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Stephan Y, Sutin AR, Terracciano A. Personality traits and the risk of urinary incontinence: Evidence from three longitudinal samples. Int J Geriatr Psychiatry 2024; 39:e6084. [PMID: 38558175 DOI: 10.1002/gps.6084] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Urinary incontinence (UI) is a common condition with a substantial negative impact on older adults' quality of life. This study examines whether individual differences in behavioral, cognitive, and emotional traits assessed by the five major dimensions of personality are related to the risk of concurrent and incident UI. METHODS Participants were older women and men (N > 26,000) from the Midlife in the United States Survey, the Health and Retirement Study, and the English Longitudinal Study of Aging. In each cohort, personality traits (measured with the Midlife Development Inventory) and demographic (age, sex, education, and race), clinical (body mass index, diabetes, blood pressure), and behavioral (smoking) factors were assessed at baseline. UI was assessed at baseline and again 8-20 years later. Results for each cohort were combined in random-effect meta-analyses. RESULTS Consistently across cohorts, higher neuroticism and lower conscientiousness were related to a higher risk of concurrent and incident UI. To a lesser extent, extraversion, openness, and agreeableness were also related to lower risk of concurrent and incident UI. BMI, diabetes, blood pressure, and smoking partially accounted for these associations. There was little evidence that age or sex moderated the associations. CONCLUSIONS The present study provides novel, robust, and replicable evidence linking personality traits to UI. The higher vulnerability for UI for individuals who score higher on neuroticism and lower on conscientiousness is consistent with findings for other multifactorial geriatric syndromes. Personality traits can help identify individuals at risk and may help contextualize the clinical presentation of comorbid emotional, cognitive, and behavioral symptoms.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, Florida, USA
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Stephan Y, Sutin AR, Terracciano A. Personality traits and the risk of sensory impairment: Evidence from the National Health and Aging Trends Study. J Psychosom Res 2023; 173:111459. [PMID: 37657125 PMCID: PMC10591274 DOI: 10.1016/j.jpsychores.2023.111459] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Sensory impairment has pervasive effects on older individuals' quality of life and health. Although recent research found an association between personality traits and the risk of hearing and vision impairment, data on older adults is limited, and no study has examined dual-sensory impairment. Therefore, the present study examined the prospective relationship between personality traits and risk of hearing, vision, and dual sensory impairment among older adults. METHOD Participants were older adults aged 67 to 94 years (N = 829) from the National Health and Aging Trends Study (NHATS). Personality traits, demographic, clinical (body mass index, diabetes, and high blood pressure), and behavioral (smoking and physical activity) factors were assessed in 2013/2014. Objective measures of hearing and vision were obtained in 2021. RESULTS Controlling for demographic factors, higher conscientiousness was associated with a lower risk of hearing (OR: 0.81; 95%CI: 0.67-0.97, p = .022), vision (OR: 0.83, 95%CI: 0.71-0.97, p = .022) and dual sensory impairment (OR: 0.70, 95%CI: 0.56-0.86, p < .001). Higher openness (OR: 0.81, 95%CI: 0.68-0.97, p = .023) and neuroticism (OR: 0.74, 95%CI: 0.62-0.88, p < .001) were associated with a lower risk of hearing impairment. Clinical and behavioral covariates partially accounted for these associations. CONCLUSION Consistent with other age-related health and cognitive outcomes, conscientiousness may be protective against sensory impairment. Surprisingly, neuroticism had a protective effect for hearing, but not vision. The findings provide novel evidence for an association between personality and sensory impairment among older adults.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, USA.
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, USA.
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Zhang H, Jiang S, Hao M, Li Y, Hu Z, Jiang X, Jin L, Wang X. Association of cardiometabolic multimorbidity with motoric cognitive risk syndrome in older adults. Alzheimers Dement (Amst) 2023; 15:e12491. [PMID: 37937160 PMCID: PMC10626031 DOI: 10.1002/dad2.12491] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION Motoric cognitive risk syndrome (MCR) is a predementia syndrome that is characterized by cognitive complaints and slow gait. Cardiometabolic multimorbidity (CMM) is associated with an increased risk of dementia. However, the relationship between CMM and MCR is still unclear. METHODS We included 4744 participants (aged 65+ years) without MCR at baseline from the National Health and Aging Trends Study (NHATS), who were followed-up from 2011 to 2018. CMM was defined as the presence of two or more cardiometabolic diseases (including diabetes mellitus, heart disease, and stroke). RESULTS CMM was significantly associated with an increased risk of MCR (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.13-1.75) in fully adjusted models. Consistent results were observed from stratified analyses of different subgroups. Increasing numbers of cardiometabolic diseases were dose-dependently associated with increased MCR risk (HR 1.33, 95% CI 1.20-1.48). DISCUSSION CMM is associated with an increased risk of MCR in older adults. HIGHLIGHTS Motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by slow gait speed and cognitive complaints.Cardiometabolic multimorbidity was associated with an increased MCR risk.An increased number of cardiometabolic diseases were dose-dependently associated with increased MCR risk.
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Affiliation(s)
- Hui Zhang
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
- Department of Vascular SurgeryShanghai Key Laboratory of Vascular Lesion Regulation and RemodelingShanghai Pudong HospitalFudan University Pudong Medical CenterShanghaiChina
| | - Shuai Jiang
- Department of Vascular SurgeryShanghai Key Laboratory of Vascular Lesion Regulation and RemodelingShanghai Pudong HospitalFudan University Pudong Medical CenterShanghaiChina
| | - Meng Hao
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Yi Li
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Zixin Hu
- Artificial Intelligence Innovation and Incubation InstituteFudan UniversityShanghaiChina
| | - Xiao‐Yan Jiang
- State Key Laboratory of CardiologyDepartment of Pathology and PathophysiologySchool of MedicineTongji UniversityShanghaiChina
| | - Li Jin
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Xiaofeng Wang
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
- National Clinical Research Centre for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
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Yao G, Luo Y, Wu H, Gao M, Sun J. Association between positive control in self-perceptions of aging and motoric cognitive risk syndrome among Chinese community-dwelling older adults: a cross-sectional study. BMC Geriatr 2023; 23:211. [PMID: 37009878 PMCID: PMC10069104 DOI: 10.1186/s12877-023-03934-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 03/26/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Self-perceptions of aging (SPA) are important psychosocial factors that lead to a wide range of outcomes including dementia. However, the relationships between positive SPA and motoric cognitive risk syndrome (MCR) which is a predementia syndrome are still unknown. This study aimed to reveal the associations of positive control and aging awareness of SPA with the risk of MCR and its components. METHODS A cross-sectional design was conducted among 1137 Chinese community-dwelling older adults. Positive control and aging awareness were defined by two dimensions of SPA (Positive control and Timeline chronic). MCR was determined according to definition. Multivariable logistic regression was used to examine the associations. RESULTS The overall prevalence of MCR was 11.5% (mean age = 71.62 ± 5.22). After adjusting for depression, anxiety, and cognitive function, positive control was associated with reduced risk of MCR (OR = 0.624, 95% CI 0.402-0.969, P = 0.036), subjective cognitive complaints (SCC) (OR = 0.687, 95% CI 0.492-0.959, P = 0.027), and gait speed (GS) (OR = 0.377, 95% CI 0.197-0.720, P = 0.003), respectively. Aging awareness was merely related to increased risk of MCR (OR = 1.386, 95% CI 1.062-1.810, P = 0.016). CONCLUSIONS This study highlights the crucial associations of positive control and aging awareness with MCR and its components. Our results emphasize that positive belief in control and adaptive aging awareness might be promising targets for preventing MCR.
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Affiliation(s)
- Guiying Yao
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China
| | - Yanyan Luo
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China.
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China.
| | - Huimin Wu
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- School of Nursing, SIAS University, Xinzheng, Henan, 451150, People's Republic of China
| | - Min Gao
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China
| | - Junjun Sun
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China
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Wen ZF, Peng SH, Wang JL, Wang HY, Yang LP, Liu Q, Zhang XG. Prevalence of motoric cognitive risk syndrome among older adults: a systematic review and meta-analysis. Aging Ment Health 2022:1-13. [PMID: 36533320 DOI: 10.1080/13607863.2022.2158305] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome. Several studies on the prevalence of MCR have been published; however, the data vary across studies with different epidemiological characteristics. Thus, this study aimed to quantitatively analyse the overall prevalence and associated epidemiological characteristics of MCR among older adults aged ≥ 60 years. METHODS The Cochrane Library, PubMed, Web of Science, CINAHL, Embase, Scopus, PsycInfo, China National Knowledge Infrastructure, Weipu Database, China Biology Medicine disc and Wanfang Database were searched from their inception to January 2022. A modified Newcastle-Ottawa Scale evaluated the risk of bias. Statistical heterogeneity among the included studies was analysed using Cochran's Q and I2 tests. A random effect model calculated pooled prevalence owing to study heterogeneity. Begg's and Egger's tests were used to assess the publication bias. Additionally, subgroup analysis and meta-regression were performed based on different epidemiological characteristics to determine heterogeneity sources. RESULTS Sixty-two studies comprising 187,558 samples were obtained. The pooled MCR prevalence was 9.0% (95% confidence interval: 8.3-9.8). A higher MCR prevalence was observed in females, older adults with a low educational level, depression and cardiovascular risk factors, South American populations, and studies with small sample sizes and cross-section designs. Furthermore, subjective cognitive complaint using scale score and gait speed using instrument gait showed higher MCR prevalence. CONCLUSION MCR is common in older adults, and various epidemiological characteristics influence its prevalence. Thus, preventive measures are required for older adults with higher MCR prevalence.
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Affiliation(s)
- Zhi-Fei Wen
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Si-Han Peng
- School Clinical, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Jia-Lin Wang
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Hong-Yan Wang
- Dean Office, Sichuan Nursing Vocational College, Sichuan, China
| | - Li-Ping Yang
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Qin Liu
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Xian-Geng Zhang
- Dean Office, Sichuan Nursing Vocational College, Sichuan, China
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Mullin DS, Cockburn A, Welstead M, Luciano M, Russ TC, Muniz-Terrera G. Mechanisms of motoric cognitive risk-Hypotheses based on a systematic review and meta-analysis of longitudinal cohort studies of older adults. Alzheimers Dement 2022; 18:2413-2427. [PMID: 35142038 PMCID: PMC10078717 DOI: 10.1002/alz.12547] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 01/31/2023]
Abstract
We aimed to refine the hypothesis that motoric cognitive risk (MCR), a syndrome combining measured slow gait speed and self-reported cognitive complaints, is prognostic of incident dementia and other major causes of morbidity in older age. We propose mechanisms on the relationship between motor and cognitive function and describe a roadmap to validate these hypotheses. We systematically searched major electronic databases from inception to August 2021 for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non-MCR group with any health outcome. Fifteen cohorts were combined by meta-analysis. Participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio [aHR] 1.76, 95% CI 1.49-2.08; I2 = 24.9%), dementia (aHR 2.12, 1.85-2.42; 33.1%), falls (adjusted Relative Risk 1.38, 1.15-1.66; 62.1%), and mortality (aHR 1.49, 1.16-1.91; 79.2%). The prognostic value of MCR is considerable and mechanisms underlying the syndrome are proposed.
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Affiliation(s)
- Donncha S Mullin
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.,Edinburgh Dementia Prevention Group, University of Edinburgh, Edinburgh, UK.,Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,NHS Lothian, Royal Edinburgh Hospital, Edinburgh, UK
| | | | - Miles Welstead
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Michelle Luciano
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Tom C Russ
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.,Edinburgh Dementia Prevention Group, University of Edinburgh, Edinburgh, UK.,Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,NHS Lothian, Royal Edinburgh Hospital, Edinburgh, UK.,Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention Group, University of Edinburgh, Edinburgh, UK.,Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Li W, Sun X, Liu Y, Ge M, Lu Y, Liu X, Zhou L, Liu X, Dong B, Yue J, Xue Q, Dai L, Dong B. Plasma metabolomics and lipidomics signatures of motoric cognitive risk syndrome in community-dwelling older adults. Front Aging Neurosci 2022; 14:977191. [PMID: 36158552 PMCID: PMC9490321 DOI: 10.3389/fnagi.2022.977191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionMotoric cognitive risk syndrome (MCR) is characterized by subjective cognitive complaints (SCCs) and slow gait (SG). Metabolomics and lipidomics may potentiate disclosure of the underlying mechanisms of MCR.MethodsThis was a cross-sectional study from the West China Health and Aging Trend cohort study (WCHAT). The operational definition of MCR is the presence of SCCs and SG without dementia or mobility disability. The test and analysis were based on untargeted metabolomics and lipidomics, consensus clustering, lasso regression and 10-fold cross-validation.ResultsThis study enrolled 6,031 individuals for clinical analysis and 577 plasma samples for omics analysis. The overall prevalence of MCR was 9.7%, and the prevalence of MCR-only, assessed cognitive impairment-only (CI-only) and MCR-CI were 7.5, 13.3, and 2.1%, respectively. By consensus clustering analysis, MCR-only was clustered into three metabolic subtypes, MCR-I, MCR-II and MCR-III. Clinically, body fat mass (OR = 0.89, CI = 0.82–0.96) was negatively correlated with MCR-I, and comorbidity (OR = 2.19, CI = 1.10–4.38) was positively correlated with MCR-III. Diabetes mellitus had the highest ORs above 1 in MCR-II and MCR-III (OR = 3.18, CI = 1.02–9.91; OR = 2.83, CI = 1.33–6.04, respectively). The risk metabolites of MCR-III showed relatively high similarity with those of cognitive impairment. Notably, L-proline, L-cystine, ADMA, and N1-acetylspermidine were significantly changed in MCR-only, and PC(40:3), SM(32:1), TG(51:3), eicosanoic acid(20:1), methyl-D-galactoside and TG(50:3) contributed most to the prediction model for MCR-III.InterpretationPre-dementia syndrome of MCR has distinct metabolic subtypes, and SCCs and SG may cause different metabolic changes to develop MCR.
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Affiliation(s)
- Wanmeng Li
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Xuelian Sun
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institute, Solna, Sweden
| | - Yu Liu
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Meiling Ge
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Ying Lu
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Lixing Zhou
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Xiaohui Liu
- School of Life Sciences, Tsinghua University, Beijing, China
| | - Biao Dong
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Jirong Yue
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Qianli Xue
- Department of Medicine, Biostatistics, and Epidemiology, Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Lunzhi Dai
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
- *Correspondence: Lunzhi Dai,
| | - Birong Dong
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
- Birong Dong,
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Stephan Y, Sutin AR, Luchetti M, Aschwanden D, Terracciano A. Facets of conscientiousness and motoric cognitive risk syndrome. J Psychiatr Res 2022; 151:73-77. [PMID: 35468428 PMCID: PMC9843494 DOI: 10.1016/j.jpsychires.2022.03.050] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 01/19/2023]
Abstract
Conscientiousness is related to a lower risk of motoric cognitive risk syndrome (MCR), a pre-dementia syndrome characterized by slow gait speed and cognitive complaints. The present study examines which facets of conscientiousness are related to concurrent and incident MCR. Participants were dementia-free older adults aged 65-99 years (N = 6001) from the Health and Retirement Study (HRS). Baseline data on conscientiousness facets and MCR (cognitive complaints and gait speed) were collected in 2008/2010, along with the covariates: demographic factors, cognition, physical activity, disease burden, depressive symptoms, and body mass index (BMI). MCR was assessed again in 2012/2014 and 2016/2018. Controlling for demographic factors, higher industriousness was related to a nearly 30% lower likelihood of concurrent MCR (Odds Ratio [OR] = 0.75, 95%CI: 0.67-0.85, p < .001) and to about 60% reduced risk of incident MCR (Hazard ratio [HR] = 0.63, 95%CI: 0.56-0.71, p < .001). Self-control, order, and responsibility were also associated with a lower likelihood of concurrent (OR range: 0.82-0.88) and incident (HR range: 0.72-0.82) MCR. Traditionalism (HR = 0.84, 95%CI: 0.75-0.93, p < .01) and virtue (HR = 0.84, 95%CI: 0.75-0.93, p < .01) were related to a lower risk of incident MCR. Cognition, physical activity, disease burden, depressive symptoms, and BMI partially accounted for these associations. Industriousness is the facet of conscientiousness with the strongest association with risk of MCR. This facet could be targeted in interventions to reduce MCR and, ultimately, dementia.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, USA
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, USA
| | - Damaris Aschwanden
- Department of Geriatrics, College of Medicine, Florida State University, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, USA
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Felix N, Ayers E, Verghese J, Blumen HM. Increased Social Support Reduces the Incidence of Motoric Cognitive Risk Syndrome. Innov Aging 2022; 6:igac048. [PMID: 36081405 PMCID: PMC9447853 DOI: 10.1093/geroni/igac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Objectives
The motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by slow gait and cognitive complaint. The relationship between MCR and social support—a potentially modifiable risk factor of dementia—is currently unknown. The current study aimed to determine whether MCR incidence varies as a function of social support in aging.
Research Design and Methods
We examined MCR incidence in 506 community-dwelling older adults (M Age 76.59; 57.3% female) without MCR or dementia at baseline. We quantified perceived levels of social support with the Medical Outcomes Study Social Support Survey, incorporating four different categories of support: (a) emotional/informational support, (b) tangible support, (c) affectionate support, and (d) positive social interactions. We used Cox regression analyses, adjusted for age, sex, race/ethnicity, education, marital status, comorbidities, and global cognition, to estimate hazard ratios (aHR) with 95% confidence intervals (CIs).
Results
Over a median follow-up time of 2.5 years (range = 1–7 years), 38 participants (9.8%) developed MCR. Increased tangible support decreased the risk of MCR by 30% (aHR: 0.70, 95% CI: 0.53–0.92, p = .011). Increased overall social support decreased the risk of MCR by 33% (aHR: 0.67, 95% CI: 0.46–0.98, p = .038). Other subcategories of social support were not associated with a decreased risk of MCR (p > .05).
Discussion and Implications
Higher levels of tangible social support, as well as overall social support, were associated with reduced risk for MCR in older adults. Increasing social support may be a promising avenue of intervention for reducing the risk of MCR, dementia, and other forms of cognitive decline.
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Affiliation(s)
- Nicole Felix
- Department of Medicine, Albert Einstein College of Medicine , Bronx, New York , USA
| | - Emmeline Ayers
- Departments of Neurology, Albert Einstein College of Medicine , Bronx, New York , USA
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine , Bronx, New York , USA
- Departments of Neurology, Albert Einstein College of Medicine , Bronx, New York , USA
| | - Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine , Bronx, New York , USA
- Departments of Neurology, Albert Einstein College of Medicine , Bronx, New York , USA
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Sun X, Tang S, Miyawaki CE, Li Y, Hou T, Liu M. Longitudinal association between personality traits and homebound status in older adults: results from the National Health and Aging Trends Study. BMC Geriatr 2022; 22:93. [PMID: 35109812 PMCID: PMC8812013 DOI: 10.1186/s12877-022-02771-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/17/2022] [Indexed: 12/02/2022] Open
Abstract
Background Personality is associated with predictors of homebound status like frailty, incident falls, mobility, and depression. However, the relationship between personality traits and homebound status is unclear. This study aims to examine the longitudinal association between personality traits and homebound status among older adults. Methods Using data of non-homebound community-dwelling adults aged 65 years and older in the 2013 and 2014 waves (baseline) of the National Health and Aging Trends Study (N = 1538), this study examined the association between personality traits and homebound status. Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency of going outside, difficulty in going outside, and whether there was help when going outside. Personality traits, including conscientiousness, extraversion, neuroticism, openness, and agreeableness were assessed using the 10-item Midlife Development Inventory on a rating scale from 1 (not at all) to 4 (a lot). Ordered logistic regression models were used to examine whether personality traits predicted homebound status in later 3 years with and without adjusting covariates. Results The sample was on average 77.0 ± 6.70 years old, and 55% were female. The majority were non-Hispanic whites (76%), and received some college or vocational school education or higher (55%). Homebound participants tended to be less educated older females. Three years later, 42 of 1538 baseline-non-homebound participants (3%) became homebound, and 195 participants (13%) became semi-homebound. Among these five personality traits, high conscientiousness (adjusted odds ratio [OR] = 0.73, p < 0.01) was associated with a low likelihood of becoming homebound after adjusting demographic and health-related covariates. Conclusions These findings provided a basis for personality assessment to identify and prevent individuals from becoming homebound. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02771-8.
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Affiliation(s)
- Xiaocao Sun
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | | | - Yuxiao Li
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | - Tianxue Hou
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | - Minhui Liu
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China.
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Sun X, Harris KE, Hou L, Xia X, Liu X, Ge M, Jia S, Zhou L, Zhao W, Zhang Y, Zhao Y, Mei Y, Zhang G, Xin L, Hao Q, Shen Y, Xiao C, Yue J, Ge N, Li Y, Dong B, Xue Q. The prevalence and associated factors of motoric cognitive risk syndrome in multiple ethnic middle‐aged to older adults in west China: A cross‐sectional study. Eur J Neurol 2022; 29:1354-1365. [PMID: 35118760 DOI: 10.1111/ene.15255] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/15/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Xuelian Sun
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | | | - Lisha Hou
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Xin Xia
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Xiaolei Liu
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Meiling Ge
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Shuli Jia
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Lixing Zhou
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Wanyu Zhao
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Yan Zhang
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Yunli Zhao
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Yang Mei
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Gongchang Zhang
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Liuyi Xin
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Qiukui Hao
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Yanjiao Shen
- Department of Guideline and Rapid Recommendation Cochrane China Centre MAGIC China Centre Chinese Evidence‐Based Medicine Centre West China Hospital Sichuan University Chengdu Sichuan China
| | - Chun Xiao
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Jirong Yue
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Ning Ge
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Ying Li
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Birong Dong
- National Clinical Research Center of Geriatrics and Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan China
| | - Qianli Xue
- Departments of Medicine, Biostatistics, and Epidemiology Johns Hopkins University Baltimore USA
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Terracciano A, Aschwanden D, Passamonti L, Toschi N, Stephan Y, Luchetti M, Lee JH, Sesker A, O'Súilleabháin PS, Sutin AR. Is neuroticism differentially associated with risk of Alzheimer's disease, vascular dementia, and frontotemporal dementia? J Psychiatr Res 2021; 138:34-40. [PMID: 33819874 PMCID: PMC8192471 DOI: 10.1016/j.jpsychires.2021.03.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 01/25/2021] [Revised: 03/10/2021] [Accepted: 03/19/2021] [Indexed: 02/04/2023]
Abstract
This study examines whether neuroticism is differentially associated with risk of incident Alzheimer's disease (AD), vascular dementia (VD), and frontotemporal dementia (FTD) using a prospective study design. Participants from the UK Biobank (N = 401,422) completed a self-report neuroticism scale in 2006-2010 and incident all-cause dementia, AD, VD, and FTD were ascertained using electronic health records or death records up to 2018. During an average follow-up of 8.8 years (3,566,123 person-years), there were 1798 incident of all-cause dementia, 675 AD, 376 VD, and 81 FTD. Accounting for age and sex, compared to individuals in the low quartile, individuals in the top quartile of neuroticism had higher risk of all-cause dementia (HR = 1.70; 95% CI: 1.49-1.93), AD (HR = 1.42; 1.15-1.75), VD (HR = 1.73; 1.30-2.29), but not FTD (HR = 0.89; 0.49-1.63). The associations with AD and VD were attenuated but remained significant after further accounting for education, household income, deprivation index, diabetes, hypertension, stroke, heart attack, ever smoker, physical activity, obesity, hemoglobin A1c, C-reactive protein, and low-density lipoprotein. The associations were not moderated by socioeconomic status. The findings were consistent in analyses that excluded cases that occurred within the first 5 years of follow-up. In conclusion, neuroticism is a robust predictor of incident AD and VD, but not FTD. This pattern suggests that the affective symptoms that distinguish dementia types may partly reflect premorbid differences in trait neuroticism.
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Affiliation(s)
| | | | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Consiglio Nazionale delle Ricerche (CNR), Milano, Italy
| | - Nicola Toschi
- Department of Biomedicine & Prevention, University "Tor Vergata", Rome, Italy; A.A. Martinos Center for Biomedical Imaging - Harvard Medical School/MGH, USA
| | | | - Martina Luchetti
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Ji Hyun Lee
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Amanda Sesker
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Páraic S O'Súilleabháin
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - Angelina R Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
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Stephan Y, Sutin AR, Canada B, Terracciano A. The Association between Subjective Age and Motoric Cognitive Risk Syndrome: Results from a Population-Based Cohort Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:2023-2028. [PMID: 33718965 DOI: 10.1093/geronb/gbab047] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The motoric cognitive risk (MCR) syndrome, characterized by cognitive complaints and slower gait speed, is a pre-dementia syndrome associated with dementia and mortality risk. The present study examined whether subjective age, that is how old or young individuals feel relative to their chronological age, is related to concurrent and incident MCR syndrome. A relation between subjective age and MCR will inform knowledge on psychological factors related to dementia risk, identify who is at greater risk, and suggest a potential target of intervention. METHOD The study sample was composed of 6,341 individuals aged 65 to 107 years without dementia from the Health and Retirement Study (HRS), a longitudinal study of adults aged 50 years and older. Participants completed measures of subjective age, cognitive complaints, and gait speed and provided information on demographic factors, cognition, physical activity, depressive symptoms, and body mass index (BMI) at baseline in 2008/2010. Incident MCR was assessed four and eight years later. RESULTS Controlling for demographic factors, an older subjective age was related to more than 60% higher likelihood of MCR at baseline and to around 50% higher risk of incident MCR over time. These associations remained significant when cognition, physical inactivity, depressive symptoms, and BMI were included in the analytic models. CONCLUSION This study provides evidence that how old individuals feel is related to concurrent and incident MCR beyond the effect of chronological age, other demographic factors, physical inactivity, depressive symptoms, BMI, and cognitive functioning.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, USA
| | | | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, USA
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Sutin AR, Luchetti M, Stephan Y, Terracciano A. Purpose in Life and Motoric Cognitive Risk Syndrome: Replicable Evidence from Two National Samples. J Am Geriatr Soc 2020; 69:381-388. [PMID: 32997804 DOI: 10.1111/jgs.16852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/30/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Motoric cognitive risk (MCR) syndrome is characterized by cognitive complaints and slow gait speed in the absence of dementia. Consistent evidence indicates that it predicts dementia and premature mortality. Less is known about its antecedents, particularly the role of psychological function. Purpose in life is an aspect of well-being that reflects a goal-oriented and -driven life that has been implicated in cognitive aging. We aimed to examine the cross-sectional association between purpose in life and MCR and to test the hypothesis that purpose is associated with a lower risk of new cases of MCR over an up to 12-year follow-up. DESIGN Cross-sectional and longitudinal multi-cohort design. SETTING Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS). PARTICIPANTS A total of 6,785 individuals from the HRS and 5,665 from the NHATS. MEASUREMENTS Participants reported on their purpose in life and cognitive complaints and completed a walking speed assessment. Cognitive complaints and walking speed were assessed again up to 12 years later in HRS and up to 7 years later in NHATS. RESULTS Higher purpose in life was associated with a 33% lower risk of MCR concurrently (meta-analytic odds ratio = .75; 95% confidence interval [CI] = .62-.90; P = .002) and an about 26% lower risk of incident MCR longitudinally (meta-analytic hazard ratio = .77; 95% CI = .70-.84; P < .001). These associations were significant in each sample, were independent of sociodemographic covariates, and persisted after controlling for personality and health-related factors (depressive symptoms, physical activity, disease burden). CONCLUSION Purpose in life is associated with a lower risk of incident MCR, an association that was replicated in two independent samples. Purpose is a malleable aspect of psychological function that is a promising target of intervention for healthier cognitive aging.
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Affiliation(s)
- Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA
| | | | - Antonio Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, Florida, USA
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Ayers E, Gulley E, Verghese J. The Effect of Personality Traits on Risk of Incident Pre-dementia Syndromes. J Am Geriatr Soc 2020; 68:1554-1559. [PMID: 32488931 DOI: 10.1111/jgs.16424] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Personality traits have been shown to be associated with the risk of dementia; less is known about their association with pre-dementia syndromes. The aim of the present study was to examine the role of personality traits as predictors of incident pre-dementia, motoric cognitive risk (MCR), and mild cognitive impairment (MCI) syndromes. DESIGN We prospectively examined the association between five personality traits (neuroticism, extraversion, conscientiousness, agreeableness, and openness) and the risk of incident MCR or MCI. MCR builds on MCI operational definitions, substituting the cognitive impairment criterion with slow gait, and it is associated with increased risk for both Alzheimer's disease and vascular dementia. SETTING Community based. PARTICIPANTS Nondemented participants (n = 524; 62% women) aged 65 years and older. MEASUREMENTS Cox proportional hazard analysis, adjusted for demographics and disease burden, was used to evaluate the risk of each pre-dementia syndrome based on baseline personality traits, measured using the Big Five Inventory. RESULTS Over a median follow-up of 3 years, 38 participants developed incident MCR, and 69 developed incident MCI (41 non-amnestic and 28 amnestic subtypes). Openness was associated with a reduced risk of developing incident MCR (adjusted hazard ratio [aHR] = .94; 95% confidence interval [CI] = .89-.99), whereas neuroticism was associated with an increased risk of incident non-amnestic MCI (aHR = 1.06; 95% CI = 1.01-1.11). These associations remained significant even after considering the confounding effects of lifestyle or mood. None of the personality traits were associated with MCI overall or amnestic MCI. CONCLUSION These findings provide evidence of a distinct relationship between personality traits and development of specific pre-dementia syndromes. J Am Geriatr Soc 68:1554-1559, 2020.
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Affiliation(s)
- Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Emma Gulley
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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