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Journal of Alzheimer's Disease : JAD 2023Physical activity (PA) has emerged as a promising approach to delay Alzheimer's disease and related dementias, but the optimal intensity of PA to improve cognitive...
BACKGROUND
Physical activity (PA) has emerged as a promising approach to delay Alzheimer's disease and related dementias, but the optimal intensity of PA to improve cognitive health remains unknown.
OBJECTIVE
To evaluate the association between duration and intensity of PA and cognitive domains (executive function, processing speed, and memory) in aging Americans.
METHODS
Linear regressions in hierarchical blocks for variable adjustment and the size of effect (η2) were analyzed by using the data of 2,377 adults (age = 69.3±6.7 years) from the NHANES 2011-2014.
RESULTS
Participants with 3-6 h/week of vigorous- and > 1 h/week of moderate-intensity PA scored significantly higher in executive function and processing speed domains of cognition compared to inactive peers (η2 = 0.005 & 0.007 respectively, p < 0.05). After adjustment, the beneficial effects of 1-3 h /week of vigorous-intensity PA became trivial for delayed recall memory domain test scores (β= 0.33; 95% CI: -0.01,0.67; η2 = 0.002; p = 0.56). There was no linear dose-response relationship between the cognitive test scores and weekly moderate-intensity of PA. Interestingly, higher handgrip strength and higher late-life body mass index were associated with a higher performance across all cognitive domains.
CONCLUSION
Our study supports habitual PA with superior cognition health in some but not all domains among older adults. Furthermore, increased muscle strength and higher late-life adiposity may also impact cognition.
Topics: Humans; Aged; Hand Strength; Nutrition Surveys; Aging; Cognition; Exercise; Physical Functional Performance; Demography
PubMed: 36847008
DOI: 10.3233/JAD-221151 -
BMC Public Health Aug 2014Domain-specific physical activities may have different correlates and health effects, but few large studies have examined these questions, especially their separate...
BACKGROUND
Domain-specific physical activities may have different correlates and health effects, but few large studies have examined these questions, especially their separate associations with adiposity.
METHODS
We analysed cross-sectional data of 466 605 adults without any prior chronic diseases, enrolled during 2004-8, from 10 diverse localities across China. Physical activity level in each of 4 domains (occupation, commuting, household, and active-recreation), calculated as metabolic equivalent (MET)-hr/day, was related to social-demographic factors and measures of adiposity (body mass index [BMI], waist circumference [WC], and bio-impedance derived percentage body fat), using multivariable linear and logistic regression models.
RESULTS
The overall mean age was 50.8 years. The mean total physical activity was 21.7 MET-hr/day, mainly from occupation (62%) and household chores (26%), but little from active-recreation (4%), with women having a much higher household activity than men. Older participants had a lower level of occupational activity but a higher level of household and active-recreational activity, particularly after retirement. There was no linear association of occupational activity with adiposity, but working women tended to have a lower adiposity (e.g. 1.0 cm WC) than non-working women. In men, there was an inverse and apparently linear association between adiposity and levels of both commuting-related and household activities, with 3 MET-hr/day associated with -0.11 and -0.13 kg/m(2) BMI, -0.42 and -0.62 cm WC, and -0.28 and -0.33 percentage points of body fat, respectively. In women, only household activity showed a linear, but weaker, association with adiposity. A higher adiposity was observed among men and women with higher levels of active-recreational activity.
CONCLUSIONS
In Chinese adults, physical activity mainly involves occupation and housework, with little from active-recreational activity. Domain-specific physical activities varied by socio-demographic factors and had different associations with adiposity.
Topics: Activities of Daily Living; Adipose Tissue; Adiposity; Adult; Aged; Body Mass Index; China; Cross-Sectional Studies; Demography; Exercise; Female; Household Work; Humans; Male; Middle Aged; Motor Activity; Obesity; Occupations; Recreation; Retirement; Sedentary Behavior; Waist Circumference; Work
PubMed: 25106853
DOI: 10.1186/1471-2458-14-826 -
Orphanet Journal of Rare Diseases Sep 2023Phenylketonuria (PKU) is a rare inborn error of metabolism affecting the catabolism of phenylalanine (Phe). To date, findings regarding health-related quality of life...
BACKGROUND
Phenylketonuria (PKU) is a rare inborn error of metabolism affecting the catabolism of phenylalanine (Phe). To date, findings regarding health-related quality of life (HRQoL) in adults with early-treated classical PKU are discrepant. Moreover, little is known about metabolic, demographic, and cognitive factors associated with HRQoL. Hence, we aimed to investigate HRQoL and its association with demographic, metabolic, and cognitive characteristics in a large European sample of adults with early-treated classical PKU.
RESULTS
This cross-sectional study included 124 adults with early-treated classical PKU from Hungary, Italy, Spain, Switzerland, and Turkey. All participants prospectively completed the PKU quality of life questionnaire (PKU-QoL), a questionnaire specifically designed to evaluate the impact of PKU and its treatment on HRQoL in individuals with PKU. In addition, information about Phe levels (concurrent and past year), demographic (age and sex), and cognitive variables (intelligence quotient, IQ) were collected. Most domains revealed little or no impact of PKU on HRQoL and more than three-quarters of the patients rated their health status as good, very good, or excellent. Nevertheless, some areas of concern for patients were identified. Patients were worried about the guilt that they experience if they do not adhere to the dietary protein restriction and they were most concerned about high Phe levels during pregnancy. Further, tiredness was the most affected symptom, and the supplements' taste was considered a main issue for individuals with PKU. The overall impact of PKU on HRQoL was higher in women (U = 1315.5, p = .012) and in adults with a lower IQ (r = - 0.448, p = .005). The overall impact of dietary protein restriction was higher in adults with higher concurrent Phe levels (r = 0.272, p = .007) and higher Phe levels during the past year (r = 0.280, p = .009).
CONCLUSION
The impact of PKU on most domains assessed in the PKU-QoL was considered to be low. These results likely reflect the successful implementation of the newborn screening resulting in the prevention of severe adverse long-term outcomes. However, a particular clinical focus should be given to patients with lower IQ, higher Phe levels, and women, as these variables were associated with a lower HRQoL.
Topics: Infant, Newborn; Pregnancy; Humans; Adult; Female; Quality of Life; Cross-Sectional Studies; Phenylketonurias; Health Status; Neonatal Screening; Phenylalanine
PubMed: 37740225
DOI: 10.1186/s13023-023-02917-w -
Human Brain Mapping Feb 2024Brain connectivity analysis begins with the selection of a parcellation scheme that will define brain regions as nodes of a network whose connections will be studied....
Brain connectivity analysis begins with the selection of a parcellation scheme that will define brain regions as nodes of a network whose connections will be studied. Brain connectivity has already been used in predictive modelling of cognition, but it remains unclear if the resolution of the parcellation used can systematically impact the predictive model performance. In this work, structural, functional and combined connectivity were each defined with five different parcellation schemes. The resolution and modality of the parcellation schemes were varied. Each connectivity defined with each parcellation was used to predict individual differences in age, education, sex, executive function, self-regulation, language, encoding and sequence processing. It was found that low-resolution functional parcellation consistently performed above chance at producing generalisable models of both demographics and cognition. However, no single parcellation scheme showed a superior predictive performance across all cognitive domains and demographics. In addition, although parcellation schemes impacted the graph theory measures of each connectivity type (structural, functional and combined), these differences did not account for the out-of-sample predictive performance of the models. Taken together, these findings demonstrate that while high-resolution parcellations may be beneficial for modelling specific individual differences, partial voluming of signals produced by the higher resolution of the parcellation likely disrupts model generalisability.
Topics: Humans; Brain Mapping; Magnetic Resonance Imaging; Brain; Cognition; Demography
PubMed: 38339892
DOI: 10.1002/hbm.26592 -
Quality of Life Research : An... Apr 2021This study's aim was to use a representative sample of the US pediatric population to estimate percentiles for several PROMIS pediatric measures: Anger, Anxiety,...
PURPOSE
This study's aim was to use a representative sample of the US pediatric population to estimate percentiles for several PROMIS pediatric measures: Anger, Anxiety, Depressive Symptoms, Family Relationships, Fatigue, Global Health, Life Satisfaction, Meaning and Purpose, Pain Behavior, Pain Interference, Physical Activity, Physical Function Mobility, Physical Function Upper Extremity, Physical Stress Experiences, Positive Affect, Psychological Stress Experiences, Sleep Disturbance, Sleep Impairment, and Peer Relationships.
METHODS
We used two separate, nationally representative samples of parents and children aged 5-17 years drawn in different years from the GfK Knowledge Panel, a dual-frame online probability panel.
RESULTS
All measures that were developed using a representative sample had a median at or near the expected value of 50. For the other measures, the 50th percentile was often 10 points or more from 50. Several domains had high floors or low ceilings. No domain's percentiles completely corresponded to the percentiles associated with a normal distribution with a mean of 50 and standard deviation of 10.
CONCLUSIONS
This work allows users to interpret a child's self-reported quality of life relative to children in the US general population. When attempting to evaluate whether a child falls above or below other children in the US, one should use the values presented in this study. In addition, we recommend that users should focus on whether a child's score falls into one of a few broad severity groups rather than on specific percentile scores.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Male; Patient Reported Outcome Measures; Quality of Life; Self Report
PubMed: 33201388
DOI: 10.1007/s11136-020-02700-5 -
International Journal of Gynecological... Jun 2016POLE mutations in high-grade endometrioid endometrial cancer (EEC) have been associated with improved survival. We sought to investigate the prevalence of POLE tumor...
OBJECTIVE
POLE mutations in high-grade endometrioid endometrial cancer (EEC) have been associated with improved survival. We sought to investigate the prevalence of POLE tumor mutation and its prognostic significance on outcomes and clinical applications in a subanalysis of women with high-grade EEC from a previously described cohort of 544 EEC patients in which POLE mutation status and survival outcomes were assessed.
METHODS
Polymerase chain reaction amplification and Sanger sequencing were used to test for POLE mutations in 72 tumors. Associations between POLE mutation, demographic and clinicopathologic features, and survival were investigated with Cox proportional hazard models.
RESULTS
POLE mutations were identified in 7 (9.7%) of 72 grade 3 EECs. No significant differences in the clinicopathologic features between those with POLE mutations and those without were identified. Adjusted for age, a decreased risk of recurrence was suggested in patients with a POLE mutation (adjusted hazard ratio, 0.37; 95% confidence interval, 0.09-1.55), as well as decreased risk of death (adjusted hazard ratio, 0.19; 95% confidence interval, 0.03-1.42).
CONCLUSIONS
POLE mutations in tumors of women with grade 3 EEC are associated with a lower risk of recurrence and death, although not statistically significant because of high variability in these estimates. These findings, consistent with recently published combined analyses, support POLE mutation status as a noteworthy prognostic marker and may favor a change in the treatment of women with grade 3 EECs, particularly in those with early-stage disease, in which omission of adjuvant therapy and decreased surveillance could possibly be appropriate.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Endometrioid; Case-Control Studies; DNA Polymerase II; Endometrial Neoplasms; Female; Humans; Middle Aged; Mutation; Neoplasm Grading; Neoplasm Recurrence, Local; Poly-ADP-Ribose Binding Proteins; Prognosis; Protein Domains; Survival Rate
PubMed: 26937754
DOI: 10.1097/IGC.0000000000000681 -
Journal of Urban Health : Bulletin of... Oct 2023Compared to previous studies commonly using a single summary score, we aimed to construct a multidomain neighborhood environmental vulnerability index (NEVI) to...
Compared to previous studies commonly using a single summary score, we aimed to construct a multidomain neighborhood environmental vulnerability index (NEVI) to characterize the magnitude and variability of area-level factors with the potential to modify the association between environmental pollutants and health effects. Using the Toxicological Prioritization Index framework and data from the 2015-2019 U.S. Census American Community Survey and the 2020 CDC PLACES Project, we quantified census tract-level vulnerability overall and in 4 primary domains (demographic, economic, residential, and health status), 24 subdomains, and 54 distinct area-level features for New York City (NYC). Overall and domain-specific indices were calculated by summing standardized feature values within the subdomains and then aggregating and weighting based on the number of features within each subdomain within equally-weighted primary domains. In citywide comparisons, NEVI was correlated with multiple existing indices, including the Neighborhood Deprivation Index (r = 0.91) and Social Vulnerability Index (r = 0.87) but provided additional information on features contributing to vulnerability. Vulnerability varied spatially across NYC, and hierarchical cluster analysis using subdomain scores revealed six patterns of vulnerability across domains: 1) low in all, 2) primarily low except residential, 3) medium in all, 4) high demographic, economic, and residential 5) high economic, residential, and health status, and 6) high demographic, economic and health status. Created using methods that offer flexibility for theory-based construction, NEVI provided detailed vulnerability metrics across domains that can inform targeted research and public health interventions aimed at reducing the health impacts from environmental exposures across urban centers.
Topics: Humans; New York City; Environmental Exposure; Health Status; Public Health; Nevus
PubMed: 37594675
DOI: 10.1007/s11524-023-00766-3 -
NeuroImage May 2021As the population ages, maintaining mental health and well-being of older adults is a public health priority. Beyond objective measures of health, self-perceived quality... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
As the population ages, maintaining mental health and well-being of older adults is a public health priority. Beyond objective measures of health, self-perceived quality of life (QoL) is a good indicator of successful aging. In older adults, it has been shown that QoL is related to structural brain changes. However, QoL is a multi-faceted concept and little is known about the specific relationship of each QoL domain to brain structure, nor about the links with other aspects of brain integrity, including white matter microstructure, brain perfusion and amyloid deposition, which are particularly relevant in aging. Therefore, we aimed to better characterize the brain biomarkers associated with each QoL domain using a comprehensive multimodal neuroimaging approach in older adults.
METHODS
One hundred and thirty-five cognitively unimpaired older adults (mean age ± SD: 69.4 ± 3.8 y) underwent structural and diffusion magnetic resonance imaging, together with early and late florbetapir positron emission tomography scans. QoL was assessed using the brief version of the World Health Organization's QoL instrument, which allows measuring four distinct domains of QoL: self-perceived physical health, psychological health, social relationships and environment. Multiple regression analyses were carried out to identify the independent global neuroimaging predictor(s) of each QoL domain, and voxel-wise analyses were then conducted with the significant predictor(s) to highlight the brain regions involved. Age, sex, education and the other QoL domains were entered as covariates in these analyses. Finally, forward stepwise multiple regressions were conducted to determine the specific items of the relevant QoL domain(s) that contributed the most to these brain associations.
RESULTS
Only physical health QoL was associated with global neuroimaging values, specifically gray matter volume and white matter mean kurtosis, with higher physical health QoL being associated with greater brain integrity. These relationships were still significant after correction for objective physical health and physical activity measures. No association was found with global brain perfusion or global amyloid deposition. Voxel-wise analyses revealed that the relationships with physical health QoL concerned the anterior insula and ventrolateral prefrontal cortex, and the corpus callosum, corona radiata, inferior frontal white matter and cingulum. Self-perceived daily living activities and self-perceived pain and discomfort were the items that contributed the most to these associations with gray matter volume and white matter mean kurtosis, respectively.
CONCLUSIONS
Better self-perceived physical health, encompassing daily living activities and pain and discomfort, was the only QoL domain related to brain structural integrity including higher global gray matter volume and global white matter microstructural integrity in cognitively unimpaired older adults. The relationships involved brain structures belonging to the salience network, the pain pathway and the empathy network. While previous studies showed a link between objective measures of physical health, our findings specifically highlight the relevance of monitoring and promoting self-perceived physical health in the older population. Longitudinal studies are needed to assess the direction and causality of the relationships between QoL and brain integrity.
Topics: Aged; Aged, 80 and over; Aging; Brain; Diffusion Magnetic Resonance Imaging; Female; Humans; Independent Living; Male; Molecular Imaging; Quality of Life
PubMed: 33549750
DOI: 10.1016/j.neuroimage.2021.117819 -
Journal of Doctoral Nursing Practice Nov 2022: Liver transplantation (LT) is the most effective treatment for patients with end-stage liver disease, which dramatically effects patient's quality of life (QoL). The...
: Liver transplantation (LT) is the most effective treatment for patients with end-stage liver disease, which dramatically effects patient's quality of life (QoL). The aim of this study was to evaluate the impact of socio-demographic and clinical factors on different QoL domains of patients who underwent orthotopic LT. : A cross-sectional study included a total of 43 patients who underwent a LT from 2013 to 2018. Socio-demographic and clinical data were recorded in each patient. The QoL was estimated using two validated questionnaires: 36-Item Short Form Health Survey (SF-36) and Chronic Liver Disease Questionnaire (CLDQ). : Male patients obtained significantly higher scores than women, in the domains of general health perception (83.2 ± 16.3 vs. 71.0 ± 18.4; = 2.229, = .031) and physical component summary (69.0 ± 7.2 vs. 62.0 ± 11.4; = 2.451, = .019). There were no significant differences in other domains of SF-36 and CLDQ. Etiology of the underlying liver disease and the presence of post-transplant complications showed no effect on score values of SF-36 and CDLQ domains ( < .05). Time from LT showed negative medium correlation with role limitations due to physical health problems ( = -0.417, = .005), while no other significant correlations were noted in other items of SF-36 and CLDQ. : Men had higher scores in the domain of general health perception and physical component summary following LT than women. With the increase in time from LT, patients experience a decrease in limitations due to physical health problems. The audit and improvement of QoL is an essential part of the individualized long-term health-care approach to LT patients.
Topics: Humans; Male; Female; Quality of Life; Liver Transplantation; Cross-Sectional Studies; Serbia; Liver Diseases
PubMed: 36351767
DOI: 10.1891/JDNP-2021-0026 -
International Journal of Environmental... Feb 2023The World Health Organization (WHO) created the concept of Integrated Care for Older People and one of its constructs is intrinsic capacity (IC). The study aimed to...
The World Health Organization (WHO) created the concept of Integrated Care for Older People and one of its constructs is intrinsic capacity (IC). The study aimed to carry out a screening with the tools designated by the WHO to assess the IC domains and whether they can be used as indicators for decision-making on integrated care for older people based on risk categorization. The interaction between the risk category and the domain scores was verified. One hundred and sixty three (163) community-dwelling older people of both genders were evaluated. Domains assessed: cognitive, psychological, vitality, locomotion, and sensory. Scores indicating a low, moderate and high risk were assigned to each domain. For all domains, there were individuals in all risk groups. Effect of risk on the domains: cognitive [χ(2) = 134.042; < 0.001], psychological [χ(2) = 92.865; < 0.001], vitality [χ(2) = 129.564; < 0.001], locomotion [χ(2) = 144.101; < 0.001], and sensory [χ(2) = 129.037; < 0.001]. Scores of the CI domains were affected by the risk category. There were individuals in all risk groups, demonstrating the importance of screening as a public health strategy, making it possible to know which risk category each elderly person belongs to and thus develop strategies in the short-, medium- and long-term.
Topics: Humans; Male; Female; Aged; Public Health; Independent Living; Quality of Life; Geriatric Assessment; Risk Factors
PubMed: 36901237
DOI: 10.3390/ijerph20054227