Relationships between physical activity, sleep and cognitive function: A narrative review

Physical health correlates of co-occurring chronic pain and PTSD Among U.S. Veterans: Results from a nationally representative study

Co-occurring chronic pain and posttraumatic stress disorder (PTSD) affects between 4%-8% of the U.S. veteran population. A large body of research has documented the psychosocial burden of the co-occurrence, but fewer studies have examined physical health conditions and functioning. The current study aimed to address this gap by examining physical health conditions and functioning of co-occurring chronic pain and PTSD. Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4,069 (age=62.2 years) U.S. veterans in 2019-2020. The sample was predominantly male (N = 3,564; 90.2%) and non-Hispanic White (N = 3,318; 78.0%). PTSD diagnoses were determined using the PTSD Checklist for DSM-5 and chronic pain and other physical health conditions using self-report and validated measures. Logistic regression analyses revealed that veterans with co-occurring chronic pain and PTSD were generally more likely to have a physical health condition (ORs 2.79-9.53) or a cognitive disorder (OR=16.55) relative to controls (ORs 2.79-9.53). ANCOVA analyses revealed that relative to veterans with chronic pain or PTSD only, those with both chronic pain and PTSD had worse physical functioning across several domains (ds=0.32-1.13). Results underscore the importance of approaching co-occurring chronic pain and PTSD using a whole person approach to care that targets both physical and mental health concerns.

Chain-mediation effect of cognitive flexibility and depression on the relationship between physical activity and insomnia in adolescents

BACKGROUND

Physical activity has positive benefits in promoting the physical and mental health of adolescents. This study focuses on the importance of adolescent mental health issues, exploring the relationship between physical activity and insomnia in adolescents, as well as the mediating roles and pathways of cognitive flexibility and depression.

METHODS

A cross-sectional study was conducted using self-reports to collect data on physical activity, insomnia, cognitive flexibility, and depression. A total of 501 valid questionnaires were collected from two middle schools in the western region of Hunan Province.

RESULTS

Physical activity directly and significantly predicted insomnia negatively (β =-0.153, SE = 0.047, p < 0.01). However, the predictive effect of physical activity on insomnia was no longer significant in the indirect effect analysis (β =-0.053, SE = 0.041, p > 0.05). Serial mediation analyses identified significant indirect effects through cognitive flexibility and depression in sequence (β =-0.029, 95% CI [-0.053,-0.011]), accounting for 18.95% of the total effect.

CONCLUSIONS

The study strengthens evidence for the associations between adolescent physical activity, insomnia, cognitive flexibility and depression, demonstrating that the beneficial effects of physical activity on insomnia are sequentially mediated through cognitive flexibility and depression. Given the dual benefits of physical activity for both sleep quality and mental health, we recommend implementing targeted physical activity interventions for adolescents, with particular emphasis on activities designed to enhance cognitive flexibility.

Correlation between physical activity levels and the risk of cognitive impairment in Chinese older adults

Objective

To analyze the correlation between the level of physical activity and the risk of cognitive impairment in Chinese older adults aged 60 years and above, and to provide correlational evidence for the development of targeted strategies to prevent cognitive impairment.

Methods

This study used five rounds of longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2020, which included 3,583 older adults aged 60 years and above. Multiple regression models were employed to evaluate the association between varying intensities of physical activity (low-intensity, moderate-intensity, and high-intensity) and the risk of developing cognitive impairment (HR).

Results

In models that were not adjusted for any variables, the risk of cognitive impairment was reduced by 25.3% in the moderate-intensity physical activity group compared to the low-intensity group (HR = 0.747, 95%CI: 0.617-0.903), and by 11.0% in the high-intensity group (HR = 0.890, 95%CI: 0.798-0.992). In the model that fully controlled for all confounding variables, the risk ratio was further reduced to 30.7% (HR = 0.693, 95%CI: 0.571-0.841) in the moderate-intensity physical activity group and 9.7% (HR = 0.903, 95% CI: 0.809-1.007) in the high-intensity group. Dose-response analysis revealed an optimal strength of association between moderate-intensity physical activity (approximately 2,800 MET-minutes per week) and cognitive health.

Conclusion

Moderate-intensity physical activity can significantly reduce the risk of cognitive impairment among older adults in China. It is recommended that health management and cognitive impairment prevention strategies for this population incorporate moderate-intensity physical activity.

Green spaces, blue spaces and human health: an updated umbrella review of epidemiological meta-analyses

Introduction

Green spaces have been recognized for their ecological services, including air purification and biodiversity protection, which contribute to the enhancement of life quality and well-being. However, despite the surge in research evaluating the impact of blue-green spaces on health outcomes, we still lack a definitive understanding of how green and blue spaces affect human health outcomes. To assess the impact of blue-green spaces on human health outcomes, we systematically summarized and evaluated the relationship between green and blue spaces and human health through an umbrella review of epidemiological meta-analyses up to the year 2024.

Methods

The study follows the PRISMA guidelines and includes meta analyses from PubMed, Embase, and Cochrane databases, focusing on evidence and methodological improvements. Inclusion criteria encompass studies on human populations, exposure to green and blue spaces, and health outcomes such as mortality, disease risk, and physiological indicators. Data extraction and quality assessment of evidence and methods are conducted using the GRADE system and AMSTAR 2 tool.

Results

We find that green space exposure is associated with reduced all-cause mortality, mortality from cardiovascular diseases, incidence of diabetes and metabolic syndrome, low birth weight, and mental health improvements. Blue spaces also show positive associations with beneficial health outcomes, including reduced obesity rates and improved psychological well-being. However, the evidence regarding green space exposure and specific health outcomes such as cancer, asthma, and allergic rhinitis remains heterogeneous and unclear.

Discussion

Green and blue spaces clearly have some impact on health. For some outcomes, the effects are robust. This article emphasizes the importance of improving residents' health through urban planning in public health strategies.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42024533346].

Mediating Effects of Executive Function on the Relationship between Sleep Problems and Emotional and Behavioral Problems among Preschoolers: Physical Activity as a Protective Factor

This study investigated three waves of data from the Anhui Preschool Children Cohort study, with a total of 1,987 mother-child dyads participating. The questionnaires on sleep problems (Wave 1), executive function (EF) (Wave 2), physical activity (PA) (Wave 2), and emotional and behavioral problems (EBPs) (Wave 1 & Wave 3) were assessed by the mothers of the children. Results showed that sleep problems, GEC (total executive dysfunction scores), and PA are all positively related to EBPs. After controlling for covariates, GEC partially mediated the association between sleep problems and EBPs (β = 0.015, 95%CI: 0.002-0.028). PA moderated the relationship between sleep problems and preschoolers' GEC (β = -0.06, P<0.05). These findings reveal the mediating role of executive dysfunction in the association between sleep problems and EBPs. It also highlights that targeted interventions to reduce sleep problems and increase PA could help reduce the risk of EBPs in preschoolers.

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

BACKGROUND AND AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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

Improving cognitive function in older adults through mind-body Qigong exercise at senior daycare centers: The role of sleep as a moderator and mediator

OBJECTIVES

Mind-body Qigong Baduanjin exercises benefit cognition in community-dwelling older adults, yet mechanisms are poorly understood. We aimed to examine the moderation and mediation roles of sleep on intervention effects in cognition.

METHODS

This 10-week trial included 78 (intervention: n = 47, control: n = 31) older Chinese adults at a daycare center. We measured the sleep quality, both subjective and objective cognition pre- and post-intervention. The intervention served as the independent variable and the post-pre changes in cognition were used as outcomes. Baseline sleep quality was examined as a moderator, while post-pre changes in sleep quality were considered as a mediator. We tested the interaction between intervention and the moderator using a linear regression model, with relevant covariates adjusted. Subgroup analyses were conducted for any potential interaction (p < 0.20). Mediation effects were analyzed through first modeling the effect of the independent variable on the mediator, and then modeling the effect of independent variable and the mediator on the outcome.

RESULTS

Compared to control, Qigong intervention significantly predicted improvements in subjective and objective cognition among older adults, particularly for poor sleepers but not good sleepers. Sleep improvements significantly mediated intervention effects on subjective cognition in participants with less daily exercise (indirect effect: β= -0.412, 95 % CI: [-0.910, -0.066]).

CONCLUSIONS

Qigong improved cognition in older Chinese, particularly those with sleep problems prior to the intervention. Sleep quality changes played a mediating role, especially in individuals with less exercise. Results shed light on future interventions in identifying targeted mediating/moderating factors of Qigong.

Digital cognitive behavioral therapy as a novel treatment for insomnia

BACKGROUND

As a substitute for traditional drug therapy, digital cognitive-behavioral therapy positively impacts the regulation of brain function, which can improve insomnia. However, there is currently a paucity of studies on digital cognitive behavioral therapy as a treatment for insomnia.

AIM

To assess digital cognitive behavioral therapy for insomnia regarding its positive impact on brain function.

METHODS

Participants were randomly assigned to either a go/no-go group or a dot-probe group. The primary outcome was quality of sleep as assessed by the actigraphy sleep monitoring bracelet, Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), and depression anxiety and stress scale (DASS-21).

RESULTS

Eighty patients were included in the analysis (go/no-go group: n = 40; dot-probe group: n = 40). We combined the total scale scores of the two groups before and after the intervention in the analysis of covariance. Our study explored whether insomnia symptoms in both groups can be improved by using digital cognitive behavioral therapy instead of trying to compare the two trials; therefore, only one P value is listed. In both groups, we found a short-term time effect on insomnia symptom severity (PSQI: P < 0.001, η 2 = 0.336; ISI: P < 0.001, η 2 = 0.667; DASS-depression: P < 0.001, η 2 = 0.582; DASS-anxiety: P < 0.001, η 2 = 0.337; DASS-stress: P < 0.001, η 2 = 0.443) and some effect on sleep efficiency (but it was not significant, P = 0.585, η 2 = 0.004).

CONCLUSION

Go/no-go task training of inhibitory function had a short-term positive effect on sleep efficiency, whereas dot-probe task training had a positive short-term effect on emotion regulation.

Enhancing Mental Health and Cognitive Functioning in Victims of Violence: Cognitive Behavioral Therapy for Sleep Disorders Among Journalists, Human Rights Defenders, and Relatives of Disappeared Persons in Mexico City

In Mexico, pervasive violence, forced disappearances, and homicides have deeply impacted certain groups, particularly journalists, activists, and human rights defenders, who are at high risk of victimization. While these groups receive state support for physical and legal safety, mental health and sleep-focused interventions remain insufficient. Collaborating with a Mexico City-based institution supporting human rights defenders and journalists, we conducted a psychometric assessment of 47 individuals affected by violence. Results showed that 80% exhibited symptoms of post-traumatic stress disorder, 25.5% showed depression, and 57.4% displayed anxiety; 95.7% reported poor sleep quality based on the Pittsburgh Sleep Quality Index. In a second phase, neuropsychological tests and polysomnographic recordings identified cognitive impairments in attention, memory, and decision-making in some participants, along with sleep disorders such as insomnia, primary snoring, obstructive sleep apnea, and bruxism. A third phase introduced Cognitive Behavioral Therapy for insomnia, nightmares, and circadian rhythm issues. Results showed improvements in sleep quality, total sleep time, and a reduction in depression, anxiety, and post-traumatic stress disorder symptoms. This approach suggests that treating sleep issues in high-risk populations can improve mental health.

24-hour movement behaviors and cognitive ability in preschool children: A compositional and isotemporal reallocation analysis

Research has supported the association between movement behaviors and cognitive ability in preschool children. However, most of the research has independently examined the various movement behaviors (e.g., physical activity, sedentary behavior, and sleep) without considering the dynamic composition of these behaviors in a 24-hour daily cycle. Therefore, this study aimed to explore the relationship between 24-hour movement behaviors and cognitive ability in preschool children. The participants were 191 Chinese preschool children from Zhuzhou aged 3-6 years. We measured light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) using the Actigraph Accelerometers and evaluated the children's sleep time based on reports from parents and teachers. The Chinese version of the Wechsler Young Children Scale of Intelligence (C-WYCSI) was used to assess cognitive ability. Compositional analysis and isotemporal substitution were performed to examine the influence of 24-hour movement behaviors on children's cognitive ability. After controlling for demographics (e.g., age and sex), the composition of 24-hour movement behaviors was significantly associated with the verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), and full intelligence quotient (FIQ). Importantly, preschool children demonstrated greater cognitive behavior when time in MVPA replaced that spent in LPA, SB, or sleep than when time spent in LPA, SB, and sleep replaced that spent in MVPA within the 24-hour cycle. Physical activity engaged in a 24-hour daily cycle has a significant effect on cognitive ability in preschool children, with increased MVPA and LPA being associated with higher PIQ and FIQ and increased sleep being associated with lower VIQ, PIQ, and FIQ. Replacing time in SB and LPA with MVPA is promising for children's cognitive development.

Acute effects of resistance exercise intensity and repetition at a predetermined volume on inhibitory control: a randomized controlled trial

Background

This study explores the effects of acute resistance exercise (RE) on inhibitory control (IC), emphasizing exercise volume.

Methods

In total, 78 young adults were randomly assigned to one of three groups: the moderate-intensity group [MI; 60% one repetition maximum (1RM), 3 × 10 reps], the low-intensity group (LI; 30% 1RM, 3 × 20 reps), or the control group (CON; 35 min reading). The exercise groups were volume-matched. Baseline equivalence was assessed via one-way analysis of variance (ANOVA) for demographic variables and chi-square for gender. One-way analysis of covariance examined post-test interreference inverse efficiency score scores, controlling for pre-test values. Two-way ANOVA assessed Group (MI, LI, CON) × Time effects on heart rate (resting; pre-test, during intervention, and post-test), rate of perceived exertion (pre-test, during intervention, and post-test), and lactate (pre-test, mid-test, and post-test). Mean differences and 95% confidence intervals supplemented p-values.

Results

IC was assessed using the Stroop Task, revealing better performance in both the MI (p = 0.026) and LI (p = 0.040) groups compared to CON, though no significant difference was found between the two exercise groups. Blood lactate levels significantly increased post-exercise in both the MI (p = 0.012) and LI (p < 0.001) groups, but again, there was no significant difference between them.

Conclusions

These findings highlight that acute RE, regardless of intensity, enhances IC and raises blood lactate when exercise volume is controlled. Practitioners might tailor RE protocols by adjusting the intensity to match individuals' capabilities without compromising the cognitive and physiological benefits.

Clinical Trial Registration

identifier (NCT05311202).

The Effect of Aerobic or Strength Training in Elderly with Cognitive Decline: The Fit4Alz Project

This study aimed to examine the effects of aerobic and strength training methodologies, either combined with or without cognitive training, on mitigating cognitive decline. A total of 154 subjects were recruited (72.8 ± 6.1 years, 69% females) and were divided into four groups: i) strength plus cognitive training (STCT, n = 56); ii) strength training (ST, n = 23); iii) aerobic training (AT, n = 41); and iv) aerobic plus cognitive training (ATCT, n = 34). Subjects were previously cognitively assessed and showed cognitive decline (less than 26 points on the Montreal Cognitive Assessment, MoCA). For 12 weeks, all groups performed 3 times a week, for 60 minutes, a training program corresponding to their attributed group. The MoCA test and the Senior Fitness test were applied at the beginning and the end of the intervention. A repeated-measures ANCOVA revealed significant time-by-group interactions for physical performance measures, including the 2-minute step-in-place (p = 0.026), arm curl (p < 0.001), chair sit-and-reach (p < 0.001), back-scratch (p < 0.001), 8-foot up-and-go (p < 0.001), and 6-minute walk tests (p < 0.001). However, no significant improvements were observed for cognitive function (MoCA, p = 0.242) or lower body strength (chair stand, p = 0.411). The AT group showed greater improvements in upper body strength compared to STCT and ST (p < 0.001; d = 0.698; p = 0.004; d = 0.598), while STCT significantly improved flexibility compared to ATCT (p < 0.001; d = 1.049). ATCT had the greatest improvements in aerobic endurance compared to STCT and ST (p = 0.004; d = 0.133; p < 0.001; d = 0.350). It was demonstrated that aerobic and strength training significantly improved overall physical performance in elderly individuals. However, no significant effects were observed on cognitive performance. Although these findings suggest that both aerobic and strength exercise, with or without cognitive training, improve overall physical fitness, further research is needed to determine its impact on cognitive performance.

Independent associations of sleep and physical activity with cognition are mediated by hippocampal microstructure in middle-aged and older adults

Sleep and physical activity levels are both associated with cognitive performance among older adults; however, the brain mechanisms underlying these beneficial relationships remain poorly understood. This study investigated cross-sectional associations of actigraphic estimates of physical activity and sleep with cognition and diffusion imaging-based measures of medial temporal lobe (MTL) gray matter microstructural integrity in adults free of dementia. Participants were 132 older adults from the Biomarkers of Cognitive Decline Among Normal Individuals (BIOCARD) cohort study (119 cognitively unimpaired and 13 with mild cognitive impairment; mean age=70.8 years). Multiple linear regression analyses assessed the relationships between total volume of physical activity (TVPA), total sleep time (TST), and sleep efficiency (SE) with cognitive performance and MTL microstructural integrity. Results indicated that greater TVPA and SE were both independently associated with higher hippocampal and parahippocampal microstructure integrity (indicated by lower mean diffusivity) and better visuospatial processing abilities, independent of the volume of these structures and of amyloid burden, measured by positron emission tomography. Additionally, higher hippocampal microstructure statistically mediated the independent associations of physical activity and sleep with visuospatial abilities, independent of MTL volume and Aβ load. These findings suggest that physical activity and sleep are independently associated with cognitive performance, and that hippocampal microstructural integrity may be an underlying mechanism supporting these associations.

Factors Associated With Life Satisfaction Among Veterans Enrolled in the Healthy Aging Project-Brain (HAP-B) Psychoeducational Class

Healthy Aging Project-Brain (HAP-B) is a novel clinical psychoeducation offering developed to encourage engagement in activities associated with successful aging. HAP-B targets sleep, socialization, physical, and cognitive activity through myth-busting, developing SMART goals, and tracking behavioral change. Study aims: (1) assess feasibility/acceptability in a Veteran population; (2) analyze pre- and post-intervention ratings to examine health and well-being; (3) explore associations between health factors and life satisfaction. The 50 participants (mean age = 70.6 years) were predominantly male-identity (88%) and White (76%). Findings, based on independent t tests, revealed improvements in life satisfaction, emotional well-being, and energy levels post-intervention. Linear regression results found higher life satisfaction was associated with lower depressive symptoms, higher emotional well-being, and higher self-efficacy. This easily implementable education intervention can result in more positive self-appraisal with encouraging downstream effects. Healthcare providers are well-positioned to utilize classes such as HAP-B to promote patient-centric approaches to brain health.

The Joint Association of Sleep Quality and Outdoor Activity with Asthma and Allergic Rhinitis in Children: A Cross-Sectional Study in Shanghai

Purpose

Aiming to investigate the combined association of sleep quality and outdoor activity with the risk of asthma and allergic rhinitis in children.

Patients and Methods

16,936 children from kindergartens and primary schools in 13 administrative districts of Shanghai, China were involved in the analyses. The Children's Sleep Habits Questionnaire (CSHQ) and the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire were respectively used to evaluate the sleep quality, allergic rhinitis and asthma. Multivariable logistic regression models were used to analyze the correlation of sleep quality, outdoor activities and their combination with children's asthma and allergic rhinitis.

Results

The overall prevalence of asthma and allergic rhinitis in our sampled children were 10.2% and 17.6%, respectively. Poor sleep quality (asthma: aOR, 1.45; 95% CI: 1.23 to 1.73; allergic rhinitis: aOR, 1.16; 95% CI: 1.03 to 1.31) and low outdoor activity (asthma: aOR, 1.30; 95% CI: 1.14 to 1.49, allergic rhinitis: aOR, 1.18; 95% CI: 1.07 to 1.32) were separately associated with higher risk of asthma and allergic rhinitis, and when the two were superimposed, an additive effect (asthma: aOR, 1.76; 95% CI: 1.30 to 2.39; allergic rhinitis: aOR, 1.46; 95% CI: 1.17 to 1.82) was revealed. These associations were independent of sleep duration, but being stronger in sleep sufficiency group. And after stratification by gender, premature birth and family history of allergy, similar associations were validated in general.

Conclusion

Poor sleep quality and low levels of outdoor activity, when combined, have a stronger association with asthma and allergic rhinitis than each factor independently, and this relationship is not influenced by sleep duration. Our findings highlight the need for public health interventions that simultaneously address multiple lifestyle factors to reduce the risk of allergic diseases.

The mediating effect of psychosomatic symptoms between physical activity and cognitive function among breast cancer patients: A path analysis

PURPOSE

Psychosomatic symptoms are frequently observed side effects in breast cancer (BC) patients and significantly influence cognitive function. However, limited research has addressed the role of psychosomatic symptoms in the relationship between physical activity and cognitive function. This study aimed to examine the mediating effect of psychosomatic symptoms on the relationship between physical activity and cognitive function in BC patients.

METHODS

A cross-sectional study was conducted across 10 hospitals in China from April 2022 to February 2023. Cognitive function was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function scale. Exercise frequency, sleep quality, fatigue, anxiety, and depression were measured using the Pittsburgh Sleep Quality Index questionnaire, Cancer Fatigue Scale, Generalized Anxiety Disorder Questionnaire-7, and Patient Health Questionnaire-9, respectively, among 741 BC patients. Correlation analysis and path analysis were performed to explore associations between variables.

RESULTS

The prevalence of cognitive impairment in BC patients was found to be 9.58%. The path model demonstrated the best fit when age was included as a moderating variable, and the association between age and sleep disorders was controlled. Physical activity showed a negative correlation with both psychosomatic symptoms and cognitive impairment (p < 0.05). It exerted a direct impact on cognitive impairment (20.3%, p < 0.001) and an indirect impact mediated through anxiety and depression (6.3%, p < 0.001). The total effect in the model was 38.6% (p < 0.001).

CONCLUSION

Physical activity has a pivotal role in improving cognitive function in BC patients, both through direct mechanisms and indirectly by reducing anxiety and depression. While enhancements in sleep quality and fatigue levels were observed, their influence on cognitive function did not reach statistical significance, indicating the need for further research. These findings underscore the importance of incorporating psychological symptom management into supportive care plans to aid cognitive recovery. A combination of physical activity and psychological interventions could provide synergistic benefits, potentially boosting cognitive improvement and enhancing the overall quality of life in BC patients.

Could sleep be a brain/cognitive/neural reserve-builder factor? A systematic review on the cognitive effects of sleep modulation in animal models

The brain/cognitive/neural reserve concept suggests that lifelong experiences, from early life through adulthood, make the brain more resilient to neuronal damage. Modifiable lifestyle factors, such as sleep, can support the development and enhance such a reserve, helping to counteract age- or disease-related brain changes and their impact on cognition. Sleep plays a crucial role in cognitive functioning, and disruptions or disorders may increase neurodegenerative risks. This systematic review aims to explore how functional and disturbed sleep impacts cognitive functions and neuromorphological mechanisms in rodents, aiming to better understand its role in brain/cognitive/neural reserve development. This systematic review, registered on PROSPERO (ID: CRD42023423901) and conducted according to PRISMA-P guidelines, searched PubMed, Scopus, Web of Science, and Embase databases for studies up to June 2022, with terms related to sleep, rodents, and cognitive functions. Of the 28,666 articles identified, 142 met the inclusion criteria. Main results showed significant cognitive decline after sleep deprivation, especially in memory performance. These findings supports the importance of sleep as a critical factor in modulating brain/cognitive/neural reserve.

Influence of Socio-Demographic, Occupational and Lifestyle Variables on Sleep Time

Background

Socio-demographic, occupational and lifestyle variables influence total sleep time. Therefore, we aimed to evaluate the influence of those variables on sleep time, and to study risk factors of being a short sleeper.

Methods

The COVISTRESS international study is an online questionnaire using the secure REDCap® software. Total sleep time was evaluated using declared bedtime and time of awakening and was analyzed as a quantitative variable and as a qualitative variable.

Results

We included 549 respondents to the questionnaire, divided into 10-year age groups ranging from <30yo to ≥60yo. The mean quantity of sleep was 7.11±1.43 hours per night. Factors that reduce total sleep time were age (coefficient -0.19, 95CI -0.33 to 0.06), being an employee (-0.46, -0.85 to -0.06), working time (-0.18, -0.31 to 0.05), smoking ≥5 cigarettes/day (-0.5, -0.95 to -0.20), high stress at work (-0.64, -0.96 to -0.32) and at home (-0.66, -0.97 to -0.35). Being a student (0.61, 0.02 to 1.19), working less than 25h per week (0.57, 0.17 to 0.97) and telework (0.46, 0.02 to 0.89) increased total sleep time. The risk factors of being a short sleeper were age (odds ratio 1.27, 95CI 1.07 to 1.51), being an employee (2.58, 1.36 to 4.89), smoking ≥5 cigarettes/day (2.73, 1.54 to 4.84) and a high level of stress at work (2.64, 1.45 to 4.82) and at home (3.89, 2.25 to 6.63). Physical activity ≥2.5 hours/week tended to decrease the risk of being a short sleeper by 35%.

Conclusion

We demonstrated the concomitant impact of sociodemographic, occupational and lifestyle behavior on sleep, which may help to build efficient preventive strategy.

A review of the application of exercise intervention on improving cognition in patients with Alzheimer's disease: mechanisms and clinical studies

Alzheimer's disease (AD) is the most common form of dementia, leading to sustained cognitive decline. An increasing number of studies suggest that exercise is an effective strategy to promote the improvement of cognition in AD. Mechanisms of the benefits of exercise intervention on cognitive function may include modulation of vascular factors by affecting cardiovascular risk factors, regulating cardiorespiratory health, and enhancing cerebral blood flow. Exercise also promotes neurogenesis by stimulating neurotrophic factors, affecting neuroplasticity in the brain. Additionally, regular exercise improves the neuropathological characteristics of AD by improving mitochondrial function, and the brain redox status. More and more attention has been paid to the effect of Aβ and tau pathology as well as sleep disorders on cognitive function in persons diagnosed with AD. Besides, there are various forms of exercise intervention in cognitive improvement in patients with AD, including aerobic exercise, resistance exercise, and multi-component exercise. Consequently, the purpose of this review is to summarize the findings of the mechanisms of exercise intervention on cognitive function in patients with AD, and also discuss the application of different exercise interventions in cognitive impairment in AD to provide a theoretical basis and reference for the selection of exercise intervention in cognitive rehabilitation in AD.

Physical activity, cathepsin B, and cognitive health

Regular physical activity (PA) is beneficial for cognitive health, and cathepsin B (CTSB) - a protease released by skeletal muscle during PA - acts as a potential molecular mediator of this association. PA-induced metabolic and mechanical stress appears to increase plasma/serum CTSB levels. CTSB facilitates neurogenesis and synaptic plasticity in brain regions (e.g., hippocampus and prefrontal cortex) that support performance in specific cognitive domains including memory, learning, and executive function. However, the evidence regarding the role of PA-induced changes in CTSB as a mediator of PA-induced cognitive health in humans is mixed. To guide future research, this article identifies key factors that may explain the observed heterogeneity in the findings from human studies and proposes a PA-CTSB-cognition model.

Temporal ablation of the ciliary protein IFT88 alters normal brainwave patterns

The primary cilium is a hair-like organelle that hosts molecular machinery for various developmental and homeostatic signaling pathways. Its alteration can cause rare ciliopathies such as the Bardet-Biedl and Joubert syndromes, but is also linked to Alzheimer's disease, clinical depression, and autism spectrum disorder. These afflictions are caused by disturbances in a wide variety of genes but a common phenotype amongst them is cognitive impairment. While cilia-mediated neural function has been widely examined in early neurodevelopment, their function in the adult brain is not well understood. To help elucidate the role of cilia in neural activity, we temporally induced the ablation of IFT88, a gene encoding the intraflagellar transport 88 protein which is neccessary for ciliogenesis, in adult mice before performing memory-related behavioral assays and electroencephalogram/electromyogram (EEG/EMG) recordings. Inducible IFT88 KO mice exhibited severe learning deficits in trace fear conditioning and Morris water maze tests. They had strongly affected brainwave activity both under isoflurane induced anesthesia and during normal activity. And additionally, inducible IFT88 KO mice had altered sleep architecture and attenuated phase-amplitude coupling, a process that underlies learning and memory formation. These results highlight the growing significance of primary cilia for healthy neural function in the adult brain.

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

Background

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

Objective

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

Methods

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

Results

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

Conclusions

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

Different physical exercise in the treatment of Alzheimer's disease

Alzheimer's disease (AD) is rapidly becoming one of the most expensive, burdening, and deadly diseases of this century. Up to now, there is still a lack of pharmacotherapy with substantial efficacy, and physical exercise is a promising and low-cost way to aid in delaying the process of AD. The aim of this review is to summarise the efficacy of different physical exercise approaches and doses in the management of AD, including aerobic exercise, resistance exercise and multicomponent exercise. A literature search using MeSH terms for each topic is undertaken using PubMed and the Web of Science Core Collection database, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesised, and summarised. This review shows that aerobic exercise has been almost unanimously recognised for the improvement of cognition, neuropsychiatric symptoms and activities of daily living. Resistance exercise also shows a good prospect in the above aspects and has a unique advantage in enhancing muscle strength, while multicomponent physical activity does not seen to significantly improve cognitive function. Each type of exercise has a dose effect, but for individuals with AD, the most appropriate exercise dose is still controversial.

Engagement in moderate-intensity physical activity supports overnight memory retention in older adults

Preserving the ability to vividly recall emotionally rich experiences contributes to quality of life in older adulthood. While prior works suggest that moderate-intensity physical activity (MPA) may bolster memory, it is unclear whether this extends to emotionally salient memories consolidated during sleep. In the current study, older adults (mean age = 72.3 ± 5.8) completed an overnight polysomnography assessment with emotional memory tested before and after sleep and a self-report questionnaire assessing habitual PA. Results show that better negative emotional memory consolidation was associated with the frequency and duration of MPA. Statistically replacing 30 min of lower-intensity activity with MPA was associated with better negative emotional memory consolidation. MPA may enhance sleep-dependent consolidation of negative memories in older adults, with modest increases in MPA yielding significant consolidation benefits. Findings may guide interventions and inform public health recommendations by demonstrating that substituting even short durations of low-intensity activity for MPA could produce significant cognitive gains in older adulthood.

The association between 'weekend warrior', regular exercise, and cognitive function in elderly individuals with and without depressive symptoms: A cross-sectional analysis from NHANES 2011-2014

BACKGROUND

While previous studies have suggested that both 'Weekend Warrior' (WW) and Regular Exercise (RE) patterns confer health benefits, the relationship between different types of physical activity (PA) and cognitive function (CF) in elderly individuals with and without depressive symptoms remains unclear.

METHODS

Our study leveraged the NHANES 2011-2014 dataset, focusing on older adults. We explore the relationship between PA and CF, stratifying by depressive status. Our statistical approach included multivariable regression analysis to identify relationships between PA levels and cognitive outcomes, along with advanced techniques such as smoothed curve fitting and threshold effect analysis to examine potential nonlinear associations and identify optimal PA pattern for cognitive health.

RESULTS

Analysis revealed a positive correlation between PA time and CF across all participants (β-depressive symptoms = 0.03, 95 % CI: 0.01-0.05; β-non-depressive symptoms = 0.01, 95%CI: 0.00-0.02). When comparing against the inactive, non-depressed participants partaking in WW showed improved cognitive scores (β-WW = 0.22, 95 % CI: 0.05-0.39), similar to those engaging in RE (β-RE = 0.15, 95 % CI: 0.09-0.21). However, among the depressed participants, significant cognitive improvements were observed in the RE (β-RE = 0.15, 95 % CI: 0.04-0.25), with the WW showing less definitive results (β-WW = 0.22, 95 % CI: -0.02-0.47).

LIMITATION

The cross-sectional nature limits causal inferences.

CONCLUSION

Our findings affirm the potential role of PA in enhancing CF among older subjects without depressive symptoms. However, only RE was associated with improved CF in those with depressive symptoms. These results are critical for crafting personalized PA guidelines to enhance cognitive health in the aging population.

Does Sleep Moderate the Effects of Exercise Training or Complex Mental and Social Activities on Cognitive Function in Adults With Chronic Stroke? Secondary Analysis of a Randomized Trial

BACKGROUND

Exercise (EX) or cognitive and social enrichment (ENRICH) are 2 strategies for promoting cognition poststroke. Whether sleep moderates the effects of EX or ENRICH on cognition in adults with chronic stroke is unknown.

METHODS

A 3-arm parallel randomized clinical trial among community-dwelling adults aged 55+ years with chronic stroke (ie, ≥12 months since stroke). Participants were randomized to 2× per week EX, ENRICH, or balance and tone control (BAT). At baseline, device-measured sleep duration and efficiency were measured using wrist-worn actigraphy; self-reported quality was measured by Pittsburgh Sleep Quality Index (PSQI). Participants were categorized at baseline as having good or poor device-measured duration, device-measured efficiency, or self-reported quality based on PSQI. The primary cognitive outcome was Alzheimer's Disease Assessment Scale Plus (ADAS-Cog-Plus) measured at baseline, 6 months (end of intervention), and 12 months (6-month follow-up). We examined if baseline sleep categorizations (ie, good vs poor) moderated the effects of EX or ENRICH on ADAS-Cog-Plus.

RESULTS

We enrolled 120 participants in the trial (EX = 34; ENRICH = 34; BAT = 52). Sleep quality (ie, device-measured sleep efficiency or self-reported sleep quality) categorization moderated effects of EX (but not ENRICH) on ADAS-Cog-Plus. Compared with BAT participants with poor sleep quality, EX participants with poor sleep quality had better ADAS-Cog-Plus performance at 6 months (estimated mean difference for those with poor device-measured sleep efficiency: -0.48; 95% CI [-0.85, -0.10]; p = .010); estimated mean difference for those with poor self-reported sleep quality: -0.38; 95% CI [-0.70, -0.07]; p = .014). There was no effect of EX on ADAS-Cog-Plus for participants with good sleep quality. Device-measured sleep duration did not moderate intervention effects.

CONCLUSIONS

Exercise is particularly beneficial in improving cognitive function in adults with chronic stroke and poor sleep quality.

Temporal Ablation of the Ciliary Protein IFT88 Alters Normal Brainwave Patterns

The primary cilium is a hair-like organelle that hosts molecular machinery for various developmental and homeostatic signaling pathways. Its alteration can cause rare ciliopathies such as the Bardet-Biedl and Joubert syndromes, but is also linked to Alzheimer's disease, clinical depression, and autism spectrum disorder. These afflictions are caused by disturbances in a wide variety of genes but a common phenotype amongst them is cognitive impairment. While cilia-mediated neural function has been widely examined in early neurodevelopment, their function in the adult brain is not well understood. To help elucidate the role of cilia in neural activity, we temporally induced the ablation of IFT88, a gene encoding the intraflagellar transport 88 protein which is neccessary for ciliogenesis, in adult mice before performing memory-related behavioral assays and electroencephalogram/electromyogram (EEG/EMG) recordings. Inducible IFT88 KO mice exhibited severe learning deficits in trace fear conditioning and Morris water maze tests. They had strongly affected brainwave activity both under isoflurane induced anesthesia and during normal activity. And additionally, inducible IFT88 KO mice had altered sleep architecture and attenuated phase-amplitude coupling, a process that underlies learning and memory formation. These results highlight the growing significance of primary cilia for healthy neural function in the adult brain.

Exploring the relationship of sleep duration on cognitive function among the elderly: a combined NHANES 2011-2014 and mendelian randomization analysis

BACKGROUND

As one of the key features of sleep, sleep duration (SD) has been confirmed to be associated with multiple health outcomes. However, the link between SD and cognitive function (CF) is still not well understood.

METHODS

We employed a combined approach utilizing data from the National Health and Nutrition Examination Survey (NHANES 2011-2014) and Mendelian Randomization (MR) methods to investigate the relationship between SD and CF. In the NHANES cross-sectional analysis, the association between these variables was primarily examined through multivariate linear regression to explore direct correlations and utilized smoothing curve fitting to assess potential nonlinear relationships. To ensure the robustness of our findings, subgroup analyses were also conducted. MR analysis was used to assess the causal relationship between SD and sleeplessness on CF. After excluding confounding factors, univariate and multivariate MR were performed using inverse variance weighting (IVW) as the main analysis method, and sensitivity analysis was performed.

RESULTS

The results of our cross-sectional study indicate a notable negative association between SD and CF, forming an inverted U-shaped curve with the inflection point occurring at SD = 6 h. This relationship remains consistent and robust across subgroup analyses differentiated by variables such as age, levels of physical activity, and frequency of alcohol intake. In MR analysis, IVW analysis showed no causal relationship between SD and sleeplessness on CF (Both P > 0.05).

CONCLUSION

Cross-sectional studies suggest the existence of an inverted U-shaped correlation between SD and CF among the elderly. However, MR analysis did not reveal a causal relationship between SD and CF, which the lack of nonlinear MR analysis may limit. These findings provide evidence from a sleep perspective for optimizing cognitive strategies in older adults.

Association Between Cognitive Function and Emotion, Sleep, Frailty, and Nutrition in Hospitalized Patients

BACKGROUND

With the rapid increase in China's aging population, cognitive impairment in the elderly has become a significant public health issue.

AIMS

In this study we performed a cross-sectional analysis to comprehensively investigate the relationship between cognitive function and emotion, sleep, frailty, nutrition, and clinical variables in hospitalized geriatric patients according to age group and sex. We determined the most important risk factors for cognitive impairment.

METHOD

A total of 1121 inpatients were recruited from the Department of Gerontology at the Fifth Affiliated Hospital of Sun Yat-sen University, China, from August 2023 to April 2024. Cognitive assessment was performed using the Mini-Mental State Examination scale and Montreal Cognitive Assessment. The sleep quality was evaluated based on the Pittsburgh Sleep Quality Index, and anxiety and depression were evaluated based on the Hamilton Anxiety Scale and Hamilton Depression Scale.

RESULTS

Sex and age differences existed with respect to cognition, emotion, and sleep quality. After full adjustment, age, education level, working status, hemoglobin level, activities of daily living, Hamilton Depression Scale, and Pittsburgh Sleep Quality Index scores were significantly and independently associated with cognitive impairment.

DISCUSSION

Geriatric patients with a better mood, sleep and nutrition status, higher education level, and more social engagement performance had superior cognitive function. Interventions, such as valuing education, improving sleep, relaxing emotions, preventing anemia, and adjusting lifestyle, may help prevent the development of cognitive deficits. Elderly and female patients required special attention.

CONCLUSIONS

Various factors were shown to contribute to maintenance of cognitive function.

Cardiorespiratory Fitness and Sleep, but not Physical Activity, are Associated with Functional Connectivity in Older Adults

BACKGROUND

Aging results in changes in resting state functional connectivity within key networks associated with cognition. Cardiovascular function, physical activity, sleep, and body composition may influence these age-related changes in the brain. Better understanding these associations may help clarify mechanisms related to brain aging and guide interventional strategies to reduce these changes.

METHODS

In a large (n = 398) sample of healthy community dwelling older adults that were part of a larger interventional trial, we conducted cross sectional analyses of baseline data to examine the relationships between several modifiable behaviors and resting state functional connectivity within networks associated with cognition and emotional regulation. Additionally, maximal aerobic capacity, physical activity, quality of sleep, and body composition were assessed. Associations were explored both through correlation and best vs. worst group comparisons.

RESULTS

Greater cardiovascular fitness, but not larger quantity of daily physical activity, was associated with greater functional connectivity within the Default Mode (p = 0.008 r = 0.142) and Salience Networks (p = 0.005, r = 0.152). Better sleep (greater efficiency and fewer nighttime awakenings) was also associated with greater functional connectivity within multiple networks including the Default Mode, Executive Control, and Salience Networks. When the population was split into quartiles, the highest body fat group displayed higher functional connectivity in the Dorsal Attentional Network compared to the lowest body fat percentage (p = 0.011; 95% CI - 0.0172 to - 0.0023).

CONCLUSION

These findings confirm and expand on previous work indicating that, in older adults, higher levels of cardiovascular fitness and better sleep quality, but not greater quantity of physical activity, total sleep time, or lower body fat percentage are associated with increased functional connectivity within key resting state networks.

Were there any missing mediators between visual impairment and anxiety symptoms? Results from Chinese Longitudinal Healthy Longevity Survey

Introduction

Visual impairment, encompassing low visual acuity and visual field loss, significantly impacts the older adult population worldwide, leading to increased disability and mortality risks. Recent studies suggest a strong association between visual impairment and anxiety, particularly among older adults. This study aims to explore the relationship between visual impairment and anxiety symptoms in older adult individuals in China, and to investigate potential mediating factors.

Methods

Data for this study were derived from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 11,702 participants aged 65 and older. Visual impairment was assessed through self-reported visual function, while anxiety symptoms were measured using the 7-item Generalized Anxiety Disorder scale (GAD-7). Additional assessments included sleep quality and duration, exercise status, and dietary diversity. Logistic regression models and mediation analysis were employed to explore associations and mediating effects.

Results

The findings indicate that visual impairment is significantly associated with increased anxiety symptoms among the older adult (OR = 1.51, 95% CI: 1.32-1.72, p < 0.001). Mediation analysis revealed that sleep quality, dietary diversity score (DDS), and plant-based DDS significantly mediated the relationship between visual impairment and anxiety. In contrast, sleep duration, exercise, and animal-based DDS did not show significant mediating effects.

Conclusion

Visual impairment is a crucial predictor of anxiety symptoms in the older adult. Improving sleep quality and promoting a diverse plant-based diet may mitigate anxiety symptoms in this population. Interventions targeting these areas could enhance the mental health and quality of life of older adult individuals with visual impairment.

Effects of an intervention combining physical activity and components of Amygdala and Insula Retraining (AIR) on sleep and working memory among older male adults

Background

Older individuals are at a particular risk of sleep disorders, a loss of cognitive and emotional control, and a poor quality of life. Pharmaceutical therapy for these conditions is commonplace but has not been particularly effective, and relatively little research exists for their treatment using non-pharmacological approaches. The effectiveness of Physical Activity plus selected components of Amygdala and Insula Retraining (PAAIR) was tested to improve sleep quality, depression, working memory, and emotion regulation among older males.

Methods

This was a parallel, randomized control trial. The study was conducted in-person among 40 older Iranian men (M age: 65.78, SD = 2.41). The participants were randomly assigned with equal allocation to either the PAAIR or a control condition. Both interventions were conducted in-person over 12 weeks. The participants met twice weekly for 45-minute sessions at a local elderly training and rehabilitation center. All participants completed measurements for sleep quality, depressive symptoms, working memory, and emotion regulation at baseline, 12 weeks (immediately after the intervention), and 8 weeks later.

Results

Among the 36 individuals who finished the study, their sleep quality, working memory, and emotion regulation improved, and their depressive symptoms were reduced from baseline to 12 weeks (post-intervention) and 8 weeks later; these effects were seen even more so for the PAAIR group compared to the control group, with large to extremely large effect sizes.

Conclusion

The findings suggest that PAAIR has the potential to enhance sleep quality, cognitive function, and emotion regulation and reduce depressive symptoms among older men, thus contributing to their quality of life and mental health.

Reduction in physical activity during Covid-19 lockdowns predicts individual differences in cognitive performance several months after the end of the safety measures

Prior studies suggest that the reductions in physical activity during Covid-19-related lockdowns impacted physical and mental health. Whether reductions in physical activity that occurred during lockdowns also relate to cognitive functions such as memory and attention is less explored. Here, we investigated whether changes in physical activity (PA) that occurred during and following Covid-19-related lockdowns could predict a variety of measures of cognitive performance in 318 young adults. Participants were assessed on their engagement in PA before, during, and after lockdowns. They also completed tests of cognitive control, working memory, and short-term memory following lockdown(s). As expected, engagement in PA decreased during lockdown and returned to near baseline levels thereafter. Decreases in PA during lockdown predicted individual differences in cognitive performance following lockdown. Greater reductions in PA during lockdown were associated with lower scores on the go/no-go task, a measure of cognitive control ability, and the n-back task, a measure of working memory performance. Larger post-lockdown increases in PA were associated with higher scores on the same tasks. Individual differences in pandemic-related stress and insomnia also predicted cognitive outcomes. These findings suggest that reductions of PA can predict cognitive performance, and underscore the importance of maintaining PA for cognitive health, especially in situations such as lockdowns.

A Compensatory Role of Physical Activity in the Association Between Sleep and Cognition

We synthesize evidence investigating the hypothesis that greater engagement in physical activity (PA) may compensate for some of the negative cognitive consequences associated with poor sleep in older adults. Potential mechanistic pathways include glymphatic clearance, influences on depression, and other comorbidities. The evidence base is largely cross-sectional and observational, and further experimental studies are required.

Risk factors and consequences of mental health problems in nurses: A scoping review of cohort studies

Mental health problems in nurses are prevalent and impairing. To date, no literature has comprehensively synthesised cohort evidence on mental health among nurses. This scoping review aimed to synthesise the existing literature on the risk factors and consequences of mental health problems in nurses. A systematic search was conducted on PubMed, EMBASE, Epistemonikos database, Web of Science, CINAHL, and PsycINFO from inception to March 2023. We identified 171 cohort studies from 16 countries, mostly (95.3%) from high-income economies. This review indicated that nurses worldwide encountered significant mental health challenges, including depression, cognitive impairment, anxiety, trauma/post-traumatic stress disorder, burnout, sleep disorder, and other negative mental health problems. These problems were closely related to various modifiable risk factors such as nurses' behaviours and lifestyles, social support, workplace bullying and violence, shift work, job demands, and job resources. Moreover, nurses' mental health problems have negative effects on their physical health, behaviour and lifestyle, occupation and organisation, and intrapersonal factors. These findings provided an enhanced understanding of mental health complexities among nurses, and shed light on policy enactment to alleviate the negative impact of mental health problems on nurses. Addressing mental health among nurses should be a top priority.

Association between vitamin B2 intake and cognitive performance among older adults: a cross-sectional study from NHANES

The impact of vitamin B2 (riboflavin) intake on cognitive performance among older adults in the United States (US) remains inadequately understood. This study aimed to explore the association between vitamin B2 intake and cognitive performance among non-institutionalized elderly people in the US. Weighted logistic regression was used to evaluate the association between vitamin B2 intake and cognitive performance. Vitamin B2 intake was determined from the mean of two 24-hour dietary recall interviews. Three cognitive ability assessment tests, namely the Immediate Recall Test (IRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), were performed. Participants included all older adults over 60 who underwent cognitive scoring, with cut-offs defined based on the lowest quartile (25th percentile) for each test (the cut-offs for the three scores were 15.625, 12, and 33, respectively). Sensitivity analysis, including dose-response curves, subgroup analyses, interaction effects, per 1 standard deviation (SD), recommended dietary allowance (RDA), and residual energy model analysis, were performed to solidify the solid association between vitamin B2 and cognitive performance. A total of 2893 individuals aged over 60 were included, with a mean age of 69 (7) years, and 46% were men. There was a significant association between vitamin B2 intake and all three cognitive scores (IRT, Odds Ratio = 0.77, 95% confidence interval: [0.65,0.92]; AFT, 0.75, [0.64,0.88]; DSST, 0.72, [0.59,0.88]). Moreover, vitamin B2 intake above the RDA reduced the risk of low cognitive performance (IRT, 0.66, [0.46,0.93]; AFT, 0.83, [0.62,1.11]; DSST, 0.65, [0.45,0.92]) compared to intake below the RDA. Dose-response curves indicated that higher vitamin B2 intake was negatively associated with the risk of low cognitive performance. Physical activity may modify the association between vitamin B2 and cognitive performance. Vitamin B2 intake was positively associated with cognitive performance among older adults. Adequate vitamin B2 intake could help protect cognitive function.

Association between outdoor light at night exposure and executive function in Chinese children

BACKGROUND

Recent evidences highlight the potential impact of outdoor Light at Night (LAN) on executive function. However, few studies have investigated the association between outdoor LAN exposure and executive function.

METHODS

We employed data from 48,502 Chinese children aged 5-12 years in a cross-sectional study conducted in Guangdong province during 2020-2021, to examine the association between outdoor LAN and executive function assessed using the validated parent-completed Behavior Rating Inventory of Executive Function. We assessed children's outdoor LAN exposure using the night-time satellite images based on the residential addresses. We used generalized linear mixed models to estimate the association between outdoor LAN exposure and executive function scores and executive dysfunction.

RESULTS

After adjusting for potential covariates, higher quintiles of outdoor LAN exposure were associated with poorer executive function. Compared to the lowest quintile (Q1), all higher quintiles of exposure showed a significant increased global executive composite (GEC) score with β (95% confidence intervals, CI) of 0.58 (0.28, 0.88) in Q2, 0.59 (0.28, 0.9) in Q3, 0.85 (0.54, 1.16) in Q4, and 0.76 (0.43, 1.09) in Q5. Higher quintiles of exposure were also associated with higher risks for GEC dysfunction with odd ratios (ORs) (95% CI) of 1.34 (1.18, 1.52) in Q2, 1.40 (1.24, 1.59) in Q3, 1.40 (1.23, 1.59) in Q4, and 1.39 (1.22, 1.58) in Q5. And stronger associations were observed in children aged 10-12 years.

CONCLUSIONS

Our study suggested that high outdoor LAN exposure was associated with poor executive function in children. These findings suggested that future studies should determine whether interventions to reduce outdoor LAN exposure can have a positive effect on executive function.

The association between physical activity and delayed neurocognitive recovery in elderly patients: a mediation analysis of pro-inflammatory cytokines

BACKGROUND

Delayed neurocognitive recovery (dNCR) can result in unfavorable outcomes in elderly surgical patients. Physical activity (PA) has been shown to improve cognitive function, potentially by reducing systemic inflammatory responses. However, there is a lack of supportive data indicating whether PA has a protective effect against dNCR.

AIMS

To examine the correlation between dNCR and PA, and to further analyze if pro-inflammatory cytokines mediate this relationship.

METHODS

This study is a prospective nested case-control investigation of elderly patients who had knee replacement surgery. dNCR was defined as a decline in cognitive function compared with baseline by using a battery of neuropsychological tests. PA was assessed with the Physical Activity Scale for the Elderly (PASE). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of IL-6, IL-1β, and TNF-α. Multivariable logistic regression analysis was conducted to assess the association between PA and dNCR. Mediation analysis was employed to evaluate whether pro-inflammatory cytokines mediate the relationship between them.

RESULTS

A cohort of 152 patients was included, resulting in an incidence rate of dNCR of 23.68%. PA was associated with dNCR after full adjustment [OR = 0.199, (95% CI, 0.061; 0.649), P = 0.007]. Mediation analysis showed that the IL-6 mediated the statistical association between PA and dNCR, with mediation proportions (%) of 77.68 (postoperative concentration of IL-6) or 27.58 (the absolute change in IL-6 before and after surgery).

CONCLUSIONS

PA serves as a protective factor against dNCR, possibly through the reduction of pro-inflammatory cytokine concentrations. THE CHINESE CLINICAL TRAIL REGISTRY: : www.http://chictr.org.cn , Registration No. ChiCTR2300070834, Registration date: April 24, 2023.

Extracts of Prunella vulgaris Enhanced Pentobarbital-Induced Sleeping Behavior in Mice Potentially via Adenosine A2A Receptor Activity

The increasing prevalence of sleep dysregulation cases has prompted the search for effective and safe sleep-enhancing agents. Numerous medications used in the treatment of sleep disorders function by enhancing γ-aminobutyric acid neurotransmitter activity. Unfortunately, these substances may induce significant adverse effects in chronic users, such as dependence and motor behavior impairments. Consequently, there is a growing interest in exploring therapeutic sleep-enhancing agents derived from natural sources, with the anticipation of causing less severe side effects. Prunella vulgaris (PV), a perennial plant indigenous to South Korea, exhibits various pharmacological effects, likely attributed to its chemical composition. Rosmarinic acid, one of its components, has previously demonstrated sleep-potentiating properties, suggesting the potential for PV to exhibit similar pharmacological effects. This study aims to investigate the potential effects of repeated administration of PV extract on the sleep behavior, brainwave activity, sleep-wake cycle, and physiological behavior of mice. Findings indicate that PV extracts exhibit sleep-enhancing effects in mice, characterized by prolonged sleep duration and a reduced onset time of pentobarbital-induced sleep. However, PV extracts only reduced alpha wave powers, with minor alterations in wakefulness and rapid-eye-movement sleep duration. In contrast to diazepam, PV extracts lack adverse effects on locomotor activity, motor coordination, or anxiety in mice. Receptor-binding assay and caffeine treatment support the potential involvement of adenosine A2A receptors in the effects of PV, suggesting distinct mechanisms of action compared to diazepam, despite both exhibiting sleep-altering effects. Overall, our results suggest that PV holds promise as a potential source of sleep-aiding agents.

Sleep Quality Moderates the Associations between Cardiorespiratory Fitness and Hippocampal and Entorhinal Volume in Middle-Aged and Older Adults

INTRODUCTION/PURPOSE

As individuals age, the entorhinal cortex (ERC) and hippocampus-crucial structures for memory-tend to atrophy, with related cognitive decline. Simultaneously, lifestyle factors that can be modified, such as exercise and sleep, have been separately linked to slowing of brain atrophy and functional decline. However, the synergistic impact of fitness and sleep on susceptible brain structures in aging adults remains uncertain.

METHODS

We examined both independent and interactive associations of fitness and subjective sleep quality with regard to ERC thickness and hippocampal volume in 598 middle-aged and older adults from the Human Connectome Lifespan Aging Project. Cardiorespiratory fitness was assessed using the 2-min walk test, whereas subjective sleep quality was measured with the continuous Pittsburgh Sleep Quality Index global score. High-resolution structural magnetic resonance imaging was used to examine mean ERC thickness and bilateral hippocampal volume. Through multiple linear regression analyses, we investigated the moderating effects of subjective sleep quality on the association between fitness and brain structure, accounting for age, sex, education, body mass index, gait speed, and subjective physical activity.

RESULTS

We found that greater cardiorespiratory fitness, but not subjective sleep quality, was positively associated with bilateral hippocampal volume and ERC thickness. Notably, significant interaction effects suggest that poor subjective sleep quality was associated with a weaker association between fitness and both hippocampal volume and ERC thickness.

CONCLUSIONS

Findings suggest the potential importance of both cardiorespiratory fitness and subjective sleep quality in preserving critical, age-vulnerable brain structures. Interventions targeting brain health should consider potential combined effects of sleep and fitness on brain health.

Association of 24-Hour movement behavior and cognitive function in older Taiwanese adults

OBJECTIVES

This study investigates how 24-hour movement behaviors (physical activity, sedentary time, sleep) relate to cognitive performance in older adults.

METHODS

213 adults (aged 65+) wore accelerometers to track activity. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Isotemporal substitution analysis examined how replacing one behavior with another affected cognition.

RESULTS

Increased light physical activity was linked to better cognitive function, whereas longer sleep had a negative impact. Replacing 30 min of sedentary behavior or sleep with light physical activity improved orientation, attention, language, and short-term memory. Substituting moderate-to-vigorous physical activity did not have the same cognitive benefit.

CONCLUSION

Encouraging older adults to replace sedentary time or excess sleep with light physical activity could support cognitive health and potentially help prevent dementia. These findings have implications for public health strategies promoting cognitive well-being in aging populations.

Let's Walk: A Quasi-Experimental Multi-Component Intervention to Improve Physical Activity and Social Engagement for Older Chinese American Adults

Physical activity (PA) is critical for healthy aging, yet < 16% of U.S. older adults meet federal recommendations for moderate to vigorous PA. Asian Americans are a rapidly growing segment of the older adult population, who are less likely to meet these guidelines, and are frequently under-represented in clinical trials. This quasi-experimental pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of a culturally tailored walking program to improve PA and social engagement for older Chinese Americans in Boston, MA. Participants at two community organizations were assigned to an enhanced walking or walking only condition for 12 weeks. Mixed effect repeated measures analysis addressed the study aims. The enhanced walking group (intervention) had fewer steps at baseline and less of a reduction in steps by 12 weeks as compared with the walking only (control) condition. Mean social engagement scores were significantly higher at 12 weeks (p = .03) for the intervention group. A culturally tailored walking intervention was feasible and acceptable for older Chinese Americans, improving social engagement and PA scores.

Sleep duration and leisure activities are involved in regulating the association of depressive symptoms, muscle strength, physical function and mild cognitive impairment

Background

In order to lessen the burden of Alzheimer's disease (AD), timely and efficient management and intervention methods for mild cognitive impairment (MCI) are crucial. MCI is seen as a transitional stage between normal aging and dementia. Although sarcopenia is an important risk factor for MCI, it is unclear what factors mediates and regulates the brain-muscle communication. Our objective was to investigate the indirect moderating effects of sleep duration and leisure activity on depressive symptoms, sarcopenia and MCI.

Method

Panel data from the 2015 China Health and Retirement Longitudinal Study (CHARLS) database was used in this investigation. we used Bootstrap sampling to determine the relationship between sleep duration, leisure activity, depressive symptoms, sarcopenia, and MCI in mediation and indirect moderation models. The outcome measurements were odds ratio (OR) and confidence interval (CI).

Result

After adjusting for confounding variables, we discovered that sarcopenia and its traits, such as handgrip strength, gait speed, standing test, and muscle mass, were significantly correlated with MCI. Second, the results implied that depressive symptoms played a role in modulating the link between physical function, muscle strength, and MCI. This moderating effect was impacted by short sleep duration and moderate to high levels of leisure activities.

Conclusion

We discovered that MCI was highly correlated not only with physical function and muscle strength but also with depressed symptoms, which acted as a partially mediating factor in this connection. Handgrip strength, gait speed, and standing test mediated the correction of MCI caused by depression symptoms. Importantly, leisure activities and sleep duration had indirect moderating effects on the above associations, and future management policies should take these factors into account.

The Impact of Exercise Cognition on Exercise Behaviors: The Mediating Role of the Satisfaction of Basic Psychological Needs in Exercise for Adolescents

In recent years, the exercise behavior of Chinese adolescents has been on the decline, which is extremely detrimental to their physical and mental health development. However, few studies have explored the mechanisms by which exercise cognition influences Chinese adolescents' exercise behavior. The present study aimed to investigate the relationship between exercise cognition and exercise behavior among Chinese adolescents and the mediating role of satisfying basic psychological needs for exercise. The study consisted of 996 adolescents (44.6% males, 55.4% females) between the ages of 12 and 15 (M = 13.34, SD = 1.059). Participants' exercise behaviors and the satisfaction of basic psychological needs for exercise data were collected via surveys. Structure equation modeling (SEM) was performed to examine the direct and indirect effects. The results were as follows: (1) adolescents' perceptions of exercise were significantly associated with exercise behavior and (2) the mediation model suggests that the satisfaction of basic psychological needs for exercise is an important mechanism by which exercise cognition influences the occurrence of exercise behavior. Therefore, it is crucial to help adolescents form good exercise cognition. Schools, families, and society should take responsibility for adolescents' formation of good exercise cognition and satisfy adolescents' basic psychological needs for exercise so as to enhance adolescents' exercise behaviors and thereby develop good exercise habits.

The Association of the 24-Hour Activity Cycle Profiles With Cognition in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study

BACKGROUND

The relationship of cognition and the 24-h activity cycle (24-HAC), encompassing physical activity, sedentary behavior, and sleep, in older adults with mild cognitive impairment (MCI) remains uncertain. Distinct combinations of 24-HAC behaviors can characterize unique activity profiles and influence cognition. We aimed to characterize 24-HAC activity profiles in older adults with MCI and assess whether differences in cognition exist across profiles.

METHODS

We conducted a cross-sectional analysis utilizing baseline data from 3 randomized controlled trials involving 253 community-dwelling older adults (55 + years) with MCI (no functional impairment, dementia diagnosis, and Montreal Cognitive Assessment score <26/30). Using MotionWatch8© wrist-worn actigraphy (+5 days), we captured the 24-HAC. Cognition was indexed by the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus). Compositional data and latent profile analyses identified distinct 24-HAC activity profiles. Analysis of covariance examined whether 24-HAC activity profiles differed in cognition.

RESULTS

Four distinct activity profiles were identified. Profile 1 ("Average 24-HAC," n = 103) engaged in all 24-HAC behaviors around the sample average. Profile 2 ("Active Chillers," n = 70) depicted lower-than-average engagement in physical activity and higher-than-average sedentary behavior. Profile 3 ("Physical Activity Masters," n = 54) were the most active and the least sedentary. Profile 4 ("Sedentary Savants," n = 26) were the least active and the most sedentary. Sleep was similar across profiles. There were no significant differences in ADAS-Cog-Plus scores between 24-HAC activity profiles (p > .05).

CONCLUSIONS

Older adults with MCI exhibited four 24-HAC activity profiles conforming to recommended physical activity and sleep guidelines. Nonetheless, cognition was similar across these profiles.

Cognitive and neuroscientific perspectives of healthy ageing

With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.

The rise of Parkinson's disease is a global challenge, but efforts to tackle this must begin at a national level: a protocol for national digital screening and "eat, move, sleep" lifestyle interventions to prevent or slow the rise of non-communicable diseases in Thailand

The rising prevalence of Parkinson's disease (PD) globally presents a significant public health challenge for national healthcare systems, particularly in low-to-middle income countries, such as Thailand, which may have insufficient resources to meet these escalating healthcare needs. There are also many undiagnosed cases of early-stage PD, a period when therapeutic interventions would have the most value and least cost. The traditional "passive" approach, whereby clinicians wait for patients with symptomatic PD to seek treatment, is inadequate. Proactive, early identification of PD will allow timely therapeutic interventions, and digital health technologies can be scaled up in the identification and early diagnosis of cases. The Parkinson's disease risk survey (TCTR20231025005) aims to evaluate a digital population screening platform to identify undiagnosed PD cases in the Thai population. Recognizing the long prodromal phase of PD, the target demographic for screening is people aged ≥ 40 years, approximately 20 years before the usual emergence of motor symptoms. Thailand has a highly rated healthcare system with an established universal healthcare program for citizens, making it ideal for deploying a national screening program using digital technology. Designed by a multidisciplinary group of PD experts, the digital platform comprises a 20-item questionnaire about PD symptoms along with objective tests of eight digital markers: voice vowel, voice sentences, resting and postural tremor, alternate finger tapping, a "pinch-to-size" test, gait and balance, with performance recorded using a mobile application and smartphone's sensors. Machine learning tools use the collected data to identify subjects at risk of developing, or with early signs of, PD. This article describes the selection and validation of questionnaire items and digital markers, with results showing the chosen parameters and data analysis methods to be robust, reliable, and reproducible. This digital platform could serve as a model for similar screening strategies for other non-communicable diseases in Thailand.

Anti-Inflammatory Diet and Protein-Enriched Diet Can Reduce the Risk of Cognitive Impairment among Older Adults: A Nationwide Cross-Sectional Research

BACKGROUND

Cognitive impairment (CI) is a common mental health disorder among older adults, and dietary patterns have an impact on cognitive function. However, no systematic researches have constructed anti-inflammatory diet (AID) and protein-enriched diet (PED) to explore their association with CI among older adults in China.

METHODS

The data used in this study were obtained from the 2018 waves of the China Longitudinal Health and Longevity Survey (CLHLS). We construct AID, PED, and calculate scores for CI. We use binary logistic regression to explore the relationship between them, and use restrictive cubic splines to determine whether the relationships are non-linear. Subgroup analysis and sensitivity analysis were used to demonstrate the robustness of the results.

RESULTS

A total of 8692 participants (mean age is 83.53 years) were included in the analysis. We found that participants with a higher AID (OR = 0.789, 95% confidence interval: 0.740-0.842, p < 0.001) and PED (OR = 0.910, 95% confidence interval: 0.866-0.956, p < 0.001) score showed lower odds of suffering from CI. Besides, the relationship between the two dietary patterns and CI is linear, and the results of subgroup analysis and sensitivity analysis are also significant.

CONCLUSION

Higher intakes of AID and PED are associated with a lower risk of CI among older adults, which has important implications for future prevention and control of CI from a dietary and nutritional perspective.

Sedentary behavior and lifespan brain health

Higher levels of physical activity are known to benefit aspects of brain health across the lifespan. However, the role of sedentary behavior (SB) is less well understood. In this review we summarize and discuss evidence on the role of SB on brain health (including cognitive performance, structural or functional brain measures, and dementia risk) for different age groups, critically compare assessment approaches to capture SB, and offer insights into emerging opportunities to assess SB via digital technologies. Across the lifespan, specific characteristics of SB (particularly whether they are cognitively active or cognitively passive) potentially act as moderators influencing the associations between SB and specific brain health outcomes. We outline challenges and opportunities for future research aiming to provide more robust empirical evidence on these observations.

Joint associations of sleep duration and physical activity with cognitive impairment among rural elderly over 65 years old: a cross-sectional study

BACKGROUND

During the long preclinical phase of dementia, accelerated cognitive impairment is regarded as a cardinal marker. Thus, the identification of risk factors for cognitive impairment is of great significance for dementia prevention. This study aims to examine the joint associations of sleep duration and physical activity with cognitive impairment among rural elderly over 65 years old, and provide suggestions for improving the cognitive function in rural elderly over 65 years old.

METHODS

A cross-sectional study was conducted in rural Nanjing by recruiting 1147 individuals aged above 65 years. Cognitive function was assessed using the brief community screening instrument for dementia. Physical activity was assessed using the Global Physical Activity Questionnaire. Data were analyzed by multivariate logistic regression models, and a significant difference was set at P < 0.05.

RESULTS

Compared with participants with proper sleep duration and sufficient physical activity, participants with short sleep duration and insufficient physical activity (odds ratio (OR): 1.820; 95% CI: 1.265 ~ 2.618), long sleep duration and sufficient physical activity (OR: 2.428; 95% CI: 1.137 ~ 5.183) showed an increased likelihood of cognitive impairment.

CONCLUSIONS

Inappropriate sleep duration combined with insufficient physical activity was associated with a significantly higher likelihood of cognitive impairment in rural elderly over 65 years old.