Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia

Estimating global prevalence of mild cognitive impairment and dementia in elderly with overweight, obesity, and central obesity: A systematic review and meta-analysis

BACKGROUND AND AIM

Previous studies have demonstrated that adiposity, particularly obesity during midlife, may have a detrimental effect on cognitive function. This study aims to estimate the global prevalence of mild cognitive impairment (MCI) and dementia in elderly aged 60 years or above with overweight, obesity, and central obesity.

METHODS

We searched PubMed, Embase, Web of Science, and Cochrane Library from inception to November 2023. DerSimonian-Laird random-effects model with Logit transformation was used. Sensitivity analysis, meta-regression, and subgroup analysis were employed to investigate determinants of the prevalence of MCI and dementia.

RESULTS

A total of 72 studies involving 2,980,947 elderly with distinct adiposity status were included. Pooled prevalence of MCI and dementia in elderly with overweight and obesity was 32.54% and 9.47%, respectively. Univariate meta-regression analysis indicated that the heterogeneity in dementia prevalence was attributable to variations in study size (R2 = 0.01, p < 0.05), while the multivariable analysis underscored that the income of country or area had the most significant predictive importance (60.3% and 90.3%) for both MCI and dementia prevalence. Subgroup analysis revealed regional disparities and diagnostic technique variations contributing to heterogeneity. Based on currently available but inadequate epidemiological data, the pooled prevalence of MCI and dementia in elderly with central obesity was calculated as 10.18% and 9.75%, respectively.

CONCLUSION

Strategies to address adiposity-associated cognitive impairment should consider multifaceted interventions beyond simple weight reduction. Macro-level initiatives such as improvement of income levels and micro-level interventions including the adoption of accurate diagnostic techniques also represent equally pivotal components.

Insomnia and risk of all-cause dementia: A systematic review and meta-analysis

BACKGROUND

The evidence on the relationship between insomnia and risk of dementia, Alzheimer's disease (AD), and Vascular dementia (VD) is not consistent. We conducted this meta-analysis to examine the evidence for the risk of developing dementia, AD, or VD in patients with all subtypes of insomnia.

METHODS

A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted using the following search strings: 'Insomnia OR Sleep initiation and Maintenance disorders OR Early morning awakening' AND 'Dementia OR Alzheimer's Disease OR Vascular Dementia' AND 'Risk'. Data extraction was done independently by two researchers. Pooled odds ratio (OR) accompanied by 95% confidence interval (CI) were calculated using either a random-effects model or a fixed-effects model. Sensitivity analyses were performed to assess the robustness of the findings. The potential for publication bias was evaluated through Egger's test and Begg's test.

RESULTS

This meta-analysis included 16 studies with a combined sample size of over 9 million individuals. Pooled analyses revealed a significant association between insomnia and dementia risk (OR = 1.36; 95% CI: 1.01-1.84), with increased risks for AD (OR = 1.52; 95% CI: 1.19-1.93) and VD (OR = 2.10; 95% CI = 2.06-2.14). Subgroup analyses showed no evidence of associations between initial insomnia (OR = 1.01; 95% CI = 0.71-1.31), sleep-maintenance insomnia (OR = 0.88; 95% CI = 0.66-1.17), and early morning awakening (OR = 0.94; 95% CI = 0.83-1.07) with dementia risk. Insomnia patients from Europe (OR = 1.24; 95% CI = 1.14-1.35), Asia (OR = 2.19; 95% CI = 2.06-2.32), and the Americas (OR = 1.05; 95% CI =  1.04-1.07) had varying risks of dementia. Subgroups with less than five years of follow-up (OR = 2.16; 95% CI = 1.81-2.60) exhibited higher dementia risks in insomnia patients, while those with more than five years of follow-up (OR = 1.17; 95% CI = 1.03-1.33) showed a lower risk.

CONCLUSION

Our meta-analysis reveals that insomnia is linked to the risk of dementia, AD, and VD. These findings suggest that insomnia may significantly contribute to the risk of all-cause dementia, highlighting the importance of early intervention and management of insomnia. Despite our efforts to minimize and explore the sources of heterogeneity, it still remained, and therefore our results should be interpreted with caution.

Health multidimensional evaluation of institutionalized older adults according to cognitive performance

The assessment of living and health conditions of the institutionalized older adults contributes to the development of health promotion measures. The high prevalence of cognitive decline in this population leads to unfavorable health outcomes, which can be prevented and managed.

Objective

To investigate the health conditions of institutionalized older adults according to global cognitive performance.

Methods

Cross-sectional study of institutionalized older adults in Brasília, Distrito Federal (DF) and Salvador, Bahia (BA) using questionnaires on multidimensional health assessment and the Mini-Mental State Examination (MMSE).

Results

Of the 185 residents, 86 were evaluated, with the majority of the sample composed of women and people aged 80 years old or older. Cognitive decline in the MMSE was associated with greater difficulties in Activities of Daily Living (ADL) (62.5%). Lower performance on the MMSE was correlated with longer length of institutionalization (p=0.043), older age (p=0.004), poorer Geriatric Oral Health Assessment Index (GOHAI) (p=0.087), greater difficulty in ADL (p<0.001), and higher scores on the Bristol scale (p<0.001). Conversely, higher education (p<0.001), better scores on the Mini Nutritional Assessment (p=0.003), larger Calf Circumference (CC) (p=0.036), and Hand Grip Strength (HGS) (p=0.0467) were associated with better performance in the MMSE.

Conclusion

The cognitive performance of institutionalized older people is correlated with sociodemographic and health variables. These results are oriented toward the formulation of public health policies and care management.

Unraveling the link between physical activity and cognitive function: the mediating impact of depressive symptoms

BACKGROUND

This study investigates the association between physical activity and cognitive function in adults aged 50 and older, with a focus on the mediating role of depressive symptoms.

METHODS

Data were drawn from Waves 7 to 9 of the English Longitudinal Study of Ageing (ELSA), including 5,499 participants aged 50 years and older. Cognitive function was assessed through measures of episodic memory, numeracy, and orientation. Physical activity was quantified using a composite measure combining the frequency of vigorous, moderate, and light exercise with their respective average metabolic equivalents. Depressive symptoms were evaluated using the CES-D-8 scale. Generalized estimating equations (GEE) were employed to examine the association between physical activity and cognitive function, while the Bootstrap method was utilized to evaluate the mediating role of depressive symptoms.

RESULTS

GEE analyses revealed that higher levels of physical activity were significantly associated with improved global cognitive function(β = 0.151, 95%CI: 0.118-0.183), episodic memory(β = 0.074, 95%CI: 0.058-0.090), numeracy(β = 0.033, 95%CI: 0.015-0.051), and orientation(β = 0.039, 95%CI: 0.022-0.057) (all P < 0.001). Physical activity also demonstrated a significant negative association with depressive symptoms(β=-0.402, 95%CI: -0.452 to -0.352) (P < 0.001), which, in turn, were linked to lower cognitive function. Notably, depressive symptoms mediated 8.46% of the association between physical activity and global cognitive function.

CONCLUSIONS

Greater engagement in physical activity is associated with better cognitive function, and this association is partially mediated by depressive symptoms. These findings underscore the importance of promoting physical activity to support cognitive health in older adults, with particular attention to its potential role in mitigating depressive symptoms.

Healthy Dietary Pattern Improves Cognitive Function in Elderly Persons With Periodontitis: A Cross-Sectional Study of NHANES

AIM

Cognitive decline is thought to be more prevalent in elderly persons with periodontitis. Greater adherence to Healthy Eating Index (HEI)-2015 has been reported to improve cognitive function in the elderly population. However, whether the benefits of HEI-2015 on cognitive function apply to elderly patients with periodontitis remains unknown.

METHODS

This is a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). The data were extracted from database 2011-2014. Cognitive function was measured through the Consortium to Establish a Registry for Alzheimer's Disease battery for immediate recall (CERAD-WL) and delayed recall (CERAD-DR), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). The data of HEI-2015 were acquired from 24-hour dietary recalls. Weighted linear regression models were performed to investigate the association between HEI-2015 and cognitive function in elderly patients with periodontitis. The associations were further investigated in subgroups of sex, cardiovascular disease status, and depression status.

RESULTS

A total of 1862 participants were included, and 1223 of them had periodontitis. Periodontitis was negatively associated with cognitive function (β = -0.45; 95% confidence interval [CI], -0.87 to -0.03). No statistically significant relationship was observed between HEI-2015 and cognitive function (β = 0.33; 95% CI, -0.02 to 0.69). Low HEI-2015 score was associated with high odds of cognitive decline in patients with periodontitis (β = -0.73; 95% CI, -1.25 to -0.21; P for trend = .01). Higher HEI-2015 was related to the lower incidence of cognitive function decline in patients with periodontitis who were female (β = -0.53; 95% CI, -1.03 to -0.03), had a socioeconomic status from 0 to 3 (β = -0.55; 95% CI, -1.00 to -0.09), did not have cardiovascular disease (β = -0.60; 95% CI, -1.14 to -0.05), and did not have depression (β = -0.57; 95% CI, -1.11 to -0.03).

CONCLUSIONS

Greater HEI-2015 adherence may improve cognitive function amongst elderly patients with periodontitis. Further studies are needed to investigate this putative association in elderly persons with periodontitis.

Effect of ashwagandha (Withania somnifera) extract with Sominone (Somin-On™) to improve memory in adults with mild cognitive impairment: A randomized, double-blind, placebo-controlled study

BACKGROUND

Mild cognitive impairment (MCI) is a condition in which people have memory or thinking problems than other people of their age. This study evaluated the effectiveness and safety of ashwagandha extract standardized with Sominone (Somin-On™) in enhancing memory and cognitive functioning in adults with MCI.

METHODS

In this randomized double-blind, placebo-controlled pilot study, 40 subjects with MCI were randomized in a 1:1 ratio to receive either Somin-On™ (250 mg daily) or a placebo for 60 days. The outcome measures, improvement in memory and other cognitive functions after 30 and 60 days were assessed using Montreal Cognitive Assessment (MoCA); Mini-mental state examination (MMSE); Wechsler Memory Scale-III (WMS-III)); and Shepard mental rotation task.

RESULTS

Subjects treated with Somin-On™ showed significant improvements in immediate memory, general memory, working memory and visuospatial processing and the response assessed using WMS-III after 30 and 60 days outperforming the placebo group. Scores on the Shepard Mental Rotation test in Somin-On™ group showed a significant rise by 12.22% at 30 days and 31.67% at 60 days, from baseline. Significant improvement was observed with Somin-On™ in memory assessment scales viz. MoCA (7.83% at 30 days and 14.77% at 60 days, from baseline) and MMSE (9.26% at 30 days and 19.21% at 60 days, from baseline) compared to placebo group.

CONCLUSIONS

The supplementation of Somin-On™ is an effective therapy to improve the immediate, general and working memory, as well as cognitive functions like attention and information processing speed in adults with MCI.

Nutrition and Dietary Patterns: Effects on Brain Function

Dietary habits are strongly associated with neuropsychological functioning [...].

Social interactions in dementia: perceptions of current situation and opportunities

BACKGROUND

Social interactions can have a beneficial effect on people with dementia (PWD). However, little is known about the details of social interactions in dementia, information that is useful for planning social interventions. The aim of our study was to gain a deeper insight, provided by people in dementia care, into (i) the characteristics of social interactions of PWD, (ii) which social interactions are considered as particularly important, (iii) how important social interactions are perceived, and (iv) what is perceived to increase social interactions among PWD.

METHODS

Responses of 501 people in dementia care (mostly family and professional caregivers; more than three-quarters female; average age 53.5 years) provided in a structured, quantitative survey were included in this analysis. Descriptive analyses were conducted.

RESULTS

The majority of PWDs' social interactions take place in their home or day care and arise from support services as well as organized activities. More than half of the participants perceived singing, telling life stories, or moving together (e.g., walking, dancing) as valuable social interactions that PWD benefit from in many ways. Positive effects (e.g., aggression, depression, positive emotions, activation) are mainly perceived for social interactions such as laughing together, touch, hugging, simply being together, or being involved in daily activities. Overall, participants rated social interactions as rather important for the course of the symptoms. A fixed social contact besides the primary caregiver and offers from the community, associations, and religious institutions are considered rather important in increasing the social interactions of PWD.

CONCLUSIONS

Simple social interactions of PWD such as laughing, eating or singing together that can be realized in the home environment and in the context of organized caregiving activities are perceived most valuable. Enhancing social interactions, especially beyond the primary caregiving context, may be valuable for those living with dementia.

The association between indoor air pollution from solid fuels and cognitive impairment: a systematic review and meta-analysis

This study aimed to comprehensively and methodically evaluate the correlation between cognitive impairment and indoor air pollution from solid fuel used for cooking/heating. PubMed, Web of Science, EMBASE, and Cochrane Library databases were searched up to December January 2023. 13 studies from three countries with a total of 277,001 participants were enrolled. A negative correlation was discovered between solid fuel usage for cooking and total cognitive score (β=-0.73, 95 % CI: -0.90 to -0.55) and episodic memory score (β=-0.23, 95 % CI: -0.30 to -0.17). Household solid fuel usage for cooking was considerably associated with a raised risk of cognitive impairment (HR=1.31, 95 % CI: 1.09-1.57) and cognitive decline (HR=1.24, 95 % CI: 1.18-1.30). Compared to continuous solid fuel use for cooking, sustained use of clean fuel and switching from solid fuel to clean fuel were associated with a lower risk of cognitive decline (OR=0.55, 95 % CI: 0.42-0.73; OR=0.81, 95 % CI: 0.71-0.93). A negative association was found between solid fuel usage for heating and total cognitive score (β=-0.43, 95 % CI: -0.59 to -0.26) and episodic memory score (β=-0.22, 95 % CI: -0.34 to -0.10). Our research provided evidence that exposure to indoor air pollution from solid fuel is a potential cause of cognitive impairment and cognitive decline. Making the switch from solid fuels to cleaner fuels could be an important step in preventing cognitive impairment in the elderly.

Body Mass Index and subjective cognitive decline among cancer survivors in the US: a cross-sectional analysis of a nationally representative survey

OBJECTIVE

Despite the strong evidence suggesting significant relationships between Body Mass Index (BMI) and cognitive functioning in the general population, there is a dearth of research on this potential association in the cancer survivor sub-population. Therefore, utilizing a nationally representative sample, the current study seeks to examine the cross-sectional association between BMI and subjective cognitive decline (SCD) in adult cancer survivors in the US.

METHODS

The 2020, 2021, and 2022 Behavioral Risk Factor Surveillance System (BRFSS) surveys were used for the analysis. Logistic regression was performed to examine the odds of SCD in a sample of 20,739 cancer survivors, controlling for age, sex, race/ethnicity, marital status, level of education, employment status, general health status, and cigarette smoking status. All analyses were weighted to account for the complex study design and to produce nationally representative population estimates.

RESULTS

The prevalence of SCD among cancer survivors in this study was approximately 15%. Significant associations between BMI and SCD were found; compared to cancer survivors with normal weight, the odds of experiencing SCD were significantly greater for those with overweight (adjusted odds ratio [AOR] 1.22, 95% confidence interval [CI] 1.01-1.49) and obesity (AOR  1.24, 95%CI 1.02-1.51).

CONCLUSION

Among cancer survivors in this study, unhealthy weight is associated with a higher risk of subjective cognitive decline. Underscoring the need for evidence-based interventions that support the cognitive health of adult cancer survivors, with a focus on those with unhealthy weight.

Exploring the association between physical activity and cognitive function among people living with dementia

BackgroundPhysical activity preserves cognitive function in people without dementia, but the relationship between physical activity and cognitive domains among people living with dementia is unclear.ObjectiveThe objective of this study was to explore the association between physical activity and cognition domains among people living with dementia.MethodsParticipants living with dementia in residential care facilities (complete case analysis: n = 24/42) completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail-Making Test, Digit Span Forward Test; perception and orientation: Benton Judgement of Line Orientation Test; language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test). Participants wore an actigraphy monitor on their non-dominant wrist over seven days. We conducted a linear regression for total physical activity (independent variable) with race (white/black), fall risk (Morse Fall Scale), and the number of comorbidities (Functional Comorbidities Index) as covariates, and cognitive tests as variables of interest.ResultsParticipants were primarily male (75%), white (87.5%), and 50%had unspecified dementia (Alzheimer's disease: 33%). Greater physical activity was associated with poorer global cognition, better executive function, and better learning and memory (ps <  0.05). Physical activity was not related to visuospatial perception, language, or complex attention.ConclusionsPhysical activity may preserve executive function and learning and memory among people living with dementia. Wandering is more common in later stages of dementia, which may explain greater physical activity observed with lower global cognition. Regularly assessing physical activity may be useful in screening and monitoring cognitive changes.

Bariatric Surgery Is Associated With Reduced Incidence of Mild Cognitive Impairment and Alzheimer Disease and Related Dementias: A Retrospective Cohort Study

Objective

To evaluate the association of bariatric surgery with reduced incidence and delayed development of mild cognitive impairment (MCI) and Alzheimer disease and related dementias (ADRD) in patients with obesity.

Background

This retrospective longitudinal study utilized Electronic Health Records from Vanderbilt University Medical Center, covering 5303 patients who underwent bariatric surgery and 10,606 propensity score-matched obese patients who did not, from 2000 to 2023. Patients with prior MCI, ADRD, schizophrenia, alcoholism, gastric cancer, gastric ulcers, inflammatory bowel disease, coagulopathy, stroke, Parkinson disease, or brain cancer were excluded from both groups.

Methods

Differences in time to MCI/ADRD between surgical and control groups were analyzed using linear regression, and adjusted for confounders: demographics, medical history, and socioeconomic status. Survival probability differences for MCI and ADRD between the 2 groups over time were assessed using Kaplan-Meier curves and log-rank tests. Incidence differences of MCI and ADRD between the groups were evaluated using Fine-Gray subdistribution hazard models, accounting for the competing risk of death and confounders.

Results

Bariatric surgery was associated with a significantly reduced incidence of ADRD, evidenced by a subdistribution hazard ratio (SHR) of 0.37 (95% confidence interval [CI]: 0.15-0.89; P = 0.03). Similarly, the incidence of MCI was significantly lower in the surgical group, with an SHR of 0.57 (95% CI: 0.39-0.85; P = 0.01). Additionally, patients who underwent bariatric surgery experienced a delay of 2.01 years before developing MCI compared with the control group (95% CI: 0.70-3.50; P = 0.004).

Conclusions

These findings suggest that bariatric surgery may serve as an effective strategy to delay the onset of MCI and reduce the risk of both MCI and ADRD in patients with obesity.

Nutritional Supplements for Healthy Aging: A Critical Analysis Review

Background: Healthy aging is defined as survival to advanced age while retaining autonomy in activities of daily living, high societal participation, and good quality of life. Sarcopenia, insomnia, cognitive impairment, and changes in sensation can be key hinderances to healthy aging, but nutritional supplements may abate their impact. As research advances, an updated review on their efficacy on age-related conditions is warranted. Results: Sarcopenia can be mitigated through proper protein intake, supplements like creatine, and in certain situations Branched-Chain Amino Acids and Vitamin D, in adults over 65. Melatonin supplementation has moderate evidence for improving sleep, while valerian root lacks evidence. Magnesium, tart cherry, and kiwifruits have shown promising impacts on sleep in limited articles. Magnesium, Vitamin D, and B vitamin supplementation have been shown to improve cognition in those with mild cognitive impairment and Alzheimer's disease but require further study prior to recommendation. The Age-Related Eye Disease Study supplement combination is routinely recommended to reduce risk of progression to advance stages of age-related macular degeneration. Alpha-Lipoic Acid and Folate have been investigated for their roles in mitigating age-related hearing losses. Conclusions: Nutritional supplements and lifestyle changes may mitigate disabilities across multiple domains of age-related illnesses and promote healthy aging.

Development and Validation of a Hypertension Risk Prediction Model Based on Particle Swarm Optimization-Support Vector Machine

BACKGROUND

Hypertension is a prevalent health issue, especially among the elderly, and is linked to multiple complications. Early and accurate detection is crucial for effective management. Traditional detection methods may be limited in accuracy and efficiency, prompting the exploration of advanced computational techniques. Machine learning algorithms, combined with optimization methods, show potential in enhancing hypertension detection.

METHODS

In 2022, data from 1460 hypertensive and 1416 non-hypertensive individuals aged 65 and above were collected from the Lujingdong Outpatient Department of the Guangdong Second Traditional Chinese Medicine Hospital. Support Vector Machine (SVM) and Particle Swarm Optimization-Support Vector Machine (PSO-SVM) models were developed, validated using the holdout method, and evaluated based on sensitivity, specificity, positive predictive value (PPV), accuracy, G-mean, F1 score, Matthews correlation coefficient (MCC), and the area under the curve (AUC) of the receiver operating characteristic curve (ROC curve).

RESULTS

The PSO-SVM model outperformed the standard SVM, especially in sensitivity (93.9%), F1 score (0.838), and AUC-ROC (0.871).

CONCLUSION

The PSO-SVM model is effective for complex classifications, particularly in hypertension detection, providing a basis for early diagnosis and treatment.

Protective and risk factors in daily life associated with cognitive decline of older adults

Background

Cognitive decline is a chronic condition which is characterized by a loss of the ability to remember, learn, and pay attention to complex tasks. Many older people are now suffering from cognitive decline, which decreases life quality and leads to disability. This study aimed to identify the risk and protective factors for cognitive decline of the older people from daily life and establish a predictive model using logistic regression.

Methods

We investigated 3,790 older people with health examination and questionnaires which included information associated with physical condition, lifestyle factors, and cognitive status. Single-factor comparison, principal component analysis with a Manova-Wilk test, multiple linear regression, and logistic regression were performed to filter the risk and protective factors regarding cognitive decline of older individuals. Then a predictive model using logistic regression was established based on the most significant protective and risk factors.

Results

We found a significant separation along the coordinate axis between people with normal and declined cognition by principal component analysis, as confirmed by the Manover-Wilk test. Single-factor comparison, multiple linear regression and logistic regression implied that gender, age, hypertension level, height, dietary habit, physical-exercise duration, physical-exercise history, and smoking history could be closely linked with cognitive decline. We also observed significant differences in height, physical exercise duration, physical-exercise years, and smoking years between the male and female of the participants. ROCs of the predictive model by logistic regression were plotted, with AUC values of 0.683 and 0.682, respectively, for the training and testing sets. Although an effective predictive model is thought to have AUC over 0.7, we still believe that the present model is acceptable because the value is close to the threshold.

Conclusion

The protective factors of cognitive decline for older people were male gender, height, keeping moderate exercising, and nicotine stimulation, and the risk factors included age, female gender, vegetarianism and hypertension. Except for the genetic factor, differences in lifestyle, such as smoking and exercise habits, may contribute to the observed differences in cognitive function between genders. The significant results could be utilized in the practice for the early intervention of cognitive decline in aged people.

Effect of Interaction of ATG7 and Plasma Metal Concentrations on Cognitive Impairment in Rural China

The objective of this study is to explore the association of plasma metal concentrations with impaired cognitive function in different genotypes of ATG7 using multiple models. A cross-sectional survey was conducted in rural China among 994 individuals aged 30 years or older. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Genetic analysis focused on two single-nucleotide polymorphisms (SNPs) in the autophagy-related gene ATG7 (rs2606757 and rs8154). Plasma concentrations of metals were quantified using inductively coupled plasma mass spectrometry. Restricted cubic splines were used to explore the association between serum metal concentration and the occurrence of mild cognitive impairment in individuals with various genotypes. Bayesian Kernel Machine Regression (BKMR) models were used to explore the interactions between individual metals. In a restricted cubic spline model, there is a nonlinear relationship between plasma concentration of Cd and the occurrence of cognitive impairment in individuals carrying the AA (P of Nonlinear = 0.008) and AT (P of Nonlinear = 0.007) genotypes at the rs2606757. However, in people carrying the TT genotype at the rs2606757 locus, the concentration of metals in plasma was not significantly associated with cognitive impairment (P of Nonlinear = 0.534). The results of the BKMR model are consistent with those of the restricted cubic spline model. The TT genotype at rs2606757 in ATG7 appears to confer greater cognitive resilience against Cd-induced cognitive damage. These findings highlight the importance of considering gene-environment interactions in the context of cognitive impairment and suggest potential avenues for preventing cognitive decline in individuals exposed to Cd. Further research is needed to elucidate the precise mechanisms underlying these interactions.

Exploring nutraceutical approaches linking metabolic syndrome and cognitive impairment

Metabolic syndrome (MetS) and mild cognitive impairment (MCI) are interconnected conditions sharing common pathological pathways, such as inflammation and oxidative stress, leading to the concept of "metabolic-cognitive syndrome." This highlights their mutual influence and potential overlapping therapeutic strategies. Although lifestyle modifications remain essential, nutraceutical supplementation has emerged as a promising adjunct for the prevention and management of these preclinical conditions. This review examines clinical and translational evidence on commonly used nutraceuticals targeting shared pathophysiological mechanisms of MetS and MCI. By addressing inflammation, oxidative stress, and metabolic dysfunction, these supplements may offer a valuable approach to mitigating the progression and consequences of both conditions. Understanding their efficacy could provide practical tools to complement lifestyle changes, offering a more comprehensive strategy for managing metabolic-cognitive syndrome.

Multisensory stimulation reduces neuropsychiatric symptoms and enhances cognitive function in older adults with dementia: A meta-analysis of randomized controlled trials

OBJECTIVE

Multisensory stimulation defined as engaging multiple senses (visual, olfactory, auditory, gustatory, and tactile), has been demonstrated to improve older adults' general health. However, its effectiveness in mitigating neuropsychiatric symptoms (NPSs) and cognitive deficits in older adults with dementia remains unclear. This meta-analysis evaluated the efficacy of multisensory stimulation in ameliorating NPSs and improving overall cognitive function in older adults with dementia.

METHODS

We searched eight databases to September 2024 without restriction. Older adults with all stages of dementia aged 65 years and above were included. To estimate the pooled effect size, Hedge's g (g) values were calculated using a random-effects model. Heterogeneity was assessed using the Q, I², and τ² statistics. Subgroup and meta-regression analyses were performed to identify moderators. Publication bias was assessed using Begg and Mazumdar's rank correlation and Egger's linear regression tests.

RESULTS

This review included 16 studies (974 patients). Multisensory stimulation significantly reduced agitation (g= -0.96; 95 %CI= -1.44, -0.48), apathy (g= -1.27; 95 %CI= -2.08, -0.46), and depression (g= -0.28; 95 %CI= -0.48, -0.07). Moreover, the intervention significantly improved overall cognitive function (g= 0.30; 95 %CI= 0.09, 0.52). However, multisensory stimulation had no significant effect on anxiety (g= -0.81; 95 %CI= -1.79, 0.17). Significant heterogeneity was observed in agitation, apathy, and anxiety. Moreover, meta-regression analyses by educational level (junior high school and above) revealed significant moderators in agitation.

CONCLUSIONS

Multisensory stimulation shows promise as a non-pharmacological intervention for older adults with dementia. It may effectively mitigate NPSs and improve cognitive function into clinical practice as an alternative therapeutic.

Neuro-Nutrition and Exercise Synergy: Exploring the Bioengineering of Cognitive Enhancement and Mental Health Optimization

The interplay between nutrition, physical activity, and mental health has emerged as a frontier in bioengineering research, offering innovative pathways for enhancing cognitive function and psychological resilience. This review explores the neurobiological mechanisms underlying the synergistic effects of tailored nutritional strategies and exercise interventions on brain health and mental well-being. Key topics include the role of micronutrients and macronutrients in modulating neurogenesis and synaptic plasticity, the impact of exercise-induced myokines and neurotrophins on cognitive enhancement, and the integration of wearable bioelectronics for personalized monitoring and optimization. By bridging the disciplines of nutrition, psychology, and sports science with cutting-edge bioengineering, this review highlights translational opportunities for developing targeted interventions that advance mental health outcomes. These insights are particularly relevant for addressing global challenges such as stress, anxiety, and neurodegenerative diseases. The article concludes with a roadmap for future research, emphasizing the potential of bioengineered solutions to revolutionize preventive and therapeutic strategies in mental health care.

Association between depressive status and mild cognitive impairment in middle-aged and elderly Chinese adults from CHARLS study

Background

The potential association between depressive status and the risk of mild cognitive impairment (MCI) remains unclear, especially in the absence of prospective evidence. This study aims to elucidate the impact of either depression score or depression on the risk of MCI using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS).

Methods

This prospective study included 5,766 participants from CHARLS followed from 2011 to 2015. We calculated the baseline depression score using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the cognitive status score after 3 years of follow-up through four dimensions: orientation, memory, calculation, and draw. We collected baseline sociological characteristics and health-related factors as covariates, using multivariate-adjusted logistics regression models (odds ratios (OR) and 95% confidence intervals (CI)) and restricted cubic splines (RCS) to estimate the effect of depressive status on MCI risk.

Results

We observed 724 new cases of MCI at follow-up. Logistics regression analysis showed that participants with depression had a 58% higher risk of developing MCI than those without depression (OR = 1.58, 95%CI: 1.35-1.85), and the positive association persisted after adjusting for covariates such as sociological characteristics of the population and health-related factors (OR = 1.24, 95%CI: 1.04-1.48). We also observed a dose-response relationship between depression score and MCI risk, with participants with 11~20 and 21~30 scores having a progressively higher risk of MCI compared to participants with depression score of 0~10 (p for trend < 0.05), and a 3% increase in MCI risk for each 1-point increase in depression scores (OR = 1.03, 95%CI: 1.01-1.04). RCS analysis also showed a nonlinear association between depression score and MCI risk (p for non-linearity = 0.001), with MCI risk increasing with increasing depression score. In addition, stratified analyses based on sex, age, marital status, residence, BMI, nighttime sleep, smoking status, alcohol drinking status, baseline serological indicators, and comorbidities showed no interaction (p for interaction > 0.05) other than serum total cholesterol levels (p for interaction = 0.008).

Conclusions

Among middle-aged and elderly adults from CHARLS, depression is an independent risk factor for MCI, indicating that individuals with more severe depression symptoms are more likely to suffer from MCI. Early depression screening based on CESD-10 may help identify individuals at high risk of MCI, and early intervention may reduce the incidence of MCI and Alzheimer's disease, thereby reducing the social care burden of an ageing population.

Joint effect of polysocial risk score, lifestyle and genetic susceptibility with the risk of dementia: A prospective cohort study

OBJECTIVES

The comprehensive impact of polysocial risk score (PsRS)-encompassing multiple social determinants of health (SDoHs) with genetic and lifestyle factors on dementia incidence remains to be elucidated.

STUDY DESIGN

This study aimed to clear the associations between PsRS and dementia incidence and evaluated how genetic and lifestyle factors modified these associations in the UK Biobank cohort.

METHODS

The detailed prospective study involved over 500,000 participants when recruited in 2006-2010. The PsRS was calculated by 12 SDoHs across psychosocial factors, socioeconomic status, and neighborhood and living environment. A healthy lifestyle score was constructed from physical activities, alcohol consumption, smoking status, and diet. A genetic risk score (GRS) was computed via genotype data from UK Biobank. The Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between PsRS, lifestyle factors, GRS and dementia.

RESULTS

Results showed the participants with intermediate (HR = 1.32, 95%CI: 1.20-1.45) and high PsRS (HR = 2.10, 95 % CI: 1.91-2.32) were significantly associated with an increased risk of dementia compared with those with a low PsRS. Then, compared with participants with low PsRS and favorable lifestyle/low GRS, high PsRS and unfavorable lifestyle/high GRS had the highest risk of dementia (HR = 3.11,95%CI: 2.63-3.68)/(HR = 3.56, 95%CI: 2.62-4.85).

CONCLUSIONS

Both high PsRS and GRS were significantly associated with higher dementia risk. A favorable lifestyle could reduce dementia incidence regardless of high PsRS or GRS. Additionally, focusing on the intervention of SDoHs would be positive in preventing dementia.

Caregiving experiences of family caregivers of disabled middle-aged and older adults enrolled in long-term care insurance: a qualitative study

BACKGROUND

Long-term care insurance (LTCI) projects were an essential components of health systems designed to support disabled people and their families. Despite LTCI has been getting more and more attention and promotion, there was a lack of qualitative study to explore the experiences of family caregivers who were directly involved in the care of disabled people enrolled in these projects. This study aimed to explore the experiences of family caregivers in the caregiving process within the context of LTCI.

METHODS

This qualitative study used inductive content analysis to explore the experiences of family caregivers of disabled people. Fifteen family caregivers from long-term care service companies and communities in Nantong city were purposively selected to participate in the study between December 2023 to February 2024. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim.

RESULTS

The results revealed a total of five major themes with thirteen sub-themes including: (1) caregiver fatigue (i.e. heavy daily care tasks, and lack of rest); (2) emotional stress (helplessness and depression, and isolated and alone); (3) perceived benefits of caregiving (emotional connection, and a new outlook on life); (4) more expectations for LTCI (expect respite care, expect medical care facilities, expect longer service duration and frequency, and expect more economic subsidies); and (5) positive evaluations of LTCI (provide psychological support, reduce the burden of care, and professional care services).

CONCLUSIONS

This study's findings improved our understanding of caregiving experiences among family caregivers of disabled people enrolled in LTCI. Identifying caregivers' experiences enabled the authorities to develop support strategies and interventions focused on helping them reduce the caregiver burden.

Associations Between Adherence to the Mediterranean Diet and Incident Sarcopenia in Prospective Cohort Studies

The loss of skeletal muscle mass and strength, known as sarcopenia, is prevalent in older adults and linked to an increased risk of disability, frailty, and early mortality. Muscle health is crucial for the functionality and independence of older adults. As the aging population continuously grows, finding cost-effective strategies for preventing and treating sarcopenia is an important public health priority. While nutrition is recognized as a key factor in the development of sarcopenia, its role in preventing and treating the condition is still under investigation. In recent decades, nutritional research has shifted from a focus on individual nutrients or healthy foods to examining the combination of nutrients and foods in dietary patterns, along with their potential synergistic and antagonistic effects. A balanced diet and regular participation in physical activity are essential for maintaining musculoskeletal health. One of the healthy eating patterns with the greatest evidence of multiple health benefits is the Mediterranean diet, which has also been linked to positive effects on muscle function in observational studies. However, there is a lack of intervention studies. This review explores the updated evidence from longitudinal prospective studies on associations between adherence to the Mediterranean diet and sarcopenia in order to promote preventive and intervention strategies for healthy muscle aging.

Neighborhood environment associations with cognitive function and structural brain measures in older African Americans

BACKGROUND

Since older adults spend significant time in their neighborhood environment, environmental factors such as neighborhood socioeconomic disadvantage, high racial segregation, low healthy food availability, low access to recreation, and minimal social engagement may have adverse effects on cognitive function and increase susceptibility to dementia. DNA methylation, which is associated with neighborhood characteristics as well as cognitive function and white matter hyperintensity (WMH), may act as a mediator between neighborhood characteristics and neurocognitive outcomes.

METHODS

In this study, we examined whether DNA methylation in peripheral blood leukocytes mediates the relationship between neighborhood characteristics and cognitive function (N = 542) or WMH (N = 466) in older African American (AA) participants without preliminary evidence of dementia from the Genetic Epidemiology Network of Arteriopathy (GENOA).

RESULTS

For a 1-mile buffer around a participant's residence, each additional fast food destination or unfavorable food store with alcohol per square mile was nominally associated with a 0.05 (95%CI: 0.01, 0.09) and a 0.04 (0.00, 0.08) second improvement in visual conceptual tracking score, respectively. Also, each additional alcohol drinking place per square mile was nominally associated with a 0.62 (0.05, 1.19) word increase in delayed recall score, indicating better memory function (all p < 0.05). Neighborhood characteristics were not associated with WMH. We did not find evidence that DNA methylation mediates the observed associations between neighborhood characteristics and cognitive function.

CONCLUSIONS

The presence of fast food destinations and unfavorable food stores with alcohol was associated cognitive measures, possibly due to greater social interaction provided in these venues. However, replication of these findings is necessary. Further examination of the potential pathways between the neighborhood environment and cognitive function/WMH may allow the development of potential behavioral, infrastructural, and pharmaceutical interventions to facilitate aging in place and healthy brain aging in older adults, especially in marginal populations that are most at risk.

Integrated healthy lifestyle even in late-life mitigates cognitive decline risk across varied genetic susceptibility

It remains unclear whether the benefits of adhering to a healthy lifestyle outweigh the effects of high genetic risk on cognitive decline. We examined the association of combined lifestyle factors and genetic risk with changes in cognitive function and six specific dimensions of cognition among older adults from the Chinese Longitudinal Healthy Longevity Survey (1998-2018, n = 18,811, a subset of 6301 participants with genetic information). Compared to participants with an unfavorable lifestyle, those with a favorable lifestyle showed a 46.81% slower rate of cognitive decline, with similar results across most cognitive domains. High genetic risk was associated with a 12.5% faster rate of cognitive decline. Individuals with a high genetic risk and a favorable lifestyle have slower cognitive decline than those with a low genetic risk and an unfavorable lifestyle. These data suggest that the benefits of a favorable lifestyle outweigh genetic factors, and therefore that adhering to a favorable lifestyle may offset the genetic risk for accelerated cognitive decline.

Associations of oxidative balance score and cognition in US older adults: A cross-sectional study of National Health and Nutrition Examination Survey (NHANES) 2011 to 2014

Background

Oxidative stress is linked to cognitive decline in the elderly. Diet, as a key energy source, affects brain function and serves as a modifiable risk factor for cognitive decline.

Objective

This study investigates the relationship between the Oxidative Balance Score (OBS), which reflects diet and lifestyle impact on oxidative stress, and cognitive function in older adults.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2011-2014, including 2716 participants aged 60 and older. Cognitive outcomes measured were the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning test, Animal Fluency test, and Digit Symbol Substitution test. Linear regression models were used to assess the relationship between the OBS and cognitive performance, with stratification and sensitivity analyses conducted to explore these associations further.

Results

Among 2716 participants, higher dietary OBS scores were linked to better cognitive test performance after adjusting for confounders. For example, the highest OBS quartile had a 4.35-point increase in CERAD immediate recall compared to the lowest quartile (OR: 4.35, 95% CI: 2.14-8.84, p = 0.001). Subgroup analyses showed this positive association across age groups and genders, though it was stronger among non-Hispanic white participants compared to other racial groups.

Conclusions

Our findings indicate a positive correlation between OBS and cognitive function in older adults, suggesting that an antioxidant-rich diet and lifestyle may help prevent cognitive decline in this population. However, since this study is cross-sectional, further prospective research is needed to confirm these results.

Dose-response relationship between the age at diagnosis of cardiovascular metabolic multimorbidity and cognitive impairment among middle-aged and older adults in China

AIMS

The purpose of this study was to explore the dose-response relationship between the age at diagnosis of cardiovascular metabolic multimorbidity and cognitive impairment among middle-aged and older adults in China.

METHODS

This is a secondary study using the China Health Retirement Longitudinal Study 2018(CHARLS 2018). The study included 1338 middle-aged and older adults. The middle-aged and older adults is defined as having cardiovascular metabolic multimorbidity if he or she has two or more of the five diseases (hypertension, diabetes, dyslipidemia, stroke, and heart disease). We measured cognitive functions by evaluating situational memory capacity and mental status. The total cognitive function score ranges from 0 to 31. Participants defined cognitive impairment as a function of subject educational level: illiteracy<17, primary school<20, junior high school and above<24. Restrictive cubic splines were used to examine the shape of the association between the age at diagnosis of cardiovascular metabolic multimorbidity and cognitive impairment.

RESULTS

The mean age was 67.72±9.96 years, with 52.0 % being female. Of the total sample, 79.1 % were cognitive impairment. When all covariates were adjusted, our study showed that the later the age of diagnosis of cardiovascular metabolic multimorbidity in middle-aged and older adults, the more cognitive impairment is exacerbated.

CONCLUSION

The later age of diagnosis of CMM in middle-aged and older adults, the higher the risk of cognitive impairment. This suggests that nurses should promptly emphasize the relationship between CMM and cognitive impairment to their patients in their daily practice and encourage patients to be screened for CMM as early as possible.

Cognitive Frailty and Aging: Clinical Characteristics, Pathophysiological Mechanisms, and Potential Prevention Strategies

Frailty has been conceptualized not only as a physical disease, but also as a multidomain entity that encompasses a multimorbid status, disability, cognitive impairment, psychosocial risk factors, and even geriatric syndromes. In addition to physical ailments and depending on the diagnostic model. Standardized neuropsychological tests can identify cognitive deficiencies along with mild cognitive impairment, a pre-dementia stage characterized by memory and/or other cognitive domain impairments with relatively preserved instrumental activities of daily living. Hence, the possibility of cognitive frailty (CF), a construct that refers to physical frailty in concurrence with non-dementia cognitive decline, is proposed. The estimated prevalence of CF ranges from 10.3 to 42.8%. It is likely that the pathway to overt cognitive impairment, which does not yet involve physical function, begins with the asymptomatic early accumulation of progressive brain damage. Thus, timely detection strategies that target the initial phases of CF are warranted. The pathophysiological components of CF include dysregulation of the hypothalamic-pituitary axis stress response, imbalance in energy metabolism, impaired cardiovascular function, mitochondrial deterioration, and vascular age-related arterial stiffness. Changes that contribute to this disease can also occur at the cellular level, including overexpression of the renin-angiotensin-aldosterone system, activation of proinflammatory pathways, endothelial dysfunction, reduced nitric oxide production, and increased oxidative stress. Non-pharmacological interventions, that range from dietary and nutritional counseling to psychosocial therapy, are currently the main approaches. Both cognitive and physical training programs are considered to be the best researched and most useful multidomain interventions. Clinicians recognize CF as a valid concept that warrants prevention and treatment strategies supported by current research.

Tailoring meat products for the elderly: A comprehensive review

The population of the elderly is projected to grow significantly in most of the developed countries in the near future. This should earn this demographic the title of 'Consumer of the future'. Meat has high quality proteins and essential vitamins which are important for all demographics but more so for the elderly due to their susceptibility to sarcopenia. This review explored the landscape of meat research and product development that meets the distinctive requirements of the elderly, drawing from published refereed articles, industry reports, and unpublished grey literature. The review emphasised the importance of understanding the evolving dietary and sensory requirements associated with ageing and how they intersect with meat consumption. One notable aspect observed is the diversity within the elderly population, which underscores the necessity for tailored approaches in meat product development to cater to the varying preferences and nutritional needs of different individuals. This review also highlights the ongoing efforts in developing meat-based products that span a spectrum of consistencies, ranging from solid to liquid forms, to accommodate the diverse needs of elderly consumers. Despite these advancements, the review found a discrepancy between the pace of meat product development for the elderly and the rapid advancements in kitchen-level technologies and suggests that further research is needed to bridge this gap and align product innovation with emerging technological trends.

Dietary changes following a lifestyle-based intervention for dementia risk reduction - results from the AgeWell.de study

PURPOSE

We investigated the effects of a multidomain lifestyle intervention conducted in older adults at increased risk for dementia on participants' diet.

METHODS

Secondary analyses of the cluster-randomized AgeWell.de-trial, testing a multidomain intervention (optimization of nutrition and medication, enhancement of physical, social and cognitive activity) in older adults at increased dementia risk. Intervention effects on a healthy diet (composite score) and its components were analyzed using Poisson- and logistic regression analyses. Stages of behavior change (transtheoretical model), and respective changes between baseline and follow-up were analyzed using mixed regression analyses.

RESULTS

A total of 819 individuals were analyzed (Mage = 69.0, SD = 4.9, nintervention/control group = 378/441). We observed a significant intervention effect on the healthy diet score (b = 0.06, IRR: 1.06, 95% CI: 1.01, 1.11). Changes were particularly due to increased fruit- and vegetable consumption, while other food components were not improved by the intervention. The intervention did not induce transitions to advanced stages of behavior change regarding a healthy diet, however, participants in the control group moved to initial stages of behavior change (OR = 1.95, 95% CI: 1.30, 2.92).

CONCLUSION

A multidomain lifestyle intervention improved participants' diet and maintained motivation to change in an at-risk-sample. However, only fruit- and vegetable consumption increased. Additional support might be necessary to encourage older adults to integrate new, healthier food components into their diet. Control group participants transitioned to initial stages of behavior change, stressing the need to encourage older adults to maintain a healthy diet as they age. AGEWELL.DE WAS PROSPECTIVELY REGISTERED IN THE GERMAN CLINICAL TRIALS REGISTER (DRKS; IDENTIFIER: DRKS00013555) ON DECEMBER 7TH, 2017: DRKS00013555.

Prevalence of cognitive impairment and its related factors among Chinese older adults: an analysis based on the 2018 CHARLS data

Background

Cognitive impairment is a major public health concern in aging societies. This study aimed to investigate the prevalence of cognitive impairment and its associated factors among Chinese adults aged 60 years and older using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS).

Methods

Utilizing data from the 2018 wave of CHARLS, we assessed participants' cognitive status using the Mini-Mental State Examination (MMSE), and the influencing factors related to cognitive impairment were analyzed by using the chi-square test and multifactor logistic regression. The prevalence of cognitive impairment was stratified by gender, education level, residence, marital status, daytime napping, and nighttime sleep duration, and the trend of cognitive impairment prevalence with age was observed.

Results

9,804 participants were finally included in the study and the overall prevalence of cognitive impairment was 44.04% (95%CI, 43.02-45.06%). The prevalence was significantly higher in females (50.8%) than males (37.1%), and increased with age, from 41.5% in those aged 60-64 years to 57.7% in those aged ≥75 years. Lower educational level, rural residence, and being divorced/ widowed/unmarried were associated with a higher prevalence of cognitive impairment (all p < 0.001). Multifactor logistic regression indicated that older age (OR = 1.51, 95%CI, 1.33-1.73 for ≥75 vs. 60-64 years), female gender (OR = 1.54, 95%CI, 1.35-1.77), higher education (OR = 0.46, 95%CI, 0.42-0.51 for primary school and below vs. illiteracy), rural areas (OR = 2.35, 95%CI, 2.07-2.65 for village vs. the center of city/town), divorced/ widowed/unmarried status (OR = 1.40, 95%CI, 1.25-1.57) and participation in physical activity (OR = 0.80, 95%CI, 0.73-0.87) were significantly associated with cognitive impairment.

Conclusion

Cognitive impairment is highly prevalent among older adults in China with substantial demographic disparities. Targeted interventions and public health strategies are needed to promote cognitive health in this rapidly aging population.

Increasing Reported Physical Activity Among Australian Adults: Progress Toward a Healthy Older Age

BACKGROUND/OBJECTIVES

A globally aging population necessitates public health action that supports healthy aging. Although it is well established that participation in physical activity (PA), sport, and active recreation are important for healthy aging, PA levels remain generally lower among older adults. This study examines trends in physical activities that older adults engage in and identifies disparities in activities across subgroups as defined by age, gender, and socioeconomic status.

METHODS

Data from two New South Wales survey data sets (New South Wales Population Health Survey and AusPlay) investigated patterns and trends of PA, sport, and active recreation between 2016 and 2021 among adults aged 65+ years. Weighted prevalence estimates of meeting PA guidelines (≥150 min/week of moderate to vigorous PA), weekly minutes spent walking and doing moderate to vigorous PA, and annual participation rates in specific activities were calculated as weighted proportions. Multivariable logistic regression models included age, gender, and socioeconomic status as independent variables.

RESULTS

Between 2016 and 2021, the proportion of older adults meeting PA guidelines increased (37.8%-51.3%). Adults aged 75+ years, older men, and those living in the least disadvantaged areas experienced greater increases in moderate to vigorous PA.

CONCLUSIONS

Older adults' reported PA levels have increased in recent years, highlighting opportunities to prioritize PA promotion in the global agenda to support healthy and active aging. Significance/Implications: This study offers insights into recent trends and noteworthy increases in PA, sport, and active recreation among older Australian adults. These can assist policymakers in developing, evaluating, and implementing population-wide strategies to maintain improved activity levels.

Prolonged nightly fasting in older adults with memory decline: A single-group pilot study exploring changes in cognitive function and cardiometabolic risk factors

Introduction

Older age significantly increases risk for cognitive decline. A growing number of older adults (≥ 65 years) experience cognitive decline that compromises immediate and/or long-term health. Interventions to mitigate cognitive decline are greatly needed. Intermittent fasting aligned with innate circadian rhythms is associated with health benefits and improved circadian rhythms; here, we explore impacts on cognition and cardiometabolic outcomes.

Methods

We conducted a single-group, pre-/post-pilot study to explore an 8-week prolonged nightly fasting intervention (14 h fasting/night) among adults 65+ years with self-reported memory decline. We explored changes in cognitive function, insomnia, and cardiometabolic risk factors. Intervention engagement/adherence were assessed. The intervention was delivered fully remotely; participants completed their fasting protocol at home and were not required to come into the lab.

Results

In total, 20 individuals signed consent and 18 participants completed the study. Participants were mean age 69.7 years, non-Hispanic White (89%), predominantly female (95%), married (50%), and employed (65%). Paired t-tests indicated an increase in cognitive function (Memory and Attention Phone Screener) (p = 0.02) with a medium effect size (Cohen's d = 0.58) and a decrease in insomnia (Insomnia Severity Index) (p = 0.04) with a medium effect size (Cohen's d = 0.52). Changes in BMI or diet quality were not observed. Engagement (66%-77%) and adherence (70%-100%) were high.

Conclusion

These pilot findings suggest that prolonged nightly fasting, targeted to align food intake with circadian rhythms, may improve cognitive function and sleep among older adults. Fully powered, randomized controlled trials to test the efficacy of this non-pharmacological, low cost-to-burden ratio intervention are needed.

The associations of dietary manganese, iron, copper, zinc, selenium and magnesium with cognitive outcomes in Chinese adults: a cross sectional study in Shanghai

Introduction

The role of individual nutrients including vitamins and minerals in cognitive function gained increasing attention in recent years. With regard to the association between dietary minerals and cognitive function, the results of human studies are inconclusive. The objective of this study was to explore the association between mineral intake and cognitive function using the data from Shanghai Health and Nutrition Survey (SHNS) in 2018.

Methods

In total, 835 adults were included in a crosssectional study, and completed a three-day dietary record to estimate their average daily intake of minerals. Mini-Mental State Examination (MMSE) was used for the assessment of cognitive function, and logistic regression analyses were performed on participants to examine the association between dietary mineral intake and cognitive performance. The participants were divided into tertiles according to their mineral intake.

Results

Participants in the second and third tertile of the dietary copper intake had lower rates of low MMSE scores compared to those in the lowest tertile. We found the adjusted OR and 95%CI values were 0.44 (0.21-0.89) and 0.40 (0.16-0.94), respectively. Participants in the second tertile of dietary magnesium intake showed a trend of lower rates of low MMSE score compared to those in the lowest tertile (p = 0.06). The adjusted OR and 95%CI values were 0.35 (0.16-0.72). No significant association were observed between any of the other minerals including iron, zinc, selenium and manganese and cognitive function.

Discussion

Our findings suggest that dietary intake of copper and magnesium may have a protective effect on cognitive performance in elderly over 60 years old. To prevent cognitive decline, elderly should get recommended amounts of copper and magnesium from diet or supplements.

Organic food consumption is positively associated with cognitive function among middle-aged and older adults: cross-sectional and longitudinal analyses

PURPOSE

Examine cross-sectional and longitudinal relationships between organic food consumption and cognitive function among older adults.

METHODS

In this study, 6077 participants were selected from the 2012 Health and Retirement Study (HRS) and the Health Care and Nutrition Study (HCNS) for cross-sectional analyses, and retaining 4882 individuals for longitudinal analyses. Organic food consumption was assessed using a Food Frequency Questionnaire and participants were categorized based on their organic dietary diversity score. Cognitive function was evaluated using the Langa-Weir classification. A multivariable linear analysis was used to investigate the associations between organic food consumption and cognitive function. Cox proportional hazards model examined the association between mild cognitive impairment (MCI) and organic food consumption.

RESULTS

Our findings revealed a positive association between the organic food consumption and cognitive function among older adults. However, the consumption of organic food was found to significantly reduce the risk of MCI only among females, with a hazard ratio of 0.80 (95% CI 0.65-0.98). Furthermore, both organic animal and plant food consumption were independently linked to a 27% and 20% reduction in the risk of incident MCI, respectively.

CONCLUSION

This research results underscores the cognitive benefits of organic diets, particularly in mitigating the risk of MCI among females. Recognizing the sex-specific nature of this association suggests the importance of considering gender perspectives in the formulation of dietary interventions aimed at cognitive health.

Photobiomodulation in the aging brain: a systematic review from animal models to humans

Aging is a multifactorial biological process that may be associated with cognitive decline. Photobiomodulation (PBM) is a non-pharmacological therapy that shows promising results in the treatment or prevention of age-related cognitive impairments. The aim of this review is to compile the preclinical and clinical evidence of the effect of PBM during aging in healthy and pathological conditions, including behavioral analysis and neuropsychological assessment, as well as brain-related modifications. 37 studies were identified by searching in PubMed, Scopus, and PsycInfo databases. Most studies use wavelengths of 800, 810, or 1064 nm but intensity and days of application were highly variable. In animal studies, it has been shown improvements in spatial memory, episodic-like memory, social memory, while different results have been found in recognition memory. Locomotor activity improved in Parkinson disease models. In healthy aged humans, it has been outlined improvements in working memory, cognitive inhibition, and lexical/semantic access, while general cognition was mainly enhanced on Alzheimer disease or mild cognitive impairment. Anxiety assessment is scarce and shows mixed results. As for brain activity, results outline promising effects of PBM in reversing metabolic alterations and enhancing mitochondrial function, as evidenced by restored CCO activity and ATP levels. Additionally, PBM demonstrated neuroprotective, anti-inflammatory, immunomodulatory and hemodynamic effects. The findings suggest that PBM holds promise as a non-invasive intervention for enhancing cognitive function, and in the modulation of brain functional reorganization. It is necessary to develop standardized protocols for the correct, beneficial, and homogeneous use of PBM.

Effects of socio-therapeutic interventions on cognitive functions among institutionalized elderly

Cognitive impairment affects over one billion people globally, with elderly individuals in institutions in China being particularly impacted. This study involved 60 elderly participants with mild cognitive impairment, who were randomly assigned to one of two groups: 30 in a control group receiving traditional programs from the elderly institution and 30 in an intervention group receiving socio-therapeutic methods. Cognitive function was assessed before the intervention, and at the end of the first, second, and third months (with unsupervised interventions in the third month). Initially, both groups had similar low MMSE scores. However, the socio-therapeutic intervention led to significant cognitive improvements in the intervention group after the first and second months, with results remaining higher than the control group by the end of the third month. The study highlights the effectiveness of socio-therapeutic interventions in enhancing cognitive function and suggests that such programs should be adopted in elderly care institutions. Further research is needed to explore long-term effects and optimal program components, with personalized interventions and family/community involvement recommended to maximize benefits.

Regular physical activity and high educational attainment positively affect cognitive function among older adults

Although educational attainment and physical activity tend to determine cognitive function among older adults, studies have shown inconsistent results. This study aimed to examine how physical activity and educational attainment relate to the cognitive function of older adults. Educational attainment was determined based on the total number of years of education received from formal educational institutions. All participants were classified as active or sedentary according to the Stanford Brief Activity Survey. Thereon, the participants were divided into four groups based on educational attainment and physical activity levels: the low education-sedentary (LESG; n=29, 74.06±5.39 years), low education-active (LEAG; n=34, 73.97±4.74 years), high education-sedentary (HESG; n=26, 74.34±5.17 years), and high education-active groups (HEAG; n=26, 74.11±4.53 years). Four domains of cognitive function were assessed using the Seoul Neuropsychological Screening Battery: attention, visuospatial function, memory, and frontal/executive function. Linear regression analyses were performed to investigate differences in cognitive function between the four groups, setting the low education-sedentary group as the reference. Among the domain of cognitive function, attention differed significantly in the LESG from that in the HESG and HEAG. Educational attainment and physical activity levels influence cognitive function. A greater number of early-life educational experiences and regular physical activity in old age enhanced the cognitive function of older adults.

Next generation brain health: transforming global research and public health to promote prevention of dementia and reduce its risk in young adult populations

Efforts to prevent dementia can benefit from precision interventions delivered to the right population at the right time; that is, when the potential to reduce risk is the highest. Young adults (aged 18-39 years) are a neglected population in dementia research and policy making despite being highly exposed to several known modifiable risk factors. The risk and protective factors that have the biggest effect on dementia outcomes in young adulthood, and how these associations differ across regions and groups, still remain unclear. To address these uncertainties, the Next Generation Brain Health team convened a multidisciplinary expert group representing 15 nations across six continents. We identified several high-priority modifiable factors in young adulthood and devised five key recommendations for promoting brain health, ranging from individual to policy levels. Increasing research and policy focus on brain health across the life course, inclusive of younger populations, is the next crucial step in the efforts to prevent dementia at the global level.

Age and Gender Disparities in the Association of Long-Term Dietary Choline and Choline Compound Intakes with Incident Cognitive Decline in Middle-Aged and Older Chinese Adults: A Prospective Cohort Study

Background/Objectives: The neuroprotective role of dietary choline during adulthood has not yet been conclusively proven. This study aims to investigate the influence of long-term choline and its constituent intakes on cognitive decline in the Chinese population. Methods: A total of 4502 subjects (≥55 years) with at least two waves of completed data and without cognitive decline at baseline were selected from the China Health and Nutrition Survey 1997-2018. Three consecutive 24 h dietary recalls were performed to collect dietary intake information for choline, phosphatidylcholine (PC), and glycerophosphocholine (GPC) measures. Several items from the Telephone Interview for Cognitive Status (Modified) were employed to perform a cognitive assessment. Cox frailty models were used to estimate hazard ratios (HRs) and 95% CIs. Results: A total of 783 participants developed cognitive decline during 26,080 person-years of follow-up. Cumulative average intakes of choline, PC, and GPC were 188.0, 126.7, and 17.1 mg/d, respectively. In the total population, after full adjustment, subjects in the lower (Q2), medium (Q3), higher (Q4), and highest (Q5) quintiles of dietary choline showed 27.8% (95% CI: 0.584, 0.894), 33.9% (95% CI: 0.522, 0.836), 23.0% (95% CI: 0.599, 0.990), and 29.3% (95% CI: 0.526, 0.949) decreases in the risk of cognitive decline compared to the lowest (Q1), respectively. Similar results were observed in PC but not GPC measures. Both higher choline and PC intakes induced a lower risk of cognitive decline for subjects ≥ 65 years at baseline (Q3 and Q4) and females (Q2-Q5). A marginally significant association of GPC was found for subjects ≥ 65 years (Q5) and males (Q4). Conclusions: These findings identify age and gender disparities relating to the protective associations of dietary choline, PC, and GPC with incident cognitive decline in middle-aged and older Chinese populations.

Light at night exposure and risk of dementia conversion from mild cognitive impairment in a Northern Italy population

BACKGROUND

A few studies have suggested that light at night (LAN) exposure, i.e. lighting during night hours, may increase dementia risk. We evaluated such association in a cohort of subjects diagnosed with mild cognitive impairment (MCI).

METHODS

We recruited study participants between 2008 and 2014 at the Cognitive Neurology Clinic of Modena Hospital, Northern Italy and followed them for conversion to dementia up to 2021. We collected their residential history and we assessed outdoor artificial LAN exposure at subjects' residences using satellite imagery data available from the Visible Infrared Imaging Radiometer Suite (VIIRS) for the period 2014-2022. We assessed the relation between LAN exposure and cerebrospinal fluid biomarkers. We used a Cox-proportional hazards model to compute the hazard ratio (HR) of dementia with 95% confidence interval (CI) according to increasing LAN exposure through linear, categorical, and non-linear restricted-cubic spline models, adjusting by relevant confounders.

RESULTS

Out of 53 recruited subjects, 34 converted to dementia of any type and 26 converted to Alzheimer's dementia. Higher levels of LAN were positively associated with biomarkers of tau pathology, as well as with lower concentrations of amyloid β1-42 assessed at baseline. LAN exposure was positively associated with dementia conversion using linear regression model (HR 1.04, 95% CI 1.01-1.07 for 1-unit increase). Using as reference the lowest tertile, subjects at both intermediate and highest tertiles of LAN exposure showed increased risk of dementia conversion (HRs 2.53, 95% CI 0.99-6.50, and 3.61, 95% CI 1.34-9.74). In spline regression analysis, the risk linearly increased for conversion to both any dementia and Alzheimer's dementia above 30 nW/cm2/sr of LAN exposure. Adding potential confounders including traffic-related particulate matter, smoking status, chronic diseases, and apolipoprotein E status to the multivariable model, or removing cases with dementia onset within the first year of follow-up did not substantially alter the results.

CONCLUSION

Our findings suggest that outdoor artificial LAN may increase dementia conversion, especially above 30 nW/cm2/sr, although the limited sample size suggests caution in the interpretation of the results, to be confirmed in larger investigations.

Association between life's essential 8 and cognitive impairment in older patients: results from NHANES 2011-2014

BACKGROUND

This study aimed to examine the association between the American Heart Association's (AHA) newly revised Life's Essential 8 (LE8) algorithm, designed for assessing cardiovascular health (CVH), and cognitive impairment among older adults in the United States.

METHODS

This study employed a cross-sectional design, utilizing data from the 2011-2014 National Health and Nutrition Examination Survey to explore the relationship between CVH and cognitive impairment in older adults. CVH scores are assessed based on the AHA definition of the LE8, categorized into three tiers: low (0-49), medium (50-79), and high (80-100). Cognitive impairment is evaluated using three distinct scoring systems: the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). The lowest quartile as the cut-off point; below or equal to the lower quartile was considered as low cognitive population, and above the lower quartile was normal population. To analyze the association, multivariable logistic regression and restricted cubic spline (RCS) models were employed.

RESULTS

A significant negative correlation exists between the LE8 and cognitive impairment. After adjusting for multiple variables, the odds ratios (OR) for cognitive impairment, as measured by the CERAD, AFT, and DSST, were compared between patients with high and low CVH. The results indicated OR values of 0.60 (95% CI: 0.36-0.98), 0.72 (95% CI: 0.52-0.97), and 0.29 (95% CI: 0.16-0.53) for the CERAD, AFT, and DSST, respectively. Additionally, the RCS curve demonstrated a significant linear relationship between lifestyle factors encapsulated by the LE8 and cognitive impairment.

CONCLUSIONS

The findings indicate higher adherence to LE8 was associated with lower odds of cognitive impairment. Furthermore, maintaining optimal CVH is crucial in preventing cognitive impairment.

Interactive association of metals and Life's Essential 8 with mortality in U.S. adults: a prospective cohort study from the NHANES dataset

BACKGROUND

Life's Essential 8 (LE8) is a novel assessment of cardiovascular health (CVH) by evaluating lifestyle, and reports of the associations between LE8 and urinary metals on mortality have been very limited. This study aimed to conduct a prospective cohort study and investigate the combined effects of metals and LE8 on mortality in U.S. adults.

METHODS

This study enrolled participants with complete information on urinary metals, LE8, mortality status, and confounders from the National Health and Nutrition Examination Survey (2005-2018). The Cox regression model, adaptive lasso penalized regression, and restricted cubic spline were used to analyze the individual effects of metals and LE8 on all-cause mortality. The additive and multiplicative interaction scales and quantile g-computation were used to evaluate the interaction and combined effects. Stratified analyses were performed to clarify whether metals and LE8 interacted with other variables to influence all-cause mortality.

RESULTS

A total of 8017 participants were included in this study. The concentrations of cadmium, cobalt, lead, antimony, and thorium were greater in the low CVH group than in the high CVH group [median (µg/L): 0.29 vs. 0.19, 0.36 vs. 0.35, 0.48 vs. 0.39, 0.05 vs. 0.04, and 0.07 vs. 0.06]. The interaction between cadmium and LE8 was statistically significant, with a synergy index of 1.169 (95% CI: 1.004, 1.361). The stratified analyses showed that the interaction between age and LE8 had an impact on all-cause mortality (P for interaction = 0.004).

CONCLUSIONS

In this representative sample of the U.S. population, we found that the combined effect of cadmium, lead, thallium, and LE8 was positively associated with all-cause mortality. Furthermore, the interaction between cadmium and LE8 influenced all-cause mortality. So people should adopt healthy behaviors and reduce heavy metal exposure to minimize the risk of adverse health outcomes.

Joint Association of Combined Healthy Lifestyle Factors and Hearing Loss With Cognitive Impairment in China

BACKGROUND

Hearing loss and lifestyle factors have been associated with cognitive impairment. We aimed to explore the joint association of combined healthy lifestyle factors and hearing loss with cognitive impairment, which has been scarcely studied.

METHODS

This baseline study used data from the CHOICE-Cohort study (Chinese Hearing Solution for Improvement of Cognition in Elders). Hearing loss was assessed by the better-ear pure-tone average. A composite healthy lifestyle score was built based on never smoking, never drinking, regular physical activity, and a balanced diet. Cognitive impairment was diagnosed by the Mini-Mental State Examination score of less than 24.

RESULTS

We included 17 057 participants aged 60 years or older in China (mean age 69.8 [standard deviation 6.2] years, 55.7% female). Among the participants, 48.3% (n = 8 234) had mild hearing loss, and 25.8% (n = 4 395) had moderate or greater hearing loss. The proportion of participants with healthy lifestyle scores of 0-1, 2, 3, and 4 was 14.9% (n = 2 539), 29.3% (n = 5 000), 37.4% (n = 6 386), and 18.4% (n = 3 132), respectively. About 29.6% (n = 5 057) participants had cognitive impairment. When compared to those with normal hearing and healthy lifestyle (scores of 3-4), participants with hearing loss plus unhealthy lifestyle (scores of 0-2) exhibited approximately twofold increased risk of cognitive impairment (odds ratio [OR] = 1.92, 95% confidence interval [CI] 1.70-2.18). Conversely, the risk was greatly attenuated by adherence to healthy lifestyle in individuals with hearing loss (OR = 1.57, 95% CI 1.40-1.76).

CONCLUSIONS

Our findings demonstrated adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of cognitive impairment among participants with hearing loss.

APOE ε4 carrier status moderates the effect of lifestyle factors on cognitive reserve

INTRODUCTION

This study examines the role of lifestyle factors in cognitive reserve among older adults, focusing on the moderating effect of apolipoprotein E (APOE) ε4 status.

METHODS

Data from 157 participants aged 45 and older from the Healthy Brain Initiative (HBI) were analyzed. Cognitive reserve was estimated using residual scores from Cognivue Clarity tests after accounting for brain atrophy and white matter hyperintensities (WMHs). Lifestyle factors included education, occupational attainment, physical activity, social engagement, diet, and mindfulness. Structural equation models were conducted to assess interactions.

RESULTS

Significant interactions were found between APOE ε4 status and mindfulness and social engagement on cognitive reserve, indicating stronger associations for APOE ε4 carriers.

DISCUSSION

APOE ε4 carriers may benefit more from certain lifestyle factors, potentially through stress reduction and anti-inflammatory pathways. These findings support integrating APOE ε4 genetic screening into personalized prevention strategies to enhance interventions aimed at preserving cognitive function and delaying dementia onset in at-risk populations.

HIGHLIGHTS

Mindfulness and social engagement have increased cognitive reserve in APOE ε4 carriers. Study uses residual scores from Cognivue Clarity tests to estimate cognitive reserve. APOE ε4 carriers show stronger associations with certain lifestyle factors on cognitive reserve. Personalized interventions could enhance cognitive resilience in genetically at-risk populations. Comprehensive assessment of multiple lifestyle factors highlights targeted intervention benefits.

Assessment of Wearable Device Adherence for Monitoring Physical Activity in Older Adults: Pilot Cohort Study

Background

Physical activity has emerged as a modifiable behavioral factor to improve cognitive function. However, research on adherence to remote monitoring of physical activity in older adults is limited.

Objective

This study aimed to assess adherence to remote monitoring of physical activity in older adults within a pilot cohort from objective user data, providing insights for the scalability of such monitoring approaches in larger, more comprehensive future studies.

Methods

This study included 22 participants from the Boston University Alzheimer's Disease Research Center Clinical Core. These participants opted into wearing the Verisense watch as part of their everyday routine during 14-day intervals every 3 months. Eighteen continuous physical activity measures were assessed. Adherence was quantified daily and cumulatively across the follow-up period. The coefficient of variation was used as a key metric to assess data consistency across participants over multiple days. Day-to-day variability was estimated by calculating intraclass correlation coefficients using a 2-way random-effects model for the baseline, second, and third days.

Results

Adherence to the study on a daily basis outperformed cumulative adherence levels. The median proportion of adherence days (wearing time surpassed 90% of the day) stood at 92.1%, with an IQR spanning from 86.9% to 98.4%. However, at the cumulative level, 32% (7/22) of participants in this study exhibited lower adherence, with the device worn on fewer than 4 days within the requested initial 14-day period. Five physical activity measures have high variability for some participants. Consistent activity data for 4 physical activity measures might be attainable with just a 3-day period of device use.

Conclusions

This study revealed that while older adults generally showed high daily adherence to the wearable device, consistent usage across consecutive days proved difficult. These findings underline the effectiveness of wearables in monitoring physical activity in older populations and emphasize the ongoing necessity to simplify usage protocols and enhance user engagement to guarantee the collection of precise and comprehensive data.

Exploring the link between sedentary behavior and cognitive decline: a comprehensive study combining Mendelian randomization and animal model experiments

Objective

The causal link between detrimental behaviors and cognitive performance remains unclear. This research seeks to investigate the causal impact of adjustable lifestyle factors on cognitive deterioration, including frequency of alcohol intake, onset of smoking, and sedentary activities like prolonged television viewing.

Methods

This research combines large-scale genetic data obtained from univariable and multivariable Mendelian randomization analyses with experimental findings obtained from animal models.

Results

Our findings reveal that the odds ratio (OR) for cognitive function deterioration was 0.445 (inverse variance weighted [IVW] 95% CI: 0.370 to 0.536, p < 0.001) for each standard deviation increase in television watching time. After adjustment for body mass index (BMI), number of days walked /moderate activity over 10+ min and education in Multivariable Mendelian Randomization (MVMR), only the genetic predisposition to increased television watching time remained significantly associated with worse cognitive function (OR 0.659, 95% CI: 0.452 to 0.960, p = 0.030). The other two habits had no significant effects. Sensitivity analyses have confirmed that genetic pleiotropy did not influence the results. To further explore the relationship between sedentary behavior and cognitive function, as well as the underlying mechanisms, we conducted a restricted cage housing experiment and a physical exercise training experiment in mice. The results showed that physical exercise significantly improved spatial memory, as assessed by the Morris water maze, and increased exploratory interest, as evaluated by the open field test (OFT) and the elevated plus-maze test, compared to the sedentary control group. These cognitive advantages may be mediated through mechanisms involving free radical scavenging and enhanced synaptic plasticity.

Conclusion

Our research provides genetic evidence indicating that extended television viewing is linked to an elevated risk of cognitive decline. Additionally, experimental data from mouse models suggest that physical exercise can counteract cognitive decline and anxiety-like behaviors induced by sedentary behavior. This protective effect is likely mediated by reactive oxygen species (ROS)-dependent mechanisms that enhance synaptic plasticity within the hippocampus.

Mediterranean Diet and Lifestyle in Persons with Mild to Moderate Alzheimer's Disease

Due to the continuous aging of the population and consequent increase in dementia, focus on its prevention is of growing importance for public health. Since effective pharmacological treatments are not yet available, other determinants of cognitive decline have become fundamental. Several studies have indicated that the Mediterranean diet (MedDiet) is associated with reduced incident cognitive decline and dementia, but few studies have been conducted in persons already diagnosed with Alzheimer's disease (AD). We age-matched 73 patients with mild-moderate AD with 73 controls (mean age for the whole group = 76.5 ± 6.5; 67.5% women). The cases had a significantly lower adherence to the MedDiet and lower physical activity vs. controls, where only one participant (1.4%) had a high adherence to the MedDiet among cases compared to 5.5% among controls, while 52.5% of the cases had a moderate adherence to the MedDiet vs. 82.2% in controls. In multivariate analysis, only the presence of AD was significantly associated with a lower adherence to the MedDiet vs. controls. Other factors examined (gender, age, physical activity level, multimorbidity, and polypharmacy) were not significantly associated with adherence to the MedDiet. Thus, AD patients had a low adherence to the MedDiet and very low physical activity. Public health strategies aimed at promoting the Mediterranean diet and physical activity for older people should be a priority.

The Hidden Dangers of Sedentary Living: Insights into Molecular, Cellular, and Systemic Mechanisms

With the aging of the global population, neurodegenerative diseases are emerging as a major public health issue. The adoption of a less sedentary lifestyle has been shown to have a beneficial effect on cognitive decline, but the molecular mechanisms responsible are less clear. Here we provide a detailed analysis of the complex molecular, cellular, and systemic mechanisms underlying age-related cognitive decline and how lifestyle choices influence these processes. A review of the evidence from animal models, human studies, and postmortem analyses emphasizes the importance of integrating physical exercise with cognitive, multisensory, and motor stimulation as part of a multifaceted approach to mitigating cognitive decline. We highlight the potential of these non-pharmacological interventions to address key aging hallmarks, such as genomic instability, telomere attrition, and neuroinflammation, and underscore the need for comprehensive and personalized strategies to promote cognitive resilience and healthy aging.

Genomic Insights into Dementia: Precision Medicine and the Impact of Gene-Environment Interaction

The diagnosis, treatment, and management of dementia provide significant challenges due to its chronic cognitive impairment. The complexity of this condition is further highlighted by the impact of gene-environment interactions. A recent strategy combines advanced genomics and precision medicine methods to explore the complex genetic foundations of dementia. Utilizing the most recent research in the field of neurogenetics, the importance of precise genetic data in explaining the variation seen in dementia patients can be investigated. Gene-environment interactions are important because they influence genetic susceptibilities and aid in the development and progression of dementia. Modified to each patient's genetic profile, precision medicine has the potential to detect groups at risk and make previously unheard-of predictions about the course of diseases. Precision medicine techniques have the potential to completely transform treatment and diagnosis methods. Targeted medications that target genetic abnormalities will probably appear, providing the possibility for more efficient and customized medical interventions. Investigating the relationship between genes and the environment may lead to preventive measures that would enable people to change their surroundings and minimize the risk of dementia, leading to the improved lifestyle of affected people. This paper provides a comprehensive overview of the genomic insights into dementia, emphasizing the pivotal role of precision medicine, and gene-environment interactions.