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Chun MY, Chae W, Seo SW, Jang H, Yun J, Na DL, Kang D, Lee J, Hammers DB, Apostolova LG, Jang SI, Kim HJ. Effects of risk factors on the development and mortality of early- and late-onset dementia: an 11-year longitudinal nationwide population-based cohort study in South Korea. Alzheimers Res Ther 2024; 16:92. [PMID: 38664771 PMCID: PMC11044300 DOI: 10.1186/s13195-024-01436-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Early-onset dementia (EOD, onset age < 65) and late-onset dementia (LOD, onset age ≥ 65) exhibit distinct features. Understanding the risk factors for dementia development and mortality in EOD and LOD respectively is crucial for personalized care. While risk factors are known for LOD development and mortality, their impact on EOD remains unclear. We aimed to investigate how hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, and osteoporosis influence the development and mortality of EOD and LOD, respectively. METHODS Using the Korean National Health Insurance Service (NHIS) database, we collected 546,709 dementia-free individuals and followed up for 11 years. In the two study groups, the Younger group (< 65 years old) and the Older group (≥ 65 years old), we applied Cox proportional hazard models to assess risk factors for development of EOD and LOD, respectively. Then, we assessed risk factors for mortality among EOD and LOD. RESULTS Diabetes mellitus and osteoporosis increased the risk of EOD and LOD development. Hypertension increased the risk of EOD, while atrial fibrillation increased the risk of LOD. Conversely, hyperlipidemia exhibited a protective effect against LOD development. Additionally, diabetes mellitus increased mortality in EOD and LOD. Hypertension and atrial fibrillation increased mortality in LOD, while hyperlipidemia decreased mortality in EOD and LOD. CONCLUSIONS Risk factors influencing dementia development and mortality differed in EOD and LOD. Targeted public health interventions addressing age-related risk factors may reduce dementia incidence and mortality.
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Affiliation(s)
- Min Young Chun
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
- Department of Neurology, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722, South Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, 363 Dongbaekjukjeon-daero, Giheung-gu, , Yongin-si, Gyeonggi-do, 16995, South Korea
| | - Wonjeong Chae
- Office of Strategic Planning, Healthcare Policy and Strategy Task Force, Yonsei University Health System, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
- Alzheimer's Disease Convergence Research Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
- Department of Neurology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, South Korea
| | - Jihwan Yun
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
- Department of Neurology, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-Gu, Bucheon-si, Gyeonggi-do, 14574, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Dongwoo Kang
- Department of Data Science, Hanmi Pharm. Co., Ltd, 14, Wiryeseong-daero, Songpa-gu, Seoul, South Korea
| | - Jungkuk Lee
- Department of Data Science, Hanmi Pharm. Co., Ltd, 14, Wiryeseong-daero, Songpa-gu, Seoul, South Korea
| | - Dustin B Hammers
- Department of Neurology, Indiana University School of Medicine, 355 W 16th St, Indianapolis, IN, USA
| | - Liana G Apostolova
- Department of Neurology, Indiana University School of Medicine, 355 W 16th St, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine Indianapolis, 355W 16th St, Indianapolis, IN, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, 355W 16th St, Indianapolis, IN, USA
| | - Sung-In Jang
- Department of Preventive Medicine, College of Medicine, Yonsei University, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722, South Korea.
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
- Alzheimer's Disease Convergence Research Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
- Department of Digital Health, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
- Department of Neurology, Indiana University School of Medicine, 355 W 16th St, Indianapolis, IN, USA.
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Ren Q, Wang S, Li J, Cao K, Zhuang M, Wu M, Geng J, Jia Z, Xie W, Liu A. Novel Social Stimulation Ameliorates Memory Deficit in Alzheimer's Disease Model through Activating α-Secretase. J Neurosci 2024; 44:e1689232024. [PMID: 38418221 PMCID: PMC10957211 DOI: 10.1523/jneurosci.1689-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/24/2024] [Accepted: 02/09/2024] [Indexed: 03/01/2024] Open
Abstract
As the most common form of dementia in the world, Alzheimer's disease (AD) is a progressive neurological disorder marked by cognitive and behavioral impairment. According to previous researches, abundant social connections shield against dementia. However, it is still unclear how exactly social interactions benefit cognitive abilities in people with AD and how this process is used to increase their general cognitive performance. In this study, we found that single novel social (SNS) stimulation promoted c-Fos expression and increased the protein levels of mature ADAM10/17 and sAPPα in the ventral hippocampus (vHPC) of wild-type (WT) mice, which are hippocampal dorsal CA2 (dCA2) neuron activity and vHPC NMDAR dependent. Additionally, we discovered that SNS caused similar changes in an AD model, FAD4T mice, and these alterations could be reversed by α-secretase inhibitor. Furthermore, we also found that multiple novel social (MNS) stimulation improved synaptic plasticity and memory impairments in both male and female FAD4T mice, accompanied by α-secretase activation and Aβ reduction. These findings provide insight into the process underpinning how social interaction helps AD patients who are experiencing cognitive decline, and we also imply that novel social interaction and activation of the α-secretase may be preventative and therapeutic in the early stages of AD.
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Affiliation(s)
- Qiaoyun Ren
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Susu Wang
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Junru Li
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Kun Cao
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Mei Zhuang
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Miao Wu
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Junhua Geng
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
| | - Zhengping Jia
- Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Wei Xie
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
- Jiangsu Co-innovation Center of Neuroregeneration, Southeast University, Nanjing 210096, China
| | - An Liu
- The Key Laboratory of Developmental Genes and Human Disease, Ministry of Education, The School of Life Science and Technology, Southeast University, Nanjing 210096, China
- Institute for Brain and Intelligence, Southeast University, Nanjing 210096, China
- Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
- Shenzhen Research Institute, Southeast University, Shenzhen 518063, China
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3
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Sutin AR, Luchetti M, Stephan Y, Terracciano A. Purpose in life and cognitive health: a 28-year prospective study. Int Psychogeriatr 2024:1-9. [PMID: 38454883 DOI: 10.1017/s1041610224000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVES To examine the prospective association between purpose in life measured at three points across middle and older adulthood and cognitive outcomes assessed 8-28 years later. DESIGN Prospective Study. SETTING Wisconsin Longitudinal Study of Aging (WLS). PARTICIPANTS WLS participants who reported on their purpose in life at Round 4 (1992-1994; Mage = 52.58), Round 5 (2003-2007; Mage = 63.74), and/or Round 6 (2010-2012; Mage = 70.25) and were administered a cognitive battery at Round 7 (2020; Mage = 79.94) were included in the analysis (N = 4,632). MEASUREMENTS Participants completed the Ryff measure of purpose in life and were administered the telephone interview for cognitive status and measures of verbal fluency, digit ordering, and numeric reasoning. RESULTS Purpose in life measured at age 52 was related to better global cognitive function and verbal fluency but unrelated to dementia at age 80. In contrast, purpose in life at ages 63-70 was associated with lower likelihood of dementia, as well as better global cognitive function and verbal fluency at age 80. The effect sizes were modest (median Beta coefficient = .05; median odds ratio = .85). A slightly steeper decline in purpose in life between ages 52 and 70 was found for individuals with dementia at age 80. CONCLUSIONS Purpose in life is associated with healthier cognitive function measured up to 28 years later. Individuals with lower purpose, especially in their 60s or older, and with steeper declines in purpose, are more likely to have dementia at age 80.
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Affiliation(s)
- Angelina R Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Martina Luchetti
- Florida State University College of Medicine, Tallahassee, FL, USA
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Bone JK, Bu F, Sonke JK, Fancourt D. Leisure engagement in older age is related to objective and subjective experiences of aging. Nat Commun 2024; 15:1499. [PMID: 38374197 PMCID: PMC10876530 DOI: 10.1038/s41467-024-45877-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
Leisure engagement has potential to slow health and functional decline in older age. However, the benefits of different leisure domains for different aspects of aging remains unclear. In 8771 older adults from the Health and Retirement Study (a longitudinal panel study), we measured engagement in physical, creative, cognitive, and community activities. Outcome-wide analyses used 23 aging experiences across seven domains eight years later (daily functioning, physical fitness, long-term physical health problems, heart health, weight, sleep, subjective perceptions of health). Physical activity was related to more positive experiences in all domains but heart health eight years later. Creative engagement was positively related to aging experiences in four domains longitudinally. Cognitive and community engagement were less consistently related to aging experiences. Physical and creative activities may influence important aging metrics, reducing age-related decline and keeping older adults functionally independent for longer, potentially limiting increasing healthcare costs.
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Affiliation(s)
- Jessica K Bone
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK.
| | - Feifei Bu
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
| | - Jill K Sonke
- Center for Arts in Medicine, University of Florida, Gainesville, FL, USA
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
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Doungsong K, Hartfiel N, Gladman J, Harwood R, Edwards RT. RCT-based Social Return on Investment (SROI) of a Home Exercise Program for People With Early Dementia Comparing In-Person and Blended Delivery Before and During the COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241246468. [PMID: 38650466 PMCID: PMC11036793 DOI: 10.1177/00469580241246468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/01/2024] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
Regular exercise and community engagement may slow the rate of function loss for people with dementia. However, the evidence is uncertain regarding the cost-effectiveness and social return on investment (SROI) of home exercise with community referral for people with dementia. This study aimed to compare the social value generated from the in-person PrAISED program delivered before March 2020 with a blended PrAISED program delivered after March 2020. SROI methodology compared in-person and blended delivery formats of a home exercise program. Stakeholders were identified, a logic model was developed, outcomes were evidenced and valued, costs were calculated, and SROI ratios were estimated. Five relevant and material outcomes were identified: 3 outcomes for patient participants (fear of falling, health-related quality of life, and social connection); 1 outcome for carer participants (carer strain), and 1 outcome for the National Health Service (NHS) (health service resource use). Data were collected at baseline and at 12-month follow-up. The in-person PrAISED program generated SROI ratios ranging from £0.58 to £2.33 for every £1 invested. In-person PrAISED patient participants gained social value from improved health-related quality of life, social connection, and less fear of falling. In-person PrAISED carer participants acquired social value from less carer strain. The NHS gained benefit from less health care service resource use. However, the blended PrAISED program generated lower SROI ratios ranging from a negative ratio to £0.08:£1. Compared with the blended program, the PrAISED in-person program generated higher SROI ratios for people with early dementia. An in-person PrAISED intervention with community referral is likely to provide better value for money than a blended one with limited community referral, despite the greater costs of the former.Trial registration: ISRCTN Registry ISRCTN15320670.
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Menhas R, Yang L, Danish Nisar R. Community-based social healthcare practices in China for healthy aging: a social prescription perspective analysis. Front Public Health 2023; 11:1252157. [PMID: 37849719 PMCID: PMC10578489 DOI: 10.3389/fpubh.2023.1252157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/29/2023] [Indexed: 10/19/2023] Open
Abstract
Background The global population is aging, and the number of people suffering from chronic diseases is increasing. In response to these trends, community-enhanced social healthcare practices are a novel paradigm of social prescribing that aims to improve both the community's and the individual's level of health by combining community involvement, organizational change, and individual-level practice. Objective The study examined the state of community-based social healthcare practices using the lens of social prescription in China with an eye on promoting healthy aging there. Method Thematic analysis approach was used in this investigation. A social prescription lens was used to conduct an open-ended theme study of China's community-based social healthcare practices for healthy aging. The research was conducted in Yiwu in Zhejiang Province, P. R. China. A sample of 24 "comprehensive evaluation team members (CETM)" was chosen using a purposive selection strategy. Results In the context of the social prescription, we analyzed social healthcare practices for healthy aging at the community level. All the comprehensive evaluation team members described community social healthcare practices under the paradigm of social prescription. After analyzing the community social healthcare practices under the paradigm of social prescription, six main themes (E-Social Prescription, Nature-based Social Prescription, Healthy Living Social Prescription, Culture-based Social Prescription, Health Screening Social Prescription, and Health Education Social Prescription) emerged for healthy aging at the community level. Conclusion Social prescribing links individuals to non-clinical services and activities, typically provided by the nonprofit and community sectors. Community-based social healthcare practices under social prescription can be an efficient and cost-effective way to assist patients with chronic diseases in managing their illnesses and enhancing their overall health and wellbeing.
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Affiliation(s)
- Rashid Menhas
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Lili Yang
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Rana Danish Nisar
- Department of Politics and International Relations (DPIR), University of Sargodha, Sargodha, Pakistan
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Rena M, Fancourt D, Bu F, Paul E, Sonke JK, Bone JK. Receptive and participatory arts engagement and subsequent healthy aging: Evidence from the Health and Retirement Study. Soc Sci Med 2023; 334:116198. [PMID: 37672847 PMCID: PMC11157693 DOI: 10.1016/j.socscimed.2023.116198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 08/15/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
RATIONALE Arts engagement is associated with prolonged longevity, but it remains unclear whether it is also associated with increases in the portion of people's lives for which they remain healthy. We investigated whether receptive and participatory arts engagement were associated with healthy aging two and four years later. METHOD We included 1269 older adults from the Health and Retirement Study (HRS), a longitudinal study of individuals aged 50 and above in the United States. Participants who completed the HRS 2014 Culture and the Arts Module and who were alive in 2016 and 2018 were eligible. We measured the number of participatory arts activities engaged in (e.g., crafts, dancing) and frequency of receptive arts engagement (e.g., going to a gallery or performance) in the past year. Healthy aging was a binary outcome, conceptualized as no major chronic diseases, no cognitive impairment, good physical functioning, and good mental health. RESULTS In logistic regression models, doing receptive arts once a month or more was associated with higher odds of healthy aging four years later compared to never engaging (odds ratio [OR] = 1.80, 95% CI = 1.10, 2.96). However, this evidence was attenuated after adjusting for demographic and socioeconomic covariates (adjusted OR = 1.44, 95% CI = 0.84, 2.46). The number of participatory arts activities engaged in was not associated with healthy aging two or four years later. In sensitivity analyses, there was some evidence that receptive engagement was associated specifically with higher odds of good physical functioning four years later. CONCLUSIONS The lack of consistent associations between receptive and participatory arts engagement and healthy aging was unexpected given previous evidence for links between arts engagement and each of the four domains of healthy aging. Our findings highlight key methodological issues that should be explored in further research with larger nationally representative samples, longer follow-ups, and more detailed measures of arts engagement.
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Affiliation(s)
- Melinda Rena
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Feifei Bu
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Elise Paul
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Jill K Sonke
- Center for Arts in Medicine, University of Florida, Gainesville, FL, USA
| | - Jessica K Bone
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.
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8
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Hayashi Y, Matskiv J, Galery K, Beauchet O. Productive arts engagement at the Tokyo Fuji Art Museum and its health effects on the older Japanese population: results of a randomized controlled trial. Front Med (Lausanne) 2023; 10:1188780. [PMID: 37484855 PMCID: PMC10359977 DOI: 10.3389/fmed.2023.1188780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023] Open
Abstract
Background This randomized controlled trial aims to compare changes in mental and physical health in older Japanese community-dwellers who participated in a productive art-based activity at the Tokyo Fuji Art Museum (intervention group) and in their counterparts, who did not participate in the intervention (control group). Methods A total of 73 older community-dwellers living in Tokyo participated in a single-blind RCT in two parallel groups (intervention group versus control group). The intervention was 2 h of productive art-based activities per week. The weekly sessions were carried out at the Tokyo Fuji Art Museum over a 12-week period. The control group did not participate in any productive art-based activity over the study period. Well-being, quality of life and frailty were assessed before the first, and after the last, art-based activity. These outcomes were assessed with the same schedule in both groups. Results The intervention group saw a significant improvement in their quality of life (p < 0.044) and mixed results on their physical health (i.e., decreased frailty status) when compared to the control group. The comparison of changes in frailty scores between M0 and M3 showed improvement in the intervention group (p = 0.014), but when adjusted for baseline characteristics by linear regressions, revealed only a trend (p = 0.070). No conclusive effect was shown with well-being. Interpretation This RCT showed mixed health effects of productive art engagement in older Japanese community-dwellers in Tokyo. Benefits were reported for quality of life and mixed effects were observed for frailty, while no significant effect was found for well-being.Clinical Trial Registration: Ethic committee of Shobi University, Tokyo (Japan), ref. A-2021-1; Clinical Trial Number NCT03679715.
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Affiliation(s)
- Yoko Hayashi
- Faculty of Informatics for Arts, Department of Information Expression, Shobi University, Kawagoe, Japan
- Representative Director, Arts Alive, Tokyo, Japan
| | - Jacqueline Matskiv
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
| | - Kevin Galery
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
| | - Olivier Beauchet
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
- Departments of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
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Sommerlad A, Kivimäki M, Larson EB, Röhr S, Shirai K, Singh-Manoux A, Livingston G. Social participation and risk of developing dementia. NATURE AGING 2023; 3:532-545. [PMID: 37202513 DOI: 10.1038/s43587-023-00387-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/22/2023] [Indexed: 05/20/2023]
Abstract
The increasing number of people with dementia globally illustrates the urgent need to reduce dementia's scale and impact. Lifetime social participation may affect dementia risk by increasing cognitive reserve, and through brain maintenance by reducing stress and improving cerebrovascular health. It may therefore have important implications for individual behavior and public health policy aimed at reducing dementia burden. Observational study evidence indicates that greater social participation in midlife and late life is associated with 30-50% lower subsequent dementia risk, although some of this may not be causal. Social participation interventions have led to improved cognition but, partly due to short follow-up and small numbers of participants, no reduction in risk of dementia. We summarize the evidence linking social participation with dementia, discuss potential mechanisms by which social participation is likely to reduce and mitigate the impact of neuropathology in the brain, and consider the implications for future clinical and policy dementia prevention interventions.
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Affiliation(s)
- Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK.
- Camden and Islington NHS Foundation Trust, London, UK.
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- University of Washington Schools of Medicine and Public Health, Seattle, WA, USA
| | - Susanne Röhr
- School of Psychology, Massey University, Manawatu, New Zealand
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Kokoro Shirai
- Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK
- Université Paris Cité, Inserm, U1153, Paris, France
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Zhu C, Walsh C, Zhou L, Zhang X. Latent Classification Analysis of Leisure Activities and Their Impact on ADL, IADL and Cognitive Ability of Older Adults Based on CLHLS (2008-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1546. [PMID: 36674302 PMCID: PMC9864528 DOI: 10.3390/ijerph20021546] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to research the trajectory of leisure activity and the health status of older adults and analyze the effects of leisure activity on the health status of older adults. Based on the longitudinal data of CLHLS (2008-2018), the latent growth curve model (LGCM) was used; we found that the leisure activities (LA), activities of daily living (ADL) ability, instrumental activities of daily living (IADL) ability, and cognitive ability (COG) of older adults show a nonlinear downward trend over time. Furthermore, the panel binary regression analysis is used to find that leisure activities have significant inhibitory effects on ADL disorder, IADL disorder, and cognitive impairment in the older population. In addition, by using latent profile analysis (LPA), the older population is classified into three groups according to the homogeneity of the older adults' choice of leisure activities, namely the types of relaxation, entertainment, and intellectual-learning, respectively. Based on the classification results, the analysis of one-way ANOVA shows that the rates of ADL disorder, IADL disorder, and cognitive impairment of older adults with different types are significantly different. Moreover, the inhibitory effect of leisure activities on the rate of ADL disorder, IADL disorder, and cognitive impairment of older adults is more significant in the middle-aged and high-aged groups. Therefore, older adults should be encouraged to increase leisure activities, especially those who are middle-aged and high-aged.
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Affiliation(s)
- Change Zhu
- Department of Management, Jiangsu University, 301 Xuefu Road, Jingkou District, Zhenjiang 212001, China
- Faculty of Social Work, University of Calgary, 2500 University Drive NW Calgary, Calgary, AB T2N 1N4, Canada
| | - Christine Walsh
- Faculty of Social Work, University of Calgary, 2500 University Drive NW Calgary, Calgary, AB T2N 1N4, Canada
| | - Lulin Zhou
- Department of Management, Jiangsu University, 301 Xuefu Road, Jingkou District, Zhenjiang 212001, China
| | - Xinjie Zhang
- Department of Management, Jiangsu University, 301 Xuefu Road, Jingkou District, Zhenjiang 212001, China
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11
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Kyaw KT, Levine A, Zhao AJ. Topical Review of Hobbies and Cognitive Health. J Alzheimers Dis 2023; 91:91-103. [PMID: 36404543 DOI: 10.3233/jad-220593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Establishing preventive measures to improve cognitive health of the growing older adult population is a public health priority. Though, the links between low-cost non-pharmacologist interventions that target activities like hobbies and cognitive health remain unclear. OBJECTIVE We conducted a topical review of extant literature to characterize prior findings in context and identify potential research opportunities. METHODS Search criteria was conducted with search terms "Hobbies and Dementia", "Hobbies and Cognitive Health," "Leisure Activities and Dementia," and "Leisure Activities and Cognitive Health". From the initial 383 articles, 25 articles were selected for review by using broad inclusion and exclusion criteria. RESULTS Of the 25 articles included in this review, 19 were longitudinal cohort, 1 was a retrospective cohort, 2 were case-control, and 3 were cross-sectional. These studies classified hobbies as leisure activities that were cognitive/intellectual, cultural, religious, social, gardening, traveling, or physical. These studies were conducted in the United States (9), United Kingdom (3), Sweden (3), France (5), Finland (1), Korea (1), Japan (2), and China (1). The associations of different types of hobbies with dementia from these studies were not consistent. Inconsistencies could be due to limitations of study design, lack of standardized methods, sample diversity, and differences in factors like social/cultural environment across the study populations. CONCLUSION This review examined existing evidence for the association between engagement in different types of hobbies and dementia and identified key knowledge gaps and promising approaches for future research.
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Affiliation(s)
- Kay T Kyaw
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Alec Levine
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Amanda Jin Zhao
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
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12
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Saheb M, Khodadadegan MA, Sahab Negah S, Saburi E, Hajali V. Effect of a combined program of running exercise and environmental enrichment on memory function and neurogenesis markers in amyloid-beta-induced Alzheimer-like model. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2023; 26:1400-1408. [PMID: 37970437 PMCID: PMC10634047 DOI: 10.22038/ijbms.2023.70269.15277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/31/2023] [Indexed: 11/17/2023]
Abstract
Objectives It is urgent to develop non-pharmacological interventions or multifactor combination approaches to combat Alzheimer's disease (AD). The effect of exercise (EX) combined with environmental enrichment (EE) on behavioral phenotypes and neurogenesis markers in an Alzheimer-like rat model was investigated. Materials and Methods The groups consisted of AD, sham-operated, AD+EX, AD+EE, and AD+EX+EE. AD was produced by injection of amyloid-beta (1-42, 6 µg) intrahippocampally, and a daily treadmill for 3 consecutive weeks was used for EX animals. EE was a large cage (50× 50× 50 cm) containing differently shaped objects. Spatial learning and memory were evaluated in the Morris water maze (MWM), and a shuttle box was used to evaluate inhibitory avoidance memory. RT-PCR was performed to assess the expression of early neurogenesis markers, DCX, and Sox2 within the hippocampus. Results Pretreatment with exercise and EE, both individually and in combination, could provide protection from memory impairments in AD rats. Combined treatment led to a significantly more pronounced improvement in memory deficits of AD rats than either paradigm alone. Combination therapy with exercise and EE could also reverse the passive avoidance memory impairment and hippocampal DCX expression of AD rats to the control levels. Conclusion These data suggest that exercise in combination with cognitive engagement can provide a non-pharmacological and multidomain policy that may prevent or delay AD symptoms.
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Affiliation(s)
- Mahsa Saheb
- Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sajad Sahab Negah
- Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Saburi
- Medical Genetics and Molecular Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Hajali
- Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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13
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MacRitchie J, Floridou GA, Christensen J, Timmers R, de Witte L. The use of technology for arts-based activities in older adults living with mild cognitive impairment or dementia: A scoping review. DEMENTIA 2023; 22:252-280. [PMID: 36194002 PMCID: PMC9772900 DOI: 10.1177/14713012221127359] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
For older adults living with mild cognitive impairment or dementia, creative arts-based activities can offer many benefits from enjoyment as leisure/recreation to an avenue to maintain cognitive, social and emotional wellbeing. With growing interest and recognition that technology could have potential to assist in delivering these activities in more accessible and personalised ways, a scoping review was undertaken to systematically examine the scientific literature for technology-assisted creative arts activities for older adults living with dementia. We searched PubMed, PsychINFO, Web of Science, Scopus and ACM Digital Library databases using keywords centering on population with dementia, an intervention using technology, and a context of creative arts, with no restrictions on the type of outcome measured. We retrieved 3739 records, with an additional 22 from hand-searching. 51 full-text articles met the inclusion and exclusion criteria. Findings of the review indicate technologies principally being designed for music activities (listening, and music-making), as well as storytelling and visual arts. The majority of devices were custom-made, with studies mainly reporting on validating the success of the device/intervention. This suggests most work in the field is currently at prototyping stage, although a few devices are now commercially available. Recommendations for future research includes involvement of participants reporting on their previous experiences in the arts and how this influences co-design choices, and inclusion of different severities of dementia in the participant/co-design group. Furthering device development past prototyping stage as well as collaboration between teams would enable comparisons to be made across different types of devices used for the same activity, and comparisons across arts-based activities that could lead to cross-disciplinary outcomes for the design of creative arts-based assistive technologies.
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Affiliation(s)
- Jennifer MacRitchie
- Department of Music, 7315The University of Sheffield, UK; Healthy Lifespan Institute, 7315The University of Sheffield, UK
| | | | | | - Renee Timmers
- Department of Music, 7315The University of Sheffield, UK; Healthy Lifespan Institute, 7315The University of Sheffield, UK
| | - Luc de Witte
- Centre for Assistive Technology and Connected Healthcare (CATCH), 7315The University of Sheffield, UK
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14
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Ownby RL, Waldrop D. Cogstim: A Shared Decision-making Model to Support Older Adults' Brain Health. Curr Alzheimer Res 2023; 20:202-208. [PMID: 37231715 DOI: 10.2174/1567205020666230525110814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/06/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023]
Abstract
The lack of effective treatments for cognitive decline in older adults has led to an interest in the possibility that lifestyle interventions can help to prevent changes in mental functioning and reduce the risk for dementia. Multiple lifestyle factors have been related to risk for decline, and multicomponent intervention studies suggest that changing older adults' behaviors can have a positive impact on their cognition. How to translate these findings into a practical model for clinical use with older adults, however, is not clear. In this Commentary, we propose a shared decision-making model to support clinicians' efforts to promote brain health in older persons. The model organizes risk and protective factors into three broad groups based on their mechanism of action and provides older persons with basic information to allow them to make evidence- and preference-based choices in choosing goals for effective brain health programs. A final component includes basic instruction in behavior change strategies such as goal setting, self-monitoring, and problem-solving. The implementation of the model will support older persons' efforts to develop a personally relevant and effective brainhealthy lifestyle that may help to reduce their risk for cognitive decline.
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Affiliation(s)
- Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, FL, 33316, USA
| | - Drenna Waldrop
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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15
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Son J, Sung P. The Reciprocal Relationship Between Social Engagement and Cognitive Function Among Older Adults in South Korea. J Appl Gerontol 2022; 42:928-941. [PMID: 36583249 DOI: 10.1177/07334648221148953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A greater number of studies have examined the impact of social engagement on cognitive function rather than the other way around, leaving their reciprocal association underexplored. Furthermore, formal and informal social engagement are not differentiated, although they may have independent relationships with cognitive function. This study aims to identify (1) whether informal and formal social engagements are effective in maintaining cognitive health and (2) if cognitive function has a bidirectional effect on social engagement. The study applies a dynamic panel data structural equation modeling with a maximum likelihood estimator (ML-SEM) to the Korean Longitudinal Study of Aging (KLoSA) data. The results confirm that frequent participation in organizational activities is more robustly associated with cognitive function than memberships or informal social contact. Concerning the bidirectional relationship, the cognitive function increases the degrees of informal and formal engagement. The study thus validates a reciprocal association between social engagement and cognitive function.
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Affiliation(s)
- Joonmo Son
- Department of Sociology and Anthropology, 37580National University of Singapore, Singapore
| | - Pildoo Sung
- Centre for Ageing Research and Education121579, Duke-NUS Medical School, Singapore
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16
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Li X, Zhang J, Hou R, Zheng M, Singh M, Li H, Li C, Zhang X, Yang X, Wu L, Wang Y, Zheng D. Bidirectional associations of intellectual and social activities with cognitive function among middle-aged and elderly adults in China. J Affect Disord 2022; 319:83-89. [PMID: 36116603 DOI: 10.1016/j.jad.2022.09.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies evaluating the association between leisure activities and cognitive function produced conflicting results. Different types of leisure activities may have different effects on cognition, and very few studies have explored their bidirectional associations. Our study aimed to explore whether intellectual and social activities had bidirectional associations with cognitive function among the middle-aged and elderly adults in China. METHODS Data was derived from the China Health and Retirement Longitudinal Study. The data in this study were based on 11,549 participants aged 45 or older whose intellectual and social activities and cognitive function were assessed at baseline. Cross-lagged panel model was used to examine the temporal relationship of intellectual and social activities with cognitive function. RESULTS Totally, 5624 participants completed the third follow-up in 2018. The results showed that the better the cognitive function they had at baseline, the more intellectual activities they were engage in (β = 0.044, P < 0.001) and vice versa (β = 0.042, P = 0.001). Additionally, better cognitive function at baseline was significantly associated with more engagement in social activities (β = 0.028, P = 0.030); in contrast, higher engagement in social activities at baseline was not related to better cognitive function (β = -0.008, P = 0.523). LIMITATIONS Engagement in social and intellectual activities was assessed via questionnaire. CONCLUSIONS Our findings indicated that there was a bidirectional relationship between intellectual activities and cognitive function. However, participation in social activities did not slow down the decline in cognitive function. Participating in intellectual activities, compared to social activities, is especially beneficial for cognitive function.
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Affiliation(s)
- Xiaochun Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jiajia Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Rui Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Manqi Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Manjot Singh
- Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, University of Western Australia, Crawley, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Haibin Li
- Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Xiaoyu Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Xinghua Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Lijuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
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17
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Tapia-Muñoz T, Staudinger UM, Allel K, Steptoe A, Miranda-Castillo C, Medina JT, Calvo E. Income inequality and its relationship with loneliness prevalence: A cross-sectional study among older adults in the US and 16 European countries. PLoS One 2022; 17:e0274518. [PMID: 36472996 PMCID: PMC9725142 DOI: 10.1371/journal.pone.0274518] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/27/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUNDS The prevalence of loneliness increases among older adults, varies across countries, and is related to within-country socioeconomic, psychosocial, and health factors. The 2000-2019 pooled prevalence of loneliness among adults 60 years and older went from 5.2% in Northern Europe to 24% in Eastern Europe, while in the US was 56% in 2012. The relationship between country-level factors and loneliness, however, has been underexplored. Because income inequality shapes material conditions and relative social deprivation and has been related to loneliness in 11 European countries, we expected a relationship between income inequality and loneliness in the US and 16 European countries. METHODS We used secondary cross-sectional data for 75,891 adults age 50+ from HRS (US 2014), ELSA (England, 2014), and SHARE (15 European countries, 2013). Loneliness was measured using the R-UCLA three-item scale. We employed hierarchical logistic regressions to analyse whether income inequality (GINI coefficient) was associated with loneliness prevalence. RESULTS The prevalence of loneliness was 25.32% in the US (HRS), 17.55% in England (ELSA) and ranged from 5.12% to 20.15% in European countries (SHARE). Older adults living in countries with higher income inequality were more likely to report loneliness, even after adjusting for the sociodemographic composition of the countries and their Gross Domestic Products per capita (OR: 1.52; 95% CI: 1.17-1.97). DISCUSSION Greater country-level income inequality was associated with higher prevalence of loneliness over and above individual-level sociodemographics. The present study is the first attempt to explore income inequality as a predictor of loneliness prevalence among older adults in the US and 16 European countries. Addressing income distribution and the underlying experience of relative deprivation might be an opportunity to improve older adults' life expectancy and wellbeing by reducing loneliness prevalence.
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Affiliation(s)
- Thamara Tapia-Muñoz
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago, Chile
- Millennium Institute for Caregiving Research, Santiago, Chile
- Millennium Nucleus on Sociomedicine, Santiago, Chile
| | - Ursula M. Staudinger
- Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Technische Universität Dresden, Dresden, Germany
| | - Kasim Allel
- Millennium Nucleus on Sociomedicine, Santiago, Chile
- Institute for Global Health, University College London, London, United Kingdom
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Claudia Miranda-Castillo
- Millennium Institute for Caregiving Research, Santiago, Chile
- Faculty of Nursing, Universidad Andres Bello, Santiago, Chile
- Millennium Institute for Research in Depression and Personality, Santiago, Chile
| | - José T. Medina
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago, Chile
- Millennium Nucleus on Sociomedicine, Santiago, Chile
| | - Esteban Calvo
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago, Chile
- Millennium Nucleus on Sociomedicine, Santiago, Chile
- Mailman School of Public Health, Columbia University, New York, NY, United States of America
- * E-mail:
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Wood D, Evangelopoulos D, Beevers S, Kitwiroon N, Katsouyanni K. Exposure to Ambient Air Pollution and the Incidence of Dementia in the Elderly of England: The ELSA Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15889. [PMID: 36497970 PMCID: PMC9736331 DOI: 10.3390/ijerph192315889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Increasing evidence suggests an adverse association between ambient air pollution and the incidence of dementia in adult populations, although results at present are mixed and further work is required. The present study investigated the relationships between NO2, PM10, PM2.5 and ozone on dementia incidence in a cohort of English residents, aged 50 years and older, followed up between 2004 and 2017 (English Longitudinal Study of Ageing; n = 8525). Cox proportional hazards models were applied to investigate the association between time to incident dementia and exposure to pollutants at baseline. Hazard ratios (HRs) were calculated per 10 μg/m3. Models were adjusted for age, gender, physical activity, smoking status and level of education (the latter as a sensitivity analysis). A total of 389 dementia cases were identified during follow-up. An increased risk of developing dementia was suggested with increasing exposure to PM2.5 (HR: 1.10; 95% confidence interval (CI): 0.88, 1.37), whilst NO2, PM10 and ozone exhibited no discernible relationships. Hazard ratios were 0.97 (CI: 0.89, 1.05) for NO2; 0.98 (CI: 0.89, 1.08) for PM10; 1.01 (CI: 0.94, 1.09) for ozone. In the London sub-sample (39 dementia cases), a 10 μg/m3 increase in PM10 was found to be associated with increased risk of dementia by 16%, although not statistically significant (HR: 1.16; CI: 0.90, 1.48), and the magnitude of effect for PM2.5 increased, whilst NO2 and ozone exhibited similar associations as observed in the England-wide study. Further work is required to fully elucidate the potentially adverse associations between air pollution exposure and dementia incidence.
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Affiliation(s)
- Dylan Wood
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Dimitris Evangelopoulos
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Sean Beevers
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Nutthida Kitwiroon
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Klea Katsouyanni
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Hong J, Park SJ, Lee JK, Jeong HJ, Oh J, Choi S, Jeong S, Kim KH, Son JS, Park SM. Association between community-level social trust and the risk of dementia: A retrospective cohort study in the Republic of Korea. Front Public Health 2022; 10:913319. [PMID: 36276340 PMCID: PMC9582360 DOI: 10.3389/fpubh.2022.913319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/12/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction It is known that biological risk factors and lifestyle behaviors are important determinants of dementia. However, there has been yet to be sufficient evidence to prove that community-level social capital is one of the determinants of dementia. This retrospective cohort study is a large, long-term, population-based study that investigated the association between community-level social trust and the risk of dementia in the Republic of Korea. Methods Data came from the Korean National Health Insurance Service database. The community-level social trust values were determined by the Korean Community Health Survey. The study population consisted of 1,974,944 participants over 50 years of age and was followed up from 1 January 2012 to 31 December 2019 with a latent period of 5 years from 1 January 2012 to 31 December 2016. Cox proportional hazards regression was utilized to obtain the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the risk of dementia according to social trust quintiles. Results Participants within the highest quintile of community-level social trust had a lower risk for overall dementia (aHR, 0.90; 95% CI, 0.86-0.94) and Alzheimer's disease (aHR, 0.90; 95% CI, 0.85-0.94) compared to those within the lowest quintile of community-level social trust. The alleviating trend association of high community-level social trust on dementia risk was maintained regardless of whether the participants had health examinations. Conclusions Our findings suggest that higher community-level social trust is associated with a reduced risk of dementia. Community-level social trust is a crucial indicator of dementia and improving community-level social trust may lead to a lower risk of dementia.
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Affiliation(s)
- Jaeyi Hong
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea,Department of Statistics, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sun Jae Park
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jong-Koo Lee
- National Academy of Medicine of Korea, Seoul, South Korea
| | - Hye Jin Jeong
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea,Comprehensive Care Clinic, Public Healthcare Center, Seoul National University Hospital, Seoul, South Korea
| | - Juhwan Oh
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea,Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam, South Korea
| | - Kyae Hyung Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea,Comprehensive Care Clinic, Public Healthcare Center, Seoul National University Hospital, Seoul, South Korea
| | - Joung Sik Son
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea,Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea,*Correspondence: Sang Min Park
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20
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Tierney S, Libert S, Gorenberg J, Wong G, Turk A, Husk K, Chatterjee HJ, Eccles K, Potter C, Webster E, McDougall B, Warburton H, Shaw L, Roberts N, Mahtani KR. Tailoring cultural offers to meet the needs of older people during uncertain times: a rapid realist review. BMC Med 2022; 20:260. [PMID: 35999539 PMCID: PMC9398500 DOI: 10.1186/s12916-022-02464-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-medical issues (e.g. loneliness, financial concerns, housing problems) can shape how people feel physically and psychologically. This has been emphasised during the Covid-19 pandemic, especially for older people. Social prescribing is proposed as a means of addressing non-medical issues, which can include drawing on support offered by the cultural sector. METHOD A rapid realist review was conducted to explore how the cultural sector (in particular public/curated gardens, libraries and museums), as part of social prescribing, can support the holistic well-being of older people under conditions imposed by the pandemic. An initial programme theory was developed from our existing knowledge and discussions with cultural sector staff. It informed searches on databases and within the grey literature for relevant documents, which were screened against the review's inclusion criteria. Data were extracted from these documents to develop context-mechanism-outcome configurations (CMOCs). We used the CMOCs to refine our initial programme theory. RESULTS Data were extracted from 42 documents. CMOCs developed from these documents highlighted the importance of tailoring-shaping support available through the cultural sector to the needs and expectations of older people-through messaging, matching, monitoring and partnerships. Tailoring can help to secure benefits that older people may derive from engaging with a cultural offer-being distracted (absorbed in an activity) or psychologically held, making connections or transforming through self-growth. We explored the idea of tailoring in more detail by considering it in relation to Social Exchange Theory. CONCLUSIONS Tailoring cultural offers to the variety of conditions and circumstances encountered in later life, and to changes in social circumstances (e.g. a global pandemic), is central to social prescribing for older people involving the cultural sector. Adaptations should be directed towards achieving key benefits for older people who have reported feeling lonely, anxious and unwell during the pandemic and recovery from it.
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Affiliation(s)
| | | | | | - Geoff Wong
- University of Oxford, Oxford, Oxfordshire, UK
| | - Amadea Turk
- University of Oxford, Oxford, Oxfordshire, UK
| | | | | | | | | | | | | | | | - Lucy Shaw
- University of Oxford, Oxford, Oxfordshire, UK
| | - Nia Roberts
- University of Oxford, Oxford, Oxfordshire, UK
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21
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Yu B, Kelly S. Does artistic activity help kids avoid obesity? Emergent considerations in the ecology of childhood BMI. Prev Med 2022; 161:107120. [PMID: 35750262 DOI: 10.1016/j.ypmed.2022.107120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/07/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
Although the positive relationship between arts engagement and mental health is well documented, arts participation may be an emergent factor in the ecology of childhood obesity. Prior research hypothesized several potential health benefits of arts participation including healthy diet and lifestyles, but the available evidence is mainly limited to cross-sectional covariate-adjustment models for the adult population. We employed a newly released panel of the Early Childhood Longitudinal Study kindergarten cohort (ECLS-K: 2011), which is a nationally representative sample of American children who entered kindergarten in 2010-2011 (n = 15,820). We applied both dynamic panel models with Maximum Likelihood estimation as well as difference-in-differences models to address unobserved heterogeneity. Our results showed that childhood arts activity is significantly associated with reduced weight status in elementary schooling. In particular, arts participation in elementary schooling reduced the risk of being overweight on a year-to-year basis; the effect size was between 12% and 23% of a SD of BMI for all children. Arts participation at kindergarten also had a significant relationship with cumulative changes in BMI over the course of elementary schooling, especially for female and White female children (about 22% and 32% of a SD of BMI). There are considerable arts participation gaps between families and regions, and these early artistic experiences appear to affect the risk of being overweight. This suggests the possibility of a larger social reproduction process via an ecological pathway that might be easily overlooked-the accumulation of arts experience and concurrent health inequalities in childhood.
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Affiliation(s)
- Baeksan Yu
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway; PROMENTA Research Center, Department of Psychology, University of Oslo, Norway.
| | - Sean Kelly
- Department of Educational Foundations, Organizations, and Policy, University of Pittsburgh, PA, USA
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22
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Lai PY, Wang WF, Chang MC, Jhang KM. The Effectiveness of Community Aging Care Centers on Global Function for People Living with Dementia. J Alzheimers Dis 2022; 89:553-562. [PMID: 35912745 DOI: 10.3233/jad-220372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The global population with dementia is growing rapidly. Dementia patients have been included in the services of the long-term care Act 2.0, supported by Taiwan's government since 2017. Community aging care centers are extensively established, which are places providing social connections and group physical and cognitive training programs for elderly people. OBJECTIVE To elucidate the efficacy of community aging care centers on cognitive function in people with dementia. METHODS A total of 1,277 patients with dementia diagnosed at the Changhua Christian Hospital outpatient departments were enrolled. A total of 113 patients who used community aging care centers and 452 subjects matched for age, education, and initial score of clinical dementia rating scale sum of boxes (CDR-SOB) control group were analyzed. The primary outcome was the change in CDR-SOB scores before and after utilization of community aging care centers. RESULTS The mean annual change of CDR-SOB scores were 1.72±2.97, 1.08±2.36, and 1.04±3.64 in control, Community Service Centers for Dementia, and community elderly stations, respectively, after about 1.5 years follow-up. Patients with dementia using community aging care centers had significantly less progression in CDR-SOB scores than those in the control group (-0.65; 95% CI: -1.27, -0.03; p = 0.041). Using one more day of community aging care centers per week significantly promotes 0.16 points of CDR-SOB decline (-0.16, 95% CI: -0.31; -0.00; p = 0.045). CONCLUSION Community aging care centers, based on the long-term care Act 2.0 in Taiwan, were effective in delaying the decline in global function in people living with dementia.
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Affiliation(s)
- Po-Yu Lai
- Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Recreation and Holistic Wellness, Ming Dao University, Changhua, Taiwan
| | - Ming-Che Chang
- Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
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23
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The role of cognitive and social leisure activities in dementia risk: assessing longitudinal associations of modifiable and non-modifiable risk factors. Epidemiol Psychiatr Sci 2022; 31:e5. [PMID: 35499392 PMCID: PMC8786616 DOI: 10.1017/s204579602100069x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIMS With the projected surge in global dementia cases and no curative treatment available, research is increasingly focusing on lifestyle factors as preventive measures. Social and cognitive leisure activities are promising targets, but it is unclear which types of activities are more beneficial. This study investigated the individual and joint contribution of cognitive and social leisure activities to dementia risk and whether they modify the risks associated with other potentially modifiable and non-modifiable risk factors. METHODS We used data from the English Longitudinal Study of Ageing (ELSA) from 7917 participants, followed up from 2008/2009 (Wave 4) until 2018/2019 (Wave 9) for incident dementia. Self-reported baseline cognitive activities (e.g. 'reading the newspaper'), the number of social memberships (e.g. being a member of a social club) and social participation (e.g. 'going to the cinema') were clustered into high and low based on a median split. Subsequently, their individual and joint contribution to dementia risk, as well as their interaction with other dementia risk factors, were assessed with Cox regression models, adjusting for age, sex, level of education, wealth and a composite score of 11 lifestyle-related dementia risk factors. RESULTS After a median follow-up period of 9.8 years, the dementia incidence rate was 54.5 cases per 10.000 person-years (95% CI 49.0-60.8). Adjusting for demographic and other lifestyle-related risk factors, higher engagement in cognitive activities (HR = 0.58; 95% CI 0.40-0.84), a greater number of social memberships (HR = 0.65; 95% CI 0.51-0.84) and more social participation (HR = 0.71; 95% CI 0.54-0.95) were associated with lower dementia risk. In a joint model, only engagement in cognitive activities (HR = 0.60; 95% CI 0.40-0.91) and social memberships (HR = 0.75; 95% CI 0.56-0.99) independently explained dementia risk. We did not find any interaction with other modifiable and non-modifiable risk factors. CONCLUSIONS Engagement in cognitive and social leisure activities may be beneficial for overall dementia risk, independent of each other and other risk factors. Both types of activities may be potential targets for dementia prevention measures and health advice initiatives.
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Stephan Y, Sutin AR, Luchetti M, Aschwanden D, Terracciano A. Self-rated health and incident dementia over two decades: Replication across two cohorts. J Psychiatr Res 2021; 143:462-466. [PMID: 34311955 DOI: 10.1016/j.jpsychires.2021.06.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 11/25/2022]
Abstract
This prospective study examined the association between self-rated health and incident dementia in two large cohorts of middle-aged and older adults. Participants were drawn from the Health and Retirement Study (HRS, N = 13,839, Mean Age = 64.32, SD = 9.04) and the English Longitudinal Study of Ageing (ELSA, N = 4649, Mean Age = 64.44, SD = 9.97). Self-rated health and covariates were assessed at baseline in 1998 and 2002, and cognitive status was tracked for up to 21 years in HRS and 17 years in ELSA, respectively. Controlling for demographic factors, poorer self-rated health was associated with higher risk of incident dementia in HRS (HR: 1.18, 95%CI: 1.12-1.24, p < .001) and ELSA (HR: 1.38, 95%CI: 1.23-1.55, p < .001). These associations remained significant when diabetes, hypertension, smoking, physical inactivity, depressive symptoms, personality, and polygenic risk for Alzheimer's Disease were included as additional covariates or when cases occurring within the first ten years of follow-up were excluded from the analyses. There was no replicable evidence that age, sex, education, race or ethnicity moderated the association. Self-rated health is a long-term, replicable predictor of incident dementia that is independent of genetic, clinical, and behavioral risk factors.
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Giebel C, Morley N, Komuravelli A. A socially prescribed community service for people living with dementia and family carers and its long-term effects on well-being. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1852-1857. [PMID: 33528081 DOI: 10.1111/hsc.13297] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/14/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Support services for people with dementia are variable depending on the area or town they live. People with dementia and family carers can often get very little support after a diagnosis. Services might not be suitable or they may not be aware of the service in the first place. The aim of this study was to evaluate a socially prescribed community service provided to people with dementia and family carers offering physical and mental activities. People with dementia and family carers were recruited from a community centre in the North West of England to complete in this study. Participants provided demographic information and completed the Short Warwick-Edinburgh Mental Well-Being Scale at baseline, and after 3 and 6 months. Postcode data were used to generate an Index of Multiple Deprivation score for information on participants' socioeconomic background. Data were analysed using paired samples t-tests to compare well-being scores between baseline and follow-up assessments. A total of 25 people with dementia (n = 14) and family carers (n = 11) participated in the service. Visits ranged from 1 to 36, with 22 and 15 participants completing the 3- and 6-month follow-up respectively. Some reasons for discontinuation were lack of transport and other commitments. Most participants lived in some of the most disadvantaged neighbourhoods. Compared to baseline, well-being was significantly higher at both follow-ups. This is one of the first studies reporting the benefits of a social prescribing service in dementia. Future implementation work needs to design an implementation plan so that the service can be implemented in other community centres across the country.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | | | - Aravind Komuravelli
- NIHR ARC NWC, Liverpool, UK
- North West Boroughs NHS Foundation Trust, Warrington, UK
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26
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Sutin AR, Aschwanden D, Luchetti M, Stephan Y, Terracciano A. Sense of Purpose in Life Is Associated with Lower Risk of Incident Dementia: A Meta-Analysis. J Alzheimers Dis 2021; 83:249-258. [PMID: 34275900 DOI: 10.3233/jad-210364] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND A sense of purpose in life has been associated with healthier cognitive outcomes across adulthood, including risk of dementia. The robustness and replicability of this association, however, has yet to be evaluated systematically. OBJECTIVE To test whether a greater sense of purpose in life is associated with lower risk of dementia in four population-based cohorts and combined with the published literature. METHODS Random-effect meta-analysis of prospective studies (individual participant data and from the published literature identified through a systematic review) that examined sense of purpose and risk of incident dementia. RESULTS In six samples followed up to 17 years (four primary data and two published; total N = 53,499; n = 5,862 incident dementia), greater sense of purpose in life was associated with lower dementia risk (HR = 0.77, 95%CI = 0.73-0.81, p < 0.001). The association was generally consistent across cohorts (I2 = 47%), remained significant controlling for clinical (e.g., depression) and behavioral (e.g., physical inactivity) risk factors, and was not moderated by age, gender, or education. CONCLUSION Sense of purpose is a replicable and robust predictor of lower risk of incident dementia and is a promising target of intervention for cognitive health outcomes.
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Affiliation(s)
- Angelina R Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
| | | | - Martina Luchetti
- Florida State University College of Medicine, Tallahassee, FL, USA
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27
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Arab A, Christie GJ, Mansouri M, Ahmadzadeh M, Sixsmith A, Ester M, Moreno S. Moderate-Intensity Physical Activity, Music and Art Activities Preserved Cognitive Health in Older Adults: An Argument for Social Prescribing Solution. Front Aging Neurosci 2021; 13:693791. [PMID: 34483879 PMCID: PMC8415746 DOI: 10.3389/fnagi.2021.693791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/05/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction: Rates of dementia are projected to increase over the coming years as global populations age. Without a treatment to slow the progression of dementia, many health policies are focusing on preventing dementia by slowing the rate of cognitive decline with age. However, it is unclear which lifestyle changes in old age meaningfully reduce the rate of cognitive decline associated with aging. Objectives: Use existing, multi-year longitudinal health data to determine if engagement in a variety of different lifestyle activities can slow the rate of cognitive decline as older adults age. Method: Data from the English Longitudinal Study of Aging was analyzed using a quasi-experimental, efficient matched-pair design inspired by the clinical trial methodology. Changes in short-term memory scores were assessed over a multi-year interval for groups who undertook one of 11 different lifestyle activities, compared to control groups matched across confounding socioeconomic and lifestyle factors. Results: Two factors, moderate-intensity physical activity and learning activities, resulted in significant positive impact on cognitive function. Conclusion: Our analysis brings cognitive benefit arguments in favor of two lifestyle activities, moderate-intensity physical activity and learning activities, while rejecting other factors advanced by the literature such as vigorous-intensity physical activity. Those findings justify and encourage the development of new lifestyle health programs by health authorities and bring forward the new health system solution, social prescribing.
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Affiliation(s)
- Ali Arab
- School of Computing Science, Simon Fraser University, Burnaby, BC, Canada
| | - Gregory J. Christie
- School of Interactive Arts and Technology, Simon Fraser University, Burnaby, BC, Canada
- Science and Technology for Aging Research Institute, Simon Fraser University, Burnaby, BC, Canada
| | - Mehrdad Mansouri
- School of Computing Science, Simon Fraser University, Burnaby, BC, Canada
| | - Maryam Ahmadzadeh
- School of Interactive Arts and Technology, Simon Fraser University, Burnaby, BC, Canada
| | - Andrew Sixsmith
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Martin Ester
- School of Computing Science, Simon Fraser University, Burnaby, BC, Canada
| | - Sylvain Moreno
- School of Interactive Arts and Technology, Simon Fraser University, Burnaby, BC, Canada
- Science and Technology for Aging Research Institute, Simon Fraser University, Burnaby, BC, Canada
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28
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Lim MH, Qualter P, Hennessey A, Smith BJ, Argent T, Holt-Lunstad J. A randomised controlled trial of the Nextdoor Kind Challenge: a study protocol. BMC Public Health 2021; 21:1510. [PMID: 34353299 PMCID: PMC8339389 DOI: 10.1186/s12889-021-11489-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/09/2021] [Indexed: 12/27/2022] Open
Abstract
Background Community interventions are often promoted as a way of reducing loneliness and social isolation in our neighbourhoods. However, those community interventions are rarely examined within rigorous study designs. One strategy that holds the potential to reduce loneliness and can promote health and wellbeing is doing acts of kindness. The current study involves evaluating the impact of kindness acts on loneliness in community-dwelling individuals using an online social networking platform. Methods This study is made up of three randomised controlled trials conducted in three countries. Each randomised controlled trial has two arms (intervention vs waitlist control) and is designed to compare the effectiveness of the KIND challenge, which involves doing at least one act of kindness per week within a four-week period. This study will recruit users of an online community, be randomised online, and will be conducted using online assessments. We will first explore the effects of the intervention on the primary outcome of loneliness, followed by secondary outcomes, social isolation, neighbour relationship quality and contact, mental health symptoms, stress, quality of life, and positive affect. Further, we will assess the feasibility, acceptability, and safety of the KIND Challenge. Discussion This study, designed to evaluate the impact of kindness on the community, will be the first large scale randomised control trial conducted across three countries, Australia, UK, and USA. It will examine the potential of community-led interventions to reduce loneliness, improve social isolation, and promote neighbourhood cohesion, health, and wellbeing, which is especially crucial during the COVID-19 public health crisis. Trial registration Clinical Trials Registry. NCT04398472. Registered 21st May 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11489-y.
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Affiliation(s)
- Michelle H Lim
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | | | - Ben J Smith
- University of Sydney, Camperdown, NSW, Australia
| | - Taylah Argent
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Julianne Holt-Lunstad
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,Brigham Young University, Provo, UT, USA
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29
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Yun SH, Jo SH, Jung HS, Koo BH, Kim HG. Characteristics of Individuals Who Converted to Dementia during a 5-Year Follow-Up. Dement Geriatr Cogn Disord 2021; 49:503-510. [PMID: 33053557 DOI: 10.1159/000510564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Early diagnosis of dementia is important; however, the diagnostic criteria for the preclinical stage of dementia, including biomarkers and pathophysiological markers, are not suitable for application in patients in real-world clinical settings. One potential noninvasive method to predict the risk of dementia conversion is the neuropsychological test. Therefore, in this study, we examined the results of various assessments, such as comprehensive neuropsychological tests, and the daily function of participants who were evaluated periodically for 5 years. METHODS All participants were outpatients or inpatients with subjective cognitive complaints, who visited a local university hospital for neuropsychiatric evaluation, between January 2011 and January 2019. Of a total of 1,652 subjects who underwent initial screening during this period, 107 were nondemented individuals. These participants underwent periodic comprehensive cognitive tests for up to 5 years. Survival and factors affecting dementia conversion were analyzed using the time-dependent Cox regression analysis. Assessment items included demographic information, including age, sex, and education; 5 cognitive domains of a comprehensive neuropsychological test including memory, language, attention, visuospatial functions, and frontal (executive) function; Barthel's activities of daily living; the mini-mental state examination findings; and clinical dementia rating (CDR) scores. RESULTS This study included 61 participants (21 women and 40 men) who developed dementia during the study period. Verification of the cognitive variables affecting dementia conversion revealed that better memory was associated with a lower risk of conversion (hazard ratio [HR] = 0.614, p = 0.005) and higher attention was associated with a higher risk of conversion (HR = 1.602, p = 0.023). In the analysis of the subscales of the CDR, a higher community affairs score (i.e., less social activities) was associated with a higher risk of conversion (HR = 10.814, p = 0.028). CONCLUSION Individuals with prominent memory decline or problems with social activities should be carefully observed for dementia conversion. Cognitive intervention techniques for cognitive stimulation, such as social and leisure activities, as well as cognitive training need to be actively used for patients in whom dementia is a concern.
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Affiliation(s)
- Seok-Ho Yun
- Department of Psychiatry, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - So-Hye Jo
- Department of Psychiatry, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Hyun-Seok Jung
- Department of Psychology, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Bon-Hoon Koo
- Department of Psychiatry, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Hye-Geum Kim
- Department of Psychiatry, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea,
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Fancourt D, Aughterson H, Finn S, Walker E, Steptoe A. How leisure activities affect health: a narrative review and multi-level theoretical framework of mechanisms of action. Lancet Psychiatry 2021; 8:329-339. [PMID: 33581775 PMCID: PMC7613155 DOI: 10.1016/s2215-0366(20)30384-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 01/24/2023]
Abstract
There is a large and growing body of evidence on the health benefits of engagement in leisure activities (voluntary, enjoyable non-work activities, such as hobbies, arts, volunteering, community group membership, sports, and socialising). However, there is no unifying framework explaining how leisure activities affect health: what the mechanisms of action are by which engagement with leisure activities leads to the prevention, management, or treatment of mental and physical illness. In this Review, we identify and map over 600 mechanisms of action. These mechanisms can be categorised as psychological, biological, social, and behavioural processes that operate at individual (micro), group (meso), and societal (macro) levels, and are synthesised into a new theoretical framework: the Multi-level Leisure Mechanisms Framework. This framework situates understanding of leisure activities within the theoretical lens of complex adaptive systems and aims to support the design of more theory-driven, cross-disciplinary studies.
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Affiliation(s)
- Daisy Fancourt
- Department of Behavioural Science & Health, University College London, London, UK.
| | - Henry Aughterson
- Department of Behavioural Science & Health, University College London, London, UK
| | - Saoirse Finn
- Department of Behavioural Science & Health, University College London, London, UK
| | - Emma Walker
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science & Health, University College London, London, UK
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Løkken BI, Merom D, Sund ER, Krokstad S, Rangul V. Association of engagement in cultural activities with cause-specific mortality determined through an eight-year follow up: The HUNT Study, Norway. PLoS One 2021; 16:e0248332. [PMID: 33705441 PMCID: PMC7951895 DOI: 10.1371/journal.pone.0248332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 02/25/2021] [Indexed: 11/18/2022] Open
Abstract
Participation in cultural activities may protect against cause-specific mortality; however, there is limited knowledge regarding this association. The present study examines the association between participation in a range of receptive and creative cultural activities and risk of cardiovascular disease- and cancer-related mortality. We also examined whether participation in such activities and influence by gender have on this association. We followed 35,902 participants of the Nord-Trøndelag Health Study (HUNT3) of Cardiovascular-Disease and Cancer Mortality from 2006-08 to 2016. Cox proportional-hazards regression was used to estimate the risk of specific mortality based on baseline cultural participation. During the eight-year follow-up, there were 563 cardiovascular-disease- and 752 cancer-related deaths among the sample (292,416 person years). Risk of cardiovascular-disease mortality was higher among non-participants in associations/club meetings (22%) and outdoor activities (23%), respectively, as well as non-attendees of art exhibitions (28%). People who engaged in music, singing, and theatre had a 27% reduced risk of cancer-related mortality when compared to non-participants. Among women, participating in associations/club meetings reduced the risk of cardiovascular-disease mortality by 36%. Men who participated in music, singing, and theatre had a 33% reduced risk of cancer mortality. Overall, a reduced risk of cardiovascular-disease mortality was associated with engaging in creative activities on weekly basis to less than twice per week. For both genders, participating in creative activities less than once a week reduced cardiovascular-disease mortality risk by 40% and 33%, respectively. For the overall sample, participating > 2 times per week in combined receptive and creative activities reduced cancer-related mortality by 29%. Participating frequently in both receptive and creative activities cultural activities was associated with lower risks of CVD and cancer-related mortality. Our data suggest that, to counteract the public health burden of cardiovascular disease- and cancer mortality, policies and initiatives to increase citizens' participation in cultural activities should be considered.
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Affiliation(s)
| | - Dafna Merom
- School of Health Science, Western Sydney University, Sydney, New South Wales, Australia
| | - Erik R. Sund
- Nord University, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Levanger Hospital, Nord-Trøndelags Hospital Trust, Levanger, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Levanger Hospital, Nord-Trøndelags Hospital Trust, Levanger, Norway
- Norwegian Resource Centre for Arts and Health, Levanger, Norway
| | - Vegar Rangul
- Nord University, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Norwegian Resource Centre for Arts and Health, Levanger, Norway
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Effectiveness of Social Prescribing Programs in the Primary Health-Care Context: A Systematic Literature Review. SUSTAINABILITY 2021. [DOI: 10.3390/su13052731] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Social prescribing (SP) is an approach that promotes the use of local non-clinical activities by people. The referral is usually made by primary health-care professionals, in a process wherein local providers play a pivotal role. The main objective of this study was to identify domains of intervention and evidence about the effectiveness of SP programs regarding health-related outcomes. A systematic literature review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in PubMed, CINHAL, and SCOPUS. Inclusion criteria of the reviewed papers were as follows: (i) effectiveness studies of interventions designated as SP or interventions entailing SP conceptual components; (ii) interventions with adults. Quality assessment was performed with the Cochrane tool for assessing risk of bias in randomized trials; an assessment tool developed by the US National Heart, Lung and Blood Institute was applied to observational studies. Overall, 13 articles were included for analysis, with a total of 4603 patients. Although three studies comprised a control group, only two followed a randomized controlled trials (RCT) design. Nine principal domains of intervention within SP were identified, with three categories of outcome measures: Physical and psychological wellbeing; Health behaviors and self-efficacy; and Health care resources end economic evaluation. SP is an emergent and promising health-care intervention, and it has been used to promote different health behaviors. Evidence of SP effectiveness on patient’s health and wellbeing is not strong. Further research is needed for understanding how SP can be applied efficiently.
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Floud S, Balkwill A, Sweetland S, Brown A, Reus EM, Hofman A, Blacker D, Kivimaki M, Green J, Peto R, Reeves GK, Beral V. Cognitive and social activities and long-term dementia risk: the prospective UK Million Women Study. Lancet Public Health 2021; 6:e116-e123. [PMID: 33516288 PMCID: PMC7848753 DOI: 10.1016/s2468-2667(20)30284-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND Although dementia is associated with non-participation in cognitive and social activities, this association might merely reflect the consequences of dementia, rather than any direct effect of non-participation on the subsequent incidence of dementia. Because of the slowness with which dementia can develop, unbiased assessment of any such direct effects must relate non-participation in such activities to dementia detection rates many years later. Prospective studies with long-term follow-up can help achieve this by analysing separately the first and second decade of follow-up. We report such analyses of a large, 20-year study. METHODS The UK Million Women Study is a population-based prospective study of 1·3 million women invited for National Health Service (NHS) breast cancer screening in median year 1998 (IQR 1997-1999). In median year 2001 (IQR 2001-2003), women were asked about participation in adult education, groups for art, craft, or music, and voluntary work, and in median year 2006 (IQR 2006-2006), they were asked about reading. All participants were followed up through electronic linkage to NHS records of hospital admission with mention of dementia, the first mention of which was the main outcome. Comparing non-participation with participation in a particular activity, we used Cox regression to assess fully adjusted dementia risk ratios (RRs) during 0-4, 5-9, and 10 or more years, after information on that activity was obtained. FINDINGS In 2001, 851 307 women with a mean age of 60 years (SD 5) provided information on participation in adult education, groups for art, craft, or music, and voluntary work. After 10 years, only 9591 (1%) had been lost to follow-up and 789 339 (93%) remained alive with no recorded dementia. Follow-up was for a mean of 16 years (SD 3), during which 31 187 (4%) had at least one hospital admission with mention of dementia, including 25 636 (3%) with a hospital admission with dementia mentioned for the first time 10 years or more after follow-up began. Non-participation in cognitive or social activities was associated with higher relative risks of dementia detection only during the first decade after participation was recorded. During the second decade, there was little association. This was true for non-participation in adult education (RR 1·04, 99% CI 0·98-1·09), in groups for art, craft, or music (RR 1·04, 0·99-1·09), in voluntary work (RR 0·96, 0·92-1·00), or in any of these three (RR 0·99, 0·95-1·03). In 2006, 655 118 women provided information on reading. For non-reading versus any reading, there were similar associations with dementia, again with strong attenuation over time since reading was recorded, but longer follow-up is needed to assess this reliably. INTERPRETATION Life has to be lived forwards, but can be understood only backwards. Long before dementia is diagnosed, there is a progressive reduction in various mental and physical activities, but this is chiefly because its gradual onset causes inactivity and not because inactivity causes dementia. FUNDING UK Medical Research Council, Cancer Research UK.
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Affiliation(s)
- Sarah Floud
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK.
| | | | - Siân Sweetland
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Anna Brown
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | | | - Albert Hofman
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Deborah Blacker
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jane Green
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Richard Peto
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Valerie Beral
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
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Felix C, Rosano C, Zhu X, Flatt JD, Rosso AL. Greater Social Engagement and Greater Gray Matter Microstructural Integrity in Brain Regions Relevant to Dementia. J Gerontol B Psychol Sci Soc Sci 2020; 76:1027-1035. [PMID: 33219690 DOI: 10.1093/geronb/gbaa173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Social engagement (SE) may protect against cognitive decline in older adults. We estimate associations of SE with gray matter (GM) microstructure in regions of interest (ROI) relevant to social cognition, among community-dwelling older adults. METHOD Cross-sectional analysis of 293 Health ABC study participants who underwent 3 Tesla magnetic resonance imaging with diffusion tensor and free from cognitive impairment was conducted. Linear regression models tested associations between SE index (marital status, not living alone, social activities, work, and volunteering) and mean diffusivity (MD) of GM ROIs, adjusted for age, race, gender, and education. Hearing and activities of daily living (ADL) difficulties were tested as confounders. Effect modification by gender was tested with interaction terms and stratification by gender. RESULTS Higher SE was significantly related to lower MD (greater GM microstructural integrity) (shown as standardized estimate [p-value]) in left middle frontal gyrus-orbital part: -.168 (.005), left caudate nucleus: -.141 (.02), left temporal pole-middle temporal gyrus: -.136 (.03), right middle frontal gyrus: -.160 (.006), right superior frontal gyrus-orbital part: -.187 (.002), and right middle frontal gyrus-orbital part: -.124 (.04), when adjusted for demographic attributes. Associations were robust to adjustments for hearing or ADL difficulty. There was significant effect modification by gender for some ROIs, with associations only for females. DISCUSSION SE is related to greater microstructural integrity of specific GM regions relevant to social cognition, that have described roles in dementia. SE may therefore be a useful preventive mechanism against loss of GM integrity in older adults.
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Affiliation(s)
- Cynthia Felix
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Jason D Flatt
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada Las Vegas
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
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Abstract
Clinicians should use a systematic approach to evaluating patients presenting with a concern for cognitive impairment. This approach includes interviewing a knowledgeable informant and performing a thorough mental status examination in order to determine the presence of functional impairments and the domains of cognition that are impaired. The results of this interview and examination determine the next steps of the diagnostic work-up. The pattern of cognitive impairment shapes the differential diagnosis. Treatment should address symptoms, and environmental, psychological, and behavioral interventions are essential.
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Affiliation(s)
- Lauren McCollum
- Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA; Ralston House, Penn Memory Center, ATTN: Maria Crudele, 3615 Chestnut Street, Philadelphia, PA 19104-2612, USA.
| | - Jason Karlawish
- Ralston House, Penn Memory Center, ATTN: Maria Crudele, 3615 Chestnut Street, Philadelphia, PA 19104-2612, USA; Division of Geriatrics, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA. https://twitter.com/jasonkarlawish
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36
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Wright L. Arts engagement, mortality and dementia: what can the data say? J Epidemiol Community Health 2020; 74:764. [PMID: 32535551 DOI: 10.1136/jech-2020-214227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/15/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Liam Wright
- Department of Epidemiology and Public Health, University College London, London, UK
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