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Lim ZH, Ng TKS, Bao Z, Yu J, Mahendran R. LFC study: Protocol for a longitudinal follow-up cohort study on ageing and mental health in community-dwelling older adults in Singapore. MethodsX 2024; 12:102606. [PMID: 38379721 PMCID: PMC10877946 DOI: 10.1016/j.mex.2024.102606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
The rapid pace of population ageing worldwide has prompted the need to better understand the ageing process. The current study, titled the Longitudinal Follow-up of the CHI (LFC) study, was a 3-year follow-up study of an earlier study titled the Community Health and Intergenerational (CHI) study. The LFC study looked to examine longitudinal changes in their cognitive functioning and psychosocial outcomes across the 3-year period. Additionally, the current study built upon the earlier CHI study by collecting neuroimaging data and exploring the long-term effects of non-pharmacological interventions, which were not examined in the prior study. A total of 653 community-dwelling participants from the baseline CHI study cohort were invited to take part in the LFC study, where they underwent a battery of neuropsychological assessments, psychosocial questionnaires, a Magnetic Resonance Imaging scan and a voice recording segment. The current study would holistically track longitudinal changes in cognitive functioning and psychosocial outcomes in the ageing population in Singapore. Unique associations between linguistics and neuroimaging data alongside cognitive and psychosocial outcomes would be explored. This study also serves to guide the development of new interventions for older adults and assist in improving the well-being of the local and global ageing population.
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Affiliation(s)
- Zhi Hao Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, MD1 – Tahir Foundation Building, 117549, Singapore
| | - Ted Kheng Siang Ng
- Department of Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
| | - Zhiming Bao
- Department of English Language and Literature, Faculty of Arts and Social Sciences, National University of Singapore, The Shaw Foundation Building, Block AS7, Level 5, 5 Arts Link, Singapore
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore
| | - Rathi Mahendran
- Mind Science Centre, National University of Singapore, Mind Care Clinic @ SBF, 160 Robinson Road, #05-07 SBF Center, 068914, Singapore
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Cao L, Han K, Lin L, Hing J, Ooi V, Huang N, Yu J, Ng TKS, Feng L, Mahendran R, Kua EH, Bao Z. Reversal of the concreteness effect can be detected in the natural speech of older adults with amnestic, but not non-amnestic, mild cognitive impairment. Alzheimers Dement (Amst) 2024; 16:e12588. [PMID: 38638800 PMCID: PMC11024957 DOI: 10.1002/dad2.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Patients with Alzheimer's disease present with difficulty in lexical retrieval and reversal of the concreteness effect in nouns. Little is known about the phenomena before the onset of symptoms. We anticipate early linguistic signs in the speech of people who suffer from amnestic mild cognitive impairment (MCI). Here, we report the results of a corpus-linguistic approach to the early detection of cognitive impairment. METHODS One hundred forty-eight English-speaking Singaporeans provided natural speech data, on topics of their choice; 74 were diagnosed with single-domain MCI (38 amnestic, 36 non-amnestic), 74 cognitively healthy. The recordings yield 267,310 words, which are tagged for parts of speech. We calculate the per-minute word counts and concreteness scores of all tagged words, nouns, and verbs in the dataset. RESULTS Compared to controls, subjects with amnestic MCI produce fewer but more abstract nouns. Verbs are not affected. DISCUSSION Slower retrieval of nouns and the reversal of the concreteness effect in nouns are manifested in natural speech and can be detected early through corpus-based analysis. Highlights Reversal of the concreteness effect is manifested in patients with Alzheimer's disease (AD) and semantic dementia.The paper reports a corpus-based analysis of natural speech by people with amnestic and non-amnestic mild cognitive impairment (MCI) and cognitively healthy controls.People with amnestic MCI produce fewer and more abstract nouns than people with non-amnestic MCI and healthy controls. Verbs appear to be unaffected.The imageability problem can be detected in natural everyday speech by people with amnestic MCI, which carries a higher risk of conversion to AD.
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Affiliation(s)
- Luwen Cao
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Kunmei Han
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Li Lin
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
- School of Foreign StudiesEast China University of Political Science and LawShanghaiChina
| | - Jiawen Hing
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Vincent Ooi
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Nick Huang
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Junhong Yu
- Cognitive and Brain Health LaboratorySchool of Social SciencesNanyang Technological UniversitySingaporeSingapore
| | - Ted Kheng Siang Ng
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Rush Institute for Healthy Aging, Department of Internal MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Lei Feng
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Centre for Healthy Longevity, Clinic LAlexandra HospitalSingaporeSingapore
| | - Rathi Mahendran
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Ee Heok Kua
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Zhiming Bao
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
- Institute of Corpus Studies and ApplicationsShanghai International Studies UniversityShanghaiChina
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Lee RZY, Yang WFZ, Mahendran R, Suárez L. Psychometric properties of the World Health Organization WHOQOL-AGE Scale in Singapore. Eur J Ageing 2024; 21:10. [PMID: 38506975 PMCID: PMC10954592 DOI: 10.1007/s10433-024-00803-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
WHOQOL-AGE is a promising quality of life (QOL) tool that has not been fully validated in Asia. The present study aimed to verify its factor structure and psychometric properties among community-dwelling older adults in Singapore. This study was cross-sectional and used data (N = 593) from the Community Health and Intergenerational study that interviewed older adults between 2018 and 2021. Confirmatory factor analysis (CFA) was used to examine the factor structure of the WHOQOL-AGE, and Cronbach's alpha coefficients were employed to examine internal consistency. Spearman's rho correlations coefficients between WHOQOL-AGE and other related scales (Satisfaction with Life and the Friendship) examined convergent validity. A Pearson's correlation coefficient between WHOQOL-AGE and compassion scale examined discriminant validity. An independent t test was used to demonstrate known-groups validity, examining differences in QOL scores between individuals with and without chronic medical conditions. Findings supported a bifactor model with more satisfactory goodness-of-fit indices than the original two-factor model and the two-correlated factor model. WHOQOL-AGE showed adequate internal consistency (Cronbach's alpha coefficients > .70). Good convergent validity was demonstrated by moderate-to-large correlations between WHOQOL-AGE and satisfaction with life (rs = .54) as well as social connectedness (rs = .33). Discriminant validity was shown by low correlations between WHOQOL-AGE and compassion (r = .19). Findings also indicated good known-groups validity (p < 0.01). The WHOQOL-AGE showed promising psychometric properties using an Asian convenience sample and can be useful in large-scale studies or busy clinical settings.
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Affiliation(s)
- Rachael Zhi Yi Lee
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore, 387380, Singapore
- Clarity Singapore Limited, Block 854 Yishun Road #01-3511, Singapore, 760854, Singapore
| | - Winson Fu Zun Yang
- Department of Psychological Science, Texas Tech University, 2700 18th St, Lubbock, TX, USA
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rathi Mahendran
- Yeo Boon Khim, Mind Science Centre, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore
- Mind Care Clinic @ SBF, 160 Robinson Road, #05-07 SBF Center, Singapore, 068914, Singapore
| | - Lidia Suárez
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore, 387380, Singapore.
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Kiah Hui Siew S, Yu J, Teo TL, Chua KC, Mahendran R, Rawtaer I. Technology and physical activity for preventing cognitive and physical decline in older adults: Protocol of a pilot RCT. PLoS One 2024; 19:e0293340. [PMID: 38394113 PMCID: PMC10889650 DOI: 10.1371/journal.pone.0293340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/07/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Cognitive frailty, defined as having both physical frailty and cognitive impairment that does not satisfy the criteria for Major Neurocognitive Disorder, represents an elevated risk for morbidity. Hence, it is crucial to mitigate such risks. Physical activity interventions have been found effective in protecting against physical frailty and cognitive deterioration. This pilot RCT examines if smartwatches and mobile phone applications can help to increase physical activity, thereby improving physical and cognitive outcomes. METHODS Older individuals (n = 60) aged 60 to 85 years old will have their physical activity tracked using a smartwatch. The subjects will be randomized into two arms: one group will receive daily notification prompts if they did not reach the recommended levels of PA; the control group will not receive prompts. Outcome variables of physical activity level, neurocognitive scores, and physical frailty scores will be measured at baseline, T1 (3 months), and T2 (6 months). Sleep quality, levels of motivation, anxiety, and depression will be controlled for in our analyses. We hypothesize that the intervention group will have higher levels of physical activity resulting in improved cognitive and physical outcomes at follow-up. This study was approved by the National University of Singapore's Institutional Review Board on 17 August 2020 (NUS-IRB Ref. No.: H-20-038). DISCUSSION Wearable sensors technology could prove useful by facilitating self-management in physical activity interventions. The findings of this study can justify the use of technology in physical activity as a preventive measure against cognitive frailty in older adults. This intervention also complements the rapidly rising use of technology, such as smartphones and wearable health devices, in our lives today. REGISTRATION DETAILS This study has been retrospectively registered on clinicaltrials.gov on 5th January 2021 (NCT Identifier: NCT04692974), after the first participant was recruited.
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Affiliation(s)
- Savannah Kiah Hui Siew
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Tat Lee Teo
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Kuang Chua Chua
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Rathi Mahendran
- Yeo Boon Khim Mind Science Centre, National University of Singapore, Singapore, Singapore
| | - Iris Rawtaer
- Department of Psychiatry, Sengkang General Hospital, Singapore, Singapore
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Anbarasan R, Tiwari BK, Mahendran R. Upcycling of seafood side streams for circularity. Adv Food Nutr Res 2024; 108:179-221. [PMID: 38460999 DOI: 10.1016/bs.afnr.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
The upcycling of seafood side streams emerges as a crucial facet in the quest for circularity within the food industry, surpassing other food sources in its significance. Seafood side stream plays an indispensable role in global food security and human nutrition. Nevertheless, losses ensue throughout the seafood supply chain, resulting in substantial waste generation. These underutilized seafood by-products contain valuable resources like edible proteins and nitrogenous compounds. Projections indicate that fishery products' utilization for human consumption will soar to 204 MT by 2030. Yet, the industry annually generates millions of tonnes of waste, predominantly from crab, shrimp, and lobster shells, leading to environmental impacts due to COD and BOD issues. A five-tier circular economic model offers a framework to manage seafood side-streams efficiently, with applications spanning pharmaceuticals, food production, animal feed, fertilizers, and energy fuel, thereby maximizing their potential and reducing waste in line with sustainability goals.
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Affiliation(s)
- R Anbarasan
- Centre of Excellence in Non-Thermal Processing, National Institute of Food Technology, Entrepreneurship and Management, Thanjavur, Tamil Nadu, India
| | | | - R Mahendran
- Centre of Excellence in Non-Thermal Processing, National Institute of Food Technology, Entrepreneurship and Management, Thanjavur, Tamil Nadu, India.
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Yu J, Ng TKS, Mahendran R. Cognitive and physical age gaps in relation to mild cognitive impairment and behavioral phenotypes. GeroScience 2024; 46:1129-1140. [PMID: 37428365 PMCID: PMC10828169 DOI: 10.1007/s11357-023-00864-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/28/2023] [Indexed: 07/11/2023] Open
Abstract
We can study how fast our biological aging clocks tick by calculating the difference (i.e., age gaps) between machine learning estimations of biological age and chronological age. While this approach has been increasingly used to study various aspects of aging, few had applied this approach to study cognitive and physical age gaps; not much is known about the behavioral and neurocognitive factors associated with these age gaps. In the present study, we examined these age gaps in relation to behavioral phenotypes and mild cognitive impairment (MCI) among community-dwelling older adults. Participants (N = 822, Agemean = 67.6) were partitioned into equally-sized training and testing samples. Cognitive and physical age-prediction models were fitted using nine cognitive and eight physical fitness test scores, respectively, within the training samples, and subsequently used to estimate cognitive and physical age gaps for each subject in the testing sample. These age gaps were then compared among those with and without MCI and correlated with 17 behavioral phenotypes in the domains of lifestyle, well-being, and attitudes. Across 5000 random train-test split iterations, we showed that older cognitive age gaps were significantly associated with MCI (versus cognitively normal) and worse outcomes across several well-being and attitude-related measures. Both age gaps were also significantly correlated with each other. These results suggest accelerated cognitive and physical aging were linked to worse well-being and more negative attitudes about the self and others and reinforce the link between cognitive and physical aging. Importantly, we have also validated the use of cognitive age gaps in the diagnosis of MCI.
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Affiliation(s)
- Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, 639798, Singapore, Singapore.
| | - Ted Kheng Siang Ng
- Department of Internal Medicine, Rush University Medical Center, Illinois, Chicago, USA
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore.
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
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Anbarasan R, Jaganmohan R, Anandakumar S, Mahendran R. Pulsed electric field treatment of soymilk: Impact on Kunitz trypsin inhibitor allergenicity, antinutritional factor, and aroma characteristics. J Food Sci 2023; 88:5093-5107. [PMID: 37961005 DOI: 10.1111/1750-3841.16837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/17/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023]
Abstract
Allergens, antinutritional factors, and lipoxygenase (LOX) enzyme present in soymilk limit its consumption as vegan milk. Therefore, the present study focuses on reducing these limiting factors using pulsed electric field (PEF) treatment. In this regard, 20-40 kV/cm electric field was applied to soymilk for the effective treatment periods of 450, 1350, and 2250 ms. After the treatment, a reduction in pH (6.60 ± 0.10 to 6.47 ± 0.12) and an increase in the conductivity (173.03 ± 0.40 to 177.33 ± 0.72 µS) were observed. Furthermore, FTIR (Fourier Transform Infrared Spectroscopy), UV (Ultra Violet) intrinsic spectra, and CD (Circular Dichroism) spectra (α-helix reduction and β-sheet increase) data indicated mild structural changes in the proteins of soymilk. As a result, PEF treatment reduced the soymilk allergenicity (67.33 ± 20.48%), LOX activity (69.45 ± 9.38%), and trypsin inhibitor activity (75.61 ± 4.04%). Apart from that, the color, viscosity, and volatiles of soymilk also had significant changes due to PEF treatment. The aroma changes in PEF-treated soymilk were highly influenced by two major principal component (PC1 & PC2) groups and they accounted for about 70% of the aroma variations. However, these changes were mild and did not induce any off-flavors and the treatment remained effective against the quality hazards like allergens, antinutritional factors, and LOX enzyme. PRACTICAL APPLICATION: PEF treatment of soymilk reduces the possible allergic reactions in human body at least by 30%. Further, it reduces the antinutritional factor and off-odor inducing compounds. Therefore, the PEF treatment can be used in industries as a pre-treatment to produce allergen and antinutritional compounds free protein isolates from soybeans.
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Affiliation(s)
- R Anbarasan
- Centre of Excellence in Non-Thermal Processing, National Institute of Food Technology, Entrepreneurship and Management, Thanjavur, Tamil Nadu, India
| | - R Jaganmohan
- Department of Food Product Development, National Institute of Food Technology, Entrepreneurship and Management, Thanjavur, Tamil Nadu, India
| | - S Anandakumar
- Department of Food Product Development, National Institute of Food Technology, Entrepreneurship and Management, Thanjavur, Tamil Nadu, India
| | - R Mahendran
- Centre of Excellence in Non-Thermal Processing, National Institute of Food Technology, Entrepreneurship and Management, Thanjavur, Tamil Nadu, India
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Bhavadharini B, Monica V, Anbarasan R, Mahendran R. Virtual, augmented, and mixed reality as a versatile tool in food consumer behavior evaluation: Recent advances in aroma, taste, and texture incorporation. Compr Rev Food Sci Food Saf 2023; 22:4925-4956. [PMID: 37830874 DOI: 10.1111/1541-4337.13248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023]
Abstract
The perceptual behavior of consumers on a product displayed in the market has a vital role in analyzing the importance given to that product. Therefore, various strategies have been developed to understand this consumer behavior in the selection of products. Immersive technologies like virtual, augmented, and mixed reality are among them. With the foremost feature of immersion in the virtual world and interaction of users with virtual objects, virtual reality, and augmented reality have unlocked their potential in research and a user-friendly tool for analyzing consumer behavior. In addition to these technologies, mixed reality also has a significant role in investigating consumer behavior. Studies on immersive technologies in food applications are vast, hence this review focuses on the applications of virtual, augmented, and mixed reality in the food selection behavior of consumers. The behavioral studies are elicited to develop new products based on consumer needs, to understand the shopping behavior in supermarkets for real-time usage, and to know the influence of emotions in a selection of products. The findings suggest that virtual, augmented, and mixed reality induce immersion of the users in food selection behavioral studies. Information on the technological advancements in the tools used for bringing immersion and interaction are discussed for its futuristic applications in food. Though immersive technology gives users a realistic virtual environment experience, its application in food systems is in the budding stage. More research on human response studies would contribute to its innovative and inevitable application in the future.
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Affiliation(s)
- B Bhavadharini
- Centre of Excellence in Nonthermal Processing, National Institute of Food Technology, Entrepreneurship and Management -Thanjavur (NIFTEM-T), Thanjavur, India
| | - V Monica
- Centre of Excellence in Nonthermal Processing, National Institute of Food Technology, Entrepreneurship and Management -Thanjavur (NIFTEM-T), Thanjavur, India
| | - R Anbarasan
- Centre of Excellence in Nonthermal Processing, National Institute of Food Technology, Entrepreneurship and Management -Thanjavur (NIFTEM-T), Thanjavur, India
| | - R Mahendran
- Centre of Excellence in Nonthermal Processing, National Institute of Food Technology, Entrepreneurship and Management -Thanjavur (NIFTEM-T), Thanjavur, India
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Liu J, Griva K, Mahendran R. Latent Profiles of Fear of Cancer Recurrence and Associations with Physical and Mental Health Outcomes. Ann Behav Med 2023; 57:743-752. [PMID: 37203254 DOI: 10.1093/abm/kaad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a multidimensional construct; however, few studies have meaningfully integrated FCR severity (i.e., level of fear) with FCR-related concepts (e.g., triggers). PURPOSE The present study determined (a) latent profiles of FCR; (b) socio-demographic variations between identified profiles; (c) interactions between identified profiles and resilience and rumination on chronic physical disorders, depressive/anxiety symptoms, and quality of life. METHODS The present study is a secondary data analysis of which 404 cancer survivors were included in this study. All participants completed the Fear of Cancer Recurrence Inventory and measures of resilience, rumination, depressive/anxiety symptoms, and quality of life. RESULTS Latent profile analysis identified three distinct profiles based on varying levels of FCR and FCR-related concepts; Profile 1 "Low FCR" (n = 108; 26.4%), Profile 2 "Moderate FCR, High coping" (n = 197; 49.4%), and Profile 3 "High FCR, distress and impairment" (n = 99; 24.3%). Profile 3 was associated with younger age and history of radiotherapy. Latent profiles of FCR significantly interacted with resilience and rumination on depressive/anxiety symptoms. CONCLUSIONS Latent profile analysis integrates FCR severity and FCR-related concepts to support a nuanced understanding of FCR. Our results suggest specific points of intervention, which extend beyond addressing FCR severity.
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Affiliation(s)
- Jianlin Liu
- Research Division, Institute of Mental Health, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore
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Siew SKH, Yu J, Kua EH, Mahendran R. Psychosocial profiles within community-dwelling older adults with Mild Cognitive Impairment: A prevalence and latent profile analysis study. Asian J Psychiatr 2023; 82:103503. [PMID: 36791608 DOI: 10.1016/j.ajp.2023.103503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/31/2022] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Mild Cognitive Impairment (MCI) is an at-risk stage for dementia and accurate prevalence studies are lacking in Singapore. From the literature, it is evident that psychosocial factors increase the risk of conversion to dementia. In this study, we sought to establish the prevalence of MCI in Singapore and study the associated psychosocial factors using latent profile analysis. METHOD 902 community-dwelling older adults, aged between 60 and 99 years old (Mage = 70.48 years), were recruited as part of the Community Health and Intergenerational Study (CHI). They completed neurocognitive assessments and questionnaires on depression and anxiety symptoms, quality of life, social support, satisfaction with life, and social connectivity. Petersen's criteria was used to diagnose MCI. Within the MCI sample, 166 subjects' psychosocial scores were entered into a latent profile analysis to identify profiles of psychosocial functioning. RESULTS The prevalence of MCI in our sample was 21.5%. They had significantly lower years of education and perceived social support and higher depressive symptoms than the normal ageing group. Three distinct profiles emerged within the MCI group corresponding to a positive (45.2%), neutral (38.5%), and negative (16.3%) pattern of psychosocial scores. These profiles did not differ significantly in terms of demographic or cognitive variables. DISCUSSION The three psychosocial profiles might reflect the differing implications of MCI on a person's well-being and the negative psychosocial profile might likely be most at risk of conversion to dementia. Future longitudinal studies are required to confirm these implications.
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Affiliation(s)
- Savannah Kiah Hui Siew
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Psychology, School of Social Sciences, Nanyang Technological University, Singapore.
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Dekka S, Paul A, Vidyalakshmi R, Mahendran R. Potential processing technologies for utilization of millets: An updated comprehensive review. J FOOD PROCESS ENG 2023. [DOI: 10.1111/jfpe.14279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Srenuja Dekka
- Department of Food Safety and Quality Testing National Institute of Food Technology, Entrepreneurship and Management (NIFTEM) Thanjavur Tamil Nadu India
| | | | - R. Vidyalakshmi
- Department of Food Safety and Quality Testing National Institute of Food Technology, Entrepreneurship and Management (NIFTEM) Thanjavur Tamil Nadu India
| | - R. Mahendran
- Centre of Excellence in Nonthermal Processing National Institute of Food Technology, Entrepreneurship and Management (NIFTEM) Thanjavur Tamil Nadu India
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Ng TKS, Tan XR, Todd M, Chen ACC, Feng L, Lu Y, Yu F, Kua EH, Mahendran R. Effects of Mindful Awareness Practice (MAP) on Subclinical Depressive and Anxiety Symptoms and General Cognitive Function in Older Adults with Mild Cognitive Impairment: A 5-Year Follow-Up of the MAP-Randomized Controlled Trial. J Alzheimers Dis 2022; 90:1677-1688. [PMID: 36314204 DOI: 10.3233/jad-220641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Few randomized controlled trials (RCTs) investigated the effects of mindfulness intervention on affective and cognitive symptoms in older adults with mild cognitive impairment (MCI). Furthermore, no RCTs on mindfulness followed participants beyond two years. OBJECTIVE To examine the longitudinal effects of a mindful awareness practice (MAP) intervention on depressive, anxiety, and cognitive symptoms in MCI. METHODS In this parallel-arm and assessor-blinded RCT, 55 community-dwelling older adults with MCI were randomized into the MAP or active control, i.e., health education program (HEP). Intervention sessions were conducted weekly for three months and monthly for the subsequent six months. Assessments and follow-up were conducted at baseline, 3-month, 9-month, and 5-year time points. Depressive, anxiety, and cognitive symptoms were measured using the Geriatric Depression Scale-15 (GDS-15), Geriatric Anxiety Inventory-20 (GAI-20), and Mini-Mental State Examination (MMSE), respectively. Linear-mixed models, following the intention-to-treat principle, were used for data analyses. RESULTS A total of 55 participants aged 60 to 86 (Mean age: 71.3±6 years old) was recruited, with n = 28 allocated to the MAP arm and n = 27 allocated to the HEP arm. Compared to HEP, GDS-15, GAI-20, and MMSE scores did not differ significantly in MAP during follow-ups. CONCLUSION Compared to HEP, MAP did not improve affective symptoms nor delay deteriorations in general cognition in community-dwelling older adults with MCI. Compared to our previous findings showing domain-specific improvements in MAP over HEP in attention and memory up to 9 months, this study highlights the importance of examining domain-specificity using detailed cognitive measures in non-pharmacological intervention with MCI.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.,Center for Innovation in Healthy and Resilient Aging (CIHRA), Phoenix, AZ, USA
| | - Xiang Ren Tan
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Angela Chia-Chen Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.,Center for Innovation in Healthy and Resilient Aging (CIHRA), Phoenix, AZ, USA
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
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Ng TK, Mahendran R, Kua E, Feng L. A 2‐year Choral Singing intervention with community‐dwelling older adults at risk of cognitive decline to improve bio‐psychological outcomes: An open‐label Randomized Controlled Trial. Alzheimers Dement 2022. [DOI: 10.1002/alz.062297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Ted K.S. Ng
- National University of Singapore Singapore Singapore
- Arizona State University Phoenix AZ USA
| | - Rathi Mahendran
- National University of Singapore Singapore Singapore
- National University Hospital Singapore Singapore
| | - Ee‐Heok Kua
- National University of Singapore Singapore Singapore
| | - Lei Feng
- National University of Singapore Singapore Singapore
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Ng TKS, Feng L, Chua RY, Goh LG, Kua EH, Mahendran R. A 5-year community program in Singapore to prevent cognitive decline. Asia Pac Psychiatry 2022; 14:e12518. [PMID: 35922040 DOI: 10.1111/appy.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/09/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There is a scarcity of naturalistic follow-up studies on cognitive stimulating activities (CSAs), particularly in a real-world setting and over long-term. We thus investigated a pooled novel CSA intervention to prevent cognitive decline amongst community-dwelling older adults without dementia. METHODS Nested within a community-based longitudinal follow-up cohort study of community-dwelling and multi-ethnic older adults (N = 991), a subset of the cohort (n = 264) underwent four single-blinded randomized controlled trials involving four novel CSAs, including mindfulness, horticulture, art therapy, and choral singing. At the cohort's 5-year follow-up, we examined if involvements in the CSAs improved cognition, compared to controls (n = 727). The primary outcomes were changes in global cognition and specific cognitive domain scores measured by the mini-mental state examination (MMSE). Exploratory subgroup analyses stratified by baseline cognitive status and the number of CSAs were also conducted. RESULTS Compared to the control group, there was a small improvement in the CSA group on the total MMSE score (d = 0.108) and MMSE-immediate recall score (d = 0.199). Furthermore, subgroup analyses revealed medium effect sizes of improvements (d = 0.420) in cognitive domains in mild cognitive impairment (MCI) (vs. cognitively healthy) and those involved in two CSAs (vs. one CSA). DISCUSSION In summary, a CSA intervention improved cognition. MCI and those involved in two CSAs gained greater benefits from the CSAs. These sustained improvements in cognitive functions could have a significant impact on delaying or preventing dementia.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, USA
| | - Lei Feng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Centre for Healthy Longevity, NUHS, Singapore, Singapore
| | - Ru Yuan Chua
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Lee Gan Goh
- Department of Family Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore
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15
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Kowsalya P, Sharanyakanth P, Mahendran R. Traditional rice varieties: A comprehensive review on its nutritional, medicinal, therapeutic and health benefit potential. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2022.104742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Yashini M, Khushbu S, Madhurima N, Sunil CK, Mahendran R, Venkatachalapathy N. Thermal properties of different types of starch: A review. Crit Rev Food Sci Nutr 2022; 64:4373-4396. [PMID: 36322685 DOI: 10.1080/10408398.2022.2141680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Starch is present in high amount in various cereals, fruits and roots & tubers which finds major application in industry. Commercially, starch is rarely consumed or processed in its native form, thus modification of starch is widely used method for increasing its application and process stability. Due to the high demand for starch in industrial applications, researchers were driven to hunt for new sources of starch, including modification of starch through green processing. Thermal properties are significant reference parameters for evaluating the quality of starch when it comes to cooking and processing. Modification of starches affects the thermal properties, which are widely studied using Differential scanning calorimeter or Thermogravimetric analysis. It could lead to a better understanding of starch's thermal properties including factors influencing and expand its commercial applications as a thickener, extender, fat replacer, etc. in more depth. Therefore, the review presents the classification of starches, factors influencing the thermal properties, measurement methods and thermal properties of starch in its native and modified form. Further, this review concludes that extensive research on the thermal properties of new sources of starch, as well as modified starch, is required to boost thermal stability and extend industrial applications.
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Affiliation(s)
- M Yashini
- Department of Food Engineering, National Institute of Food Technology Entrepreneurship and Management-Thanjavur, Thanjavur, India
| | - S Khushbu
- University of Hohenheim, Stuttgart, Germany
| | - N Madhurima
- Department of Food Engineering, National Institute of Food Technology Entrepreneurship and Management-Thanjavur, Thanjavur, India
| | - C K Sunil
- Department of Food Engineering, National Institute of Food Technology Entrepreneurship and Management-Thanjavur, Thanjavur, India
| | - R Mahendran
- Centre of Excellence in Non-Thermal Processing, National Institute of Food Technology Entrepreneurship and Management-Thanjavur, Thanjavur, India
| | - N Venkatachalapathy
- Department of Food Engineering, National Institute of Food Technology Entrepreneurship and Management-Thanjavur, Thanjavur, India
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17
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Ng TKS, Han MFY, Loh PY, Kua EH, Yu J, Best JR, Mahendran R. Differential associations between simple physical performance tests with global and specific cognitive functions in cognitively normal and mild cognitive impairment: a cross-sectional cohort study of Asian community-dwelling older adults. BMC Geriatr 2022; 22:798. [PMID: 36229767 PMCID: PMC9563467 DOI: 10.1186/s12877-022-03434-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical performance declines and executive dysfunctions are predictors of dementia. However, their associations are not well understood in Asian older adults without dementia (cognitively normal [CN] and mild cognitive impairment [MCI]), especially in a single study. Objective Examine the associations between physical performance measures with executive function (EF)-based and non-EF-based neurocognitive tests and whether preclinical dementia cognitive status i.e., CN and MCI, moderated these associations. Methods We examined cross-sectional cohort of 716 community-dwelling older adults without dementia (CN = 562 and MCI = 154) using multivariable linear regression models. We associated three simple physical performance measures, namely timed-up-and-go (TUG), fast gait speed (FGS), and 30-s chair stand test (30 s-CST), with a comprehensive neurocognitive test battery measuring EF and non-EF cognitive functions. Moderating effects of cognitive status on the associations were examined. In all models, we controlled for pertinent covariates, including age, education, medical and psychiatric status. Results Upon controlling for covariates, TUG was most strongly and positively associated with multiple EF-based neurocognitive tests, followed by FGS, with 30 s-CST having the weakest associations. For all physical performance measures, no significant associations with non-EF-based neurocognitive tests were detected. Cognitive status significantly moderated the associations between all physical measures and several neurocognitive tests, with stronger associations in the MCI than CN. Conclusion Compared to FGS and 30 s-CST, TUG had the most robust associations with multiple EF-based cognitive functions. Given their differential associations with global and detailed neurocognitive tests and significant moderating effects of cognitive status, findings highlight a need to carefully consider the choices of simple physical performance tests when using these tests with a heterogenous group of community-dwelling older adults without dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03434-4.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore. .,Edson College of Nursing and Health Innovation, Arizona State University, Health North, Suite 301, 550 N 3rd Street, Phoenix, AZ, 85004, USA.
| | - Madeline Fu Yun Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Ping Yeap Loh
- Department of Human Science, Faculty of Design, Kyushu University, Shiobaru 4-9-1, Fukuoka, 815-8540, Japan
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.,Department of Psychological Medicine, National University Hospital, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, 515 W Hastings St, Vancouver, B.C, V6B 5K3, Canada
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.,Department of Psychological Medicine, National University Hospital, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
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18
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Dharini M, Jaspin S, Mahendran R. Cold plasma reactive species: Generation, properties, and interaction with food biomolecules. Food Chem 2022; 405:134746. [DOI: 10.1016/j.foodchem.2022.134746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/16/2022] [Accepted: 10/23/2022] [Indexed: 11/30/2022]
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19
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20
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Yap AC, Mahendran R, Kua EH, Zhou W, Wang DY. Olfactory dysfunction is associated with mild cognitive impairment in community-dwelling older adults. Front Aging Neurosci 2022; 14:930686. [PMID: 36004001 PMCID: PMC9393534 DOI: 10.3389/fnagi.2022.930686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Olfactory impairment is aging related and is associated with cognitive decline in older adults. However, it remains unclear if an olfactory impairment is associated with mild cognitive impairment (MCI) and the degree of impairment in the MCI subtypes. Materials and methods In a cohort of community-living older adults aged 60 years and above, 670 participants were recruited from the Community Health and Intergenerational (CHI) Study. Olfactory function was assessed using a locally developed nine-item smell test in association with neurocognitive assessments. Analysis of covariance (ANCOVA) was used to examine the association of smell identification score and clinical cognitive status while considering demographic, clinical, and neuropsychological factors with Bonferroni correction for group comparisons. Results Age-related smell detection between normal aging (NA) and MCI participants had no significant difference. The overall mean smell identification score in older adults was negatively correlated with age. The mean smell identification score of MCI participants was also not significantly different as compared with NA, but an amnestic MCI multiple domain (aMCI_MD) subgroup had significantly lower (impaired) mean smell identification scores compared with the NA and MCI single domain (amnestic and non-amnestic) group. Conclusion This study demonstrated that olfactory identification impairment is a comorbidity in older adults with amnestic MCI (aMCI) and is a potential marker associated with an early stage of a neurocognitive disorder. The smell test could act as a screening tool to help in the early detection of smell impairment for heterogeneous syndromes of MCI among community-dwelling older adults. Clinicians and researchers could benefit from utilizing the locally developed smell test to screen their patients or research participants before the initiation of an appropriate health intervention or in a clinical trial.
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Affiliation(s)
- Ai Che Yap
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- *Correspondence: Ee Heok Kua,
| | - Weibiao Zhou
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
- Weibiao Zhou,
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- De Yun Wang,
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21
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Sulthan Ibrahim A, Mahendran R, Anbarasu P, Rajendran K, Sathish S. Ni3S2 entrenched MWCNT composite as a low-cost Pt-free counter electrode for dye-sensitized solar cell: Conversion efficiency reached to 9.28%. INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2022.109841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Kaavya R, Pandiselvam R, Gavahian M, Tamanna R, Jain S, Dakshayani R, Khanashyam AC, Shrestha P, Kothakota A, Arun Prasath V, Mahendran R, Kumar M, Khaneghah AM, Nayik GA, Dar AH, Uddin J, Ansari MJ, Hemeg HA. Cold plasma: a promising technology for improving the rheological characteristics of food. Crit Rev Food Sci Nutr 2022; 63:11370-11384. [PMID: 35758273 DOI: 10.1080/10408398.2022.2090494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
At the beginning of the 21st century, many consumers show interest in purchasing safe, healthy, and nutritious foods. The intent requirement of end-users and many food product manufacturers are trying to feature a new processing technique for the healthy food supply. The non-thermal nature of cold plasma treatment is one of the leading breakthrough technologies for several food processing applications. The beneficial response of cold plasma processing on food quality characteristics is widely accepted as a substitution technique for new food manufacturing practices. This review aims to elaborate and offer crispy innovative ideas on cold plasma application in various food processing channels. It highlights the scientific approaches on the principle of generation and mechanism of cold plasma treatment on rheological properties of foods. It provides an overview of the behavior of cold plasma in terms of viscosity, crystallization, gelatinization, shear stress, and shear rate. Research reports highlighted that the cold plasma treated samples demonstrated a pseudoplastic behavior. The published literatures indicated that the cold plasma is a potential technology for modification of native starch to obtain desirable rheological properties. The adaptability and environmentally friendly nature of non-thermal cold plasma processing provide exclusive advantages compared to the traditional processing technique.
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Affiliation(s)
- R Kaavya
- Department of Dairy and Food Science, South Dakota State University, Brookings, South Dakota, USA
| | - R Pandiselvam
- Physiology, Biochemistry, and Post-Harvest Technology Division, ICAR-Central Plantation Crops Research Institute, Kasaragod, Kerala, India
| | - Mohsen Gavahian
- Department of Food Science, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - R Tamanna
- Innovation and Technology, Kraft Heinz Company, Chicago, Illinois, USA
| | - Surangna Jain
- Department of Biotechnology, Mahidol University, Bangkok, Thailand
| | - R Dakshayani
- Department of Food Processing and Quality Control, ThassimBeevi Abdul Kader College for Women, Ramanathapuram, Tamil Nadu, India
| | | | - Pratiksha Shrestha
- Department of Food Technology and Quality Control (DFTQC), National Food and Feed Reference Laboratory (NFFRL), Babarmahal, Nepal
| | - Anjineyulu Kothakota
- Agro-Processing & Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (NIIST), Thiruvananthapuram, Kerala, India
| | - V Arun Prasath
- Department of Food Process Engineering, National Institute of Technology, Rourkela, Odisha, India
| | - R Mahendran
- Centre of Excellence in Non-Thermal Processing, National Institute of Food Technology, Entrepreneurship and Management (NIFTEM-T), Thanjavur, Tamil Nadu, India
| | - Manoj Kumar
- Chemical and Biochemical Processing Division, ICAR-Central Institute for Research on Cotton Technology, Mumbai, Maharashtra, India
| | - Amin Mousavi Khaneghah
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Gulzar Ahmad Nayik
- Department of Food Science and Technology, Government Degree College Shopian, Srinagar, Jammu & Kashmir, India
| | - Aamir Hussain Dar
- Department of Food Technology, Islamic University of Science and Technology Kashmir, Awantipora, Jammu & Kashmir, India
| | - Jalal Uddin
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Javed Ansari
- Department of Botany, Hindu College Moradabad (Mahatma Jyotiba Phule Rohilkhand University, Bareilly, Uttar Pradesh), India
| | - Hassan A Hemeg
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
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23
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Sharma K, Modupalli N, Venkatachalapathy N, Mahendran R, Vidyalakshmi R. Light emitting diode assisted non‐thermal pasteurization of
Punica granatum L
. juice. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.16773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kulbhushan Sharma
- Department of Food Engineering National Institute of Food Technology Entrepreneurship and Management (formerly Indian Institute of Food Processing Technology) Thanjavur India
| | - Nikitha Modupalli
- Department of Food Engineering National Institute of Food Technology Entrepreneurship and Management (formerly Indian Institute of Food Processing Technology) Thanjavur India
| | - N. Venkatachalapathy
- Department of Food Engineering National Institute of Food Technology Entrepreneurship and Management (formerly Indian Institute of Food Processing Technology) Thanjavur India
| | - R. Mahendran
- Centre of Excellence in Non‐Thermal Processing National Institute of Food Technology Entrepreneurship and Management (formerly Indian Institute of Food Processing Technology) Thanjavur India
| | - R. Vidyalakshmi
- Department of Food Safety and Quality Testing National Institute of Food Technology Entrepreneurship and Management (formerly Indian Institute of Food Processing Technology) Thanjavur India
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Anbarasan R, Jaspin S, Bhavadharini B, Pare A, Pandiselvam R, Mahendran R. Chlorpyrifos pesticide reduction in soybean using cold plasma and ozone treatments. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.113193] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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25
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Kiah Hui Siew S, Chia JL, Mahendran R, Yu J. Older adults’ perceptions of government handling of COVID-19: Predictors of protective behaviors from lockdown to post-lockdown. PLoS One 2022; 17:e0263039. [PMID: 35108322 PMCID: PMC8809562 DOI: 10.1371/journal.pone.0263039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background Distrust, and more broadly, public perception of government’s handling of a crisis, has been a widely studied topic within health crisis research and suggests that these perceptions are significantly associated with the behavior of its citizens. Purpose To understand which aspects of the public’s perception of government handling of the COVID-19 pandemic predicted engagement of protective behaviors among older adults, who are the most vulnerable to COVID-19. Methods Participants were recruited from an ongoing biopsychosocial study on aging amongst community-dwelling older adults. There were two rounds of data collection, during the national lockdown and post-lockdown. The average length of follow-up was 5.88 months. N = 421 completed the first round of data collection and N = 318 subsequently completed the second round of questionnaires. Results During the lockdown, perceptions that pandemic-related measures in place were sufficient, effective, timely, provided a sense of safety, important information was easily accessible, and government handling of the pandemic could be trusted, were found to significantly predict engagement in protective behaviors. During post-lockdown, only perceptions that measures in place were sufficient, provided a sense of safety, and important information was easily accessible, remained significant predictors. The perception that COVID-19 measures were clear and easy to understand now became a significant predictor. Conclusions Public perceptions of government handling of the pandemic predicted engagement in protective behaviors but were less important during post-lockdown. To effectively engage older adults in protective behavior, our findings suggest for pandemic-related information to be accessible, introducing timely safety measures, and having easy-to-understand instructions for nuanced measures.
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Affiliation(s)
- Savannah Kiah Hui Siew
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- * E-mail:
| | - Jonathan Louis Chia
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
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26
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Ng TKS, Coughlan CM, Heyn PC, Tagawa A, Carollo J, Kua E, Mahendran R. Increased Plasma brain‐derived neurotrophic factor (BDNF) as a Biomarker for Differentiating Mild Cognitive Impairment from Cognitive Healthy: A case‐control study. Alzheimers Dement 2021. [DOI: 10.1002/alz.058648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ted Kheng Siang Ng
- Arizona State University Phoenix AZ USA
- University of Colorado Colorado CO USA
- National University of Singapore Singapore Singapore
| | - Christina M Coughlan
- Department of Neurology University of Colorado Alzheimer's and Cognition Center and the Linda Crnic Institute for Down Syndrome University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Patricia C Heyn
- University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Alex Tagawa
- University of Colorado Denver, Anschutz Medical Campus Colorado CO USA
| | - James Carollo
- University of Colorado Denver, Anschutz Medical Campus Colorado CO USA
| | - Ee‐Heok Kua
- National University of Singapore Singapore Singapore
- National University Hospital Singapore Singapore
| | - Rathi Mahendran
- National University of Singapore Singapore Singapore
- National University Hospital Singapore Singapore
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27
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Ng TKS, Chua RY, Feng L, Goh LG, Kua E, Mahendran R. Effects of novel Cognitive Stimulating Activities (CSAs) on cognition and depression: A 5‐year pragmatic and naturalistic study. Alzheimers Dement 2021. [DOI: 10.1002/alz.054717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ted Kheng Siang Ng
- University of Colorado Colorado CO USA
- National University of Singapore Singapore Singapore
| | - Rhu Yuan Chua
- National University of Singapore, Yong Loo Lin School of Medicine, Department of Psychological Medicine Singapore Singapore
| | - Lei Feng
- National University of Singapore Singapore Singapore
| | - Lee Gan Goh
- National University of Singapore Singapore Singapore
- National University Hospital Singapore Singapore
| | - Ee‐Heok Kua
- National University of Singapore Singapore Singapore
- National University Hospital Singapore Singapore
| | - Rathi Mahendran
- National University of Singapore Singapore Singapore
- National University Hospital Singapore Singapore
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Tam WWS, Poon SN, Mahendran R, Kua EH, Wu XV. Impacts of COVID-19 and partial lockdown on family functioning, intergenerational communication and associated psychosocial factors among young adults in Singapore. BMC Psychiatry 2021; 21:595. [PMID: 34836516 PMCID: PMC8617365 DOI: 10.1186/s12888-021-03599-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/08/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has changed our daily lives. Most of the working adults adopted the work-from-home arrangement while students shifted to home-based learning. Being confined together allows families to foster stronger bonds. On the other hand, the on-going pandemic could have negative impacts on family relationships. The COVID-19 outbreak is still on-going worldwide, understanding more about the changes in family functioning and its associated psychological impacts in a pandemic would allow the authorities to provide more targeted support to families. OBJECTIVES This study aimed to examine the factors associated with family functioning among young adults in Singapore during the COVID-19 pandemic. Family functioning refers to the quality of interactions among family members, and consists of cohesion, flexibility and communication. METHODS A cross-sectional online survey was conducted (N = 390). The Family Adaptability and Cohesion Evaluation Scale Short Form (FACES-IV-SF) and Global Perceptions of Intergenerational Communication Scale (GPIC) were used to examine family functioning and intergeneration communication during the partial lockdown. Center for Epidemiologic Studies Depression Scale (CESD), Social Support Questionnaire-Brief (SSQ-B), Perceived Stress Scale 4 (PSS), UCLA Loneliness Scale, and Brief Resilient Coping Scale (BRCS) examined the psychosocial impact. Descriptive statistics, Pearson's correlation coefficients, and regression model were employed in the analysis. RESULTS The FACES-IV-SF score for total circumplex ratio has a mean of 1.57(SD = 0.58), suggesting that participants generally perceived their families as functioning relatively well. The mean scores for CESD, PSS, Loneliness and BRCS were 12.4(6.2), 8.0(2.6), 5.7(1.9) and 12.6(3.1) respectively. The mean scores of the 4 domains of GPIC were 21.5(4.0) for Accommodation, 25.0(6.7) for Non-Accommodation, 17.2(3.3) for Respect-Obligation, and 18.9(4.8) for Avoidant. CONCLUSION The results suggested that family functioning is significantly associated with intergenerational communication and satisfaction with social support in a pandemic. Participants with balanced levels of cohesion and flexibility in their families are more likely to be able to cope with the psychological impacts of the pandemic. The findings serve to inform intervention and preventive efforts to improve family functioning and reduce the risk of psychological distress in a pandemic.
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Affiliation(s)
- Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2 MD11, 10 Medical Drive, Singapore, 117597 Singapore
| | - Sum Nok Poon
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2 MD11, 10 Medical Drive, Singapore, 117597 Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2 MD11, 10 Medical Drive, Singapore, 117597 Singapore
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Liu LY, Lu Y, Shen L, Li CB, Yu JT, Yuan CR, Ye KX, Chao YX, Shen QF, Mahendran R, Kua EH, Yu DH, Feng L. Prevalence, risk and protective factors for mild cognitive impairment in a population-based study of Singaporean elderly. J Psychiatr Res 2021; 145:111-117. [PMID: 34894520 DOI: 10.1016/j.jpsychires.2021.11.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 12/17/2022]
Abstract
The prevalence of dementia has been widely reported, and its potential risk and protective factors are well-characterized. However, there is a scarcity of related information regarding mild cognitive impairment (MCI). Thus this population-based study aimed to determine the prevalences of MCI and its subtypes, as well as to identify the risk and protective factors for MCI in the Chinese elderly population of Singapore. Results showed that the overall prevalence of MCI was 12.5%, while the gender-adjusted prevalence of MCI was 12.3%. Gender was found to be significantly associated with the subtypes of MCI, with males more likely to have amnestic MCI and females more likely to have non-amnestic MCI. Older age, lower educational levels, lower social activity levels, depression, hypertension, hyperlipidemia, diabetes and stroke were found to be risk factors for MCI in univariate analysis. However, multivariable analysis showed that only hypertension and stroke were the significant risk factors for MCI. Higher educational levels and active social engagements were significant protective factors for MCI in multivariable analysis. Age and depression had boundary significant associations with the prevalence of MCI. After adjusting for gender, the influence of hypertension, stroke, social engagement, age and depression on MCI remained unchanged, except that education became a boundary significant lower risk factor of MCI development. In conclusion, this study presented the prevalence, risk and protective factors for MCI among Singaporean Chinese older adults, which facilitates the screening of vulnerable groups for MCI.
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Affiliation(s)
- Ling-Yun Liu
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chun-Bo Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology, Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chua Ru Yuan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kaisy Xinhong Ye
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yin Xia Chao
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore; Academic Development Department, DUKE-NUS Medical School, Singapore, Singapore
| | - Qing-Feng Shen
- Department of Geriatric Psychiatry, Xuzhou Oriental People's Hospital, Xuzhou, China
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - De-Hua Yu
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China; Academic Department of General Practice, Tongji University School of Medicine, Shanghai, China; Shanghai General Practice and Community Health Development Research Center, Shanghai, China.
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore; Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Jaspin S, Anbarasan R, Dharini M, Mahendran R. Structural analysis of tapioca xerogel and its water and oil triggered shape change. Food Structure 2021. [DOI: 10.1016/j.foostr.2021.100226] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Ng TKS, Feng L, Fam J, Rawtaer I, Kumar AP, Rane G, Cheah IKM, Mahendran R, Lee YK, Tan EC, Goh LG, Kua EH, Mahendran R. Mindfulness Awareness Practice (MAP) to Prevent Dementia in Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Trial and Implementation Outcomes. Int J Environ Res Public Health 2021; 18:10205. [PMID: 34639513 PMCID: PMC8508350 DOI: 10.3390/ijerph181910205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND With an aging population, developing non-pharmacological interventions (NPIs) to delay dementia has become critical. Apart from cognitive decline, dementia is associated with multiple pathophysiology, including increased oxidative stress, dysregulated gene expressions, cytokine, neurotrophin, and stress markers, telomere shortening, and deteriorations in brain connectivity. Although mindfulness practices have been proposed to ameliorate these biological changes, no empirical studies were conducted. We thus aimed to investigate the effects of mindfulness awareness practice (MAP) to prevent cognitive decline and improve peripheral biomarkers in community-dwelling older adults diagnosed with mild cognitive impairment (MCI). METHODS/DESIGN This was a single-blinded and parallel-group randomized controlled trial with two arms (intervention and active control arms), conducted over nine months. A total of 60 consenting community-dwelling older adults diagnosed with MCI were planned to be randomized in a 1:1 ratio to either the MAP or the Health Education Program (HEP). Interventions were performed weekly for the initial 12 weeks, and monthly for the subsequent six months. Outcome measures were assessed at baseline, 3-month, and 9-month post-intervention by blinded assessors. Primary outcomes were neurocognitive tests, comprehensive peripheral biomarkers, and brain imaging scans. Secondary outcomes included basic health screening measures, affective symptoms, and measures of physical functions. Linear-mixed models were used to examine the effects of MAP on these outcome measures. SIGNIFICANCE This is the first randomized controlled trial to systematically investigate the effects of a mindfulness intervention in improving cognitive functions and various biomarkers in community-dwelling older adults diagnosed with MCI. Our findings have the potential to inform mindfulness intervention as a novel approach to delay dementia.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Lei Feng
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Johnson Fam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Iris Rawtaer
- Department of Psychiatry, Sengkang General Hospital & SingHealth Duke-NUS Centre of Memory and Cognitive Disorders, Singapore 544886, Singapore;
| | - Alan Prem Kumar
- Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore; (A.P.K.); (G.R.)
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore
| | - Grishma Rane
- Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore; (A.P.K.); (G.R.)
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore
| | - Irwin Kee-Mun Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 8 Medical Drive, Singapore 117597, Singapore;
| | - Ratha Mahendran
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Yuan Kun Lee
- Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore 117545, Singapore;
| | - Ene Choo Tan
- Division of Clinical Support Services, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore;
| | - Lee Gan Goh
- Department of Family Medicine, National University Health System, 1E Kent Ridge Rd, Singapore 119228, Singapore;
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
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Siew SKH, Han MFY, Mahendran R, Yu J. Regression-Based Norms and Validation of the Cambridge Neuropsychological Test Automated Battery among Community-Living Older Adults in Singapore. Arch Clin Neuropsychol 2021; 37:457-472. [PMID: 34530442 DOI: 10.1093/arclin/acab073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The Cambridge Neuropsychological Test Automated Battery (CANTAB) is widely used in research and clinical settings. However, little is known about the use of the CANTAB in the local aging context. This study aimed to develop normative data for various CANTAB measures in community-living older adults in Singapore. Normative data were built using the regression-based approach. A secondary aim was to examine the concurrent validity of CANTAB measures with their traditional neurocognitive test counterparts. METHOD A total of 210 older adults (Mage = 67.27 years, SD = 5.45) from an existing cohort study completed standard neurocognitive tests and a CANTAB battery. A total of 160 were normal aging, 46 diagnosed with Mild Cognitive Impairment (MCI), and one diagnosed with Dementia. Older adults with MCI and Dementia were not included in the calculation of norms but were included in other analyses. For the CANTAB battery, regression-based norms were generated for each CANTAB measure, with age, sex, and education included as covariates. Concurrent validity was examined by correlating the CANTAB measures with their traditional neurocognitive counterparts. RESULTS As expected, performance across most CANTAB measures declined significantly with increasing age and decreasing education levels. There were no significant effects of sex on most CANTAB measures. Our study also showed that some CANTAB measures demonstrated good concurrent validity as they significantly correlated with their traditional neurocognitive test counterparts. CONCLUSIONS We have developed age, sex, and education-specific CANTAB norms for use in the local aging context. The advantages and challenges of using the CANTAB in the local aging context are discussed.
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Affiliation(s)
- Savannah K H Siew
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549
| | - Madeline F Y Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549.,Psychology, School of Social Sciences, Nanyang Technological University, Singapore 639818
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Shorey S, Kua EH, Tam W, Chan V, Goh YS, Lim HM, Lim LHK, Tian CS, Mahendran R. "Where-There-Is-No-Psychiatrist Integrated Personal Therapy" among Community-Dwelling Older Adults: A Randomized Pilot Study. Int J Environ Res Public Health 2021; 18:ijerph18189514. [PMID: 34574438 PMCID: PMC8468930 DOI: 10.3390/ijerph18189514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 01/07/2023]
Abstract
In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (W.T.); (V.C.); (Y.S.G.)
- Correspondence: ; Tel.: +65-66011294; Fax: 65-67767135
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.H.K.); (C.S.T.); (R.M.)
| | - Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (W.T.); (V.C.); (Y.S.G.)
| | - Valerie Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (W.T.); (V.C.); (Y.S.G.)
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (W.T.); (V.C.); (Y.S.G.)
| | - Hong Meng Lim
- Department of Physiology, National University of Singapore, Singapore 117593, Singapore; (H.M.L.); (L.H.K.L.)
| | - Lina Hsiu Kim Lim
- Department of Physiology, National University of Singapore, Singapore 117593, Singapore; (H.M.L.); (L.H.K.L.)
| | - Cheong Sing Tian
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.H.K.); (C.S.T.); (R.M.)
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.H.K.); (C.S.T.); (R.M.)
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Fong ZH, Tan SH, Mahendran R, Kua EH, Chee TT. Arts-based interventions to improve cognition in older persons with mild cognitive impairment: A systematic review of randomized controlled trials. Aging Ment Health 2021; 25:1605-1617. [PMID: 32643397 DOI: 10.1080/13607863.2020.1786802] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES As the global burden of dementia rises, the search for preventive measures such as interventions for mild cognitive impairment (MCI) remains a research priority. While arts-based interventions have demonstrated some success in improving cognitive functioning among older adults and those with dementia, its effectiveness for older persons with MCI remains unexplored. We conducted a systematic review to examine the effects of arts-based interventions on cognition in older persons with MCI. METHOD The following databases were searched in November 2019: PubMed, EMBASE, PsycINFO, and CINAHL Plus, supplemented by Google Scholar and ALOIS. Study inclusion criteria were older persons aged ≥ 60 with MCI; arts-based interventions such as dance, drama, music, or visual arts; and randomized controlled trial with cognitive outcome. Database search, study selection, and data extraction were conducted independently by 2 reviewers. RESULTS Eleven randomized controlled trials examining 13 interventions (817 participants) were identified, of which 4 involved visual arts, 4 dance/movement, 3 music, and 2 storytelling. Significant improvement on at least one cognitive outcome was reported in 10 of the 13 interventions. These included improvements in global cognition (6/7 interventions), learning and memory (5/9), complex attention (4/10), executive functioning (2/6), language (2/3), and perceptual-motor function (1/4). CONCLUSION This review found that arts-based interventions can potentially improve various aspects of cognitive functioning in older persons with MCI, although our confidence was dampened by methodological limitations such as the moderate-to-high risk of bias present in studies and heterogeneity in the way MCI was defined. Recommendations for future research are discussed.
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Affiliation(s)
- Zhi Hui Fong
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ser Hong Tan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore.,Academic Development Department, Duke-NUS Medical School, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
| | - Tji Tjian Chee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
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Yu J, Rawtaer I, Feng L, Kua EH, Mahendran R. The functional and structural connectomes associated with geriatric depression and anxiety symptoms in mild cognitive impairment: Cross-syndrome overlap and generalization. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110329. [PMID: 33865926 DOI: 10.1016/j.pnpbp.2021.110329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Geriatric depression and anxiety disorders often manifest as neuropsychiatric symptoms among those with mild cognitive impairment. Both tend to co-occur, and overlap in symptomology and etiology. Such commonalities are likely to be reflected in the brain as common neural correlates. Using connectome-based predictive modeling (CPM), we examined the functional and structural connectomes predicting depression and anxiety symptoms, and subsequently the overlap and cross-syndrome generalization of the connectomes associated with either disorder. Ninety-one older adults completed self-reported measures of depression and anxiety, and underwent diffusion tensor imaging and resting-state functional magnetic resonance imaging. Functional connectivity (FC) and structural connectivity (SC) matrices were derived from these scans and, in various combinations, entered into CPM models to predict either type of symptoms. Leave-one-out cross-validation was performed. Predictive accuracy was assessed via the correlation between predicted and observed scores (ρpredicted-observed). While FC or SC features alone significantly predicted either type of symptoms, these symptoms were best predicted by models that consisted of both FC and SC features (depression: ρpredicted-observed = 0.497; anxiety: ρpredicted-observed = 0.455). The features common to depression and anxiety were identified and entered into another model which was similarly accurate in predicting either type of symptoms. Moreover, cross-syndrome generalization was observed- the depression-associated features significantly predicted anxiety symptoms (ρpredicted-observed = 0.403) and vice-versa (ρpredicted-observed = 0.378). These FC and SC features are complementary biomarkers of geriatric depression and anxiety symptoms. Both types of symptoms are largely underpinned by common patterns of altered FC and SC, alluding to the transdiagnostic neurobiological susceptibility in both disorders.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore.
| | - Iris Rawtaer
- Department of Psychological Medicine, Sengkang General Hospital, 110 Sengkang E way, 544886, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
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Yang WFZ, Lee RZY, Kuparasundram S, Tan T, Chan YH, Griva K, Mahendran R. Cancer caregivers unmet needs and emotional states across cancer treatment phases. PLoS One 2021; 16:e0255901. [PMID: 34379667 PMCID: PMC8357113 DOI: 10.1371/journal.pone.0255901] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022] Open
Abstract
Study objective To investigate the association between family cancer caregivers’ unmet daily needs and emotional states of depression, anxiety and stress across their care recipient’s treatment phases. Method A cross-sectional study design and self-report questionnaires were used. Family caregivers (N = 237) of cancer patients in ambulatory cancer clinics were recruited from May to December 2017, and completed a sociodemographic and medical questionnaire, the Depression Anxiety Stress Scale and Needs Assessment of Family Caregivers-Cancer Scale. Hierarchical linear regression was conducted to examine the influence of each predictor (sociodemographic variables, unmet personal care and role management needs, cancer treatment phase) on the Depression Anxiety Stress Scale total score, depression subscale, anxiety subscale, and the stress subscale. Results Family caregivers’ unmet daily activity needs, in particular higher unmet personal care needs, during the intermediate phase (6–9 months), were significantly associated (ps<0.05) with overall distress (b = 4.93) and stress (b = 2.26). In the chronic treatment phase (>9 months), the significant association of unmet personal care needs was with overall distress (b = 5.91), anxiety (b = 1.97) and stress (b = 2.53). After completing treatment, unmet role management needs were only significantly associated with stress (b = -1.59). Caregivers’ higher depression was also associated with greater unmet role management needs, regardless of treatment phases. Conclusions Intermediate and chronic cancer treatment phases were identified as having greatest effect on caregivers’ unmet daily activity needs and emotions. Unmet personal care needs played the major effect on overall negative emotional states in the intermediate treatment phase and stress in the chronic treatment phase. Close attention to caregivers needs in intermediate and chronic treatment phases, would be highly beneficial in alleviating negative emotional disturbances.
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Affiliation(s)
- Winson Fu Zun Yang
- National University of Singapore, Singapore, Singapore
- Department of Psychological Science, College of Arts and Sciences, Texas Tech University, Lubbock, Texas, United States of America
| | | | | | - Terina Tan
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | | | - Konstadina Griva
- Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, Singapore, Singapore
| | - Rathi Mahendran
- National University of Singapore, Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- * E-mail:
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Yu J, Mahendran R. COVID-19 lockdown has altered the dynamics between affective symptoms and social isolation among older adults: results from a longitudinal network analysis. Sci Rep 2021; 11:14739. [PMID: 34282245 PMCID: PMC8289844 DOI: 10.1038/s41598-021-94301-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/06/2021] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 lockdown has drastically limited social interactions and brought about a climate of fear and uncertainty. These circumstances not only increased affective symptoms and social isolation among community dwelling older adults but also alter the dynamics between them. Using network analyses, we study the changes in these dynamics before and during the lockdown. Community-dwelling older adults (N = 419) completed questionnaires assessing depression, anxiety, and social isolation, before the COVID-19 pandemic, as part of a cohort study, and during the lockdown period. The total scores of these questionnaires were compared across time. For the network analyses, partial correlation networks were constructed using items in the questionnaires as nodes, separately at both timepoints. Changes in edges, as well as nodal and bridge centrality were examined across time. Depression and anxiety symptoms, and social isolation had significantly increased during the lockdown. Significant changes were observed across time on several edges. Greater connectivity between the affective and social isolation nodes at lockdown was observed. Depression symptoms have become more tightly coupled across individuals, and so were the anxiety symptoms. Depression symptoms have also become slightly decoupled from those of anxiety. These changing network dynamics reflect the greater influence of social isolation on affective symptoms across individuals and an increased vulnerability to affective disorders. These findings provide novel perspectives and translational implications on the changing mental health context amidst a COVID-19 pandemic situation.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore.
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore, Singapore.
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Ng TKS, Gan DRY, Mahendran R, Kua EH, Ho RCM. Social connectedness as a mediator for horticultural therapy's biological effect on community-dwelling older adults: Secondary analyses of a randomized controlled trial. Soc Sci Med 2021; 284:114191. [PMID: 34271401 DOI: 10.1016/j.socscimed.2021.114191] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Elevated levels of inflammatory marker and a lack of social connectedness are two prominent risk factors for developing dementia and depression. Horticultural therapy (HT) has been shown to improve social connectedness and inflammatory markers. However, the underpinning mechanisms of HT remained unknown. Within this study, we hypothesized that improved social connectedness mediates the effects of HT on IL-6 levels. METHODS The present study is a secondary analysis of a randomized controlled trial investigating the bio-psycho-social effects of HT. Social connectedness was operationalized as positive relationships with others (PRWO), a sub-scale of the Ryff's scale of psychological well-being. IL-6 was quantified using a commercial ELISA kit. Outcomes were assessed at baseline, 3-month and 6-month post-intervention. Mediation analyses with bootstrapping were run to investigate our primary hypothesis. All analyses were controlled for covariates. RESULTS We recruited 59 participants (78% women; 67.10 ± 4.31 years). 29 participants partook in HT and 30 participants were included in the waitlist control group. At baseline, social connectedness was significantly correlated with IL-6 levels (β = -0.12, 95% CI = -0.21 to -0.03, p = 0.008). Furthermore, social connectedness at 3-month significantly mediated the effects of HT on IL-6 levels at 6-month (β = 0.32, 95% CI = 0.09 to 0.54, p = 0.005; β = -0.25, 95% CI = -0.45 to -0.05, p = 0.016). CONCLUSIONS These findings highlight the critical roles of social connectedness as a social determinant of health in eliciting HT's biological effects. When administering HT, interventionalists should consider social connectedness as a modifiable factor for ameliorating increased inflammation in older adults.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore.
| | - Daniel R Y Gan
- Real Estate Foundation Postdoctoral Fellow at the Gerontology Research Centre, Simon Fraser University, #2800-515 West Hastings St, Vancouver, B.C, V6B 5K3, Canada
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore
| | - Roger C-M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore; Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore
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Lim XY, Yap AC, Mahendran R, Yu J. The interplay between anxiety, fear, protective behaviors, compassion, and resilience among older adults during a COVID-19 lockdown: a structural equation modeling study. Transl Behav Med 2021; 11:1172-1178. [PMID: 33793946 PMCID: PMC8139136 DOI: 10.1093/tbm/ibaa143] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The implementation of lockdown measures to curb the transmission of Coronavirus
disease-2019 (COVID-19) has brought about significant psychological impacts and older
adults have been identified as one of the vulnerable groups. In the current COVID-19
context among older adults in the community, the fear of COVID-19, anxiety symptoms,
compassion, resilience, and the practice of protective behaviors are possibly related to
each other in several ways. How these factors relate to each other would have important
implications in managing the spread of the disease and its mental health consequences. To
this end, we modeled their interrelationships using a structural equation model. Older
adults (N = 421), aged 60 and above completed various
questionnairesCOVID-19 Fear Inventory, Short form of the Geriatric Anxiety Inventory,
COVID-19 Risky and Protective Behaviours, Resilience Appraisals Scale, and Compassion
Scale during a COVID-19 lockdown. The relationships between these variables were assessed
within a structural equation model. The findings showed that older adults who are more
compassionate engage in protective behaviors more frequently. Additionally, frequent
practice of protective behaviors and greater resilience predicted lower anxiety among
older adults. Greater fear predicted higher anxiety levels but did not significantly
influence an individuals engagement in protective behaviors. Mental health services are
crucial in fostering resilience and supporting older adults psychologically. Social
services are also necessary in maintaining and enhancing social support for older adults.
Importantly, these findings suggest that public health communications could promote
compassion and avoid using a fear-based approach to increase engagement in protective
behaviors. This study focused on the interrelations between various psychosocial factors (i.e., fear
of COVID-19, compassion, and resilience) and the behavioral (i.e., engagement in
protective health behaviors) and psychological responses (i.e., anxiety) to COVID-19 among
community-dwelling older adults. The study analyzed self-reported data from 421 older
adults who are aged 60 and above. The findings showed that older adults who are more
compassionate engage in protective behaviors more frequently. Additionally, older adults
who showed greater resilience and engage in protective health behaviors more frequently
reported lower anxiety levels. Lastly, greater fear of COVID-19 predicted greater anxiety
among older adults but did not significantly influence their engagement in protective
health behaviors.
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Affiliation(s)
- Xin Ying Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ai Che Yap
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Academic Development Department, Duke-NUS Medical School, Singapore
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Arokiamary B, Russell V, Lim HA, Koay JM, Xia J, Zhao XH, Xu X, Wu DX, Chen JX, Kua EH, Mahendran R. Educational environments in Asian medical schools: A cross-national comparison between Malaysia, Singapore, and China. Asia Pac Psychiatry 2021; 13:e12454. [PMID: 33646626 DOI: 10.1111/appy.12454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 01/09/2021] [Accepted: 02/15/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Perceptions of the educational environment (EE) represent an important source of information on medical students' learning experience. Understanding and addressing these perceptions can help inform initiatives designed to improve the learning experience and educational outcomes, while comparison of student perceptions across medical schools can provide an added perspective. The aim of the study was to compare the EEs of three Asian medical schools: Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Yong Loo Lin School of Medicine, Singapore and Xiangya School of Medicine, China. METHODS Medical students in the clinical years (N = 1063) participated in a cross-sectional study using the Dundee Ready Educational Environment Measure (DREEM). Data were analyzed using SPSS version 22. RESULTS There were significant differences between the three medical schools in the total DREEM scores (F [2, 1059] = 38.29, p < .001), but all were in the category "more positive than negative" (mean score 135.42, range 128.97-142.44). Highest DREEM scores were noted in year 5 at RUMC (139.79 ± 79), year 3 at YLL (145.93 ± 14.52), and year 4 at XSM (138.56 ± 18.91). Variations in total and subscale DREEM scores were also found between clinical years in each medical school. DISCUSSION Total DREEM scores at the three medical schools are similar to those reported from other undergraduate settings. However, significant variations occurred in perceptions of the EE, as students progressed through the clinical years. Greater attention to the learning environment and the curriculum may improve students' educational experience.
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Affiliation(s)
- Bharathy Arokiamary
- Department of Psychiatry, Royal College of Surgeons Ireland & University College Dublin Malaysia Campus, George Town, Malaysia
| | - Vincent Russell
- Department of Psychiatry, Royal College of Surgeons Ireland & University College Dublin Malaysia Campus, George Town, Malaysia.,Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Haikel Asyraf Lim
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Department of Academic Development, Duke-NUS Medical School, Singapore, Singapore
| | - Jun Min Koay
- School of Pre-University Studies, DISTED College Penang, George Town, Malaysia
| | - Jie Xia
- Medical Psychological Institute, Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiao-Hua Zhao
- Medical Psychological Institute, Second Xiangya Hospital of Central South University, Changsha, China
| | - Xin Xu
- Medical Psychological Institute, Second Xiangya Hospital of Central South University, Changsha, China
| | - Da-Xing Wu
- Medical Psychological Institute, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun-Xiang Chen
- Medical Psychological Institute, Second Xiangya Hospital of Central South University, Changsha, China
| | - Ee Heok Kua
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Department of Academic Development, Duke-NUS Medical School, Singapore, Singapore
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Ng TKS, Slowey PD, Beltran D, Ho RCM, Kua EH, Mahendran R. Effect of mindfulness intervention versus health education program on salivary Aβ-42 levels in community-dwelling older adults with mild cognitive impairment: A randomized controlled trial. J Psychiatr Res 2021; 136:619-625. [PMID: 33199051 DOI: 10.1016/j.jpsychires.2020.10.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Few randomized controlled trials have investigated the effects of mindfulness intervention on older adults diagnosed with mild cognitive impairment (MCI). Specifically, scarce literature exists on the potential benefits of mindfulness intervention on biomarkers representing AD hallmarks. Our previous studies showed the potential of Mindful Awareness Practice (MAP) in improving multiple biomarkers of gut microbiota, systemic inflammation, and synaptic functions. Extending these findings, in this study, we conducted analysis on bio-banked saliva samples, examining whether MAP improved salivary amyloid beta-42 (Aβ-42) levels in community-dwelling older adults diagnosed with MCI. We also explored the moderating role of education level, an indicator of cognitive reserve, on intervention effect. METHODS A total of 55 community-dwelling older adults diagnosed with MCI were randomized into either the treatment arm, MAP, or the active control arm, the health education program (HEP). Interventions were performed for a total of nine months. Field and laboratory investigators who were blinded to the treatment allocations collected saliva samples at baseline, 3-month, and 9-month follow-ups. Salivary Aβ-42 levels were quantified using a commercial assay. Linear-mixed models were used to examine the effect of MAP on salivary Aβ-42 levels. RESULTS Compared to the HEP arm, MAP participants had no significantly modified Aβ-42 levels throughout the 9-month intervention period, regardless of subgroup analyses stratified by either sex or MCI-subtypes (amnestic and non-amnestic). Exploring the moderating effect of education, participants in the HEP arm with higher education levels had significantly lower salivary Aβ-42 at 3-month time-point. DISCUSSION Taken together with our previous findings and other mindfulness interventional studies failing to find a significant effect on peripheral Aβ-42, we conclude the non-significant effects of mindfulness intervention on ameliorating peripheral Aβ-42 levels. Conversely, participants in the HEP arm with higher cognitive reserve had significantly improved salivary Aβ-42, highlighting the role of cognitive reserve in moderating treatment response in MCI.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, National University of Singapore, Singapore.
| | - Paul D Slowey
- Oasis Diagnostics® Corporation, Vancouver, WA, USA; Central South University, Changsha, China
| | | | - Roger C M Ho
- Department of Psychological Medicine, National University Hospital, Singapore; Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore; Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Faculty of Education, Huaibei Normal University, Vietnam, China
| | - Ee Heok Kua
- Department of Psychological Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore
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Han MFY, Mahendran R, Yu J. Associations Between Fear of COVID-19, Affective Symptoms and Risk Perception Among Community-Dwelling Older Adults During a COVID-19 Lockdown. Front Psychol 2021; 12:638831. [PMID: 33833722 PMCID: PMC8021922 DOI: 10.3389/fpsyg.2021.638831] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/04/2021] [Indexed: 01/11/2023] Open
Abstract
Fear is a common and potentially distressful psychological response to the current COVID-19 pandemic. The factors associated with such fear remains relatively unstudied among older adults. We investigated if fear of COVID-19 could be associated with a combination of psychological factors such as anxiety and depressive symptoms, and risk perception of COVID-19, and demographic factors in a community sample of older adults. Older adults (N = 413, M age = 69.09 years, SD = 5.45) completed measures of fear of COVID-19, anxiety and depressive symptoms, and risk perception of COVID-19, during a COVID-19 lockdown. These variables, together with demographics, were fitted to a structural equation model. Anxiety and depressive symptoms were highly correlated with each other and were combined into the higher order latent variable of affective symptoms for analyses. The final model revealed that fear of COVID-19 was positively associated with psychological factors of affective symptoms and risk perception. Older age was associated with greater fear of COVID-19. Our findings showed that fear of COVID-19 can be a projection of pre-existing affective symptoms and inflated risk perceptions and highlighted the need to address the incorrect risk perceptions of COVID-19 and socio-affective issues among older adults in the community.
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Affiliation(s)
- Madeline F. Y. Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, Singapore, Singapore
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Yu J, Rawtaer I, Feng L, Fam J, Kumar AP, Kee-Mun Cheah I, Honer WG, Su W, Lee YK, Tan EC, Kua EH, Mahendran R. Mindfulness intervention for mild cognitive impairment led to attention-related improvements and neuroplastic changes: Results from a 9-month randomized control trial. J Psychiatr Res 2021; 135:203-211. [PMID: 33497874 DOI: 10.1016/j.jpsychires.2021.01.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 12/23/2020] [Accepted: 01/16/2021] [Indexed: 01/18/2023]
Abstract
Mindfulness-based interventions can enhance cognitive abilities among older adults, thereby effectively delaying cognitive decline. These cognitive enhancements are theorized to accompany neuroplastic changes in the brain. However, this mindfulness-associated neuroplasticity has yet to be documented adequately. A randomized controlled trial was carried out among participants with mild cognitive impairment (MCI) to examine the effects of a mindfulness-based intervention on various cognitive outcomes and cortical thickness (CT) in the context of age-related cognitive impairment. Participants were assigned to a mindfulness awareness program (MAP)(n = 27) and an active control condition - health education program (n = 27). In both, they attended weekly sessions for three months and subsequently, monthly sessions for six months. Cognitive assessments and structural scans were carried out across three time-points. Whole brain analyses on CT were carried out and were supplemented with region of interest-based analyses. ROI values and cognitive outcomes were analyzed with mixed MANOVAs and followed up with univariate ANOVAs. Nine-month MAP-associated gains in working memory span and divided attention, along with an increased CT in the right frontal pole and decreased CT in the left anterior cingulate were observed. Three-month MAP-associated CT increase was observed in the left inferior temporal gyrus but did not sustain thereafter. MAP led to significant cognitive gains and various CT changes. Most of these neurobehavioral changes, may require sustained effort across nine months, albeit at a reduced intensity. MAP can remediate certain cognitive impairments and engender neuroplastic effects even among those with MCI.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Iris Rawtaer
- Department of Psychiatry, Sengkang General Hospital, Singhealth Duke-Nus Academic Medical Centre, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Johnson Fam
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alan Prem Kumar
- Cancer Science Institute of Singapore, National University of Singapore, And Medical Science Cluster, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Irwin Kee-Mun Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Wayne Su
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Yuan Kun Lee
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University Hospital, Singapore
| | - Ene Choo Tan
- KK Research Laboratory, KK Women's and Children's Hospital, Singapore; SingHealth Duke-NUS Paediatrics Academic Clinical Program, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore.
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Han M, Tan XY, Lee R, Lee JK, Mahendran R. Impact of Social Media on Health-Related Outcomes Among Older Adults in Singapore: Qualitative Study. JMIR Aging 2021; 4:e23826. [PMID: 33595437 PMCID: PMC8294634 DOI: 10.2196/23826] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The worldwide spread of digitalization has led to the harnessing of technology to improve health outcomes. Paying attention to older adults' social needs via social media is one way to promote healthy aging. Although 56% of older adults are smartphone users, little is known about their use patterns of social media. OBJECTIVE This exploratory study aims to determine the experiences of social media apps' use among older adults in Singapore and understand their perceptions of its impact on health-related outcomes. METHODS This study used a qualitative research design with an interpretative approach. Using maximum variation purposive sampling, normal aging older adults (N=16) who were aged between 60 and 80 years and experienced in the use of internet-enabled technology were recruited from an existing community study. Semistructured, in-depth interviews were conducted. Employing a thematic analysis, interviews were transcribed verbatim and analyzed for codes inductively. RESULTS The following themes and subthemes were identified as key moderators of older adults' experiences on social media apps: (1) personal attitudes: participants were encouraged to use social media due to the increased accessibility, which enabled the ease of contact, but perceptions that the quality of interactions was compromised and its associated risks reduced their use; and (2) social influences: the desire to bond with co-users and the availability of support increased use. In addition, use of social media apps was perceived to positively impact health through its ability to keep older adults cognitively engaged, improve health communication, and increase social connectedness. However, opinions remained mixed on older adults' vulnerability to social media addiction. CONCLUSIONS Personal and social contexts determine older adults' social media use. This study's findings provide practical insights into how social media can be deployed to improve health-related outcomes in older adults.
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Affiliation(s)
- Madeline Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xin Yi Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rachael Lee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jeong Kyu Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, Singapore, Singapore
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Liu J, Mahendran R, Chong SA, Subramaniam M. Elucidating the Impact of Childhood, Adulthood, and Cumulative Lifetime Trauma Exposure on Psychiatric Symptoms in Early Schizophrenia Spectrum Disorders. J Trauma Stress 2021; 34:137-148. [PMID: 33096583 DOI: 10.1002/jts.22607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/18/2020] [Accepted: 08/31/2020] [Indexed: 12/30/2022]
Abstract
Cumulative lifetime trauma has a profound impact on the development of schizophrenia spectrum disorders. However, few studies have determined participants' most distressing (i.e., "worst") life event in childhood or adulthood or examined whether this event contributes to poorer clinical outcomes. The present study aimed to (a) determine the associations between the worst life event and demographic/clinical variables and (b) examine the associations between the worst life event and psychiatric symptoms (i.e., positive, negative, depressive, and anxiety symptoms). Participants (N = 150) were outpatients newly diagnosed with schizophrenia spectrum disorders who were assessed for lifetime trauma exposure, positive and negative symptoms of schizophrenia, and symptoms of depression and anxiety. Multinomial logistic regression analysis was conducted to examine the associations between demographic and clinical variables and worst life events (none, childhood, or adulthood). Multiple linear regression analyses were performed to examine the associations between worst life events and psychiatric symptoms. More participants reported that their worst life event occurred during adulthood (31.1%) than childhood (21.3%). Adulthood trauma was associated with male gender, older age, non-Chinese ethnicity, and psychiatric comorbidities; childhood trauma was associated with a family history of depression/anxiety. Adulthood trauma was significantly associated with more severe positive psychotic symptoms, f2 = 0.19, whereas childhood and adulthood trauma exposure were both significantly associated with more severe depressive and anxiety symptoms, f2 s = 0.19 and 0.25, respectively. Our findings underscore the importance of conducting assessments for worst life events and the associated risk factors to develop meaningful formulations and appropriate trauma-focused treatment plans.
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Affiliation(s)
- Jianlin Liu
- Research Division, Institute of Mental Health, Singapore.,Department of Psychological Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore.,Academic Development Department, Duke-National University of Singapore Medical School, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Ng TKS, Tagawa A, Ho RCM, Larbi A, Kua EH, Mahendran R, Carollo JJ, Heyn PC. Commonalities in biomarkers and phenotypes between mild cognitive impairment and cerebral palsy: a pilot exploratory study. Aging (Albany NY) 2021; 13:1773-1816. [PMID: 33497355 PMCID: PMC7880365 DOI: 10.18632/aging.202563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
Clinically, individuals with cerebral palsy (CP) experience symptoms of accelerated biological aging. Accumulative deficits in both molecular underpinnings and functions in young adults with CP can lead to premature aging, such as heart disease and mild cognitive impairment (MCI). MCI is an intermediate stage between healthy aging and dementia that normally develops at old age. Owing to their intriguingly parallel yet “inverted” disease trajectories, CP might share similar pathology and phenotypes with MCI, conferring increased risk for developing dementia at a much younger age. Thus, we examined this hypothesis by evaluating these two distinct populations (MCI= 55, CP = 72). A total of nine measures (e.g., blood biomarkers, neurocognition, Framingham Heart Study Score (FHSS) were compared between the groups. Compared to MCI, upon controlling for covariates, delta FHSS, brain-derived neurotrophic factor (BDNF) levels, and systolic blood pressure were significantly lower in CP. Intriguingly, high-sensitivity CRP, several metabolic outcomes, and neurocognitive function were similar between the two groups. This study supports a shared biological underpinning and key phenotypes between CP and MCI. Thus, we proposed a double-hit model for the development of premature aging outcomes in CP through shared biomarkers. Future longitudinal follow-up studies are warranted to examine accelerated biological aging.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Alex Tagawa
- Children's Hospital Colorado, Center for Gait and Movement Analysis (CGMA), Aurora, CO 80045, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Roger Chun-Man Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore.,Biomedical Global Institute of Healthcare Research and Technology (BIGHEART), National University of Singapore, Singapore, Singapore.,Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.,Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Anis Larbi
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore.,Academic Development Department, Duke-NUS Medical School, Singapore, Singapore
| | - James J Carollo
- Children's Hospital Colorado, Center for Gait and Movement Analysis (CGMA), Aurora, CO 80045, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Patricia C Heyn
- Children's Hospital Colorado, Center for Gait and Movement Analysis (CGMA), Aurora, CO 80045, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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48
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Wong GCL, Ng TKS, Lee JL, Lim PY, Chua SKJ, Tan C, Chua M, Tan J, Lee S, Sia A, Ng MKW, Mahendran R, Kua EH, Ho RCM, Larbi A. Horticultural Therapy Reduces Biomarkers of Immunosenescence and Inflammaging in Community-Dwelling Older Adults: A Feasibility Pilot Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2021; 76:307-317. [PMID: 33070170 PMCID: PMC7812436 DOI: 10.1093/gerona/glaa271] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND With the challenges that aging populations pose to health care, interventions that facilitate alleviation of age-related morbidities are imperative. A prominent risk factor for developing age-related morbidities is immunosenescence, characterized by increased chronic low-grade inflammation, resulting in T-cell exhaustion and senescence. Contact with nature and associated physical activities have been shown to boost immunity in older adults and may be promoted in the form of horticultural therapy (HT). We aimed to examine the effects of HT on immunosenescence. METHOD We conducted a randomized controlled trial with 59 older adults assigned to either the HT intervention or waitlist control group. Older adults in the HT intervention group underwent HT intervention program over 6 months. Venous blood was drawn at baseline and at the third and sixth month from the commencement of this study. For participants who attended all 3 blood collection time points (HT: n = 22; waitlist: n = 24), flow cytometry analysis was performed on whole blood samples to evaluate the kinetics of lymphocyte subsets over the intervention period, revealing the composition of CD4+ and CD8+ subsets expressing exhaustion markers-CD57, CTLA4, and KLRG1. Enzyme-linked immunosorbent assays were employed to measure changes in plasma IL-6 levels. RESULTS HT is associated with increased numbers of naive CD8+ T cells and fewer CTLA4-expressing terminally differentiated effector CD4+ and CD8+ memory T cells re-expressing CD45RA (TEMRA). Furthermore, IL-6 levels were reduced during HT, and the frequencies of naive and TEMRA CD8+ T cells were found to be associated with IL-6 levels. CONCLUSION HT is associated with a reduction in the levels of biomarkers that measure the extent of T-cell exhaustion and inflammaging in older adults. The positive effects of HT on T-cell exhaustion were associated with the reduction of IL-6 levels.
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Affiliation(s)
| | - Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
| | - Jia Le Lee
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Pei Yi Lim
- Department of Biological Sciences, Singapore Polytechnic
| | | | - Crystal Tan
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Michelle Chua
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Janice Tan
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Samantha Lee
- Department of Biological Sciences, Singapore Polytechnic
| | - Angelia Sia
- Centre for Urban Greenery and Ecology Research, National Parks Board, Singapore
| | - Maxel K W Ng
- Horticulture & Community Gardening Division, National Parks Board, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Anis Larbi
- Singapore Immunology Network, Agency for Science, Technology and Research
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49
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Yang WFZ, Chan YH, Griva K, Kuparasundram S, Mahendran R. Lifestyle and Symptom Management Needs: A Network Analysis of Family Caregiver Needs of Cancer Patients. Front Psychiatry 2021; 12:739776. [PMID: 34616323 PMCID: PMC8488172 DOI: 10.3389/fpsyt.2021.739776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Previous research on the needs of family cancer caregivers (FCCs) have not elucidated associations between specific caregiving needs. Network analysis, a statistical approach that allows the estimation of complex relationship patterns, helps facilitate the understanding of associations between needs and provides the opportunity to identify and direct interventions at relevant and specific targets. No studies to date, have applied network analysis to FCC populations. The aim of the study is to explore the network structure of FCC needs in a cohort of caregivers in Singapore. FCCs (N = 363) were recruited and completed a self-report questionnaire on socio-demographic data, medical data on their loved ones, and the Needs Assessment of Family Caregivers-Cancer scale. The network was estimated using state-of-the-art regularized partial correlation model. The most central needs were having to deal with lifestyle changes and managing care-recipients cancer-related symptoms. The strongest associations were between (1) having enough insurance coverage and understanding/navigating insurance coverage, (2) managing cancer-related pain and managing cancer-related symptoms, (3) being satisfied with relationships and having intimate relationships, and (4) taking care of bills and paying off medical expenses. Lifestyle changes, living with cancer, and symptom management are central to FCCs in Singapore. These areas deserve special attention in the development of caregiver support systems. Our findings highlight the need to improve access to social and medical support to help FCCs in their transition into the caregiving role and handle cancer-related problems.
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Affiliation(s)
- Winson Fu Zun Yang
- Department of Psychological Science, Texas Tech University, Lubbock, TX, United States.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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50
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Feng L, Romero-Garcia R, Suckling J, Tan J, Larbi A, Cheah I, Wong G, Tsakok M, Lanskey B, Lim D, Li J, Yang J, Goh B, Teck TGC, Ho A, Wang X, Yu JT, Zhang C, Tan C, Chua M, Li J, Totman JJ, Wong C, Loh M, Foo R, Tan CH, Goh LG, Mahendran R, Kennedy BK, Kua EH. Effects of choral singing versus health education on cognitive decline and aging: a randomized controlled trial. Aging (Albany NY) 2020; 12:24798-24816. [PMID: 33346748 PMCID: PMC7803497 DOI: 10.18632/aging.202374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 11/20/2020] [Indexed: 11/25/2022]
Abstract
We conducted a randomized controlled trial to examine choral singing’s effect on cognitive decline in aging. Older Singaporeans who were at high risk of future dementia were recruited: 47 were assigned to choral singing intervention (CSI) and 46 were assigned to health education program (HEP). Participants attended weekly one-hour choral singing or weekly one-hour health education for two years. Change in cognitive function was measured by a composite cognitive test score (CCTS) derived from raw scores of neuropsychological tests; biomarkers included brain magnetic resonance imaging, oxidative damage and immunosenescence. The average age of the participants were 70 years and 73/93 (78.5%) were female. The change of CCTS from baseline to 24 months was 0.05 among participants in the CSI group and -0.1 among participants in the HEP group. The between-group difference (0.15, p=0.042) became smaller (0.12, p=0.09) after adjusting for baseline CCTS. No between-group differences on biomarkers were observed. Our data support the role of choral singing in improving cognitive health in aging. The beneficial effect is at least comparable than that of health education in preventing cognitive decline in a community of elderly people. Biological mechanisms underlying the observed efficacy should be further studied.
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Affiliation(s)
- Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Centre for Healthy Longevity, National University Health System, Singapore, Singapore
| | | | - John Suckling
- Department of Psychiatry, University of Cambridge, UK
| | - Jasmine Tan
- Department of Psychology, Goldsmiths, University of London, UK
| | - Anis Larbi
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | - Irwin Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Glenn Wong
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | | | - Bernard Lanskey
- Yong Siew Toh Conservatory of Music, National University of Singapore, Singapore
| | - Darius Lim
- Darius Lim, Voices of Singapore Choral Society, Singapore
| | - Jialiang Li
- Department of Statistics and Applied Probability, Faculty of Science, National University of Singapore, Singapore
| | - Joanna Yang
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Benjamin Goh
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Allan Ho
- NTUC Health Co-operative Limited, Singapore
| | - Xiu Wang
- Beijing Chui Yang Liu Hospital, Beijing, PR China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Can Zhang
- Genetics and Aging Research Unit, McCance Center for Brain Health, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Crystal Tan
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | - Michelle Chua
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | - Junhua Li
- School of Computer Science and Electronic Engineering, University of Essex, UK
| | - John J Totman
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Caroline Wong
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marie Loh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
| | - Roger Foo
- Cardiovascular Research Institute, National University Health Systems, Singapore.,Genome Institute of Singapore, Singapore
| | - Chay Hoon Tan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lee Gan Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Academic Development Department, Duke-NUS Medical School, Singapore
| | - Brian K Kennedy
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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