR "orthostatic intolerance" OR "hypotension" combined with the Mesh terms "cognitive dysfunction" OR "Alzheimer disease" OR "dementia" OR "cognition disorder" OR "neurocognitive disorder" OR "cognition" OR "neuropsychological test". Of the 746 selected studies, 15 longitudinal studies met the selection criteria, of which i) 5 studies were eligible for meta-analysis of mean MMSE score comparison, ii) 5 studies for the association of OH and cognitive impairment, and iii) 6 studies for the association between OH and incident dementia. The pooled effect size in fixed-effects meta-analysis was: i) -0.25 (-0.42; -0.07) for the mean MMSE score, which indicates that the MMSE score was lower for those with OH; ii) OR (95 % CI) = 1.278 (1.162; 1.405), P < 0.0001, indicating a 28 % greater risk of cognitive impairment for those with OH at baseline; and iii) HR (95 % CI) = 1.267 (1.156; 1.388), P < 0.0001, indicating a 27 % greater risk of incident dementia for those with OH at baseline. Patients with OH had a lower MMSE score and higher risk of cognitive impairment and incident dementia in this meta-analysis of longitudinal studies. This study confirmed the presence of an association between OH and cognitive disorders in older adults.
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Affiliation(s)
- Guillaume T Duval
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France.
| | - Eve Raud
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France
| | - Hugo Gohier
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France
| | - Moustapha Dramé
- University of the French West Indies, EpiCliV Research Unit, Fort-de-France, Martinique; University Hospitals of Martinique, Department of Clinical Research and Innovation, Fort-de-France, Martinique
| | - Maturin Tabue-Teguo
- Department of Geriatrics, University Hospital of Martinique, Fort-de-France, Martinique
| | - Cédric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France; Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, St. Joseph's Health Care London, Gait and Brain Lab, Lawson Health Research Institute, the University of Western Ontario, London, ON, Canada; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
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Estácio JC, Cera ML, Mangilli LD. Swallowing performance of elderly people and sociodemographic, cognitive and language factors. Codas 2024; 36:e20220319. [PMID: 38836826 PMCID: PMC11189153 DOI: 10.1590/2317-1782/20242022319pt] [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: 04/14/2023] [Accepted: 12/15/2023] [Indexed: 06/06/2024] Open
Abstract
PURPOSE To analyze the correlation between swallowing, language and cognition performance and describe the sociodemographic data of elderly people without previous neurological disorders. METHODS Analytical cross-sectional study, with non-probabilistic sample for convenience and data collection by telecall. The aspiration screening test (Yale Swallow Protocol) was used to identify and exclude elderly people at risk of aspiration. Then, sociodemographic data were collected, and instruments were applied: activity of daily living (IADLs), risk of dysphagia (EAT-10), cognitive screening (Mini Mental State Examination - MMSE) and language (Montreal-Toulouse Language Battery - MTL-Brazil). RESULTS The sample consisted of 32 elderly people from the Federal District, with a mean age of 69.00±7.73 years and schooling of 10.00±5.60 years. The scores on the EAT-10, MMSE and MTL Battery instruments were altered in four, 22 and 26 elderly, respectively, indicating, in this case, risk of dysphagia, suggestion of cognitive alteration and language alteration. Regarding food, of the total sample, 13 seniors (40%) complained of needing modified food, as well as 10 of these also obtained MMSE scores suggestive of cognitive alteration. When comparing the groups with and without complaints and/or risk of dysphagia, there was no statistically significant difference in relation to sociodemographic, cognitive and language variables. Binary logistic regression models also showed no statistically significant results. CONCLUSION The present study, when correlating the swallowing, language and cognition findings, did not obtain statistically significant results. It was observed that the elderly with swallowing complaints also showed results suggestive of cognitive and language changes in the tests performed, but there was no statistically significant difference in relation to the elderly without complaints or swallowing changes.
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Affiliation(s)
- Jaqueline Cardoso Estácio
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade de Brasília – UnB - Brasília (DF), Brasil.
| | - Maysa Luchesi Cera
- Curso de Fonoaudiologia, Faculdade de Ceilândia, Universidade de Brasília – UnB - Brasília (DF), Brasil.
| | - Laura Davison Mangilli
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade de Brasília – UnB - Brasília (DF), Brasil.
- Curso de Fonoaudiologia, Faculdade de Ceilândia, Universidade de Brasília – UnB - Brasília (DF), Brasil.
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Huang E, Li H, Han H, Guo L, Liang Y, Huang Z, Qin K, Du X. Polydopamine-Coated Kaempferol-Loaded MOF Nanoparticles: A Novel Therapeutic Strategy for Postoperative Neurocognitive Disorder. Int J Nanomedicine 2024; 19:4569-4588. [PMID: 38799697 PMCID: PMC11127663 DOI: 10.2147/ijn.s455492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose The primary objective of this study was to develop an innovative nanomedicine-based therapeutic strategy to alleviate Postoperative Neurocognitive Disorder (PND) in patients undergoing surgery. Patients and Methods To achieve this goal, polydopamine-coated Kaempferol-loaded Metal-Organic Framework nanoparticles (pDA/KAE@ZIF-8) were synthesized and evaluated. The study involved encapsulating Kaempferol (KAE) within ZIF-8 nanoparticles, followed by coating with polydopamine (PDA) to enhance biocompatibility and targeted delivery. The characterization of these nanoparticles (NPs) was conducted using various techniques including Scanning Electron Microscopy, Fourier-Transform Infrared Spectroscopy, X-ray Diffraction, and Ultraviolet-Visible spectroscopy. The efficacy of pDA/KAE@ZIF-8 NPs was tested in both in vitro and in vivo models, specifically focusing on their ability to penetrate the blood-brain barrier and protect neuronal cells against oxidative stress. Results The study found that pDA/KAE@ZIF-8 NPs efficiently penetrated the blood-brain barrier and were significantly taken up by neuronal cells. These nanoparticles demonstrated remarkable Reactive Oxygen Species (ROS) scavenging capabilities and stability under physiological conditions. In vitro studies showed that pDA/KAE@ZIF-8 NPs provided protection to HT-22 neuronal cells against H2O2-induced oxidative stress, reduced the levels of pro-inflammatory cytokines, and decreased apoptosis rates. In a PND mouse model, the treatment with pDA/KAE@ZIF-8 NPs significantly improved cognitive functions, surpassing the effects of KAE alone. This improvement was substantiated through behavioral tests and a noted reduction in hippocampal inflammation. Conclusion The findings from this study underscore the potential of pDA/KAE@ZIF-8 NPs as an effective nanotherapeutic agent for PND. This approach offers a novel direction in the postoperative care of elderly patients, with the potential to transform the therapeutic landscape for neurocognitive disorders following surgery. The application of nanotechnology in this context opens new avenues for more effective and targeted treatments, thereby improving the quality of life for patients suffering from PND.
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Affiliation(s)
- Enhao Huang
- Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530007, People’s Republic of China
- Key Laboratory for Basic Science and Prevention of Perioperative Organ Dysfunction, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Huadao Li
- Key Laboratory for Basic Science and Prevention of Perioperative Organ Dysfunction, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
- Department of Anesthesiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Hanghang Han
- Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530007, People’s Republic of China
- Key Laboratory for Basic Science and Prevention of Perioperative Organ Dysfunction, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Lianshan Guo
- Department of Emergency, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530007, People’s Republic of China
| | - Yubing Liang
- Department of Anesthesiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Zijin Huang
- Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530007, People’s Republic of China
| | - Ke Qin
- Guilin People’s Hospital, Guilin, Guangxi Zhuang Autonomous Region, 541100, People’s Republic of China
| | - Xueke Du
- Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530007, People’s Republic of China
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Cui X, Zheng X, Lu Y. Prediction Model for Cognitive Impairment among Disabled Older Adults: A Development and Validation Study. Healthcare (Basel) 2024; 12:1028. [PMID: 38786438 PMCID: PMC11121056 DOI: 10.3390/healthcare12101028] [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: 03/22/2024] [Revised: 05/02/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Disabled older adults exhibited a higher risk for cognitive impairment. Early identification is crucial in alleviating the disease burden. This study aims to develop and validate a prediction model for identifying cognitive impairment among disabled older adults. A total of 2138, 501, and 746 participants were included in the development set and two external validation sets. Logistic regression, support vector machine, random forest, and XGBoost were introduced to develop the prediction model. A nomogram was further established to demonstrate the prediction model directly and vividly. Logistic regression exhibited better predictive performance on the test set with an area under the curve of 0.875. It maintained a high level of precision (0.808), specification (0.788), sensitivity (0.770), and F1-score (0.788) compared with the machine learning models. We further simplified and established a nomogram based on the logistic regression, comprising five variables: age, daily living activities, instrumental activity of daily living, hearing impairment, and visual impairment. The areas under the curve of the nomogram were 0.871, 0.825, and 0.863 in the internal and two external validation sets, respectively. This nomogram effectively identifies the risk of cognitive impairment in disabled older adults.
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Affiliation(s)
| | | | - Yun Lu
- School of International Pharmaceutical Business, China Pharmaceutical University, 639 Longmian Avenue, Jiangning District, Nanjing 211198, China; (X.C.); (X.Z.)
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Lee HW, Chen SJ, Tsai KJ, Hsu KS, Chen YF, Chang CH, Lin HH, Hsueh WY, Hsieh HP, Lee YF, Chiang HC, Chang JY. Targeting cathepsin S promotes activation of OLF1-BDNF/TrkB axis to enhance cognitive function. J Biomed Sci 2024; 31:46. [PMID: 38725007 PMCID: PMC11084077 DOI: 10.1186/s12929-024-01037-2] [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: 11/27/2023] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Cathepsin S (CTSS) is a cysteine protease that played diverse roles in immunity, tumor metastasis, aging and other pathological alterations. At the cellular level, increased CTSS levels have been associated with the secretion of pro-inflammatory cytokines and disrupted the homeostasis of Ca2+ flux. Once CTSS was suppressed, elevated levels of anti-inflammatory cytokines and changes of Ca2+ influx were observed. These findings have inspired us to explore the potential role of CTSS on cognitive functions. METHODS We conducted classic Y-maze and Barnes Maze tests to assess the spatial and working memory of Ctss-/- mice, Ctss+/+ mice and Ctss+/+ mice injected with the CTSS inhibitor (RJW-58). Ex vivo analyses including long-term potentiation (LTP), Golgi staining, immunofluorescence staining of sectioned whole brain tissues obtained from experimental animals were conducted. Furthermore, molecular studies were carried out using cultured HT-22 cell line and primary cortical neurons that treated with RJW-58 to comprehensively assess the gene and protein expressions. RESULTS Our findings reported that targeting cathepsin S (CTSS) yields improvements in cognitive function, enhancing both working and spatial memory in behavior models. Ex vivo studies showed elevated levels of long-term potentiation levels and increased synaptic complexity. Microarray analysis demonstrated that brain-derived neurotrophic factor (BDNF) was upregulated when CTSS was knocked down by using siRNA. Moreover, the pharmacological blockade of the CTSS enzymatic activity promoted BDNF expression in a dose- and time-dependent manner. Notably, the inhibition of CTSS was associated with increased neurogenesis in the murine dentate gyrus. These results suggested a promising role of CTSS modulation in cognitive enhancement and neurogenesis. CONCLUSION Our findings suggest a critical role of CTSS in the regulation of cognitive function by modulating the Ca2+ influx, leading to enhanced activation of the BDNF/TrkB axis. Our study may provide a novel strategy for improving cognitive function by targeting CTSS.
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Affiliation(s)
- Hao-Wei Lee
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan
- Taipei Cancer Center, TMU Research Center of Cancer Translational Medicine, Taipei Medical University Hospital, College of Medicine, Taipei Medical University, No. 252, Wuxing St., Xinyi Dist., Taipei, 110301, Taiwan (R.O.C.)
| | - Szu-Jung Chen
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan
| | - Kuen-Jer Tsai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kuei-Sen Hsu
- Institute of Basic Medical Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Fan Chen
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan
| | - Chih-Hua Chang
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Han Lin
- Immunology Research Center, National Health Research Institutes, Zhunan, Taiwan
| | - Wen-Yun Hsueh
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan
| | - Hsing-Pang Hsieh
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan
| | - Yueh-Feng Lee
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan
| | - Huai-Chueh Chiang
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan
| | - Jang-Yang Chang
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan.
- Taipei Cancer Center, TMU Research Center of Cancer Translational Medicine, Taipei Medical University Hospital, College of Medicine, Taipei Medical University, No. 252, Wuxing St., Xinyi Dist., Taipei, 110301, Taiwan (R.O.C.).
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Wang Y, Dou L, Wang N, Zhao Y, Nie Y. An analysis of factors influencing cognitive dysfunction among older adults in Northwest China based on logistic regression and decision tree modelling. BMC Geriatr 2024; 24:405. [PMID: 38714934 PMCID: PMC11077840 DOI: 10.1186/s12877-024-05024-y] [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: 11/06/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Cognitive dysfunction is one of the leading causes of disability and dependence in older adults and is a major economic burden on the public health system. The aim of this study was to investigate the risk factors for cognitive dysfunction and their predictive value in older adults in Northwest China. METHODS A cross-sectional study was conducted using a multistage sampling method. The questionnaires were distributed through the Elderly Disability Monitoring Platform to older adults aged 60 years and above in Northwest China, who were divided into cognitive dysfunction and normal cognitive function groups. In addition to univariate analyses, logistic regression and decision tree modelling were used to construct a model to identify factors that can predict the occurrence of cognitive dysfunction in older adults. RESULTS A total of 12,494 valid questionnaires were collected, including 2617 from participants in the cognitive dysfunction group and 9877 from participants in the normal cognitive function group. Univariate analysis revealed that ethnicity, BMI, age, educational attainment, marital status, type of residence, residency status, current work status, main economic source, type of chronic disease, long-term use of medication, alcohol consumption, participation in social activities, exercise status, social support, total scores on the Balanced Test Assessment, total scores on the Gait Speed Assessment total score, and activities of daily living (ADL) were significantly different between the two groups (all P < 0.05). According to logistic regression analyses, ethnicity, BMI, educational attainment, marital status, residency, main source of income, chronic diseases, annual medical examination, alcohol consumption, exercise status, total scores on the Balanced Test Assessment, and activities of daily living (ADLs) were found to influence cognitive dysfunction in older adults (all P < 0.05). In the decision tree model, the ability to perform activities of daily living was the root node, followed by total scores on the Balanced Test Assessment, marital status, educational attainment, age, annual medical examination, and ethnicity. CONCLUSIONS Traditional risk factors (including BMI, literacy, and alcohol consumption) and potentially modifiable risk factors (including balance function, ability to care for oneself in daily life, and widowhood) have a significant impact on the increased risk of cognitive dysfunction in older adults in Northwest China. The use of decision tree models can help health care workers better assess cognitive function in older adults and develop personalized interventions. Further research could help to gain insight into the mechanisms of cognitive dysfunction and provide new avenues for prevention and intervention.
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Affiliation(s)
- Yu Wang
- Zhejiang Provincial People's Hospital, No.158 Shangtang Road, Hangzhou City, Zhejiang Province, 310014, People's Republic of China
| | - Li Dou
- The Second Affiliated Hospital of Xinjiang Medical University, No. 38, North 2nd Lane, Nanhu East Road, Shuimogou District, Urumqi City, Xinjiang Uygur Autonomous Region, 830063, People's Republic of China
| | - Ni Wang
- School of Nursing, Xinjiang Medical University, No.567 Shangde North Road, Urumqi City, Xinjiang Uygur Autonomous Region, 830000, People's Republic of China
| | - Yanjie Zhao
- School of Nursing, Xinjiang Medical University, No.567 Shangde North Road, Urumqi City, Xinjiang Uygur Autonomous Region, 830000, People's Republic of China
| | - Yuqin Nie
- The Second Affiliated Hospital of Xinjiang Medical University, No. 38, North 2nd Lane, Nanhu East Road, Shuimogou District, Urumqi City, Xinjiang Uygur Autonomous Region, 830063, People's Republic of China.
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Guo J, Xu X, Geng Q, Wang T, Xu K, He J, Long Y, Zhang Q, Jing W, Li Z, Pan Y, Xu P, Hou Z. Efficacy of surgical intervention over conservative management in intertrochanteric fractures among nonagenarians and centenarians: a prospective cohort study. Int J Surg 2024; 110:2708-2720. [PMID: 38376871 DOI: 10.1097/js9.0000000000001143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Optimal treatment strategy for nonagenarians and centenarians with hip fractures (NCHF) remained unknown. The authors aimed to compare the outcomes of surgical and conservative management in NCHF. METHODS A prospective cohort study was conducted based on CPMHF database with NCHF patients hospitalized during 2014-2020. Comorbidities were evaluated by mECM score and restricted cubic spline was utilized to visually assess the dose-effect relationship between the mECM and outcomes. Propensity score matching was performed to balance baseline characteristics between nonsurgical and surgical groups. Multivariate logistic regression, Cox proportional hazard analysis, and survival analysis were employed for unfavorable outcomes (UFO) evaluation. Competing risk of death were analyzed based on Fine and Gray's hazard model and then constructed nomogram models for predicting survival rates. Subgroup analyses were used to determine potential population heterogeneity and sensitivity analyses were performed to test robustness of the results. RESULTS The authors found increasing trends for UFO with the increase in the mECM score, and that high mECM score (HMS, ≥3) was independently associated with a 2.42-fold (95% CI: 2.07-3.54; P =0.024) increased risk of UFO, which remained significant after considering the competing role of death and were more pronounced in nonsurgical treatment, women, no insurance, and patients with spouse (all P for interaction <0.05). Surgical intervention was identified to be significant protective factors for UFO (RR, 0.59; 95% CI: 0.46-0.75; P <0.001) and severe complications (RR, 0.63; 95% CI: 0.41-0.96; P =0.033) after propensity score matching, as well as survival (HR, 0.40, 95% CI: 0.28-0.58; P <0.001), which remained significant after considering the competing role of death and in all sensitivity analyses and were more pronounced in HMS participants ( P for interaction=0.006). Subgroup analyses revealed surgical patients with HMS had a significantly higher UFO rate (excluding death, P <0.001) while nonsurgical patients with HMS had higher mortality rate as compared to the others ( P =0.005). CONCLUSION Surgical treatment for NCHF yields better outcomes compared to conservative treatment.
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Affiliation(s)
- Junfei Guo
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | - Xin Xu
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | | | - Tao Wang
- Department of Orthopedic Surgery
| | - Ke Xu
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | - Jinwen He
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | | | | | - Wensen Jing
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | - Zheng Li
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | - Ying Pan
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | - Peng Xu
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi
| | - Zhiyong Hou
- Department of Orthopedic Surgery
- NHC Key Laboratory of Intelligent Orthopedic Equipment (Third Hospital of Hebei Medical University)
- Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, People's Republic of China
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10
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Saha S, Das P, Das T, Das P, Roy TB. A study about the impact of indoor air pollution on cognitive function among middle-aged and older adult people in India. Arch Public Health 2024; 82:57. [PMID: 38664719 PMCID: PMC11044570 DOI: 10.1186/s13690-024-01286-5] [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: 11/16/2023] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In the 21st century, people still use solid fuel for cooking at home, resulting in poor indoor air quality. Prolonged exposure to such conditions may negatively affect one's cognitive function. So, the present study examines the possible association between IAP and the cognitive function of individuals aged 45 years or above in India. METHODS The study utilizes secondary data, procured from the longitudinal ageing study in India (2017-18). Treatment effects through regression-adjusted models were applied to represent the association between IAP and cognitive health and the results are represented by beta coefficient (β). Three separate models with a 95% confidence interval adjusting with the other factors like housing environment, individual and behavioural were framed. RESULTS The study revealed that households without a separate kitchen (β = -0.64; 95%CI: -0.90 to -0.39) and electricity (β = -0.97; 95%CI: -1.34 to -0.61) significantly affect cognitive strength. Cognitive decline is likely more pronounced among older adults (β = -1.19; 95%CI: -1.42 to -0.96) than the middle-aged population. Moreover, the cognitive ability of rural residents (β = -1.11; 95%CI: -1.49 to -0.73) and women (β = -2.05; 95%CI: -2.29 to -1.81) is negatively associated with IAP exposure. Older adults with no reading habits (β = -6.28; 95%CI: -6.72; to -5.85) and physical inactivity (β = -0.96; 95%CI: -1.22 to -0.70) had a sign of notable decline in cognitive ability. CONCLUSIONS Findings revealed that cognitive function is negatively associated with IAP, demanding a deep intervention plan to minimize the detrimental effect.
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Affiliation(s)
- Subhadeep Saha
- Department of Geography, Raiganj University, Uttar Dinajpur, Raiganj, West Bengal, 733134, India
| | - Priya Das
- Department of Geography, University of Gour Banga, Malda, West Bengal, 732101, India
| | - Tanu Das
- Department of Geography, Raiganj University, Uttar Dinajpur, Raiganj, West Bengal, 733134, India
| | - Partha Das
- Department of Geography, Raiganj University, Uttar Dinajpur, Raiganj, West Bengal, 733134, India
| | - Tamal Basu Roy
- Department of Geography, Raiganj University, Uttar Dinajpur, Raiganj, West Bengal, 733134, India.
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11
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Ai F, Li E, Dong A, Zhang H. Association between disability and cognitive function in older Chinese people: a moderated mediation of social relationships and depressive symptoms. Front Public Health 2024; 12:1354877. [PMID: 38689766 PMCID: PMC11058663 DOI: 10.3389/fpubh.2024.1354877] [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: 12/13/2023] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
Objective Many previous studies have found that disability leads to cognitive impairment, and in order to better understand the underlying mechanisms between disability and cognitive impairment, the present study aimed to investigate the moderating role of social relationships, including their role as mediators between disability and cognitive impairment in depressive symptoms. Study design This is a cross-sectional study. Methods A total of 5,699 Chinese older adults from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS) were included in this study, and PROCESS macro was used to perform simple mediator and moderator mediator analyses, which were used to analyze the relationship between depressive symptoms and social relationships between disability and cognitive impairment. Results The results of this study showed significant correlations between disability, cognitive impairment, depressive symptoms, and social relationships, and that depressive symptoms mediated the relationship between disability and cognitive functioning [B = -0.232; 95% CI: (-0.304, -0.164)], and that social relationships mediated disability and cognitive functioning through pathway a (Disability-Depressive Symptoms) [B = 0.190; 95% CI: (0.020, 0.036)], path b (depressive symptoms-cognitive impairment) [B = 0.029; 95% CI: (0.015, 0.042)], and path c' (incapacitation-cognitive impairment) [B = 0.492; 95% CI: (0.298, 0.685)] to modulate the effect of incapacitation on cognitive impairment. In addition, social activities and social networks moderated the mediation model directly or indirectly, whereas social support moderated only the direct effect. Conclusion This study explains the intrinsic link between incapacitation and cognitive impairment in Chinese older adults, and that social relationships and depressive symptoms can directly or indirectly modulate the effects between them. This provides a basis for healthcare professionals to be able to better develop interventions that can be used to improve the level of cognitive functioning and mental health of older adults.
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Affiliation(s)
| | | | | | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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12
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Zarringhadam M, Hasanvand S, Birjandi M, Beiranvand A. Associations between cognitive function and lifestyle in community-living older people: a correlational study. BMC Res Notes 2024; 17:101. [PMID: 38594711 PMCID: PMC11003163 DOI: 10.1186/s13104-024-06766-z] [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: 11/08/2023] [Accepted: 04/03/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Previous studies have examined relationship between cognitive function and lifestyle; however, the nature of this relationship is expected to vary in diverse cultural and low-income setting where lifestyle practices differ from those in high-income countries. AIM This study aims to investigate the correlation between lifestyle factors and cognitive function among individuals aged 60 years and older in 2021. METHODS This cross-sectional, Community-based study involved 300 older adults from comprehensive urban health centers in Khorramabad, Iran, selected through stratified cluster sampling. Data were collected using the demographic information questionnaire, Mini-Mental State Examination, and Lifestyle Questionnaire. Data management and analysis were performed using SPSS (version 22) and independent t-tests, Pearson's correlation coefficient, ANOVA, and multiple linear regression analysis were used. A p value < 0.05 was considered significant. RESULTS The study included 156 males (52%) and 144 females (48%). Findings revealed a significant correlation between cognitive function and lifestyle (P < 0.001). Multiple linear regression analysis indicated that physical health, environmental health, exercise, accident prevention, and avoidance of medication exerted the most significant positive effect on cognitive function. Conversely, social health exhibited a notable negative influence on cognitive function. (P < 0.001). CONCLUSION The results suggest that specific aspects of lifestyle, such as physical health, accident prevention, and avoidance of medication are associated with cognitive function in older adults. Consequently, lifestyle promotion programs may enhance cognitive function and improve the quality of life among older adults.
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Affiliation(s)
- Maryam Zarringhadam
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Shirin Hasanvand
- Social Determinants of Health Research Center, School of Nursing & Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mehdi Birjandi
- Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Afsaneh Beiranvand
- Social Determinants of Health Research Center, School of Nursing & Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
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13
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Hu J, Ye M, Xi J. Late Life Cognitive Function Trajectory Among the Chinese Oldest-Old Population-A Machine Learning Approach. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-21. [PMID: 38590205 DOI: 10.1080/01634372.2024.2339982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
Informed by the biopsychosocial framework, our study uses the Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset to examine cognitive function trajectories among the oldest-old (80+). Employing K-means clustering, we identified two latent groups: High Stability (HS) and Low Stability (LS). The HS group maintained satisfactory cognitive function, while the LS group exhibited consistently low function. Lasso regression revealed predictive factors, including socioeconomic status, biological conditions, mental health, lifestyle, psychological, and behavioral factors. This data-driven approach sheds light on cognitive aging patterns and informs policies for healthy aging. Our study pioneers non-parametric machine learning methods in this context.
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Affiliation(s)
- Jierong Hu
- Department of Innovative Social Work, City University of Macau, Macau, China
| | - Minzhi Ye
- School of Lifespan Development and Educational Science, Kent State University, Kent, USA
| | - Juan Xi
- Department of Sociology, Akron University, Akron, USA
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14
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Wang X, Yin Z, Yang Y, Fu X, Guo C, Pu K, Zang S. Association of plant-based dietary patterns with depression and anxiety symptoms in Chinese older adults: A nationwide study. J Affect Disord 2024; 350:838-846. [PMID: 38278327 DOI: 10.1016/j.jad.2024.01.159] [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: 06/30/2023] [Revised: 11/26/2023] [Accepted: 01/14/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND The associations of plant-based dietary patterns with depression and anxiety symptoms among older adults have not been extensively studied. Therefore, the purpose of this study was to examine these associations in Chinese older adults. METHODS Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was employed in the present study. The simplified food frequency questionnaire was used to assess the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). The Center for Epidemiologic Studies Depression Scale-10 (CES-D-10) was used to evaluate depression symptoms, and the Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess anxiety symptoms. This study employed logistic regression and linear regression to examine the associations between plant-based dietary patterns and symptoms of depression and anxiety. RESULTS This study included 11,971 older adults, with a mean age of 83.23 ± 11.10 years. The results indicated that PDI and hPDI were negative associated with depression symptoms (adjusted β -0.09, 95 % CI -0.11, -0.07) (adjusted β -0.09, 95 % CI -0.11, -0.07) and anxiety symptoms (adjusted β -0.03, 95 % CI -0.04, -0.02) (adjusted β -0.04, 95 % CI -0.05, -0.02), while uPDI was positive associated with depression symptoms (adjusted β 0.09, 95 % CI 0.07, 0.11) and anxiety symptoms (adjusted β 0.04, 95 % CI 0.03, 0.05). CONCLUSIONS The findings from this study have the potential to promote healthy dietary patterns in older adults, and may have implications for the prevention and management of depression and anxiety in this population.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Zhihua Yin
- Department of Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Ying Yang
- Library of China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Xiao Fu
- Department of Gastroenterology, Qingdao Huangdao District Central Hospital, No. 9 Huangpujiang Road, Huangdao District, Qingdao, Shandong Province 266555, China
| | - Chaowei Guo
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Keping Pu
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China.
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15
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Wang L. The impact of long-term care insurance pilot on the mental health of older adults: Quasi-experimental evidence from China. SSM Popul Health 2024; 25:101632. [PMID: 38405165 PMCID: PMC10891319 DOI: 10.1016/j.ssmph.2024.101632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/08/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024] Open
Abstract
The Chinese government launched pilot programs for a long-term care insurance system in response to the ongoing increase in the aging population. This study uses the difference-in-differences (DID) model to analyze the impact of long-term care insurance on older adults' mental health based on China Health and Retirement Longitudinal Study (CHARLS) four-period panel data from 2011 to 2018. This study found that long-term care insurance reduced Center for Epidemiological Studies Depression Scale (CES-D) scores among older adults by 1.059 points. Moreover, there was an improvement of 0.181 and 0.870 points in mental status and scenario memory scores, respectively. The impact of the long-term care insurance pilot program on improving the mental health of older adults was more pronounced, especially for those with chronic diseases or disabilities as well as those living in rural and western regions. This study also revealed that long-term care insurance enhances mental health by reducing medical expenses and increasing daily companionship and social interaction. Therefore, a pilot study of long-term care insurance showed a significant improvement in the mental health of older adults. To provide a comprehensive care service system for older adults, the government should expand the scope of the pilot program and increase the accessibility of mental health services for older adults.
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Affiliation(s)
- Lianjie Wang
- Department of Sociology, Jiangnan University, Wuxi, China
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16
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Maimaitituerxun R, Chen W, Xiang J, Xie Y, Xiao F, Wu XY, Chen L, Yang J, Liu A, Dai W. Predictive model for identifying mild cognitive impairment in patients with type 2 diabetes mellitus: A CHAID decision tree analysis. Brain Behav 2024; 14:e3456. [PMID: 38450963 PMCID: PMC10918605 DOI: 10.1002/brb3.3456] [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: 10/30/2023] [Revised: 02/04/2024] [Accepted: 02/10/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND As the population ages, mild cognitive impairment (MCI) and type 2 diabetes mellitus (T2DM) become common conditions that often coexist. Evidence has shown that MCI could lead to reduced treatment compliance, medication management, and self-care ability in T2DM patients. Therefore, early identification of those with increased risk of MCI is crucial from a preventive perspective. Given the growing utilization of decision trees in prediction of health-related outcomes, this study aimed to identify MCI in T2DM patients using the decision tree approach. METHODS This hospital-based case-control study was performed in the Endocrinology Department of Xiangya Hospital affiliated to Central South University between March 2021 and December 2022. MCI was defined based on the Petersen criteria. Demographic characteristics, lifestyle factors, and T2DM-related information were collected. The study sample was randomly divided into the training and validation sets in a 7:3 ratio. Univariate and multivariate analyses were performed, and a decision tree model was established using the chi-square automatic interaction detection (CHAID) algorithm to identify key predictor variables associated with MCI. The area under the curve (AUC) value was used to evaluate the performance of the established decision tree model, and the performance of multivariate regression model was also evaluated for comparison. RESULTS A total of 1001 participants (705 in the training set and 296 in the validation set) were included in this study. The mean age of participants in the training and validation sets was 60.2 ± 10.3 and 60.4 ± 9.5 years, respectively. There were no significant differences in the characteristics between the training and validation sets (p > .05). The CHAID decision tree analysis identified six key predictor variables associated with MCI, including age, educational level, household income, regular physical activity, diabetic nephropathy, and diabetic retinopathy. The established decision tree model had 15 nodes composed of 4 layers, and age is the most significant predictor variable. It performed well (AUC = .75 [95% confidence interval (CI): .71-.78] and .67 [95% CI: .61-.74] in the training and validation sets, respectively), was internally validated, and had comparable predictive value compared to the multivariate logistic regression model (AUC = .76 [95% CI: .72-.80] and .69 [95% CI: .62-.75] in the training and validation sets, respectively). CONCLUSION The established decision tree model based on age, educational level, household income, regular physical activity, diabetic nephropathy, and diabetic retinopathy performed well with comparable predictive value compared to the multivariate logistic regression model and was internally validated. Due to its superior classification accuracy and simple presentation as well as interpretation of collected data, the decision tree model is more recommended for the prediction of MCI in T2DM patients in clinical practice.
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Affiliation(s)
- Rehanguli Maimaitituerxun
- Department of Epidemiology and Health Statistics, Xiangya School of Public HealthCentral South UniversityChangshaHunanChina
| | - Wenhang Chen
- Department of NephrologyXiangya Hospital, Central South UniversityChangshaHunanChina
| | - Jingsha Xiang
- Department of Human ResourcesJinan Central Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Yu Xie
- Department of Epidemiology and Health Statistics, Xiangya School of Public HealthCentral South UniversityChangshaHunanChina
| | - Fang Xiao
- Department of Toxicology, Xiangya School of Public HealthCentral South UniversityChangshaHunanChina
| | - Xin Yin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public HealthCentral South UniversityChangshaHunanChina
| | - Letao Chen
- Infection Control CenterXiangya Hospital, Central South UniversityChangshaHunanChina
| | - Jianzhou Yang
- Department of Preventive MedicineChangzhi Medical CollegeChangzhiShanxiChina
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public HealthCentral South UniversityChangshaHunanChina
| | - Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public HealthCentral South UniversityChangshaHunanChina
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17
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Yang Y, Zhu D, Qi R, Chen Y, Sheng B, Zhang X. Association between Intake of Edible Mushrooms and Algae and the Risk of Cognitive Impairment in Chinese Older Adults. Nutrients 2024; 16:637. [PMID: 38474765 DOI: 10.3390/nu16050637] [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: 02/06/2024] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Previous studies have investigated the association between diet and cognitive impairment, yet there is limited investigation into the link between edible mushrooms and algae intake and cognitive decline. This study aims to explore the association between edible mushrooms and algae intake and the risk of cognitive impairment in individuals aged 65 years and above in China. Cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) formed the basis of this study. Edible mushrooms and algae intake was evaluated using a simplified food frequency questionnaire (FFQ) and cognitive function was assessed using the Mini-Mental State Examination (MMSE). A binary logistic regression model was used to evaluate odds ratios (ORs) and 95% confidence intervals (CIs), with subgroup analysis conducted. Among 14,150 older adults, the average age was (85.33 ± 11.55), with a cognitive impairment prevalence of 22.7; multi-model adjustments showed a 25.3% lower probability of cognitive impairment for those occasionally consuming edible mushrooms and algae (OR: 0.747, 95% CI: 0.675~0.826). Furthermore, a 29% lower risk was observed in those with daily intake (OR: 0.710, 95% CI: 0.511~0.987). Subgroup analysis demonstrated significant risk reduction in women (OR: 0.589, 95% CI: 0.375~0.925, p = 0.022), individuals with disability in activities of daily living (OR: 0.568, 95% CI: 0.367~0.878, p = 0.011), and those with low social activity levels (OR: 0.671, 95% CI: 0.473~0.950, p = 0.025). This study concludes that edible mushrooms and algae intake significantly impacts the risk of cognitive impairment in older adults. These results provide insights and impetus for further research into this area. Additional cohort studies or intervention trials are necessary to confirm the potential benefits of edible mushrooms and algae in promoting cognitive health.
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Affiliation(s)
- Yun Yang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Danni Zhu
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ran Qi
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yanchun Chen
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Baihe Sheng
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
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18
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Zhai L, Yang Y, Zhang J, Hou W, Yang Y, Ding D, Li C, Zhu Y. Association between cognitive dysfunction and diabetes in patients over 65 years old: a cross-sectional study using propensity score matching. J Rehabil Med 2024; 56:jrm18372. [PMID: 38380813 PMCID: PMC10896218 DOI: 10.2340/jrm.v56.18372] [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: 08/07/2023] [Accepted: 01/15/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES To investigate the association between diabetes and cognitive dysfunction in the elderly population, and examine the impact of cognitive dysfunction on level of activities of daily living (ADL) in patients with diabetes. METHODS Data analysis was conducted on 2,951 individuals aged over 65 years from the Chinese Longitudinal Healthy Longevity Survey cohort. Propensity score matching was utilized to mitigate selection bias. Multivariate binary logistic regression was performed to analyse the association between diabetes and cognitive dysfunction in the study subjects. In addition, the relationship between ADL and cognitive function in patients with diabetes was analysed using the Wilcoxon rank-sum test. RESULTS A significant association (p = 0.017) was found between diabetes and the occurrence of cognitive dysfunction in older adults. Subgroup analyses revealed that diabetes patients with cognitive dysfunction exhibited a worse ADL dependence compared with those without cognitive dysfunction (p < 0.001). CONCLUSION These findings indicate that diabetes is associated with cognitive dysfunction in older adults. Meanwhile, there is an association between cognitive impairment and ADL level in subjects with diabetes. As such, healthcare professionals should pay close attention to the occurrence of cognitive dysfunction and ADL decline during diagnosis and treatment, and proactive prevention and intervention strategies should be implemented.
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Affiliation(s)
- Liwen Zhai
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yao Yang
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Jun Zhang
- Department of Rehabilitation Medicine, Hainan Cancer Hospital, Haikou, Hainan, China
| | - Weiqian Hou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yujie Yang
- School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Dongfang Ding
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Conghui Li
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Zhu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China.
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Ma T, Liao J, Ye Y, Li J. Social support and cognitive activity and their associations with incident cognitive impairment in cognitively normal older adults. BMC Geriatr 2024; 24:38. [PMID: 38191348 PMCID: PMC10775559 DOI: 10.1186/s12877-024-04655-5] [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: 11/03/2023] [Accepted: 01/01/2024] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES To explore the associations of social support, and cognitive activity with cognitive impairment incidence, and further examine the mediation effect of cognitive activity on the association between social support and cognitive impairment incidence based on a nationwide elderly Chinese cohort. METHODS We collected the participants from an ongoing cohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 9394 older adults aged 65 or more years and free of cognitive impairment who participated in the CLHLS between 2008 and 2018 were included. The information on social support and cognitive activity was collected through a questionnaire. The incident cognitive impairment cases were identified through the Mini-Mental State Examination scale (MMSE). Cox proportional hazard regression models were conducted to calculate the hazard ratios (HRs) and 95% confidence interval (CI) of social support and cognitive activity associated with cognitive impairment. We used casual mediation models to assess the indirect association of cognitive activities underlying the association between social support and cognitive impairment. RESULTS The adjusted HRs (95% CI) of incident cognitive impairment were 0.956 (0.932 to 0.980), and 0.895 (0.859 to 0.933) associated with per 1 score increase in social support and cognitive activity score, respectively. Better adherence to social support was associated with a higher cognitive activity score (adjusted β = 0.046, 95% CI[0.032-0.060]). The baseline cognitive activity, as well as the mean cognitive activity at baseline and during the first follow-up wave, mediate the association between social support and the incidence of cognitive impairment, accounting for 11.4% and 12.6% of the total association, respectively. The participants who were aged 80 years or older, or those with mild daily functional limitations gained more benefits in the development of cognitive activity related to social support, leading to a reduction in the risks of cognitive impairment. CONCLUSION The results of this nationwide cohort provide consistent evidence linking social support, and cognitive activity to reduced risk of subsequent cognitive impairment incidence. These findings provide additional evidence to inform the social strategies to prevent cognitive impairment incidence in elderly people.
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Affiliation(s)
- Tianpei Ma
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqiang Liao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuguo Ye
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jiayuan Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Liu M, Yang J, Wang C, Yang S, Wang J, Hou C, Wang S, Li X, Li F, Yang H, Li H, Liu S, Chen S, Hu S, Li X, Li Z, Li R, Li H, Bao Y, Shi Y, Tang Z, Fang X, He Y. Cohort profile: Beijing Healthy Aging Cohort Study (BHACS). Eur J Epidemiol 2024; 39:101-110. [PMID: 38177569 DOI: 10.1007/s10654-023-01050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/08/2023] [Indexed: 01/06/2024]
Abstract
The Beijing Healthy Aging Cohort Study (BHACS) was established to supplement the limited data of a large representative cohort of older people based on the general population and was designed to evaluate the prevalence, incidence, and natural history of cognitive decline, functional disability, and conventional vascular risk factors. The aim was to determine the evolution of these conditions by estimating the rates and determinants of progression and regression to adverse outcomes, including dementia, cardiovascular events, cancer, and all-cause death. It can therefore provide evidence to help policy makers develop better policies to promote healthy aging in China. BHACS consisted of three cohorts (BLSA, CCHS-Beijing, and BECHCS) in Beijing with a total population of 11 235 (6281 in urban and 4954 in rural areas) and an age range of 55 years or older (55-101 years) with a mean age of 70.35 ± 7.71 years (70.69 ± 7.62 years in urban and 69.92 ± 7.80 years in rural areas). BHACS-BLSA conducted the baseline survey in 2009 with a multistage stratification-random clustering procedure for people aged 55 years or older; BHACS-CCHS-Beijing conducted the baseline survey in 2013-2015 with a stratified multistage cluster random sampling method for people aged 55 years or older; and BHACS-BECHCS conducted the baseline survey in 2010-2014 with two-stage cluster random sampling method for people aged 60 years or older. Data were collected through questionnaires, physical measurements, and laboratory analyses. Topics covered by BHACS include a wide range of physical and mental health indicators, lifestyles and personal, family, and socio-economic determinants of health. There are no immediate plans to make the cohort data freely available to the public, but specific proposals for further collaboration are welcome. For further information and collaboration, please contact the corresponding author Yao He (e-mail: yhe301@x263.net).
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Affiliation(s)
- Miao Liu
- Graduate School, Medical School of Chinese PLA, Beijing, 100853, China
| | - Junhan Yang
- Graduate School, Medical School of Chinese PLA, Beijing, 100853, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Chunxiu Wang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jianhua Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Chengbei Hou
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiaoying Li
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Fang Li
- Department of Gerontology, Fuxing Hospital, Capital Medical University, Beijing, 100038, China
| | - Hongbing Yang
- Miyun County Hospital of Traditional Chinese Medicine, Beijing, 101500, China
| | - Haowei Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shaohua Liu
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shimin Chen
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shimin Hu
- Department of Gerontology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xuehang Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhiqiang Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Rongrong Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Huaihao Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yinghui Bao
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yueting Shi
- Graduate School, Medical School of Chinese PLA, Beijing, 100853, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xianghua Fang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
- State Key Laboratory of Kidney Diseases, Beijing, 100853, China.
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Qi Y, Zhang Z, Fu X, Han P, Xu W, Cao L, Guo Q. Adherence to a healthy lifestyle and its association with cognitive impairment in community-dwelling older adults in Shanghai. Front Public Health 2023; 11:1291458. [PMID: 38179562 PMCID: PMC10765578 DOI: 10.3389/fpubh.2023.1291458] [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: 09/12/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction There is a growing body of recent literature linking the association of specific or multiple lifestyles with cognitive impairment, but most of these studies have been conducted in Western populations, and it is necessary to study multiple lifestyles and cognitive abilities in different populations, with the primary population of this study being a select group of community-dwelling older adults in Shanghai, China. Methods The sample included 2,390 community-dwelling Chinese participants. Their cognitive function was assessed using the Mini-Mental State Examination (MMSE). We defined a healthy lifestyle score on the basis of being non-smoking, performing ≥210 min/wk moderate/vigorous-intensity physical activity, having light to moderate alcohol consumption, eating vegetables and fruits daily, having a body mass index (BMI) of 18.5-23.9 kg/m2, and having a waist-to-hip ratio (WHR) <0.90 for men and <0.85 for women, for an overall score ranging from 0 to 6. Results Compared with participants with ≤2 healthy lifestyle factors, the adjusted odds ratio (OR) and 95% confidence interval (CI) for participants with 4, 5, and 6 healthy lifestyle factors were 0.53 (95% CI, 0.29-0.98), 0.40 (95% CI, 0.21-0.75), and 0.36 (95% CI, 0.16-0.79), respectively. Only WHR (OR = 0.54, 95% CI = 0.37-0.78) and physical activity (OR = 0.69, 95% CI = 0.51-0.92) were associated with cognitive impairment. A healthy lifestyle correlated with overall cognition (β = 0.066, orientation (β = 0.049), language ability (β = 0.060), delayed recall (β = 0.045) and executive function (β = 0.044) (P all < 0.05). Conclusion The study provides evidence on an inverse association between healthy lifestyles and cognitive impairment. We investigated whether healthy lifestyle was related to specific cognitive functions to provide a theoretical basis for accurate clinical prescription.
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Affiliation(s)
- Yiqiong Qi
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | | | - Xiya Fu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Weixin Xu
- Department of Laboratory Medicine of Central Hospital of Jiading District Shanghai Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Liou Cao
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, Fuzhou, China
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Souza-Lima J, Matsudo SM, Valdivia-Moral P, Pérez W, Drenowatz C, Zenteno JS, Ferrari G. Association between cardiovascular risk factors and cognitive impairment in adults aged 60 years or older from Chile: a cross-sectional study. BMC Geriatr 2023; 23:806. [PMID: 38053094 PMCID: PMC10696861 DOI: 10.1186/s12877-023-04410-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/16/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Few studies in Latin America have examined the association between cardiovascular risk factors and cognitive impairment (CI) in a nationally representative sample. Therefore, this study aimed to estimate the prevalence of CI in a nationally representative sample of adults aged 60 years or older from Chile and to investigate the association between cardiovascular risk factors and CI. METHODS Data from the cross-sectional 2016-2017 National Health Survey of Chile, which included 2031 adults (63.7% women) was used. Body mass index, metabolic syndrome (blood pressure, triglycerides, fasting glucose or treatment for diabetics, waist circumference, and HDL cholesterol), risk of cardiovascular disease (history and measured variables, using the Framingham risk score), tobacco use, and physical activity were measured. CI was assessed using the Mini-Mental Status Examination (MMSE). RESULTS Overall, the prevalence of CI was 12.2% at the national level. Significant differences in CI were observed by age, education level, risk of cardiovascular disease, and smoking. High risk of cardiovascular disease was associated with higher odds of CI (OR: 2.04; 95%CI: 1.20-3.45) compared to low risk. Smoking was significantly associated with a lower likelihood of CI (OR: 0.56; 95%CI: 0.36-0.87) compared to never smoking. Body mass index, metabolic syndrome, and physical activity were not associated with CI. CONCLUSIONS This study provided additional support for previous findings on the relationship between cognitive decline and an elevated risk of cardiovascular disease. Worse CI was associated with the group with the highest risk of cardiovascular disease, and the presence of lifestyle factors, such as obesity and physical inactivity, exacerbate this relationship, but not being a current smoker.
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Affiliation(s)
| | | | | | - Waldo Pérez
- Hémera Centro de Observación de la tierra, Facultad de Ciencias Universidad Mayor, Santiago, Chile
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, Linz, Austria
| | - Jorge Sapunar Zenteno
- Centro de Excelencia de Medicina Translacional, Facultad de Medicina, Universidad de La Frontera, Chile
| | - Gerson Ferrari
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile.
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Yan S, Pang M, Wang J, Chen R, Liu H, Xu X, Li B, Li Q, Kong F. A comparative study of bibliometric analysis on old adults' cognitive impairment based on Web of Science and CNKI via CiteSpace. HEALTH ECONOMICS REVIEW 2023; 13:56. [PMID: 38041746 PMCID: PMC10693164 DOI: 10.1186/s13561-023-00470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION The purpose of this study was to analyze the current status, the research hot spots and frontiers of cognitive impairment (CI) on old adults from 2012 to 2022 based on Web of Science (WoS) and China National Knowledge Infrastructure (CNKI) via CiteSpace, and provide new in-sights for researchers. METHODS The articles regarding the old adults' CI in the WoS and CNKI were retrieved from 2012 to 2022. CiteSpaceV.6.1.R4 was used to generate network maps. RESULTS Four thousand seven hundred thirteen publications and 304 publications from CNKI were retrieved. Overall, from 2012 to 2022, the trend of articles published in WoS and CNKI were increasing. Data from WoS showed that USA, University of California, Petersen RC were the most influential country, institution and author respectively; Folstein MF, Neurology and a diagnosis guideline of mild CI were the most cited author, journal and reference separately; while the keywords of CI could be summarized in 3 aspects: related disease and symptom, risk factors, manifestations. Data from CNKI illustrated that Peking Union Medical College, Dan Liu were the most influential institution and scholar respectively, while the keywords of CI could be summarized in 3 aspects: related disease and symptoms, risk factors, intervention. CONCLUSION Articles published on old adults' CI were drawing an increasing amount of attention from 2012 to 2022 both in WoS and CNKI. Keywords of CI in WoS and CNKI both focused on risk factors, related disease and symptom, yet WoS contributed more to the mechanism and CNKI contributed more to the intervention.
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Affiliation(s)
- Shuyi Yan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Rui Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Hui Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Xixing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Bingsong Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Qinling Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
- Institute of Health and Elderly Care, Shandong University, Jinan, China.
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Cao K, Hao J, Wang NL. Visual impairment as a risk factor of cognitive function impairment A six-year cohort study. Eur J Ophthalmol 2023; 33:2146-2153. [PMID: 37070140 DOI: 10.1177/11206721231169613] [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: 04/19/2023]
Abstract
PURPOSE To explore whether baseline visual impairment (VI) increases the risk of cognitive function impairment (CFI). METHODS We conducted a population-based cohort study, with a six-year follow-up period. The exposure factor of interest in this study was VI. The Mini-Mental State Examination (MMSE) was used to assess participants' cognitive function. The Logistic regression model was used to investigate whether baseline VI had an effect on CFI. Confounding factors were adjusted in the regression model. The odds ratio (OR) and 95% confidence interval (CI) were used to quantify the effect of VI on CFI. RESULTS A total of 3297 participants were included in the present study. The mean age of included participants was 58.5 ± 7.2 years. Male accounted for 1480 (44.9%) of all participants. At baseline, 127 (3.9%) of the participants had VI. The MMSE score of participants who had VI at baseline decreased by 1.7 ± 3.3 points on average during the six-year follow-up, and that of participants who had no VI at baseline decreased by 1.1 ± 3.3 points on average. The difference was significant (t = 2.03, p = 0.040). Results of the multivariable Logistic regression model showed that VI was a risk factor for CFI, with an OR of 1.052 (95%CI: 1.014 to 1.092, p = 0.017). CONCLUSIONS Averagely, participants with VI experienced a decline in cognitive function 0.1 points faster per year than participants without VI, as measured by MMSE score. VI is an independent risk factor for CFI.
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Affiliation(s)
- Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Hao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ning-Li Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Kong X, Han F, Li J, Wang W, Sun Y, Wu Y. Serial multiple mediation of loneliness and depressive symptoms in the relationship between pain and cognitive function among older people. Aging Ment Health 2023; 27:2102-2110. [PMID: 37278696 DOI: 10.1080/13607863.2023.2219626] [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: 10/31/2022] [Accepted: 05/19/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Although the negative effect of pain on cognitive function has been widely reported, it is unclear how the effect is mediated. The aim of this study is to analyze the mediating role of loneliness and depressive symptoms in the association between pain and cognitive function. METHODS A total of 6,309 participants aged ≥50 years from 2012/13 (T1), 2014/15 (T2), 2016/17 (T3) and 2018/19 (T4) of the English Longitudinal Study of Aging (ELSA) were included. Of them, 55.8% were females, and the median age (rang) was 65 (50-99) years at T1. Serial mediation analysis was performed using Mplus 8.3. RESULTS The mediation model explained 10.1% of the variance in loneliness, 22.1% of the variance of depressive symptoms, and 22.7% of the variance of cognitive function. Higher level pain was associated with poorer cognitive function (c: β = -0.057; p < 0.001). The negative effect of pain on cognition was mediated separately and sequentially through loneliness and depressive symptoms, with loneliness and depressive symptoms explaining 8.8% of the total effect, respectively, and the pathway of loneliness and subsequent depression explaining 1.8%. CONCLUSIONS Diversified interventions aimed at treating pain in older adults would be beneficial for their mental health and cognitive function.
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Affiliation(s)
- Xiangjie Kong
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Fulei Han
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Jing Li
- Critical Care Medical Center, Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
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Li Q, Guo Z, Hu F, Xiao M, Zhang Q, Wen J, Ying T, Zheng D, Wang Y, Yang S, Hou H. Tourism experiences reduce the risk of cognitive impairment in the Chinese older adult: a prospective cohort study. Front Public Health 2023; 11:1271319. [PMID: 37942247 PMCID: PMC10629014 DOI: 10.3389/fpubh.2023.1271319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Background Given the etiological complexity of cognitive impairment, no effective cure currently exists for precise treatment of dementia. Although scholars have noted tourism's potential role in managing cognitive impairment and mild dementia, more robust empirical investigation is needed in this area. This study aimed to examine the associations between tourism and cognitive impairment and dementia in older Chinese adults. Method From a nationwide community-based cohort, 6,717 individuals aged ≥60 were recruited from 2011 to 2014, of whom 669 (9.96%) had had at least one tourism experience in the 2 years prior to enrollment. All the participants were then prospectively followed up until 2018. The association between tourism and cognitive impairment was examined by the Cox proportional hazards regression model. The adjusted hazard ratio (aHR) and its 95% confidence interval (CI) were calculated to evaluate the effect of tourism experience on cognitive impairment and dementia. Results A total of 1,416 individuals were newly diagnosed with cognitive impairment and 139 individuals with dementia onset during follow-up. The incidence of cognitive impairment was significantly lower among participants with tourism experiences (316.94 per 10,000 person-years) than those without such experiences (552.38 per 10,000 person-years). Cox regression showed that tourism decreased the risk of cognitive impairment (aHR = 0.69, 95% CI: 0.41-0.62) when adjusted for behavioral covariates and characteristics. Compared with participants without tourism experiences, those with 1, 2, and ≥3 tourism experiences had a lower risk of cognitive impairment with the aHRs of 0.72 (95% CI: 0.52-0.99), 0.65 (0.42-1.01), and 0.68 (0.44-0.98), respectively. Tourism experiences also reduced participants' risk of dementia (aHR = 0.41, 95% CI: 0.19-0.89). Conclusion Our findings demonstrated associations between tourism and reduced risks of cognitive impairment and dementia in older Chinese adults. Thus, tourism could serve as a novel approach to dementia prevention.
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Affiliation(s)
- Qian Li
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Zheng Guo
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Fangli Hu
- Centre for Precision Health, Edith Cowan University, Joondalup, WA, Australia
| | - Mengfei Xiao
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Qiang Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Jun Wen
- School of Business and Law, Edith Cowan University, Joondalup, WA, Australia
| | - Tianyu Ying
- Department of Tourism and Hotel Management, Zhejiang University, Hangzhou, China
| | - Danni Zheng
- Department of Tourism, Fudan University, Shanghai, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Song Yang
- Department of Endocrinology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Bahati Y, Nyanza EC, Asori M, Mutayoba R, Thomas DSK. Influence of intermittent iron and folic acid supplementation on cognitive abilities among adolescent girls in northwestern Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002079. [PMID: 37851636 PMCID: PMC10584093 DOI: 10.1371/journal.pgph.0002079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/12/2023] [Indexed: 10/20/2023]
Abstract
Iron and folic acid (IFA) supplementation to reduce anemia is key for improving substantial lost disability adjusted life years (DALYs) for adolescent girls. This study assessed the impact of weekly IFA supplementation (WIFAS) on cognitive ability among adolescent girls in the Simiyu Region in northernwestern Tanzania. This cross-sectional comparative evaluation study of 770 adolescent girls (396 -WIFAS supplemented; 374 -not supplemented) evaluated the association between WIFAS and cognitive ability through a face-to-face survey and cognitive ability assessment using standardized tests (Span-forward Test, Span-backward Test and Maze Test). Using a modified Poisson regression, we controlled for the geographic setting (urban vs rural), availability of potable water and feeding programs in schools, age and school level of adolescent girls, parental status, main parental economic activities, and the number of teachers. Participants were between the ages of 11 and 19 years, with more than half (57%) between 12-15 years of age. Those with WIFAS had higher cognitive ability (Span-forward scores, χ2 = 46.34% p <0.001; Span-forward, χ2 = 46.34% p <0.001; and Global Composite Cognitive Performance (GCCP), χ2 = 32.52% p<0.001). Among the IFA supplemented adolescent girls, secondary school level had a significantly higher score with respect to Span-backward (aPR = 1.43, 95% CI = 1.06-1.62); Span-forward ability (aPR = 1.26, 95% CI = 1.04-1.53) and Maze Test ability (aPR = 1.12, 95% CI = 1.01-1.25) as compared to their counterpart in primary school level. Individual adolescent girls with WIFAS and living with both parents performed much better on the Span-backward Test (aPR = 1.22, 95% CI = 1.07-1.68) as compared to those living with relatives and/or orphans. The presence of potable water program among the WIFAS schools resulted in a higher Span-backward ability (aPR = 1.34, 95% CI = 1.03-1.89); and GCCP (aPR = 1.27, 95% CI = 1.03-1.75). Adolescent girls from WIFAS schools with feeding program had higher Span-forward (aPR = 1.38, 95% CI = 1.03-1.63) ability as well as a higher Maze Test (aPR = 1.15, 95% CI = 1.07-1.26) score. The present study provides compelling evidence that WIFAS is positively associated with higher cognitive ability among adolescent girls. Nevertheless, IFA interventions are still rare in communities across Tanzania.
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Affiliation(s)
- Yasinta Bahati
- Department of Environmental, Occupational, and Department of Environmental, Occupational Health, and GIS, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Amref Health Africa and Nutrition International, Regional Health Management Team-Simiyu Region, Simiyu Region, Tanzania
| | - Elias C. Nyanza
- Department of Environmental, Occupational, and Department of Environmental, Occupational Health, and GIS, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Moses Asori
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
| | - Rita Mutayoba
- Amref Health Africa and Nutrition International, Regional Health Management Team-Simiyu Region, Simiyu Region, Tanzania
| | - Deborah S. K. Thomas
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
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Wang J, Chen XX, Liu D, Tian E, Guo ZQ, Chen JY, Kong WJ, Zhang SL. Association of Hearing Status and Cognition With Fall Among the Oldest-Old Chinese: A Nationally Representative Cohort Study. Ear Hear 2023; 44:1212-1220. [PMID: 37046369 DOI: 10.1097/aud.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVES The oldest-old (aged ≥80 years) are the most rapidly growing population and age is related to hearing impairment (HI) and cognitive decline. We aimed to estimate the association between HI and fall, and the effect of different cognitive states on this association among the oldest-old Chinese population. DESIGN A total of 6931 Chinese oldest-old were included in the 2018 cross-cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The presence of HI was identified by using a dichotomized metric of self-reported hearing status. Cognitive function was evaluated by using the modified Mini-Mental State Examination (MMSE). Cognitive impairment was defined as the MMSE score below 24 points. Data on fall history were collected by questionnaires survey from the participants or their relatives. We studied the association of hearing status and cognitive function with fall by using multivariable logistic regressions, upon adjustment of sociodemographic characteristics, lifestyles, and health conditions. RESULTS Our participants were aged 92 (range 80 to 117) on average, with 60.1% being women. In total, 39.1% of the participants had reported HI, 50.1% had cognitive impairment, and 26.2% had a history of falling. Participants with HI had a higher incidence of cognitive impairment (79.4%), as compared with their counterparts without HI (31.3%). Compared with those without HI, HI patients had a higher risk of falling after full adjustment for potential confounders (OR = 1.16 [95% confidence interval, CI, 1.01, 1.32], p = 0.031). In comparison with HI participants without cognitive impairment, HI patients with cognitive impairment had a higher fall risk (OR = 1.45 [95% CI = 1.23, 1.72], p < 0.001). CONCLUSIONS Association of hearing status and cognition with fall was, for the first time, examined on the basis of a nationally-representative oldest-old Chinese population. Poor cognitive performance was common in individuals with HI, and those with HI and cognitive impairment further increased the risk of falling.
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Affiliation(s)
- Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- School of Public Health, Wuhan University, Hubei, China
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Dan Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - E Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhao-Qi Guo
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing-Yu Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei-Jia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Su-Lin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Jia Y, Shang J, Zhang H, He N, Ma J. Clinical Outcomes of Enhanced Recovery After Surgery Program in Elderly Patients Undergoing Transabdominal Preperitoneal. J Laparoendosc Adv Surg Tech A 2023; 33:884-889. [PMID: 37262198 DOI: 10.1089/lap.2023.0168] [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: 06/03/2023] Open
Abstract
Background: Enhanced recovery after surgery (ERAS) protocol is an effective evidence-based multidisciplinary protocol to optimize the postsurgical recovery process through perioperative interventions. The aim of the present study was to evaluate the effects of ERAS program on operation-related indicators, complications, pain, and quality of life in patients older than 60 years undergoing the transabdominal preperitoneal (TAPP) approach. Methods: This was a retrospective study of prospectively collected data from a single institution. A total of 160 elderly patients who underwent TAPP were divided into two groups: 80 patients in the ERAS group from January 2019 to December 2020, and 80 patients in the non-ERAS group from January 2021 to December 2022 in the non-ERAS group, and the groups were managed with the ERAS protocol and conventional management, respectively. We compared differences in operation-related indicators, complications, pain, and quality of life between the two groups. Results: Operation-related indicators (exhaust time, postoperative eating time, time to first ambulation, hospitalization cost, and postoperative hospital stay) and early postoperative pain of the ERAS group were superior to those of the non-ERAS group, and the difference had statistical significance (P < .05). More importantly, our results demonstrated that compared with the non-ERAS group, the application of ERAS in inguinal hernia patients may reduce postoperative complications (urinary retention, chronic pain) and improve quality of life. Conclusion: The ERAS program might provide the efficiency and safety approach to optimize clinical outcomes in the elderly patients older than 60 years undergoing TAPP approach.
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Affiliation(s)
- Yaofei Jia
- People's Hospital of Changwu County, Xianyang, China
| | - Junjie Shang
- People's Hospital of Changwu County, Xianyang, China
| | - Hao Zhang
- People's Hospital of Changwu County, Xianyang, China
| | - Na He
- People's Hospital of Changwu County, Xianyang, China
| | - Jianjun Ma
- People's Hospital of Changwu County, Xianyang, China
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Ma W, Wu B, Yu Y, Zhong R. Longitudinal associations between social relationships and cognitive function among Chinese older adults: The mediating role of healthy lifestyles. Geriatr Nurs 2023; 53:102-108. [PMID: 37478806 DOI: 10.1016/j.gerinurse.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND We aimed to explore whether social relationships and cognitive function were reciprocally related and whether healthy lifestyles mediate their association. METHODS This study included 3372 Chinese adults from the years 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey. RESULTS Baseline social relationships were negatively associated with a change in cognitive function (β = -0.030, p = 0.043). Participants with a 1 standard deviation (SD) increase in social relationships had an approximately 6% reduced risk of developing cognitive impairment. However, baseline cognitive function did not independently predict social relationships. The association between △social relationships and △cognitive function was partially mediated by △a healthy lifestyle (B = 0.025, 95% CI = 0.013-0.041). CONCLUSIONS The association between social relationships and cognitive function may be unidirectional. Policies that promote cognitive function based on social relationships would benefit by taking into account lifestyle factors.
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Affiliation(s)
- Weibo Ma
- School of Public Administration, Faculty of Economics and Management, East China Normal University, Shanghai, China
| | - Bei Wu
- NYU Aging Incubator and Hartford Institute for Geriatric Nursing, New York, USA
| | - Ying Yu
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Renyao Zhong
- School of Public Administration, Faculty of Economics and Management, East China Normal University, Shanghai, China.
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Guo J, He Q, Peng C, Dai R, Li W, Su Z, Li Y. Machine learning algorithms to predict risk of postoperative pneumonia in elderly with hip fracture. J Orthop Surg Res 2023; 18:571. [PMID: 37543618 PMCID: PMC10403839 DOI: 10.1186/s13018-023-04049-0] [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: 06/14/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Hip fracture (HF) is one of the most common fractures in the elderly and is significantly associated with high mortality and unfavorable prognosis. Postoperative pneumonia (POP), the most common postoperative complication of HF, can seriously affect patient prognosis and increase the burden on the healthcare system. The aim of this study was to develop machine learning models for identifying elderly patients at high risk of pneumonia after hip fracture surgery. METHODS From May 2016 to November 2022, patients admitted to a single central hospital for HF served as the study population. We extracted data that could be collected within 24 h of patient admission. The dataset was divided into training and validation sets according to 70:30. Based on the screened risk factors, prediction models were developed using seven machine learning algorithms, namely CART, GBM, KNN, LR, NNet, RF, and XGBoost, and their performance was evaluated. RESULTS Eight hundred five patients were finally included in the analysis and 75 (9.3%) patients suffered from POP. Age, CI, COPD, WBC, HB, GLU, STB, GLOB, Ka+ which are used as features to build machine learning models. By evaluating the model's AUC value, accuracy, sensitivity, specificity, Kappa value, MCC value, Brier score value, calibration curve, and DCA curve, the model constructed by XGBoost algorithm has the best and near-perfect performance. CONCLUSION The machine learning model we created is ideal for detecting elderly patients at high risk of POP after HF at an early stage.
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Affiliation(s)
- Jiale Guo
- Department of Orthopedics, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Qionghan He
- Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Caiju Peng
- Department of Orthopedics, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Ru Dai
- Department of Orthopedics, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Wei Li
- Department of Orthopedics, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Zhichao Su
- Department of Orthopedics, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yehai Li
- Department of Orthopedics, Chaohu Hospital of Anhui Medical University, Hefei, China.
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Miladitiya A, Juniarto AZ, Nugrohowati AK, Winarni TI. The Role of Body Mass Index, Advanced Age, and Low Educational Attainment in Mild Cognitive Impairment among the Older Adult Population: A Study in a Rural Area in Indonesia. J Nutr Gerontol Geriatr 2023; 42:144-160. [PMID: 37610863 DOI: 10.1080/21551197.2023.2249835] [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: 08/25/2023]
Abstract
This study evaluated the prevalence of mild cognitive impairment (MCI) and factors associated with MCI among older adults in a rural area of Indonesia. This cross-sectional study was conducted in a rural area of East Java, Indonesia. Four hundred and twenty-seven older adults aged ≥60 years were included in the study. MCI was assessed using the Brain Health Test Cognitive Tool. Data related to possible risk factors were obtained using semi-structured questionnaires. The indirect body mass index was determined based on ulnar length. The prevalence of MCI was 12.9%. Being underweight (<18.5 kg/m2) (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.17-4.97; p = 0.016), requiring assistance to manage money or medications (OR, 2.72; 95% CI, 1.02-7.23; p = 0.045), age ≥70 years (OR, 2.50; 95% CI, 1.11-5.60; p = 0.026), and having an educational attainment of ≤6 years (OR, 4.92; 95% CI, 1.92-12.60; p = 0.001) were significantly associated with MCI. In this Indonesian older adult population, underweight people who had an educational attainment of <6 years, those aged ≥70 years, and those who needed assistance to manage money or medications were more likely to have MCI.
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Affiliation(s)
- Aulia Miladitiya
- Magister of Nutrition, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | - Achmad Zulfa Juniarto
- Department of Biology, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | - Annta Kern Nugrohowati
- Clinical Nutrition Department, Diponegoro National Hospital, Semarang, Central Java, Indonesia
| | - Tri Indah Winarni
- Department of Anatomy, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
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Sharifi S, Babaei Khorzoughi K, Khaledi-Paveh B, Rahmati M. Association of intergenerational relationship and supports with cognitive performance in older adults: A systematic review. Geriatr Nurs 2023; 52:146-151. [PMID: 37307634 DOI: 10.1016/j.gerinurse.2023.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE As individuals age, cognitive decline can significantly impact their quality of life. This systematic review aims to investigate the potential association between parent-child relationships among older adults in Eastern Asian countries and their cognitive performance. METHODS For this research, a systematic search was conducted on several electronic databases including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar search engine, up to March 2023. RESULTS Out of 418 articles, 6 were eligible for inclusion in the study. The findings suggest that intergenerational relationships, particularly emotional support and two-way financial communications, are associated with maintaining cognitive health in older adults. CONCLUSIONS Intergenerational relationships affect cognitive health in older adults, with implications for healthcare, social welfare, and the economy. Further research is required to investigate the effects of children's visits on cognitive health and explore the complexities of intergenerational relationships on cognitive health in aging populations.
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Affiliation(s)
- Sina Sharifi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kimia Babaei Khorzoughi
- Faculty of Education and Psychology, Islamic Azad University Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Behnam Khaledi-Paveh
- Department of Geriatric and Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Mahmoud Rahmati
- Department of Geriatric and Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
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Wang Y, Chen T. Perceived Control, Control Strategies, and Subjective Well-being in the Elderly: A Longitudinal Study of Health Behavior. Am J Health Behav 2023; 47:549-557. [PMID: 37596744 DOI: 10.5993/ajhb.47.3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
Objectives: We analyzed the directional effect of perceived control and control strategies on subjective well-being in middle-aged and elderly people with historical data, and to provide data support for the intervention of well-being in the later years of the elderly group, so as to help them age successfully.Methods: Using data from the CLHLS between 2005 and 2014, we collected demographic and social data of the same elderly population over the decade. We also gathered information on changes in well-being, perceived control, and the use of control strategies. To analyze the longitudinal relationship between subjective well-being and perceived control, including the impact of control strategies on subjective well-being, we used a multilevel growth model with MPLUS. Results: We found that subjective well-being and perceived control were not affected by time. However, changes in perceived control in older adults could predict their level of subjective well-being. Those with higher initial levels of perceived control experienced greater increases in subjective well-being. Additionally, the use of control strategies had a significant influence on changes in subjective well-being, explaining 70.5% of the variance. Conclusion: Combined use of multiple control strategies is a feasible way to improve subjective well-being in later life.
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Affiliation(s)
- Yiyin Wang
- Institute of Psychology, Chinese Academy of Sciences, and Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Tianyong Chen
- Institute of Psychology, Chinese Academy of Sciences, and Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
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Liu G, Lu Z, Shan Y, Wang J, Shi X, Zong D, Li S, Kong F. Association between self-reported oral health and cognitive function among the community-dwelling elderly in Jinan, China: the mediating effect of life satisfaction. Front Psychol 2023; 14:1116325. [PMID: 37303887 PMCID: PMC10248475 DOI: 10.3389/fpsyg.2023.1116325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Background Deterioration of self-reported oral health and decline in cognitive function are two main adverse health outcomes experienced by the older adults. Little evidence was found on the psychosocial mechanism between self-reported oral health and cognitive function. This study explores the association between self-reported oral health and cognitive function and examines the mediating effect of life satisfaction among the community-dwelling elderly in Jinan, China. Methods A total of 512 older individuals (60+) were included in the study. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination scale (MMSE), and self-reported oral health was measured using the Chinese version of the Geriatric Oral Health Assessment Index (GOHAI). Pearson correlation analysis was used to determine the relationship between self-reported oral health, life satisfaction, and cognitive function. Multivariate linear regression analysis was conducted to explore the possible effect of covariates. Structural equation modelling and Bootstrap analyses were conducted to verify the mediating role of life satisfaction. Results The mean MMSE score was 25.65 ± 4.42. Better self-reported oral health was significantly associated with a higher level of life satisfaction, and those with higher life satisfaction experienced better cognitive function. Age, educational level and source of living expenses were found to be cofounding variables. Life satisfaction partially mediated the effect of self-reported oral health on cognitive function (95% confidence interval [CI]: 0.010 to 0.075). The mediating effect of life satisfaction accounted for 24% of the total effect. Conclusion The level of cognitive function was relatively high. Self-reported oral health was positively associated with cognitive function, and the mediating effect of life satisfaction was proven to exist in the community-dwelling older individuals. Early screening for oral diseases and a greater focus on life satisfaction are recommended.
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Affiliation(s)
- Guangwen Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Zhongqian Lu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Ying Shan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xinfei Shi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Di Zong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Mao S, Xie L, Lu N. Activity engagement and cognitive function among chinese older adults: moderating roles of gender and age. BMC Geriatr 2023; 23:223. [PMID: 37024815 PMCID: PMC10080791 DOI: 10.1186/s12877-023-03912-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Many studies have found that engaging in activities, including physical exercise, social interaction, and cognitive training, is beneficial for preventing cognitive decline among older adults; however, the demographic differences in the association between activity engagement and cognitive functions remain understudied. This study investigates: (a) the influence of activity engagement on cognitive functions among Chinese older adults, and (b) the moderating roles of age and gender in these associations . METHODS The data were derived from the China Health and Retirement Longitudinal Study in 2018, which included 9803 participants aged 60 or older. A multiple regression model was used to test the study hypotheses. RESULTS Engaging in physical activity (b = 1.578, p < .001), social interaction (b = 1.199, p < .001), and cognitive activity (b = 1.468, p < .001) was positively associated with cognitive functions, whereas the effect of volunteer activities on cognitive functions was not significant (b = -.167, p = .390). Light- and moderate-intensity activities were beneficial for cognition (light: b = .847, p < .001; moderate: b = 1.189, p < .001), but vigorous-intensity activity was negatively related to cognition (b = -.767, p < .001). In addition, women and participants with advanced age appeared to benefit more from cognitive activities than their male and younger counterparts, respectively (gender: b = 1.217, p = .002; age: b = .086, p = .004). The adverse effects of vigorous-intensity activities (including agricultural work) on cognitive health were stronger for women and younger participants (gender: b = -1.472, p < .001; age: b = .115, p < .001). The protective effects of moderate-intensity activities on people's cognition increased with increasing age (b = .055, p = .012). CONCLUSIONS The findings indicate that participating in physical, social, and cognitive activities can help older adults to maintain cognitive health. They suggest that older adults should select activities while considering activity intensity and their individual characteristics.
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Affiliation(s)
- Shan Mao
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Lili Xie
- Center for Population and Development Studies, Renmin University of China, Room 604, Chongde Building, No. 59, Zhongguancun Street, Haidian District, Beijing, 100872, China.
- School of Interdisciplinary Studies, Renmin University of China, Beijing, China.
| | - Nan Lu
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
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Mai S, Cai J, Zheng W, Li L. Path analysis of social engagement, loneliness and cognitive function among Chinese older adults. PSYCHOL HEALTH MED 2023; 28:1087-1099. [PMID: 36424712 DOI: 10.1080/13548506.2022.2151635] [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] [Indexed: 11/27/2022]
Abstract
This study established a research model to fully understand the relationship of social engagement, loneliness and cognitive function among Chinese older adults. In the latest wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a total of 12,852 participants aged 65 years and older were included in the study. Path analysis was performed to examine our hypotheses. The social engagement had a positive relationship with normal cognitive function while loneliness had a negative one, and the standardized regression weights were 0.618 (p < 0.01) and -0.046 (p < 0.01), respectively. Watching TV or listening to the radio had the greatest association with cognitive function, followed by housework, outdoor activities, reading newspapers or books, playing cards or mahjong, and raising domestic animals or pets. Loneliness played a mediating role between social engagement and cognitive function. Social engagement could be considered as one of the interventions to improve older adults' health.
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Affiliation(s)
- Shumin Mai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Jingjing Cai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Weijun Zheng
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, P.R.China
| | - Lu Li
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, P.R.China
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Li Z, Gong X, Cui X, Zhang W, Wang Y, Wu D, Yang M, Jia X, Duan C, Liu L, Guo J, Jia R, Zhang X, Chen Y, Tang Y, Liu M, Wang Y. Body mass index and death by cognitive impairment. Aging Clin Exp Res 2023; 35:689-698. [PMID: 36795235 DOI: 10.1007/s40520-023-02346-6] [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: 11/21/2022] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Epidemiological studies have reported that among participants with impaired cognitive, overweight and mild obesity are associated with substantially improved survival, this finding has been termed the "obesity paradox" and has led to uncertainty about secondary prevention. AIMS To explore whether the association of BMI with mortality differed in different MMSE score, and whether the obesity paradox in patient with cognitive impairment (CI) is real. METHODS The study used data from CLHLS, a representative prospective population-based cohort study in China, which included 8348 participants aged ≥ 60 years between 2011 and 2018. The independent association between BMI and mortality in differed MMSE score by calculating hazard ratios (HRs) in multivariate Cox regression analysis. RESULTS During a median (IQR) follow-up of 41.18 months, a total of 4216 participants died. In the total population, underweight increased the risk of all-cause mortality (HRs, 1.33; 95% CI 1.23-1.44), compared with normal weight, and overweight was associated with a decreased risk of all-cause mortality (HR 0.83; 95% CI 0.74-0.93). However, compared to normal weight, only underweight was associated with increased mortality risk among participants with MMSE scores of 0-23, 24-26, 27-29, and 30, and the fully-adjusted HRs (95% CIs) for mortality were 1.30 (1.18, 1.43), 1.31 (1.07, 1.59), 1.55 (1.34, 1.80) and 1.66 (1.26, 2.20), respectively. The obesity paradox was not found in individuals with CI. Sensitivity analyses carried out had hardly any impact on this result. CONCLUSION We found no evidence of an obesity paradox in patients with CI, compared with patients of normal weight. But underweight individuals may have increased mortality risk whether in the population with CI or not. And overweight/obese people with CI should continue to aim for normal weight.
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Affiliation(s)
- Zhiqiang Li
- School of Public Health, China Medical University, Shenyang, China.,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Xinran Gong
- School of Public Health, China Medical University, Shenyang, China.,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Xin Cui
- Second Medical Center of Chinese People's Liberation Army General Hospital, Haidian District, Beijing, China
| | - Wuping Zhang
- Foreign Language Department, Graduate School of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yanding Wang
- School of Public Health, China Medical University, Shenyang, China.,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Di Wu
- School of Public Health, China Medical University, Shenyang, China.,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Meitao Yang
- School of Public Health, China Medical University, Shenyang, China.,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Xinjing Jia
- School of Public Health, China Medical University, Shenyang, China.,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Chunyuan Duan
- School of Public Health, China Medical University, Shenyang, China.,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Lisha Liu
- Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China.,School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jinpeng Guo
- Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Ruizhong Jia
- Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Xiushan Zhang
- Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Yong Chen
- Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Yue Tang
- Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China
| | - Miao Liu
- Department of Epidemiology and Statistics, Graduate School of Chinese PLA General Hospital, Beijing, China.
| | - Yong Wang
- School of Public Health, China Medical University, Shenyang, China. .,Chinese People's Liberation Army Center for Disease Control and Prevention, Dongda Street No.20 in Fengtai District, Beijing, 100071, China.
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Wang Z, Ni X, Gao D, Fang S, Huang X, Jiang M, Zhou Q, Sun L, Zhu X, Su H, Li R, Huang B, Lv Y, Pang G, Hu C, Yang Z, Yuan H. The relationship between sleep duration and activities of daily living (ADL) disability in the Chinese oldest-old: A cross-sectional study. PeerJ 2023; 11:e14856. [PMID: 36815994 PMCID: PMC9936868 DOI: 10.7717/peerj.14856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/14/2023] [Indexed: 02/16/2023] Open
Abstract
Objective To investigate the relationship between sleep duration and activities of daily living (ADL) disability, and to explore the optimal sleep duration among oldest-old Chinese individuals. Methods In this cross-sectional study, 1,798 participants (73.2% female) were recruited from Dongxing and Shanglin in Guangxi Zhuang Autonomous Region, China in 2019. The restricted cubic spline function was used to assess the dose-response relationship between sleep duration and ADL disability, and the odds ratios (ORs) of the associations were estimated by logistic regression models. Results The overall prevalence of ADL disability was 63% (64% in females and 58% in males). The prevalence was 71% in the Han population (72% in females and 68% in males), 60% in the Zhuang population (62% in females and 54% in males) and 53% in other ethnic population (53% in females and 53% in males). A nonlinear relationship between sleep duration and ADL disability was observed. Sleep duration of 8-10 hours was associated with the lowest risk of ADL disability. Sleep duration (≥12 hours) was associated with the risk of ADL disability among the oldest-old individuals after adjusting for confounding factors (OR = 1.47, 95% CI [1.02, 2.10], p < 0.05). Conclusion Sleep duration more than 12 hours may be associated with an increased risk of ADL disability in the oldest-old individuals, and the optimal sleep duration among this population could be 8-10 h.
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Affiliation(s)
- Zhaoping Wang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Xiaolin Ni
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Danni Gao
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China,Peking University Fifth School of Clinical Medicine (Beijing Hospital), Beijing, China
| | - Sihang Fang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Xiuqing Huang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Mingjun Jiang
- Respiratory Department, Beijing Children’s Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children’s Health, Beijing, China
| | - Qi Zhou
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Liang Sun
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Xiaoquan Zhu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Huabin Su
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Rongqiao Li
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Bin Huang
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Yuan Lv
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Guofang Pang
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Caiyou Hu
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Ze Yang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Huiping Yuan
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China,Peking University Fifth School of Clinical Medicine (Beijing Hospital), Beijing, China
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Duan X, Dang Y, Kang C, Rong P, Yan M, Zhang S, Cui J, Zhao Y, Chen F, Zhou J, Wang D, Pei L. Associations between trajectories of cardiovascular risk factor change and cognitive impairment in Chinese elderly: A nationwide cohort study. Front Aging Neurosci 2023; 15:1084136. [PMID: 36845661 PMCID: PMC9950264 DOI: 10.3389/fnagi.2023.1084136] [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: 10/30/2022] [Accepted: 01/23/2023] [Indexed: 02/12/2023] Open
Abstract
Objectives This study aimed to investigate the relationship between long-term trajectories of changes in cardiovascular risk factors (CVRFs) and the risk of cognitive impairment among Chinese adults over 60 years old. Methods Data were obtained from the Chinese Longitudinal Healthy Longevity Survey 2005-2018. Cognitive function was evaluated longitudinally through the Chinese version of the Mini-Mental State Examination (C-MMSE), and cognitive impairment (C-MMSE ≤23) was used as the main outcome variable. The cardiovascular risk factors, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and body mass index (BMI), were continuously measured in the follow-up duration. The patterns of trajectories of changes in CVRFs were derived from the latent growth mixture model (LGMM). The Cox regression model was used to evaluate the cognitive impairment hazard ratio (HR) across different CVRF trajectories. Results A total of 5,164 participants aged ≥60 years with normal cognitive function at baseline were included in the study. After a median follow-up of 8 years, 2,071 participants (40.1%) developed cognitive impairment (C-MMSE ≤ 23). The four-class trajectories of SBP and BMI were obtained by means of LGMM, and the trajectories of DBP, MAP, and PP were grouped into a three-class subgroup. In the final adjusted Cox model, the lowered SBP [adjusted HR (aHR): 1.59; 95% CI: 1.17-2.16], lowered PP (aHR: 2.64; 95% CI: 1.66-4.19), and progressively obese (aHR: 1.28; 95% CI: 1.02-1.62) and stable slim (aHR: 1.13; 95% CI: 1.02-1.25) were associated with the higher risk of cognitive impairment. Low stable DBP (aHR: 0.80; 95% CI: 0.66-0.96) and elevated PP (aHR: 0.76; 95% CI: 0.63-0.92) decreased the risk for cognitive impairment among participants. Conclusion Lowered SBP, lowered PP, progressive obesity, and stable slim increased the risk for cognitive impairment in the Chinese elderly. Low stable DBP and elevated PP were protective against cognitive impairment, but more DBP lowering and ≥25 mmHg growth in PP contributed to a higher risk of cognitive impairment. The findings have important implications for preventing cognitive impairment in elder adults based on the long-term trajectories of changes in CVRFs.
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Affiliation(s)
- Xinyu Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yusong Dang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Chenxi Kang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Peixi Rong
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Mingxin Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Shutong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jing Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yaling Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Fangyao Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jing Zhou
- Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Duolao Wang
- Biostatistics Unit, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom,Department of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Leilei Pei
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China,*Correspondence: Leilei Pei, ✉
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Fan J, Bai J, Liu W, Cai J. Effects of intensive vs. standard blood pressure control on cognitive function: Post-hoc analysis of the STEP randomized controlled trial. Front Neurol 2023; 14:1042637. [PMID: 36816574 PMCID: PMC9930906 DOI: 10.3389/fneur.2023.1042637] [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: 09/12/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Background The STEP (Strategy of Blood Pressure Intervention in the older Hypertensive Patients) trial showed that intensive systolic blood pressure (SBP) control resulted in a lower incidence of cardiovascular events than standard treatment. This study analyzed the effects of intensive SBP lowering on cognitive function. Methods STEP was a multicenter, randomized controlled trial of hypertensive patients aged 60-80 years. Participants were randomly assigned (1:1) to SBP goals of 110-130 mmHg (intensive treatment) or 130-150 mmHg (standard treatment). Each individual was asked to complete a cognitive function test (Mini-Mental State Examination; MMSE) at baseline and during follow-up. The primary outcome for this study was the annual change in MMSE score. Subjects with a score less than education-specific cutoff point were categorized as cognitive decline. Results The analysis enrolled 6,501 participants (3,270 participants in the intensive-treatment and 3,231 participants in the standard-treatment groups). Median follow-up was 3.34 years. There was a minor change in MMSE score, with an annual change of -0.001 [95% confidence interval [CI] -0.020, 0.018] and 0.030 (95% CI 0.011, 0.049) in the intensive- and standard-treatment groups, respectively (p = 0.052). Cognitive decline occurred in 46/3,270 patients (1.4%) in the intensive-treatment group and 42/3,231 (1.3%) in the standard-treatment group (hazard ratio 0.005, 95% CI 0.654, 1.543, p = 0.983). Conclusions Compared with standard treatment, intensive SBP treatment did not result in a significant change in cognitive function test score. The impact of intensive blood pressure lowering was not evident using this global cognitive function test. Trial registration ClinicalTrials.gov. Unique identifier: NCT03015311.
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Affiliation(s)
- Jiali Fan
- Department of Hypertension, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jingjing Bai
- Department of Hypertension, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Liu
- Department of Cardiology, Beijing Jishuitan Hospital, Peking University Fourth Hospital, Beijing, China,Wei Liu ✉
| | - Jun Cai
- Department of Hypertension, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,*Correspondence: Jun Cai ✉
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Cao X, Liu Q, Liu J, Yang B, Zhou J. The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships. Front Public Health 2023; 11:1149769. [PMID: 37089498 PMCID: PMC10116415 DOI: 10.3389/fpubh.2023.1149769] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/16/2023] [Indexed: 04/25/2023] Open
Abstract
Background Given the potentially negative effects of hearing loss on mental health and cognitive function, it is critical to gain a better understanding of the mechanisms underlying the link between hearing loss and cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their components in the role of depressive symptoms as a mediator between hearing loss and cognitive impairment. Methods Cross-sectional analyses were conducted with 8,094 Chinese older adults (aged ≥65 years) from the Chinese Longitudinal Healthy Longevity Survey in 2018. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of depressive symptoms and social relationships in the association between hearing loss and cognitive impairment. Results There is a significant correlation between hearing loss, depressive symptoms, social relationships, and cognitive function. Depressive symptoms partially mediated the association between hearing loss and cognitive function [standardized regression B-coefficient (B) = -0.114; 95% confidence interval (CI): (-0.158, -0.076)]. Social relationships moderated the effect of hearing loss on cognitive function through both path b (depressive symptoms - cognitive function) [B = 0.021; 95% CI: (0.008, 0.034)], and path c' (hearing loss-cognitive function) [B = 0.597; 95% CI: (0.463, 0.730)]. Furthermore, social activities and social networks moderated both the direct and indirect effects of moderated mediation. However, there appeared to be no moderated effect of social support for both the direct and indirect paths. Conclusion Social relationships moderated both the direct and indirect effects of depressive symptoms on the association between hearing loss and cognitive impairment. These findings shed light on the mechanisms underlying the relationship between hearing loss and cognitive impairment in Chinese older adults. It might be worthwhile to recommend multidimensional health and social interventions aimed at improving mental health and social inclusion among older adults with hearing loss.
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qian Liu
- Department of Psychology, Hunan Normal University, Changsha, China
| | - Jiali Liu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bingfang Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiansong Zhou
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jiansong Zhou,
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Jia X, Su C, Du W, Zhang X, Wang L, Huang F, Bai J, Wei Y, Wang Z, Zhang B, Wang H. Association of Dietary Quality with Cognitive Function in Chinese Adults Aged 55 Years and Above: A Longitudinal Study. J Nutr Health Aging 2023; 27:514-523. [PMID: 37498099 DOI: 10.1007/s12603-023-1941-x] [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: 04/13/2023] [Accepted: 05/15/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES Diet is an important modifiable factor for brain health and aging. Present study aimed to explore association of dietary quality with cognitive function and poor cognition in middle-aged and older adults participating in the China Health and Nutrition Survey (CHNS). DESIGN A longitudinal study with a twenty-year follow-up. SETTING AND PARTICIPANTS Data were drawn from the CHNS 1997, 2000, 2004, 2006, 2015 and 2018. Subjects aged 55 years and more who participated in at least two waves and had completed data on socio-demographics, lifestyle, disease history, anthropometrics, dietary measure and cognitive assessment were eligible in present study. METHODS Baseline diet were assessed by 3-day 24-hour dietary recalls and used to evaluate diet quality via China Elderly Dietary Guidelines Index 2022 (CDGI 2022-E). Cognitive function was examined using part items of the Telephone Interview for Cognitive Status-modified. Three-level linear mixed effects models and three-level mixed effects logistic regression models were performed to estimate the association between diet quality and cognitive function and odds of poor cognition, respectively. RESULTS At baseline, 4173 subjects with median age of 63.7 years were recruited. Median of CDGI 2022-E total score was 44.7. Median score of global cognition was 16.0, and the proportion of people with poor cognitive function was 13.9%. Difference in global cognitive score was observed by tertiles of CDGI 2022-E (p<0.05). Significant associations of high diet quality with increment in global cognitive score [β (95%CI): 0.704 (0.394~1.015)], composite cognitive z score [0.086 (0.045~0.128)] and standardized verbal memory score [0.221 (0.122~0.320)] were observed in total subjects. Consistent associations were also found in those below 65 years at baseline. The likelihood of poor cognition in the highest tertile of CDGI 2022-E decreased by 18% (95%CI: 0.698~0.965) relative to the lowest tertile group in total population. CONCLUSIONS High diet quality may be beneficial for improving cognitive function and delaying cognitive decline in Chinese middle-aged and older population.
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Affiliation(s)
- X Jia
- Wang Huijun, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China, Tel: +86-010-66237089;
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Zhang N, Chen F, Wang C, Yan P. Incidence of cognitive impairment after hypothetical interventions on depression, nighttime sleep duration, and leisure activity engagement among older Chinese adults: An application of the parametric g-formula. Front Public Health 2023; 11:1088833. [PMID: 36875389 PMCID: PMC9975736 DOI: 10.3389/fpubh.2023.1088833] [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: 11/03/2022] [Accepted: 01/19/2023] [Indexed: 02/17/2023] Open
Abstract
Background Cognitive impairment is an age-relevant intermediate stage where cognition declines to a state between the normal aging process and dementia. Earlier studies reported that depression, inappropriate nighttime sleep duration (NSD), and limited leisure activity engagement are cognitive impairment risk factors among older adults. Thus, we postulated that interventions on depression, sleep duration, and leisure activity engagement can reduce cognitive impairment risk. However, no earlier research ever explored this. Methods The data of 4,819 respondents aged 60 years and above, without cognitive impairment at baseline and with no prior history of memory-related diseases, including Alzheimer's disease, Parkinson's disease, and encephalatrophy, were obtained from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. The parametric g-formula, an analytic tool for estimating standardized outcome distributions using covariate (exposure and confounders)-specific estimates of the outcome distribution, was used to estimate 7-year cumulative cognitive impairment risks among older Chinese adults, under independent hypothetical interventions on depression, NSD, and leisure activity engagement, which was subdivided into social activity (SA) and intellectual activity (IA) for the different intervention combinations. Results The observed cognitive impairment risk was 37.52%. Independent intervention on IA was the most effective factor in reducing incident cognitive impairment, with a risk ratio (RR) of 0.75 (95% confidence interval [CI]: 0.67-0.82), followed by depression (RR: 0.89, 95% CI: 0.85-0.93) and NSD (RR: 0.88, 95% CI: 0.80-0.95). The joint intervention combining depression, NSD, and IA interventions could reduce the risk by 17.11%, with an RR of 0.56 (95% CI: 0.48-0.65). In subgroup analyses, independent interventions on depression and IA had analogously significant effects on men and women. However, interventions on depression and IA had stronger effects on literate than illiterate individuals. Conclusions Hypothetical interventions on depression, NSD, and IA reduced cognitive impairment risks among older Chinese adults, both independently and jointly. The findings of the present study suggest that the intervention measures on depression, inappropriate NSD, limited intellectual activities, and their combination may prove to be effective strategies for preventing cognitive impairment among older adults.
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Affiliation(s)
- Nan Zhang
- Department of Surgical Nursing, School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Fenghui Chen
- Department of Internal Medicine Nursing, School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Cui Wang
- Department of Health Science, School of Nursing, Peking University, Beijing, China
| | - Ping Yan
- Department of Surgical Nursing, School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
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Hong H, Wang S, Yu X, Jiaerken Y, Guan X, Zeng Q, Yin X, Zhang R, Zhang Y, Zhu Z, Huang P, Zhang M. White Matter Tract Injury by MRI in CADASIL Patients is Associated With Iron Accumulation. J Magn Reson Imaging 2023; 57:238-245. [PMID: 35735742 DOI: 10.1002/jmri.28301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Widespread white matter (WM) injury is a hallmark feature of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). However, controversies about the mechanism of WM tract injury exist persistently. Excessive iron accumulation, frequently reported in CADASIL patients, might cause WM tract injury. PURPOSE To test the association between iron accumulation and WM tract injury in CADASIL patients. STUDY TYPE Retrospective. POPULATION A total of 35 CADASIL patients (age = 50.4 ± 6.4, 62.9% female) and 48 healthy controls (age = 55.7 ± 8.0, 68.8% female). FIELD STRENGTH/SEQUENCE Diffusion-weighted spin-echo echo-planar sequence; enhanced susceptibility-weighted angiography (ESWAN) gradient echo sequence on a 3 T scanner. ASSESSMENT The phase images acquired by ESWAN were used to calculate quantitative susceptibility mapping (QSM). Iron accumulation was evaluated in deep gray matters using QSM. WM tract injury was quantified by diffusion metrics based on WM major tracts skeleton. We compared iron deposition between groups and analyzed the correlation between WM tract injury and iron deposition in regions showing significant differences from healthy controls. Exploratory analysis was carried out to investigate whether WM tract injury mediated the relationship between iron deposition and cognitive impairment evaluated by Mini-Mental State Examination (MMSE). STATISTICAL TESTS General linear model (GLM), partial correlation, stepwise linear regression and mediation analysis were used. The threshold of statistical significance was set as p < 0.05. RESULTS Compared with healthy controls, CADASIL patients had significantly increased iron deposition in the caudate and putamen. Aberrant iron deposition in these two regions was significantly associated with decreased WM fractional anisotropy (FA) (caudate, r = -0.373; putamen, r = - 0.421), and increased radial diffusivity (RD) (caudate, r = 0.372; putamen, r = 0.386). Furthermore, WM tract injury mediated the relationship between iron deposition and cognitive impairment. DATA CONCLUSION Patients with CADASIL show increased iron deposition in the caudate and putamen that is correlated to WM tract injury, which may in turn mediate the association with cognitive impairment. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Hui Hong
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xinfeng Yu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xinzhen Yin
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Ruiting Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yao Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Zili Zhu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
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Risk Factors and Outcomes of Extended Length of Stay in Older Adults with Intertrochanteric Fracture Surgery: A Retrospective Cohort Study of 2132 Patients. J Clin Med 2022; 11:jcm11247366. [PMID: 36555982 PMCID: PMC9784786 DOI: 10.3390/jcm11247366] [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: 10/19/2022] [Revised: 11/17/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
We aimed to identify the risk factors associated with an extended length of hospital stay (eLOS) in older hip-fracture patients and to explore the relationships between eLOS and mortality and functional outcomes. In this retrospective analysis of surgically treated intertrochanteric fracture (IF) patients, all variables were obtained and compared between the eLOS group and the normal LOS group. All participants were followed-up for a minimum of two years and the relation between the eLOS and all-cause mortality and functional outcomes were compared. After adjustment for potential confounders, we identified that patients with high modified Elixhauser's Comorbidity Measure (mECM) had the highest likelihood of eLOS, followed by obesity, admission in winter, living in urban, pulmonary complications, admission in autumn, and time from injury to surgery. In addition, our results showed no significant difference in the mortality and functional outcomes between the two groups during follow-up. By identifying these risk factors in the Chinese geriatric population, it may be possible to risk-stratify IF patients and subsequently streamline inpatient resource utilization. However, the differences between health care systems must be taken into consideration. Future studies are needed to preemptively target the modifiable risk factors to demonstrate benefits in diminishing eLOS.
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Du P, Guo J, Zhu Y, Cui Y, Li J, Feng Z, Hou Z, Zhang Y. Incidence and risk factors associated with postoperative surgical site infection in younger adults with hip fractures: a case-control study. INTERNATIONAL ORTHOPAEDICS 2022; 46:2953-2962. [PMID: 36222882 DOI: 10.1007/s00264-022-05607-7] [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: 07/28/2022] [Accepted: 10/05/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Hip fracture is associated with high morbidity and mortality. The most common complication after hip fracture is surgical site infection (SSI). The goal was to investigate risks associated with SSI in young adults who underwent surgery for hip fractures. METHODS We conducted a case-control study enrolling 1243 patients from Jan 2015 to Dec 2019. This study investigated the multifaceted factors including demographics, lifestyles, comorbidities, surgical variables, and laboratory test results. Patients were divided into the case group (developed SSI) and control group (not developed SSI). Univariate analyses and multivariate logistic regression analyses were used to identify the risk factors independently associated with SSI. RESULTS A total of 25 patients including 16 (1.8%) in femoral neck fracture and nine (2.5%) in intertrochanteric fracture developed SSI post-operatively, with an accumulated incidence rate of 2.0%. Among them, four cases (1.6%) were deep SSI and 21 cases (98.4%) were superficial SSI. In most cases, Staphylococcus aureus caused the infections. Diabetes mellitus (OR 4.05, 95%CI: 1.08-15.23, P = 0.038), cerebrovascular disease (OR 3.71, 95%CI: 1.14-12.03, P = 0.029), heart disease (OR 6.23, 95%CI: 1.81-21.48, P = 0.004), and operative time (OR 1.01, 95%CI: 1.01-1.02, P = 0.002) in femoral neck fractures while ALP (> upper limit) (OR 33.39, 95%CI: 2.21-504.89, P = 0.011) and CK (> upper limit) (OR 40.97, 95%CI: 1.70-989.31, P = 0.022) in intertrochanteric fractures were found to be significantly associated with SSI. CONCLUSION Targeted pre-operative management, depending on the patients' fracture type and risk factors, should be developed to reduce post-operative SSI rates of younger adults with hip fracture.
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Affiliation(s)
- Pei Du
- Department of Infection Control and Prevention, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Epidemiology and Statistics, Hebei Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Junfei Guo
- Department of Orthopaedics Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Institute of Hebei Province, Shijiazhuang, China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, China
| | - Yanbin Zhu
- Department of Orthopaedics Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Institute of Hebei Province, Shijiazhuang, China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, China
| | - Yi Cui
- Department of Infection Control and Prevention, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianmei Li
- Department of Infection Control and Prevention, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhongjun Feng
- Department of Infection Control and Prevention, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhiyong Hou
- Department of Orthopaedics Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
- Orthopaedic Institute of Hebei Province, Shijiazhuang, China.
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, China.
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, China.
| | - Yingze Zhang
- Department of Orthopaedics Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
- Orthopaedic Institute of Hebei Province, Shijiazhuang, China.
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, China.
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, China.
- Chinese Academy of Engineering, Beijing, China.
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Su J, Xiao X. Factors leading to the trajectory of cognitive decline in middle-aged and older adults using group-based trajectory modeling: A cohort study. Medicine (Baltimore) 2022; 101:e31817. [PMID: 36451491 PMCID: PMC9704883 DOI: 10.1097/md.0000000000031817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Currently, studies exploring factors associated with the cognition at some time point and no study identifying the trajectories of cognitive changes and factors might associate with the trajectories of cognitive changes in people. This study was to identify factors associated with the trend of cognitive decline in middle-aged and older people. In this cohort study, the data of 6954 subjects were collected from China Health and Retirement Longitudinal Survey database. Group-based trajectory modeling was applied for identifying three different trajectories of cognitive function change [high initial level and slow decline group (n = 1024), moderate initial level and moderate decline group (n = 2673) and low initial level and rapid decline (LRD) group (n = 3277)]. Univariate and multivariate logistic regression analysis was conducted to identify variables influencing factors of the trajectories of cognitive function in middle-aged and older people. The follow-up interval was 2 years from 2011 to 2015, and 3 years from 2015 to 2018 via face-to-face interview. High initial level and slow decline group versus LRD group, age (OR = 2.591, 95% CI: 1.962-3.421), gender (OR = 1.398, 95% CI: 1.133-1.725), education (OR = 0.051, 95% CI: 0.039-0.068), place of residence (OR = 2.768, 95% CI: 1.663-4.606), disabled (OR = 1.557, 95% CI: 1.189-2.039), family annual income (OR = 0.757, 95% CI: 0.618-0.929), sleep duration (OR = 1.266, 95% CI: 1.023-1.567), instrumental activity of daily living impairment (OR = 2.513, 95% CI: 1.947-3.245), community activities participation (OR = 0.611, 95% CI: 0.500-0.748), depression (OR = 1.471, 95% CI: 1.185-1.828), and systolic blood pressure (OR = 1.005, 95% CI: 1.001-1.009) were factors influencing the trajectories of cognitive function. Comparing moderate initial level and moderate decline group and LRD group, age (OR = 1.245, 95% CI: 1.052-1.474), gender (OR = 1.244, 95% CI: 1.062-1.458), education (OR = 0.244, 95% CI: 0.190-0.314), marital status (OR = 1.291, 95% CI: 1.079-1.546), place of residence (OR = 1.677, 95% CI: 1.358-2.071), disability (OR = 1.396, 95% CI: 1.180-1.652), smoking (OR = 1.249, 95% CI: 1.071-1.457), family annual income (OR = 0.863, 95% CI: 0.768-0.970), sleep duration (OR = 1.215, 95% CI: 0.973-1.541), instrumental activity of daily living impairment (OR = 1.309, 95% CI: 1.098-1.560), community activities participation (OR = 0.804, 95% CI: 0.718-0.900) and depression (OR = 1.383, 95% CI: 1.217-1.571) were factors associated with the trajectories of cognitive function changes. Middle-aged and older adults who had characteristics associated with increased risk of cognitive decline might be provided with timely interventions.
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Affiliation(s)
- Jun Su
- Department of Neurology, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- * Correspondence: Jun Su, Department of Neurology, the First Affiliated Hospital of Shenzhen University, No. 3002 Sungang West Road, Futian District, Shenzhen 518035, China (e-mail: )
| | - Xiaohua Xiao
- Department of Geriatric Medicine, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
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Pons-Novell J, Guillen M. The Autonomous Capacity of the Elderly Population in Spain for Shopping and Preparing Meals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14828. [PMID: 36429546 PMCID: PMC9691086 DOI: 10.3390/ijerph192214828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
A loss of the ability to buy and prepare meals, especially in people aged 65 and over, leads to a deterioration in their optimal level of nutrition. The Index of Autonomy in Food Acquisition (IAFA) was used to identify contributing factors. This is a composite indicator for shopping and meal preparation that can be used to assess the degree of autonomous capacity observed in a specific group. Data from the European Health Survey in Spain (7167 respondents aged 65 and over) show that capacity decreased with age and that women were less affected than men, with very little difference found in levels of autonomous capacity by territory. However, in relation to different income levels, after standardizing for age and sex, no evidence was found for differences in the ability to access and prepare meals in groups that were separated by income level. This result shows the importance of standardizing when analysing food acquisition autonomy in groups of people aged 65 years and over.
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Huang Y, Wang H, Yang C, Luo Y, Ding Y, Jin H, Wen S. Evaluation of changes in the cognitive function of adult cynomolgus monkeys under stress induced by audio-visual stimulation by applying modified finger maze test. Front Neurosci 2022; 16:959174. [PMID: 36389243 PMCID: PMC9660267 DOI: 10.3389/fnins.2022.959174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/26/2022] [Indexed: 11/27/2022] Open
Abstract
Stress in life is ubiquitous and unavoidable. Prolonged exposure to severe stress can lead to physical intolerance and impair cognitive function. Non-human primates are considered to be the best animal model for studying cognitive function, especially memory and attention. The finger maze test, with the advantages of short training time and lower cost, is recommended to evaluate learning and memory in non-human primates. In this study, we modified the finger maze test method to evaluate the cognitive function of single-housed cynomolgus monkeys. The flexibility and attention of cynomolgus monkeys were assessed by performing the complex task test and the stranger intrusion interference test, respectively, which increased the difficulty of obtaining rewards, and the ability of long-term memory was also evaluated by the memory test. Furthermore, the changes in cognitive function of the cynomolgus monkeys were tested by using the finger maze test after audio-visual stimulation, and the changes in the cortisol levels during stimulation were also analyzed. We found that, after completing the learning test, there was no significant decrease in their success rate when monkeys processed multitasks at the same time. In the stranger intrusion interference test, all subjects were distracted, but the accuracy did not decrease. The monkeys completed the memory tests in the 1st and 2nd months after the learning tests, with a high success rate. However, the success rate decreased significantly at the end of the 4th month. During audio-visual stimulation, the plasma cortisol level significantly increased in the first 2 months and was maintained at a high level thereafter. One month after audio-visual stimulation, the accuracy of the memory test was significantly reduced, and the total time of distraction was significantly prolonged. In conclusion, chronic audio-visual stimulation can increase blood cortisol levels and impair cognitive function. The modified finger maze test can evaluate many aspects of cognitive function and assess the changes in the cognitive function of adult cynomolgus monkeys under stress.
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Affiliation(s)
- Ying Huang
- Department of Psychology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Hong Wang
- Department of Psychology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Chen Yang
- Department of Psychology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Yuchong Luo
- Department of Psychology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Yongyan Ding
- Hong Kong and Macao Central Nervous Regeneration Research Institute, Ji'nan University, Guangzhou, China
| | - Hongjun Jin
- Guangdong Provincial Key Laboratory of Biomedical Imaging, Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
- *Correspondence: Hongjun Jin
| | - Shenglin Wen
- Department of Psychology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
- Shenglin Wen
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