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Guan T, Zhang C, Zou X, Chen C, Zhou L, Wu X, Hao J. The Influence of Alcohol Consumption, Depressive Symptoms and Sleep Duration on Cognition: Results from the China Health and Retirement Longitudinal Study. Int J Environ Res Public Health 2022; 19:12574. [PMID: 36231874 PMCID: PMC9566793 DOI: 10.3390/ijerph191912574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
AIM Healthy cognition-related factors include alcohol consumption, depressive symptoms, and sleep duration. However, less is known about the role of these factors in the dyad or tripartite relationships. In this study, we examined whether there were potential mediation effects, moderation effects, and interactions between these factors in the longitudinal study. METHODS Both cross-sectional data analysis and a longitudinal study were performed using baseline and 2018 data from the China Health and Retirement Longitudinal Study (CHARLS) cohort. CHARLS is a nationwide survey program covering 450 villages and 150 counties in 28 provinces that aims to investigate comprehensive demographic information. After selecting participants from the CHARLS cohort, 15,414 were included in the study. Non-drinkers, those who drink more than once a month, and those who drink less than once a month were defined by their alcohol consumption. Depressive symptoms were defined as nondepressed (less than or equal to 12) and depressed (more than 12). Sleep duration was defined as 7-8 h per night, ≤6 h per night, and ≥9 h per night. The total cognitive scores were calculated from memory, orientation, and executive tests. The PROCESS macro in SPSS was used to analyze all mediations and moderating mediations. RESULTS Alcohol consumption has a positive correlation with cognition. The global cognition z scores of participants with depressive symptoms were significantly lower than those of the control (all p's < 0.001), in different models. The memory score (β: -0.148; 95% CI: -0.240 to -0.056; p = 0.002), the executive score (β: -0.082; 95% CI: -0.157 to -0.006; p = 0.033), and the global cognition score (β: -0.105; 95% CI: -0.187 to -0.023; p = 0.012) of participants defined as ≤6 h per night were, obviously, less than the control (7-8 h per night). An association between depression and alcohol consumption has been found, and the protective effects have been reversed by depression, which caused the cognition decline. Sleep duration was identified as a moderator, influencing the relationship between depressive symptoms and cognitive function. Besides, there was an interaction causing cognition decline among alcohol consumption, depressive symptoms, and sleep duration. Cognitive function showed a marked downward trend with increasing age. CONCLUSIONS In this model, depression primarily mediates the relationship between alcohol consumption and cognition, and sleep duration changes the mediation effect. Furthermore, there is a significant interaction between alcohol consumption, depressive symptoms, and sleep duration, which are significantly associated with cognitive function.
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Affiliation(s)
- Tianyue Guan
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Chao Zhang
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Xuanmin Zou
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Chen Chen
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Li Zhou
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Xiaochang Wu
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
| | - Jiahu Hao
- Maternal, Child, and Adolescent Health Department, Anhui Medical University, Hefei 230032, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei 230032, China
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Tevik K, Bergh S, Selbæk G, Johannessen A, Helvik AS. A systematic review of self-report measures used in epidemiological studies to assess alcohol consumption among older adults. PLoS One 2021; 16:e0261292. [PMID: 34914759 PMCID: PMC8675766 DOI: 10.1371/journal.pone.0261292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background There is a lack of standardization regarding how to assess and categorize alcohol intake in older adults. The aim of this study was to systematically review methods used in epidemiological studies to define drinking patterns and measure alcohol consumption among older adults. Methods A systematic search was conducted in the MEDLINE, PubMed, PsycINFO, EMBASE, and CINAHL databases for studies published from January 2009 to April 2021. Studies were included if they were observational studies with a quantitative design; the mean age of the participants was ≥ 65 years; questionnaires, screening tools, or diagnostic tools were used to define alcohol consumption; and alcohol consumption was self-reported. Results Of 492 studies considered, 105 were included. Among the 105 studies, we detected 19 different drinking patterns, and each drinking pattern had a wide range of definitions. The drinking patterns abstaining from alcohol, current drinking, and risk drinking had seven, 12 and 21 diverse definitions, respectively. The most used questionnaire and screening tools were the quantity-frequency questionnaire, with a recall period of 12 months, and the full and short versions of the Alcohol Use Disorders Identification Test, respectively. Conclusion No consensus was found regarding methods used to assess, define, and measure alcohol consumption in older adults. Identical assessments and definitions must be developed to make valid comparisons of alcohol consumption in older adults. We recommend that alcohol surveys for older adults define the following drinking patterns: lifetime abstainers, former drinkers, current drinkers, risk drinking, and heavy episodic drinking. Standardized and valid definitions of risk drinking, and heavy episodic drinking should be developed. The expanded quantity-frequency questionnaire including three questions focused on drinking frequency, drinking volume, and heavy episodic drinking, with a recall period of 12 months, could be used.
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Affiliation(s)
- Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- * E-mail:
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Aud Johannessen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Vestfold, Norway
| | - Anne-S. Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Zhang Y, Li Y, Zheng X, Zhu L, Xu B. Association between alcohol consumption in midlife and cognitive function in old age: Findings from the China health and Nutrition Survey. Nutr Metab Cardiovasc Dis 2021; 31:3044-3053. [PMID: 34642057 DOI: 10.1016/j.numecd.2021.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Alcohol consumption has been reported to impair the physical and mental health of the elderly. This study aimed to explore the association between alcohol consumption patterns in midlife and cognition in the elderly among the Chinese population. METHODS AND RESULTS Study subjects were individuals aged ≥45 years in the shared database of the China Health and Nutrition Survey in 1997, who were followed up in 2006. A questionnaire was used to collect information about alcohol consumption (frequency, amount and type). Alcohol consumption (grams/week) was classified into none, light (≤84), light-to-moderate (84.01-168), moderate-to-heavy (168.01-336) and heavy (≥336.01) categories in men, and none, light (<42) and moderate (≥42) categories in women. Cognitive function was measured in 2006 using a subset of items from the modified Telephone Interview for Cognitive Status. The lowest quintile was used as the cut-off point for cognitive impairment. A multivariate logistic regression model was applied. The study involved 1926 participants with a mean age of 56.91 years, and men accounted for 51.66% of the total participants. Drinking behaviours and cognitive scores had significant sexual difference (P < 0.001). Cognitive impairment was identified in 135 men and 237 women. Compared with light drinking, heavy drinking and non-drinking were associated with cognitive impairment in men [adjusted odds ratio (aOR) and 95% CI were 2.19 (1.59-3.00), 1.54 (1.21-1.96), respectively; P < 0.001]. Compared with light drinkers, female non-drinkers and moderate drinkers were associated with cognitive impairment [aOR and 95% CI were 1.54 (1.16-2.03) and 1.75 (1.08-2.85), respectively; P < 0.001]. CONCLUSIONS Scientific evidence on the adverse effects of heavy drinking on elderly cognition and the possibly protective effects of light drinking could influence policy decisions on alcohol consumption in China.
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Affiliation(s)
- Yuge Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xubin Zheng
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Liping Zhu
- Shanghai Center for Women and Children's Health, Shanghai, China
| | - Biao Xu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
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Galindo-Aldana GM, Murillo-Macías C, Cedano-Gasca A, Padilla-López A, García-León IA. Drug Trend Study in Mexican Population: Consumption and Cognitive Dysfunction Correlates. Rev Fac Med 2019. [DOI: 10.15446/revfacmed.v67n4.64157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Drug abuse screening tests (DAST) are a useful tool in decision making regarding the planning and implementation of drug-related public health policies. In addition, they constitute a rapid way to obtain data on the effects of drug consumption in specific populations.Objective: To describe the correlation between drug abuse (per type of drug) and cognitive dysfunction prevalence based on the information reported in a DAST.Materials and methods: A DAST was administered to 1299 individuals from 5 cities in Baja California, Mexico. In addition, an internal consistency reliability test was conducted to determine the internal consistency level of the instrument.Results: Several correlations between the consumption of different drugs were found. The main associations were found between methamphetamine and marijuana consumption. In addition, a positive correlation between the age at first drug use and cognitive impairment was found.Conclusions: DAST are brief administration instruments that allow obtaining data on drug abuse and drug addiction patterns. In addition, they can be used to identify the interaction between the consumption patterns of different drugs and the possible association between age at first drug use and cognitive dysfunction.
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Hui X, Li J, Lao Y, Jia B, Hou L, Lu Z, Gu Q, Niu J, Bao H, Yan P, Yao L. Association between alcohol consumption and mild cognitive impairment: A protocol of dose-response meta-analysis. Medicine (Baltimore) 2019; 98:e16098. [PMID: 31277109 PMCID: PMC6635151 DOI: 10.1097/md.0000000000016098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The objective of this study is to investigate the potential dose-response association between alcohol consumption and the risk of mild cognitive impairment (MCI). METHODS We will perform a dose-response meta-analysis (DRMA) of cohort studies to explore the dose-response relationship between alcohol intake and MCI. A comprehensive literature search of PubMed, EMBASE, The Cochrane Library, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wan-Fang Database will be conducted. Two investigators will independently select studies, extract data, and assess the quality of the included study. The Newcastle-Ottawa Scale will be used to assess the quality of include studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and A MeaSurement Tool to Assess systematic Reviews (AMSTAR) will be used to assess the quality of evidence and methodological quality. Any disagreement will be resolved by the third investigator. We will use the hazard ratio as the effect indicator, and piecewise linear regression model and restricted cubic spline model will be used for linear and nonlinear trend estimation, respectively. There is no requirement of ethical approval and informed consent. DISCUSSION This is the first DRMA to explore the dose-response relationship between alcohol intake and MCI. We predict it will provide high-quality evidence to prevent clinical MCI and dementia. REGISTRATION The DRMA is registered in the PROSPERO (CRD42019127261) international prospective register of systematic review.
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Affiliation(s)
- Xu Hui
- School of Public Health, Lanzhou University
| | - Jing Li
- School of Public Health, Lanzhou University
| | - Yongfeng Lao
- Second Clinical Medical College of Lanzhou University
| | - Bibo Jia
- School of Public Health, Lanzhou University
| | - Lijuan Hou
- First Clinical Medical College of Lanzhou University
| | - Zhenxing Lu
- First Clinical Medical College of Lanzhou University
| | - Qinghong Gu
- Evidence-Based Medicine Center of Lanzhou University
| | | | | | - Peijing Yan
- Institute of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou
| | - Liang Yao
- Evidence-Based Medicine Center of Lanzhou University
- Chinese Medicine Faculty of Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
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Ren L, Zheng Y, Wu L, Gu Y, He Y, Jiang B, Zhang J, Zhang L, Li J. Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China. Sci Rep 2018; 8:3575. [PMID: 29476112 PMCID: PMC5824836 DOI: 10.1038/s41598-018-21983-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 02/14/2018] [Indexed: 11/26/2022] Open
Abstract
To investigate the prevalence of cognitive impairment and its risk factors among Chinese elders aged over 80 years, a community-based, cross-sectional study was conducted from May to June 2016 in Shanghai, China. Cognitive function was measured by using Mini-Mental Status Examination. Multiple logistic regression assessed associations between risk factors and cognitive impairment. Of 480 participants, 30% were diagnosed with cognitive impairment. Women [adjusted odds ratio (AOR): 1.71, 95% confidence interval (CI): 1.03-2.83], solitary life (AOR: 3.15, 1.89-5.26), monthly income less than 2000 Chinese yuan (AOR: 3.47, 1.18-10.23) were significantly associated with increased risk of cognitive impairment, compared with men, non-solitary life, and monthly income greater than 4000 Chinese yuan, respectively. Overweight (AOR: 0.59, 0.36-0.97), being physically active at least 60 minutes per day (AOR: 0.59, 0.35-0.95), antihypertensive drugs users (AOR: 0.45, 0.28-0.72), and lipid lowering drugs users (AOR: 0.21, 0.06-0.76) significantly lowered the risk of cognitive impairment, compared with normal weight, inadequate outdoor activity, and non-medication users, respectively. Accordingly, this study found that women, solitary life, lower income was associated with increased risk of cognitive impairment, while overweight, being physically active, and antihypertensive and lipid lowering drugs usage might lower the risk.
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Affiliation(s)
- Longbing Ren
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Yongtao Zheng
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Lezhou Wu
- Department of Data Science, Children's Hospital of Philadelphia, Philadelphia, PA, 19147, USA
| | - Yijun Gu
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Yusheng He
- Department of Neurology, Tongji Hospital, Tongji University, Shanghai, China
| | - Bo Jiang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Jie Zhang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Lijuan Zhang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China.
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China.
| | - Jue Li
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China.
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China.
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