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Van Asbroeck S, Köhler S, van Boxtel MPJ, Lipnicki DM, Crawford JD, Castro-Costa E, Lima-Costa MF, Blay SL, Shifu X, Wang T, Yue L, Lipton RB, Katz MJ, Derby CA, Guerchet M, Preux PM, Mbelesso P, Norton J, Ritchie K, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Dardiotis T, Rolandi E, Davin A, Rossi M, Gureje O, Ojagbemi A, Bello T, Kim KW, Han JW, Oh DJ, Trompet S, Gussekloo J, Riedel-Heller SG, Röhr S, Pabst A, Shahar S, Rivan NFM, Singh DKA, Jacobsen E, Ganguli M, Hughes T, Haan M, Aiello AE, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Gao Q, Brodaty H, Trollor J, Kochan N, Lobo A, Santabárbara J, Gracia-Garcia P, Sachdev PS, Deckers K. Lifestyle and incident dementia: A COSMIC individual participant data meta‐analysis. Alzheimers Dement 2024. [PMID: 38676366 DOI: 10.1002/alz.13846] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis. RESULTS A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed. DISCUSSION Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups. HIGHLIGHTS A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.
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Affiliation(s)
- Stephanie Van Asbroeck
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Martin P J van Boxtel
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Erico Castro-Costa
- René Rachou Institute, Fiocruz Minas, Belo Horizonte, Minas Gerais, Brazil
| | | | - Sergio Luis Blay
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Carol A Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pascal Mbelesso
- Department of Neurology, Amitié Hospital, Bangui, Central African Republic
| | - Joanna Norton
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
| | - Karen Ritchie
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
- Institut du Cerveau Trocadéro, Paris, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of Gothenburg, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of Gothenburg, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
- Department of Clinical Genetics, Section Genomics of Neurodegenerative Diseases and Aging, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of Gothenburg, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Elena Rolandi
- Golgi Cenci Foundation, Milan, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | | | - Oye Gureje
- Department of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry, College of Medicine University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- Department of Psychiatry, College of Medicine University of Ibadan, Ibadan, Nigeria
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Stella Trompet
- Department of Internal Medicine, section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Jacobijn Gussekloo
- Department of Internal Medicine, section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
- Health and Ageing Research Team (HART), School of Psychology, Massey University, Palmerston North, Aotearoa New Zealand
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Center for Healthy Ageing & Wellness (H-CARE), Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Fatin Malek Rivan
- Center for Healthy Ageing & Wellness (H-CARE), Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Ageing & Wellness (H-CARE), Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Departments of Neurology, and Epidemiology, University of Pittsburgh School of Medicine and School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Tiffany Hughes
- Department of Graduate Studies in Health and Rehabilitation Sciences, Bitonte College of Health and Human Services, Youngstown State University, Youngstown, Ohio, USA
| | - Mary Haan
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Allison E Aiello
- Columbia Aging Center and the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ding Ding
- Institute of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Higashi-ku, Fukuoka, Japan
| | - Tao Chen
- Department of Physical Education, Sports and Health Research Center, Tongji University, Shanghai, China
| | - Sanmei Chen
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tze Pin Ng
- Department of Psychological Medicine, Gerontology Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Gerontology Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Gerontology Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Developmental Disability Neuropsychiatry, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Santabárbara
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Department of Public Health, Universidad de Zaragoza, Zaragoza, Spain
| | - Patricia Gracia-Garcia
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, Maastricht, The Netherlands
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Sprague B, Zhu X, Rosso A, Verghese J, Delbaere K, Lipnicki D, Sachdev P, Ng T, Gwee X, Yap K, Kim KW, Han J, Oh D, Narazaki K, Chen T, Chen S, Brodaty H, Numbers K, Kochan N, Walker R, Paddick SM, Gureje O, Ojagbemi A, Bello T, Rosano C. Correlates of Gait Speed Among Older Adults From 6 Countries: Findings From the COSMIC Collaboration. J Gerontol A Biol Sci Med Sci 2023; 78:2396-2406. [PMID: 36975099 PMCID: PMC10692426 DOI: 10.1093/gerona/glad090] [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] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Few studies have compared gait speed and its correlates among different ethnogeographic regions. The goals of this study were to describe usual and rapid gait speed, and identify their correlates across Australian, Asian, and African countries. METHODS We used data from 6 population-based cohorts of adults aged 65+ from 6 countries and 3 continents (N = 6 472), with samples ranging from 231 to 1 913. All cohorts are members of the Cohort Studies of Memory in an International Consortium collaboration. We investigated whether clinical (body mass index [BMI], hypertension, stroke, apolipoprotein status), psychological (cognition, mood, general health), and behavioral factors (smoking, drinking, physical activity) correlated with usual (N = 4 cohorts) and rapid gait speed (N = 3 cohorts) similarly across cohorts. Regression models were controlled for age, sex, and education, and were sex-stratified. RESULTS Age- and sex-standardized usual gait speed means ranged from 0.61 to 1.06 m/s and rapid gait speed means ranged from 1.16 to 1.64 m/s. Lower BMI and better cognitive function consistently correlated with faster gait speed in all cohorts. Less consistently, not having hypertension and greater physical activity engagement were associated with faster gait speed. Associations with mood, smoking, and drinking were largely nonsignificant. These patterns were not attenuated by demographics. There was limited evidence that the associations differed by sex, except physical activity, where the greater intensity was associated with usual gait among men but not women. CONCLUSIONS This study is among the first to describe the usual and rapid gait speeds across older adults in Africa, Asia, and Australia.
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Affiliation(s)
- Briana N Sprague
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Tze Pin Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong Hospital, Singapore, Singapore
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai, China
| | - Sanmei Chen
- Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Richard W Walker
- Department of Medicine, North Tyneside General Hospital, North Shields, UK
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute; Newcastle University, Newcastle upon Tyne, UK
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
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Chen T, Chen S, Honda T, Nofuji Y, Kishimoto H, Narazaki K. Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan. J Phys Act Health 2023; 20:886-893. [PMID: 37268301 DOI: 10.1123/jpah.2022-0411] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 03/27/2023] [Accepted: 04/17/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up. METHODS In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA. RESULTS On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years. CONCLUSIONS Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.
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Affiliation(s)
- Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai,China
| | - Sanmei Chen
- Global Health Nursing, Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima,Japan
| | - Takanori Honda
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka,Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo,Japan
| | - Hiro Kishimoto
- Faculty of Arts and Science, Kyushu University, Fukuoka,Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka,Japan
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Gong J, Harris K, Lipnicki DM, Castro‐Costa E, Lima‐Costa MF, Diniz BS, Xiao S, Lipton RB, Katz MJ, Wang C, Preux P, Guerchet M, Gbessemehlan A, Ritchie K, Ancelin M, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Kosmidis MH, Guaita A, Rolandi E, Davin A, Gureje O, Trompet S, Gussekloo J, Riedel‐Heller S, Pabst A, Röhr S, Shahar S, Singh DKA, Rivan NFM, van Boxtel M, Köhler S, Ganguli M, Chang C, Jacobsen E, Haan M, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Numbers K, Mather KA, Scazufca M, Lobo A, De‐la‐Cámara C, Lobo E, Sachdev PS, Brodaty H, Hackett ML, Peters SAE, Woodward M. Sex differences in dementia risk and risk factors: Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium. Alzheimers Dement 2023; 19:3365-3378. [PMID: 36790027 PMCID: PMC10955774 DOI: 10.1002/alz.12962] [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] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Sex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups. METHODS A total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and women-to-men ratio of hazard ratios (RHRs) for associations between RFs and all-cause dementia were derived from mixed-effect Cox models. RESULTS Incident dementia occurred in 2089 (66% women) participants over 4.6 years (median). Women had higher dementia risk (HR, 1.12 [1.02, 1.23]) than men, particularly in low- and lower-middle-income economies. Associations between longer education and former alcohol use with dementia risk (RHR, 1.01 [1.00, 1.03] per year, and 0.55 [0.38, 0.79], respectively) were stronger for men than women; otherwise, there were no discernible sex differences in other RFs. DISCUSSION Dementia risk was higher in women than men, with possible variations by country-level income settings, but most RFs appear to work similarly in women and men.
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Affiliation(s)
- Jessica Gong
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- The George Institute for Global HealthImperial College LondonLondonUK
| | - Katie Harris
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Erico Castro‐Costa
- Center for Studies in Public Health and Aging Rene Rachou InstituteOswaldo Cruz FoundationBelo HorizonteBrazil
| | - Maria Fernanda Lima‐Costa
- Center for Studies in Public Health and Aging Rene Rachou InstituteOswaldo Cruz FoundationBelo HorizonteBrazil
| | - Breno S. Diniz
- UConn Center on AgingDepartment of PsychiatrySchool of MedicineUniversity of Connecticut Health CenterFarmingtonConnecticutUSA
| | - Shifu Xiao
- Department of Geriatric PsychiatryShanghai Mental Health CentreShanghai Jiaotong University School of MedicineShanghaiChina
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Mindy J. Katz
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Cuiling Wang
- Department of Epidemiology and Community HeathAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Pierre‐Marie Preux
- Inserm U1094, IRD U270, Univ. LimogesCHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zoneInstitute of Epidemiology and Tropical NeurologyOmegaHealthLimogesFrance
| | - Maëlenn Guerchet
- Inserm U1094, IRD U270, Univ. LimogesCHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zoneInstitute of Epidemiology and Tropical NeurologyOmegaHealthLimogesFrance
| | - Antoine Gbessemehlan
- Inserm U1094, IRD U270, Univ. LimogesCHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zoneInstitute of Epidemiology and Tropical NeurologyOmegaHealthLimogesFrance
| | - Karen Ritchie
- INM Institute for Neurosciences of MontpellierUniv MontpellierINSERMMontpellierFrance
| | - Marie‐Laure Ancelin
- INM Institute for Neurosciences of MontpellierUniv MontpellierINSERMMontpellierFrance
| | - Ingmar Skoog
- Department of Psychiatry and NeurochemistryCenter for Ageing and Health (Age Cap)University of GothenburgGothenburgSweden
| | - Jenna Najar
- Department of Psychiatry and NeurochemistryCenter for Ageing and Health (Age Cap)University of GothenburgGothenburgSweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and NeurochemistryCenter for Ageing and Health (Age Cap)University of GothenburgGothenburgSweden
| | - Nikolaos Scarmeas
- 1st Department of NeurologyAiginition HospitalNational and Kapodistrian University of Athens Medical SchoolAthensGreece
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA
| | - Mary Yannakoulia
- Department of Nutrition and DieteticsHarokopio UniversityAthensGreece
| | - Mary H. Kosmidis
- Lab of Cognitive NeuroscienceSchool of PsychologyAristotle University of ThessalonikiThessalonikiGreece
| | | | - Elena Rolandi
- Golgi Cenci FoundationAbbiategrassoItaly
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | | | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental HealthNeurosciences and Substance AbuseDepartment of PsychiatryUniversity of IbadanIbadanNigeria
| | - Stella Trompet
- Section of Gerontology and GeriatricsDepartment of Internal MedicineLeiden University Medical CenterLeidenthe Netherlands
| | - Jacobijn Gussekloo
- Section of Gerontology and GeriatricsDepartment of Internal MedicineLeiden University Medical CenterLeidenthe Netherlands
- Department of Public Health and Primary CareLeidenthe Netherlands
| | - Steffi Riedel‐Heller
- Institute of Social MedicineOccupational Health and Public Health (ISAP)University of LeipzigLeipzigGermany
| | - Alexander Pabst
- Institute of Social MedicineOccupational Health and Public Health (ISAP)University of LeipzigLeipzigGermany
| | - Susanne Röhr
- Institute of Social MedicineOccupational Health and Public Health (ISAP)University of LeipzigLeipzigGermany
| | - Suzana Shahar
- Centre for Healthy Ageing and WellnessUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia
| | | | | | - Martin van Boxtel
- Alzheimer Centrum LimburgSchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgSchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Mary Ganguli
- Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Chung‐Chou Chang
- Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Erin Jacobsen
- Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Mary Haan
- Department of Epidemiology and BiostatisticsSchool of MedicineUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Ding Ding
- Institute of NeurologyNational Center for Neurological DisordersNational Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Qianhua Zhao
- Institute of NeurologyNational Center for Neurological DisordersNational Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Zhenxu Xiao
- Institute of NeurologyNational Center for Neurological DisordersNational Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Kenji Narazaki
- Center for Liberal ArtsFukuoka Institute of TechnologyFukuokaJapan
| | - Tao Chen
- Sports and Health Research CenterDepartment of Physical EducationTongji UniversityShanghaiChina
| | - Sanmei Chen
- Global Health NursingDepartment of Health SciencesGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tze Pin Ng
- Gerontology Research ProgrammeDepartment of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeQueenstownSingapore
| | - Xinyi Gwee
- Gerontology Research ProgrammeDepartment of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeQueenstownSingapore
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Karen A. Mather
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Marcia Scazufca
- Instituto de Psiquiátria e LIM‐23Hospital da ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Antonio Lobo
- Department of Medicine and Psychiatry Universidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- n°33 CIBERSAMMadridSpain
| | - Concepción De‐la‐Cámara
- Department of Medicine and Psychiatry Universidad de ZaragozaZaragozaSpain
- n°33 CIBERSAMMadridSpain
| | - Elena Lobo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- n°33 CIBERSAMMadridSpain
- Department of Public Health Universidad de ZaragozaZaragozaSpain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Maree L. Hackett
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- Faculty of Health and WellbeingUniversity of Central LancashireLancashireUK
| | - Sanne A. E. Peters
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- The George Institute for Global HealthImperial College LondonLondonUK
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Mark Woodward
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- The George Institute for Global HealthImperial College LondonLondonUK
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Chen T, Chen S, Honda T, Kishimoto H, Nofuji Y, Narazaki K. Accelerometer-measured sedentary behavior and risk of functional disability in older Japanese adults: a 9-year prospective cohort study. Int J Behav Nutr Phys Act 2023; 20:91. [PMID: 37496006 PMCID: PMC10369703 DOI: 10.1186/s12966-023-01490-6] [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] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/06/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The associations of sedentary time and patterns with functional disability among older adults remain unclear, and few studies have accounted for the co-dependency of sedentary behavior and physical activities when modeling sedentary behavior with risk of functional disability. We aimed to examine the associations between sedentary time and patterns and risk of incident functional disability, and assess whether replacing sedentary time with light physical activity (LPA) or moderate-to-vigorous intensity physical activity (MVPA) is associated with reduced risk of functional disability in community-dwelling older adults. METHODS A total of 1,687 Japanese adults aged ≥ 65 years without functional disability at baseline were prospectively followed-up for 9 years (2011-2020). Functional disability was ascertained using the national database of Japan's Long-term Care Insurance System. Sedentary time and patterns, LPA, and MVPA were measured using a tri-axial accelerometer secured to participants' waists. RESULTS During follow-up, 466 participants developed functional disability. Compared with the lowest quartile of total sedentary time, the multivariable-adjusted hazard ratios (95% confidence intervals) of functional disability for the second, third, and top quartiles were 1.21 (0.91‒1.62), 1.45 (1.10‒1.92), and 1.40 (1.05‒1.88) (p for trend = 0.01). After further adjusting for MVPA, total sedentary time was no longer significantly associated with the risk of functional disability (p for trend = 0.41). Replacing 10 min/day of sedentary time with the same amount of MVPA (but not LPA) was significantly associated with a 12% reduced risk of functional disability (hazard ratio [95% confidence interval]: 0.88 [0.84‒0.92]). No significant association was observed between sedentary bout length and functional disability. CONCLUSION Higher levels of total sedentary time were associated with an increased risk of incident functional disability. However, this association was not independent of MVPA. Replacing sedentary time with MVPA, but not LPA, was associated with reduced risk of functional disability in older adults.
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Affiliation(s)
- Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, 1239 Siping Road, Shanghai, 200-092, China
| | - Sanmei Chen
- Global Health Nursing, Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima, 734-8553, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Hiro Kishimoto
- Faculty of Arts and Science, Kyushu University, 744 Motooka Nishi-Ku, Fukuoka, 819-0395, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae, Itabashi, Tokyo, 173-0015, Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, 3-30-1 Wajiro-Higashi, Higashi-Ku, Fukuoka, 811-0295, Japan.
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Mizutani S, Matsuzaki H, Iyota K, Tani A, Oku S, Tabuchi H, Fujiwara A, Hase-Tamaru S, Kishimoto H, Narazaki K. Changes of Oral and Physical Functions in Older Japanese Who Participated in Keyboard Harmonica and Exercise Classes during COVID-19-Related Movement Restrictions. Int J Environ Res Public Health 2023; 20:3700. [PMID: 36834392 PMCID: PMC9961220 DOI: 10.3390/ijerph20043700] [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: 01/18/2023] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Many older people have restricted activities or movements because of the coronavirus disease 2019 (COVID-19) pandemic, which causes concerns about secondary health problems. This study aimed to investigate how frailty-prevention activities implemented by local governments have changed the health of community-dwelling older people during the COVID-19 pandemic. In this observational study, the participants were 23 older Japanese people who took part in keyboard harmonica or exercise classes in 2021. Oral function examination and physical function tests were conducted at baseline and after 10 months of follow-up. In each class, the participants met 15 times and worked on assignments at home. The results showed that oral diadochokinesis/pa/, which represents lip dexterity, improved during 10 months (from 6.6 to 6.8 times/s, p < 0.046); however, grip strength (p < 0.005) and total skeletal muscle mass (p < 0.017) decreased in the keyboard harmonica group. In the exercise group, a statistically significant difference was found only in grip strength, which decreased (p < 0.003). The oral and physical functions of older people who participated in frailty-prevention activities implemented by local governments characteristically changed. Moreover, activity restrictions during the COVID-19 pandemic may have caused decreased grip strength.
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Affiliation(s)
- Shinsuke Mizutani
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- OBT Research Center, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hideaki Matsuzaki
- Department of Rehabilitation Center, Fukuoka Mirai Hospital, 5-1 Kashiiteriha, Higashi-ku, Fukuoka 813-0017, Japan
- Department of Behavior and Health Sciences, Graduate School of Human–Environment Studies, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Kiyomi Iyota
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Asuka Tani
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Saori Oku
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hiroaki Tabuchi
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Akiko Fujiwara
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Shizuka Hase-Tamaru
- Department of Life, Environment and Materials Science, Faculty of Engineering, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka 811-0295, Japan
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human–Environment Studies, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
- Faculty of Arts and Science, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka 811-0295, Japan
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Matsuzaki H, Kishimoto H, Nofuji Y, Chen T, Narazaki K. Author's reply to comments on "Predictive ability of the total score of the Kihon checklist for the incidence of functional disability in older Japanese adults: An 8-year prospective study". Geriatr Gerontol Int 2022; 22:985-986. [PMID: 36239252 DOI: 10.1111/ggi.14493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Hideaki Matsuzaki
- Department of Rehabilitation Center, Fukuoka Mirai Hospital, Fukuoka, Japan.,Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan.,Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai, China
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka, Japan
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Matsuzaki H, Kishimoto H, Nofuji Y, Chen T, Narazaki K. Predictive ability of the total score of the Kihon checklist for the incidence of functional disability in older Japanese adults: An 8-year prospective study. Geriatr Gerontol Int 2022; 22:723-729. [PMID: 35919927 DOI: 10.1111/ggi.14435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/26/2021] [Revised: 04/08/2022] [Accepted: 06/17/2022] [Indexed: 01/07/2023]
Abstract
AIM To investigate the association between the total score of the Kihon checklist (t-KCL score) and functional disability over an 8-year follow-up period, and to examine whether the t-KCL score in the basic model with risk factors contributes to the incremental predictive ability for functional disability among older adults. METHODS We followed 2209 older adults aged ≥65 years without functional disability at baseline. The t-KCL score was determined using a baseline survey questionnaire. Functional disability was defined based on information from long-term care certifications. The association between the t-KCL score and functional disability was examined using the Cox proportional hazards model. The incremental predictive ability of the t-KCL score for functional disability was evaluated by the difference of the C-statistic, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI). RESULTS The median follow-up period was 7.8 years, and 557 participants developed functional disability. The adjusted hazard ratio (95% confidence interval [CI]) of functional disability for a 1-point increase of the t-KCL score was 1.08 (1.06-1.10). Adding the t-KCL score to the basic model significantly improved the C-statistic (95% CI) from 0.747 (0.728-0.768) to 0.760 (0.741-0.781). When the t-KCL score was added to the basic model, the NRI and IDI were 0.187 (95% CI: 0.095-0.287) and 0.020 (95% CI: 0.012-0.027), respectively. CONCLUSIONS The t-KCL score had an independent positive association with functional disability over an 8-year follow-up. Furthermore, adding the t-KCL score to the basic model improved the predictive ability for functional disability. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Hideaki Matsuzaki
- Department of Rehabilitation Center, Fukuoka Mirai Hospital, Fukuoka, Japan.,Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan.,Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai, China
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka, Japan
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Yamamoto T, Tanoue Y, Uehara Y, Higaki Y, Tanaka H, Narazaki K. Intermittent Exercise at Lactate Threshold Induces Lower Acute Stress than Its Continuous Counterpart in Middle-to-Older Aged Men. Int J Environ Res Public Health 2022; 19:ijerph19127503. [PMID: 35742753 PMCID: PMC9223607 DOI: 10.3390/ijerph19127503] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 12/10/2022]
Abstract
This study aimed to compare the degree of exhaustion and trophic effects between continuous exercise (CE) and intermittent exercise (IE) at lactate threshold (LT) intensity. Seven healthy men (age: 43-69 years) performed the following three experimental tests in a randomized crossover order: (1) control; (2) CE, performed as a 20-min of cycling at LT intensity; and (3) IE, performed as 20 sets of a one-min bout of cycling at LT intensity with a 30-s rest between every two sets. Heart rate (HR), blood lactate concentration (LA), rating of perceived exertion (RPE), catecholamines, cortisol, growth hormone, insulin-like growth factor (IGF)-1, and brain-derived neurotrophic factor (BDNF) were measured. The sampling timing in each test was as follows: 10 min before the onset of exercise, at the 25%, 50%, and 100% time points of exercise, and at 10 min after exercise. IE was found to be accompanied by a lower degree of exhaustion than CE in measures of HR, LA, RPE, catecholamines, and cortisol. In terms of trophic effects, both of IGF-1 and BDNF increased in CE, while a marginal increase of BDNF was observed in IE. The results indicated that IE induces lower stress than CE, but may not be effective for inducing trophic effects.
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Affiliation(s)
- Taiki Yamamoto
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka 814-0180, Japan; (T.Y.); (Y.U.); (Y.H.)
- The Fukuoka University Institute for Physical Activity, Fukuoka University, Fukuoka 814-0180, Japan
| | - Yukiya Tanoue
- Ritsumeikan-Global Innovation Research Organization, Ritsumeikan University, Shiga 525-0058, Japan;
- Research Organization of Science and Technology Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Shiga 525-0058, Japan
| | - Yoshinari Uehara
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka 814-0180, Japan; (T.Y.); (Y.U.); (Y.H.)
- The Fukuoka University Institute for Physical Activity, Fukuoka University, Fukuoka 814-0180, Japan
| | - Yasuki Higaki
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka 814-0180, Japan; (T.Y.); (Y.U.); (Y.H.)
- The Fukuoka University Institute for Physical Activity, Fukuoka University, Fukuoka 814-0180, Japan
| | - Hiroaki Tanaka
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka 814-0180, Japan; (T.Y.); (Y.U.); (Y.H.)
- The Fukuoka University Institute for Physical Activity, Fukuoka University, Fukuoka 814-0180, Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka 811-0295, Japan
- Correspondence:
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Chen T, Honda T, Chen S, Kishimoto H, Kumagai S, Narazaki K. Potential utility of physical function measures to improve the risk prediction of functional disability in community-dwelling older Japanese adults: a prospective study. BMC Geriatr 2021; 21:476. [PMID: 34470612 PMCID: PMC8411504 DOI: 10.1186/s12877-021-02415-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 08/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background While gait speed, one-leg standing balance, and handgrip strength have been shown to be independent predictors for functional disability, it is unclear whether such simple measures of physical function contribute to improved risk prediction of functional disability in older adults. Methods A total of 1,591 adults aged ≥ 65 years and without functional disability at baseline were followed up for up to 7.9 years. Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Maximum gait speed, one-leg standing time, and handgrip strength were measured at baseline. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of physical function and functional disability incidence. The incremental predictive value of each physical function measure for risk prediction was quantified using the difference in overall C-statistic, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI) index. Results During follow-up (median: 7.8 years), functional disability was identified in 384 participants. All of the physical function measures were inversely associated with the risk of functional disability, independent of potential confounding factors. The multivariable adjusted HRs (95 % CIs) for functional disability per one standard deviation increment of maximum gait speed, one-leg-standing time, and hand grip strength were 0.73 (0.65–0.83), 0.68 (0.59–0.79), and 0.72 (0.59–0.86), respectively. Incorporation of each of maximum gait speed, one-leg-stand time, and hand grip strength into a basic model with other risk factors significantly improved C-statistic from 0.770 (95 % CIs, 0.751–0.794) to 0.778 (0.759–0.803), 0.782 (0.760–0.805), and 0.775 (0.756–0.800), respectively (all p < 0.05). A model including all three measures had the highest C-statistic of 0.787 (0.765–0.810). The improvements in risk prediction were also confirmed by category-free NRI and IDI index. Conclusions Adding any of the three measures to a basic model with other known risk factors significantly improved the prediction of functional disability and addition of all three measures provided further improvement of the prediction in older Japanese adults. These data provide robust evidence to support the practical utility of incorporating these simple physical function measures into functional disability risk prediction tools. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02415-3.
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Affiliation(s)
- Tao Chen
- Sport and Health Research Center, Department of Physical Education, Tongji University, 1239 Siping Road, 200092, Shanghai, China
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Sanmei Chen
- Department of Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami Ward, 734-8553, Hiroshima, Japan
| | - Hiro Kishimoto
- Faculty of Arts and Science, Kyushu University, 744 Motooka Nishi-ku, 819-0395, Fukuoka, Japan
| | - Shuzo Kumagai
- Institute of Convergence Bio-Health, Dong-A University, 37 Nakdong-daero 550 beon-gil, Hadan-dong, Saha-gu, 49-315, Busan, South Korea.,Kumagai Institute of Health Policy, 4-47-1 Hiratadai, 816-0812, Kasuga-shi, Fukuoka, Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, 3-30-1 Wajiro- higashi, Higashi-ku, 811-0295, Fukuoka, Japan.
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Yatsugi H, Chen T, Chen S, Narazaki K, Nagayoshi S, Kumagai S, Kishimoto H. Normative Data of Objectively Measured Physical Activity and Sedentary Time in Community-Dwelling Older Japanese. Int J Environ Res Public Health 2021; 18:ijerph18073577. [PMID: 33808283 PMCID: PMC8037252 DOI: 10.3390/ijerph18073577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The amounts of moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), and sedentary time (ST) by sex, age, and body mass index (BMI) in older Japanese adults have not been known. We conducted this study to determine the actual physical activity (PA) and ST in this population. SUBJECTS AND METHODS A total of 3998 community-dwelling Japanese adults aged ≥65 years were investigated. Their levels of PA and ST and number of steps taken daily were assessed for seven consecutive days by a tri-axial accelerometer. Normative values of daily PA and ST were analyzed by age and BMI groups in the men and the women and are presented as mean, median, or decile. RESULTS The subjects generally adhered to the PA guideline, i.e., ≥10 metabolic equivalents (METs)·hour MVPA per week. Older age was associated with lower adherence to the PA guideline. CONCLUSIONS Normative values (mean, median, or decile) were yielded for MVPA, LPA, and ST based on accelerometer readings in a large sample of older community-dwelling Japanese adults. One-half of the subjects' waking time was spent being sedentary, and >70% of the subjects met the current PA guideline by engaging in MVPA.
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Affiliation(s)
- Harukaze Yatsugi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan; (H.Y.); (S.N.)
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai 200092, China;
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan 250012, China;
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka City, Fukuoka 811-0295, Japan;
| | - Sho Nagayoshi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan; (H.Y.); (S.N.)
- Development Center, Clinical Development Department, Technology Development HQ, Omron Healthcare Co., Ltd., 53 Kunotsubo, Terado-cho, Muko, Kyoto 617-0002, Japan
| | - Shuzo Kumagai
- Institute of Covergence Bio-Health, Dong-A University, B08-0302, 37 Nakdong-daero 550 Beon-gil, Saha-gu, Busan 49315, Korea;
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan; (H.Y.); (S.N.)
- Faculty of Arts and Science, IC15, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan
- Correspondence: ; Tel./Fax: +81-92-802-6071
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Chen T, Honda T, Chen S, Narazaki K, Kumagai S. Dose-Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study. J Gerontol A Biol Sci Med Sci 2021; 75:1763-1770. [PMID: 32134454 PMCID: PMC7494030 DOI: 10.1093/gerona/glaa046] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 09/20/2019] [Indexed: 01/28/2023] Open
Abstract
Background It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of <10 minutes protects against disability risks or if only 10 minutes bouts of MVPA is critical. Additionally, it is unclear whether light physical activity (LPA) or its accumulation patterns is associated with functional disability. Methods A total of 1,687 adults aged ≥65 years and without functional disability at baseline were followed up for 6 years. Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Physical activity was measured using a tri-axial accelerometer secured to the waist. Results Functional disability was identified in 274 participants (16.2%). When examined as quartiles, higher levels of all MVPA measures were dose-dependently associated with lower risk of functional disability. Associations of MVPA in ≥10 and <10 minutes bouts remained significant in a mutually adjusted model. Neither total LPA nor LPA in bout of ≥10 minutes, but LPA in bouts of <10 minutes was associated with functional disability. Analyses using restricted cubic spline functions showed that associations of all MVPA measures and LPA in bouts of <10 minutes with functional disability were linear (p for nonlinear >.05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of <10 minutes were 0.86 (0.81–0.92) and 0.96 (0.93–0.99), respectively. Conclusions Higher MVPA, regardless accumulation patterns, or LPA in bouts of <10 minutes was associated with lower risk of functional disability in a linear dose–response manner in older adults.
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Affiliation(s)
- Tao Chen
- Center for Health Science and Counseling, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Environments Research Laboratory, Comprehensive Research Organization, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Kenji Narazaki
- Department of Socio-Environmental Studies, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, Fukuoka, Japan
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13
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Chen T, Honda T, Chen S, Narazaki K, Kumagai S. Corrigendum to: Dose-Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study. J Gerontol A Biol Sci Med Sci 2021; 76:176. [PMID: 33205211 PMCID: PMC7756685 DOI: 10.1093/gerona/glaa231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Tao Chen
- Center for Health Science and Counseling, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Environments Research Laboratory, Comprehensive Research Organization, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Kenji Narazaki
- Department of Socio-Environmental Studies, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, Fukuoka, Japan
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14
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Röhr S, Pabst A, Riedel-Heller SG, Jessen F, Turana Y, Handajani YS, Brayne C, Matthews FE, Stephan BCM, Lipton RB, Katz MJ, Wang C, Guerchet M, Preux PM, Mbelesso P, Ritchie K, Ancelin ML, Carrière I, Guaita A, Davin A, Vaccaro R, Kim KW, Han JW, Suh SW, Shahar S, Din NC, Vanoh D, van Boxtel M, Köhler S, Ganguli M, Jacobsen EP, Snitz BE, Anstey KJ, Cherbuin N, Kumagai S, Chen S, Narazaki K, Ng TP, Gao Q, Gwee X, Brodaty H, Kochan NA, Trollor J, Lobo A, López-Antón R, Santabárbara J, Crawford JD, Lipnicki DM, Sachdev PS. Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study. Alzheimers Res Ther 2020; 12:167. [PMID: 33339532 PMCID: PMC7749505 DOI: 10.1186/s13195-020-00734-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 07/03/2020] [Accepted: 11/26/2020] [Indexed: 12/20/2022]
Abstract
Background Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer’s disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts. Methods We combined individual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence. Results The sample comprised 39,387 cognitively unimpaired individuals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI = 23.3–24.4%) and IRT (25.6%, 95%CI = 25.1–26.1%); however, prevalence estimates varied largely between studies (QH 6.1%, 95%CI = 5.1–7.0%, to 52.7%, 95%CI = 47.4–58.0%; IRT: 7.8%, 95%CI = 6.8–8.9%, to 52.7%, 95%CI = 47.4–58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in Asian and Black African people compared to White people, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades. Conclusions SCD is frequent in old age. Having a quarter of older individuals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help individuals with SCD who seek medical advice. Moreover, a standardized instrument to measure SCD is needed to overcome the measurement variability currently dominant in the field.
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Affiliation(s)
- Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany. .,Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Yuda Turana
- Department of Neurology, School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Yvonne S Handajani
- Center for Health Research, School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Carol Brayne
- Cambridge Public Health, Cambridge University, Cambridge, UK
| | - Fiona E Matthews
- MRC Biostatistics Unit, Institute of Public Health, Cambridge University, Cambridge, UK.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Blossom C M Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.,Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Maëlenn Guerchet
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,CHU, Department of Medical Information & Evaluation, Clinical Research and Biostatistic Unit, Limoges, France
| | - Pascal Mbelesso
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Neurology, Amitié Hospital, Bangui, Central African Republic
| | - Karen Ritchie
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Marie-Laure Ancelin
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France
| | - Isabelle Carrière
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France
| | - Antonio Guaita
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Annalisa Davin
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Suzana Shahar
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah C Din
- Centre for Rehabilitation Science and Special Needs, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Divya Vanoh
- School of Health Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Erin P Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kaarin J Anstey
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia.,Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Department of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka, 811-0295, Japan
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Department of Developmental Disability Neuropsychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Medicine and Psychiatry, Universidad de Zaragoza and Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Raúl López-Antón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabárbara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - John D Crawford
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
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15
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Makkar SR, Lipnicki DM, Crawford JD, Kochan NA, Castro-Costa E, Lima-Costa MF, Diniz BS, Brayne C, Stephan B, Matthews F, Llibre-Rodriguez JJ, Llibre-Guerra JJ, Valhuerdi-Cepero AJ, Lipton RB, Katz MJ, Zammit A, Ritchie K, Carles S, Carriere I, Scarmeas N, Yannakoulia M, Kosmidis M, Lam L, Fung A, Chan WC, Guaita A, Vaccaro R, Davin A, Kim KW, Han JW, Suh SW, Riedel-Heller SG, Roehr S, Pabst A, Ganguli M, Hughes TF, Jacobsen EP, Anstey KJ, Cherbuin N, Haan MN, Aiello AE, Dang K, Kumagai S, Narazaki K, Chen S, Ng TP, Gao Q, Nyunt MSZ, Meguro K, Yamaguchi S, Ishii H, Lobo A, Lobo Escolar E, De la Cámara C, Brodaty H, Trollor JN, Leung Y, Lo JW, Sachdev P. Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment. Arch Gerontol Geriatr 2020; 91:104112. [PMID: 32738518 PMCID: PMC7724926 DOI: 10.1016/j.archger.2020.104112] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 05/01/2020] [Accepted: 05/12/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4). METHODS Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School. RESULTS Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers. CONCLUSION High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.
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Affiliation(s)
- Steve R Makkar
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | | | | | - Breno Satler Diniz
- Department of Psychiatry, Faculty of Medicine University, Toronto, Canada; Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto, ON, Canada
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge University, UK
| | - Blossom Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Matthews
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Jorge J Llibre-Guerra
- Institute of Neurology and Neurosurgery Havana, Cuba, Memory and Aging Center, UCSF San Francisco, United States
| | | | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States; Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States
| | - Andrea Zammit
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States
| | - Karen Ritchie
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France; Université de Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Sophie Carles
- Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, F-75014 France; Paris Descartes University, Paris, France; Univ Paris-Sud, Villejuif, France
| | - Isabelle Carriere
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France; Université de Montpellier, Montpellier, France
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H Sergievsky Center, Department of Neurology, Columbia University, New York, NY, United States
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens, Greece
| | - Mary Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Linda Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Ada Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Antonio Guaita
- Golgi Cenci Foundation, Corso San Martino 10, 20081 Abbiategrasso, Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, Corso San Martino 10, 20081 Abbiategrasso, Italy
| | - Annalisa Davin
- Golgi Cenci Foundation, Corso San Martino 10, 20081 Abbiategrasso, Italy
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung Wan Suh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Tiffany F Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, OH, United States
| | - Erin P Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Mary N Haan
- University of California, School of Medicine, Department of Epidemiology and Biostatistics, CA, United States
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Carolina Population Center, Chapel Hill, NC, United States
| | - Kristina Dang
- University of California, School of Medicine, Department of Epidemiology and Biostatistics, CA, United States
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka, 816-8580, Japan
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Department of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka 811-0295, Japan
| | - Sanmei Chen
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo 162-8655, Japan
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kenichi Meguro
- Geriatric Behavioral Neurology, Tohoku University, Japan
| | | | - Hiroshi Ishii
- Geriatric Behavioral Neurology, Tohoku University, Japan
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universidad de Zaragoza, Zaragoza, Spain
| | - Elena Lobo Escolar
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universidad de Zaragoza, Zaragoza, Spain
| | - Concepción De la Cámara
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universidad de Zaragoza, Zaragoza, Spain
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia; Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Julian N Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Australia
| | - Yvonne Leung
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Jessica W Lo
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia; Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
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16
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Maasakkers CM, Claassen JAHR, Gardiner PA, Olde Rikkert MGM, Lipnicki DM, Scarmeas N, Dardiotis E, Yannakoulia M, Anstey KJ, Cherbuin N, Haan MN, Kumagai S, Narazaki K, Chen T, Ng TP, Gao Q, Nyunt MSZ, Crawford JD, Kochan NA, Makkar SR, Sachdev PS, Thijssen DHJ, Melis RJF. The Association of Sedentary Behaviour and Cognitive Function in People Without Dementia: A Coordinated Analysis Across Five Cohort Studies from COSMIC. Sports Med 2020; 50:403-413. [PMID: 31529300 PMCID: PMC6985182 DOI: 10.1007/s40279-019-01186-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Besides physical activity as a target for dementia prevention, sedentary behaviour is hypothesized to be a potential target in its own right. The rising number of persons with dementia and lack of any effective treatment highlight the urgency to better understand these modifiable risk factors. Therefore, we aimed to investigate whether higher levels of sedentary behaviour are associated with reduced global cognitive functioning and slower cognitive decline in older persons without dementia. METHODS We used five population cohorts from Greece, Australia, USA, Japan, and Singapore (HELIAD, PATH, SALSA, SGS, and SLAS2) from the Cohort Studies of Memory in an International Consortium. In a coordinated analysis, we assessed the relationship between sedentary behaviour and global cognitive function with the use of linear mixed growth model analysis (mean follow-up range of 2.0-8.1 years). RESULTS Baseline datasets combined 10,450 older adults without dementia with a mean age range between cohorts of 66.7-75.1 years. After adjusting for multiple covariates, no cross-sectional association between sedentary behaviour and cognition was found in four studies. One association was detected where more sedentary behaviour was cross-sectionally linked to higher cognition levels (SLAS2, B = 0.118 (0.075; 0.160), P < 0.001). Longitudinally, there were no associations between baseline sedentary behaviour and cognitive decline (P > 0.05). CONCLUSIONS Overall, these results do not suggest an association between total sedentary time and lower global cognition in older persons without dementia at baseline or over time. We hypothesize that specific types of sedentary behaviour may differentially influence cognition which should be investigated further. For now, it is, however, too early to establish undifferentiated sedentary time as a potential effective target for minimizing cognitive decline in older adults without dementia.
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Affiliation(s)
- Carlijn M Maasakkers
- Department of Geriatrics/Radboud Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Route 925, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - Jurgen A H R Claassen
- Department of Geriatrics/Radboud Alzheimer Center, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul A Gardiner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Mater Research Institute, The University of Queensland, South Brisbane, QLD, Australia
| | - Marcel G M Olde Rikkert
- Department of Geriatrics/Radboud Alzheimer Center, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CheBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, Medical School Athens, Athens, Greece
- Department of Neurology, Gertrude H Sergievsky Center, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Randwick, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, USA
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, Kasuga, Fukuoka, Japan
| | - Kenji Narazaki
- Department of Socio-Environmental Studies, Faculty of Socio-Environmental Studies, Fukuoka Institute of Technology, Higashi-ku, Fukuoka, Japan
| | - Tao Chen
- Center for Health Science and Counseling, Kyushu University, Kasuga, Fukuoka, Japan
| | - Tze Pin Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Ma S Z Nyunt
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - John D Crawford
- Centre for Healthy Brain Ageing (CheBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CheBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Steve R Makkar
- Centre for Healthy Brain Ageing (CheBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CheBA), School of Psychiatry, University of New South Wales, Sydney, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Dick H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - René J F Melis
- Department of Geriatrics/Radboud Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Route 925, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
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Lipnicki DM, Makkar SR, Crawford JD, Thalamuthu A, Kochan NA, Lima-Costa MF, Castro-Costa E, Ferri CP, Brayne C, Stephan B, Llibre-Rodriguez JJ, Llibre-Guerra JJ, Valhuerdi-Cepero AJ, Lipton RB, Katz MJ, Derby CA, Ritchie K, Ancelin ML, Carrière I, Scarmeas N, Yannakoulia M, Hadjigeorgiou GM, Lam L, Chan WC, Fung A, Guaita A, Vaccaro R, Davin A, Kim KW, Han JW, Suh SW, Riedel-Heller SG, Roehr S, Pabst A, van Boxtel M, Köhler S, Deckers K, Ganguli M, Jacobsen EP, Hughes TF, Anstey KJ, Cherbuin N, Haan MN, Aiello AE, Dang K, Kumagai S, Chen T, Narazaki K, Ng TP, Gao Q, Nyunt MSZ, Scazufca M, Brodaty H, Numbers K, Trollor JN, Meguro K, Yamaguchi S, Ishii H, Lobo A, Lopez-Anton R, Santabárbara J, Leung Y, Lo JW, Popovic G, Sachdev PS. Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study. PLoS Med 2019; 16:e1002853. [PMID: 31335910 PMCID: PMC6650056 DOI: 10.1371/journal.pmed.1002853] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/14/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority. This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. METHODS AND FINDINGS We harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54-105 (mean = 72.7) years and without dementia at baseline. Studies had 2-15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mass index, cardiovascular disease, depression, diabetes, self-rated health, high cholesterol, hypertension, peripheral vascular disease, physical activity, smoking, and history of stroke. Associations with risk factors were determined for a global cognitive composite outcome (memory, language, processing speed, and executive functioning tests) and Mini-Mental State Examination score. Individual participant data meta-analyses of multivariable linear mixed model results pooled across cohorts revealed that for at least 1 cognitive outcome, age (B = -0.1, SE = 0.01), APOE*4 carriage (B = -0.31, SE = 0.11), depression (B = -0.11, SE = 0.06), diabetes (B = -0.23, SE = 0.10), current smoking (B = -0.20, SE = 0.08), and history of stroke (B = -0.22, SE = 0.09) were independently associated with poorer cognitive performance (p < 0.05 for all), and higher levels of education (B = 0.12, SE = 0.02) and vigorous physical activity (B = 0.17, SE = 0.06) were associated with better performance (p < 0.01 for both). Age (B = -0.07, SE = 0.01), APOE*4 carriage (B = -0.41, SE = 0.18), and diabetes (B = -0.18, SE = 0.10) were independently associated with faster cognitive decline (p < 0.05 for all). Different effects between Asian people and white people included stronger associations for Asian people between ever smoking and poorer cognition (group by risk factor interaction: B = -0.24, SE = 0.12), and between diabetes and cognitive decline (B = -0.66, SE = 0.27; p < 0.05 for both). Limitations of our study include a loss or distortion of risk factor data with harmonization, and not investigating factors at midlife. CONCLUSIONS These results suggest that education, smoking, physical activity, diabetes, and stroke are all modifiable factors associated with cognitive decline. If these factors are determined to be causal, controlling them could minimize worldwide levels of cognitive decline. However, any global prevention strategy may need to consider ethno-regional differences.
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Affiliation(s)
- Darren M. Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Steve R. Makkar
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - John D. Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A. Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge University, Cambridge, United Kingdom
| | - Blossom Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Jorge J. Llibre-Guerra
- Institute of Neurology and Neurosurgery, Havana, Cuba
- Memory and Aging Center, University of California, San Francisco, San Francisco, California, United States of America
| | | | - Richard B. Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
| | - Carol A. Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
| | - Karen Ritchie
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France
- Université de Montpellier, Montpellier, France
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Marie-Laure Ancelin
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France
- Université de Montpellier, Montpellier, France
| | - Isabelle Carrière
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France
- Université de Montpellier, Montpellier, France
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, United States of America
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Georgios M. Hadjigeorgiou
- University of Thessaly, Larissa, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Linda Lam
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wai-chi Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Ada Fung
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | | | | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Korea
- Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Wan Suh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kay Deckers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Erin P. Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Tiffany F. Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, Ohio, United States of America
| | - Kaarin J. Anstey
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mary N. Haan
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Allison E. Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Kristina Dang
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, Kasuga, Japan
| | - Tao Chen
- Center for Health Science and Counseling, Kyushu University, Kasuga, Japan
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marcia Scazufca
- Instituto de Psiquiatria e LIM-23, Hospital da Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian N. Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Kenichi Meguro
- Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan
| | | | - Hiroshi Ishii
- Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Madrid, Spain
| | - Raul Lopez-Anton
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Madrid, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabárbara
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Madrid, Spain
- Department of Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain
| | - Yvonne Leung
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Jessica W. Lo
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Gordana Popovic
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- School of Mathematics and Statistics, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
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Chen S, Honda T, Narazaki K, Chen T, Kishimoto H, Kumagai S. Physical Frailty and Risk of Needing Long-Term Care in Community-Dwelling Older Adults: a 6-Year Prospective Study in Japan. J Nutr Health Aging 2019; 23:856-861. [PMID: 31641736 DOI: 10.1007/s12603-019-1242-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the association between physical frailty and risk of needing long-term care, and compare the predictive value and clinical usefulness of a simple frailty scale (FRAIL) with that of the original Cardiovascular Health Study (CHS) criteria. DESIGN AND SETTING A 6-year prospective cohort study of community-dwelling older adults in a west Japanese suburban town. PARTICIPANTS 1,554 older adults aged 65 years and over who were initially free of long-term care needs at baseline. MEASUREMENTS Physical frailty was defined by the CHS criteria and the FRAIL scale. The onset of needing long-term care was ascertained using national records of certification of long-term care needs. Cox proportional hazard models were used to estimate the association between physical frailty and risk of needing long-term care. Decision curve analysis was performed to compare the clinical usefulness of the two physical frailty criteria. RESULTS During a median follow-up of 5.8 years, 244 were ascertained as needing long-term care. Baseline physical frailty was significantly associated with elevated risk of needing long-term care, with a multivariable-adjusted hazard ratio (HR) of 2.00 (95% confidence interval [CI], 1.32-3.02) for being frail and 1.50 (95% CI, 1.10-2.03) for being pre-frail as defined by the CHS criteria, compared with being robust (p for trend = 0.001). Similar results were found for physical frailty defined by the FRAIL scale, with a multivariable-adjusted HR (95% CIs) of 2.11 (1.25-3.56) for being frail and 1.73 (1.28-2.35) for being pre-frail vs. being robust (p for trend < 0.001). The two physical frailty criteria had similar net benefits in identifying individuals at high risk for needing long-term care. CONCLUSIONS Physical frailty is significantly associated with an increased risk of needing long-term care in community-dwelling older adults in Japan. Compared with the original CHS criteria, the simple FRAIL scale has comparable predictive value and clinical usefulness for identifying individuals at risk for needing long-term care.
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Affiliation(s)
- S Chen
- Dr. Shuzo Kumagai, Center for Health Science and Counseling, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, Fukuoka Prefecture 819-0315, Japan, Telephone number: +81 92-802-5112, Fax number: +81 922-802-5112, E-mail:
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Haeuchi Y, Honda T, Chen T, Narazaki K, Chen S, Kumagai S. Association between participation in social activity and physical fitness in community-dwelling older Japanese adults. Nihon Koshu Eisei Zasshi 2018; 63:727-737. [PMID: 28100892 DOI: 10.11236/jph.63.12_727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Purpose This study aimed to examine the relationship between participation in social activity and both, composite and individual measures of physical fitness in community-dwelling older adults.Methods This study was conducted using baseline data from the Sasaguri Genkimon Study (SGS), a longitudinal cohort study conducted in 2011. Participants were 1,365 community-dwelling men and women aged 65 years or above, who did not require certified nursing care and who resided in Sasaguri, a town located east of the Fukuoka metropolitan area. Participation in social activity was assessed by asking participants whether they engaged in any of eight social activities. Physical fitness tests assessed participants' handgrip strength and knee extension strength as measures of muscle strength, and their one-leg standing time, 5-m maximum gait speed, and 5-repetition sit-to-stand rate as measures of their physical performance. Multiple linear regression and logistic regression analyses were conducted to assess the relationship between participation in social activity and each measure of physical fitness, adjusting for sex; age; body mass index; socioeconomic status; solitary living; exercise, habitual drinking and smoking; accelerometer-measured, moderate-to-vigorous physical activity; cognitive function; instrumental activities of daily living; distress; social network; and comorbidities.Results A total of 83.6% of the participants were engaged in at least one social activity. After adjusting for potential confounders, engagement in social activity was positively associated with a higher composite physical fitness score, faster gait speed and 5-repetition sit-to-stand rate, and longer one-leg standing time (P=0.008, P=0.030, P=0.034, and P=0.009, respectively).Conclusion Participation in social activity was significantly associated with physical fitness, specifically those related to locomotive function. These associations were independent of various confounders including socioeconomic status, and comorbidities.
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Affiliation(s)
- Yuka Haeuchi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University
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Chen S, Honda T, Narazaki K, Chen T, Kishimoto H, Haeuchi Y, Kumagai S. Physical Frailty Is Associated with Longitudinal Decline in Global Cognitive Function in Non-Demented Older Adults: A Prospective Study. J Nutr Health Aging 2018; 22:82-88. [PMID: 29300426 DOI: 10.1007/s12603-017-0924-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the relationship between physical frailty and subsequent decline in global cognitive function in the non-demented elderly. DESIGN AND SETTING A prospective population-based study in a west Japanese suburban town, with two-year follow-up. PARTICIPANTS Community-dwellers aged 65 and older without placement in long-term care, and not having a history of dementia, Parkinson's disease and depression at baseline, who participated in the cohort of the Sasaguri Genkimon Study and underwent follow-up assessments two years later (N = 1,045). MEASUREMENTS Global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Physical frailty was identified according to the following five components: weight loss, low grip strength, exhaustion, slow gait speed and low physical activities. Linear regression models were used to examine associations between baseline frailty status and the MoCA scores at follow-up. Logistic regression models were used to estimate the risk of cognitive decline (defined as at least two points decrease of MoCA score) according to baseline frailty status. RESULTS Seven hundred and eight non-demented older adults were included in the final analyses (mean age: 72.6 ± 5.5 years, male 40.3%); 5.8% were frail, and 40.8% were prefrail at baseline. One hundred and fifty nine (22.5%) participants experienced cognitive decline over two years. After adjustment for baseline MoCA scores and all confounders, being frail at baseline was significantly associated with a decline of 1.48 points (95% confidence interval [CI], -2.37 to -0.59) in MoCA scores, as compared with non-frailty. Frail persons were over two times more likely to experience cognitive decline (adjusted odds ratio 2.28; 95% CI, 1.02 to 5.08), compared to non-frail persons. CONCLUSION Physical frailty is associated with longitudinal decline in global cognitive function in the non-demented older adults over a period of two years. Physically frail older community-dwellers should be closely monitored for cognitive decline that can be sensitively captured by using the MoCA.
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Affiliation(s)
- S Chen
- Dr. Shuzo Kumagai, Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga Koen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan, Telephone number: +81 92-583-7853, Fax number: +81 92-583-7853, E-mail:
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Chen T, Haeuchi Y, Honda T, Chen S, Narazaki K, Nagayoshi S, Kuamagai S. OBJECTIVE PHYSICAL ACTIVITY, SEDENTARY TIME, AND INCIDENT DISABILITY IN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T. Chen
- Kyushu University, Kasuga, Japan,
| | | | - T. Honda
- Kyushu University, Kasuga, Japan,
- Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan,
| | - S. Chen
- Kyushu University, Kasuga, Japan,
- Central South University, Changsha, China
| | - K. Narazaki
- Fukuoka Institute of Technology, Fukuoka, Japan,
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Narazaki K, Tanoue Y, Hatamoto Y, Higaki Y, Tanaka H. IGF-1 Response In Middle-aged And Older Men During Continuous And Intermittent Cycling At Lactate Threshold. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517496.86070.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Honda T, Chen S, Yonemoto K, Kishimoto H, Chen T, Narazaki K, Haeuchi Y, Kumagai S. Sedentary bout durations and metabolic syndrome among working adults: a prospective cohort study. BMC Public Health 2016; 16:888. [PMID: 27562190 PMCID: PMC5000401 DOI: 10.1186/s12889-016-3570-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 02/10/2016] [Accepted: 08/20/2016] [Indexed: 02/09/2023] Open
Abstract
Background This study aimed to examine the associations between time spent in prolonged and non-prolonged sedentary bouts and the development of metabolic syndrome. Methods We used data from a prospective study of Japanese workers. Baseline examination was conducted between 2010 and 2011. A total of 430 office workers (58 women) aged 40-64 years without metabolic syndrome were followed up by annual health checkups until 2014. Metabolic syndrome was defined as having ≥ 3 out of 5 diagnostic criteria from the Joint Interim Statement 2009 definition. Sedentary time was assessed using a tri-axial accelerometer. Time spent in total, prolonged (accumulated ≥ 30 min) and non-prolonged sedentary bouts (accumulated < 30 min) was calculated. Cox proportional hazards models were used to estimate the risk of developing metabolic syndrome. Results During a median follow-up of 3 years, 83 participants developed metabolic syndrome. After adjustment for age, sex, education, smoking, and family income, positive associations were observed between time spent in prolonged sedentary bouts and the development of metabolic syndrome. After additional adjustment for moderate-to-vigorous physical activity, those in the three highest quartiles of time spent in prolonged sedentary bouts showed higher risk of metabolic syndrome compared to the lowest quartile group, with adjusted hazard ratios (95 % confidence intervals) of 2.72 (1.30 – 5.73), 2.42 (1.11 – 5.50), and 2.85 (1.31 – 6.18), respectively. No associations were seen for time spent in total and non-prolonged sedentary bouts. Conclusions Sedentary behavior accumulated in a prolonged manner was associated with an increased risk of metabolic syndrome. In devising public health recommendations for the prevention of metabolic disease, the avoidance of prolonged uninterrupted periods of sedentary behavior should be considered. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3570-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Takanori Honda
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan.,Research Fellow of the Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Sanmei Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, 67 Asahi-machi, Kurume, Fukuoka Prefecture, 830-0011, Japan
| | - Hiro Kishimoto
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan
| | - Tao Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan
| | - Kenji Narazaki
- Department of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 811-0295, Japan
| | - Yuka Haeuchi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan
| | - Shuzo Kumagai
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan. .,Faculty of Arts and Science, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan.
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Chen T, Narazaki K, Chen S, Haeuchi Y, Kumagai S. P1‐029: The Dynamic Association Between Physical and Cognitive Functions in Non‐Demented Community‐Dwelling Older Adults: A 2‐YEAR Longitudinal Analysis. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Tao Chen
- Faculty of Arts and Science Kyushu UniversityKasugaJapan
| | - Kenji Narazaki
- Faculty of Social and Environmental Studies Fukuoka Institute of TechnologyFukuokaJapan
| | - Sanmei Chen
- Graduate School of Human-Environment Studies, Kyushu UniversityKasugaJapan
| | - Yuka Haeuchi
- Graduate School of Human-Environment Studies, Kyushu UniversityKasugaJapan
| | - Shuzo Kumagai
- Faculty of Arts and Science Kyushu UniversityKasugaJapan
- Graduate School of Human-Environment Studies, Kyushu UniversityKasugaJapan
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Narazaki K, Aoyagi R, Nakashima S, Hatamoto Y, Higaki Y, Tanaka H. Intermittent Running at Lactate Threshold Evokes a Comparable Insulin-like Growth Factor-1 Response to Its Continuous Counterpart. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487685.41551.5b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Scribbans TD, Berg K, Narazaki K, Janssen I, Gurd BJ. Heart rate during basketball game play and volleyball drills accurately predicts oxygen uptake and energy expenditure. J Sports Med Phys Fitness 2015; 55:905-913. [PMID: 25323479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM There is currently little information regarding the ability of metabolic prediction equations to accurately predict oxygen uptake and exercise intensity from heart rate (HR) during intermittent sport. The purpose of the present study was to develop and, cross-validate equations appropriate for accurately predicting oxygen cost (VO2) and energy expenditure from HR during intermittent sport participation. METHODS Eleven healthy adult males (19.9±1.1yrs) were recruited to establish the relationship between %VO2peak and %HRmax during low-intensity steady state endurance (END), moderate-intensity interval (MOD) and high intensity-interval exercise (HI), as performed on a cycle ergometer. Three equations (END, MOD, and HI) for predicting %VO2peak based on %HRmax were developed. HR and VO2 were directly measured during basketball games (6 male, 20.8±1.0 yrs; 6 female, 20.0±1.3yrs) and volleyball drills (12 female; 20.8±1.0yrs). Comparisons were made between measured and predicted VO2 and energy expenditure using the 3 equations developed and 2 previously published equations. RESULTS The END and MOD equations accurately predicted VO2 and energy expenditure, while the HI equation underestimated, and the previously published equations systematically overestimated VO2 and energy expenditure. CONCLUSION Intermittent sport VO2 and energy expenditure can be accurately predicted from heart rate data using either the END (%VO2peak=%HRmax x 1.008-17.17) or MOD (%VO2peak=%HRmax x 1.2-32) equations. These 2 simple equations provide an accessible and cost-effective method for accurate estimation of exercise intensity and energy expenditure during intermittent sport.
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Affiliation(s)
- T D Scribbans
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada -
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Chen T, Narazaki K, Honda T, Chen S, Haeuchi Y, Nofuji YY, Matsuo E, Kumagai S. Tri-Axial Accelerometer-Determined Daily Physical Activity and Sedentary Behavior of Suburban Community-Dwelling Older Japanese Adults. J Sports Sci Med 2015; 14:507-514. [PMID: 26336336 PMCID: PMC4541113] [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: 01/07/2015] [Accepted: 04/17/2015] [Indexed: 06/05/2023]
Abstract
Knowledge regarding accelerometer-derived physical activity (PA) and sedentary behavior (SED) levels is scarce for Japanese older adults. The aims of this study were therefore to 1) describe levels of PA and SED in Japanese community-dwelling older adults, using tri-axial accelerometer; 2) examine the variation of PA and SED with respect to sex, age, and body mass index (BMI). Participants of this study were from the baseline survey of the Sasaguri Genkimon Study, who were 65 years or older and not certified as those requiring long-term care. PA was assessed objectively for seven consecutive days using tri-axial accelerometer. A total of 1,739 participants (median age: 72 years, men: 38.0%) with valid PA data were included. Overall, participants in the present study spent 54.5% of their waking time being sedentary and 45.5% being active, of which 5.4% was moderate-to-vigorous physical activity (MVPA). Women accumulated more minutes of light physical activity (LPA) and MVPA compared with men. In contrast, men spent more time being sedentary. Mean steps per day did not differ between sexes. Furthermore, participants with higher BMI (BMI ≥25) had lower PA levels, and longer SED compared with those with lower BMI (BMI <). PA levels were lower and SED was longer with age. The present study is the first to demonstrate that the levels of PA and SED differed by sex, age, and BMI in Japanese community-dwelling older adults. In particular, women were more active compared with men, providing unique insight into the current level of PA in older adults. Data presented in the study will enable further investigation of additional determinants of PA and SED in order to develop effective population-based intervention strategies to promote PA and reduce prolonged SED in the Japanese population and possibly other rapidly aging societies. Key pointsAccelerometer, that is capable to assess PA more precisely in large scale epidemiological studies, provides opportunity for improving understanding of daily PA in older adults.This study first demonstrated that the levels of PA and SED differed by sex, age, and BMI in Japanese community-dwelling older people.Women were more active compared with men, in terms of more minutes of MVPA.
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Affiliation(s)
- Tao Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Kenji Narazaki
- Central Research Institute for Physical Activity, Fukuoka University , Fukuoka, Japan
| | - Takanori Honda
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Sanmei Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Yuki Haeuchi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Yu Y Nofuji
- Tokyo Metropolitan Institute of Gerontology , Tokyo, Japan
| | - Eri Matsuo
- Tokyo Metropolitan Institute of Gerontology , Tokyo, Japan
| | - Shuzo Kumagai
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan ; Faculty of Arts and Science, Kyushu University , Fukuoka, Japan
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Chen S, Honda T, Narazaki K, Chen T, Nofuji Y, Haeuchi Y, Kumagai S. P3‐261: Combination of the clock drawing test with frailty phenotype for the prediction of incident disability in two‐year follow‐up among nondemented community‐dwelling older adults. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sanmei Chen
- Graduate School of Human-Environment StudiesKyushu UniversityKasuga CityJapan
| | - Takanori Honda
- Graduate School of Human-Environment StudiesKyushu UniversityKasuga CityJapan
| | - Kenji Narazaki
- Central Research Institute for Physical ActivityFukuoka UniversityFukuoka CityJapan
| | - Tao Chen
- Graduate School of Human-Environment StudiesKyushu UniversityKasuga CityJapan
| | - Yu Nofuji
- Tokyo Metropolitan Institute of GerontologyTyokoJapan
| | - Yuka Haeuchi
- Graduate School of Human-Environment StudiesKyushu UniversityKasuga CityJapan
| | - Shuzo Kumagai
- Graduate School of Human-Environment StudiesKyushu UniversityKasuga CityJapan
- Faculty of Arts and ScienceKyushu UniversityKasuga CityJapan
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Chen S, Honda T, Narazaki K, Chen T, Nofuji Y, Kumagai S. Global cognitive performance and frailty in non-demented community-dwelling older adults: Findings from the Sasaguri Genkimon Study. Geriatr Gerontol Int 2015; 16:729-36. [PMID: 26082148 DOI: 10.1111/ggi.12546] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2015] [Indexed: 11/28/2022]
Abstract
AIM To investigate the associations of global cognitive performance with frailty and pre-frailty in non-demented community-dwelling older adults. METHOD A cross-sectional study was carried out using data from the baseline survey of the Sasaguri Genkimon Study in 2011. The study sample consisted of 1565 older adults with complete data and no evidence of dementia. Global cognitive performance was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Frailty state was defined using the Cardiovascular Health Study criteria, based on five components: unintentional weight loss, low grip strength, exhaustion, low gait speed and low physical activity. RESULTS Total MoCA and MMSE scores, and their domain-specific scores decreased across the non-frail, pre-frail and frail groups. Poorer total MoCA and MMSE scores, as well as their domain-specific scores, were associated with the greater likelihood of being frail, but not with pre-frailty after full adjustment. The strength of the association with frailty was greater for total MoCA score than for total MMSE score. Domain-specific scores for visuospatial abilities and attention domains in both of the MoCA and MMSE were consistently associated with the likelihood of pre-frailty and frailty, even after being mutually adjusted for all domains. CONCLUSIONS The MoCA performance is more strongly associated with the odds of frailty than the MMSE performance in the relatively functional and non-demented older adult population. The present findings could contribute to further exploration of possible common pathways that can be targeted in the prevention and management for both of these two conditions. Geriatr Gerontol Int 2015; ●●: ●●-●●.
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Affiliation(s)
- Sanmei Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Kenji Narazaki
- Central Research Institute for Physical Activity, Fukuoka University, Fukuoka, Japan
| | - Tao Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Yu Nofuji
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuzo Kumagai
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan.,Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
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Chen T, Narazaki K, Haeuchi Y, Chen S, Honda T, Kumagai S. Associations of Light Physical Activity and Sedentary Time with IADL Disability in Community-dwelling Older Adults. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478849.57611.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chen S, Honda T, Chen T, Narazaki K, Haeuchi Y, Supartini A, Kumagai S. Screening for frailty phenotype with objectively-measured physical activity in a west Japanese suburban community: evidence from the Sasaguri Genkimon Study. BMC Geriatr 2015; 15:36. [PMID: 25887474 PMCID: PMC4391124 DOI: 10.1186/s12877-015-0037-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 12/08/2014] [Accepted: 03/24/2015] [Indexed: 12/25/2022] Open
Abstract
Background The low physical activity domain of the frailty phenotype has been assessed with various self-reported questionnaires, which are prone to possible recall bias and a lack of diagnostic accuracy. The primary purpose of this study was to define the low physical activity domain of the frailty phenotype using accelerometer-based measurement and to evaluate the internal construct validity among older community-dwellers. Secondly, we examined potential correlates of frailty in this population. Methods We conducted a cross-sectional study of 1,527 community-dwelling older men and women aged 65 and over. Data were drawn from the baseline survey of the Sasaguri Genkimon Study, a cohort study carried out in a west Japanese suburban community. Frailty phenotypes were defined by the following five components: unintentional weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Of these criteria, physical activity was objectively measured with a tri-axial accelerometer. To confirm our measure’s internal validity, we performed a latent class analysis (LCA) to assess whether the five components could aggregate statistically into a syndrome. We examined the correlates of frailty using multiple stepwise logistic regression models. Results The estimated prevalence of frailty was 9.3% (95% confidence intervals, CI, 8.4-11.2); 43.9% were pre-frail (95% CI, 41.5-46.4). The percentage of low physical activity was 19.5%. Objectively-assessed physical activity and other components aggregated statistically into a syndrome. Overall, increased age, poorer self-perceived health, depressive and anxiety symptoms, not consuming alcohol, no engagement in social activities, and cognitive impairment were associated with increased odds of frailty status, independent of co-morbidities. Conclusions This study confirmed the internal construct validity of the frailty phenotype that defined the low energy expenditure domain with the objective measurement of physical activity. Accelerometry may potentially standardize the measurement of low physical activity and improve the diagnostic accuracy of the frailty phenotype criteria in primary care setting. The potential role of factors associated with frailty merits further studies to explore their clinical application. Electronic supplementary material The online version of this article (doi:10.1186/s12877-015-0037-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sanmei Chen
- Department of Health Behavior and Sciences, Graduate School of Human-Environment Studies, Kyushu University, Kasuga City, Japan.
| | - Takanori Honda
- Department of Health Behavior and Sciences, Graduate School of Human-Environment Studies, Kyushu University, Kasuga City, Japan.
| | - Tao Chen
- Department of Health Behavior and Sciences, Graduate School of Human-Environment Studies, Kyushu University, Kasuga City, Japan.
| | - Kenji Narazaki
- Department of Health Behavior and Sciences, Graduate School of Human-Environment Studies, Kyushu University, Kasuga City, Japan.
| | - Yuka Haeuchi
- Department of Health Behavior and Sciences, Graduate School of Human-Environment Studies, Kyushu University, Kasuga City, Japan.
| | - Atin Supartini
- Department of Health Behavior and Sciences, Graduate School of Human-Environment Studies, Kyushu University, Kasuga City, Japan.
| | - Shuzo Kumagai
- Department of Health Behavior and Sciences, Graduate School of Human-Environment Studies, Kyushu University, Kasuga City, Japan. .,Faculty of Arts and Science, 6-1 Kasuga koen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan.
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Honda T, Chen S, Kishimoto H, Narazaki K, Kumagai S. Identifying associations between sedentary time and cardio-metabolic risk factors in working adults using objective and subjective measures: a cross-sectional analysis. BMC Public Health 2014; 14:1307. [PMID: 25526746 PMCID: PMC4302076 DOI: 10.1186/1471-2458-14-1307] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 09/19/2014] [Accepted: 12/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behavior has been reported to be associated with metabolic and vascular health independent of moderate-to-vigorous physical activity (MVPA). In order to select appropriate options to measure sedentary behavior in practice and research settings, it is worthwhile to characterize the extent to which objective and subjective measures of sedentary behavior quantify adverse health risks in the same population. This cross-sectional analysis compared accelerometer-derived and self-reported sedentary time to identify their association with cardio-metabolic risk factors. METHODS Cross-sectional analysis was conducted using data from 661 Japanese workers (145 women) aged 20-64 years. Participants wore a tri-axial accelerometer device for 10 consecutive days and completed the Japan Atherosclerosis Longitudinal Study Physical Activity Questionnaire. Data on body mass index, waist circumference, resting blood pressure, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, total:HDL cholesterol ratio, blood glucose, and glycosylated hemoglobin (HbA1c) were obtained from annual health examinations. RESULTS Both accelerometer-derived and self-reported sedentary time were deleteriously associated with triglycerides, HDL-cholesterol, total:HDL ratio, and HbA1c after adjustment for potential confounders including MVPA. There were no significant differences in regression coefficients between the two measures. Thus, the magnitude of the associations of both measures with cardio-metabolic risk factors was similar, despite poor agreement between them. Occupational sedentary time was correlated with both measures of total sedentary time, and more consistently associated with cardio-metabolic risk factors than sedentary leisure time. CONCLUSIONS Both accelerometer and self-report measurements are similarly associated with cardio-metabolic risk factors in a Japanese working adult population. Subjective and objective measures of sedentary behaviors appear to capture different aspects of behaviors. Further efforts to establish data processing methods integrating objective and subjective measures are needed to more effectively assess sedentary time's relationship to health outcomes.
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Affiliation(s)
| | | | | | | | - Shuzo Kumagai
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture 816-8580, Japan.
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Narazaki K, Matsuo E, Honda T, Nofuji Y, Yonemoto K, Kumagai S. Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems. J Sports Sci Med 2014; 13:590-596. [PMID: 25177186 PMCID: PMC4126296] [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: 03/19/2014] [Accepted: 05/09/2014] [Indexed: 06/03/2023]
Abstract
Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score ≥24) were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%). Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p < 0.001). These associations were preserved after additional adjustment for years of formal education, body mass index, and other confounding factors (p < 0.001). The present study first demonstrated the associations between multiple aspects of physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community-based preventive care of dementia. Key pointsThere is a great need for identifying lifestyle-related markers which help detect subtle cognitive impairment in the preclinical or earlier phase of dementia.In the present study, each of the five physical fitness measures employed was linearly and positively associated with the Montreal Cognitive Assessment score in the present older adults without apparent cognitive problems, after adjusting for age, sex, education, body mass index, and other confounding factors.The results suggest the potential of each physical fitness measure as a single lifestyle-related marker of low cognitive function in the population, which can be useful in community-based preventive care of dementia.
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Affiliation(s)
- Kenji Narazaki
- Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Eri Matsuo
- Tokyo Metropolitan Institute of Gerontology , Tokyo, Japan
| | - Takanori Honda
- Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Yu Nofuji
- Tokyo Metropolitan Institute of Gerontology , Tokyo, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University , Fukuoka, Japan
| | - Shuzo Kumagai
- Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan ; Faculty of Arts and Science, Kyushu University , Fukuoka, Japan
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Jingu K, Matsushita H, Takeda K, Narazaki K, Ariga H, Umezawa R, Sugawara T, Miyata G, Onodera K, Nemoto K, Yamada S. Results of chemoradiotherapy for stage I esophageal cancer in medically inoperable patients compared with results in operable patients. Dis Esophagus 2013; 26:522-7. [PMID: 22925398 DOI: 10.1111/j.1442-2050.2012.01396.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 12/11/2022]
Abstract
The purpose of the present study was to evaluate long-term results of chemoradiotherapy for clinical T1b-2N0M0 esophageal cancer and to compare outcomes for operable and inoperable patients. Patients with stage I esophageal cancer (Union for International Cancer Control [UICC] 2009), excluding patients with cT1a esophageal cancer, were studied. All patients had histologically proven squamous cell carcinoma. Operable patients received cisplatin and 5-fluorouracil with concurrent radiotherapy of 60 Gy including a 2-week break. Inoperable patients received nedaplatin and 5-fluorouracil with concurrent radiotherapy of 60-70 Gy without a pause. End-points were overall survival rate (OS), cause-specific survival rate (CSS), progression-free survival rate (PFS), and locoregional control rate (LC). Thirty-seven operable patients and 30 medically inoperable patients were enrolled. There was a significant difference in only age between the operable group and inoperable group (P = 0.04). The median observation period was 67.9 months. In all patients, 5-year OS, CSS, PFS, and LC were 77.9%, 91.5%, 66.9%, and 80.8%, respectively. Comparison of the operable group and inoperable group showed that there was a significant difference in OS (5-year, 85.5% vs. 68.7%, P = 0.04), but there was no difference in CSS, PFS, or LC. Grade 3 or more late toxicity according to Common Terminology Criteria for Adverse Events v 3.0 was found in seven patients. Even in medically inoperable patients with stage I esophageal cancer, LC of more than 80% can be achieved with chemoradiotherapy. However, OS in medically inoperable patients is significantly worse than that in operable patients.
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Affiliation(s)
- K Jingu
- Department of Radiation Oncology, Tohoku University School of Medicine, Sendai 980-8574, Japan.
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Kobayashi Y, Narazaki K, Akagi R, Nakagaki K, Kawamori N, Ohta K. Calculation of force and power during bench throws using a Smith machine: the importance of considering the effect of counterweights. Int J Sports Med 2013; 34:820-4. [PMID: 23459856 DOI: 10.1055/s-0032-1329955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
For achieving accurate and safe measurements of the force and power exerted on a load during resistance exercise, the Smith machine has been used instead of free weights. However, because some Smith machines possess counterweights, the equation for the calculation of force and power in this system should be different from the one used for free weights. The purpose of this investigation was to calculate force and power using an equation derived from a dynamic equation for a Smith machine with counterweights and to determine the differences in force and power calculated using 2 different equations. One equation was established ignoring the effect of the counterweights (Method 1). The other equation was derived from a dynamic equation for a barbell and counterweight system (Method 2). 9 female collegiate judo athletes performed bench throws using a Smith machine with a counterweight at 6 different loading conditions. Barbell displacement was recorded using a linear position transducer. The force and power were subsequently calculated by Methods 1 and 2. The results showed that the mean and peak power and force in Method 1 were significantly lower relative to those of Method 2 under all loading conditions. These results indicate that the mean and peak power and force during bench throwing using a Smith machine with counterweights would be underestimated when the calculations used to determine these parameters do not account for the effect of counterweights.
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Affiliation(s)
- Y Kobayashi
- Department of Sports Sciences, Japan Institute of Sports Sciences, Tokyo, Japan.
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Honda T, Narazaki K, Matsuo E, Nofuji Y, Yamashita S, Kishimoto H, Nagayoshi S, Kumagai S. Tri-axial accelerometer-derived sedentary time and its correlates among community-dwelling older adults in Japan. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Narazaki K, Nofuji Y, Honda T, Matsuo E, Yonemoto K, Kumagai S. Normative data for the montreal cognitive assessment in a Japanese community-dwelling older population. Neuroepidemiology 2012; 40:23-9. [PMID: 23075757 DOI: 10.1159/000339753] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 05/28/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although the Montreal Cognitive Assessment (MoCA) is acknowledged as a promising neuropsychological tool, its normative data for older populations have not been established yet. The purpose of this study was to provide normative data for the MoCA in Japanese community-dwelling older people. METHODS In a Japanese town, 1,977 participants aged 65 years or older (mean age 73.6 years; male 41.3%) completed MoCA tests. After descriptive and regression analyses, normative data were developed for MoCA scores in the population. RESULTS The mean MoCA score observed (21.8 points) was lower than that for normal controls (27.4 points) in the original validation study of the MoCA. Additionally, 82.6% of MoCA scores fell below the standard cutoff of 26 points for detecting mild cognitive impairment (MCI). The regression analysis showed that higher age and fewer years of formal education were associated with lower MoCA scores (p < 0.001). Normative data for MoCA scores were presented with respect to age and education. CONCLUSION This study provided normative data for the MoCA in a Japanese community-dwelling older population. This research also suggests that conventional use of the MoCA as a screening tool for MCI might be problematic in cultures different from that in which the cutoff was developed.
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Affiliation(s)
- Kenji Narazaki
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
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Takeda K, Ogawa Y, Ariga H, Kotoh M, Sakayauchi T, Fujimoto K, Kubozono M, Narazaki K, Takai Y, Yamada S. 7051 Clinical predictors of late gastrointestinal and genitourinary toxicity after three-dimensional conformal radiotherapy using seven coplanar fields to localize prostate cancer. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71429-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Berg K, Narazaki K, Latin R, Vincent W, Meisinger M, Sjoberg C, Kaufman C. Oxygen cost and energy expenditure of racquetball. J Sports Med Phys Fitness 2007; 47:395-400. [PMID: 18091677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIM Many sports are played intermittently in bursts of high, moderate, and low intensity activity. The pattern of exercise intensity has been assessed from heart rate (HR) and time motion analysis and few data are available based on assessment of exercise intensity by means of direct measurement of oxygen uptake. The aim of this study was to directly assess oxygen uptake (VO(2)) using a portable metabolic measuring device to describe the aerobic demand and to determine the associated energy expenditure (EE). METHODS Fourteen recreational racquetball players (3 females and 11 males; mean age, height, and mass of 23.1+/-2.8 years, 178.1+/-7.1 cm, and 81.1+/-19.6 kg, respectively) played for 40 min while wearing a portable metabolic system to assess VO(2) and a Polar watch to measure HR. Rating of perceived exertion (RPE) (Borg 6-20 scale) was assessed at 5 min intervals during breaks in play. RESULTS The mean VO(2), HR, and RPE over 40 min of play were 27.3+/-1.8 mL/kg/min, 155.3+/-2.8 bpm, and 12.9+/-0.6, respectively. The associated EE was a total of 1 844 kj (440 kcal) or 465 kj/min (11.1 kcal/min). These data were examined across 13.3 min time periods of play, in order to determine if they changed during play because of fatigue. VO(2) decreased significantly (P<0.05), while HR increased (P<0.05). RPE rose across periods of play, but not significantly. CONCLUSION Recreational racquetball appears to elicit a VO(2) that would allow aerobic conditioning in many persons. It does so with an RPE that is nearly ''somewhat hard''.
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Affiliation(s)
- K Berg
- University of Nebraska at Omaha, Omaha, NE, USA.
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Narazaki K, Oleynikov D, Stergiou N. Objective assessment of proficiency with bimanual inanimate tasks in robotic laparoscopy. J Laparoendosc Adv Surg Tech A 2007; 17:47-52. [PMID: 17362179 DOI: 10.1089/lap.2006.05101] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Development of objective criteria and optimum training protocols are priorities for robotic laparoscopy. However, studies that have attempted to objectify learning have been limited due to lack of task complexity and absence of comparisons between experts and novices. Our aim was to address these limitations and assess proficiency in robotic laparoscopy using bimanual inanimate tasks. MATERIALS AND METHODS Six experts and 18 novice users of the da Vinci surgical system (Innovative Surgical, Sunnyvale, CA) performed three bimanual surgical manipulations, two of them in opposite directions, for a total of five different test tasks. During each task, elapsed time and kinematics with respect to the instrument tips were measured and a bimanual coordination analysis was conducted to assess the relationship between the simultaneous movements of both arms. Specifically, task completion time, total traveling distance of the instrument tips, and mean absolute relative phase-a variable for the assessment of bimanual coordination-were calculated for each task and compared between groups. RESULTS The experts showed significantly shorter task completion times for all tasks (P < 0.05). Significantly higher mean absolute relative phase values were observed for the experts in two tasks (P < 0.05). There were no significant differences regarding total travel distance. CONCLUSION Expert users of the da Vinci surgical system performed the designed surgical tasks faster and with higher bimanual dexterity than novices. Bimanual coordination analysis and the tasks used in this study show promise for becoming important components of the objective criteria needed to quantify proficiency in robotic laparoscopy.
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Affiliation(s)
- Kenji Narazaki
- University of Nebraska at Omaha, Omaha, Nebraska 68182, USA
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Berg K, Narazaki K, Shinohara M. Physiological Responses to Stochastic Intermittent Running. Med Sci Sports Exerc 2006. [DOI: 10.1249/00005768-200605001-03011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Judkins TN, Oleynikov D, Narazaki K, Stergiou N. Robotic surgery and training: electromyographic correlates of robotic laparoscopic training. Surg Endosc 2006; 20:824-9. [PMID: 16508816 DOI: 10.1007/s00464-005-0334-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2005] [Accepted: 10/25/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND Robotic laparoscopic surgery has been shown to decrease task completion time, reduce errors, and decrease training time, as compared with manual laparoscopic surgery. However, current literature has not addressed the physiologic effects, in particular muscle responses, to training with a robotic surgical system. The authors seek to determine the frequency response of electromyographic (EMG) signals of specific arm and hand muscles with training using the da Vinci Surgical System. METHODS Seven right-handed medical students were trained in three tasks with the da Vinci Surgical System over 4 weeks. These subjects, along with eight control subjects, were tested before and after training. Electromyographic (EMG) signals were collected from four arm and hand muscles during the testing sessions, and the median EMG frequency and bandwidth were computed. RESULTS The median frequency and frequency bandwidth both were increased after training for two of the three tasks. CONCLUSION The results suggest that training reduces muscle fatigue as a result of faster and more deliberate movements. These changes occurred predominantly in muscles that were the dominant muscles for each task, whereas the more demanding task recruited more diverse motor units. An evaluation of the physiologic demands of robotic laparoscopic surgery using electromyography can provide us with a meaningful quantitative way to examine performance and skill acquisition.
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Affiliation(s)
- T N Judkins
- University of Nebraska at Omaha, 6001 Dodge Street, Omaha, NE 68182, USA
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Narazaki K, Oleynikov D, Stergiou N. Robotic surgery training and performance: identifying objective variables for quantifying the extent of proficiency. Surg Endosc 2005; 20:96-103. [PMID: 16374675 DOI: 10.1007/s00464-005-3011-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Accepted: 10/02/2005] [Indexed: 01/18/2023]
Abstract
BACKGROUND To understand the process of skill acquisition in robotic surgery and to allow useful real-time feedback to surgeons and trainees in future generations of robotic surgical systems, robotic surgical skills should be determined with objective variables. The aim of this study was to assess skill acquisition through a training protocol, and to identify variables for the quantification of proficiency. METHODS Seven novice users of the da Vinci Surgical System engaged in 4 weeks of training that involved practicing three bimanual tasks with the system. Seven variables were determined for assessing speed of performance, bimanual coordination, and muscular activation. These values were compared before and after training. RESULTS Significant improvements were observed through training in five variables. Bimanual coordination showed differences between the surgical tasks used, whereas muscular activation patterns showed better muscle use through training. The subjects also performed the surgical tasks considerably faster within the first two to three training sessions. CONCLUSIONS The study objectively demonstrated that the novice users could learn to perform surgical tasks faster and with more consistency, better bimanual dexterity, and better muscular activity utilization. The variables examined showed great promise as objective indicators of proficiency and skill acquisition in robotic surgery.
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Affiliation(s)
- K Narazaki
- University of Nebraska, Omaha, NE 68182, USA
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