Associations Between Abdominal Obesity, Chewing Difficulty and Cognitive Impairment in Dementia-Free Chinese Elderly

Correlation between the utilization of sodium-glucose cotransporter-2 (SGLT2) inhibitors and the risk of dementia: a nationwide population-based study in Taiwan

The impact of sodium-glucose cotransporter 2 inhibitors (SLGT2i) usage on reducing the risk of dementia remains uncertain. Our research seeks to establish the association between dementia risk and SLGT2 inhibitors among individuals with diabetes. This study relied on data from the Taiwan National Health Insurance Database (NHIRD), which was established in 1995 coinciding with the launch of the National Health Insurance (NHI) program by the Taiwanese government. The NHI program was implemented to enhance the healthcare system and public health in Taiwan. Patients with type 2 diabetes mellitus (T2DM) administered SGLT2i between 2016 and 2019 were included in the SGLT2i cohort. The comparison cohort consisted of patients who did not receive SGLT2i, propensity score matching by sex, age (in 5-y intervals), index date year, insurance fee, urbanization, comorbidities, and medications, with a 1:1 ratio of the exposure group. SGLT2i users had a significantly lower risk of dementia than non-SGLT2i users after adjusting for age, sex, insurance fees, urbanization, comorbidities, and medications (adjusted HR = 0.53, 95%CI: 0.50-0.57). The results revealed that patients treated with SGLT2i have a lower risk of dementia in Taiwan.

The association between abdominal obesity and depressive symptoms among Chinese adults: Evidence from national and regional communities

BACKGROUND

The association between body shape and depressive symptoms has been reported in adults. The present study aimed to investigate the association between body shape-specific abdominal obesity and depressive symptoms among multi-regional Asian adults.

METHODS

The 2011-2012 China Health and Retirement Longitudinal Study and 2022-2023 Hangzhou study were used as the discovery and validation datasets, respectively. Body shape was assessed by body mass index categories. Abdominal obesity was defined as a body shape index (ABSI) ≥ 75th centile. Depression was measured using 10-item Centre for Epidemiological Studies Depression Scale and Geriatric Depression Scale short 15-item version, respectively. General linear and multinomial logistic models were used to explore the association of ABSI, abdominal obesity with depressive scores and presence, respectively.

RESULTS

A total of 12,229 and 1210 participants were included in the discovery and validation datasets, respectively. A non-linear reverse L-shaped association was found between ABSI and depressive scores. Participants with abdominal obesity had higher depressive scores (β = 0.05, 95%CI = 0.01-0.09; and β = 0.13, 95%CI = 0.01-0.24; respectively). Stratified analyses showed that abdominal obesity was associated with higher depressive scores (β = 0.09, 95%CI = 0.00-0.17; and β = 0.25, 95%CI = 0.05-0.46; respectively) and presence (OR = 1.46, 95%CI = 1.02-2.10; and OR = 3.95, 95%CI = 1.58-9.84; respectively) in overweight adults. Furthermore, abdominal obesity was associated with depressive symptoms among overweight females, but not among males.

LIMITATION

Causal links weren't addressed because of the observational study design.

CONCLUSION

Abdominal obesity exhibited a positive association with depressive symptoms among Asian overweight adults, particularly in females. Prevention and early diagnosis of depressive symptoms should focus on overweight females.

Masticatory Function, Sex, and Risk of Dementia Among Older Adults: A Population-Based Cohort Study

BACKGROUND

A decline in masticatory function may indicate brain dysfunction related to dementia, but the relationship between masticatory function and dementia risk remains unclear. This study aimed to investigate whether masticatory function is associated with the risk of cognitive decline and dementia.

METHODS

Data were obtained from the nationwide prospective cohort study of randomly sampled community-dwelling Koreans aged ≥ 60 years. The 5,064 non-demented participants, whose number of chewing cycles per bite was assessed by clinical interview, were followed for 8 years with biennial assessments of cognitive performance and clinical diagnoses of all-cause dementia and Alzheimer's disease (AD). Structural brain magnetic resonance imaging was collected from a subset of cohort participants and their spouses for imaging analyses.

RESULTS

Males who chewed ≥ 30 cycles/bite had faster decline in global cognition and memory function and were at higher risk for incident all-cause dementia (hazard ratio [HR], 2.91; 95% confidence interval [CI], 1.18-7.18) and AD (HR, 3.22; 95% CI, 1.14-9.11) compared to males with less than 10 cycles/bite. Additionally, increased chewing cycles in males were associated with reduced brain volume, particularly in regions involved in compensatory cognitive control of mastication. There was no significant association between chewing cycles and the risk of dementia or brain volume in females.

CONCLUSION

Older men who frequently chew their meals could be considered a notable population at risk for dementia who should be carefully assessed for their cognitive trajectories.

Association between a body shape index and cognitive impairment among us older adults from a cross-sectional survey of the NHANES 2011-2014

PURPOSE

This study aimed to assess the relationship between A Body Shape Index (ABSI) and cognitive impairment among older adults in the United States.

METHODS

This cross-sectional study analyzed cognitive function in 2,752 individuals aged 60 and older using data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Cognitive assessments were conducted using the Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). A Body Shape Index (ABSI) was calculated from waist circumference (WC), weight, and height. The relationship between ABSI and cognitive outcomes was examined through multifactorial linear regression, smooth curve fitting, and subgroup and interaction analyses.

RESULTS

With complete data, 2752 persons 60 and older participated in the study. After adjusting for covariables, these results showed statistically significant negative relationships between ABSI, IRT, and DSST scores. The negative correlation between DSST and ABSI is more substantial in males than females. There is less of a negative link between ABSI, AFT, and DSST among drinkers who consume 12 or more drinks annually compared to those who consume less. Furthermore, compared to individuals without high blood pressure(HBP), those who suffered HBP showed a more significant negative connection between ABSI and AFT.

CONCLUSION

Lower cognitive function was linked to higher ABSI.

Association between Chewing Difficulty and Dietary Ca, Vitamin D, and Mg Intake in Korean Older Adults: 8th Korea National Health and Nutrition Examination Survey (KNHANES) (2020-2021)

Nutrition intake plays a pivotal role in chewing difficulty (CD). This cross-sectional descriptive study aims to explore the associations between CD and the dietary intake of calcium (Ca), vitamin D, and magnesium (Mg) in adults aged 65 and older, utilizing data from the 8th Korea National Health and Nutrition Examination Survey (2020-2021). The chewing function was assessed using a 5-point scale questionnaire that inquired about discomfort experienced during mastication. "Very uncomfortable" and "uncomfortable," two of the five response options, were categorized as being indicative of CD. Dietary intake was assessed through 24 h dietary recall interviews, and nutrient calculations were based on the 10th revised edition of the Korean Food Composition Table. Data (N = 2942) were analyzed using descriptive statistics and multi-logistic regression analyses in a composite sample plan file. Among the 2942 subjects, groups with insufficient daily nutrient intake had significantly higher odds ratios (ORs) for CD compared to their counterparts. In men, the ORs for Ca (1.56), Mg (1.75), and the combined intake of Mg (1.64) with Ca were elevated. In women, the ORs for Ca (1.74), Mg (1.53), and the combined intake of Mg (1.43) with Ca showed similar trends. After adjusting for age, family income, and family size variables, men's ORs for Mg (1.55) and the combined intake of Mg (1.55) with Ca remained elevated, while women's OR for Ca (1.58), Mg (1.42), and the combined intake of Mg (1.34) with Ca remained significant. Dietary vitamin D intake did not significantly impact the OR for CD. After adjusting for natural tooth numbers, self-perceived oral health, and obesity, no significant association was found between CD and these nutrients. In conclusion, this study underscores the importance of promoting the recommended daily intake of magnesium alongside dietary calcium to address CD.