The association between physical activity and cognitive function in the elderly in rural areas of northern China

Cross-sectional study of activity habits, socioeconomic status, and cognitive performance in central China's adult population

Activity habits has been demonstrated to confer cognitive benefits. However, the extent to which these activities can mitigate cognitive disparities in older adults resulting from socioeconomic inequality remains unclear. We assessed cognitive performance and leisure activities in participants aged ≥ 65 years from 31 urban and 48 rural communities in Central China. A life-cycle composite socioeconomic status (SES) index incorporating education, occupational prestige, disposable income, and healthcare facility proximity categorized participants into low-, middle-, and high-SES groups. Logistic and linear regression models were employed to examine the associations between leisure activities and cognition, stratified by sex and age across different SES groups. This cross-sectional survey had a total of 8,597 eligible participants aged ≥ 65 years (mean age: 72.2 years, female: 55.1%). Compared to those of high SES, individuals with middle (OR = 1.86, 95% CI: 1.57-2.19) and low SES (OR = 3.62, 95% CI: 2.83-4.64) exhibited a higher prevalence of cognitive impairment and lower cognitive performance. Physical activity and cognitive leisure activity (PA and CLA) demonstrated a linear association with global and sub-domain cognitive performance, with a combined correlation with global cognition (β = 0.13, 95% CI: 0.10-0.15) being higher than that of CLA (β = 0.09, 95% CI: 0.07-0.11) and PA (β = 0.04, 95% CI: 0.02-0.06); our analysis revealed a stronger association between leisure activities and cognitive performance in low-SES individuals, with a notable effect size (combined: β = 0.35, 95% CI: 0.25-0.45; CLA: β = 0.27, 95% CI: 0.19-0.35 and PA: β = 0.09, 95% CI: 0.00-0.16) and in the > 70 years group, both (combined: β = 0.45, 95% CI: 0.31-0.59; CLA: β = 0.35, 95% CI: 0.24-0.47 and PA: β = 0.12, 95% CI: 0.02-0.22) and higher in men (combined: β = 0.39, 95% CI: 0.24-0.54; CLA: β = 0.30, 95% CI: 0.19-0.40 and PA: β = 0.09, 95% CI: -0.03-0.20). Our findings indicate that leisure activities are significantly associated with cognitive performance among older adults across all SES groups, particularly those in low SES categories. This study supports engagement in cognitively stimulating activities to prevent dementia in older adults of low SES.

The Association of Wnt Signaling Pathway Gene Variants, Blood Lipoproteins and Cognitive Function in Elderly People

Wnt signaling is believed to play an important role in the nervous system. However, few studies have examined the association between gene variants of the Wnt signaling pathway and mild cognitive impairment (MCI). Additionally, the potential modulation of this association by blood lipoproteins remains poorly understood. We aimed to investigate these associations in the present analysis. The cross-sectional study comprised 459 participants from 17 villages in Jimo District, Qingdao, Shandong Province. A total of 46 single nucleotide polymorphisms (SNPs) in nine Wnt signaling pathway genes were included. Cognitive function was measured using Montreal Cognitive Assessment (MOCA). Polygenic risk scores (PRS) were used to summarize the effect of each gene. Ordered logistic regression and Poisson regression with robust variance were applied to examine the associations of SNPs with MCI and the dimension score of MOCA. Interaction analysis was conducted to verify the interaction with lipoproteins. A random forest classifier was used to develop a predictive model for MCI. The SNP PRKCA-rs2286674 was associated with MCI across three models. The risk of MCI increased by 31% and 2% for each unit increase of PRS of PRKCA and WNT7B respectively. Based on the multiplicative interaction model, the effects of certain PRSs on the risk of MCI were modified by blood lipoproteins. Integrating total PRS into the prediction model significantly improved the ability to predict MCI. Genetic variations in Wnt signaling pathway were associated with MCI in older adults. Interaction effects between gene variants and blood lipoproteins on MCI were observed.

Impact of physical activity on the depression and self-care ability among Chinese older adults during the COVID-19 pandemic: propensity score matching analysis

INTRODUCTION

The present study aimed to explore the effect of different levels of physical activity on depression, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) among older adults over the age of 60.

METHODS

Data on older adults' health were obtained from the China Longitudinal Aging Social Survey (CLASS) conducted in 2021. A questionnaire was used to survey older adults aged 60 years and older in 28 regions of China. The International Physical Activity Questionnaire (IPAQ) was used to evaluate physical activity, and participants were categorized into groups based on their physical activity levels: vigorous (5.38%), moderate (16.33%), light (74.58%), and no physical activity (control group). The CES-D9 scale was used to assess the level of depression, and both the activities of daily living (ADLs) scale and the instrumental activities of daily living (IADLs) scale were used to evaluate self-care ability. Propensity score matching was used to determine the intensity of physical activity that affected depression, instrumental daily activity ability (IADLs), and activities of daily living (ADLs) among the participants.

RESULTS

The participation rates of vigorous, moderate, and light physical activities among the older adult Chinese participants were 5.38%, 16.33%, and 74.58%, respectively. Propensity score matching (PSM) showed moderate and light physical activity decreased depression by -0.367 and - 0.409 units, respectively. Moderate and light physical activity increased instrumental activities of daily living (IADLs) by 0.165 and 0.607 units, respectively. Light physical activity increased the level of activities of daily living (ADLs) by 0.265 units.

CONCLUSION

Moderate and light physical activity in older adults alleviates depression and improves instrumental activities of daily living (IADLs), and light physical activity improves the level of activities of daily living (ADLs).

Independent and joint associations of dietary diversity and physical activity on mental health among older adults in China: a cross-sectional study

BACKGROUND

The joint association of dietary diversity (DD) and physical activity (PA) on anxiety, depressive symptoms, and their comorbidity have not been extensively explored. Hence, this study focused on examining this association.

METHODS

Data in this cross-sectional study was derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Based on self-reported dietary diversity score (DDS) questions were used to assess DD, ranging from 0 to 8. DDS < 5 was defined as insufficient DD and DDS ≥ 5 was defined as sufficient DD. PA was based on a self-reported binary question. Anxiety was assessed using the Generalized Anxiety Disorder Scale-7 (GAD-7), and depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression Scale-10 (CESD-10). The independent and joint associations of DD and PA on anxiety, depressive symptoms, and their comorbidity were examined by multivariable-adjusted binary logistic regression models.

RESULTS

In this cross-sectional study, sufficient DD was independently associated with a decreased risk of anxiety (adjusted OR = 0.57, 95% CI = 0.50-0.65), depressive symptoms (adjusted OR = 0.69, 95% CI = 0.63-0.77), and their comorbidity (adjusted OR = 0.58, 95% CI = 0.49-0.68). Similarly, exposure to current exercise was also a significant protective factor for mental health. Importantly, co-exposure to sufficient DD and current exercise may amplify the protective effects on mental health (adjusted OR = 0.47, 95% CI = 0.38-0.57 for anxiety; adjusted OR = 0.36, 95% CI = 0.31-0.42 for depressive symptoms; adjusted OR = 0.37, 95% CI = 0.29-0.48 for their comorbidity). The robustness of these associations was demonstrated in four sensitivity analyses.

CONCLUSIONS

Our study found that sufficient DD and current exercise were associated with a decreased risk of mental health disorders. Importantly, the combination of both appeared to enhance this protective effect. Our findings promote the joint assessment of DD and PA to provide new insights into health-related behaviors for prevention strategies for mental health disorders in older adults.

Chain-mediated effect of physical activity between Chinese language-based L2 motivational self-system and intended effort

The L2 Motivational Self System (L2MSS) determines an individual's motivation in second language learning and influences the learning experience and intended effort. Although physical activity (PA) has been shown to enhance academic efficacy, the role of PA in whether it promotes second language learning efficacy has not been elucidated. Therefore, the present study examined PA as a mediator and explored its ameliorative effects in L2MSS. A total of 981 international students from different countries were selected from 8 universities in Beijing as research subjects and were surveyed by International Physical Activity Questionnaire (IPAQ), L2MSS, Learning Experience Scale, and Intended Effort Scale. Differences, correlations, and mediated model were analyzed by ANOVA, Pearson, and structural equation modeling (SEM). The proportions of PA in this study were comparable to those observed in previous studies, with the lowest prevalence of individuals exhibiting high levels of PA, followed by those with medium levels, and the highest prevalence of individuals with low levels. With the exception of ideal L2 self, PA had a significant enhancing effect on L2MSS, learning experience, and intended effort (F = 2.36, η²=0.05, ; F = 3.16, η²=0.04, ; F = 2.33, η²=0.05; P < 0.05), and was incrementally associated with ought-to l2 self, endeavor degree, and time spent (F = 4.23, η²=0.05, ; F = 7.21, η²=0.04, ; F = 5.93, η²=0.03; P < 0.01). In terms of correlations, there were general and significant positive correlations between PA and the rest of the indicators (r > 0.3, P < 0.05), except for learning desire and ought-to L2 self (r = 0.293). According to the SEM test, in addition to the direct effect of L2MSS on intended effort, the following paths existed: (1) ILS→PA→IE (effect=-0.265, ratio = 31.28%, 95%CI=[0.124, 0.527]), (2) OLS→PA→IE (effect = 0.179, ratio = 17.94%, 95%CI=[0.074, 0.256]), (3) ILS→PA→LE→IE (effect = 0.116, ratio = 10.69%, 95%CI=[0.042, 0.248]), (4) OLS→PA→LE→IE (effect = 0.108, ratio = 4.15%, 95%CI=[0.039, 0.126]). total indirect effect0.304 (ratio = 59.61%, 95%CI=[0.069, 0.289]). (1) PA had an ameliorative effect on L2MSS, learning experience, and intended effort, and increasing PA level increased the significance of this effect. (2) PA level positively predicts L2MSS, learning experience, and intended effort. (3) PA is an important mediator in the process of L2MSS that influences the learning experience and intended effort, so MPA at least 3 days a week can increase the efficiency of second language learning. This study will provide a referable predictive model and a richer theoretical foundation for Chinese language learning and dissemination.

Prognostic value of glycaemic variability for mortality in critically ill atrial fibrillation patients and mortality prediction model using machine learning

BACKGROUND

The burden of atrial fibrillation (AF) in the intensive care unit (ICU) remains heavy. Glycaemic control is important in the AF management. Glycaemic variability (GV), an emerging marker of glycaemic control, is associated with unfavourable prognosis, and abnormal GV is prevalent in ICUs. However, the impact of GV on the prognosis of AF patients in the ICU remains uncertain. This study aimed to evaluate the relationship between GV and all-cause mortality after ICU admission at short-, medium-, and long-term intervals in AF patients.

METHODS

Data was obtained from the Medical Information Mart for Intensive Care IV 3.0 database, with admissions (2008-2019) as primary analysis cohort and admissions (2020-2022) as external validation cohort. Multivariate Cox proportional hazards models, and restricted cubic spline analyses were used to assess the associations between GV and mortality outcomes. Subsequently, GV and other clinical features were used to construct machine learning (ML) prediction models for 30-day all-cause mortality after ICU admission.

RESULTS

The primary analysis cohort included 8989 AF patients (age 76.5 [67.7-84.3] years; 57.8% male), while the external validation cohort included 837 AF patients (age 72.9 [65.3-80.2] years; 67.4% male). Multivariate Cox proportional hazards models revealed that higher GV quartiles were associated with higher risk of 30-day (Q3: HR 1.19, 95%CI 1.04-1.37; Q4: HR 1.33, 95%CI 1.16-1.52), 90-day (Q3: HR 1.25, 95%CI 1.11-1.40; Q4: HR 1.34, 95%CI 1.29-1.50), and 360-day (Q3: HR 1.21, 95%CI 1.09-1.33; Q4: HR 1.33, 95%CI 1.20-1.47) all-cause mortality, compared with lowest GV quartile. Moreover, our data suggests that GV needs to be contained within 20.0%. Among all ML models, light gradient boosting machine had the best performance (internal validation: AUC [0.780], G-mean [0.551], F1-score [0.533]; external validation: AUC [0.788], G-mean [0.578], F1-score [0.568]).

CONCLUSION

GV is a significant predictor of ICU short-term, mid-term, and long-term all-cause mortality in patients with AF (the potential risk stratification threshold is 20.0%). ML models incorporating GV demonstrated high efficiency in predicting short-term mortality and GV was ranked anterior in importance. These findings underscore the potential of GV as a valuable biomarker in guiding clinical decisions and improving patient outcomes in this high-risk population.

Association between sleep quality and cognitive impairment in older adults hypertensive patients in China: a case-control study

Background

Previous studies have found that poor sleep quality promotes the occurrence of cognitive impairment (CI), but this relationship has been rarely reported in older adults hypertensive patients. The purpose of this study was to investigate the relationship between sleep quality and CI in older adults hypertensive patients and the mediating effect of sleep quality between physical activity (PA) and CI.

Methods

A total of 2072 older adults hypertensive patients were included in this case-control study. Five hundred and eighteen older adults hypertensive patients with CI were matched 1:3 by age and sex to 1,554 older adults hypertensive patients with normal cognitive function. The International Physical Activity Questionnaire-Long Form, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination were used to evaluate PA intensity, sleep quality, and cognitive function in older adults hypertensive patients. Multivariate logistic regression and the mediation package in R Language were used to analyze the relationship between sleep quality and CI and the mediating effect of sleep quality between PA intensity and CI in older adults hypertensive patients.

Results

After adjusting for all confounding factors, sleep quality was positively correlated with CI in older adults hypertensive patients (OR = 2.565, 95%CI: 1.958-3.360, p < 0.001), and this relationship also existed in the older adults hypertensive patients with education levels of primary school and below and junior high school and above (OR = 2.468, 95%CI: 1.754-3.473, p < 0.001; OR = 2.385, 95%CI: 1.367-4.161, p = 0.002). In addition, sleep quality mediated part of the mediating effect between PA intensity and CI in older adults hypertensive patients (Za*Zb: - 17.19339; 95%CI: -0.37312, -0.04194).

Conclusion

Poor sleep quality was associated with the occurrence of CI in older adults hypertensive patients, and this relationship also existed in older adults hypertensive patients with education levels of primary school and below and junior high school and above.

Prolonged moderate to vigorous physical activity may lead to a decline in cognitive performance: a Mendelian randomization study

Objective

This study investigates the causal relationship between moderate to vigorous physical activity and cognitive performance.

Methods

Genetic loci strongly related to moderate to vigorous physical activity from genome-wide association studies were used as instrumental variables. These were combined with genetic data on cognitive performance from different Genome-Wide Association Study (GWAS) to conduct a two-sample Mendelian randomization analysis. The primary analysis used inverse variance weighting within a random effects model, supplemented by weighted median estimation, MR-Egger regression and other methods, with results expressed as Beta coefficient.

Results

This study selected 19 SNPs closely related to physical activity as instrumental variables. The multiplicative random-effects Inverse-Variance Weighted (IVW) analysis revealed that moderate to vigorous physical activity was negatively associated with cognitive performance (Beta = -0.551; OR = 0.58; 95% CI: 0.46-0.72; p < 0.001). Consistent results were obtained using the fixed effects IVW model (Beta = -0.551; OR = 0.58; 95% CI: 0.52-0.63; p < 0.001), weighted median (Beta = -0.424; OR = 0.65; 95% CI: 0.55-0.78; p < 0.001), simple mode (Beta = -0.467; OR = 0.63; 95% CI: 0.44-0.90; p < 0.001), and weighted mode (Beta = -0.504; OR = 0.60; 95% CI: 0.44-0.83; p < 0.001). After adjusting for BMI, smoking, sleep duration, and alcohol intake frequency, the multivariate MR analysis also showed a significant association between genetically predicted MVPA and cognitive performance, with Beta of -0.599 and OR = 0.55 (95% CI: 0.44-0.69; p < 0.001).

Conclusion

The findings of this study indicate that genetically predicted moderate to vigorous physical activity may be associated with a decline in cognitive performance.

Threshold effect of physical exercise on its association to diabetes mellitus in short sleep population: evidence from a nationwide study

BACKGROUND

The prevalence of diabetes mellitus (DM) is a significant public health concern, especially among individuals with short sleep duration. Understanding the relationship between physical exercise and DM in this population is crucial for developing effective prevention strategies. However, the presence of a potential threshold effect of exercise on DM risk remains unclear.

METHODS

Using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2018, this population-based study investigated the association between physical exercise and DM in individuals with short sleep duration (no more than 7 hours per night). Weighted logistic regression analyses were conducted, adjusting for demographic and lifestyle factors. Additionally, a two-piecewise linear regression model was employed to identify any threshold effect of exercise on DM risk.

RESULTS

This study included 15,092 participants identified with short sleep duration. Demographic characteristics stratified by DM status indicate higher prevalence among certain groups, such as middle-aged and older adults, males, and non-Hispanic Whites. The analysis revealed an inverse association between exercise levels and DM prevalence among the short sleep population. In the fully adjusted model, individuals engaging in sufficient exercise (> 600 MET-minutes/week) exhibited significantly reduced odds of developing DM [OR (95% CI): 0.624(0.527,0.738), p < 0.001]. Furthermore, the segmented regression model identified an inflection point at 2000 MET-minutes/week, below which a significant correlation between exercise and DM was observed.

CONCLUSIONS

This study provides evidence of a threshold effect of physical exercise on its association with DM in individuals with short sleep duration. Tailored exercise interventions targeting this population may help mitigate DM risk and improve overall health outcomes. Further research is warranted to validate these findings and explore optimal exercise thresholds for DM prevention strategies.

Effects of low-intensity home-based exercise on cognition in older persons with mild cognitive impairment: a direct comparison of aerobic versus resistance exercises using a randomized controlled trial design

Background

It has been reported that both aerobic exercise and resistance exercise can improve cognitive function in older people with mild cognitive impairment (MCI), but it is unclear which type of exercise has a higher impact on cognitive function. Additionally, low-intensity exercise is considered safe for the elderly and can be done at home. This study aimed to compare the effects of 3-month low-intensity home-based exercises, aerobic versus resistance exercises, on cognitive function in people with MCI.

Methods

This study was a single-blind randomized controlled trial conducted in a suburban community. Ninety eligible participants aged 60-80 years were randomly assigned into aerobic exercise, resistance exercise or control group (30 in each group). The aerobic and resistance exercise groups underwent 3 months of low-intensity exercise at home (35 min/day, 5 days/week). The control group performed their usual daily activities. The Montreal Cognitive Assessment Thai version (MoCA), Trail Making Test Part A and B (TMT-A, TMT-B), Stroop Color and Word Test (SCWT), forward and backward Digit Span Test (DST-F, DST-B) and Stick Design Test (SDT) were administered before training, 3-month after training and 3-month follow-up.

Results

All participants completed a 3-month exercise program, but during the follow-up, data were gathered from 28, 27, and 26 participants in the aerobic, resistance, and control groups, respectively. Both aerobic and resistance groups showed significant improvements in all outcome measures during posttraining and follow-up, except SDT, while there was no cognitive improvement in control group at posttraining and follow-up. Compared to those in the control group, the aerobic group had significant improvements in MoCA, TMT-A, TMT-B, and SCWT, while resistance group had significant improvements in MoCA and TMT-B at posttraining and follow-up. There were no differences in any outcome measures between aerobic and resistance groups, except SCWT, which was significantly greater in the aerobic group than in the resistance group posttraining.

Conclusion

Low-intensity exercise, whether aerobic or resistance training, was effective at improving cognitive function in older people with MCI, and the effects were sustained at the 3-month follow-up.Clinical trial registration:thaiclinicaltrials.org, TCTR20231110003.

The Relationship Between Social Isolation and Cognitive Frailty Among Community-Dwelling Older Adults: The Mediating Role of Depressive Symptoms

Purpose

Social isolation and depression have an impact on cognitive frailty. However, the underlying mechanisms between these variables have not been well defined. This study aims to investigate the mediating role of depressive symptoms in the association between social isolation and cognitive frailty among older adults in China.

Methods

From Mar 2023 to Aug 2023, a cross-sectional study was conducted with 496 community-dwelling older adults aged ≥60 years in Nanjing, Jiangsu Province, China. Demographic information was collected using the General Information Questionnaire. The Lubben Social Network Scale-6 (LSNS-6), Geriatric Depression Scale 15-item (GDS-15), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and FRAIL scale were used for the questionnaire survey. Multiple linear regression and binary logistic regression were utilized to explore the associations among social isolation, depressive symptoms, and cognitive frailty, and Bootstrap analysis was used to explore the mediating role of depressive symptoms in social isolation and cognitive frailty.

Results

Linear regression results revealed that social isolation was positively associated with depressive symptoms (β = 0.873, p < 0.001). Logistic regression analysis showed that social isolation (OR = 1.769, 95% CI = 1.018~3.075) and depressive symptoms (OR = 1.227, 95% CI = 1.108~1.357) were significantly associated with cognitive frailty. Mediation analysis demonstrated that depressive symptoms significantly mediated the relationship between social isolation and cognitive frailty, with an indirect effect of 0.027 (95% CI = 0.003~0.051), and the mediating effect accounted for 23.6% of the total effect.

Conclusion

Social isolation is associated with cognitive frailty in community-dwelling older adults, and depressive symptoms partially mediate the effect between social isolation and cognitive frailty. Active promotion of social integration among older individuals is recommended to enhance their mental health, reduce the incidence of cognitive frailty, and foster active aging.

Association between intensity of physical activity and cognitive function in hypertensive patients: a case-control study

Previous studies have shown that a higher intensity of physical activity (PA) is associated with a lower risk of cognitive impairment (CI), whereas hypertension is associated with higher CI. However, there are few studies on the association between PA intensity and cognitive function in hypertensive patients. This study investigated the association between PA intensity and cognitive function in hypertensive patients. A total of 2035 hypertensive patients were included in this study, including 407 hypertensive patients with CI and 1628 hypertensive patients with normal cognitive function matched 1:4 by age and sex. The International Physical Activity Questionnaire-Long Form and the Mini-mental State Examination were used to evaluate PA intensity, total metabolic equivalents, and cognitive function in patients with hypertension. Multivariate logistic regression was used to analyze the correlation between PA intensity and CI in hypertensive patients. The Spearman correlation coefficient was used to analyze the correlation between PA intensity and the total score of each component of the MMSE and the correlation between PA total metabolic equivalents and cardiac structure in hypertensive patients. After adjusting for all confounding factors, PA intensity was negatively associated with CI in hypertensive patients (OR = 0.608, 95% CI: 0.447-0.776, P < 0.001), and this association was also observed in hypertensive patients with education level of primary school and below and junior high school and above (OR = 0.732, 95% CI: 0.539-0.995, P = 0.047; OR = 0.412, 95% CI: 0.272-0.626, P < 0.001). The intensity of PA in hypertensive patients was positively correlated with orientation (r = 0.125, P < 0.001), memory (r = 0.052, P = 0.020), attention and numeracy (r = 0.151, P < 0.001), recall ability (r = 0.110, P < 0.001), and language ability (r = 0.144, P < 0.001). PA total metabolic equivalents in hypertensive patients were negatively correlated with RVEDD and LAD (r = - 0.048, P = 0.030; r = - 0.051, P = 0.020) and uncorrelated with LVEDD (r = 0.026, P = 0.233). Higher PA intensity reduced the incidence of CI in hypertensive patients. Therefore, hypertensive patients were advised to moderate their PA according to their circumstances.

Associations between frailty and mild cognitive impairment in older adults: Evidence from rural Chiang Mai Province

Thailand entered an aged society phase in 2000, with mild cognitive impairment (MCI) and frailty becoming prevalent among the older adult population. However, no studies have yet examined these issues specifically within rural communities. This study aims to explore the relationship between frailty and MCI among older adults in rural Thailand. It was a cross-sectional study conducted between December 2022 and June 2023. A questionnaire was administered by trained village health volunteers. The survey targeted older adults aged 60 years and above, residing in rural Chiang Mai, Thailand, with those having a history of dementia, depression, and brain injury being excluded from participation. Nine hundred eighty-four participants among the older adults were available for analysis. The mean age was 69.8 (SD 7.9) with 62.2% females (n = 612). The median frequency of exercise was three days (0-7). The prevalence of MCI and frailty among rural older adults in the community was 35.6% (n = 350) and 8% (n = 79), respectively. There were four factors associated with an increased risk of MCI, including age (aOR = 1.07, 95% CI 1.04-1.09, p < 0.001), smoking cigarettes (aOR 1.95, 95% CI 1.27-2.98, p = 0.002), feelings of loneliness (aOR 1.43, 95% CI 1.01-2.03, p = 0.043), and the presence of frailty (aOR 1.92, 95% CI 1.10-3.35, p = 0.022). There were two factors associated with a lower risk of MCI: a higher education level (aOR 0.90, 95% CI 0.86-0.94, p <0.001) and engaging in frequent exercise (aOR 0.9, 95% CI 0.86-0.95, p < 0.001). Frailty exhibited an association with an elevated risk of MCI among older adults in rural communities. Enhancing screening through health volunteers and primary healthcare professionals, coupled with bolstering community-driven health promotion initiatives, becomes imperative.

Classification of cognitive ability of healthy older individuals using resting-state functional connectivity magnetic resonance imaging and an extreme learning machine

BACKGROUND

Quantitative determination of the correlation between cognitive ability and functional biomarkers in the older brain is essential. To identify biomarkers associated with cognitive performance in the older, this study combined an index model specific for resting-state functional connectivity (FC) with a supervised machine learning method.

METHODS

Performance scores on conventional cognitive test scores and resting-state functional MRI data were obtained for 98 healthy older individuals and 90 healthy youth from two public databases. Based on the test scores, the older cohort was categorized into two groups: excellent and poor. A resting-state FC scores model (rs-FCSM) was constructed for each older individual to determine the relative differences in FC among brain regions compared with that in the youth cohort. Brain areas sensitive to test scores could then be identified using this model. To suggest the effectiveness of constructed model, the scores of these brain areas were used as feature matrix inputs for training an extreme learning machine. classification accuracy (CA) was then tested in separate groups and validated by N-fold cross-validation.

RESULTS

This learning study could effectively classify the cognitive status of healthy older individuals according to the model scores of frontal lobe, temporal lobe, and parietal lobe with a mean accuracy of 86.67%, which is higher than that achieved using conventional correlation analysis.

CONCLUSION

This classification study of the rs-FCSM may facilitate early detection of age-related cognitive decline as well as help reveal the underlying pathological mechanisms.