Protein Intake and Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis

Introduction: The present study investigated the association between protein intake and cognitive function in older adults. Methods: We performed a literature search with no restriction on publication year in MEDLINE, SCOPUS, CINAHL, AgeLine from inception up to October 2020. Observational studies that investigated as a primary or secondary outcome the association of protein intake and cognitive function in older adults aged ⩾60 years were included. Results: Nine cross-sectional studies that investigated a total of 4929 older adults were included in the qualitative analysis. Overall cognitive function was examined in 6 studies. Four investigations reported null associations and 2 studies found that older adults with a high protein intake had higher global cognitive function than their counterparts. Results from the meta-analysis suggested that there were no significant associations between protein consumption and global cognitive function in older adults, regardless of gender. Three studies investigated other cognitive domains. Memory and protein intake were significantly and positively correlated in all studies. In addition, visuospatial, verbal fluency, processing speed, and sustained attention were positively associated with protein consumption in 1 study each. Conclusion: No significant associations between protein intake and global cognitive function were observed in neither qualitative nor quantitative analyses. The association between protein consumption with multiple other cognitive domains were also tested. As a whole, 3 studies reported a positive and significant association between high protein intake and memory, while 1 study observed a significant and positive association with visuospatial, verbal fluency, processing speed, and sustained attention.

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Effects of physical exercise on cognitively impaired older adults: a meta-analysis of randomized control trials

10.21203/rs.3.rs-15634/v1 ◽

2020 ◽

Author(s):

Lenka Sontakova ◽

Alzbeta Bartova ◽

Klara Dadova ◽

Iva Holmerova ◽

Michal Steffl

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Physical Exercise ◽

Cognitive Functions ◽

Cognitive Impairments ◽

Meta Analysis ◽

Randomized Control Trials ◽

Global Cognitive Function ◽

Randomized Control

Abstract Objectives: The main aim of this meta-analysis was to compare the effects of different physical activities on cognitive functions in older adults divided according to cognitive impairment levels. Methods: We searched Web of Science, Scopus, and PubMed for randomized control trials (RCT). A standardized mean difference (SMD) of the pre-post intervention score of global cognitive function tests were calculated by the random model in the Cochrane meta-analyses for people with cognitive impairment generally and across three levels - mild, mild to moderate, and moderate to severe cognitive impairment separately. Additionally, an unstandardized coefficient beta (B) was calculated in generalized linear models to estimate the effects of exercise, cognitive impairment severity, age, female ratio, length of intervention, and time of exercise a week on the global cognitive function. Results: Data from 26 studies involving 1,137 participants from intervention groups and 1,187 participants from control groups were analyzed. Physical exercise had a positive effect on cognitive functions in people across all levels of cognitive impairments SMD (95 % confidence interval [CI]) = 1.19 (0.77 - 1.62); however, heterogeneity was considerably high I 2 = 95%. Aerobic (B = 8.881) and resistance exercise (B = 4.464) was significantly associated with better results in global cognitive functions when compared to active control. A higher number of female participants cin intervention groups had a statistically significant effect on the global cognitive function (B = 0.229). onclusions: Physical exercise was associated with cognitive function improvement in older people with cognitive impairments. Aerobic exercise was more strongly associated than resistance exercise to combat cognitive decline. Keywords: Physical activity, Dementia, Aging, Meta-analysis, Aerobic exercise, Cognitive function

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Impact of Virtual Reality-Based Therapies on Cognition and Mental Health of Stroke Patients: Systematic Review and Meta-analysis

Journal of Medical Internet Research ◽

10.2196/31007 ◽

2021 ◽

Vol 23 (11) ◽

pp. e31007

Author(s):

Qi Zhang ◽

Yu Fu ◽

Yanhui Lu ◽

Yating Zhang ◽

Qifang Huang ◽

...

Keyword(s):

Mental Health ◽

Virtual Reality ◽

Executive Function ◽

Cognitive Function ◽

Verbal Fluency ◽

Meta Analysis ◽

Cochrane Library ◽

Visuospatial Function ◽

Global Cognitive Function

Background Stroke remains one of the major chronic illnesses worldwide that health care organizations will need to address for the next several decades. Individuals poststroke are subject to levels of cognitive impairment and mental health problems. Virtual reality (VR)-based therapies are new technologies used for cognitive rehabilitation and the management of psychological outcomes. Objective This study performed a meta-analysis to evaluate the effects of VR-based therapies on cognitive function and mental health in patients with stroke. Methods A comprehensive database search was performed using PubMed, MEDLINE (Ovid), Embase, Cochrane Library, and APA PsycINFO databases for randomized controlled trials (RCTs) that studied the effects of VR on patients with stroke. We included trials published up to April 15, 2021, that fulfilled our inclusion and exclusion criteria. The literature was screened, data were extracted, and the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.3 software. Results A total of 894 patients from 23 RCTs were included in our meta-analysis. Compared to traditional rehabilitation therapies, the executive function (standard mean difference [SMD]=0.88, 95% confidence interval [CI]=0.06-1.70, P=.03), memory (SMD=1.44, 95% CI=0.21-2.68, P=.02), and visuospatial function (SMD=0.78, 95% CI=0.23-1.33, P=.006) significantly improved among patients after VR intervention. However, there were no significant differences observed in global cognitive function, attention, verbal fluency, depression, and the quality of life (QoL). Conclusions The findings of our meta-analysis showed that VR-based therapies are efficacious in improving executive function, memory, and visuospatial function in patients with stroke. For global cognitive function, attention, verbal fluency, depression, and the QoL, further research is required. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42021252788; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252788

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Cognitive function in clinical burnout: a systematic review and meta-analysis

10.31234/osf.io/n2htg ◽

2021 ◽

Author(s):

Hanna Malmberg Gavelin ◽

Magdalena E Domellöf ◽

Elisabeth Åström ◽

Andreas Nelson ◽

Nathalie H Launder ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Function ◽

Cognitive Dysfunction ◽

Processing Speed ◽

Health Management ◽

Meta Analysis ◽

Healthy Controls ◽

Short Term ◽

Cognitive Domains ◽

Visuospatial Abilities

Clinical burnout has been associated with impaired cognitive functioning; however, previous findings have been heterogeneous and the specific domains that are affected and the magnitude of impairment is unclear. The aim of this systematic review and multivariate meta-analysis was to assess cognitive function in clinical burnout and identify the pattern and severity of cognitive dysfunction across cognitive domains. We identified 17 studies encompassing 730 patients with clinical burnout and 649 healthy controls. Clinical burnout was associated with small to moderate impairments in episodic memory (g = -0.36, 95 % CI -0.57 to -0.15), short-term and working memory (g = -0.36, 95 % CI -0.52 to -0.20), executive function (g = -0.39, 95 % CI -0.55 to -0.23), attention and processing speed (g = -0.43, 95 % CI -0.57 to -0.29) and fluency (g = -0.53, 95 % CI -1.04 to -0.03). There were no differences between patients and controls in crystallized (k = 6 studies) and visuospatial abilities (k = 4). Our findings suggest that clinical burnout is associated with cognitive impairment across multiple cognitive domains. Cognitive dysfunction needs to be considered in the clinical and occupational health management of burnout to optimize rehabilitation and prognosis.

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Relative Protein Intake and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Nutrients ◽

10.3390/nu10091330 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1330 ◽

Cited By ~ 31

Author(s):

Hélio Coelho-Júnior ◽

Luiz Milano-Teixeira ◽

Bruno Rodrigues ◽

Reury Bacurau ◽

Emanuele Marzetti ◽

...

Keyword(s):

Older Adults ◽

Physical Function ◽

Physical Functioning ◽

Protein Intake ◽

Observational Studies ◽

Meta Analysis ◽

High Protein ◽

High Protein Intake ◽

Low Protein ◽

Very High

(1) Background: The present work aims to conduct a systematic review and meta-analysis of observational studies, in order to investigate the association of relative protein intake and physical function in older adults; (2) Methods: Observational studies, that investigated the association between protein intake and physical function in older adults, were retrieved from MEDLINE, SCOPUS, CINAHL, AgeLine, EMBASE, and Cochrane-CENTRAL. Two independent researchers conducted study selection and data extraction; (3) Results: Very high protein intake (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) groups showed better lower limb physical functioning and walking speed (WS) performance, respectively, in comparison to individuals who present relative low protein (<0.80 g/kg/day) intake. On the other hand, relative high protein intake does not seem to propitiate a better performance on isometric handgrip (IHG) and chair rise in comparison to relative low protein intake. In addition, there were no significant differences in the physical functioning of high and middle protein intake groups; (4) Conclusions: In conclusion, findings of the present study indicate that a very high (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) are associated with better lower-limb physical performance, when compared to low protein (<0.80 g/kg/day) intake, in community-dwelling older adults. These findings act as additional evidence regarding the potential need to increase protein guidelines to above the current recommendations. However, large randomized clinical trials are needed to confirm the addictive effects of high-protein diets (≥1.0 g/kg/day) in comparison to the current recommendations on physical functioning. All data are available in the Open ScienceFramework.

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Plasma Long Chain Fatty Acids and Cognitive Function in Older Adults: A Comparison of Statistical Analyses

Innovation in Aging ◽

10.1093/geroni/igab046.048 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 13-13

Author(s):

Caroline Duchaine ◽

Pierre-Hugues Carmichael ◽

Nancy Presse ◽

Alexandra Fiocco ◽

Pierrette Gaudreau ◽

...

Keyword(s):

Older Adults ◽

Fatty Acids ◽

Cognitive Function ◽

Sex Education ◽

Processing Speed ◽

Verbal Memory ◽

Successful Aging ◽

Omega 3 ◽

Cognitive Domains ◽

Long Chain

Abstract Omega-3 fatty acids (FAs) have been suggested as modifiable protective factors for cognitive decline because of their neuroprotective properties. However, the evidence is still inconsistent regarding types of omega-3 FAs, and the probable interrelation with other circulating long chain FAs (LCFAs). This study aimed to evaluate associations between 14 plasma LCFAs and four cognitive domains using a principal component analysis (PCA) and to compare results with those obtained using standard methods. A group of 386 healthy older adults aged 77 ± 4 years (53% women), selected from the NutCog Study, a sub-study from the Québec cohort on Nutrition and Successful Aging (NuAge), underwent a cognitive evaluation and fasting blood sampling. Verbal and non-verbal episodic memory, executive functioning, and processing speed were evaluated using validated tests. LCFAs circulating concentrations were measured by high-performance liquid chromatography using published procedures. Linear regressions adjusted for age, sex, education, and BMI were used to evaluate cross-sectional associations between LCFAs, using PCA or a more standard grouping (omega-3, omega-6, monounsaturated, and saturated LCFAs), and cognitive performance. Higher scoring on the omega-3 PCA factor and higher concentrations of total omega-3 FAs were both associated with better episodic non-verbal memory and processing speed. Higher eicosapentaenoic acid (EPA omega-3) was also associated with these two cognitive domains and with episodic verbal memory. The associations with total omega-3 FAs taken separately were of smaller magnitude than those with PCA. These results suggest that omega-3 FAs should be considered in combination with other LCFAs when evaluating the association with cognitive function.

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The Effect of Curcumin Differs on Individual Cognitive Domains across Different Patient Populations: A Systematic Review and Meta-Analysis

Pharmaceuticals ◽

10.3390/ph14121235 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1235

Author(s):

I-Chen Tsai ◽

Chih-Wei Hsu ◽

Chun-Hung Chang ◽

Ping-Tao Tseng ◽

Ke-Vin Chang

Keyword(s):

Working Memory ◽

Placebo Group ◽

Cognitive Function ◽

Processing Speed ◽

Verbal Memory ◽

Meta Analysis ◽

Visual Learning ◽

Clinical Effectiveness ◽

Cognitive Domains ◽

Significant Difference

Curcumin is a polyphenol with strong antioxidant and anti-inflammatory effects that has been shown to be effective in ameliorating cognitive decline in animal studies. However, its clinical effectiveness is inconclusive, and relevant gastrointestinal adverse events (AEs) have been reported. The aim of this meta-analysis was to summarize the existing evidence from randomized controlled trials (RCTs) of effects of curcumin on overall cognitive function, individual cognitive domains, and gastrointestinal AE. The study includes 8 RCTs and 389 participants. A random-effects model was used for the meta-analysis. Compared with the placebo group, the curcumin group was associated with an improvement in working memory (Hedges’ g = 0.396, 95% confidence interval (CI) = 0.078 to 0.714, p = 0.015) and a borderline benefit in processing speed (Hedges’ g = 0.303, 95% CI = ‒0.013 to 0.619, p = 0.06). In the domains of language, episodic memory/visual learning, verbal memory, cognitive flexibility/problem solving, and overall cognitive function, no significant difference existed for the comparison between the curcumin and placebo groups. The curcumin group had a significantly higher risk of gastrointestinal AEs than the placebo group (odds ratio = 3.019, 95% CI = 1.118 to 8.150, p = 0.029). In the future, the effects of curcumin on working memory, processing speed, and gastrointestinal AE should be further investigated.

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Impact of Virtual Reality-Based Therapies on Cognition and Mental Health of Stroke Patients: Systematic Review and Meta-analysis (Preprint)

10.2196/preprints.31007 ◽

2021 ◽

Author(s):

Qi Zhang ◽

Yu Fu ◽

Yanhui Lu ◽

Yating Zhang ◽

Qifang Huang ◽

...

Keyword(s):

Mental Health ◽

Virtual Reality ◽

Executive Function ◽

Cognitive Function ◽

Verbal Fluency ◽

Meta Analysis ◽

Cochrane Library ◽

Visuospatial Function ◽

Global Cognitive Function

BACKGROUND Stroke remains one of the major chronic illnesses worldwide that health care organizations will need to address for the next several decades. Individuals poststroke are subject to levels of cognitive impairment and mental health problems. Virtual reality (VR)-based therapies are new technologies used for cognitive rehabilitation and the management of psychological outcomes. OBJECTIVE This study performed a meta-analysis to evaluate the effects of VR-based therapies on cognitive function and mental health in patients with stroke. METHODS A comprehensive database search was performed using PubMed, MEDLINE (Ovid), Embase, Cochrane Library, and APA PsycINFO databases for randomized controlled trials (RCTs) that studied the effects of VR on patients with stroke. We included trials published up to April 15, 2021, that fulfilled our inclusion and exclusion criteria. The literature was screened, data were extracted, and the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.3 software. RESULTS A total of 894 patients from 23 RCTs were included in our meta-analysis. Compared to traditional rehabilitation therapies, the executive function (standard mean difference [SMD]=0.88, 95% confidence interval [CI]=0.06-1.70, P=.03), memory (SMD=1.44, 95% CI=0.21-2.68, P=.02), and visuospatial function (SMD=0.78, 95% CI=0.23-1.33, P=.006) significantly improved among patients after VR intervention. However, there were no significant differences observed in global cognitive function, attention, verbal fluency, depression, and the quality of life (QoL). CONCLUSIONS The findings of our meta-analysis showed that VR-based therapies are efficacious in improving executive function, memory, and visuospatial function in patients with stroke. For global cognitive function, attention, verbal fluency, depression, and the QoL, further research is required. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42021252788; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252788

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Watching TV and Cognition: The SPAH 2-Year Cohort Study of Older Adults Living in Low-Income Communities

Frontiers in Neurology ◽

10.3389/fneur.2021.628489 ◽

2021 ◽

Vol 12 ◽

Author(s):

Laís Fajersztajn ◽

Vanessa Di Rienzo ◽

Carina Akemi Nakamura ◽

Marcia Scazufca

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Low Income ◽

Verbal Fluency ◽

Regression Models ◽

Leisure Activities ◽

Immediate Memory ◽

Global Cognitive Function ◽

Watching Tv

Watching TV is a highly prevalent leisure activity among older adults and, in many cases, the only leisure option of those living in low-income communities. While engaging in leisure activities have proven to protect older adults from cognitive decline, the effects of watching TV on cognition of this population is controversial in the literature. This study investigated the impact of watching TV on global cognitive function, immediate memory, verbal fluency, risk of dementia of amnestic mild cognitive impairment (aMCI) in a cohort of older adults residents of socioeconomically deprived areas of São Paulo, Brazil. We used data from the São Paulo Aging & Health Study (SPAH). Participants aged 65 years or over, with no dementia diagnosis at baseline and who completed the 2-year follow-up assessment were included in this study (n = 1,243). Multivariable linear regression models were performed to assess the effect of watching TV on global cognitive function, immediate memory and verbal fluency. Multivariable logistic regression models were used to evaluate the risk of developing dementia and aMCI. Models were controlled by cognitive performance at baseline, sociodemographic characteristics and functional status. Cognitive performance at baseline and follow-up were similar. Thirty-one participants were diagnosed with dementia, and 23 with aMCI 24 months after inclusion in the study. Watching TV did not show any positive or negative effect on global cognitive function, immediate memory, verbal fluency, risk of dementia and risk of aMCI. It is good news that watching TV did not predict the decline in cognition in elders. However, it is essential to increase opportunities for other leisure activities for low-income and low-educated older adults if we do consider that leisure activities protect cognition decline in older adults. In the coming decades, developing countries will experience the highest burden of dementia and more than fun, public policies to promote leisure activities might be a strategy to alleviate this burden shortly.

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Weight Status Influences Carotid Intima-Media Thickness to Executive Function Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1183 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 367-368

Author(s):

Desiree Bygrave ◽

Regina Wright

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Verbal Fluency ◽

Weight Status ◽

Carotid Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Overweight And Obesity ◽

Media Thickness

Abstract Carotid atherosclerosis has emerged as an early predictor of reduced cognitive function. Underlying this association are risk factors, such as overweight and obesity, that promote carotid atherosclerosis and poor cognitive outcomes. Given the prevalence of overweight and obesity among older adults, there is a critical need to better understand how atherosclerosis influences cognitive function in the context of elevated weight. To address this gap, the current study examined relations between carotid atherosclerosis (carotid intima-media thickness [IMT]), and attention (Trailmaking Test) and executive function (Verbal Fluency Test) performance, and whether they varied as a function of weight status (body mass index [BMI] classification). Data were analyzed from 162 older adults (mean age = 68.43y, 34% male, 41% African American), free of major disease. Mutliple regression and analysis of variance analyses, adjusted for age, sex, education and mean arterial pressure, showed a statistically significant IMT x BMI interaction for Verbal Fluency performance (p=.04) and a trending IMT x BMI interaction for Trailmaking A performance (p=.05). Simple effects analysis of IMT and Verbal Fluency performance showed that this association was most pronounced among those who are obese. Findings suggest atherosclerosis may influence executive function in the context of obesity among older adults. As the development of carotid atherosclerosis is strongly related to aging, our findings suggest that maintaining a healthy weight may reduce its impact on executive function in older adulthood.

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Orientation and verbal fluency in the English Longitudinal Study of Ageing: modifiable risk factors for falls?

International Psychogeriatrics ◽

10.1017/s1041610218002065 ◽

2018 ◽

Vol 31 (10) ◽

pp. 1491-1498 ◽

Cited By ~ 3

Author(s):

T. O. Smith ◽

S. R. Neal ◽

G. Peryer ◽

K. J. Sheehan ◽

M. P. Tan ◽

...

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Verbal Fluency ◽

Functional Performance ◽

Community Dwelling ◽

Cognitive Domain ◽

Cognitive Domains ◽

Risk Factors For Falls ◽

Prospective Longitudinal ◽

English Longitudinal Study

ABSTRACTObjectives:To determine the relationship between falls and deficits in specific cognitive domains in older adults.Design:An analysis of the English Longitudinal Study of Ageing (ELSA) cohort.Setting:United Kingdom community-based.Participants:5197 community-dwelling older adults recruited to a prospective longitudinal cohort study.Measurements:Data on the occurrence of falls and number of falls, which occurred during a 12-month follow-up period, were assessed against the specific cognitive domains of memory, numeracy skills, and executive function. Binomial logistic regression was performed to evaluate the association between each cognitive domain and the dichotomous outcome of falls in the preceding 12 months using unadjusted and adjusted models.Results:Of the 5197 participants included in the analysis, 1308 (25%) reported a fall in the preceding 12 months. There was no significant association between the occurrence of a fall and specific forms of cognitive dysfunction after adjusting for self-reported hearing, self-reported eyesight, and functional performance. After adjustment, only orientation (odds ratio [OR]: 0.80; 95% confidence intervals [CI]: 0.65–0.98, p = 0.03) and verbal fluency (adjusted OR: 0.98; 95% CI: 0.96–1.00; p = 0.05) remained significant for predicting recurrent falls.Conclusions:The cognitive phenotype rather than cognitive impairmentper semay predict future falls in those presenting with more than one fall.

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