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Background: Previous studies have confirmed that physical exercise may be beneficial for brain health, but there is little data on this among older Chinese. Objective: The purpose of this study was to explore the relationship between physical exercise and cognitive impairment, and to explore the possible mechanism by which physical exercise prevents cognitive decline. Materials and methods: 192 older adults with dementia, 610 older adults with mild cognitive impairment (MCI), and 2,218 healthy older adults were included in the study. Through standardized questionnaires, we obtained their general demographic information (such as gender, age, education, etc.), disease-related information (hypertension and diabetes) and physical exercise information (such as whether they did physical exercise and the frequency of physical exercise, etc.). The mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess their overall cognitive function, while the Wechsler block diagram was used to assess their executive function. Moreover, 164 healthy, randomly selected older adults also underwent brain MRI scans at the same time, and the target brain regions included hippocampus, gray matter, and cerebellar cortex. Results: By using stepwise multiple logistics regression analysis, we found that physical exercise was associated with both MCI (p = 0.001*, OR = 0.689, 95%CI: 0.553-0.859) and dementia (p < 0.001*, OR = 0.501, 95%CI: 0.354-0.709), independent of gender, age, education, and other factors. The results of ROC curve showed that the area under the curve of physical exercise in predicting MCI and dementia was 0.551 (p < 0.001*, 95%CI: 0.525-0.577) and 0.628 (p = 0.001*, 95%CI: 0.585-0.671), respectively. The results of partial correlation analysis showed that physical exercise was associated with left cerebellar cortex (r = 0.163, p = 0.023), right cerebellar cortex (r = 0.175, p = 0.015) and Wechsler block diagram score (r = 0.235, p = 0.011). Moreover, the results of linear regression analysis mediation model showed that physical exercise may affect Wechsler block diagram score through influencing the thickness of right cerebellum cortex, and the latter may play a partial mediation effect (indirect B = 0.001, p = 0.045). Conclusion: Physical exercise might be a protective factor for mild cognitive impairment and dementia among the Chinese elderly, and there might be an association among physical exercise, executive function, and the thickness of the cerebellar cortex.
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PURPOSE: To investigate the prevalence, influencing factors, and cognitive characteristics of depressive symptoms in elderly patients with chronic schizophrenia. PATIENTS AND METHODS: A total of 241 elderly patients with chronic schizophrenia and 156 healthy controls were enrolled in this study. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms; the Positive and Negative Syndrome Scale was used to assess psychotic symptoms; and both the Mini-Mental State Examination and Montreal Cognitive Assessment were used to assess overall cognitive function, while the Activity of Daily Living Scale was used to assess daily living ability. RESULTS: The prevalence of depressive symptoms was 48.5% (117/241) in elderly patients with chronic schizophrenia, which was substantially higher than that of normal controls (17.3%, 27/156). Using a stepwise binary logistic regression analysis, we found that high education (p=0.006, odds ratio [OR]=1.122, 95% confidence interval [CI]:1.034-1.218) and hypertension (p=0.019, OR=0.519, 95% CI: 0.300-0.898) were influencing factors for the comorbidity of depressive symptoms. Compared with individuals without depressive symptoms, individuals with depressive symptoms usually display worse overall cognitive function and more severe impairment of activities of daily living, but fewer psychotic symptoms. Interestingly, the GDS score was negatively correlated with the course of the disease (r=-0.157, p=0.016), suggesting that patients who had recently been admitted to the hospital were more likely to develop depression. CONCLUSION: Elderly patients with chronic schizophrenia are often associated with higher levels of depression. Therefore, their overall cognitive function is worse, and their activities of daily living are more seriously impaired. Therefore, these patients should be provided with appropriate psychological comfort, especially those who have recently been admitted to the hospital.
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Background: The epidemic infection of coronavirus disease 2019 (COVID-19) may have a profound impact on dentistry, mainly due to the mode of transmission of the pathogen, which poses a risk to almost all dental operations. Therefore, this study aimed to investigate the prevalence and influencing factors of anxiety, depression, perceived stress, and acute stress disorder among dental medical staff in emergency situations during the COVID-19 epidemic. Methods: From April 3, 2020, to April 10, 20204, a multicenter cross-sectional study was conducted among 808 first-line dental professionals at an emergency department in mainland China. A self-designed questionnaire was used to collect general demographic information. The 7-item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), 10-item Perceived Stress Scale (PSS-10), and Acute Stress Disorder Scale (ASDS) were used to assess the severity of symptoms of anxiety, depression, perceived stress, and acute stress disorder (ASD), respectively. Results: The prevalence rates of depression, anxiety, perceived pressure, and ASD among the frontline dental medical staff were 46.4, 36.3, 65.2, and 1.1%, respectively. The frontline dental medical staff who were working in the Wuhan area reported experiencing more anxiety (p = 0.038) and perceived stress (p < 0.001) compared with those who were not working in the Wuhan area. The frontline dental medical staff who were working in a general hospital reported experiencing more dissociation symptoms (p = 0.001) compared with those working in a specialized or private hospital. Individuals with a past medical history reported experiencing more anxiety (p = 0.009), depression (p < 0.001), and perceived stress (p = 0.003) than those without, and individuals with lower levels of education showed higher levels of anxiety (p = 0.038). Binary logistic regression analysis results (after controlling for other confounders) suggested that having a past medical history was a risk factor for both anxiety (p = 0.002; OR = 2.441; 95% CI, 1.384-4.306) and perceived stress (p = 0.001; OR = 1.417; 95% CI, 1.145-1.754). Conclusions: The prevalence of mental symptoms was high among the first-line emergency dental staff. Male sex, working in the Wuhan area, working in a general hospital, a past medical history, and lower levels of education were risk factors. Therefore, we need to pay close attention to the mental health problems of frontline dentists during the COVID-19 outbreak and adopt active preventive strategies to maintain their physical and mental health.
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Background: In China, intergenerational rearing is a ubiquitous phenomenon based on unique national conditions. This study aimed to explore family dynamics in intergenerational rearing families as well as their correlation with older household members' anxiety and depression. Methods: The elderly from intergenerational (n = 141) and non-intergenerational rearing families (n = 266) were investigated using the following scales: the general information questionnaire, Self-Rating Scale of Systemic Family Dynamics, Geriatric Depression Scale, and Self-Rating Anxiety Scale. Results: Scores from the four dimensions (family atmosphere, system logic, individuation, and the concept of disease) of the structure of family dynamics were computed. The comparison of these dimensions scores and the total scores of grandparents' anxiety and depression for the two groups were not statistically significant (p > 0.05). In Pearson's correlation analysis, no significant correlation between the family atmosphere dimension and the total score of the grandparents' depression and anxiety scales was observed. The system logic aspect was negatively correlated with depression and anxiety scale scores. The individual dimension was positively correlated with the anxiety scale scores. The disease concept dimension was positively correlated with depression and anxiety scale scores. Hence, the results were statistically significant. Conclusion: There were no significant differences in terms of family dynamics and risk of anxiety and depression among grandparents between the two family types. The system logic, individuation, and disease concept dimensions were correlated with their anxiety and depression.
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BACKGROUND: With the rapid increase in ageing population, China is confronted with the daunting challenge of a growing number of patients with neurocognitive disorders (NCDs). This trend makes the maintenance of self-health and early intervention essential, highlighting the need for a tool that assesses self-efficacy of older adults in maintaining brain health or cognitive function. AIM: This study aimed to design the Brain Health Self-Efficacy Scale (BHSES) to measure elderly individuals' attitudes to NCDs, motivations and future plans for controlling risks. The psychometric properties of BHSES have been validated. METHODS: Based on the current literature and relevant models, a 19-item scale was created during the first stage. A total of 660 older adults in the Yinhang community of Shanghai were included. The statistical approaches of item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), criterion-related validity and reliability test were used to evaluate the quality of BHSES. In addition, the Geriatric Depression Scale (GDS) and the Self-Rating Anxiety Scale (SAS) were used as criteria to test the criterion-related validity. RESULTS: To test item differentiation, the study adopted item analysis and excluded item 8. Selecting a random half of the sample for EFA, the BHSES was refined to 16 items, which were categorised into the following three dimensions: 'memory belief efficacy', 'self-care efficacy' and 'future planning efficacy'. These were highly consistent with the hypothesis model. Its cumulative variance contribution rate reached 61.14%, with factor loads of all items above 0.5. The three-factor model was confirmed by the remaining data through CFA. All fit indices reached the acceptable level (χ2=3.045, Goodness of Fit Index=0.898, adjusted Goodness of Fit Index=0.863, Comparative Fit Index=0.916, Incremental Fit Index=0.917, Tucker-Lewis Index=0.900, root mean square error of approximation=0.079 and root mean residual=0.068). The GDS and SAS scores revealed significant correlations with the BHSES score, indicating a high criterion-related validity. The overall Cronbach's α coefficient was 0.793, with the α coefficients' distribution of subdimensions ranging from 0.748 to 0.883. CONCLUSIONS: The 16-item, self-compiled BHSES is a reliable and valid measurement. It could help identify older adults with potential risks for developing NCDs or with high suspicion of cognitive impairment onset in recent periods and also offer insight into tracking brain health self-efficacy in association with cognition status.
