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Gao Y, Zhang Z, Song J, Gan T, Lin Y, Hu M, Wu IX. Combined healthy lifestyle behaviours and incident dementia: A systematic review and dose-response meta-analysis of cohort studies. Int J Nurs Stud 2024; 156:104781. [PMID: 38744152 DOI: 10.1016/j.ijnurstu.2024.104781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND The associations of combined healthy lifestyle behaviours and incident dementia have not been systematically reviewed and the dose-response relationship was uncertain. OBJECTIVES To evaluate the associations of combined healthy lifestyle behaviours with incident dementia and other cognitive outcomes, assess the dose-response relationship between the number of lifestyle behaviours and incident dementia, and summarise the adherence to healthy lifestyle behaviours. DESIGN Systematic review and meta-analysis. METHODS PubMed, EMBASE, Web of Science and PsycINFO were searched from inception to 20 Jan 2024. Cohort studies reporting associations of combined healthy lifestyle behaviours with incident dementia or other cognitive outcomes were included. We used the random-effects meta-analysis to pool the risk estimates and the robust error meta-regression method to examine the dose-response relationship. The methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 22 articles including 25 cohort studies mostly from high-income economics were included, with all assessed as high methodological quality. Adherence to a healthy lifestyle was associated with a decreased risk of incident dementia, either per healthy lifestyle behaviour increase (pooled hazard ratio 0.89, 95 % confidence interval 0.85-0.94) or the highest level versus the lowest level (pooled hazard ratio 0.61, 95 % confidence interval 0.49-0.76). An inverse, linear dose-response relationship (Pnon-linear = 0.845) between the number of healthy lifestyle behaviours and incident dementia was observed, with an 11 % risk reduction for each healthy behaviour increase. A relatively limited number of included studies indicated that adherence to a healthy lifestyle combination could yield benefits for cognitive decline, global cognition, memory and executive function. In addition, the adherence rates typically decreased as the number of healthy lifestyle behaviours increased. CONCLUSIONS Adherence to a healthy lifestyle was associated with a lower risk of incident dementia and other cognitive outcomes. It is important to find a subtle balance between the benefits and adherence. Further large cohort studies for combined lifestyle behaviours with specific cognitive outcomes and dose-response relationships are required, especially based on middle- and low-income populations. REGISTRATION The study was registered in PROSPERO (CRD42023418509). TWEETABLE ABSTRACT Engaging in a greater number of healthy lifestyle behaviours yields increased benefits in preventing dementia, albeit with lower adherence rates as a trade-off. Finding a delicate balance between the benefits and adherence is crucial.
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Affiliation(s)
- Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Zixuan Zhang
- Changsha Center for Disease Control and Prevention, Changsha, China
| | - Jinlu Song
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Ting Gan
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
| | - Yali Lin
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Irene Xinyin Wu
- Xiangya School of Public Health, Central South University, Changsha, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, China.
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Ali S, Alizai H, Hagos DJ, Rubio SR, Calabia D, Serrano Jimenez P, Senthil VA, Appel L. mHealth Apps for Dementia, Alzheimer Disease, and Other Neurocognitive Disorders: Systematic Search and Environmental Scan. JMIR Mhealth Uhealth 2024; 12:e50186. [PMID: 38959029 DOI: 10.2196/50186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/30/2024] [Accepted: 04/23/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Lifestyle behaviors including exercise, sleep, diet, stress, mental stimulation, and social interaction significantly impact the likelihood of developing dementia. Mobile health (mHealth) apps have been valuable tools in addressing these lifestyle behaviors for general health and well-being, and there is growing recognition of their potential use for brain health and dementia prevention. Effective apps must be evidence-based and safeguard user data, addressing gaps in the current state of dementia-related mHealth apps. OBJECTIVE This study aims to describe the scope of available apps for dementia prevention and risk factors, highlighting gaps and suggesting a path forward for future development. METHODS A systematic search of mobile app stores, peer-reviewed literature, dementia and Alzheimer association websites, and browser searches was conducted from October 19, 2022, to November 2, 2022. A total of 1044 mHealth apps were retrieved. After screening, 152 apps met the inclusion criteria and were coded by paired, independent reviewers using an extraction framework. The framework was adapted from the Silberg scale, other scoping reviews of mHealth apps for similar populations, and background research on modifiable dementia risk factors. Coded elements included evidence-based and expert credibility, app features, lifestyle elements of focus, and privacy and security. RESULTS Of the 152 apps that met the final selection criteria, 88 (57.9%) addressed modifiable lifestyle behaviors associated with reducing dementia risk. However, many of these apps (59/152, 38.8%) only addressed one lifestyle behavior, with mental stimulation being the most frequently addressed. More than half (84/152, 55.2%) scored 2 points out of 9 on the Silberg scale, with a mean score of 2.4 (SD 1.0) points. Most of the 152 apps did not disclose essential information: 120 (78.9%) did not disclose expert consultation, 125 (82.2%) did not disclose evidence-based information, 146 (96.1%) did not disclose author credentials, and 134 (88.2%) did not disclose their information sources. In addition, 105 (69.2%) apps did not disclose adherence to data privacy and security practices. CONCLUSIONS There is an opportunity for mHealth apps to support individuals in engaging in behaviors linked to reducing dementia risk. While there is a market for these products, there is a lack of dementia-related apps focused on multiple lifestyle behaviors. Gaps in the rigor of app development regarding evidence base, credibility, and adherence to data privacy and security standards must be addressed. Following established and validated guidelines will be necessary for dementia-related apps to be effective and advance successfully.
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Affiliation(s)
- Suad Ali
- Faculty of Health, York University, Toronto, ON, Canada
- Knowledge, Innovation, Talent, Everywhere, OpenLab, University Health Network, Toronto, ON, Canada
- Women's Brain Health Initiative, Toronto, ON, Canada
| | - Hira Alizai
- Faculty of Health, York University, Toronto, ON, Canada
| | | | | | - Dale Calabia
- Faculty of Health, York University, Toronto, ON, Canada
| | | | | | - Lora Appel
- Faculty of Health, York University, Toronto, ON, Canada
- Knowledge, Innovation, Talent, Everywhere, OpenLab, University Health Network, Toronto, ON, Canada
- Michael Garron Hospital, Toronto, ON, Canada
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Ruiz-González C, Román P, Rueda-Ruzafa L, Cardona D, Requena M, Alarcón R. Environmental pesticide exposure and Alzheimer's disease in southern Spain: A cross-sectional study. Psychiatry Res 2024; 337:115932. [PMID: 38696970 DOI: 10.1016/j.psychres.2024.115932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/04/2024]
Abstract
The intensive cultivation under plastic in southern Spain has made the agricultural model highly productive. Although strict regulations on pesticide usage exist, exposure to pesticides in the environment has been associated with an increased appearance of neurodegenerative diseases including Alzheimer's disease (AD). A cross-sectional study was performed to examine the prevalence and risk of AD related to pesticide exposure in Andalusia (Spain). We utilized the Odds Ratio statistical test to compare the prevalence rate of AD in the exposed and unexposed areas. 40,044 cases were collected from computerized hospital records between 2000 and 2021. Districts with higher pesticide use showed significantly higher prevalence rates and increased risk of developing AD, compared to those with lower pesticide use. These findings provide further evidence supporting an increased risk of AD following environmental exposure to pesticides at the level of the general population.
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Affiliation(s)
- Cristofer Ruiz-González
- Torrecárdenas University Hospital, Calle Hermandad de Donantes de Sangre, s/n 04009, Almería, Spain; Research Group CTS-1114 Health Sciences, University of Almeria, Almeria, Spain
| | - Pablo Román
- Research Group CTS-1114 Health Sciences, University of Almeria, Almeria, Spain; Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento s/n, La Cañada 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento s/n, La Cañada 04120, Spain
| | - Lola Rueda-Ruzafa
- Research Group CTS-1114 Health Sciences, University of Almeria, Almeria, Spain; Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento s/n, La Cañada 04120 Almeria, Spain.
| | - Diana Cardona
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento s/n, La Cañada 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento s/n, La Cañada 04120, Spain
| | - Mar Requena
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento s/n, La Cañada 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento s/n, La Cañada 04120, Spain
| | - Raquel Alarcón
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento s/n, La Cañada 04120 Almeria, Spain; Health Research Center, University of Almeria, Carretera Sacramento s/n, La Cañada 04120, Spain
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Nucci D, Sommariva A, Degoni LM, Gallo G, Mancarella M, Natarelli F, Savoia A, Catalini A, Ferranti R, Pregliasco FE, Castaldi S, Gianfredi V. Association between Mediterranean diet and dementia and Alzheimer disease: a systematic review with meta-analysis. Aging Clin Exp Res 2024; 36:77. [PMID: 38519775 PMCID: PMC10959819 DOI: 10.1007/s40520-024-02718-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/01/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Dementia affects 5-8% of the population aged over 65 years (~50 million worldwide). Several factors are associated with increased risk, including diet. The Mediterranean diet (MedDiet) has shown potential protective effects against several chronic diseases. AIMS This systematic review with meta-analysis aim was to assess the association between adherence to the MedDiet and the risk of dementia in the elderly. METHODS PRISMA-2020 guidelines were followed. PubMed/MEDLINE and Scopus were searched on 17 July 2023. The Newcastle-Ottawa Scale tool was used to assess the risk of bias. The protocol was pre-registered in PROSPERO (registration number: CRD 42023444368). Heterogeneity was assessed using the I2 test. Publication bias was assessed by visual inspection of the funnel plot and by Egger's regression asymmetry test. The final effect size was reported as OR or HR, depending on the study design of the included studies. RESULTS Out of 682 records, 21 were included in the analysis. The pooled OR was 0.89 (95% CI = 0.84-0.94) based on 65,955 participants (I2 = 69.94). When only cohort studies were included, HR was 0.84 (95% CI = 0.76-0.94) based on 55,205 participants (I2 = 89.70). When only Alzheimer Disease was considered OR was 0.73 (95% CI = 0.62-0.85) based on 38,292 participants (I2 = 63.85). DISCUSSION Despite the relatively low risk reduction associated with higher adherence to MedDiet among elderly, it should be considered that this population is the most affected. CONCLUSIONS Adherence to MedDiet could be an effective non-pharmacological measure to reduce the burden of dementia, even among elderly.
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Affiliation(s)
- Daniele Nucci
- Struttura Semplice Dipartimentale Igiene Alimenti E Nutrizione, Dipartimento Di Igiene E Prevenzione Sanitaria, Azienda Di Tutela Della Salute (ATS) Brescia, Via Duca Degli Abruzzi, 15, 25124, Brescia, Italy
| | - Andrea Sommariva
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Luca Mario Degoni
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Giulia Gallo
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Matteo Mancarella
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Federica Natarelli
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Antonella Savoia
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Via Tronto 10/a, 60100, Ancona, Italy
| | - Roberta Ferranti
- Struttura Semplice Dipartimentale Igiene Alimenti E Nutrizione, Dipartimento Di Igiene E Prevenzione Sanitaria, Azienda Di Tutela Della Salute (ATS) Brescia, Via Duca Degli Abruzzi, 15, 25124, Brescia, Italy
| | | | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy.
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Iso-Markku P, Aaltonen S, Kujala UM, Halme HL, Phipps D, Knittle K, Vuoksimaa E, Waller K. Physical Activity and Cognitive Decline Among Older Adults: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e2354285. [PMID: 38300618 PMCID: PMC10835510 DOI: 10.1001/jamanetworkopen.2023.54285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
Importance Physical activity is associated with the risk for cognitive decline, but much of the evidence in this domain comes from studies with short follow-ups, which is prone to reverse causation bias. Objective To examine how length of follow-up, baseline age, physical activity amount, and study quality modify the longitudinal associations of physical activity with cognition. Data Sources Observational studies of adults with a prospective follow-up of at least 1 year, a valid baseline cognitive measure or midlife cohort, and an estimate of the association of baseline physical activity and follow-up cognition were sought from PsycInfo, Scopus, CINAHL, Web of Science, SPORTDiscus, and PubMed, with the final search conducted on November 2, 2022. Study Selection Two independent researchers screened titles with abstracts and full-text reports. Data Extraction and Synthesis Two reviewers independently assessed study quality and extracted data. Pooled estimates of association were calculated with random-effects meta-analyses. An extensive set of moderators, funnel plots, and scatter plots of physical activity amount were examined. This study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures Pooled estimates of the associations between physical activity and global cognition, as well as specific cognitive domains, were examined. Results A total of 104 studies with 341 471 participants were assessed. Analysis of binary outcomes included 45 studies with 102 452 individuals, analysis of follow-up global cognition included 14 studies with 41 045 individuals, and analysis of change in global cognition included 25 studies with 67 463 individuals. Physical activity was associated with a decreased incidence of cognitive impairment or decline after correction for funnel plot asymmetry (pooled risk ratio, 0.97; 95% CI, 0.97-0.99), but there was no significant association in follow-ups longer than 10 years. Physical activity was associated with follow-up global cognition (standardized regression coefficient, 0.03; 95% CI, 0.02-0.03) and change in global cognition (standardized regression coefficient, 0.01; 95% CI, 0.01 to 0.02) from trim-and-fill analyses, with no clear dose-response or moderation by follow-up length, baseline age, study quality or adjustment for baseline cognition. The specific cognitive domains associated with physical activity were episodic memory (standardized regression coefficient, 0.03; 95% CI, 0.02-0.04) and verbal fluency (standardized regression coefficient, 0.05; 95% CI, 0.03-0.08). Conclusions and Relevance In this meta-analysis of the association of physical activity with cognitive decline, physical activity was associated with better late-life cognition, but the association was weak. However, even a weak association is important from a population health perspective.
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Affiliation(s)
- Paula Iso-Markku
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hanna-Leena Halme
- Helsinki University Hospital Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Daniel Phipps
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Keegan Knittle
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Katja Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Ferreira NV, Gonçalves NG, Szlejf C, Goulart AC, de Souza Santos I, Duncan BB, Schmidt MI, Barreto SM, Caramelli P, Feter N, Castilhos RM, Drager LF, Lotufo P, Benseñor I, Suemoto CK. Optimal cardiovascular health is associated with slower cognitive decline. Eur J Neurol 2024; 31:e16139. [PMID: 38015440 DOI: 10.1111/ene.16139] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Life's Simple 7, a lifestyle and cardiovascular index associated with cognition, has been updated to Life's Essential 8 (LE8) to include sleep. LE8 has been related to cardiovascular outcomes but its association with cognition is unclear. METHODS In this longitudinal analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), LE8 score was based on health behaviors (diet, physical activity, nicotine exposure, and sleep health) as well as health-related factors (body mass index, blood lipids, blood glucose, and blood pressure). Cognition was assessed in three waves, 4 years apart, using the Consortium to Establish a Registry for Alzheimer's Disease - Word List, semantic and phonemic verbal fluency, the Trail-Making Test B (TMT-B), and a global composite score. We used linear mixed-model analysis, inverse probability weighting, and interaction analysis. RESULTS At baseline, the mean age of the study cohort was 51.4 ± 8.9 years, 56% were women, and 53% were White. Higher baseline LE8 scores were associated with slower decline in global cognition (β = 0.001, 95% confidence interval [CI] 0.001, 0.002; p < 0.001), memory (β = 0.001, 95% CI 0.000, 0.002; p = 0.013), verbal fluency (β = 0.001, 95% CI 0.000, 0.002; p = 0.003), and TMT-B (β = 0.004, 95% CI 0.003, 0.005; p < 0.001). This association was mainly driven by LE8 health factors, particularly blood glucose and blood pressure. Age, sex, and race were modifiers of the association between LE8 and global cognitive decline (p < 0.001), suggesting it was more pronounced in older, male, and Black participants. CONCLUSIONS Higher baseline LE8 scores were associated with slower global and domain-specific cognitive decline during 8 years of follow-up, mainly due to health factors such as blood glucose and blood pressure. Sociodemographic factors were modifiers of this association.
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Affiliation(s)
- Naomi Vidal Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculdade Adventista da Amazonia, Benevides, Brazil
| | | | - Claudia Szlejf
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Itamar de Souza Santos
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandhi Maria Barreto
- Deparment of Preventive and Social Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natan Feter
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luciano F Drager
- Unidade de Hipertensão, Instituto do Coracao (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Sáez-Gutiérrez S, Fernandez-Rodriguez EJ, Sanchez-Gomez C, Garcia-Martin A, Polo-Ferrero L, Barbero-Iglesias FJ. Effectiveness of Different Neurocognitive Intervention Approaches on Functionality in Healthy Older Adults: A Systematic Review. Behav Sci (Basel) 2024; 14:87. [PMID: 38392440 PMCID: PMC10886235 DOI: 10.3390/bs14020087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/24/2024] Open
Abstract
Subtle loss of functionality in healthy older adults is considered one of the most important predictors of cognitive decline. Neurocognitive interventions are increasingly being used, from a preventive maintenance approach to functional capacity. This study evaluates the effectiveness of different neurocognitive approaches on the functionality of healthy older adults. In this systematic review (CRD42023473944), an extensive search was conducted for articles published in the last 10 years (2013-2023) in the following databases: Medline, Scopus, and Web of Science. A total of 809 trials were identified, of which 18 were considered to be eligible for inclusion in the review. The data revealed heterogeneity in sample size, measures of functional assessment, neurocognitive interventions used, number of sessions, session duration, and time. Traditional cognitive stimulation is shown to have no significant functional benefit, while other less commonly used neurocognitive interventions, such as those based on everyday cognition, are associated with more significant benefits. Moreover, it is demonstrated that although the Instrumental Activities of Daily Living scale (IADL) is the most used test in similar studies, it is not sensitive enough to detect changes in functionality in healthy elderly individuals, with other tests such as the Timed Instrumental Activities of Daily Living (TIADL) being more advantageous. Therefore, a new guideline is proposed for its use in clinical practice and research, using homogeneous study protocols and neurocognitive interventions that allow for the transfer and generalization of results in daily life.
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Affiliation(s)
- Susana Sáez-Gutiérrez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Eduardo J Fernandez-Rodriguez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Celia Sanchez-Gomez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Department of Developmental and Educational Psychology, University of Salamanca, 37007 Salamanca, Spain
| | - Alberto Garcia-Martin
- Department of Labour Law and Social Work, University of Salamanca, 37007 Salamanca, Spain
| | - Luis Polo-Ferrero
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Fausto J Barbero-Iglesias
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
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Almanza-Aguilera E, Cano A, Gil-Lespinard M, Burguera N, Zamora-Ros R, Agudo A, Farràs M. Mediterranean diet and olive oil, microbiota, and obesity-related cancers. From mechanisms to prevention. Semin Cancer Biol 2023; 95:103-119. [PMID: 37543179 DOI: 10.1016/j.semcancer.2023.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 07/02/2023] [Accepted: 08/01/2023] [Indexed: 08/07/2023]
Abstract
Olive oil (OO) is the main source of added fat in the Mediterranean diet (MD). It is a mix of bioactive compounds, including monounsaturated fatty acids, phytosterols, simple phenols, secoiridoids, flavonoids, and terpenoids. There is a growing body of evidence that MD and OO improve obesity-related factors. In addition, obesity has been associated with an increased risk for several cancers: endometrial, oesophageal adenocarcinoma, renal, pancreatic, hepatocellular, gastric cardia, meningioma, multiple myeloma, colorectal, postmenopausal breast, ovarian, gallbladder, and thyroid cancer. However, the epidemiological evidence linking MD and OO with these obesity-related cancers, and their potential mechanisms of action, especially those involving the gut microbiota, are not clearly described or understood. The goals of this review are 1) to update the current epidemiological knowledge on the associations between MD and OO consumption and obesity-related cancers, 2) to identify the gut microbiota mechanisms involved in obesity-related cancers, and 3) to report the effects of MD and OO on these mechanisms.
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Affiliation(s)
- Enrique Almanza-Aguilera
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain
| | - Ainara Cano
- Food Research, AZTI, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio, Spain
| | - Mercedes Gil-Lespinard
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain
| | - Nerea Burguera
- Food Research, AZTI, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio, Spain
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain; Department of Nutrition, Food Sciences, and Gastronomy, Food Innovation Network (XIA), Institute for Research on Nutrition and Food Safety (INSA), Faculty of Pharmacy and Food Sciences University of Barcelona, Barcelona, Spain.
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain
| | - Marta Farràs
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain.
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Saucedo Figueredo MC, Morilla-Herrera JC, Kaknani Uttumchandani S, Durá Pérez E, San Alberto Giraldos M, Nava Del Val MA, Hierrezuelo Martín MJ, Gómez Borrego AB, García Irazusta M, Gálvez González M, Miguel Morales-Asencio J. Longitudinal assessment of the eating pattern of people with dementia and its association with problems for feeding and malnutrition: a prospective follow-up study protocol. BMJ Open 2023; 13:e068790. [PMID: 37230516 DOI: 10.1136/bmjopen-2022-068790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Dementia conditions the patient's nutrition from the beginning and vice versa. Generating difficulties for feeding (FEDIF) will influence its evolution. There are currently few nutritional longitudinal studies in people with dementia. Most focus on problems already established. The Edinburgh Feeding Evaluation in Dementia (EdFED) Scale identifies FEDIF of patients with dementia by studying their behaviours while eating or being fed. It also indicates areas of potential clinical interventions. METHODS AND ANALYSIS Prospective multicentre observational study carried out in nursing homes, Alzheimer's day care centres and primary healthcare centres. The study population will be dyads composed by the patient (diagnosed of dementia, over 65 years of age and who have feeding difficulties) and their family caregiver. Sociodemographic variables and nutritional status (body mass index, Mini Nutritional Assessment, blood test and calf and arm circumference) will be assessed. The Spanish version of the EdFED Scale will be completed and the presence of nursing diagnoses related to feeding behaviours will be collected. Follow-up will take place for 18 months. ETHICS AND DISSEMINATION All data will be carried out respecting European legislation 2016/679 in data protection, and the Spanish 'Organic Law 3/2018 of December 2005'. The clinical data will be kept segregated and encrypted. The informed consent has been obtained. The research has been authorised by the Costa del Sol Health Care District on 27 February 2020 and the Ethics Committee on 2 March 2021. It has obtained funding from the Junta de Andalucía on 15 February 2021. Findings of the study will be presented at provincial, national and international conferences and published in peer-reviewed journals.
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Affiliation(s)
- María Carmen Saucedo Figueredo
- Primary Health Care Costa del Sol District, Los Boliches Health Care Centre, Andalucia Health Service (SAS), Fuengirola, Andalucia, Spain
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
| | - Juan Carlos Morilla-Herrera
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Residences Unit, Malaga and Valle del Guadalhorce Primary Health Care District, Andalucia Health Service (SAS), Malaga, Andalucia, Spain
| | - Shakira Kaknani Uttumchandani
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Nursing Department, University of Malaga, Health Science Faculty, Malaga, Andalucia, Spain
| | - Elena Durá Pérez
- Andalusian Public Foundation for Research in Biomedicine and Health of Malaga, FIMABIS, Malaga, Andalucia, Spain
| | - Mercedes San Alberto Giraldos
- Primary Health Care Costa del Sol District, La Lobilla Health Care Center, Andalucia Health Service (SAS), Estepona (Málaga), Andalucia, Spain
| | - Maria Antonia Nava Del Val
- Primary Health Care Costa del Sol District, Las Albarizas Health Care Center, Andalucia Health Service (SAS), Marbella, Andalucia, Spain
| | - María Jesús Hierrezuelo Martín
- Primary Health Care Costa del Sol District, Las Lagunas Health Care Center, Servicio Andaluz de Salud, Mijas Costa, Andalucia, Spain
| | - Ana Belén Gómez Borrego
- Community Mental Health Unit, Virgen de la Victoria University Hospital, Servicio Andaluz de Salud, Estepona, Andalucia, Spain
| | - Manuela García Irazusta
- Primary Health Care Costa del Sol District, Fuengirola Oeste Health Care Center, Servicio Andaluz de Salud, Marbella, Andalucia, Spain
| | - María Gálvez González
- Primary Health Care Costa del Sol District, La Carihuela Health Care Center, Servicio Andaluz de Salud, Benalmadena, Andalucia, Spain
| | - Jose Miguel Morales-Asencio
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Nursing Department, University of Malaga, Málaga, Andalucia, Spain
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Dimakopoulos GA, Vrahatis AG, Exarchos TP, Ntanasi E, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N, Vlamos P. Application of Machine Learning Techniques in the HELIAD Study Data for the Development of Diagnostic Models in MCI and Dementia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1424:187-192. [PMID: 37486493 DOI: 10.1007/978-3-031-31982-2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
The increase in the population's life expectancy leads to an increase in the incidence of dementia and, therefore, in diseases such as Alzheimer's. Towards this direction, the HELIAD1 study is the first large-scale epidemiological study aimed at assessing epidemiological data on dementia, mild mental decline, and other neuropsychiatric disorders associated with old age. This is a huge study with several computational challenges, most of which can be addressed by machine learning processes. The objectives of this study were to detect patterns in the HELIAD clinical data that classify with high accuracy various levels of cognitive impairment by training ML algorithms and hence apply derived model on future clinical data to predict with the same accuracy the class variable. We propose a machine learning method based on RUSBoost classifier to identify a critical subset of biomarkers that classify accurately between neurological patients with mild cognitive impairment (MCI) or dementia of the Alzheimer's type (DAT) and the cognitively healthy control (CHC) group. In this study we used a highly skewed (imbalanced) dataset with most observations (majority class) belonging to the CHC group. The method proposed predicts accurately the clinical diagnosis label and effectively classifies the neurological patients from the CHC class. In particular, the classification accuracy (actual vs predicted) for the three classes of the clinical diagnosis was 97%, 78%, and 91% for control, MCI, and dementia class, respectively.
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Affiliation(s)
- George A Dimakopoulos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece
| | - Aristidis G Vrahatis
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece
| | - Themis P Exarchos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece
| | - Eva Ntanasi
- Department of Nutrition and Diatetics, Harokopio University, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Diatetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
- Department of Neurology, Columbia University, New York, NY, USA
| | - Panagiotis Vlamos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece.
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11
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Nutrition Patterns of Polish Esports Players. Nutrients 2022; 15:nu15010149. [PMID: 36615806 PMCID: PMC9824454 DOI: 10.3390/nu15010149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to quantify the dietary patterns (DPs) of Polish esports players aged 18-26 years. Data were obtained via questionnaires that assessed dietary habits and frequency of food consumption. Dietary patterns were derived using Principal Component Analysis (PCA) and Factor Analysis (FA). In total, nine distinct DPs were identified. Eight DPs were considered unhealthy; 'fast food', 'High-processed food, meat and confectionery', 'Sweet', 'Fat-diary products', 'Vegetable-fruit', 'Spices and additives', 'Fats' and 'Cereal'; and only one was deemed healthy. E-athletes presented mostly poor dietary habits, which included: irregular eating of meals, frequent snacking, at least three meals a day and composition of snacks, frying of meat dishes and sweetening of hot drinks. Healthy dietary habits included proper hydration during the day and consumption of mainly non-sparkling water. The unbalanced and largely unhealthy dietary habits of esports players raise health concerns for these e-athletes, particularly when combined with a sedentary lifestyle. Future research could assess the nutritional knowledge of this group as it relates to national guidelines, investigate interventions designed to introduce healthier eating options into their lifestyle and examine the relationship between DPs and health or cognitive performance.
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