355 research outputs found

    Physical, psychological, demographic and modifiable risk factors for age related cognitive impairment associated with possible dementia and frailty

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    The population of China is ageing. Accompanying this aging population, dementia and frailty have a growing importance. However there is little consensus on the association between dementia and frailty, in terms of how the criteria that are part of this two syndromes overlap, as both disorders are age-related and increase the risk for falls, further leading to loss of independence. To meet the above needs, the thesis describes research into different frailty diagnostic criteria, as well as its association with dementia symptoms. We examined cognitive measures that can be used for assessment of Mild Cognitive Impairment (MCI) and dementia screening (the Hopkins Verbal Learning Test, HVLT) and compared its discriminant ability with the commonly used cognitive screening tool, the Mini-Mental State Examination (MMSE) in distinguishing Cognitive Impairment (including MCI and dementia) from No Cognitive Impairment (NCI, normal controls) in two community-dwelling elderly Chinese populations and in one institutionalised elderly population in Shanghai, China. Subsequently we investigated whether physical and cognitive symptoms clustered together to form frailty phenotypes. We employed indicators that have been widely used to diagnose frailty, including physical measures (grip strength, Time-Up and Go test, 15 feet gait speed test and Berg balance test), and psychological measures (the HVLT and the MMSE) to predict cognitive impairment (CI) and frailty. Additionally, we described demographics (age, gender, education) and other potential modifiers when detecting cognitive impairment and functional disability. We then built up a model for possible frailty phenotype using various indicators. Lastly, we examined whether demographic (age, gender, education and profession), and lifestyle (smoking/alcohol history, exercise frequency, and dietary habit) could be used to predict future cognitive impairment. It was found that advanced age, lower education (no or primary level), and being vegetarian were significant risk factors for cognitive impairment. Furthermore, whereas high consumption of green vegetables is a protector against cognitive impairment, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China.To meet the above needs, the thesis describes research into different frailty diagnostic criteria, as well as its association with dementia symptoms. We examined cognitive measures that can be used for assessment of Mild Cognitive Impairment (MCI) and dementia screening (the Hopkins Verbal Learning Test, HVLT) and compared its discriminant ability with the commonly used cognitive screening tool, the Mini-Mental State Examination (MMSE) in distinguishing Cognitive Impairment (including MCI and dementia) from No Cognitive Impairment (NCI, normal controls) in two community-dwelling elderly Chinese populations and in one institutionalised elderly population in Shanghai, China. Subsequently we employed these two cognitive measures to investigate whether they were part of the frailty syndrome among elderly from the community-based studies. We investigated whether physical and cognitive symptoms clustered together to form frailty phenotypes. We employed indicators that have been widely used to diagnose frailty, including physical measures (grip strength, Time-Up and Go test, 15 feet gait speed test and Berg balance test), and psychological measures (the HVLT and the MMSE) to predict cognitive impairment (CI). We found four distinct subtypes of elderly characterised by increasing care needs: 1. Persona elderly as defined by age >78, year of education12.7 seconds and 15 feet gait speed >4.4 seconds; 3. Persona Cognitive impairment, defined by a MMSE total score <25, a HVLT Immediate Recall (IR) score <15, and a HVLT Delayed Recall (DR) <5; 4. Persona Physical frailty (balance,) defined by a Berg Balance test score of <53. Additionally, we described demographics (age, gender, education) and other potential modifiers when detecting cognitive impairment and functional disability. We then built up a model for possible frailty phenotype using various indicators, Frailty here was defined as: 1.Low BMI as measured by this algorithm: BMI= Weight (kg)/Height (m)2 2.Weakness (upper and lower body): grip strength in the lowest quintile, adjusted for gender; and TUG get up with assistance or unable to get up 3.Slowness (lower body): TUG score in the lowest quintile, adjusted for gender; and 15 feet gait speed in the lowest quintile, adjusted for gender; 4.Poor balance: Berg Balance test score in the lowest quintile, adjusted for gender; 5.Low physical activity: engaging in exercise less than once per week. An individual with 4 or more present frailty components out of a total of 7 was considered to be frail , whereas equal or less than 3 characteristics were hypothesized to be pre-frail . Those with no present frailty components were considered as robust. Lastly, we examined whether demographic (age, gender, education and profession), and lifestyle (smoking/alcohol history, exercise frequency, and dietary habit) could be used to predict future cognitive impairment (as defined by a HVLT IR score of ≤19). The results of our studies show that compared to the MMSE, the HVLT is superior in differentiating MCI and dementia from NCI, and is also less affected by demographic factors in detecting frailty. Furthermore, in the current study, physical, psychological, demographic and other modifiable risk factors cluster together into different phenotypes of cognitive impairment and functional disability in these cohorts. A phenotype of frailty is built up using BMI, grip strength, TUG, 15 feet gait speed, balance and exercise frequency as indicators. The most common was the elderly phenotype followed by the cognitively impaired. A novel finding of the current study is that only 4.8% (8 out 168) of the whole sample fulfilled all three categories in the current study (cognitive impairment, functional disability and frailty). Finally, advanced age, lower education (no or primary level), and being vegetarian were significant risk factors for cognitive impairment. Furthermore, whereas high consumption of green vegetables is a protector against cognitive impairment, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China

    Tofu intake is associated with poor cognitive performance among community-dwelling elderly in China

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    © 2015 IOS Press and the authors. All rights reserved.Tofu is a soy product which is commonly consumed in Asian countries, such as China and Indonesia. Several studies found negative associations of high tofu consumption with cognitive function in older Asian populations. However, the effect of tofu on cognitive function remains disputed as it was not found in Western populations. In the present study, the effect of weekly tofu intake on cognitive performance was investigated in an observational cross sectional study of 517 Chinese elderly from Shanghai. Similar to earlier studies, results showed that a higher weekly intake of tofu was associated with worse memory performance using the Hopkins Verbal Learning Test (β =-0.10, p = 0.01) after controlling for age, gender, education, being vegetarian, and weekly intake of fruit/juice, green vegetables, and orange/red vegetables. Furthermore, among older elderly (≥68 years of age), high tofu intake increased the risk of cognitive impairment indicative of dementia (OR = 1.27, 95% CI = 0.99-1.64, p = 0.04), after adjusting for all covariates. Consumption of meat and green vegetables independently also reduced risk of dementia. To conclude, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China. Similar findings were reported in Indonesia and in Japanese Americans in the US. These findings suggest that the effect of tofu on cognition in elderly should be further investigated

    Risk factors for possible dementia using the Hopkins verbal learning test and the mini-mental state examination in Shanghai

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    Using a combination of the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental State Examination (MMSE), we investigated the prevalence of possible dementia (DEM) in community-dwelling elderly in Shanghai. Subsequently, we investigated significant risk factors for DEM and generated a DEM self-checklist for early DEM detection and case management. We found that among a total of 521 participants using a HVLT cut-off score of <19 and a MMSE cut-off score of <24, a total of 69 DEM cases were identified. Risk factors, such as advanced age (≥68 years), low education (no or primary level), self-reported history of hypertension, and self-reported subjective memory complaints (SMC) were significantly predictive of DEM. The presence of ≥3 out of four of the above mentioned risk factors can effectively discriminate DEM cases from non-DEM subjects

    Cluster analysis of physical and cognitive ageing patterns in older people from Shanghai

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    This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no problems with ADL. Twenty-eight percent of participants needed help with ADL, with the majority of this group being over 80 years of age. Significant predictors of reductions in functional independence included age, balance, global cognitive function (MMSE) and the gait measures. Cluster analysis revealed a protective effect of education on cognitive function that did not appear to extend to physical function. Consistency of such phenotypes of ageing clusters in other cohort studies may provide helpful models for dementia and frailty prevention measures

    Lusin-type approximation of Sobolev by Lipschitz functions, in Gaussian and RCD(K,)RCD(K,\infty) spaces

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    We establish new approximation results, in the sense of Lusin, of Sobolev functions by Lipschitz ones, in some classes of non-doubling metric measure structures. Our proof technique relies upon estimates for heat semigroups and applies to Gaussian and RCD(K,)RCD(K, \infty) spaces. As a consequence, we obtain quantitative stability for regular Lagrangian flows in Gaussian settings

    Understanding the Reaction Mechanism of Nickel-Catalyzed Enantioselective Arylative Activation of the Aromatic C–O Bond

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    Mild synthetic methods to transform aromatic carbon–oxygen (C–O) bonds into useful molecules have great potential in renewable biomass conversion. Recently, a Ni–NHC (N-heterocyclic carbene) complex catalyzing an asymmetric ring-opening reaction of dinaphthofuran with PhMgCl at room temperature was reported. In this work, we carried out density functional theory (DFT) calculations to investigate the detailed mechanism. The DFT results reveal a novel mechanism that involves Mg(II)–O coordination followed by migration of the phenyl nucleophile to the Ni(0) metal center prior to oxidative addition of a C–O bond to Ni(0). Insights into how the chiral NHC ligand helps induce the enantioselectivity have been obtained

    Homoleptic Rare-Earth Aryloxide Based Lewis Pairs for Polymerization of Conjugated Polar Alkenes

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    An efficient Lewis pair polymerization of conjugated polar alkenes utilizing simple, homoleptic rare-earth aryloxides with a combination of phosphines and N-heterocyclic carbenes was developed. The polymerizations were found to be active for Lewis acids across the full range of rare-earth metals, and the catalytic activities were observed to be dependent on the ionic radii of the rare-earth metals and the steric and electronic profiles of the Lewis bases. For the methyl methacrylate polymerization, a syndiotactic polymer was produced with an <i>rr</i> value of up to 85%. This rare-earth Lewis pair polymerization system was also found to be effective on more challenging acrylates and acrylamide monomers, such as <i>tert</i>-butyl methacrylate, furfuryl methacrylate, and <i>N,N</i>-dimethylacrylamide. In the case of furfuryl methacrylate, the polymerization proceeded in a controlled manner with a high initiation efficiency. FLP-type addition was confirmed as the initiating step by stoichiometric reactions producing the zwitterionic active species and an end-group analysis

    Distribution of observed gender-specific overall crossover frequency in 22 autosomes

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    <p><b>Copyright information:</b></p><p>Taken from "A variance component analysis on recombination rate in the COGA pedigrees"</p><p></p><p>BMC Genetics 2005;6(Suppl 1):S58-S58.</p><p>Published online 30 Dec 2005</p><p>PMCID:PMC1866725.</p><p></p

    Additional file 1 of Association between obesity, physical activity, and cognitive decline in Chinese middle and old-aged adults: a mediation analysis

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    Supplementary Material 1: Table S1. Permutations of trajectory groups of cognitive function scores and corresponding Bayesian Information Criterion. Table S2. The participants' characteristics according to the cognitive function trajectory groups. Table S3. Association between lipid metabolites with trajectories of cognitive function. Figure S1. Trajectories of the cognitive function score and its five measures (immediate word recall, delayed word recall, orientation, visuo-construction, and attention). The solid lines mean estimated values and the dotted lines display the 95% CI

    Error Accumulations in Adhesive Energies of Dihydrogen Molecular Chains: Performances of the XYG3 Type of Doubly Hybrid Density Functionals

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    We have systematically analyzed the error accumulations in the adhesive energies for a series of hydrogen molecular chains calculated by various kinds of density functional theory (DFT) methods. In particular, we have focused on some representative doubly hybrid (DH) functionals of either the B2PLYP type (B2PLYP, B2PLYP-D, and B2GP-PLYP) or the XYG3 type (XYG3, XYGJ-OS, and xDH-PBE0). The hydrogen molecular chain models have recently been proposed by Zheng et al. (<i>J. Chem. Phys.</i> <b>2012</b>, <i>137</i>, 214106) to identify the delocalization errors (DEs) in thermodynamic properties. From the perspective of DEs, it is shown here that the XYG3 type of DH functionals yield good performance on the calculated adhesive energies due to the minimizing effects of DEs, highlighting the underlying physics for the successes or failures of the approximate functionals. Examination was also extended to HF-DFT, where DFT energies are evaluated with the Hartree–Fock (HF) densities
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