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Xie W, Kong C, Luo W, Zheng J, Zhou Y. C-reactive protein and cognitive impairment: A bidirectional Mendelian randomization study. Arch Gerontol Geriatr 2024; 121:105359. [PMID: 38412560 DOI: 10.1016/j.archger.2024.105359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES While C-reactive protein (CRP) has been solidly linked as a risk factor for cognitive impairment, observational research alone cannot definitively demonstrate a causal relationship. This study therefore sought to determine whether there was an association between CRP and the development of cognitive impairment. METHODS This study employed bidirectional Mendelian randomization (MR) to investigate the genetic association between CRP and cognitive impairment. genome-wide association studies (GWAS) summary statistics for both were sourced from IEU Open GWAS or prior reports. Cognitive GWAS's used were on tests designed to assess cognitive performance, fluid intelligence, prospective memory, and reaction time. The MR analysis applied several methods, including inverse variance-weighted (IVW), MR Egger, weighted median, simple mode, and weighted mode approaches, then use of MR sensitivity analyses to interrogate findings. RESULTS Forward MR analysis showed that genetically proxied CRP was associated with prospective memory (P = 0.009), whereas there is little evidence to support an association between CRP and other cognitive tests. Reverse MR analysis indicated a potential association between genetic proxy cognitive performance (P = 0.002) and fluid intelligence score (P = 0.019) with CRP levels. For genetically proxied CRP on prospective memory, the level of pleiotropy (P > 0.05) and no genetic variant heterogeneity (P > 0.05) made bias unlikely, and leave-one-out tests also confirmed robust associations. CONCLUSIONS The effect of genetically proxied CRP on prospective memory, with little evidence on other cognitive tests. The reverse MR shows some evidence of genetically proxied cognition (cognitive performance and fluid intelligence) on CRP levels.
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Affiliation(s)
- Wenhuo Xie
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Chenghua Kong
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Wei Luo
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, Fuzhou, China
| | - Jiaping Zheng
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, Fuzhou, China.
| | - Yu Zhou
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fujian Medical University, Fuzhou, China.
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Monteiro A, Castro P, Pereira G, Ferreira C, Polonia J, Lobo M, Azevedo E. Cerebral blood flow regulation and cognitive performance in hypertension. J Cereb Blood Flow Metab 2024:271678X241254680. [PMID: 38738526 DOI: 10.1177/0271678x241254680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
We examined the relation between transcranial Doppler (TCD) markers of cerebral blood flow regulation and cognitive performance in hypertension (HT) patients to evaluate the predictive value of these markers for cognitive decline. We assessed dynamic cerebral autoregulation (dCA), vasoreactivity to carbon dioxide, and neurovascular coupling (NVC) in the middle (MCA) and posterior (PCA) cerebral arteries of 52 patients. Neuropsychological evaluation included the Montreal Cognitive Assessment and tests covering attention, executive function, processing speed, and memory. Notably, reduced rate time in the PCA significantly predicted better processing speed (p = 0.003). Furthermore, reduced overshoot systolic cerebral blood velocity in the PCA and reduced phase in the VLF range in the MCA (p = 0.021 and p = 0.017, respectively) significantly predicted better memory. Intriguingly, enhanced dCA in the MCA predicted poorer memory performance, while reduced NVC in the PCA predicted both superior processing speed and memory performance. These findings suggest that HT-induced changes in cerebral hemodynamics impact cognitive performance. Further research should verify these observations and elucidate whether these changes represent adaptive responses or neurovascular inefficiency. TCD markers might provide insights into HT-related cognitive decline.
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Affiliation(s)
- Ana Monteiro
- UnIC@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
- Department of Neurology, Unidade Local de Saúde Alto Ave - Hospital de Guimarães, E.P.E., Guimarães, Portugal
| | - Pedro Castro
- UnIC@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
- Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
| | - Gilberto Pereira
- Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
| | - Carmen Ferreira
- Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
| | - Jorge Polonia
- CINTESIS@RISE, Department of Medicine, Faculty of Medicine of University of Porto, Porto, Portugal
- Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Mariana Lobo
- CINTESIS@RISE, MEDCIDS Department, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Elsa Azevedo
- UnIC@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
- Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
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Ji K, Sun M, Hong Y, Li L, Wang X, Li C, Yang S, Du W, Xu K, Zhou H. Association of vitamin B1 intake with geriatric cognitive function: An analysis of the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. Heliyon 2024; 10:e28119. [PMID: 38601615 PMCID: PMC11004520 DOI: 10.1016/j.heliyon.2024.e28119] [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: 08/24/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 04/12/2024] Open
Abstract
Background The association between dietary vitamin B1 intake and cognitive performance in the noninstitutionalized older adult population of the United States remains unclear. Purpose This study aimed to investigate the association between vitamin B1 intake and cognitive performance in older adults in the United States. Methods Vitamin B1 intake was assessed through two 24-h dietary recalls. Weighted logistic regression was used to evaluate the association between vitamin B1 intake and three cognitive scores (immediate recall test [IRT], animal fluency test [AFT], and digit symbol substitution test [DSST]). Cognitive performance was measured by these three tests, and individuals scoring below the lowest quartile were categorized as cognitive impairment. Sensitivity analysis, including dose-response curves, subgroup analyses, interaction effects, per 1 SD, and quartiles, were performed to ensure the accuracy of the conclusion. Results A total of 2896 participants over the age of 60 were included in this study. In the adjusted final model, the association between vitamin B1 intake and low cognitive performance in old age was statistically significant, with the following odds ratios (ORs) and 95% confidence intervals (CIs): IRT, 0.75 (0.57, 0.97), P = 0.018; AFT, 0.68 (0.50, 0.92), P = 0.007; DSST, 0.71 (0.54, 0.92), P = 0.005. Subgroup analyses showed that this association was statistically significant among males, white, low-education, and no memory impairment. The results of the sensitivity analyses confirmed the association between VB1 and cognitive function in old age and the absence of interactions in the final calibrated model. Conclusion Dietary vitamin B1 intake is negatively associated with cognitive performance in older adults.
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Affiliation(s)
- Kangkang Ji
- Department of Central Laboratory, Binhai County People's Hospital, Yancheng 224000, China
- Department of Clinical Nutrition, Binhai County People's Hospital, Yancheng 224000, China
| | - Minli Sun
- Department of Geriatrics, Binhai County People's Hospital, Yancheng 224000, China
| | - Ye Hong
- Department of Clinical Nutrition, Binhai County People's Hospital, Yancheng 224000, China
| | - Li Li
- Department of Central Laboratory, Binhai County People's Hospital, Yancheng 224000, China
| | - Xin Wang
- Department of Geriatrics, Binhai County People's Hospital, Yancheng 224000, China
| | - Chaonian Li
- Department of Geriatrics, Binhai County People's Hospital, Yancheng 224000, China
| | - Shengkai Yang
- Department of Neurocentres, Binhai County People's Hospital, Yancheng 224000, China
| | - Wenjuan Du
- Department of Neurocentres, Binhai County People's Hospital, Yancheng 224000, China
| | - Kangjie Xu
- Department of Central Laboratory, Binhai County People's Hospital, Yancheng 224000, China
| | - Hai Zhou
- Department of Central Laboratory, Binhai County People's Hospital, Yancheng 224000, China
- Department of Neurocentres, Binhai County People's Hospital, Yancheng 224000, China
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Feng Y, Wang J, Zhang R, Wang Y, Wang J, Meng H, Cheng H, Zhang J. Mediterranean diet related to 3-year incidence of cognitive decline: results from a cohort study in Chinese rural elders. Nutr Neurosci 2024:1-12. [PMID: 38598413 DOI: 10.1080/1028415x.2024.2336715] [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: 04/12/2024]
Abstract
OBJECTIVE This study aims to examine the effect of the Mediterranean diet (MeDi) on cognitive decline among the Chinese elderly with a 3-year follow-up. METHODS This study is divided into two waves: wave-1 January 2019 to June 2019 (n = 2313); wave-2 January 2022 to March 2022 (n = 1648). MeDi scores were calculated from the Mediterranean Diet Adherence Screener (MEDAS), with the scoring of low compliance (0-6 points) and high compliance (7-14 points). The Mini-Mental State Examination (MMSE) was used to assess cognitive function. An MMSE score dropping ≥ 2 points from baseline was defined as cognitive decline. The relationships between MeDi score and cognitive decline were analyzed by linear regression models or Binary logistic regression. RESULTS During the 3-year follow-up, 23.8% of patients exhibited cognitive decline. The study revealed a significant difference in MMSE score changes between low and high MeDi adherence groups (p < 0.001). MeDi score was negatively correlated with cognitive deterioration (β = -0.020, p = 0.026). MeDi score was only negatively associated with cognitive decline in the female subgroup aged ≥65 years (β = -0.034, p = 0.033). The food beans (OR = 0.65, 95%CI:0.51, 0.84), fish (OR = 0.72, 95%CI:0.54, 0.97), and cooked vegetables (OR = 0.68, 95%CI:0.53, 0.84) were protective factors for cognitive decline. CONCLUSIONS This study suggests that greater adherence to the MeDi is linked to a reduced risk of cognitive decline in elderly people. However, this is found only in women who are 65 years old or older. It also found long-term adherence to beans, fish, and vegetables are more effective in improving cognitive function.
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Affiliation(s)
- Yuping Feng
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, People's Republic of China
| | - Jiancheng Wang
- Department of General Practice Medicine, Hospital of Gansu Health Vocational College, Lanzhou, People's Republic of China
| | - Rong Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, People's Republic of China
| | - Yunhua Wang
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Jing Wang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, People's Republic of China
| | - Hongyan Meng
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, People's Republic of China
| | - Hu Cheng
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Juxia Zhang
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, People's Republic of China
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Pinyopornpanish K, Buawangpong N, Soontornpun A, Thaikla K, Pateekhum C, Nantsupawat N, Wiwatkunupakarn N, Jiraporncharoen W, Angkurawaranon C. A household survey of the prevalence of subjective cognitive decline and mild cognitive impairment among urban community-dwelling adults aged 30 to 65. Sci Rep 2024; 14:7783. [PMID: 38565884 PMCID: PMC10987517 DOI: 10.1038/s41598-024-58150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
While it is possible to detect cognitive decline before the age of 60, and there is a report indicating that certain cognitive abilities peak in one's 30s, the evidence regarding cognitive problems in populations younger than 65 years is scarce. This study aims to (1) determine the proportion of community-dwelling adults with different cognitive status, and (2) determine the prevalence of neuropsychiatric behaviors. A population-based survey was conducted in Chiang Mai, Thailand. Individuals aged 30 to 65 were recruited and assessed for demographic data, memory complaints, cognitive performance, and neuropsychiatric symptoms using self-reported questionnaires. In a total of 539 participants, 33.95% had mild cognitive impairment (MCI), 7.05% had subjective cognitive decline (SCD), and 52.50% had neuropsychiatric symptoms. The risk of MCI increased with age, and neuropsychiatric symptoms were significantly higher in those with MCI or SCD than in those without (p < 0.001). The most common complaints were sleep problems, anxiety, and irritability. Screening for MCI in adults aged < 65 years might be useful. However, further investigation on the appropriate age to screen and the program's cost-effectiveness is suggested.
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Affiliation(s)
- Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Atiwat Soontornpun
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kanittha Thaikla
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chanapat Pateekhum
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Nopakoon Nantsupawat
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nutchar Wiwatkunupakarn
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand.
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Bartoli D, Brugnera A, Grego A, Alvaro R, Vellone E, Pucciarelli G. Stroke disease-specific quality of life trajectories and their associations with caregivers' anxiety, depression, and burden in stroke population: a longitudinal, multicentre study. Eur J Cardiovasc Nurs 2024; 23:160-168. [PMID: 37249041 DOI: 10.1093/eurjcn/zvad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 05/04/2023] [Accepted: 05/26/2023] [Indexed: 05/31/2023]
Abstract
AIMS The aims of this study were to: (i) test if there are clusters of stroke survivors who experience distinct trajectories of quality of life (QOL) from hospital rehabilitation discharge to 12-month follow-up; (ii) test if any sociodemographic or clinical variables predict this class membership; and (iii) examine the associations between the clusters of stroke survivors' and their caregivers' trajectories of anxiety, depression, and burden over time. METHODS AND RESULTS A total of 415 stroke survivors and their caregivers were recruited in Italy for this 1-year, longitudinal, multicentre prospective study, filling out a survey at five time points. We found two distinct trajectories of change in stroke survivors' psychological QOL (i.e. Memory, Communication, Emotion, and Participation). The first trajectory (86% of the survivors) included those who started with greater levels of QOL and improved slightly to markedly in all psychological domains, while the second trajectory (14% of the survivors) comprised those who started with lower overall levels of psychological QOL and experienced a worsening or no changes at all in these dimensions up to 12-month follow-up. Very few clinical and sociodemographic variables at baseline predicted class membership. Finally, caregivers of those patients who experienced no change or a worsening in psychological QOL reported greater distress and burden over time. CONCLUSION Our results highlight the need for more tailored interventions to improve patients' psychological QOL and consequently their caregivers' well-being. This requires a shift from a stroke survivor-centred approach to a stroke survivor- and caregiver-centred one.
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Affiliation(s)
- Davide Bartoli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Andrea Grego
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Grasina A, Espirito-Santo H, Lemos L, Vilar MM, Simões-Cunha L, Daniel F. Mini-ACE: Validation Study Among Older People in Long-Term Care. J Cogn 2024; 7:5. [PMID: 38223221 PMCID: PMC10785962 DOI: 10.5334/joc.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/25/2023] [Indexed: 01/16/2024] Open
Abstract
Background The Mini-Addenbrooke's Cognitive Examination (M-ACE) is a valid and reliable tool that accurately differentiates various types of cognitive impairment from Normal-cognition assessed in multiple settings. However, its validity among older individuals in long-term care (LTC) was not yet established. Therefore, we sought to assess the Portuguese M-ACE's validity, reliability, and accuracy in detecting cognitive impairment no-dementia (CIND) in LTC users. Methods A comprehensive assessment was performed on 196 LTC Portuguese users aged ≥ 60 years, among whom 71 had Normal-cognition, and 125 had CIND. Results The M-ACE was found to be reliable (McDonald's ω = .86, Cronbach's α = .85) and consistent over time (r = .72; ICC = .83) and between raters (k = .92). Strong correlations with related measures supported construct validity (both r = .67). The M-ACE accurately distinguished CIND from Normal-cognition with a cut-off of 17 points (AUC = 0.81, Sensitivity = 81.7%, Specificity = 74.4%). Conclusion Our findings suggest that the Portuguese M-ACE is a valid and reliable cognitive assessment tool for LTC users, allowing for accurate differentiation between CIND and Normal-cognition. Thus, the M-ACE's use could contribute to the early detection and intervention of cognitive disorders, especially among older adults in LTC.
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Affiliation(s)
| | - Helena Espirito-Santo
- Miguel Torga Institute of Higher Education (ISMT), Coimbra, PT
- Centro de Estudos e Investigação em Saúde, Universidade de Coimbra, Coimbra, Portugal
- Centro de Investigação em Neuropsicologia e Intervenção Cognitiva e Comportamental, Portugal
| | - Laura Lemos
- Miguel Torga Institute of Higher Education (ISMT), Coimbra, PT
- Centro de Estudos e Investigação em Saúde, Universidade de Coimbra, Coimbra, Portugal
| | - Maria Manuela Vilar
- Faculdade de Psicologia e de Ciências de Educação da Universidade de Coimbra (FPCEUC), Coimbra, Portugal
| | - Luís Simões-Cunha
- Miguel Torga Higher Education Institute (ISMT), Coimbra, Portugal
- Research and Development Center of the Military University Institute, Lisboa, Portugal
| | - Fernanda Daniel
- Centro de Inovação em Biomedicina e Biotecnologia da Universidade de Coimbra, Coimbra, Portugal
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Tian Y, Fan L, Zhou M, Du W. Impact of long-term care insurance on health inequality in older adults in China based on the concentration index approach. Int Health 2024; 16:83-90. [PMID: 37039047 PMCID: PMC10759298 DOI: 10.1093/inthealth/ihad025] [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: 12/17/2022] [Revised: 02/23/2023] [Accepted: 03/24/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Several studies have shown that social security would reduce health inequalities. However, little was known about the relationship between long-term care insurance and health inequality. We aimed to evaluate the impact of long-term care insurance on health status and health inequality in older adults using a nationally representative cohort. METHODS Based on four waves of data from the China Health and Retirement Longitudinal Study (CHARLS 2011, 2013, 2015 and 2018), we used the staggered difference in difference (DID) design with the order probit regression models and the concentration index approach as well as decomposition analysis to assess the contribution of long-term care insurance towards residents' health status and health inequality in older adults aged ≥65 y. We further used the semi-parametric DID model for robustness testing. RESULTS Long-term care insurance demonstrated its role, improving self-assessed health in the study population (βcoefficient: 0.090, 95% CI 0.087 to 0.092, p<0.001). The estimation results of the semi-parametric DID were consistent with those of the staggered DID. The income-related health concentration index was 0.0005, having a contribution rate of 1.639% to health inequality in older adults. Decomposition analysis revealed that different policies and residential areas were more influential on the observed health inequalities. CONCLUSIONS The findings implied that long-term care insurance has widened the health inequality while improving health status in older adults. Additional investment in more comprehensive insurance coverage and increased accessibility to enhance implementation of long-term care insurance is warranted to close the gap.
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Affiliation(s)
- Yong Tian
- School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou district, Nanjing 210009, Jiangsu, China
| | - Lijun Fan
- School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou district, Nanjing 210009, Jiangsu, China
| | - Menghan Zhou
- School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou district, Nanjing 210009, Jiangsu, China
| | - Wei Du
- School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou district, Nanjing 210009, Jiangsu, China
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9
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Xiong B, Bailey DX, Prudon P, Pascoe EM, Gray LC, Graham F, Henderson A, Martin-Khan M. Identification and information management of cognitive impairment of patients in acute care hospitals: An integrative review. Int J Nurs Sci 2024; 11:120-132. [PMID: 38352291 PMCID: PMC10859579 DOI: 10.1016/j.ijnss.2023.11.001] [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: 03/22/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 02/16/2024] Open
Abstract
Objectives Recognition of the cognitive status of patients is important so that care can be tailored accordingly. The objective of this integrative review was to report on the current practices that acute care hospitals use to identify people with cognitive impairment and how information about cognition is managed within the healthcare record as well as the approaches required and recommended by policies. Methods Following Whittemore & Knafl's five-step method, we systematically searched Medline, CINAHL, and Scopus databases and various grey literature sources. Articles relevant to the programs that have been implemented in acute care hospitals regarding the identification of cognitive impairment and management of cognition information were included. The Mixed Methods Appraisal Tool and AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) Checklist were used to evaluate the quality of the studies. Thematic analysis was used to present and synthesise results. This review was pre-registered on PROSPERO ( CRD42022343577). Results Twenty-two primary studies and ten government/industry publications were included in the analysis. Findings included gaps between practice and policy. Although identification of cognitive impairment, transparency of cognition information, and interaction with patients, families, and carers (if appropriate) about this condition were highly valued at a policy level, sometimes in practice, cognitive assessments were informal, patient cognition information was not recorded, and interactions with patients, families, and carers were lacking. Discussion By incorporating cognitive assessment, developing an integrated information management system using information technology, establishing relevant laws and regulations, providing education and training, and adopting a national approach, significant improvements can be made in the care provided to individuals with cognitive impairment.
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Affiliation(s)
- Beibei Xiong
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Daniel X. Bailey
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane & Women’s Hospital, Brisbane, Australia
| | - Paul Prudon
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Elaine M. Pascoe
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Leonard C. Gray
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Frederick Graham
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Dementia and Delirium, Division of Medicine, Princess Alexandra Hospital, Brisbane, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Amanda Henderson
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Nursing Practice Development Unit, Princess Alexandra Hospital, Brisbane, Australia
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Australia
- Griffith Health, Griffith University, Brisbane, Australia
- School of Nursing, Midwifery and Paramedicine, The University of the Sunshine Coast, Brisbane, Australia
| | - Melinda Martin-Khan
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
- School of Nursing, University of Northern British Columbia, Prince George, Canada
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10
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Chen H, Wang B, Lv R, Zhou T, Shen J, Song H, Xu X, Ma Y, Yuan C. Progression and trajectory network of age-related functional impairments and their combined associations with mortality. iScience 2023; 26:108368. [PMID: 38058300 PMCID: PMC10696261 DOI: 10.1016/j.isci.2023.108368] [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: 03/27/2023] [Revised: 07/06/2023] [Accepted: 10/26/2023] [Indexed: 12/08/2023] Open
Abstract
Age-related functional impairments (ARFIs) contribute to the loss of independence in older adults, but their progressions, interrelations, and combined relations with mortality are largely unknown. We conducted a prospective study among 17,914 participants in the Health and Retirement Study (2000-2020). The incidence rates of visual impairment, hearing impairment, physical frailty, and cognitive impairment increased exponentially with age, while those of restless sleep and depression increased relatively slowly. These ARFIs were associated with each other in temporal sequence and constituted a hazard network. We observed a dose-response relationship between the number of ARFIs and mortality risk, and the dyads involving physical frailty demonstrated the strongest associations with mortality. Our findings may assist in the identification of individuals at higher mortality risk and highlight the potential for future investigations to explore the impact of multiple ARFIs in aging.
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Affiliation(s)
- Hui Chen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Binghan Wang
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Rongxia Lv
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Tianjing Zhou
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jie Shen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Huan Song
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Xiaolin Xu
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Changzheng Yuan
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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11
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Wang H, Ling Q, Wu Y, Zhang M. Association between the triglyceride glucose index and cognitive impairment and dementia: a meta-analysis. Front Aging Neurosci 2023; 15:1278730. [PMID: 38161596 PMCID: PMC10757637 DOI: 10.3389/fnagi.2023.1278730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024] Open
Abstract
Background The triglyceride and glucose (TyG) index is an alternative index of insulin resistance (IR). We aimed to clarify the relationship between the TyG index and cognitive impairment and dementia. Methods We conducted a comprehensive search of the PubMed, Cochrane Library, and Embase databases until February 2023 to identify relevant studies. Random-effects models were used to pool effect sizes, and the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) was used to assess the quality of the evidence. Results Ten studies were included, with seven of which investigated the relationship between the TyG index and cognitive impairment and three exploring the association between the TyG index and dementia. When the TyG index was described as a categorical variable, it was positively associated with the risk of cognitive impairment (OR = 2.32; 95% CI 1.39-3.87) and dementia (OR = 1.14, 95% CI 1.12-1.16). The association of the TyG index with the risk of cognitive impairment (OR = 3.39, 95% CI 1.67-6.84) and dementia (OR = 1.37, 95% CI 1.03-1.83) remained significant for per 1 unit increment in the TyG index. The GRADE assessment indicated a very low certainty for cognitive impairment. Low certainty and moderate certainty were observed for dementia when the TyG index was analyzed as a categorical variable and as a continuous variable, respectively. Conclusion The TyG index is associated with an increased risk of cognitive impairment and dementia. Further prospective research is warranted to confirm these findings.Systematic review registration: https://www.crd.york.ac.uk/, Protocol registration number: CRD42023388028.
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Affiliation(s)
- Huan Wang
- Department of Geriatrics, Liaoning Jinqiu Hospital, Shenyang, China
| | - Qin Ling
- Second Clinical Medical College of Nanchang University, Nanchang, China
| | - Yifan Wu
- Second Clinical Medical College of Nanchang University, Nanchang, China
| | - Mingjie Zhang
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
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12
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Lu K, Liu T, Wu X, Zhong J, Ou Z, Wu W. Association between serum iron, blood lead, cadmium, mercury, selenium, manganese and low cognitive performance in old adults from National Health and Nutrition Examination Survey (NHANES): a cross-sectional study. Br J Nutr 2023; 130:1743-1753. [PMID: 36941743 DOI: 10.1017/s0007114523000740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Cognitive decline is a public health problem for the world's ageing population. This study was to evaluate the relationships between serum Fe, blood Pb, Cd, Hg, Se and Mn and cognitive decline in elderly Americans. Data of this cross-sectional study were extracted from the National Health and Nutritional Examination Survey (NHANES 2011-2014). Cognitive performance was measured by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency and Digit Symbol Substitution Test (DSST) tests. Weighted univariable and multivariate logistic regression analyses were used to assess the associations between six trace elements and low cognitive performance. Subgroup analyses based on diabetes and hypertension history were further assessed the associations. A total of 2002 adults over 60 years old were included. After adjusting covariates, elevated serum Fe levels were associated with the decreased risk of low cognitive performance, especially in the elderly without diabetes history and with hypertension history. High blood Cd levels were associated with the high odds of low cognitive performance in old adults with diabetes and hypertension history. Elevated blood Mn levels were connected with low cognitive performance in old hypertensive people. High blood Pb levels were related to the high odds of low cognitive performance, especially in the elderly without diabetes and hypertension history. High blood Se levels were linked to the decreased risk of low cognitive performance in all the elderly. Appropriate Fe, Se supplementation and Fe-, Se-rich foods intake, while reducing exposure to Pb, Cd and Mn may be beneficial for cognitive function in the elderly.
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Affiliation(s)
- Kui Lu
- Department of Neurology, Zhongshan City People's Hospital, Zhongshan528403, Guangdong, People's Republic of China
| | - Tian Liu
- President's Office, Zhongshan City People's Hospital, Zhongshan 528403, Guangdong, People's Republic of China
| | - Xiaoyan Wu
- Department of Neurology, the Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou511300, Guangdong, People's Republic of China
| | - Jianqiang Zhong
- Department of Neurology, the Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou511300, Guangdong, People's Republic of China
| | - Zhenri Ou
- Department of Neurology, Zhongshan City People's Hospital, Zhongshan528403, Guangdong, People's Republic of China
| | - Wenjun Wu
- Department of Neurology, Zhongshan City People's Hospital, Zhongshan528403, Guangdong, People's Republic of China
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13
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Keramat SA, Lee V, Patel R, Hashmi R, Comans T. Cognitive impairment and health-related quality of life amongst older Australians: evidence from a longitudinal investigation. Qual Life Res 2023; 32:2911-2924. [PMID: 37289356 PMCID: PMC10473991 DOI: 10.1007/s11136-023-03449-3] [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] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Australia's population is steadily growing older, with older persons expected to make up over 20% of the population by 2066. Ageing is strongly associated with a significant drop in cognitive ability, ranging from mild cognitive impairment to severe cognitive impairment (dementia). This study examined the association between cognitive impairment and health-related quality of life (HRQoL) in older Australians. METHODS Two waves of longitudinal data from the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey were utilised, with the age cut-off for older Australians defined as above 50. The final analysis included 10,737 person-year observations from 6892 unique individuals between 2012 and 2016. This study utilised the Backwards Digit Span (BDS) test and Symbol Digit Modalities test (SDMT) to assess cognitive function. HRQoL was measured using the physical and mental component summary scores of the SF-36 Health Survey (PCS and MCS). Additionally, HRQoL was measured using health state utility values (SF-6D score). A longitudinal random-effects GLS regression model was used to analyse the association between cognitive impairment and HRQoL. RESULTS This study found that approximately 89% of Australian adults aged 50 or older had no cognitive impairment, 10.16% had moderate cognitive impairment, and 0.72% had severe cognitive impairment. This study also found that moderate and severe cognitive impairment were both negatively associated with HRQoL. Older Australians with moderate cognitive impairment scored worse on the PCS (β = - 1.765, SE = 0.317), MCS (β = - 1.612, SE = 0.326), and SF-6D (β = - 0.024, SE = 0.004) than peers without cognitive impairment given other covariates reference categories remain constant. Older adults experiencing severe cognitive had lower PCS (β = - 3.560, SE = 1.103), and SF-6D (β = - 0.034, SE = 0.012) scores compared to their counterparts with no cognitive impairment given other covariates reference categories remain constant. CONCLUSION We found evidence that HRQoL is negatively associated with cognitive impairment. Our findings will be beneficial for the future cost-effectiveness intervention targeted at reducing cognitive impairment since it provides information on the disutility associated with moderate and severe cognitive impairment.
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Affiliation(s)
- Syed Afroz Keramat
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia.
| | - Vanessa Lee
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Rajat Patel
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Rubayyat Hashmi
- The Australian Centre for Housing Research, The University of Adelaide, Adelaide, Australia
| | - Tracy Comans
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
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14
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Zhu X, Luo Z, Tian G, Hu Z, Li S, Wang QM, Luo X, Chen L. Hypotension and cognitive impairment among the elderly: Evidence from the CLHLS. PLoS One 2023; 18:e0291775. [PMID: 37725634 PMCID: PMC10508618 DOI: 10.1371/journal.pone.0291775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND While high blood pressure has been linked to cognitive impairment, the relationship between low blood pressure, especially hypotension, and cognitive impairment has not been well studied. Therefore, this study aimed to assess the prevalence of hypotension and cognitive impairment in the seniors of China, and the association between hypotension and cognitive function impairment. METHODS The data was derived from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured by objective examination. The Chinese version of the Mini-Mental State Examination (CMMSE) was used to evaluate the cognitive impairment of the elderly. Generalized linear models were conducted to evaluate the association of hypotension with cognitive impairment. RESULTS The prevalence of hypotension and cognitive impairment in the Chinese elderly were 0.76% and 22.06%, respectively. Participants with hypotension, lower SBP, and lower DBP, had odds ratios of 1.62, 1.38, and 1.48 for cognitive impairment, respectively. Besides, the CMMSE scores decreased by 2.08, 0.86, and 1.08 in the elderly with hypotension, lower SBP, and DBP, compared with those with non-hypotension, higher SBP, and DBP, respectively. Subgroup analyses showed that the association of cognitive impairment with hypotension was stronger in Chinese elderly who had decreased activity of daily living. Moreover, there was statistical evidence of a nonlinear dose-response relationship of SBP and DBP with cognitive impairment (Pnonlinear < 0.05). CONCLUSION Hypotension was a potential risk factor for cognitive impairment of the Chinese elderly, especially for those having decreased activity of daily living. Blood pressure management should be conducted to prevent them from cognitive impairment.
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Affiliation(s)
- Xidi Zhu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the Teaching Affiliate of Harvard Medical School, Boston, Massachusetts, United States of America
| | - Zhicheng Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Gang Tian
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the Teaching Affiliate of Harvard Medical School, Boston, Massachusetts, United States of America
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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15
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Kaur A, Sonal A, Ghosh T, Ahamed F. Cognitive reserve and other determinants of cognitive function in older adults: Insights from a community-based cross-sectional study. J Family Med Prim Care 2023; 12:1957-1964. [PMID: 38024901 PMCID: PMC10657110 DOI: 10.4103/jfmpc.jfmpc_2458_22] [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: 12/19/2022] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background India will be the home of 323 million elderly persons by 2050. This means a surge in the dependent population primarily due to age-related cognitive decline. Evidence suggests that life course factors may have a modulatory role on cognitive function. The present study explores such potential influence by investigating the effect of cognitive reserve (a latent construct using education and occupation) and physical, psychological, and social determinants on cognitive function in community dwelling elderly. Methods A community-based cross-sectional study was conducted in urban areas of West Bengal (India) among elderly aged ≥60 years. Data was collected by personal interviews for socio-demographic and medical profile. Cognitive function was assessed using Bangla Adaptation of Mini-Mental State Examination (BAMSE). Educational level and occupational complexity were used as proxy indicators for calculating cognitive reserve. Results Of the 370 elderlies interviewed (mean age = 68.9 years), cognitive function was abnormal in 13.5%. The cognitive function had a significant inverse relationship with depression symptoms, loneliness, hypertension, anemia, and basic activities of daily living. There was a significant difference in the cognitive reserve of the elderly with normal and abnormal cognitive function (mean 33.7 and 26.8, respectively). In the presence of covariates like sleep quality, depression, hypertension, and hemoglobin levels, the effect of age on cognitive function had a significant mediation influence of cognitive reserve - total effect = -0.2349; 95% CI = (-0.2972 to -0.1725) and direct effect = -0.2583; 95% CI = (-0.3172 to -0.1994). Conclusion The quantum of effect of the age on cognitive function decreases with good cognitive reserve as a cognitive reserve has a significant mediation effect on the relationship between age and cognitive function.
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Affiliation(s)
- Amandeep Kaur
- Department of Community Medicine and Family Medicine, AIIMS, Kalyani, West Bengal, India
| | - Akanksha Sonal
- Department of Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Tandra Ghosh
- Department of Physiology, AIIMS, Kalyani, West Bengal, India
| | - Farhad Ahamed
- Department of Community Medicine and Family Medicine, AIIMS, Kalyani, West Bengal, India
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16
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Hung YC, Lao WL, Yeh CJ, Lee MC. The mediating effect of leisure activities in the relationship between depression and cognitive decline in middle age and older adults in Taiwan. BMC Geriatr 2023; 23:315. [PMID: 37217889 DOI: 10.1186/s12877-023-03984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/19/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Depression can affect the development of cognitive functions, and there are many people with depressive symptoms and cognitive decline in the aging population. The role of mediators between depressive symptoms and the subsequent cognitive decline remains unclear. We aimed to investigate whether depressive symptoms can slow down cognitive decline through a mediator. METHODS A total of 3,135 samples were collected in 2003, 2007, and 2011. This study used the CES-D10 and SPMSQ (Short Portable Mental State Questionnaire) to measure depression and cognitive functions. The effect of depression trajectory on the subsequent cognitive dysfunction was analyzed using multivariable logistic regression, and the mediating effect was analyzed using the Sobel test. RESULTS The results of the multivariable linear regression analysis showed that after including different variables in each model, such as leisure activities and mobility in 2003 and 2007, women had a higher percentage of depressive symptoms in each model, compared to men. The effect of depression in 2003 on cognitive decline in 2011 was mediated by intellectual leisure activities in 2007 in men (Z=-2.01) and physical activity limitation in 2007 in women (Z=-3.02). CONCLUSIONS The mediation effect of this study shows that people with depressive symptoms will reduce their participation in leisure activities, which will lead to the degeneration of cognitive function. We suggest that if depressive symptoms are addressed as early as possible, people will have the ability and motivation to delay the decline of cognitive function through participation in leisure activities.
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Affiliation(s)
- Yu-Chan Hung
- Department of Public Health, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan
| | - Wai-Lam Lao
- Department of Public Health, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan
| | - Chih-Jung Yeh
- Department of Public Health, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan.
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, Sanmin Rd, West District, 403, Taichung City, Taiwan.
- Institute of Medicine, Chung Shan Medical University, No.110, Sec.1, Jianguo N.Rd, Taichung City, 40201, Taiwan.
- Institute of Population Health Sciences, National Health Research Institutes, No.35, Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan.
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Tamblay N, Boggs D, Huidobro B, Tapia-Mora D, Anabalon K, Delgado C, Polack S, Bright T, Torrente MC. Prevalence of Cognitive Impairment and Its Association With Hearing Loss Among Adults Over 50 Years of Age: Results From a Population-Based Survey in Santiago, Chile. Am J Audiol 2023; 32:150-159. [PMID: 36692926 DOI: 10.1044/2022_aja-22-00042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE The purpose of this study was to estimate the prevalence of cognitive impairment and explore its association with hearing loss and other sociodemographic and clinical risk factors, using an objective measurement of hearing levels, in adults over 50 years of age. METHOD A population-based survey was completed in Santiago, Chile between December 2019 and March 2020. Participants were screened for cognitive impairment using the Short Chilean Mini-Mental State Examination and hearing levels were assessed with tonal audiometry (hearTest). Data on demographic, socioeconomic, and clinical characteristics were collected. RESULTS A total of 538 persons completed the assessment. The prevalence of cognitive impairment in the 50+ population was 9.3% (95% confidence interval [CI] [5.8, 14.7]). Cognitive impairment was significantly higher in individuals with any level of hearing loss (odds ratio [OR] = 2.19, 95% CI [1.00, 4.80], adjusted for age, sex, education, socioeconomic position [SEP], and head trauma). Subjects with hearing loss and who reported any use of hearing aids (16% of the sample) had a lower risk of cognitive impairment (OR of nonusers 3.64, 95% CI [1.00, 13.28], adjusted for age, sex, education, SEP, and head trauma). CONCLUSION Strategies for addressing cognitive impairment should further explore the integration of early diagnosis of hearing loss and the regular use of hearing aids.
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Affiliation(s)
- Natalia Tamblay
- Department of Otorhinolaryngology, Faculty of Medicine, Universidad de Chile, Santiago
| | - Dorothy Boggs
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Barbara Huidobro
- Department of Otorhinolaryngology, Pontificia Universidad Católica de Chile, Santiago
| | - Daniel Tapia-Mora
- Department of Speech and Hearing Sciences, Faculty of Medicine, Universidad de Chile, Santiago.,School of Speech and Hearing Sciences, Universidad de los Andes, Santiago, Chile
| | - Katherine Anabalon
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago
| | - Carolina Delgado
- Unidad de Cerebro Saludable, Departamento de Neurología y Neurocirugía, Hospital Cínico Universidad de Chile.,Departamento de Neurociencia Facultad de Medicina Universidad de Chile, Santiago
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Tess Bright
- Centre for Health Equity, The University of Melbourne, Victoria, Australia
| | - Mariela C Torrente
- Department of Otorhinolaryngology, Faculty of Medicine, Universidad de Chile, Santiago.,Hospital Clínico Universidad de Chile, Santiago
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18
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Sun S, Liu D, Zhou Y, Yang G, Cui LB, Xu X, Guo Y, Sun T, Jiang J, Li N, Wang Y, Li S, Wang X, Fan L, Cao F. Longitudinal real world correlation study of blood pressure and novel features of cerebral magnetic resonance angiography by artificial intelligence analysis on elderly cognitive impairment. Front Aging Neurosci 2023; 15:1121152. [PMID: 36819723 PMCID: PMC9935573 DOI: 10.3389/fnagi.2023.1121152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Objective This study aims to investigate novel clinical risk factors for cognitive impairment (CI) in elderly. Methods A total of 3221 patients (259 patients with CI and 2,962 subjects without CI) were recruited into this nested case-control study who underwent cerebral magnetic resonance angiography (MRA) from 2007 to 2021. All of the clinical data with MRA imaging were recorded followed by standardization processing blindly. The maximum stenosis score of the posterior circulatory artery, including the basilar artery, and bilateral posterior cerebral artery (PCA), was calculated by the cerebral MRA automatic quantitative analysis method. Logistic regression (LR) analysis was used to evaluate the relationship between risk factors and CI. Four machine learning approaches, including LR, decision tree (DT), random forest (RF), and support vector machine (SVM), employing 5-fold cross-validation were used to establish CI predictive models. Results After matching with age and gender, 208 CI patients and 208 control subjects were finalized the follow-up (3.46 ± 3.19 years) with mean age at 84.47 ± 6.50 years old. Pulse pressure (PP) in first tertile (<58 mmHg) (OR 0.588, 95% confidence interval (CI): 0.362-0.955) was associated with a decreased risk for CI, and ≥50% stenosis of the left PCA (OR 2.854, 95% CI: 1.387-5.872) was associated with an increased risk for CI after adjusting for body mass index, myocardial infarction, and stroke history. Based on the means of various blood pressure (BP) parameters, the performance of the LR, DT, RF and SVM models accurately predicted CI (AUC 0.740, 0.786, 0.762, and 0.753, respectively) after adding the stenosis score of posterior circulatory artery. Conclusion Elderly with low pulse differential pressure may have lower risk for cognitive impairment. The hybrid model combined with the stenosis score of posterior circulatory artery, clinical indicators, and the means of various BP parameters can effectively predict the risk of CI in elderly individuals.
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Affiliation(s)
- Shasha Sun
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Dongyue Liu
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yanfeng Zhou
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China,Laboratory of Computational Biology and Machine Intelligence, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Ge Yang
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China,Laboratory of Computational Biology and Machine Intelligence, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Long-Biao Cui
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xian Xu
- Department of Radiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yuanhao Guo
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China,Laboratory of Computational Biology and Machine Intelligence, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Ting Sun
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jiacheng Jiang
- Department of Radiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Na Li
- Nankai University School of Medicine, Nankai University, Tianjin, China
| | - Yabin Wang
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Sulei Li
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xinjiang Wang
- Department of Radiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Li Fan
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China,Li Fan,
| | - Feng Cao
- Department of Cardiology, Chinese PLA Medical School, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China,*Correspondence: Feng Cao,
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Poudel S, Vennam RR, Shrestha A, Reddy KR, Wijewardane NK, Reddy KN, Bheemanahalli R. Resilience of soybean cultivars to drought stress during flowering and early-seed setting stages. Sci Rep 2023; 13:1277. [PMID: 36690693 PMCID: PMC9870866 DOI: 10.1038/s41598-023-28354-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Drought stress during the reproductive stage and declining soybean yield potential raise concerns about yield loss and economic return. In this study, ten cultivars were characterized for 20 traits to identify reproductive stage (R1-R6) drought-tolerant soybean. Drought stress resulted in a marked reduction (17%) in pollen germination. The reduced stomatal conductance coupled with high canopy temperature resulted in reduced seed number (45%) and seed weight (35%). Drought stress followed by rehydration increased the hundred seed weight at the compensation of seed number. Further, soybean oil decreased, protein increased, and cultivars responded differently under drought compared to control. In general, cultivars with high tolerance scores for yield displayed lower tolerance scores for quality content and vice versa. Among ten cultivars, LS5009XS and G4620RX showed maximum stress tolerance scores for seed number and seed weight. The observed variability in leaf reflectance properties and their relationship with physiological or yield components suggested that leaf-level sensing information can be used for differentiating drought-sensitive soybean cultivars from tolerant ones. The study led to the identification of drought-resilient cultivars/promising traits which can be exploited in breeding to develop multi-stress tolerant cultivars.
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Affiliation(s)
- Sadikshya Poudel
- Department of Plant and Soil Sciences, Mississippi State University, Mississippi State, MS, USA
| | - Ranadheer Reddy Vennam
- Department of Plant and Soil Sciences, Mississippi State University, Mississippi State, MS, USA
| | - Amrit Shrestha
- Department of Agricultural & Biological Engineering, Mississippi State University, Mississippi State, MS, USA
| | - K Raja Reddy
- Department of Plant and Soil Sciences, Mississippi State University, Mississippi State, MS, USA
| | - Nuwan K Wijewardane
- Department of Agricultural & Biological Engineering, Mississippi State University, Mississippi State, MS, USA
| | - Krishna N Reddy
- Crop Production Systems Research Unit, USDA-ARS, Stoneville, MS, USA
| | - Raju Bheemanahalli
- Department of Plant and Soil Sciences, Mississippi State University, Mississippi State, MS, USA.
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20
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Al-Amoud MM, Omar DI, Almashjary EN, Alomary SA. Morbidity profile among older people at primary health care centers in Saudi Arabia during the period 2012-2020. Saudi Med J 2023; 44:45-56. [PMID: 36634948 PMCID: PMC9987671 DOI: 10.15537/smj.2023.44.1.20220465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/05/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To evaluate the morbidity profile and explore the geriatric giants, health problems, and their risk factors among old people in the older people health clinics at primary health care centers (PHCCs) in Saudi Arabia. METHODS This is a record-based descriptive cross-sectional study. Data was collected between 2012-2020 using the health data of older people to whom comprehensive geriatric assessment (CGA) was carried out at 1,481 PHCCs in Saudi Arabia. Data included sociodemographic and health related characteristics, medications, results of CGA, complete clinical examination, and laboratory results. Assessment was carried out for diabetes, hypertension, obesity, underweight, vision and hearing impairments, depression, memory and cognitive impairment, risk of falls, urine incontinence, bronchial asthma, and anemia. RESULTS A total of 193,715 older people were screened. A high prevalence of diabetes (55.4%), hypertension (49.1%), diabetes and hypertension co-morbidity (26.8%), and obesity (22.2%) were found. The overall prevalence of anemia was 4.7% and asthma 8.9%. The prevalence of positive screening for depression was 5.9%, 2.9% for memory and cognitive impairment, 6.3% for urine incontinence, and 4.0% for risk of fall. The prevalence of vision impairment was 20.6%, hearing impairments was 12.6%, and for underweight it was 5.4%. There was high prevalence of risk factors like smoking (8.5%), and polypharmacy (25.3%). Health regions varied widely in prevalence of the studied health conditions. CONCLUSION The study findings highlight the importance of CGA in early detection of geriatric giants, health problems, and associated risk factors among Saudi older people.
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Affiliation(s)
- Maysoon M. Al-Amoud
- From the General Directorate of Health Programs and Chronic Diseases (Al-Amoud, Omar, Almashjary, Alomary), Ministry of Health, Riyadh, Kingdom of Saudi Arabia, and from the Department of Community (Omar), Environmental and Occupational Medicine, Faculty of Medicine, Benha University, Benha, Egypt.
- Address correspondence and reprint request to: Dr. Maysoon M. Al-Amoud, General Directorate of Health Programs and Chronic Diseases, Ministry of Health, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0002-7562-5609
| | - Doaa I. Omar
- From the General Directorate of Health Programs and Chronic Diseases (Al-Amoud, Omar, Almashjary, Alomary), Ministry of Health, Riyadh, Kingdom of Saudi Arabia, and from the Department of Community (Omar), Environmental and Occupational Medicine, Faculty of Medicine, Benha University, Benha, Egypt.
| | - Eman N. Almashjary
- From the General Directorate of Health Programs and Chronic Diseases (Al-Amoud, Omar, Almashjary, Alomary), Ministry of Health, Riyadh, Kingdom of Saudi Arabia, and from the Department of Community (Omar), Environmental and Occupational Medicine, Faculty of Medicine, Benha University, Benha, Egypt.
| | - Shaker A. Alomary
- From the General Directorate of Health Programs and Chronic Diseases (Al-Amoud, Omar, Almashjary, Alomary), Ministry of Health, Riyadh, Kingdom of Saudi Arabia, and from the Department of Community (Omar), Environmental and Occupational Medicine, Faculty of Medicine, Benha University, Benha, Egypt.
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Panchawagh S, Karandikar Y, Pujari S. Antihypertensive therapy is associated with improved visuospatial, executive, attention, abstraction, memory, and recall scores on the montreal cognitive assessment in geriatric hypertensive patients. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 4:100165. [PMID: 37131908 PMCID: PMC10149192 DOI: 10.1016/j.cccb.2023.100165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
Background The prevalence of Mild Cognitive Impairment (MCI) has increased over the past few decades. However, it can potentially be reversed if detected early. Early detection of MCI using the sensitive Montreal Cognitive Assessment (MoCA) might prove to be an important cog in the wheel in identifying and slowing down this morbid pandemic in hypertensive persons. Objectives To study the association of antihypertensive agents on cognitive scores and prevalence of MCI using the MoCA. Materials and methods This is a single-center, controlled, observational, cross-sectional study in a tertiary care teaching hospital in India. Cognitive assessment was done using the Montreal Cognitive Assessment. Data on MoCA scores were comprehensively analyzed. Results A total of N = 210 patients (n = 105 the in study and control groups) were included in the study. The median (IQR) MoCA score (out of 30 points) in patients taking antihypertensives was 26 (25 - 27), while it was 24 (22 - 25) in the control group. There was no difference in MoCA scores between patients taking lipophilic or hydrophilic antihypertensives. Similarly, there was no difference in MoCA scores between patients taking different drug regimens. Conclusion Anti-hypertensive therapy and lower blood pressure had a statistically significant positive association with visuospatial, executive, attention, abstraction, memory, and recall MoCA scores. Patients on antihypertensive therapy also had a lower prevalence of MCI. MoCA scores were similar in patients on either lipophilic or hydrophilic drugs and were similar between patients on different antihypertensive drug classes.
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Affiliation(s)
- Suhrud Panchawagh
- Department of Medicine, Smt. Kashibai Navale Medical College & General Hospital, Pune, India
| | - Yogita Karandikar
- Department of Pharmacology, Smt. Kashibai Navale Medical College & General Hospital, Pune, India
| | - Shripad Pujari
- Department of Neurology, Deenanath Mangeshkar Hospital, Pune, India
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22
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Alam R, Quintero Silva L, Jahan N, Chodzko-Zajko W, Ogunjesa B, Selzer Ninomiya A, Schwingel A. Relationships of Low Cognitive Performance and Sleep Disorder With Functional Disabilities Among Older Adults. J Aging Health 2022:8982643221143221. [DOI: 10.1177/08982643221143221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives This study examined the relationships of low cognitive performance and sleep disorder with functional disabilities among older adults. Methods: NHANES 2011–2014 data on 3179 individuals [Mage=69.71] were analyzed. Functional domains included: activities of daily living (ADL), instrumental ADL (IADL) and leisure and social activities (LSA). Animal Fluency Test and the Digit Symbol Substitution Test assessed cognitive performance. Participants self-reported having physician-diagnosed sleep disorder. Results: Participants with both low cognitive performance and sleep disorder had 4- to 10-times greater odds for ADL, IADL, and LSA difficulties compared to the participants with no low cognitive performance/sleep disorder. Participants with only low cognitive performance and those with only sleep disorder were two to three times more likely to experience these difficulties. Discussion: Low cognitive performance and sleep disorder together or independently were associated with functional disabilities. Participants with both low cognitive performance and sleep disorder had higher odds of functional disabilities.
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Affiliation(s)
- Rifat Alam
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Laura Quintero Silva
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Nilufer Jahan
- Department of Organic and Geriatric Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Wojtek Chodzko-Zajko
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Babatope Ogunjesa
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ana Selzer Ninomiya
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Andiara Schwingel
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Buchholz I, Marten O, Janssen MF. Feasibility and validity of the EQ-5D-3L in the elderly Europeans: a secondary data analysis using SHARE(d) data. Qual Life Res 2022; 31:3267-3282. [PMID: 35624409 PMCID: PMC9546963 DOI: 10.1007/s11136-022-03158-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 12/26/2022]
Abstract
PURPOSE To determine feasibility and validity of the EQ-5D-3L in the elderly European population. METHODS Secondary data analysis based on the study of health, ageing, and retirement in Europe (SHARE) to determine the percentage of missing items for EQ-5D dimensions and EQ VAS, and to demonstrate convergent/divergent validity with measures included in the SHARE survey. Known-groups validity was tested using literature-based hypotheses. Correlation coefficients and Cohen's f are reported. RESULTS Missing values were below 3% across all EQ-5D dimensions and gender strata, slightly increasing with age. Individuals' responses to each EQ-5D dimension were related to their ratings of other measures in expected directions. The EQ VAS and all EQ-5D dimensions (except anxiety/depression) moderately to strongly correlated with physical [e.g. number of limitations in activities of daily living (ADL): r = 0.313-0.658] and generic measures [CASP (control, autonomy, self-realization, pleasure)-19 scale, self-perceived health, number of symptoms: r = 0.318-0.622], while anxiety/depression strongly correlated with the EURO-D scale (r = 0.527). Both EQ-5D dimensions and EQ VAS discriminated well between two [or more] groups known to differ [e.g. anxiety/depression discriminated well between persons classified as depressed/not depressed using the EURO-D scale, f = 0.51; self-care differentiated best between individuals without and with 1 + ADL limitations, f = 0.69]. Sociodemographic variables like gender, education, and partner in household were hardly associated with EQ VAS scores (f < 0.25). CONCLUSION With item non-response of less than 3%, good discriminatory, and construct properties, the EQ-5D-3L showed to be a feasible and valid measure in the elderly Europeans.
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Affiliation(s)
| | - Ole Marten
- Department of Health Economics and Health Care Management, Bielefeld University, 33615, Bielefeld, Germany
| | - Mathieu F Janssen
- Department of Medical Psychology and Psychotherapy Erasmus MC, Erasmus University, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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A Systematic Review of the Current Evidence from Randomised Controlled Trials on the Impact of Medication Optimisation or Pharmacological Interventions on Quantitative Measures of Cognitive Function in Geriatric Patients. Drugs Aging 2022; 39:863-874. [PMID: 36284081 PMCID: PMC9626423 DOI: 10.1007/s40266-022-00980-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/25/2022]
Abstract
Background Cognitive decline is common in older people. Numerous studies point to the detrimental impact of polypharmacy and inappropriate medication on older people’s cognitive function. Here we aim to systematically review evidence on the impact of medication optimisation and drug interventions on cognitive function in older adults. Methods A systematic review was performed using MEDLINE and Web of Science on May 2021. Only randomised controlled trials (RCTs) addressing the impact of medication optimisation or pharmacological interventions on quantitative measures of cognitive function in older adults (aged > 65 years) were included. Single-drug interventions (e.g., on drugs for dementia) were excluded. The quality of the studies was assessed by using the Jadad score. Results Thirteen studies met the inclusion criteria. In five studies a positive impact of the intervention on metric measures of cognitive function was observed. Only one study showed a significant improvement of cognitive function by medication optimisation. The remaining four positive studies tested methylphenidate, selective oestrogen receptor modulators, folic acid and antipsychotics. The mean Jadad score was low (2.7). Conclusion This systematic review identified a small number of heterogenous RCTs investigating the impact of medication optimisation or pharmacological interventions on cognitive function. Five trials showed a positive impact on at least one aspect of cognitive function, with comprehensive medication optimisation not being more successful than focused drug interventions. More prospective trials are needed to specifically assess ways of limiting the negative impact of certain medication in particular and polypharmacy in general on cognitive function in older patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40266-022-00980-9.
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Wen S, Elias PM, Wakefield JS, Mauro TM, Man MQ. The link between cutaneous inflammation and cognitive impairment. J Eur Acad Dermatol Venereol 2022; 36:1705-1712. [PMID: 35748522 PMCID: PMC9481668 DOI: 10.1111/jdv.18360] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/30/2022] [Indexed: 12/01/2022]
Abstract
Cognitive impairment is a symptom of neurological disorders, including dementia and Alzheimer's disease; and mild cognitive impairment can be a precursor of both disorders. Aged humans and animal models with other systemic disorders, such as cardiovascular diseases and diabetes, display a higher incidence of cognitive decline. Epidemiological studies have shown that the incidence of cognitive impairment also is higher in subjects with certain inflammatory skin disorders, including psoriasis and chronic eczematous dermatitis. Chronologically aged individuals exhibit increased cutaneous inflammation and elevated circulating cytokine levels, linked to alterations in epidermal function, which itself can induce cutaneous inflammation. Conversely, strategies that improve epidermal function can lower cytokine levels in both the skin and circulation. Thus, it seems likely that epidermal dysfunction could contribute, at least in part, to the development of chronic low-grade inflammation, also termed 'inflammaging', in the elderly. The evidence of cognitive impairment in patients with inflammatory dermatoses suggests a link between cutaneous inflammation and cognitive impairment. Because of the pathogenic role of epidermal dysfunction in ageing-associated cutaneous inflammation, improvements in epidermal function could be an alternative approach for mitigation of the ageing-associated decline in cognitive function.
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Affiliation(s)
- S Wen
- Dermatology Hospital, Southern Medical University, Guangdong, China
| | - P M Elias
- Dermatology Service, Veterans Affairs Medical Center San Francisco, San Francisco, California, USA
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - J S Wakefield
- Dermatology Service, Veterans Affairs Medical Center San Francisco, San Francisco, California, USA
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - T M Mauro
- Dermatology Service, Veterans Affairs Medical Center San Francisco, San Francisco, California, USA
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - M-Q Man
- Dermatology Hospital, Southern Medical University, Guangdong, China
- Dermatology Service, Veterans Affairs Medical Center San Francisco, San Francisco, California, USA
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
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Positive Effect of Cognitive Training in Older Adults with Different APOE Genotypes and COVID-19 History: A 1-Year Follow-Up Cohort Study. Diagnostics (Basel) 2022; 12:diagnostics12102312. [PMID: 36292001 PMCID: PMC9600912 DOI: 10.3390/diagnostics12102312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Older people suffer from cognitive decline; several risk factors contribute to greater cognitive decline. We used acquired (COVID-19 infection) and non-modifiable (presence of APOE rs429358 and rs7412 polymorphisms) factors to study the progression of subjective cognitive impairment while observing patients for one year. Cognitive training was used as a protective factor. (2) Methods: Two groups of subjects over the age of 65 participated in the study: group with subjective cognitive decline receiving cognitive training and individuals who did not complain of cognitive decline without receiving cognitive training (comparison group). On the first visit, the concentration of antibodies to COVID-19 and APOE genotype was measured. At the first and last point (1 year later) the Mini-Mental State Examination scale and the Hospital Anxiety and Depression Scale were performed. (3) Results: COVID-19 infection did not affect cognitive function. A significant role of cognitive training in improving cognitive functions was revealed. Older adults with APOE-ε4 genotype showed no positive effect of cognitive training. (4) Conclusions: Future research should focus on cognitive dysfunction after COVID-19 in long-term follow-up. Attention to the factors discussed in our article, but not limited to them, are useful for a personalized approach to maintaining the cognitive health of older adults.
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Kim R, Chung W. Effect of Aging on Educational Differences in the Risk of Cognitive Impairment: A Gender-Specific Analysis Using Korean Longitudinal Study of Aging (2006–2016). Healthcare (Basel) 2022; 10:healthcare10061062. [PMID: 35742113 PMCID: PMC9222920 DOI: 10.3390/healthcare10061062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
This study examined the effect of aging on gender-specific educational differences in the risk of cognitive impairment using a nationally representative sample of 4278 men and 5495 women aged 45 years and older from the dataset of the Korean Longitudinal Study of Aging. Sociodemographics, lifestyle, and medical conditions were included as covariates in the mixed logistic regression analysis models. The prevalence of cognitive impairment was higher in women than in men at baseline. The risk of cognitive impairment in each age group decreased with education in both men and women. The risk by educational rank was worse at lower levels and increased with age, more so for women than men. Aging appears to widen the impact of educational differences on the risk of cognitive impairment and is more unfavorable for women than for men. Public health policies regarding population aging need to consider this and identify the target population to reduce both the level of and the difference in the risk of cognitive impairment.
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Affiliation(s)
- Roeul Kim
- Labor Welfare Research Institute, Korea Workers’ Compensation and Welfare Service, Seoul 07254, Korea;
| | - Woojin Chung
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-1522
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Štemberger-Kolnik T, Ljubič A, Filej B, Poredoš M, Kaučič BM. Differences in Health Literacy of Older Adults According to Sociodemographic Characteristics. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The research is based on the concept of health literacy. This is the “sixth vital sign” to navigating the healthcare system and raising self-efficacy in the field of healthcare.
AIM: The study aim was to present the health literacy of the elderly in the Savinja statistical region in Slovenia.
METHODS: The study was based on a non-experimental quantitative research approach. The study included 199 elderly people aged 65 and more, without the presence of dementia. The data were collected using the Health Literacy and Montreal Cognitive Assessment questionnaire. We used a non-random, convenience sampling.
RESULTS: We established that in the study population, 64.8 % of the population was below the level of acceptable general health literacy, whereas only 3.5 % of this population had an excellent level of health literacy. Statistically significant differences in the level of health literacy are shown in the field of healthcare treatment in older adults living with their families (F = 5,198; p ˂ 0,001). Respondents who engaged in activities in day care centres also had a higher level of health literacy (t = 3,738; p < 0,001). People with low health literacy, who use health services more frequently, should be given access to health education, based on individual presentation of contents, supported by andragogical knowledge.
CONCLUSION: The health literacy of older adults is the basis for their greater care for their own health and a better quality of life.
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Huang G, Ren G. Interaction between ω-6 fatty acids intake and blood cadmium on the risk of low cognitive performance in older adults from National Health and Nutrition Examination Survey (NHANES) 2011-2014. BMC Geriatr 2022; 22:292. [PMID: 35392817 PMCID: PMC8988388 DOI: 10.1186/s12877-022-02988-7] [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: 11/16/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Identifying preventable diets and environmental exposure is essential to ensuring the health of the aging population. This study evaluated the interaction effect between blood cadmium and ω-6 fatty acids intake on low cognitive performance in Americans. Method The data of this cross-sectional study were obtained from the 2011–2012 and 2013–2014 National Health and Nutritional Examination Survey (NHANES). Cognitive performance was measured by the Consortium to Establish a Registry for Alzheimer’s Disease test, Animal Fluency Test, and Digit Symbol Substitution Test. Multivariate logistic regression models were used. Results A total of 1,918 individuals were included, with 467 (24.35%) low cognitive performance. Compared with participants with normal-level blood cadmium, those with high-level blood cadmium had a higher risk of low cognitive performance [odds ratio (OR) was 1.558 with 95% confidence interval (CI): 1.144–2.123]. Low-level ω-6 fatty acids intake was positively associated with low cognitive performance [OR = 1.633 (95%CI: 1.094–2.436)] compared with normal-level intake. Moreover, there was a significant interaction between low-level ω-6 fatty acids intake and high-level blood cadmium on the risk of low cognitive performance (relative excess risk due to interaction: 0.570, 95%CI: 0.208-0.932; the attributable proportion of interaction: 0.219, 95%CI: 0.102‐0.336; synergy index: 1.552, 95%CI: 1.189‐2.027). Conclusions There was a synergistic interaction between low-level ω-6 fatty acids intake and high-level blood cadmium on low cognitive performance. Low-level ω-6 fatty acids intake may amplify the adverse effects of long-term exposure to cadmium on cognitive performance. This may have a certain significance for the prevention of cognitive decline in the elderly. Supplementary information The online version contains supplementary material available at 10.1186/s12877-022-02988-7.
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Affiliation(s)
- Guangxiang Huang
- Department of Neurology, The First People's Hospital of Xiaoshan District, Xiaoshan First Affiliated Hospital of Wenzhou Medical University, 311200, Hangzhou, Zhejiang, P. R. China
| | - Gang Ren
- Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, No.99 Longcheng Street, Shanxi, 030032, Taiyuan, P. R. China.
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The Intestinal Barrier Dysfunction as Driving Factor of Inflammaging. Nutrients 2022; 14:nu14050949. [PMID: 35267924 PMCID: PMC8912763 DOI: 10.3390/nu14050949] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/13/2022] Open
Abstract
The intestinal barrier, composed of the luminal microbiota, the mucus layer, and the physical barrier consisting of epithelial cells and immune cells, the latter residing underneath and within the epithelial cells, plays a special role in health and disease. While there is growing knowledge on the changes to the different layers associated with disease development, the barrier function also plays an important role during aging. Besides changes in the composition and function of cellular junctions, the entire gastrointestinal physiology contributes to essential age-related changes. This is also reflected by substantial differences in the microbial composition throughout the life span. Even though it remains difficult to define physiological age-related changes and to distinguish them from early signs of pathologies, studies in centenarians provide insights into the intestinal barrier features associated with longevity. The knowledge reviewed in this narrative review article might contribute to the definition of strategies to prevent the development of diseases in the elderly. Thus, targeted interventions to improve overall barrier function will be important disease prevention strategies for healthy aging in the future.
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Zhang XM, Wu XJ, Cao J, Jiao J, Chen W. Association between Cognitive Frailty and Adverse Outcomes among Older Adults: A Meta-Analysis. J Nutr Health Aging 2022; 26:817-825. [PMID: 36156673 DOI: 10.1007/s12603-022-1833-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to pool the effect size of the association between cognitive frailty and adverse outcomes (e.g., falls, disability, and hospitalization) among older adults. DESIGN Systematic review and meta-analysis. METHODS PubMed, ScienceDirect, and Embase were searched from their respective inceptions to June 1, 2022. We extracted prospective cohort studies that reported the association between cognitive frailty and adverse outcomes. Random or fixed-effects models based on heterogeneity were used to pool the effect sizes of independent associations of cognitive frailty, frailty only, and cognitive impairment only with each adverse outcome. RESULTS Fifteen studies involving 49,122 older adults were included in the meta-analysis. Older adults with cognitive frailty had higher odds ratios (OR) for falls (1.82, 95% confidence interval [CI]: 1.29-2.58), disability (3.17, 95%CI: 2.24-4.48), and hospitalization (1.78, 95%CI: 1.48-2.14) compared with those without frailty and cognitive impairment. Older adults with frailty only demonstrated a high risk for falls (pooled OR 1.76, 95%CI: 1.25-2.48), disability (pooled OR 1.82, 95%CI: 1.43-2.33), and hospitalization (pooled OR 1.64, 95% CI: 1.45-1.85). The influence of cognitive impairment only on adverse outcomes was lower compared with cognitive frailty or frailty. Subgroup analyses showed that those with cognitive frailty (defined by the frailty phenotype plus Mini-Mental State Examination) were at greater risk for developing adverse outcomes. CONCLUSION Our findings indicate that cognitive frailty is an independent risk factor for adverse outcomes (e.g., falls, disability, and hospitalization). Early screening and comprehensive intervention may improve cognitive frailty and reduce the risk for adverse outcomes among older adults.
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Affiliation(s)
- X M Zhang
- Xiao-Ming Zhang, Xin-Juan Wu, Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital (Dongdan campus), No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing 100730, China, ,
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Sun B, Zhao Y, Lu W, Chen Y. The Relationship of Malnutrition With Cognitive Function in the Older Chinese Population: Evidence From the Chinese Longitudinal Healthy Longevity Survey Study. Front Aging Neurosci 2021; 13:766159. [PMID: 34880747 PMCID: PMC8645828 DOI: 10.3389/fnagi.2021.766159] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/13/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objective: Few studies have explored the relationship between malnutrition measured by the Geriatric Nutritional Risk Index (GNRI) and cognitive performance. This study aimed to investigate the association of malnutrition with cognitive function in the Chinese population. Methods: It was a prospective longitudinal study and used three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2011–2012, 2014, and 2017–2018. Participants aged 60 years or older without mental illness and cerebrovascular diseases were eligible. The GNRI was used to assess nutritional status as follows: normal nutrition (a GNRI > 98), mild malnutrition (92 ≤ a GNRI ≤ 98), and moderate-to-severe malnutrition (a GNRI < 92). Cognitive performance was evaluated by the Mini-Mental State Examination (MMSE) scores. The relationship between the GNRI and cognitive function was analyzed using a linear mixed-effects model. Results: A total of 1,632 subjects were analyzed, including 741 males and 891 females. Of these, 65.0, 19.4, and 15.6% of subjects were at normal nutritional status, mild, and moderate-to-severe malnutrition, respectively. After adjusting for potential confounders, participants under mild and moderate-to-severe malnutrition status have a lower MMSE score [β (95% CI): –0.95 (–1.60, –0.25) and –1.39 (–2.21, –0.57), respectively], compared with those having normal nutrition. Also, there was a linear trend in the association of malnutrition risk with cognitive function in the total population [β (95% CI): –0.74 (–1.13, –0.35)]. However, a significant association of malnutrition with cognitive function was observed only among illiterate females aged above 90 years. Conclusion: This study suggested that there was a significant relationship between the GNRI and cognitive function in the Chinese elderly. Furthermore, subjects with more serious malnutrition have a worse cognitive function, especially in the oldest illiterate females. Clinicians should put more emphasis on assessing the nutritional and cognitive status of the elderly to timely intervene and prevent cognitive impairment.
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Affiliation(s)
- Boran Sun
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yihao Zhao
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
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