Cognitive Impairment Mediates the Association between Dietary Inflammation and Depressive Symptoms in the Elderly

Sun, Mengzi; Hu, Yueyang; Wang, Xuhan; Yan, Shoumeng; Guo, Yinpei; Li, Jing; Xie, Zechun; Li, Bo

doi:10.3390/nu14235118

Cited by 11 publications

(2 citation statements)

References 40 publications

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“…In addition, our findings also indicate that middle-aged and older people with hypertension, diabetes, or arthritis who also suffer from depressive symptoms are at a higher risk of mortality. Numerous studies have already demonstrated the association between depressive symptoms and cardiovascular diseases, diabetes, chronic inflammation, and immune system disorders ( 113 – 116 ). These cross-sectional studies have indicated that depressive symptoms exacerbate the condition of chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases

Zhu,

Wang,

et al. 2024

Front. Public Health

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IntroductionIt remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases.MethodsData were collected from the China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan–Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality.ResultsOut of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09–1.33]). An increased rate was observed for 55–64 years old (HR = 1.23 [95% CI, 1.03–1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18–1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30–1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61–2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00–1.40]), diabetes (HR = 1.41[95% CI, 1.02–1.95]), and arthritis (HR = 1.29 [95% CI, 1.09–1.51]).ConclusionDepressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.

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Section: Discussionmentioning

confidence: 99%

Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases

Zhu,

Wang,

et al. 2024

Front. Public Health

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“…Language uency is rated based on the number of animals named [55]. Participants' working memory, processing speed, and sustained attention are gauged within two minutes using the Digital Symbol Substitution Test (DSST), requiring them to accurately replicate symbols from a grid of 133 boxes [56,57].…”

Section: Outcome Variablesmentioning

confidence: 99%

Association between serum alanine transaminase/aspartate aminotransferase (ALT/AST) ratio and cognitive impairment in US older adults

Wang,

2024

Preprint

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Background and aims:The prevalence of cognitive impairment is increasing, especially in South Korea and South America. It is hypothesized that the alanine transaminase-to-aspartate aminotransferase ratio (ALT/AST), a marker of liver function, may influence cognitive function. However, as of now, there is no consensus on the clinical evidence supporting the link between ALT/AST ratio and cognitive impairment. Methods: Data from two cycles (2011-2014) of the National Health and Nutrition Examination Survey (NHANES) were utilized to investigate the correlation between serum ALP levels and cognitive impairment. Cognitive function was assessed through three tests: the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency (AF), and Digit Symbol Substitution Test (DSST) scores. The inflection point for cognitive impairment was defined as CERAD < 5, AF < 14, and DSST < 34. Weighted multiple logistic regression models were applied to explore the relationship between ALT/AST ratio and cognitive impairment. Generalized additive models (GAM) and a smooth curve fit (penalty spline method) were employed to examine potential nonlinear associations. Subgroup analyses and interaction tests were also carried out. Results: The study enrolled a total of 2765 adults aged 60 years and older. Our findings revealed a significant correlation between ALT/AST levels and a reduced likelihood of cognitive impairment in the CERAD test results [fully adjusted odds ratio (OR) = 0.53, 95% confidence interval (CI): 0.34-0.83]. Specifically, in the highest quartile (Q4) of CERAD scores, this association remained significant [fully adjusted Q4: OR = 0.67, 95% CI: 0.50-0.88], with a trend significance (p = 0.012). A notable association was observed between ALT/AST levels and a decreased probability of cognitive impairment in the DSST test outcomes [fully adjusted OR = 0.46, 95% CI: 0.28-0.77]. Particularly, in Q3 [fully adjusted OR = 0.69, 95% CI: 0.50-0.94] and Q4 [fully adjusted OR = 0.60, 95% CI: 0.44-0.82], displaying a significant trend across quartiles (p = 0.004). The generalized additive models (GAM) and smooth curve analyses revealed a nonlinear relationship between serum ALT/AST levels and cognitive impairment. Additionally, inflection points for ALT/AST were determined as 1.29 (CERAD test), 0.63 (AF test), and 0.87 (DSST test), respectively. Significant interactions were noted between ALT/AST and cognitive impairment concerning the CERAD test, taking into account race, education, and alcohol (P < 0.05). Moreover, significant interactions were observed between ALT/AST and cognitive impairment in connection with the CERAD test, considering age, race, alcohol, and hypertension (P < 0.05). Lastly, significant interactions were identified between ALT/AST and cognitive impairment associated with the CERAD test, accounting for alcohol, vigorous work activity, high cholesterol, and hypertension (P < 0.05). Conclusions: In conclusion, our study unveils a non-linear relationship and a threshold effect between serum ALT/AST levels and cognitive impairment. Validating these results necessitates large-scale prospective clinical trials utilizing rigorous methodologies and comprehensive datasets.

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Overlooked cases of mild cognitive impairment: Implications to early Alzheimer’s disease

Mian,

Tahiri,

Eldin

et al. 2024

Ageing Research Reviews

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Cognitive Impairment Mediates the Association between Dietary Inflammation and Depressive Symptoms in the Elderly

Cited by 11 publications

References 40 publications

Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases

Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases

Association between serum alanine transaminase/aspartate aminotransferase (ALT/AST) ratio and cognitive impairment in US older adults

Overlooked cases of mild cognitive impairment: Implications to early Alzheimer’s disease

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