Synergistic impact of plasma albumin and cognitive function on all-cause mortality in Chinese older adults: a prospective cohort study.

Background: Hypoalbuminemia and cognitive impairment (CI) each independently increase the mortality risk in older adults. However, these two geriatric syndromes can occur simultaneously. In community-dwelling older adults, is the combination of hypoalbuminemia and CI linked to a higher mortality risk than either condition alone? Objective: We aimed to investigate the association between plasma albumin, cognitive function, and their synergistic effect on mortality in Chinese community-dwelling older adults. Methods: Data from the Chinese Longitudinal Healthy Longevity Survey (2012) included 1,858 participants aged ≥65. Baseline assessments comprised albumin levels and cognitive status. All-cause mortality was confirmed through 2014-2018 surveys. Cox proportional hazards models assessed associations, and restricted cubic splines explored albumin-mortality relationship. Results: During a median follow-up of 48.85 months, 921 deaths. Albumin≥35 g/L vs < 35g/L [HR: 1.33 (95%CI, 1.10, 1.62)] and CI vs normal cognition [HR: 1.69 (95%CI, 1.43, 1.99)] independently predicted mortality. A dose-response relationship with mortality was observed for albumin quartiles (p < 0.001). Each SD increase in MMSE or albumin correlated with 22% and 15% lower mortality risk, respectively. Combined hypoproteinemia and CI increased the mortality risk by 155%, with a notably higher risk in males, those aged <85 years, and individuals living in rural areas. Interaction effects of albumin and CI on mortality were observed (p < 0.001). In the single CI group, older adults had a 61% increased risk of mortality in the hypoproteinaemia group compared with the albumin-normal group. Restricted cubic spline revealed a reverse J-shaped association, particularly for participants without CI. For individuals with CI, albumin levels were inversely associated with mortality risk. Conclusion: Hypoproteinemia and CI, individually and combined, increased all-cause mortality risk in Chinese older adults, with stronger effects observed in males, younger older adults, and those living in rural areas. These findings emphasize the importance of targeted adjustments and early nutrition programs in health prevention and clinical care for older adults.

Importance of serum albumin in machine learning-based prediction of cognitive function in the elderly using a basic blood test.

Introduction: In this study, we investigated the correlation between serum albumin levels and cognitive function, and examined the impact of including serum albumin values in the input layer on the prediction accuracy when forecasting cognitive function using deep learning and other machine learning models. Methods: We analyzed the electronic health record data from Osaka Medical and Pharmaceutical University Hospital between 2014 and 2021. The study included patients who underwent cognitive function tests during this period; however, patients from whom blood test data was not obtained up to 30 days before the cognitive function tests and those with values due to measurement error in blood test results were excluded. The Mini-Mental State Examination (MMSE) was used as the cognitive function test, and albumin levels were examined as the explanatory variable. Furthermore, we estimated MMSE scores from blood test data using deep learning models (DLM), linear regression models, support vector machines (SVM), decision trees, random forests, extreme gradient boosting (XGBoost), and light gradient boosting machines (LightGBM). Results: Out of 5,017 patients who underwent cognitive function tests, 3,663 patients from whom blood test data had not been obtained recently and two patients with values due to measurement error were excluded. The final study population included 1,352 patients, with 114 patients (8.4%) aged below 65 and 1,238 patients (91.6%) aged 65 and above. In patients aged 65 and above, the age and male sex showed significant associations with MMSE scores of less than 24, while albumin and potassium levels showed negative associations with MMSE scores of less than 24. Comparing MMSE estimation performance, in those aged below 65, the mean squared error (MSE) of DLM was improved with the inclusion of albumin. Similarly, the MSE improved when using SVM, random forest and XGBoost. In those aged 65 and above, the MSE improved in all models. Discussion: Our study results indicated a positive correlation between serum albumin levels and cognitive function, suggesting a positive correlation between nutritional status and cognitive function in the elderly. Serum albumin levels were shown to be an important explanatory variable in the estimation of cognitive function for individuals aged 65 and above.

Relationship between domain-specific physical activity and cognitive function in older adults - findings from NHANES 2011-2014.

Objective: To determine the relationship between domain-specific physical activity (PA) (e.g., occupational PA [OPA], transport-related PA [TPA], and recreational PA [RPA]) and cognitive function in older adults. Methods: The data was obtained from the 2011-2014 cycle of the NHANES. We utilized weighted multivariate linear regression models among the included 2,924 people aged 60 years or older for our purposes. Results: RPA and total PA according to WHO guidelines were associated with verbal fluency (RPA ß: 1.400, 95% CI: 0.776, 2.024, p = 0.002; total PA ß: 1.115, 95% CI: 0.571, 1.659, p = 0.001), processing speed and executive function (RPA ß: 2.912, 95% CI. 1.291, 4.534, p = 0.005; total PA ß: 2.974, 95% CI: 1.683, 4.265, p < 0.001) were positively correlated, and total PA was correlated with delayed memory performance (ß: 0.254, 95% CI: 0.058, 0.449, p = 0.019). No significant association was observed between OPA, TPA, and various aspects of cognitive function among individuals over 60 years. Conclusion: There was no noteworthy correlation discovered between OPA and TPA in relation to cognitive function. However, RPA and total PA exhibited significant associations with verbal fluency, processing speed, and executive function. Additionally, maintaining PA levels ranging from 600 to 1,200 MET-min/week would yield the most favorable outcomes for cognitive function.

Effects of multicomponent exercise on cognitive function in persons with mild cognitive impairment: A systematic review and meta-analysis.

BACKGROUND: Multicomponent exercise has the potential to improve cognitive function in people with mild cognitive impairment. However, the effects of multicomponent exercise on specific cognitive subdomains in mild cognitive impairment and the optimal combination of exercise components remain unclear. OBJECTIVE: This systematic review aimed to (a) investigate the effects of multicomponent exercise on different cognitive subdomains in people with mild cognitive impairment and (b) investigate the effects of different combinations of multicomponent exercise on global cognition in people with mild cognitive impairment. DESIGN: A systematic review and meta-analysis. METHODS: Six electronic databases, including PubMed, Medline, EMBASE, Web of Science, Cochrane Library, and CINAHL were systematically searched from inception to January 1st, 2023. Randomized controlled trials assessing the effect of multicomponent exercise interventions on cognitive function in people with mild cognitive impairment were included. The risk of bias was assessed using the Cochrane collaborative bias assessment tool. A random-effects model was used to calculate standardized mean difference. Subgroup analyses, meta-regression, and sensitive analysis were performed. If a meta-analysis was not feasible, studies were synthesized narratively. RESULTS: Twenty studies were identified for systematic review and meta-analysis. Multicomponent exercise significantly improved global cognition [SMD = 1.04; 95 % confidence interval (CI): 0.53, 1.55], cognitive flexibility (SMD = -1.04; 95 % CI: -1.81, -0.27), processing speed (SMD = 0.43; 95 % CI: 0.04, 0.82), verbal fluency (SMD = 0.38; 95 % CI: 0.13, 0.63), attention (SMD = -0.90; 95 % CI: -1.68, -0.12) and memory (SMD = 0.36; 95 % CI: 0.04, 0.69) in mild cognitive impairment. The multicomponent exercise including cardiovascular (exercise that promotes cardiovascular health, such as endurance training or aerobic exercise) and motor (exercises that improve physical abilities, such as balance, coordination, agility, flexibility, etc.) components positively affected global cognition in people with mild cognitive impairment (SMD = 1.06; 95 % CI: 0.55, 1.57). CONCLUSIONS: The findings of this study suggest that multicomponent exercise has a positive impact on various cognitive domains, including global cognition, cognitive flexibility, processing speed, verbal fluency, attention and memory in mild cognitive impairment. Specifically, the combination of exercises including cardiovascular and motor components was found to be effective in improving global cognition. However, further research is needed to investigate the optimal frequency and intensity of the multicomponent exercise intervention, and more detail about exercise combinations of the motor component (not classified in this study) for individuals with mild cognitive impairment. REGISTRATION: The protocol was registered on PROSPERO (CRD42023400302).

Hippocampus-specific knockdown of Shati/Nat8l impairs cognitive function and electrophysiological response in mice.

Shati/Nat8l was identified as an upregulated molecule in the nucleus accumbens (NAc) of mice following repeated methamphetamine administration. Region-specific roles of this molecule are associated with psychiatric disorders. In the present study, we examined the importance of Shati/Nat8l in the hippocampus because of its high expression in this region. Mice with a hippocampus-specific knockdown of Shati/Nat8l (hippocampal Shati-cKD) were prepared by the microinjection of adeno-associated virus (AAV) vectors carrying Cre into the hippocampus of Shati/Nat8lflox/flox mice, and their phenotypes were investigated. Drastic reduction in the expression and function of Shati/Nat8l in the hippocampus was observed in Shati-cKD mice. These mice exhibited cognitive dysfunction in behavioral experiments and impaired the electrophysiological response to the stimuli, which elicits long-term potentiation. Shati/Nat8l in the hippocampus is suggested to possibly play an important role in synaptic plasticity to maintain cognitive function. This molecule could be a therapeutic target for hippocampus-related disorders such as dementia.

Heart rate variability biofeedback enhances cognitive, motor, psychological, and autonomic functions in post-stroke rehabilitation.

Post-stroke patients often experience psychological distress and autonomic nervous system (ANS) dysregulation, impacting their well-being. This study evaluated the effectiveness of heart rate variability (HRV) biofeedback on cognitive, motor, psychological, and ANS functions in sixty-two ischemic stroke patients (43 males, mean age = 60.1) at a Medical Center in southern Taiwan. To prevent interaction, we allocated patients to the HRV biofeedback or control (usual care) group based on their assigned rehabilitation days, with 31 patients in each group. Assessments conducted at baseline, three, and six months included the Montreal Cognitive Assessment (MoCA), Fugl-Meyer Assessment for Upper Extremities (FMA-UE), Perceived Stress Scale, Hospital Anxiety and Depression Scales (HADS), and HRV indices. Mixed-effect models were used to analyze Group by Time interactions. The results revealed significant interactions across all functions. At 3 months, significant improvements in the HRV biofeedback group were observed only in MoCA, FMA-UE, and HADS-depression scores compared to the control group. By 6 months, all measured outcomes demonstrated significant improvements in the biofeedback group relative to the control group. These results suggest that HRV biofeedback may be an effective complementary intervention in post-stroke rehabilitation, warranting further validation.

Changes in higher order cognitive function between four watch keeping schedules.

Maritime industries utilize many different watch keeping schedules to maintain vigilance and crew safety around the clock. These schedules can be fatiguing, negatively impacting vigilant attention. This has led to the consideration of schedules that might allow for more sleep time, but how these schedules impact higher order cognitive function remains unclear. These schedules require assessment with tasks that are relevant to real-world operations on maritime vessels. This study investigated the effect of four schedules on higher order cognitive function. N = 27 (16 female) participants were recruited to a 10-day laboratory study, comparing four schedules. The schedules investigated were eight-on/eight-off/four-on/four-off (8/8/4/4) with sleep from 09:30 to 16:00 (condition A); six-on/six-off (6/6) with sleep from 08:30 to 12:30 and 21:30 to 00:00 (condition B); four-on/four-off (4/4/4/4/4/4) with sleep from 18:00 to 00:30 (condition C); and four-on/four-off (4/4/4/4/4/4) with sleep from 01:30 to 08:00 (condition D). Higher order cognitive function was assessed 2-3× daily whilst "on watch" using tests of visual scanning, learning, working memory, mental flexibility, and visuomotor control. Conditions were ranked and stability of performance on watch was compared between conditions using Kruskal-Wallis tests. Cognitive function within condition B was ranked the worst for most of the tasks. However, the stability of higher order cognitive function was poorest across the waking day within condition A. These findings highlight the variability in cognitive capacities during different watch keeping schedules.

The Association Between Prolactin Levels and Cognitive Function in Female Patients With Severe Mental Disorders.

OBJECTIVE: Cognition impairments are considered as a fundamental characteristic of severe mental disorders (SMD). Recent studies suggest that hyperprolactinemia may exert a detrimental influence on cognitive performance in patients with SMD. The objective of this study was to investigate the correlation between serum prolactin levels and cognitive function in female individuals diagnosed with SMD. METHODS: We conducted a study on 294 patients with SMD and 195 healthy controls, aged between 14 to 55 years old. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), while prolactin levels were measured in serum. Descriptive analysis and comparative analysis were performed to compare cognitive function and prolactin levels between groups, and linear regression models were used to explore the relationship between prolactin and cognitive function. RESULTS: Compared to the healthy control, individuals with SMD exhibited significantly higher levels of prolactin, while scoring lower on RBANS total and every index scores. Furthermore, a negative association between prolactin levels and cognitive function (RBANS total index score, attention, and delayed memory) was observed in SMD patients. Importantly, this inverse correlation between prolactin and cognition function (RBANS total index score, total scale score, and attention) persisted in patients who were not taking medications that could potentially influence serum prolactin levels. CONCLUSION: Our study reveals a significant correlation between elevated prolactin levels and cognitive impairment in female patients with SMD, underscoring the importance of monitoring prolactin levels in order to prevent cognitive deterioration among female SMD patients.

The Different Associations of White Matter Hyperintensities With Severity of Dementia and Cognitive Impairment According to the Distance From the Lateral Ventricular Surface in Patients With Alzheimer's Disease.

OBJECTIVE: White matter hyperintensities (WMH) are common among the elderly. Although WMH play a key role in lowering the threshold for the clinical expression of dementia in Alzheimer's disease (AD)-related pathology, the clinical significance of their location is not fully understood. This study aimed to investigate the association between WMH and cognitive function according to the location of WMH in AD. METHODS: Subjects underwent clinical evaluations including volumetric brain magnetic resonance imaging study and neuropsychological tests using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet. WMH were calculated using automated quantification method. According to the distance from the lateral ventricular surface, WMH within 3 mm, WMH within 3-13 mm, and WMH over 13 mm were classified as juxtaventricular WMH (JVWMH), periventricular WMH (PVWMH), and deep WMH (DWMH), respectively. RESULTS: Total WMH volume was associated with poor performance in categorical verbal fluency test (ß=-0.197, p=0.035). JVWMH volume was associated with poor performances on categorical verbal fluency test (ß=-0.201, p=0.032) and forward digit span test (ß= -0.250, p=0.012). PVWMH volume was associated with poor performances on categorical verbal fluency test (ß=-0.185, p=0.042) and word list memory test (ß=-0.165, p=0.042), whereas DWMH volume showed no association with cognitive tests. PVWMH volume were also related to Clinical Dementia Rating Scale Sum of Boxes score (ß=0.180, p=0.026). CONCLUSION: WMH appear to exhibit different associations with the severity of dementia and cognitive impairment according to the distance from ventricle surface in AD.

Age differences in the moderating effects of neighbourhood disadvantage on the relationship between physical activity and cognitive function: A longitudinal analysis of the Canadian Longitudinal Study on Aging.

OBJECTIVES: To explore whether the association between physical activity (PA) and cognition is moderated by neighbourhood disadvantage, and whether this relationship varies with age. STUDY DESIGN: A longitudinal analysis of the Canadian Longitudinal Study on Aging, wherein we included participants (N = 41,599) from urban areas who did not change their residential postal code from baseline (2010-2015) to first follow-up (2015-2018). MAIN OUTCOME MEASURES: At baseline, we measured PA using the Physical Activity Scale for the Elderly, and neighbourhood disadvantage using the Material and Social Deprivation Indices. RESULTS: Using latent change score regression models, we determined that higher PA at baseline was independently associated with greater maintenance in memory performance from baseline to first follow-up both for adults aged 45-64 (B = 0.04, SE = 0.01, p = 0.001) and for those aged 65+ years (B = 0.12, SE = 0.02, p < 0.001). For participants aged 45-64 years, greater material deprivation was independently associated with declines in memory performance (B = -0.10, SE = 0.03, p < 0.001). In addition, greater social deprivation was associated with a stronger effect of PA on changes in executive functions (B = 0.17, SE = 0.08, p = 0.025) for adults aged 45-64 years; greater material deprivation was associated with a stronger effect of PA on changes in memory performance (B = 0.07, SE = 0.03, p = 0.022). We failed to detect any interactions between PA and neighbourhood disadvantage among adults aged 65+ years (all p values >0.05). CONCLUSION: For middle-aged adults, the benefits of PA on cognitive performance may be strongest among adults living with greater neighbourhood social and material disadvantages. For older adults, PA may be beneficial to cognitive performance irrespective of neighbourhood disadvantages.

Plasma homocysteine and longitudinal change in cognitive function among urban adults.

BACKGROUND: Cross-sectional and longitudinal studies have inconsistently linked cognitive performance and change over time to an elevated level of homocysteine (Hcy), with few conducted among urban adults. METHODS: Longitudinal data [Visit 1 (2004-2009) and Visit 2 (2009-2013)] were analyzed from up to 1430 selected Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) participants. Baseline and follow-up blood Hcy was measured, while 11 cognitive function test scores were assessed at either of these two visits. Overall, sex- and race-stratified associations were evaluated using mixed-effects linear regression models, adjusting for key potential confounders. Interaction effects between Hcy and serum levels of folate and vitamin B-12 were also tested. RESULTS: We found that greater LnHcyv1 was significantly associated with poorer baseline attention based on higher Loge (TRAILS A, in seconds) [ß (SE): 0.101 (0.031), P = 0.001]. Heterogeneity was also found by sex and by race. Most notably, among men only, LnHcyv1 was associated with faster decline on the BVRT (# of errors), a measure of visuo-spatial memory (ß (SE): 0.297(0.115), P = 0.010, reduced model); while among African American adults only, an elevated and increasing LnHcy over time was associated with faster rate of decline on Loge (TRAILS B, in seconds) [ß (SE): +0.012 (0.005), p = 0.008], a measure of executive function. Interactions between Hcy, folate and vitamin B-12 blood exposures were also detected. CONCLUSIONS: In summary, sex- and race-specific adverse association between elevated Hcy and cognitive performance over time were detected among middle-aged urban adults, in domains of attention, visuo-spatial memory and executive functioning.

The association between Weight-adjusted-Waist Index (WWI) and cognitive function in older adults: a cross-sectional NHANES 2011-2014 study.

BACKGROUND: The impact of obesity on cognitive function has engendered considerable interest. Weight-adjusted waist index (WWI) has emerged as a novel and innovative marker of obesity that reflects weight-independent abdominal obesity. However, the association between WWI and cognitive function remains unclear. To address this gap, the present study aims to explore the relationship between weight-adjusted waist index (WWI) and cognitive performance in older adults. METHODS: We conducted a cross-sectional investigation using datasets from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. The study included 3,472 participants (48.59% male, 51.41% female) of various races (Mexican American, Other Hispanic, Non-Hispanic White, Non-Hispanic Black, and Other), with a mean age of 69.95 years (SD = 6.94). Multivariate regression and smoothing curve fitting were used to investigate the linear and nonlinear relationship between WWI and cognitive performance in the following domains: learning and memory, verbal fluency, and processing speed, as measured by Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), respectively. Subgroup analysis and interaction tests were conducted to examine the stability of this relationship across groups. Machine learning models based on random forests were used to analyze the predictive performance of WWI for cognitive function. RESULTS: A total of 3,472 participants were included in the analysis. The results revealed significant negative associations between WWI and low scores on the CERAD-WL [-0.96 (-1.30, -0.62)], AFT [-0.77 (-1.05, -0.49)], and DSST [-3.67 (-4.55, -2.79)]. This relationship remained stable after converting WWI to a categorical variable. In addition, this significant negative association was more pronounced in men than women and diminished with advancing age. Non-linear threshold effects were observed, with correlations intensifying between WWI and CERAD-WL when WWI surpassed 12.25, AFT when WWI surpassed 11.54, and DSST when WWI surpassed 11.66. CONCLUSIONS: A higher WWI, indicating increased abdominal obesity, was associated with deficits in learning, memory, verbal fluency, and processing speed among older adults. These findings suggest that abdominal obesity may play a crucial role in cognitive decline in this population. The stronger relationship observed between WWI and cognition in men highlights the need for gender-specific considerations in interventions targeting abdominal obesity. The results demonstrate the importance of interventions targeting abdominal obesity to preserve cognitive performance in older adults.

Dietary gangliosides rescue GM3 synthase deficiency outcomes in mice accompanied by neurogenesis in the hippocampus.

Ganglioside GM3 synthase is a key enzyme involved in the biosynthesis of gangliosides. GM3 synthase deficiency (GM3SD) causes an absence of GM3 and all downstream biosynthetic derivatives, including all the a-, b-, c-series gangliosides, commonly found in neural tissues. The affected individuals manifest with severe irritability, intractable seizures, hearing loss, blindness, and profound intellectual disability. It has been reported that oral ganglioside supplementation has achieved some significant improvements in clinical symptoms, growth parameters, and developmental and cognitive scores in GM3SD patients. To gain insight into the molecular mechanisms of this supplementation, we performed supplementation of oral bovine milk gangliosides to GM3 synthase-deficient mice from early weaning periods. The oral milk ganglioside preparations were dominated by GM3 and GD3 gangliosides. Oral milk ganglioside supplementation improved the decreased cognitive function observed in GM3 synthase-deficient mice. The improvement in cognitive function was accompanied by increased ganglioside levels and neurogenesis in the hippocampus in the supplemented animals.

Association of Myostatin With Complications and Cognition in Lung Cancer Patients With Sarcopenia.

INTRODUCTION: The risk of surgery and postoperative complications increases greatly in frail older patients with sarcopenia. The purpose of this study is to explore the correlation between myostatin (MSTN) levels and cognitive function and postoperative pulmonary complications (PPCs) in older patients undergoing thoracoscopic lobectomy and to determine whether MSTN could be used to predict the risk of postoperative complications and cognitive impairment. METHODS: A prospective observational study was conducted at the First Affiliated Hospital of Bengbu Medical College, China, between January 2023 and June 2023. The risk factors of PPCs and postoperative cognitive impairment were studied using backward stepwise logistic regression analysis. The independent factors were formed into a linear regression equation to construct a risk score model for each patient. The 122 patients who participated in the study were divided into two groups, a low-level group and a high-level group, based on an MSTN level cut-off; the preoperative MSTN cut-off values was 25.55 ng/mL for cognitive dysfunction and 22.29 ng/mL for PPCs. The PPCs and cognitive function of the groups were compared. RESULTS: Preoperative MSTN was confirmed as a risk factor for postoperative cognitive dysfunction and PPCs. After surgery, the proportion of patients with cognitive impairment in the high-level group was significantly higher than in the low-level group (P < 0.001). In the high-level group, the incidence of respiratory tract infections was 17.9% higher (P = 0.021), hypoxaemia was 20.5% higher (P = 0.001) and respiratory failure was 14.4% higher (P = 0.012) than in the low-level group. In addition, a high level of MSTN increased the length of hospital stay (P < 0.001) and decreased the Barthel Index score (P < 0.001). CONCLUSIONS: The study findings suggest that MSTN could be used as an index to predict complications and cognitive impairment after thoracoscopic lobectomy in older patients with sarcopenia and to provide evidence for reducing postoperative cognitive impairment and PPCs.

Effects of daily listening to 6 Hz binaural beats over one month: an event-related potentials study.

The aim of the present study was to identify cognitive alterations, as indicated by event-related potentials (ERPs), after one month of daily exposure to theta binaural beats (BBs) for 10 minutes. The recruited healthy subjects (n = 60) were equally divided into experimental and control groups. For a month, the experimental group was required to practice BBs listening daily, while the control group did not. ERPs were assessed at three separate visits over a span of one month, with a two-week interval between each visit. At each visit, ERPs were measured before and after listening. The auditory and visual ERPs significantly increased the auditory and visual P300 amplitudes consistently at each visit. BBs enhanced the auditory N200 amplitude consistently across all visits, but the visual N200 amplitude increased only at the second and third visits. Compared to the healthy controls, daily exposure to BBs for two weeks resulted in increased auditory P300 amplitude. Additionally, four weeks of BBs exposure not only increased auditory P300 amplitude but also reduced P300 latency. These preliminary findings suggest that listening to BBs at 6 Hz for 10 minutes daily may enhance certain aspects of cognitive function. However, further research is needed to confirm these effects and to understand the underlying mechanisms. Identifying the optimal duration and practice of listening to 6 Hz BBs could potentially contribute to cognitive enhancement strategies in healthy individuals.

Internet and Gambling: Insights from Australia's NBN Rollout.

Gambling is a well-known leisure activity that leads to significant consequences when consumed excessively. We provide an analysis of the impact of access to faster and more reliable internet connection on gambling. We rely on variations in the rollout of Australia's largest infrastructure project, National Broadband Network (NBN) installation, to measure internet speed at the postcode level. Using gambling data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, we find that access to high-speed internet is associated with a decline in gambling proxied by the Problem Gambling Severity Index (PGSI). However, a closer look at the various forms of gambling show that internet speed is associated with an increase in online-based gambling activities, which constitute a relatively small proportion of gambling activities that Australians participate in. In contrast, internet speed is associated with a decline in venue-based gambling activities, which constitute a large proportion of gambling activities that occur in Australia, and therefore explains the overall negative effect on gambling. We find that social capital and cognitive functioning are channels through which internet speed influences gambling.

Land- and water-based aerobic exercise program on health-related outcomes in breast cancer survivors (WaterMama): study protocol for a randomized clinical trial.

BACKGROUND: Breast cancer is a prevalent form of cancer among women worldwide, often accompanied by physical and psychological side effects due to the disease and the treatment's aggressiveness. Regular physical exercise has emerged as a non-pharmacological approach to improve the quality of life of breast cancer survivors. We herein report the protocol of the WaterMama Study, which aims to evaluate the effects of land- or water-based aerobic exercise programs, compared to a health education program, on cancer-related fatigue and other health-related outcomes in breast cancer survivors. METHODS: The WaterMama trial is a randomized, single-blinded, three-arm, parallel, superiority trial. We aim to recruit 48 women ≥ 18 years of age who have completed primary treatment for stage I-III breast cancer. Participants are randomly allocated in a 1:1:1 ratio to 12-week interventions of aerobic exercise training programs either in the aquatic or land environment (two weekly 45-min sessions) plus health education (a weekly 45-min session), or an active-control group receiving health education alone (a weekly 45-min session). The primary outcome is cancer-related fatigue, and the secondary outcomes include cardiorespiratory fitness, muscular performance, muscle morphology, functional capacity, mental health, cognitive function, pain, and quality of life. Outcomes assessments are conducted before and after the 12-week intervention period. The analysis plan will employ an intention-to-treat approach and per protocol criteria. DISCUSSION: Our conceptual hypothesis is that both aerobic exercise programs will positively impact primary and secondary outcomes compared to the health education group alone. Additionally, due to its multi-component nature, we expect the aquatic exercise program promote more significant effects than the land exercise program on cancer-related fatigue, muscular outcomes, and pain. TRIAL REGISTRATION: The study was prospectively registered at ClinicalTrials.gov NCT05520515. Registered on August 26, 2022. https://clinicaltrials.gov/ct2/show/NCT05520515.

Multivariate brain-cognition associations in euthymic bipolar disorder.

BACKGROUND: People with bipolar disorder (BD) tend to show widespread cognitive impairment compared to healthy controls. Impairments in processing speed (PS), attention and executive function (EF) may represent 'core' impairments that have a role in wider cognitive dysfunction. Cognitive impairments appear to relate to structural brain abnormalities in BD, but whether core deficits are related to particular brain regions is unclear and much of the research on brain-cognition associations is limited by univariate analysis and small samples. METHODS: Euthymic BD patients (n = 56) and matched healthy controls (n = 26) underwent T1-weighted MRI scans and completed neuropsychological tests of PS, attention and EF. We utilised public datasets to develop normative models of cortical thickness (n = 5977) to generate robust estimations of cortical abnormalities in patients. Canonical correlation analysis was used to assess multivariate brain-cognition associations in BD, controlling for age, sex and premorbid IQ. RESULTS: BD showed impairments on tests of PS, attention and EF, and abnormal cortical thickness in several brain regions compared to healthy controls. Impairments in tests of PS and EF were most strongly associated with cortical thickness in the left inferior temporal, right entorhinal and right temporal pole areas. CONCLUSION: Impairments in PS, attention and EF can be observed in euthymic BD and may be related to abnormal cortical thickness in temporal regions. Future research should continue to leverage normative modelling and multivariate methods to examine complex brain-cognition associations in BD. Future research may benefit from exploring covariance between traditional brain structural morphological metrics such as cortical thickness, cortical volume and surface area.

Vagus nerve stimulation (VNS) preventing postoperative cognitive dysfunction (POCD): two potential mechanisms in cognitive function.

Postoperative cognitive dysfunction (POCD) impacts a significant number of patients annually, frequently impairing their cognitive abilities and resulting in unfavorable clinical outcomes. Aimed at addressing cognitive impairment, vagus nerve stimulation (VNS) is a therapeutic approach, which was used in many mental disordered diseases, through the modulation of vagus nerve activity. In POCD model, the enhancement of cognition function provided by VNS was shown, demonstrating VNS effect on cognition in POCD. In the present study, we primarily concentrates on elucidating the role of the VNS improving the cognitive function in POCD, via two potential mechanisms: the inflammatory microenvironment and epigenetics. This study provided a theoretical support for the feasibility that VNS can be a potential method to enhance cognition function in POCD.