Association between dietary diversity and cognitive impairment among the oldest-old: findings from a nationwide cohort study

Author(s):  
Jiazhen Zheng ◽  
Rui Zhou ◽  
Furong Li ◽  
Liren Chen ◽  
Keyi Wu ◽  
...  
2021 ◽  
Vol 8 ◽  
Author(s):  
Jia Wangping ◽  
Han Ke ◽  
Wang Shengshu ◽  
Song Yang ◽  
Yang Shanshan ◽  
...  

Objective: To evaluate the combined effects of anemia and cognitive function on the risk of all-cause mortality in oldest-old individuals.Design: Prospective population-based cohort study.Setting and Participants: We included 1,212 oldest-old individuals (men, 416; mean age, 93.3 years).Methods: Blood tests, physical examinations, and health questionnaire surveys were conducted in 2012 were used for baseline data. Mortality was assessed in the subsequent 2014 and 2018 survey waves. Cox proportional hazards models were used to evaluate anemia, cognitive impairment, and mortality risk. We used restricted cubic splines to analyze and visualize the association between hemoglobin (Hb) levels and mortality risk.Results: A total of 801 (66.1%) deaths were identified during the 6-year follow-up. We noted a significant association between anemia and mortality (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.14–1.54) after adjusting for confounding variables. We also observed a dose-response relationship between the severity of anemia and mortality (P < 0.001). In the restricted cubic spline models, Hb levels had a reverse J-shaped association with mortality risk (HR 0.88, 95% CI 0.84–0.93 per 10 g/L-increase in Hb levels below 130 g/L). The reverse J-shaped association persisted in individuals without cognitive impairment (HR 0.88, 95% CI 0.79–0.98 per 10 g/L-increase in Hb levels below 110 g/L). For people with cognitive impairment, Hb levels were inversely associated with mortality risk (HR 0.83, 95% CI 0.78–0.89 per 10 g/L-increase in Hb levels below 150 g/L). People with anemia and cognitive impairment had the highest risk of mortality (HR 2.60, 95% CI 2.06–3.27).Conclusion: Our results indicate that anemia is associated with an increased risk of mortality in oldest-old people. Cognitive impairment modifies the association between Hb levels and mortality.


2020 ◽  
Author(s):  
Erico Castro-Costa ◽  
Jerson Laks ◽  
Cecilia Godoi Campos ◽  
Josélia OA Firmo ◽  
Maria Fernanda Lima-Costa ◽  
...  

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amir Motamedi ◽  
Maryam Ekramzadeh ◽  
Ehsan Bahramali ◽  
Mojtaba Farjam ◽  
Reza Homayounfar

Abstract Background Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Methods This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. Results Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. Conclusions Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041695
Author(s):  
Catherine Elliott ◽  
Caroline Alexander ◽  
Alison Salt ◽  
Alicia J Spittle ◽  
Roslyn N Boyd ◽  
...  

IntroductionThe current diagnostic pathways for cognitive impairment rarely identify babies at risk before 2 years of age. Very early detection and timely targeted intervention has potential to improve outcomes for these children and support them to reach their full life potential. Early Moves aims to identify early biomarkers, including general movements (GMs), for babies at risk of cognitive impairment, allowing early intervention within critical developmental windows to enable these children to have the best possible start to life.Method and analysisEarly Moves is a double-masked prospective cohort study that will recruit 3000 term and preterm babies from a secondary care setting. Early Moves will determine the diagnostic value of abnormal GMs (at writhing and fidgety age) for mild, moderate and severe cognitive delay at 2 years measured by the Bayley-4. Parents will use the Baby Moves smartphone application to video their babies’ GMs. Trained GMs assessors will be masked to any risk factors and assessors of the primary outcome will be masked to the GMs result. Automated scoring of GMs will be developed through applying machine-based learning to the data and the predictive value for an abnormal GM will be investigated. Screening algorithms for identification of children at risk of cognitive impairment, using the GM assessment (GMA), and routinely collected social and environmental profile data will be developed to allow more accurate prediction of cognitive outcome at 2 years. A cost evaluation for GMA implementation in preparation for national implementation will be undertaken including exploring the relationship between cognitive status and healthcare utilisation, medical costs, health-related quality of life and caregiver burden.Ethics and disseminationEthics approval has been granted by the Medical Research Ethics Committee of Joondalup Health Services and the Health Service Human Research Ethics Committee (1902) of Curtin University (HRE2019-0739).Trial registration numberACTRN12619001422112.


2021 ◽  
pp. 1-8
Author(s):  
Xiao Liu ◽  
Ayiguli Abudukeremu ◽  
Yuan Jiang ◽  
Zhengyu Cao ◽  
Maoxiong Wu ◽  
...  

Background: Several kinds of motor dysfunction can predict future cognitive impairment in elderly individuals. However, the ability of the fine motor index (FINEA) and gross motor index (GROSSA) to predict the risk of cognitive impairment has not been assessed. Objective: We investigated the associations between FINEA/GROSSA and cognitive impairment. Methods: The data of 4,745 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). We first assessed the correlation between the FINEA GROSSA and MMSE in a cross-sectional study. Then, we further investigated the predictive role of the incidence of cognitive impairment in a prospective cohort study. Results: We found that both FINEA and GROSSA were negatively correlated with MMSE in both the unadjusted (FINEA: B = –1.00, 95%confidence intervals (CI): –1.17, –0.83, t = –11.53, p <  0.001; GROSSA: B = –0.85, 95%CI: –0.94, –0.76, t = –18.29, p <  0.001) and adjusted (FINEA: B = –0.63, 95%CI: –0.79, –0.47, t = –7.77, p <  0.001; GROSSA: B = –0.57, 95%CI: –0.66, –0.48, t = –12.61, p <  0.001) analyses in a cross-sectional study. In a prospective cohort study, both high FINEA and high GROSSA were associated with an increased incidence of cognitive function impairment (FINEA: adjusted odds ratios (OR) = 2.35, 95%CI: 1.05, 5.23, p = 0.036; GROSSA adjusted OR = 3.00, 95%CI: 1.49, 6.03, p = 0.002) after 2 years of follow-up. Conclusion: Higher FINEA and GROSSA scores were both associated with an increased incidence of cognitive impairment. FINEA or GROSSA might be a simple tool for identifying patients with cognitive impairment.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yanfeng Ren ◽  
Maohua Miao ◽  
Wei Yuan ◽  
Jiangwei Sun

Abstract Background Although a U-shaped association between sleep duration and all-cause mortality has been found in general population, its association in the elderly adults, especially in the oldest-old, is rarely explored. Methods In present cohort study, we prospectively explore the association between sleep duration and all-cause mortality among 15,092 participants enrolled in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2005 to 2019. Sleep duration and death information was collected by using structured questionnaires. Cox regression model with sleep duration as a time-varying exposure was performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). The dose-response association between them was explored via a restricted cubic spline function. Results During an average follow-up of 4.51 (standard deviation, SD: 3.62) years, 10,768 participants died during the follow-up period. The mean (SD) age of the participants was 89.26 (11.56) years old. Compared to individuals with moderate sleep duration (7–8 hours), individuals with long sleep duration (> 8 hours) had a significantly higher risk of all-cause mortality (HR: 1.13, 95%CI: 1.09–1.18), but not among individuals with short sleep duration (≤ 6 hours) (HR: 1.02, 95%CI: 0.96–1.09). Similar results were observed in subgroup analyses based on age and gender. In the dose-response analysis, a J-shaped association was observed. Conclusions Sleep duration was associated with all-cause mortality in a J-shaped pattern in the elderly population in China.


The Lancet ◽  
2018 ◽  
Vol 392 ◽  
pp. S65
Author(s):  
John S Ji ◽  
Anna Zhu ◽  
Chen Bai ◽  
Peter James ◽  
Lijing Yan ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030052 ◽  
Author(s):  
Kenneth Lo ◽  
Qing Liu ◽  
Tracy Madsen ◽  
Steve Rapp ◽  
Jiu-Chiuan Chen ◽  
...  

ObjectiveTo examine the associations of dietary and supplemental magnesium (Mg) as assessed by a semi-quantitative food frequency questionnaire with cognitive outcomes among ageing women.DesignThis work conducts a prospective cohort study of participants enrolled in the Women’s Health Initiative Memory Study (WHIMS), which was subsequently extended and named WHIMS-Epidemiology of Cognitive Health.SettingForty clinical centres in the USA.ParticipantsPostmenopausal women aged 65–79 years without dementia on enrolment.Main outcome measuresPhysician-adjudicated mild cognitive impairment (MCI) and/or probable dementia (PD).ResultsParticipants were excluded (n=1006) if they had extreme values of dietary energy intake, had missing or extreme body mass index values, with prevalent MCI/PD at baseline, received only one cognitive assessment or had been followed up for <1 year. During >20 years of follow-up, 765 (11.8%) out of 6473 participants developed MCI/PD. For MCI/PD and MCI, the risks tended to be lower among participants in quintiles Q2–Q5 of Mg consumption compared with those in the lowest quintile. Participants in Q3 had a significantly lower risk of MCI/PD (HR 0.69, 95% CI 0.53 to 0.91) and MCI (HR 0.63, 95% CI 0.45 to 0.87) after multivariate adjustments. No significant association was observed between total Mg intake and PD. The association between total Mg intake, MCI/PD and MCI was non-linear as suggested by the likelihood test.ConclusionsTotal Mg intake between the estimated average requirement and the recommended dietary allowances may associate with a lower risk of MCI/PD and MCI.Trial registration numberNCT00685009.


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