Association between exercise and the risk of dementia: results from a nationwide longitudinal study in China

ObjectiveThis study was conducted to examine the causal association between exercise and the risk of dementia among older Chinese adults.DesignLongitudinal population-based study with a follow-up duration of 9 years.SettingData for the Chinese Longitudinal Healthy Longevity Survey waves occurring from 2002 to 2011–2012 were extracted from the survey database.ParticipantsIn total, 7501 dementia-free subjects who were older than 65 years were included at baseline. Dementia was defined as a self-reported or proxy-reported physician’s diagnosis of the disease.Outcome measures and methodsRegular exercise and potential confounding variables were obtained via a self-report questionnaire. We generated longitudinal logistic regression models based on time-lagged generalised estimating equation to examine the causal association between exercise and dementia risk.ResultsOf the 7501 older Chinese people included in this study, 338 developed dementia during the 9-year follow-up period after excluding those who were lost to follow-up or deceased. People who regularly exercised had lower odds of developing dementia (OR=0.53, 95% CI 0.33 to 0.85) than those who did not exercise regularly.ConclusionRegular exercise was associated with decreased risk of dementia. Policy-makers should develop effective public health programmes and build exercise-friendly environments for the general public.

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Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00648-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Hossein Farhadnejad ◽

Karim Parastouei ◽

Hosein Rostami ◽

Parvin Mirmiran ◽

Fereidoun Azizi

Keyword(s):

Metabolic Syndrome ◽

Positive Association ◽

Population Based ◽

Population Based Study ◽

Logistic Regression Models ◽

Increased Risk ◽

Confounding Variables ◽

Adjusted Model ◽

Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

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Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

Journal of Neurology ◽

10.1007/s00415-019-09584-7 ◽

2019 ◽

Vol 267 (1) ◽

pp. 259-266

Author(s):

Aleksander H. Erga ◽

Guido Alves ◽

Ole Bjørn Tysnes ◽

Kenn Freddy Pedersen

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Short Form ◽

Population Based ◽

Self Report ◽

Cognitive Changes ◽

Compulsive Behaviors ◽

Changes Over Time ◽

Over Time

Abstract The longitudinal course of ICBs in patients with Parkinson’s disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson’s disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive–Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1–5.6; p = 0.022) and 5.1 (95% CI 2.4–11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91–0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56–10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.

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Cardiovascular health and near visual impairment among older adults in the Republic of Congo: a population-based study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa304 ◽

2020 ◽

Author(s):

Antoine Gbessemehlan ◽

Catherine Helmer ◽

Cécile Delcourt ◽

Farid Boumediene ◽

Bébène Ndamba-Bandzouzi ◽

...

Keyword(s):

Older Adults ◽

Visual Acuity ◽

Visual Impairment ◽

Cardiovascular Health ◽

Central Africa ◽

Population Based ◽

Sub Saharan Africa ◽

Logistic Regression Models ◽

Sub Saharan

Abstract Background Visual impairment (VI) and determinants of poor cardiovascular health are very common in sub-Saharan Africa. However, we do not know whether these determinants are associated to VI among older adults in this region. This study aimed at investigating the association between the determinants of poor cardiovascular health and near VI among older adults living in Congo. Methods Participants were Congolese older adults aged ≥ 65 years included in EPIDEMCA-FU (Epidemiology of Dementia in Central Africa - Follow-up) population-based cohort. Near VI was defined as visual acuity < 20/40 measured at 30 cm. Associations between determinants of poor cardiovascular health collected at baseline and near visual acuity measured at 1 st follow-up were investigated using multivariable logistic regression models. Results Among the 549 participants included, 378 (68.8% [95% Confidence Interval: 64.9%-72.7%]) had near VI. Of the determinants of poor cardiovascular health explored, we found that having high BMI ≥ 25 kg/m 2 (Odds Ratio= 2.15 [95% CI: 1.25–3.68]), diabetes (OR=2.12 [95% CI: 1.06–4.25]) and hypertension (OR=1.65 [95% CI: 1.02–2.64]) were independently associated with near VI. Conclusions Several determinants of poor cardiovascular health were associated to near VI in this population. This study suggests that promoting a good cardiovascular health could represent a target for VI prevention among older adults.

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Personality-Related Determinants of Subtle Cognitive Decline in Old Age: A Population-Based Study

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000441388 ◽

2016 ◽

Vol 6 (1) ◽

pp. 120-132 ◽

Cited By ~ 1

Author(s):

Cristelle Rodriguez ◽

Emiliano Albanese ◽

Alan Pegna ◽

Simona Toma ◽

Marine Ackermann ◽

...

Keyword(s):

Cognitive Decline ◽

Protective Factor ◽

Brain Aging ◽

Population Based ◽

Community Dwelling ◽

Personality Factors ◽

Healthy Controls ◽

Logistic Regression Models ◽

Healthy Elderly

Background/Aims: Recent studies of cases with mild cognitive impairment (MCI) suggested that besides Alzheimer disease (AD)-related biomarkers, some personality dimensions are associated with progression to AD. To date, there are no studies addressing the psychological determinants of subtle cognitive decline in healthy elderly controls. Methods: 488 community-dwelling healthy controls were assessed with a detailed neuropsychological battery at baseline and an 18-month follow-up. Personality factors and facets were investigated at baseline using the NEO-Personality Inventory-Revised (NEO-PI-R). Upon follow-up, there were 264 stable controls (sCON) and 224 deteriorating controls (dCON). Their personality data were compared to those of the 102 MCI cases using one-way analysis of variance and logistic regression models. Results: Significantly higher scores of Openness factor (as well as Aesthetics, Ideas and Values facets) were found in sCON than in both dCON and MCI cases. The three groups did not differ in the other NEO-PI-R factor and facet scores. Openess factor (and the same facets) was associated with cognitive preservation in healthy controls (OR: 0.72, 95% CI: 0.59, 0.87). Lower scores in the same factor and facets conferred higher risk to have MCI (OR: 0.61, 95% CI: 0.46, 0.79). Conclusion: Higher openness to new experiences and thoughts may be a protective factor against early cognitive decline in brain aging.

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Change in Working Time in a Population-Based Cohort of Patients With Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2011.41.4375 ◽

2012 ◽

Vol 30 (23) ◽

pp. 2853-2860 ◽

Cited By ~ 24

Author(s):

Marie Høyer ◽

Karin Nordin ◽

Johan Ahlgren ◽

Leif Bergkvist ◽

Mats Lambe ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Diagnosis ◽

Sociodemographic Factors ◽

Population Based ◽

Working Time ◽

Full Time ◽

Logistic Regression Models ◽

Work Limitations ◽

Quality Register

Purpose We examined changes in working time 16 months after a breast cancer diagnosis and identified factors associated with job discontinuation and/or decreased working time. Patients and Methods This was a population-based cohort study with 735 patients identified in the Regional Breast Cancer Quality Register of Central Sweden. The study sample consisted of 505 women (age < 63 years at diagnosis) who completed questionnaires at baseline and at follow-up (on average 4 and 16 months after diagnosis, respectively). Clinical register data and questionnaire data on sociodemographic factors were obtained at baseline. Self-reported work-related data were obtained at follow-up. Odds ratios were estimated by using logistic regression models. Results Compared with prediagnosis working time, 72% reported no change in working time, 2% reported an increase, 15% reported a decrease, and 11% did not work at follow-up. Chemotherapy increased the likelihood (odds ratio [OR], 2.45; 95% CI, 1.38 to 4.34) of job discontinuation/decreased working time. Among chemotherapy recipients, associated factors included full-time work prediagnosis (OR, 3.25; 95% CI, 1.51 to 7.01), cancer-related work limitations (OR, 5.26; 95% CI, 2.30 to 12.03), and less value attached to work (OR, 3.69; 95% CI, 1.80 to 7.54). In the nonchemotherapy group, older age (OR, 1.09; 95% CI, 1.02 to 1.17) and less value attached to work (OR, 5.00; 95% CI, 2.01 to 12.45) were associated with the outcome. Conclusion The majority of women treated for breast cancer returned to their prediagnosis working time. Chemotherapy and cancer-related work limitations are important factors to take into account in identifying women in need of support. Moreover, it is important to consider the woman's own valuation of labor market participation.

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Age, gender, and residence differences in prevalence and patterns of multimorbidity among older Chinese: Evidence from Chinese Longitudinal Healthy Longevity Survey

10.21203/rs.3.rs-1246294/v1 ◽

2022 ◽

Author(s):

Siyue Han ◽

Guangju Mo ◽

Tianjing Gao ◽

Qing Sun ◽

Huaqing Liu ◽

...

Keyword(s):

Older Adults ◽

Chronic Diseases ◽

Functional Decline ◽

Self Report ◽

Care Utilization ◽

Rule Mining ◽

Demographic Differences ◽

Healthy Longevity ◽

Older Chinese ◽

Multimorbid Patients

Abstract Background With the dramatic acceleration of ageing in China, multimorbidity among the older adults has become increasingly common，which are associated with more functional decline and higher health care utilization and mortality. Understanding demographic differences of patterns of multimorbidity is in favor of making targeted intervention strategies. The purpose of this study was to reveal age- specific, gender- specific, and residence- specific prevalence and patterns of multimorbidity among older adults in China. Methods The present analysis is based on the 2018 wave of Chinese Longitudinal Health Longevity Survey (CLHLS). We selected 13 chronic diseases from the CLHLS survey, and information was collected based on self-report. Multimorbidity was defined as the coexistence of two or more chronic diseases from 13 chronic diseases in the same individual. Descriptive statistical analysis was used to examine multimorbidity according to age, sex, and residence. Patterns and trends of chronic disease pairs and multimorbidity were explored using association rule mining. Results 9,660 individuals aged 65-117 years in the CLHLS were analyzed in this study. Overall, 74.4% of all participants had one or more morbidities, and 42.4% were multimorbid. The prevalence of individual chronic diseases ranged from 1.5% for cancer to 41.8% for hypertension, and each disease was often accompanied by one or more other chronic diseases. The prevalence of multimorbidity does not always increase with age. The subgroups with the highest prevalence of multimorbidity was 80-89 years old (48.2%), female (45.0%) and urban (47.2%) group. Prevalence of the hypertension- diabetes pattern decreases with age and is higher in women than in men. The prevalence of hypertension- depression pattern was at the highest among the 90-117 years and rural older adults, while the other groups were hypertension-heart disease. Moreover, it was noteworthy that the multimorbidity rate of dyslipidemia is the highest at 95.5% among the 13 chronic diseases. Conclusions The prevalence of multimorbidity among older Chinese was substantial, and patterns of multimorbidity differed in age, sex, and residence. Future efforts are needed to identify possible prevention strategies and guidelines targeted demographic differences of multimorbid patients to promote health in older adults.

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Loneliness as a risk factor for frailty transition among older Chinese people

10.21203/rs.2.14917/v5 ◽

2020 ◽

Author(s):

SHA SHA ◽

Yuebin Xu ◽

Lin Chen

Keyword(s):

Strong Predictor ◽

Frailty Index ◽

Outcome Variable ◽

Physical Frailty ◽

Healthy Longevity ◽

Increased Risk ◽

Older Chinese ◽

Definition Of ◽

High Level

Abstract Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people.Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR=0.78, 95%CI: 0.68–0.91, p<0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01–1.41, p<0.05) after 3 years and 1.34 (95%CI: 1.08–1.66, p<0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, 95%CI: 1.25–2.55, p<0.01; often loneliness: OR= 1.74, 95%CI: 1.21–2.50, p<0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants.Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.

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Loneliness Predicts Development of Pain, Fatigue, and Depression in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.3228 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 896-896

Author(s):

Victoria Powell ◽

Navasuja Kumar ◽

Mohammed Kabeto ◽

Andrzej Galecki ◽

Daniel Clauw ◽

...

Keyword(s):

Total Sample ◽

Estimating Equation ◽

Study Data ◽

Symptom Cluster ◽

Psychosocial Stressors ◽

Logistic Regression Models ◽

Increased Risk ◽

The Central Nervous System ◽

Retirement Study

Abstract Pain, fatigue, and depression form a well-recognized symptom cluster that is posited to have a shared mechanism. It is possible that chronic psychosocial stressors such as loneliness may impact the central nervous system and immune system, potentially leading to symptom cluster development. Loneliness is an increasingly recognized type of psychosocial stress, especially among older American adults. Thus, we investigated whether loneliness increased risk of developing the symptom cluster of pain, fatigue, and depression over time. Using Health and Retirement Study data from 2006 – 2016, we examined self-respondents ≥50 years-old for the presence of co-occurring pain, fatigue, and depressive symptoms surpassing threshold levels (ie., the symptom cluster). Loneliness (measured by the 3-item UCLA Loneliness Scale) at baseline was used as the predictor of interest. Of the total sample (n=11,766), n=5,956 (50.6%) had up to two complete sets of follow-up symptom cluster measurements. Logistic regression models for longitudinal data were fitted using a generalized estimating equation (GEE). After adjusting for demographic and clinical variables, loneliness strongly predicted the development of the symptom cluster (adjusted OR=3.16 (95% CI 2.77, 3.61)) as well as each component symptom (pain adjusted OR=1.54 (95% CI 1.42, 1.67); fatigue adjusted OR=1.88 (95% CI 1.74, 2.03); depression adjusted OR = 3.87 (95% CI 3.55, 4.21). Further research should investigate whether interventions targeting loneliness or other psychosocial stressors may have a role in prevention of this symptom cluster.

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Changes in insomnia subtypes in early Parkinson disease

Neurology ◽

10.1212/wnl.0000000000003540 ◽

2016 ◽

Vol 88 (4) ◽

pp. 352-358 ◽

Cited By ~ 16

Author(s):

Lena K. Tholfsen ◽

Jan P. Larsen ◽

Jörn Schulz ◽

Ole-Bjørn Tysnes ◽

Michaela D. Gjerstad

Keyword(s):

Parkinson Disease ◽

Rating Scale ◽

Estimating Equation ◽

Population Based ◽

Sleep Maintenance ◽

Statistical Measures ◽

Number Of Patients ◽

Scale Scores ◽

Drug Naïve

Objective:To examine the development of factors associated with insomnia in a cohort of originally drug-naive patients with incident Parkinson disease (PD) during the first 5 years after diagnosis.Methods:One hundred eighty-two drug-naive patients with PD derived from a population-based incident cohort and 202 control participants were assessed for insomnia before treatment initiation and were repeatedly examined after 1, 3, and 5 years. Insomnia was diagnosed according to the Stavanger Sleepiness Questionnaire. The Parkinson's Disease Sleep Scale was used to differentiate sleep initiation problems from problems of sleep maintenance. Generalized estimating equation models were applied for statistical measures.Results:The prevalence of insomnia in general was not higher in patients with PD compared to controls at the 5-year follow-up. There were changes in the prevalence of the different insomnia subtypes over the 5-year follow-up. The prevalence of solitary problems in sleep maintenance increased from 31% (n = 18) in the drug-naive patients at baseline to 49% (n = 29) after 1 year and were associated with the use of dopamine agonists and higher Montgomery-Åsberg Depression Rating Scale scores. The prevalence of solitary sleep initiation problems decreased continuously from 21% (n = 12) at baseline to 7.4% (n = 4) after 5 years; these were associated with less daytime sleepiness.Conclusions:The prevalence rates of the different insomnia subtypes changed notably in patients with early PD. The frequency of sleep maintenance problems increased, and these problems were associated with dopamine agonist use and depressive symptoms, while the total number of patients with insomnia remained stable. Our findings reflect the need for early individual assessments of insomnia subtypes and raise the possibility of intervention to reduce these symptoms in patients with early PD.

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Natural history of insomnia symptoms in the transition from childhood to adolescence: population rates, health disparities, and risk factors

SLEEP ◽

10.1093/sleep/zsaa187 ◽

2020 ◽

Author(s):

Julio Fernandez-Mendoza ◽

Elizaveta Bourchtein ◽

Susan Calhoun ◽

Kristina Puzino ◽

Cynthia K Snyder ◽

...

Keyword(s):

Risk Factors ◽

Low Socioeconomic Status ◽

Clinical History ◽

Population Based ◽

Self Report ◽

Full Remission ◽

Penn State ◽

Racial Ethnic ◽

Insomnia Symptoms

Abstract Study Objectives To determine the sociodemographic, behavioral, and clinical risk factors associated with the persistence, remission, and incidence of insomnia symptoms in the transition from childhood to adolescence. Methods The Penn State Child Cohort is a random, population-based sample of 700 children (5–12 years at baseline), of whom 421 were followed-up as adolescents (12–23 years at follow-up). Subjects underwent polysomnography, clinical history, physical exam, and parent- and self-reported scales at baseline and follow-up. Insomnia symptoms were defined as a parent- or self-report of difficulty falling and/or staying asleep. Results The 421 subjects with baseline (Mage = 8.8 years) and follow-up (Mage = 17 years) data were 53.9% male and 21.9% racial/ethnic minorities. The persistence of childhood insomnia symptoms (CIS) was 56% (95% CI = 46.5–65.4), with only 30.3% (95% CI = 21.5–39.0) fully remitting. The incidence of adolescent insomnia symptoms was 31.1% (95% CI = 25.9–36.3). Female sex, racial/ethnic minority, and low socioeconomic status as well as psychiatric/behavioral or neurological disorders, obesity, smoking, and evening chronotype were associated with a higher persistence or incidence of insomnia symptoms. Conclusions CIS are highly persistent, with full remission occurring in only a third of children in the transition to adolescence. Sex-, racial/ethnic-, and socioeconomic-related disparities in insomnia occur as early as childhood, while different mental/physical health and lifestyle/circadian risk factors play a key role in the chronicity of CIS versus their incidence in adolescence. CIS should not be expected to developmentally remit and should become a focus of integrated pediatric/behavioral health strategies.

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