[show abstract][hide abstract] ABSTRACT: Previous studies have shown that poor cognition and low body mass index were associated with increased mortality. But few studies have investigated the association between cognition and mortality across the entire cognitive spectrum while adjusting for BMI. The objective of this study is to examine the associations between cognitive function, BMI and 7-year mortality in a rural elderly Chinese cohort.
A prospective cohort of 2,000 Chinese age 65 and over from four rural counties in China were followed for 7-years. Cognitive function, BMI and other covariate information were obtained at baseline. Cox's proportional hazard models were used to determine the effects of cognitive function and BMI on mortality risk.
Of participants enrolled, 473 (23.7%) died during follow-up. Both lower cognitive function (HR = 1.48, p = 0.0049) and lower BMI (HR = 1.6, p < 0.0001) were independently associated with increased mortality risk compared to individuals with average cognitive function and normal weight. Higher cognitive function was associated with lower mortality risk (HR = 0.69, p = 0.0312). We found no significant difference in mortality risk between overweight/obese participants and those with normal weight.
Cognitive function and BMI were independent predictors of mortality risk. Intervention strategies for increasing cognitive function and maintaining adequate BMI may be important in reducing morality risk in the elderly population.
[show abstract][hide abstract] ABSTRACT: Organochlorine pesticides can interfere with the thyroid hormones that play an important role in early neurodevelopment. Although organochlorine pesticides have been banned in China since 1983, their residues are still detectable in the environment. However, few studies have investigated the adverse health effects of prenatal exposure to organochlorine pesticide residues on newborns in China. The present study, conducted in Yancheng City, Jiangsu Province, China, aimed to examine the association between the levels of organochlorine pesticides in maternal and cord sera and to assess the impact of prenatal exposure to organochlorine pesticides on thyroid hormone levels in cord serum. Eleven organochlorine pesticides in maternal and cord sera were measured in 247 mother–infant pairs recruited from Yancheng City between February 2010 and June 2010. The concentration of the thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH) were determined in cord serum. Among the 11 tested organochlorine pesticides, the detectable levels of hexachlorobenzene (HCB), β-hexachlorocycolohexane (β-HCH) and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) in both maternal and cord sera were above 50%. The levels of β-HCH and p,p'-DDE in maternal sera were positively associated with the levels in cord sera (r=0.421, P<0.01; r=0.288, P<0.01). After adjusting for confounders, the TSH level in cord serum samples was negatively associated with the HCB level (OR=0.535, 95% CI=(0.304–0.941)). Our data demonstrated that DDT, β-HCH and HCB residues bioconcentrate in maternal and cord sera. Moreover, the correlation analysis suggested that organochlorine pesticides in maternal blood can transfer through the placenta and affect newborn thyroid hormone levels.
Environmental Research 01/2014; 129:47–51. · 3.24 Impact Factor
[show abstract][hide abstract] ABSTRACT: In utero exposure to organochlorine pesticides (OCPs) is thought to be potentially harmful to fetal development. We aimed to investigate the associations of maternal and cord serum OCPs levels with infant birth weight in China. In this study, we measured serum levels of 18 OCPs in 81 mother–infant pairs, including DDT, hexachlorocyclohexanes (BHC), hexachlorobenzene (HCB), heptachlors, chlordanes, endosulfan-I, and mirex using a high-resolution-gas-chromatography with high-resolution-mass-spectrometry method. We found that p,p′-DDE and β-BHC had the highest detection rate in both maternal and cord blood serum (97.2% and 96.7%, respectively), followed by HCB (93.0%, 51.7%), p,p′-DDT (88.7%, 36.7%), and p,p′-DDD (83.1%, 60.0%). Among all OCPs, the concentration of p,p′-DDE was the highest (mothers geometric mean (GM): 203.54 ng g−1, newborns GM: 116.14 ng g−1), followed by HCB (70.62 ng g−1, 65.16 ng g−1), and β-BHC (67.67 ng g−1, 33.39 ng g−1). Multiple linear regression analyses showed that each 1 ng g−1 increment of cord serum p,p′-DDE, total DDT, and β-BHC was associated with a 0.10 g, 0.10 g, and 0.92 g decrease in infant birth weight, respectively, and as the cord serum concentrations of p,p′-DDT, p,p′-DDD, HCB and mirex increased, the infant birth weight was also decreased, although the associations were not statistically significant due to the relatively small sample size. These results suggest that p,p′-DDE, β-BHC, and HCB were the predominant OCPs in the serum of Chinese pregnant women and cord blood of their newborns. Prenatal exposure to DDT, β-BHC, HCB, and mirex were associated with a decrease in birth weight, but these results need validation in larger sample-sized studies.
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Studies concerning the effect of different types of leisure activities on various cognitive domains are limited. This study tests the hypothesis that mental, physical, and social activities have a domain-specific protection against cognitive decline. METHODS: A cohort of a geographically defined population in China was examined in 2003-2005 and followed for an average of 2.4 years. Leisure activities were assessed in 1,463 adults aged 65 years and older without cognitive or physical impairment at baseline, and their cognitive performances were tested at baseline and follow-up examinations. RESULTS: High level of mental activity was related to less decline in global cognition (β = -.23, p < .01), language (β = -.11, p < .05), and executive function (β = -.13, p < .05) in ANCOVA models adjusting for age, gender, education, history of stroke, body mass index, Apolipoprotein E genotype, and baseline cognition. High level of physical activity was related to less decline in episodic memory (β = -.08, p < .05) and language (β = -.15, p < .01). High level of social activity was associated with less decline in global cognition (β = -.11, p < .05). Further, a dose-response pattern was observed: although participants who did not engage in any of the three activities experienced a significant global cognitive decline, those who engaged in any one of the activities maintained their cognition, and those who engaged in two or three activities improved their cognition. The same pattern was observed in men and in women. CONCLUSIONS: Leisure activities in old age may protect against cognitive decline for both women and men, and different types of activities seem to benefit different cognitive domains.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 08/2012; · 4.31 Impact Factor
[show abstract][hide abstract] ABSTRACT: Selenium is considered a protective agent against free radicals through the maintenance of better enzyme activity. The few studies examining the relationship between selenium and depression have yielded inconsistent results and none of these studies considered the role of cognitive function in this context.
A cross-sectional evaluation of 1737 rural Chinese age 65 and over from two provinces in China was conducted. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Cognitive function was assessed using various cognitive instruments. Selenium measures were obtained from nail samples. Other information collected included demographic characteristics and medical history. Analysis of covariance models were used to identify factors associated with GDS score.
Higher selenium levels were associated with lower GDS scores adjusting for demographic and medical conditions (p = 0.0321). However, the association between selenium and depressive symptoms was no longer significant when cognitive function score was adjusted in the model (p = 0.2143).
Higher selenium level was associated with lower depressive symptoms without adjusting for cognition in this cohort. However, after cognition was adjusted in the model the association between selenium and depressive symptoms was no longer significant, suggesting that selenium's association with depressive symptoms may be primarily through its association with cognitive function.
[show abstract][hide abstract] ABSTRACT: Normative information is important for appropriate interpretation of cognitive test scores as a critical component of dementia diagnosis in the elderly population. A cross-sectional evaluation of 1826 participants aged 65 years and older from four rural counties in China was conducted using six cognitive instruments including tests of global cognitive function (the Community Screening Instrument for Dementia), memory (Word List Learning and Recall tasks from the Consortium to Establish a Registry for Alzheimer's Disease, IU Story), language (Animal Fluency Test), and executive function (IU Token). Multiple regression models adjusting for demographic variables were used to provide standardized residuals z-scores and corresponding percentile ranking for each cognitive test. In all cognitive tests older age was associated with worse test performance while exposure to education was related to better cognitive test performance. We also detected a significant gender difference with men scoring better than women and a significant gender by education interaction on two tests. The interaction indicates that gender difference in test scores was much smaller in participants with more education than those who had less or no education. These demographically adjusted, regression-based norms can be a useful tool to clinicians involved with differential diagnosis of cognitive and memory disorders in older adults in rural China.
The Clinical Neuropsychologist 03/2012; 26(4):641-53. · 1.68 Impact Factor
[show abstract][hide abstract] ABSTRACT: To develop a method for determining 11 kinds of phthalate metabolites in urine simultaneously.
The phthalate metabolites in human urine samples were hydrolyzed by glucuronidase, and then were concentrated by solid-phase extraction and eluted by methanol/acetonitrile (1 : 1, V/V). After chromatographic separation on phenyl column, the analytes were analyzed qualitatively and quantitatively under MRM mode.
The limits of detection (LOD) for the eleven kinds of phthalate metabolites were in the range of 0.13 - 2.27 ng/ml. The mean recoveries at the two spiked levels were 67% - 108%, with the relative standard deviation (RSD) of less than 12%.
The method can be used to determine the residues of eleven kinds of phthalate metabolites in urine accurately and sensitively.
Wei sheng yan jiu = Journal of hygiene research 01/2012; 41(1):109-12.
[show abstract][hide abstract] ABSTRACT: To investigate the relationship between environmental risk factors and respiratory and eye symptoms of women in rural areas, so as to provide baseline data for the intervention of indoor air pollution.
A household survey on the environmental risk factors and the health of 1575 rural women was analyzed.
After age and income being adjusted, the OR of smoking, passive smoking, no ventilation indoors, using both coal and biomass versus respiratory symptoms were 2.42, 1.35, 1.52 and 1.44. The OR of cooking years and the age of beginning to cook versus respiratory symptoms were 1.44 and 0.92. The OR of no ventilation indoors, using both coal and biomass versus eye symptoms were 1.67 and 1.49. The OR of cooking years and the age of beginning to cook versus eye symptoms were 1.56 and 0.92. The OR of increasing cooking time everyday versus eye symptoms was 1.36.
Exposure to indoor air pollution during cooking time was the most significant environmental risk factor for the respiratory and eye symptoms in rural women.
Wei sheng yan jiu = Journal of hygiene research 05/2011; 40(3):345-7.
[show abstract][hide abstract] ABSTRACT: To know the relationship between selenium exposure level and cognitive function and its influencing factors in rural elderly people.
A cross-sectional survey of 200 local rural elderly people were conducted by using dietary questionnaire and six cognitive questionnaires. The local environment samples were collected including food and nail and blood sample of study individuals. The trace amount of selenium were determined with 2, 3-diaminonaphthalenet fluorometric determination. Multiple stepwise regression was used to examine the association between selenium exposure level and the composite Z score adjusting for age, gender, education, and other factors that might influence the cognitive scores.
There were significant positively relationships between three selenium exposure indexes. The results showed that food selenium intake level and blood selenium level could significantly affected the Z score after adjusting age, education and other factors by using multiple stepwise regression analysis (P < 0.001).
Lower selenium exposure level maybe associated with lower cognitive function in rural elderly people.
Wei sheng yan jiu = Journal of hygiene research 07/2010; 39(4):483-5, 490.
[show abstract][hide abstract] ABSTRACT: To examine the association between hypertension and cognitive decline in older adults.
Prospective observational study.
Four rural counties in China.
Two thousand rural Chinese aged 65 and older (median age 70, range 65-92) participated in a baseline evaluation. A follow-up evaluation of 1,737 subjects was conducted 2.5 years after baseline.
Cognitive function was assessed using the Community Screening Instrument for Dementia (CSID), Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning and Recall Tests, Indiana University (IU) Story Recall Test, Animal Fluency Test, and IU Token Test. Hypertension was defined as the mean of two readings of systolic blood pressure (BP) of 140 mmHg or greater, diastolic BP of 90 mmHg or greater, or according to self-report. Cognitive decline was derived as the difference between baseline and follow-up scores. Analysis of covariance models were used to estimate the association between hypertension, BP, and cognitive decline, adjusting for other covariates.
Greater decline was found on the CERAD 10-Word List Learning (P<.001) and Recall (P=.01) scores for subjects with hypertension than for those without. In particular, significantly greater decline was seen in the group with hypertension that was not taking medication than in the group without hypertension. No significant difference on cognitive decline was found between subjects with hypertension who were taking medication and those without hypertension.
Untreated hypertension was associated with greater cognitive decline in this Chinese cohort. Better hypertension detection and treatment in elderly people, especially in developing countries, may offer protection against cognitive decline.
Journal of the American Geriatrics Society 06/2009; 57(6):1051-7. · 3.98 Impact Factor
[show abstract][hide abstract] ABSTRACT: Se is an essential trace element in human nutrition associated with antioxidant activity. Previous studies on predictors of toenail Se or serum Se have mostly concentrated on demographic factors such as age and gender. The present paper examines the association between apoE genotype and Se levels in nail samples in a rural elderly Chinese cohort.
Two thousand Chinese aged 65 years and over from four counties in China were enrolled in a cohort to study the association of Se with cognitive decline. Nail samples were collected from each participant and analysed for Se levels. Dietary Se intake was estimated from an FFQ using Se contents measured in food items collected from each village. Blood samples on filter cards were collected and analysed for apoE genotype. Mixed-effect models were constructed with nail Se level as the dependent variable and each village as the random effect, which controlled for the potential confounding effect from correlation in Se measures obtained from participants residing in the same village.
In this elderly Chinese cohort, carriers of the apoE epsilon4 allele had significantly lower Se levels measured in nail samples than non-carriers after adjusting for other significant covariates and controlling for estimated dietary Se intake. There was no significant difference between the two genotypes on estimated Se dietary intake (P = 0.6451).
Future studies are needed to examine the mechanism underlying the association between the apoE epsilon4 allele and Se levels, including the role of oxidative stress and that of reduced lipid metabolism in the apoE epsilon4 carriers.
Public Health Nutrition 04/2009; 12(12):2371-6. · 2.25 Impact Factor
[show abstract][hide abstract] ABSTRACT: Late life depression has been studied in many populations around the world. However, findings on risk factors for late life depression have remained inconsistent.
A cross-sectional survey of 1737 rural Chinese age 65 and over from two provinces in China was conducted assessing cognitive functions using various cognitive instruments and collecting information on demographic characteristics and medical history. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Analysis of covariance and logistic regression models were used to identify factors associated with the continuous GDS score, mild or severe depression.
In this cohort, 26.5% (95% CI: 24.4-28.6%) met the criteria for mild depression and 4.3% (95% CI: 3.4-5.4%) for severely depression. Living alone, history of heart attack, head injury, and fracture were associated with higher depressive symptoms. Alcohol consumption and higher cognitive function were associated with lower depressive symptoms. Living alone, not attended school, history of head injury, fracture, and low cognitive function were associated with increased probability of mild depression. Living alone, history of stroke or heart attack, and low cognitive function were associated with severe depression.
Depression, particularly mild depression, is common in rural elderly Chinese. Among a number of factors identified in this cohort as being significantly associated with depressive symptoms, living alone and lower cognitive function were the most consistent factors associated with depressive symptoms, mild and severe depression. History of stroke, heart attack, and fracture were also risk factors for depressive symptoms.
International Journal of Geriatric Psychiatry 04/2009; 24(12):1358-66. · 2.98 Impact Factor
[show abstract][hide abstract] ABSTRACT: To investigate the relationship between genetic polymorphisms of GSTT1, GSTM1 and arsenic methylation level.
247 residents in an industrial arsenic polluted village were randomly selected as subjects. The genetic polymorphisms of GSTM1 and GSTT1 were detected by multiple PCR method. Urinary inorganic arsenic (iAs), monomethylarsenic acid (MMA) and dimethylarsenic acid (DMA) concentrations were determined by ion chromatogram combined with HG-AFS.
No significant differences in the relative proportion of urinary iAs, MMA and DMA were observed between the individuals with GSTT1 positive genotype and the individuals with GSTT1 null genotype. No significant differences in the relative proportion of urinary iAs, MMA and DMA were observed between the individuals with GSTM1 positive genotype and the individuals with GSTM1 null genotype. And no significant differences in the relative proportion of urinary iAs, MMA and DMA was observed among the individuals with different GSTM1 and GSTT1 associated genotype.
The polymorphisms of GSTT1 and GSTM1 were not associated with arsenic metabolism level in the studied population.
Wei sheng yan jiu = Journal of hygiene research 08/2008; 37(4):432-4.
[show abstract][hide abstract] ABSTRACT: Trace elements are involved in metabolic processes and oxidation-reduction reactions in the central nervous system and could have a possible effect on cognitive function. The relationship between trace elements measured in individual biological samples and cognitive function in an elderly population had not been investigated extensively.
The participant population is part of a large cohort study of 2000 rural elderly Chinese persons. Six cognitive assessment tests were used to evaluate cognitive function in this population, and a composite score was created to represent global cognitive function. Trace element levels of aluminum, calcium, cadmium, copper, iron, lead, and zinc were analyzed in plasma samples of 188 individuals who were randomly selected and consented to donating fasting blood. Analysis of covariance models were used to assess the association between each trace element and the composite cognitive score adjusting for demographics, medical history of chronic diseases, and the apolipoprotein E (APOE) genotype.
Three trace elements-calcium, cadmium, and copper-were found to be significantly related to the composite cognitive score. Increasing plasma calcium level was associated with higher cognitive score (p <.0001). Increasing cadmium and copper, in contrast, were significantly associated with lower composite score (p =.0044 and p =.0121, respectively). Other trace elements did not show significant association with the composite cognitive score.
Our results suggest that calcium, cadmium, and copper may be associated with cognitive function in the elderly population.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 06/2008; 63(6):635-41. · 4.31 Impact Factor
[show abstract][hide abstract] ABSTRACT: To study the effect of high concentration arsenic in drinking water on children's intelligence.
Pupils in Hangjinhou Qi were selected as subjects. Arsenic in drinking water and urine was determined. These subjects were divided into control( < 0.05mg/L, group A), mild exposure (0.05 - 0.1mg/L, group B) and heavy exposure group(> or = 0.1 mg/L, group C), according to arsenic concentration in drinking water. The Chinese combined Raven' s test was applied to evaluate the intelligence of children. In addition, the questionnaire survey was conducted to find out information, such as general information of households, source of drinking water, health of subjects and their parents, education of parents, etc.
The boys' average intelligence quotients (IQ) were 99.4 (group A), 96.5 (group B), 94.9 (group C). On the other hand, average IQs of girls were 101.3 (group A), 98.3 (group B) and 94.2 (group C) in the sequence from high to low. When other factors were adjusted, the average intelligence quotient of girls who exposured to arsenic higher than 0.1 mg/L were significantly decreased, compared with control groups, while boys' IQ did not show so.
Children's ingested the dring water contaminating arsenic ( > 1.0mg/L) for the long run probably could have adverse effect on their intelligence development in some degree. Girls' IQ seemed more susceptible to arsenic.
Wei sheng yan jiu = Journal of hygiene research 06/2007; 36(3):347-9.
[show abstract][hide abstract] ABSTRACT: Selenium is a trace element associated with antioxidant activity and is considered to be a protective agent against free radicals through enhanced enzyme activity. Studies on selenium and cognitive function or Alzheimer's disease have yielded inconsistent results. A cross-sectional survey of 2,000 rural Chinese aged 65 years or older from two provinces in the People's Republic of China was conducted from December 2003 to May 2005 by use of the Community Screening Instrument for Dementia, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test, the Indiana University Story Recall Test, the Animal Fluency Test, and the Indiana University Token Test. Over 70% of the study participants have lived in the same village since birth. Nail samples were collected and analyzed for selenium contents. Analysis-of-covariance models were used to estimate the association between quintile selenium levels measured in nail samples and cognitive test scores, with adjustment for other covariates. Lower selenium levels measured in nail samples were significantly associated with lower cognitive scores (p < 0.0087 for all tests) except the Animal Fluency Test (p = 0.4378). A dose-response effect of selenium quintiles was also seen for those significant associations. Results in this geographically stable cohort support the hypothesis that a lifelong low selenium level is associated with lower cognitive function.
American Journal of Epidemiology 04/2007; 165(8):955-65. · 4.78 Impact Factor
[show abstract][hide abstract] ABSTRACT: Indoor air pollution (IAP) from biomass and coal is a leading cause of mortality and disease burden in the developing world. There is limited evidence of the community effectiveness of interventions for reducing IAP exposure. We conducted a community-based intervention study of stove and health education interventions in four low-income Chinese provinces: Gansu, Guizhou, Inner Mongolia, and Shaanxi. Separate townships in one county in each province were assigned to stove plus behavioral interventions, behavioral interventions alone, and control. Data on household fuel and stove use, and on concentrations of respirable particles (RPM), carbon monoxide (CO), and sulfur dioxide (SO2), were collected in peak and late heating seasons before and after interventions. The effectiveness of interventions was evaluated using difference-in-difference analysis. Pollutant concentrations were also measured in controlled tests, in which stoves were operated by expert users. In controlled tests, there was consistent and substantial reduction in concentrations of RPM (>88%) and CO (>66%); in the two coal-using provinces, SO2 concentrations declined more in Shaanxi than in Guizhou. In community implementation, combined stove and behavioral interventions reduced the concentrations of pollutants in rooms where heating was the main purpose of stove use in the peak heating season, with smaller, non-significant, reduction in late heating season. Gansu was the only province where combined stove and behavioral interventions led to pollution reduction where cooking was the primary purpose of stove use. Compared to the control group, no significant IAP reductions were seen in groups with health education alone.
Environmental Research Letters 12/2006; 1(1):014010. · 3.58 Impact Factor
[show abstract][hide abstract] ABSTRACT: Indoor air pollution (IAP) from household use of biomass and coal is a leading environmental health risk in many developing nations. Much of the initial research on household energy technology overlooked the complex interactions of technological, behavioral, economic, and infrastructural factors that determine the success of environmental health interventions. Consequently, despite enormous interest in reducing the large and inequitable risks associated with household energy use in international development and global health, there is limited empirical research to form the basis for design and delivery of effective interventions. We used data from four poor provinces in China (Gansu, Guizhou, Inner Mongolia, and Shaanxi) to examine the linkages among technology, user knowledge and behavior, and access and infrastructure in exposure to IAP from household energy use. We conclude that broad health risk education is insufficient for successful risk mitigation when exposure behaviors are closely linked to day-to-day activities of households such as cooking and heating, or have other welfare implications, and hence cannot be simply stopped. Rather, there should be emphasis on the economic and infrastructure determinants of access to technology, as well as the details of behaviors that affect exposure. Better understanding of technology-behavior interface would also allow designing technological interventions that account for, and are robust to, behavioral factors or to provide individuals and households with alternative behaviors. Based on the analysis, we present technological and behavioral interventions for these four Chinese provinces.
Social Science [?] Medicine 07/2006; 62(12):3161-76. · 2.73 Impact Factor