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Associations of Long-Term Tea Consumption with Depressive and Anxiety Symptoms in Community-Living Elderly: Findings from the Diet and Healthy Aging Study
Abstract
Objective:
To examine the association between long-term tea consumption and depressive and anxiety symptoms in community-living elderly.
Design:
Community based cross-sectional study.
Setting:
The Diet and Healthy Aging Study (DaHA), a prospective cohort study in Singapore.
Participants:
614 elderly aged 60 years and above, who were free of dementia and cognitive impairment.
Measurements:
Information on tea consumption was obtained through interviewer-administered questionnaire. Long-term tea drinking was defined as regular consumption for at least 15 years. Depressive and anxiety symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15) and the 20-item Geriatric Anxiety Inventory (GAI), respectively. A generalized structural equation model (gSEM) was applied to ascertain the association between long-term tea consumption and depressive and anxiety symptoms.
Results:
About 59% of the subjects had consumed tea for over 15 years. Long term tea consumption was significantly associated with a reduced odds of having depressive and anxiety symptoms, after adjusting for demographics (i.e., age, gender, education and ethnicity), comorbid conditions (i.e., heart disease, diabetes, stroke, hypertension and hyperlipidaemia) and long-term coffee consumption.
Conclusion:
There was evidence suggesting that long-term tea consumption was associated with reduced depressive and anxiety symptoms among community-living elderly. This suggests that it is worthwhile to further investigate the role of tea's bioactive compounds in promoting mental health in aging.
... Mixed findings are reported from less than a dozen cross-sectional and prospective cohort studies [15][16][17][18] and two meta-analyses [19,20] published in 2015 and 2016 have summarized the heterogeneous association between tea drinking and depression with divergent conclusions. Since then, there have been several more crosssectional studies that support an inverse association of tea consumption with depression [21][22][23][24][25][26]. However, there remains a paucity of studies that examine the dose-response effect for different types of tea. ...
... Daily consumption of one or more cups of green, fermented, or floral tea was associated with up to 50% lowered odds of having depressive symptoms. These findings are in line with previous observations of an inverse association of tea consumption with the risk of depression [22][23][24][25][26][27]. ...
... One is that several types of tea consumption were investigated simultaneously in the study. Most prior studies mainly investigated only one type of tea alone [21,24]; or unspecified tea type [18,22,23,26]. In two studies, green and black (fermented) tea were both investigated [25,26]. ...
Abstract Background Existing research indicates that tea drinking may exert beneficiary effects on mental health. However, associations between different types of tea intake and mental health such as depression have not been fully examined. The purpose of this study was to examine the associations of green tea, fermented tea, and floral tea consumption with depressive symptoms. Methods We used data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, a nationwide survey on older adults in mainland China. A total of 13,115 participants (mean age 83.7 years, 54.2% were women) with valid responses were included in the analysis. The type (green, fermented [black, Oolong, white, yellow, dark, and compressed teas], and floral) and the frequency of tea consumption were recorded, and depressive symptoms were assessed using 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10). We examined the associations between the type and the frequency of tea intake and depression, controlling for a set of demographic, socioeconomic, psychosocial, behavioral, and health-related variables. Results Overall, intakes of green tea, fermented tea, and floral tea were all significantly associated with lower prevalence of depressive symptoms, independent of other risk factors. Compared with the group of no tea intake, the adjusted ORs of depressive symptoms for daily green tea, fermented tea, and floral tea intake were 0.85 (95% CI: 0.76–0.95), 0.87 (95% CI: 0.76–0.99), and 0.70 (95% CI: 0.59–0.82), respectively. Linear associations were observed between the frequencies of all three types of tea intake and depressive symptoms (P
... Experimental research has highlighted the potential anti-depressant effects of tea polyphenols and suggest that regular tea consumption may reduce the risk and severity of depression in humans (3)(4)(5)(6)(7)(8)(9)(10). Epidemiological evidence for the benefits of tea consumption on mental health and wellbeing is however inconclusive (11,12). Mixed findings are reported from about a dozen studies (13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The majority of studies are of cross-sectional design, and there is a paucity of prospective cohort studies that examine dose-response effect for different types of tea. ...
... Our study adds to a growing body of recent epidemiological reports supporting the anti-depressant effects of tea consumption in older people, particularly in Asian populations (13,15,16,(18)(19)(20)(21)(22). The dose-response association appears to ...
... Flowchart of cohort recruitment and data extraction support a threshold level for 3 or more cups of teadaily, and possibly as well for 1-2 cups daily, especially for green tea. Prior studies have variously investigated unspecified tea type, which included two reports of null association with depression (14,17,20,21) or only one type (green tea) alone which both reported positive association with reduced depressive symptoms (18,20). In two studies which investigated both green and black tea (16,19) one study in rural North China reported lower odds of depressive symptoms for green and black tea (16), whereas the other study in Eastern China reported an inverse association of black tea and depression, but not for green tea (19). ...
Objectives
Experimental evidence suggest that tea polyphenols have anti-depressant effect and tea consumption may reduce the risk and severity of depression. We investigated whether tea consumption was associated with changes in depressive symptoms over time among Asian older adults.DesignPopulation-based prospective cohort study with mean 4 years of follow up.SettingSingapore Longitudinal Ageing Study (SLAS) of community-living older persons.Participants3177 participants overall (mean age 67 years) and 3004 participants who were depression-free at baseline.MeasurementsBaseline tea consumption which include Chinese (black, oolong or green) tea or Western (mixed with milk) tea and change in Geriatric Depression Scale (GDS) measure of depression. Incident depression was defined by GDS≥5, and GDS depression improvement or deterioration by GDS change of ≥4 points. Estimated odds ratio and 95% confidence intervals (OR, 95%CI) were adjusted for baseline age, sex, ethnicity, education, housing type, single/divorced/widowed, living alone, physical and social activity, smoking, alcohol, number of comorbidities, MMSE, and baseline GDS level.ResultsCompared to non-tea drinkers, participants who consumed ≥3 cups of tea of all kinds were significantly less likely to have worsened GDS symptoms: OR=0.32, 95% CI=0.12, 0.84. Among baseline depression-free participants, the risk of incident GDS (≥5) depression was significantly lower (OR=0.34, 95%CI=0.13, 0.90) for daily consumption of all types of tea, and Chinese (black, oolong or green) tea (OR=0.46, 95%CI=0.21,0.99).Conclusion
This study suggests that tea may prevent the worsening of existing depressive symptoms and the reduce the likelihood of developing threshold depression.
... In addition to cognitive functions, tea drinking has also been linked to mental health. For example, studies have found that tea drinking can reduce stress (Unno et al., 2016(Unno et al., , 2017, play an independent and protective role in reducing depression (García-Blanco et al., 2017), and alleviate distressing symptoms associated with anxiety (Chan et al., 2018;Pan et al., 2017). Thus, these results showed that tea drinking can enhance mental health. ...
... Finally, the current study did not indicate a significant relationship between tea drinking and depression or anxiety, which is inconsistent with previous studies (Chan et al., 2018;García-Blanco et al., 2017;Pan et al., 2017). This finding could be linked to the characteristics of the older adults included in the present study. ...
Cognitive disorders have emerged as an important public health problem among older adults in China. Cohort studies investigating the relationship between tea consumption, various cognitive functions, and mental health have exhibited limited evidence and inconsistent findings. The present study aimed to explore the associations between these variables among community-dwelling Chinese older adults. Analysis of covariance (ANCOVA) was used to compare scores on cognitive functions among green tea-consumers (GTC), other types of tea consumers (OTC), and non-tea-consumers (NTC), after adjusting for gender, education, residence, drinking, smoking, and hobbies. Thereafter, binary logistic regression analysis was applied to evaluate the role of tea consumption in differentiating between patients with mild cognitive impairments (MCI) and the controls without impairment. Among 972 participants, green tea consumption was significantly associated with improved performance on global cognitive function except for mental health assessments. In contrast to NTC, reduced risk of cognitive impairment was observed for both GTC and OTC after adjusting for demographic, lifestyle, and body health indicators. Furthermore, a significant correlation was found between tea consumption and improved cognitive performance. Thus, tea consumption played an important role in distinguishing older adults with mild cognitive impairment from older adults without cognitive impairment.
... Mixed ndings are reported from less than a dozen cross-sectional and prospective cohort studies [16][17][18][19] and two meta-analyses 20,21 published in 2015 and 2016 have summarized the heterogeneous association between tea drinking and depression with divergent conclusions. Since then, there have been several more cross-sectional studies which support an inverse association of tea consumption with depression [22][23][24][25][26][27] . However, there remains a paucity of studies that examine dose-response effect for different types of tea. ...
... One is that several types of tea consumption were investigated simultaneously in the study. Most prior studies mainly investigated only one type of tea alone 22,25 ; or unspeci ed tea type 19,23,24,27 . In two studies, green and black (fermented) tea were both investigated 26,27 . ...
Background
Existing research indicates that tea drinking may exert beneficiary effects on mental health. However, associations between different types of tea intake and mental health such as depression are not fully examined. The purpose of this study was to examine the associations of green tea, fermented tea, and flowering tea consumption with depressive symptoms.
Methods
We used data from the 2018 wave of Chinese Longitudinal Healthy Longevity Survey. The type (green, fermented [black, Oolong, white, yellow, dark, and compressed teas], and flower) and frequency of tea consumption and depressive symptoms for 13,115 participants were assessed. We examined the associations between type and frequency of tea intake and depression, controlling for a set of demographic, socioeconomic, psychosocial, behavioral, and health-related variables.
Results
Overall, intake of green tea, fermented tea, and flower tea were all significantly associated with a lower prevalence of depression, independent of other risk factors. Compared with the group for no tea intake, the adjusted ORs for daily green tea, fermented tea, and flower tea intake were 0.85 (0.76-0.95), 0.87 (0.76-0.99), and 0.70 (0.59-0.82), respectively. Linear associations were observed between frequency of all types of tea intake with depressive symptoms (Ps for trend<0.05). The associations of type and frequency of tea intake and depressive symptoms were robust in several sensitivity analyses.
Conclusions
Among Chinese old adults, regularly consumed any type of tea (green, fermented or flower) were less likely to show depressive symptoms, the associations seemed more pronounced among flower tea and green tea drinkers.
... 17 On the other hand, the DaHA (cohort) study placed emphasis on dietary factors and its association with healthy ageing and reduced risk of age-related medical conditions. 5 For instance, the bioactive compounds found in mushroom and long-term tea consumption were associated with delay in cognitive impairment and reduced depression/anxiety symptoms, respectively. 5 18 The cohort study later invited suitable subjects to participate in subsequent non-pharmacological RCTs that aimed to improve cognitive and psychological health-art therapy and music reminiscence activity, 19 mindfulness awareness programme 20 and horticultural therapy. ...
... The medical history of participants and their family will be collected using the self-reported questionnaire from the Diet and Health Aging study. 5 Medical conditions such as hypertension, stroke, diabetes, hyperlipidaemia, cancer, cataracts, mental health illnesses and many more will be recorded. ...
Introduction
Ageing is associated with a multitude of healthcare issues including dementia, depression, frailty, morbidity associated with chronic disease and high healthcare utilisation. With Singapore’s population projected to age significantly over the next two decades, it has become increasingly important to understand the disease burden and etiological process among older adults. The Community Health and Intergenerational study aims to holistically examine ageing in place by investigating the resilience and vulnerability factors of the ageing process in the biological, psychological and social domains within the environment.
Methods and analysis
Using a cohort multiple randomised controlled trial design, comprehensive health profiles of community-dwelling older adults will be collected. The objective is to recruit 1000 participants (aged 60–99 years) living in the western region of Singapore within a period of 3 years (2018–2020). Assessments include basic sociodemographic, physical health and function (cardiac, oral and blood profiles and visual function), cognitive functioning, daily functioning, physical fitness, emotional state, free-flowing speech, sleep quality, social connectedness, caregiver burden, intergenerational communication, quality of life, life satisfaction, attitudes to ageing and gratitude and compassion. Results from the cohort will enable future studies to identify at-risk groups and develop interventions to improve the physical and mental health and quality of life of older adults.
Ethics and dissemination
Approval of the cohort study by the National University of Singapore Institutional Review Board (NUS-IRB Reference code: H-17-047) was obtained on 12 October 2017. Written consent will be obtained from all participants. Findings from the cohort study will be disseminated by publication of peer-reviewed manuscripts, presentations at scientific meetings and conferences with local stakeholders.
... Epidemiological studies have reported that the consumption of tea has preventive effects on psychiatric disorders, including depression [13] and cognitive decline leading to dementia [14,15]. An epidemiological survey in Finland reported that people who consume black tea score lower on the Beck Depression Inventory and have lower rates of depression [16], whereas another epidemiological study reported that tea reduces the risk of anxiety and depressive mood [17]. ...
... Theaflavins suppressed production of pro-inflammatory cytokines in murine and human microglia, and hence neurotoxic effects of activated microglia. This finding is consistent with epidemiological studies reporting that tea consumption suppresses cognitive decline and depressive symptoms [13][14][15]. The anti-inflammatory effect of theaflavins was stronger than those of other polyphenols like catechin in green tea and chlorogenic acid and caffeic acid in coffee, but it was equivalent to that of EGCG in green tea. ...
Inflammation in the brain is associated with various disorders including Alzheimer’s disease and depression. Thus, inflammation has received increasing attention regarding preventive approaches to such disorders. Epidemiological investigations have reported that drinking tea reduces the risk of dementia and depression. Theaflavins, a polyphenol found in black tea, are known to have anti-oxidative and anti-inflammation effects, but the effects of theaflavins on cognitive decline and depression induced by inflammation have not been investigated. To address this research gap, the present study assessed whether theaflavins could protect synapses and dendrites damaged by inflammation and prevent concomitant memory impairment and depression-like behavior in mice. Intracerebroventricular injection with lipopolysaccharide (LPS) induces neural inflammation associated with reduced spontaneous alternations in the Y-maze test and increased immobility in the tail suspension test, indicating impaired spatial memory and depression-like behavior, respectively. Oral administration with theaflavins prevented these behavioral changes induced by LPS. Theaflavins also suppressed productions of inflammatory cytokines and prevented dendritic atrophy and spine loss in the brain. Notably, theaflavins have a stronger anti-inflammatory effect than other polyphenols such as catechin, chlorogenic acid, and caffeic acid. These results suggest that theaflavins can suppress neural inflammation and prevent the symptoms of inflammation-related brain disorders.
... Other studies have focused on the effects of tea consumption on depression and sleep quality. It has been shown that frequent tea drinkers have significantly lower levels of depression (22)(23)(24)(25)(26)(27) and that frequent tea drinking is effective in improving sleep quality in older adults (28)(29)(30), while depression and sleep disturbance are often considered risk factors for cognitive function in older people (31)(32)(33)(34)(35). Therefore, we hypothesise that depression levels and sleep quality may play mediating roles in the association between frequent tea consumption and cognitive function. ...
Objectives
This present study aims to investigate the effect of tea consumption on cognitive function and examine possible psychosocial mechanisms in older adults.
Participants and methods
The data of this study came from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS), and a total of 11,910 valid samples were included. We used ordinary least squares (OLS) to explore whether frequent tea consumption had significant effect on the cognitive function of older people. The problem of endogeneity was addressed by using a propensity score matching (PSM). Then we further explored the psychosocial mechanisms of the effect using a stepwise regression approach.
Results
Frequent tea consumption produced a positive effect on Mini-Mental State Examination (MMSE) score (coefficient = 0.340, p < 0.01), and PSM showed similar results. Specifically, the positive effect of green tea (coefficient 0.409, p < 0.01) was significantly greater than the other teas (coefficient 0.261, p < 0.1). Moreover, frequent tea drinkers were 59.7, 74.8, and 81.8% less likely to have severe, moderate and mild cognitive impairment respectively, compared to infrequent tea drinkers ( p < 0.01). Levels of depression and sleep quality had partial mediation effect for frequent tea consumption on cognitive function, accounting for 27.6 and 3.5% of the total effect, respectively.
Conclusion
Frequent tea consumption was found to have beneficial effects on cognitive function, especially in older people with green tea intake. Sleep quality and levels of depression partially mediated the association between frequent tea consumption and cognitive function among Chinese older adults.
... In examination of dietary habits, participants with frequent (≥4 days per week) fruit consumption and active (≥4 days per week) bowel movement within 10 minutes were negatively associated with MCI occurrence [29]. In addition, a cross-sectional evaluation of diet-mental health relationship found that long-term tea consumption was significantly associated with a reduced odds of having depressive and anxiety symptoms among DaHA participants [30]. In a Magnetic Resonance Imaging (MRI) study, we found that regular tea drinkers had more efficient brain structural network as compared with non-tea drinkers [31]. ...
How diet is related with cognition and health has not been systematically examined in Asians whose eating habits are very different from their counterparts in the West and the biological mechanisms underlying such www.aging-us.com 2 AGING links are not well known yet. The diet and healthy aging (DaHA) study is a community-based longitudinal study conducted to examine the role of diet and nutrition in promoting cognitive, emotional, and physical health among community-living elderly Singaporeans. The first wave of DaHA, conducted from 2011 to 2017, provided detailed information on diet and baseline cognitive function and health from 1010 community-living elderly in Singapore. Biomarkers of oxidative stress, systemic inflammation, and genetic information were collected. The ongoing second wave of DaHA is conducted from 2017 to 2020, which provides follow-up assessments using established cognitive tests and clinical tools. This well-characterized cohort, with its archived biological samples and high-quality data on diet and lifestyle factors will allow researchers to explore the relationships among diet, nutrition, genes, cognition, mental and physical health in an extremely cost-effective manner. Translations of the research findings into clinical and public health practices will potentially help to promote cognitive health at the population level and reduce healthcare costs related to cognitive impairment.
... Moreover, a higher consumption of fish rich in long-chain n-3 PUFA could contribute to brain functioning and serotonin neurotransmission (29) . Furthermore, a previous study has also reported that tea consumption significantly reduced depressive and anxiety symptoms among community-living elderly (30) . On the other hand, pickled vegetables contain large amounts of salt, which could increase the risk of hypertension, a risk factor for mental disorders (31) . ...
Objective
The current study aimed to evaluate the association of major dietary patterns with anxiety in middle-aged adults in eastern China.
Design
Dietary intake was assessed using a semi-quantitative FFQ. Binary logistic regression analysis was used to estimate OR and 95 % CI for anxiety according to quartiles of each dietary pattern score.
Setting
Evidence regarding the relationship between dietary patterns and anxiety in the Chinese population is scarce.
Participants
The study participants were 1360 Chinese adults aged 45–59 years, who participated in a health survey at the time of periodic check-up in the city of Linyi, Shandong Province, China.
Results
Four major dietary patterns were identified by factor analysis: traditional Chinese, western, grains–vegetables and high-salt diets. After adjusting for potential confounders, participants in the highest quartile of the western pattern had greater odds for anxiety, compared with those in the lowest quartile (OR 1·35, 95 % CI 1·000, 3·086, P < 0·05). In contrast, participants in the highest quartile of the grains–vegetables pattern had lower odds for anxiety than did those in the lowest quartile (OR 0·78, 95 % CI 0·574, 1·000, P < 0·05). Moreover, no significant associations were observed between the traditional Chinese and high-salt patterns and the risk of anxiety.
Conclusions
Our findings indicate that the western pattern is associated with an increased risk, and the grains–vegetables pattern is associated with a decreased risk of anxiety.
... Thus, the foods were categorized based on the results of previous studies on the correlations between cognitive function and symptoms of depression with the intake of cooked rice with other grains and legumes [12], beans [26], eggs [13], meat and processed foods [16], poultry [27], fish [8], vegetables [8], seaweeds [13], and nuts [8]. In addition, coffee (54.53%), cooked rice with other grains and legumes (54.39%), and cooked rice (47.24%) were considered the most frequently consumed food items in Korea based on the 2015 National nutrition statistics [28], and, in particular, the intake of coffee was reported to affect health [29][30][31]. The food items were then classified and categorized in detail as presented in Table 1. ...
BACKGROUND/OBJECTIVE
As aging progresses, the number of patients with cognitive impairment also increases. Cognitive function is not generally correlated with diet, and there is debate over that association. Thus, the present study aimed to investigate the association between dietary intake and cognitive function among adults aged 50 years or older.
SUBJECTS/METHODS
Between July 2017 and March 2018, 324 adults aged over 50 years from Gwangju Sun-Han hospital participated in a dietary survey. The frequency of food intake and related information were collected using a semi-quantitative food frequency questionnaire (SQ-FFQ) and determining the mini-mental state examination (MMSE) level for 276 participants. The association between dietary intake and cognitive function was assessed by performing logistic regression analysis.
RESULTS
Depending on the MMSE score, the participants' age, education level, inhabitation status, medications, alcohol consumption, sleep duration, physical activity, and short geriatric depression scale score were significantly different (P < 0.05). Moreover, those participant characteristics were associated with either decreased or increased odds ratios (OR) for the risk of mild cognitive impairment (MCI). Based on analysis of the participants' intake of 112 detailed food items, which were categorized into 20 food types, intakes of cooked white rice (< 2 times/day compared with ≥ 3 times/day) (P < 0.05), properly cooked rice with other grains and legumes (P < 0.001), fruits (P < 0.05), milk (low fat and normal) (P = 0.044), liquid-type yogurt (P = 0.019), and curd-type yogurt (P = 0.015) were found to significantly decrease the OR for the risk of MCI.
CONCLUSIONS
Associations were significant between the risk of MCI and the intake of certain food types. Specifically, a moderate intake of cooked white rice and an adequate intake of whole grains, fruits, milk, and dairy products were associated with reduced risks of MCI among adults aged over 50 years.
... The ORs were 0.79 (95% CI: 0.42, 1.48) for low tea consumption participants, 0.47 (95% CI: 0.25, 0.88) for medium tea consumption participants, and 0.27 (95% CI: 0.11, 0.63) for high tea consumption participants (p = 0.01) [23]. A cohort study involving 614 adults aged 60 or older who were free of dementia and CoI showed that long-term tea consumption for at least 15 years was associated with reduced depressive and anxiety symptoms among community-living elderly persons [24]. ...
Neurodegenerative disease Alzheimer’s disease (AD) is attracting growing concern because of an increasing patient population among the elderly. Tea consumption is considered a natural complementary therapy for neurodegenerative diseases. In this paper, epidemiological studies on the association between tea consumption and the reduced risk of AD are reviewed and the anti-amyloid effects of related bioactivities in tea are summarized. Future challenges regarding the role of tea in preventing AD are also discussed.
Accumulating evidence has reported the associations of coffee consumption with physical conditions and mortality, but the associations with mental disorders were limited. The objective of this study was to examine the associations of coffee consumption with incident depression and anxiety, and to assess whether the associations differed by coffee subtypes (instant, ground, and decaffeinated coffee) or additives (milk, sugar-sweetened, and artificial-sweetened). In this prospective cohort study, we utilized data from the UK Biobank and included a total of 146,566 participants who completed the touchscreen questionnaire at baseline between 2006 and 2010. During the follow-up, incident depression and anxiety were measured in 2016 using the Patient Health Questionnaire (PHQ)-9 and the Generalised Anxiety Disorder Assessment (GAD)-7, respectively. Multivariable-adjusted logistic regression models and restricted cubic splines were used to assess the associations. Approximately 80.7% of participants reported consuming coffee, and most drank 2 to 3 cups per day (41.2%). We found J-shaped associations between coffee consumption and both incident depression and anxiety, with the lowest risk of the mental disorders occurring at around 2-3 cups per day. Results were similar for participants who drank 2-3 cups of ground coffee, milk-coffee, or unsweetened coffee. Our findings highlight that 2-3 cups of coffee consumption could be recommended as part of a healthy lifestyle to improve mental health.
Background
Vast accumulative evidence suggests that the consumption of tea and its components have various potential health benefits. This study used a longitudinal study to examine the causality between tea consumption and frailty in older Chinese people.
Methods
This study employed the longitudinal data from 2008 to 2014 of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which were systematically collected through face-to-face interviews. Two thousand four hundred and seventy three participants completed six-follow-up surveys in 2014 and were analyzed in this study. The frailty index recommended by Searle and co-authors, including 44 health deficits, was used. A Generalized Estimating Equation (GEE) was applied to determine the risk ratio (RR) with a 95% confidence interval (CI) for frailty, and further subgroup analyses were conducted to investigate whether the risk differed stratified by age, sex, and socioeconomic status. Additionally, the interaction between tea consumption with sex and frailty was tested.
Results
Of the 2,473 participants, 14.1% were consistent daily tea drinkers, and 22.6% reported frailty at the 6-year follow-up. Compared to non-tea drinkers, consistent daily tea drinkers reported a significantly lower ratio of having frailty [risk ratio (RR) = 0.54, 95% confidence interval (CI): 0.38–0.78], adjusting for sociodemographic characteristics, health behavior, socioeconomic status, and chronic illnesses. In further subgroup analyses, consistent daily tea consumption significantly reduced the risk of frailty for males (RR = 0.53, 95% CI: 0.32–0.87) but not females (RR = 0.65, 95% CI: 0.37–1.12); in the young (RR = 0.40, 95% CI: 0.22–0.74) but not in the oldest (aged ≥ 80) (RR = 0.66, 95% CI: 0.40–1.06); informal education (RR = 0.48, 95% CI: 0.28–0.84) but not formal education (RR = 0.62, 95% CI: 0.37–1.03); financial dependence (RR = 0.42, 95% CI: 0.25–0.71) but not financial independence (RR = 0.71, 95% CI: 0.41–1.23). Additionally, females showed a lower tea-mediated risk of frailty in occasional tea consumers (RR = 0.51, 95% CI: 0.29–0.89) and inconsistent tea drinkers (RR = 0.58, 95% CI: 0.37–0.93).
Conclusions
Habitual tea consumption can reduce the risk of frailty in older Chinese, and the benefit varied by age, sex, education, and financial support.
Background
The prospective studies on the effect of particular type of tea consumption, especially green tea, on depressive symptoms are limited.
Objective
The aim of this study is to investigate the prospective association between green tea consumption and depressive symptoms in a large general adult population.
Methods
This prospective cohort study investigated 7524 participants aged 25 to 90 years from May 2013 to December 2018 and they were free of cardiovascular disease, cancer, and depressive symptoms at baseline. Green tea consumption was obtained through a validated food frequency questionnaire. Depressive symptoms were assessed by using the Self-Rating Depressive Scale (SDS). The association between green tea consumption and depressive symptoms was analyzed by Cox proportional hazards regression models.
Results
A total of 1064 first incident cases of depressive symptoms (SDS ≥45) occurred during 14,661 person-years of follow-up (median follow-up of 2.0 years). In the crude model, the hazard ratios (95% confidence intervals) were 1.00 (reference), 0.95 (0.81, 1.12), 0.97 (0.83, 1.14) and 0.95 (0.79, 1.14), respectively. After adjusting for demographic characteristics, lifestyle factors, and dietary intake, the multivariable adjusted hazard ratios (95% confidence intervals) were 1.00 (reference), 0.88 (0.74, 1.05), 0.84 (0.69, 1.02) and 0.78 (0.63, 0.97), respectively.
Conclusions
The prospective study suggests that frequent green tea consumption is associated with a decreased risk of depressive symptoms in the general Chinese population.
Previous studies showed that some components in tea had potential beneficial effects on depression. However, population-based studies examining the potential benefits of tea on depression were limited. We hypothesized that older Chinese with habitual tea consumption had lower levels of depressive symptoms than those without habitual tea consumption. A cross-sectional analysis of baseline data from the Guangzhou Biobank Cohort Study (GBCS) was conducted. Depressive symptoms were measured by the 15-item Geriatric Depression Scale (GDS) score (continuous), with the presence defined by a GDS≥ 8. Of 10014 participants, 421 (4.20%) had depressive symptoms. After adjusting for potential confounders, compared to never-consumers, occasional and regular consumers had lower GDS score (β (95% confidence interval): -0.29 (-0.46, -0.11) and -0.60 (-0.78, -0.42), respectively), and regular consumers showed lower odds of depressive symptoms (OR (95% CI): 0.51 (0.35, 0.72). In regular tea consumers, greater frequency, amount per occasion and per week, and higher amount-years showed lower GDS score (all P for trend <0.001) and lower odds of depressive symptoms (all P for trend< 0.05) than non-consumers. The results were similar by different types of tea (green tea, black tea and oolong tea) consumed. Further adjustment for social characteristics of tea consumption attenuated the association slightly but not fully. In conclusion, habitual tea consumption was associated with lower levels of depressive symptoms among older Chinese, which might be partly explained by social interaction during consumption. Further investigation on causation and mechanisms, including mechanistic randomized controlled trials is warranted.
Neurodegenerative and neuropsychiatric diseases have attracted global attention with an overwhelming burden on families and society. Tea contains many bioactive compounds, such as polyphenols and theanine, which could contribute to the neuroprotective effects of tea. The possible mechanisms of action include regulating signaling pathways and gut microbiota; inhibiting abnormal protein aggregation; normalizing the hyperactivity of the hypothalamic-pituitary-adrenal axis; as well as antioxidant and anti-inflammatory properties of tea for Parkinson’s disease, Alzheimer’s disease, and depression. In this narrative revie w, the effects of tea on these diseases were summarized, and special attention was paid to the mechanisms of action.
Abbreviations: AChE, acetylcholinesterase; ACTH, adrenocorticotropin; AKT, serine-threonine protein kinase; BChE, butyrylcholinesterase; BDNF, brain-derived neurotrophic factor; CI, confidence interval; COX-2, cyclooxygenase-2; CRH, corticotrophin-releasing hormone; CREB, cyclic adenosine monophosphate response element-binding protein; EC, epicatechin; ECG, epicatechin-3-gallate; EGC, epigallocatechin; EGCG, epigallocatechin gallate; ERK, extracellular signal-regulated kinase; GABA, gamma-aminobutyric acid; GSK-3β, glycogen synthase kinase-3β; HPA, hypothalamic-pituitary-adrenal; HR, hazard ratio; IL, interleukin; MAOB, monoamine oxidase B; MPTP, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine; NFκB, nuclear factor kappa-light-chain-enhancer of activated B cells; Nrf2, nuclear factor erythroid 2-related factor 2; NOS, nitric oxide species; OR, odds ratio; PGC-1α; peroxisome proliferator-activated receptor gamma coactivator-1α; PI3K, phosphoinositide 3-kinase; PKC, protein kinase C; ROS, reactive oxygen species; RR, risk ratio; TLR4, Toll-like receptor 4; TNF-α; umor necrosis factor alpha; 6-OHDA, 6-hydroxydopamine.
Depression is a mood disorder which currently affects 350 million individuals worldwide. Recently, research has suggested a protective role of diet for depression. The Mediterranean-style dietary pattern has been highlighted in several systematic reviews as a promising candidate for reducing depressive symptoms. It has been speculated that this could be due to the high polyphenol content of foods commonly found in the diet. Therefore, the aim of this review was to assess the effects of polyphenols found in a Mediterranean diet on the symptoms of depression. A systematic literature review was conducted of original research which assessed the role of polyphenols on the symptoms of depression in humans. The following databases were searched: PROQUEST, SCOPUS (Elsevier), MEDLINE (EBSCO), CINAHL, and EMBase, up to 18 February, 2019. The inclusion criteria consisted of both observational and experimental research in adults aged 18-80 y that assessed depression scores in relation to polyphenol intake. A total of 37 studies out of 12,084 met the full inclusion criteria. Of these, 17 were experimental studies and 20 were observational studies. Several different polyphenols were assessed including those from tea, coffee, citrus, nuts, soy, grapes, legumes, and spices. Twenty-nine of the studies found a statistically significant effect of polyphenols for depression. This review has found both an association between polyphenol consumption and depression risk, as well as evidence suggesting polyphenols can effectively alleviate depressive symptoms. The review uncovered gaps in the literature regarding the role of polyphenols for depressive symptoms in both young adults and men. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42019125747. Adv Nutr 2019;00:1-14.
Background
Prior literature on subjective cognitive decline (SCD) mostly focused on memory complaints. It is uncertain whether the other non‐memory complaints are equally relevant and can be used, alongside memory complaints, to identify populations at high risk of cognitive impairment. We investigated how the memory and non‐memory complaints of SCD cluster with each other among community‐dwelling individuals, as well as evaluated the differential utility of the symptom‐clusters of SCD in predicting objective cognitive performance.
Methods
This study included 736 participants who were ≥60 years and had normal cognition, using the baseline data of an ongoing cohort study. Participants completed baseline assessments which comprised a SCD scale, a global cognitive measure, and neuropsychological tests. Symptom‐clusters of SCD – as identified from exploratory and confirmatory factor analyses – were included in structural equation models to predict baseline changes in neuropsychological tests.
Results
The symptoms of SCD were split into two distinct factors, of which Factor 1 was reported much more frequently than Factor 2. Each standard deviation (SD) increment in Factor 1 led to 0.16–0.50 SD increase in global cognition, immediate memory, visuospatial, language, attention and delayed memory (p<0.05). In contrast, each SD increment in Factor 2 worsened some of the cognitive domains by 0.18–0.37 SD.
Conclusions
The various complaints of SCD can have different implications among cognitively‐normal older persons, and may possibly be classified into ‘Age‐related symptoms’ and ‘Pathological symptoms’. The findings highlight the need for caution when selecting SCD measures; as well as illustrate the potential utility of SCD subtypes to inform on the underlying neurobiology.
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We examined the cross-sectional association between mushroom intake and mild cognitive impairment (MCI) using data from 663 participants aged 60 and above from the Diet and Healthy Aging (DaHA) study in Singapore. Compared with participants who consumed mushrooms less than once per week, participants who consumed mushrooms >2 portions per week had reduced odds of having MCI (odds ratio = 0.43, 95% CI 0.23-0.78, p = 0.006) and this association was independent of age, gender, education, cigarette smoking, alcohol consumption, hypertension, diabetes, heart disease, stroke, physical activities, and social activities. Our cross-sectional data support the potential role of mushrooms and their bioactive compounds in delaying neurodegeneration.
Responses: We thank Dr Joob and Dr Wiwanitkit for their interest in our research work and the valuable comments and suggestions they have provided. I fully agree with them that some uncontrolled factors, such as the intake of other foods, beverages or activities, may help protect against depressive and anxiety symptoms, and hence residual confounding cannot be completely ruled out. Further investigation is needed for a definitive conclusion. Indeed, motivated by growing evidence on neuroprotective benefits of tea consumption (1), my coworkers and I are now planning a new study in which we aim to assess the effects of tea drinking on brain health in a randomized controlled trial.
To the editor, the publication on “Associations of Long-Term Tea Consumption with Depressive and Anxiety Symptoms in Community-Living Elderly” is very interesting (1). Chan et al. concluded that “There was evidence suggesting that long-term tea consumption was associated with reduced depressive and anxiety symptoms among community-living elderly (1).” In fact, tea drinking is a rooted behavior among Chinese Asian population. The health usefulness of tea is approved. Neuroprotective system due to tea drinking is believed to due to the active ingredients including to flavonoids (2). In a recent report, the green tea was found to have more neuroprotective activity than red and black tea (3). It is no doubt that the long-term tea consumption can result in neuroprotective effect as reported by Chan et al (1). However, as noted by Chan, further investigation is needed. The main concern for the present report is confounding effect that is not controllable. The studied elderly might have other foods, beverages or activities that can help protect against depressive and anxiety symptoms. Finally, tea contain caffeine, an extremely high dose drinking might result in problem, induction of anxiety instead of prevention of anxiety (4).
Logistic regression analysis based on data from 822 Han Chinese oldest old aged 92+ demonstrated that interactions between
carrying FOXO1A-266 or FOXO3-310 or FOXO3-292 and tea drinking at around age 60 or at present time were significantly associated
with lower risk of cognitive disability at advanced ages. Associations between tea drinking and reduced cognitive disability
were much stronger among carriers of the genotypes of FOXO1A-266 or FOXO3-310 or FOXO3-292 compared with noncarriers, and
it was reconfirmed by analysis of three-way interactions across FOXO genotypes, tea drinking at around age 60, and at present
time. Based on prior findings from animal and human cell models, we postulate that intake of tea compounds may activate FOXO
gene expression, which in turn may positively affect cognitive function in the oldest old population. Our empirical findings
imply that the health benefits of particular nutritional interventions, including tea drinking, may, in part, depend upon
individual genetic profiles.
Background
Tea consumption has been reported to be associated with lowered risk of cardiovascular disease, stroke and osteoporosis that cause functional disability, but its association with physical function has not been investigated directly.
Objective
We examined the association between tea consumption and performance in gait and balance, instrumental and basic activities of daily living (IADL and BADL) in a cross-sectional study of community-living older persons.
Method
Baseline data of 2398 adults aged ≥ 55 years in the Singapore Longitudinal Ageing Studies who completed self-reported current tea consumption, Performance Oriented Mobility Assessment (POMA) of gait and balance, and self reports of BADL and IADL were analyzed.
Results
In multivariate analyses controlling for age, gender, education, housing type, co-morbidities, hospitalization, arthritis and hip fracture, GDS depression score, MMSE cognitive score, body mass index, creatinine, serum albumin, haemoglobin, physical activities score and coffee consumption, tea consumption was positively associated with better balance (β=0.06, p<0.01), gait (β=0.01, p=0.02), IADL (β=0.03, p=0.01) and BADL (β=0.01, p=0.05). Strongly positive associations were observed for black/oolong tea in multivariate analyses, and for green tea consumption only in univariate analysis, whereas coffee consumption was not associated at all.
Conclusions
Tea consumption was associated with better physical functional performances in community-living older adults.
We aimed to examine the relationship between tea consumption and cognitive function in older adults.
Cross-sectional study.
The Singapore Longitudinal Aging Studies (SLAS), a community-based study in urban Singapore.
716 Chinese adults aged > or = 55 years.
Self-reported current tea consumption habits (frequency and type). Cognitive performance was assessed by a battery of neuropsychological tests; composite domain scores on attention, memory, executive function, and information processing speed were computed using raw test scores. The Mini-Mental State Examination (MMSE) total score was used as a measure of global cognitive function.
After adjusting for potential confounders, total tea consumption was independently associated with better performances on global cognition (B=0.055, SE=0.026, p=0.03), memory (B=0.031, SE=0.012, p=0.01), executive function (B=0.032, SE=0.012, p=0.009), and information processing speed (B=0.04, SE=0.014, p=0.001). Both black/oolong tea and green tea consumption were associated with better cognitive performance. There was no association between coffee consumption and cognitive function.
Tea consumption was associated with better cognitive performance in community-living Chinese older adults. The protective effect of tea consumption on cognitive function was not limited to particular type of tea.
This review summarizes the literature on the association between tea consumption and cognitive health in late life. Population-based studies reviewed in this article suggest that tea drinking has beneficial effects on cognitive function of elderly persons. However, a cause-effect relationship between tea consumption and cognitive decline and dementia could not be drawn given inconsistent findings from only two longitudinal cohort studies. The neuroprotective effects of tea consumption could be due to catechins, L-theanine and other compounds in tea leaves. More longitudinal observational study is needed. Information on life-time tea consumption and blood concentrations of catechins and L-theanine could be collected in future studies.
Green tea is reported to have various beneficial effects (eg, anti-stress response and antiinflammatory effects) on human health. Although these functions might be associated with the development and progression of depressive symptoms, no studies have investigated the relation between green tea consumption and depressive symptoms in a community-dwelling population.
The aim of this study was to investigate the relations between green tea consumption and depressive symptoms in elderly Japanese subjects who widely consumed green tea.
We conducted a cross-sectional study in 1058 community-dwelling elderly Japanese individuals aged >or=70 y. Green tea consumption was assessed by using a self-administered questionnaire, and depressive symptoms were evaluated by using the 30-item Geriatric Depression Scale with 2 cutoffs: 11 (mild and severe depressive symptoms) and 14 (severe depressive symptoms). If a participant was consuming antidepressants, he or she was considered to have depressive symptoms.
The prevalence of mild and severe and severe depressive symptoms was 34.1% and 20.2%, respectively. After adjustment for confounding factors, the odds ratios (95% CI) for mild and severe depressive symptoms when higher green tea consumption was compared with green tea consumption of <or=1 cup/d were as follows: 2-3 cups green tea/d (0.96; 95% CI: 0.66, 1.42) and >or=4 cups green tea/d (0.56; 95% CI: 0.39, 0.81) (P for trend: 0.001). Similar relations were also observed in the case of severe depressive symptoms.
A more frequent consumption of green tea was associated with a lower prevalence of depressive symptoms in the community-dwelling older population.
Caffeine stimulates central nervous system on a short term. However, the long-term impact of caffeine on cognition remains unclear. We aimed to study the association between coffee and/or tea consumption at midlife and dementia/Alzheimer's disease (AD) risk in late-life. Participants of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study were randomly selected from the survivors of a population-based cohorts previously surveyed within the North Karelia Project and the FINMONICA study in 1972, 1977, 1982 or 1987 (midlife visit). After an average follow-up of 21 years, 1409 individuals (71%) aged 65 to 79 completed the re-examination in 1998. A total of 61 cases were identified as demented (48 with AD). Coffee drinkers at midlife had lower risk of dementia and AD later in life compared with those drinking no or only little coffee adjusted for demographic, lifestyle and vascular factors, apolipoprotein E epsilon4 allele and depressive symptoms. The lowest risk (65% decreased) was found in people who drank 3-5 cups per day. Tea drinking was relatively uncommon and was not associated with dementia/AD. Coffee drinking at midlife is associated with a decreased risk of dementia/AD later in life. This finding might open possibilities for prevention of dementia/AD.
The literature suggests that the following effects on behavior of adult humans may occur when individuals consume moderate amounts of caffeine. (1) Caffeine increases alertness and reduces fatigue. This may be especially important in low arousal situations (e.g. working at night). (2) Caffeine improves performance on vigilance tasks and simple tasks that require sustained response. Again, these effects are often clearest when alertness is reduced, although there is evidence that benefits may still occur when the person is unimpaired. (3) Effects on more complex tasks are difficult to assess and probably involve interactions between the caffeine and other variables which increase alertness (e.g. personality and time of day). (4) In contrast to the effects of caffeine consumption, withdrawal of caffeine has few effects on performance. There is often an increase in negative mood following withdrawal of caffeine, but such effects may largely reflect the expectancies of the volunteers and the failure to conduct "blind" studies. (5) Regular caffeine usage appears to be beneficial, with higher users having better mental functioning. (6) Most people are very good at controlling their caffeine consumption to maximise the above positive effects. For example, the pattern of consumption over the day shows that caffeine is often consumed to increase alertness. Indeed, many people do not consume much caffeine later in the day since it is important not to be alert when one goes to sleep. In contrast to effects found from normal caffeine intake, there are reports that have demonstrated negative effects when very large amounts are given or sensitive groups (e.g. patients with anxiety disorders) were studied. In this context caffeine has been shown to increase anxiety and impair sleep. There is also some evidence that fine motor control may be impaired as a function of the increase in anxiety. Overall, the global picture that emerges depends on whether one focuses on effects that are likely to be present when caffeine is consumed in moderation by the majority of the population or on the effects found in extreme conditions. The evidence clearly shows that levels of caffeine consumed by most people have largely positive effects on behavior. Excessive consumption can lead to problems, especially in sensitive individuals.
Anxiety symptoms and anxiety disorders are highly prevalent among elderly people, although infrequently the subject of systematic research in this age group. One important limitation is the lack of a widely accepted instrument to measure dimensional anxiety in both normal old people and old people with mental health problems seen in various settings. Accordingly, we developed and tested of a short scale to measure anxiety in older people.
We generated a large number of potential items de novo and by reference to existing anxiety scales, and then reduced the number of items to 60 through consultation with a reference group consisting of psychologists, psychiatrists and normal elderly people. We then tested the psychometric properties of these 60 items in 452 normal old people and 46 patients attending a psychogeriatric service. We were able to reduce the number of items to 20. We chose a 1-week perspective and a dichotomous response scale.
Cronbach's alpha for the 20-item Geriatric Anxiety Inventory (GAI) was 0.91 among normal elderly people and 0.93 in the psychogeriatric sample. Concurrent validity with a variety of other measures was demonstrated in both the normal sample and the psychogeriatric sample. Inter-rater and test-retest reliability were found to be excellent. Receiver operating characteristic analysis indicated a cut-point of 10/11 for the detection of DSM-IV Generalized Anxiety Disorder (GAD) in the psychogeriatric sample, with 83% of patients correctly classified with a specificity of 84% and a sensitivity of 75%.
The GAI is a new 20-item self-report or nurse-administered scale that measures dimensional anxiety in elderly people. It has sound psychometric properties. Initial clinical testing indicates that it is able to discriminate between those with and without any anxiety disorder and between those with and without DSM-IV GAD.
Objectives
To examine the relationships between tea consumption habits and incident neurocognitive disorders (NCD) and explore potential effect modification by gender and the apolipoprotein E (APOE) genotype. DesignPopulation-based longitudinal study. SettingThe Singapore Longitudinal Aging Study (SLAS). Participants957 community-living Chinese elderly who were cognitively intact at baseline. MeasurementsWe collected tea consumption information at baseline from 2003 to 2005 and ascertained incident cases of neurocognitive disorders (NCD) from 2006 to 2010. Odds ratio (OR) of association were calculated in logistic regression models that adjusted for potential confounders. ResultsA total of 72 incident NCD cases were identified from the cohort. Tea intake was associated with lower risk of incident NCD, independent of other risk factors. Reduced NCD risk was observed for both green tea (OR=0.43) and black/oolong tea (OR=0.53) and appeared to be influenced by the changing of tea consumption habit at follow-up. Using consistent nontea consumers as the reference, only consistent tea consumers had reduced risk of NCD (OR=0.39). Stratified analyses indicated that tea consumption was associated with reduced risk of NCD among females (OR=0.32) and APOE e4 carriers (OR=0.14) but not males and non APOE e4 carriers. Conclusion
Regular tea consumption was associated with lower risk of neurocognitive disorders among Chinese elderly. Gender and genetic factors could possibly modulate this association.
The effect of tea intake on blood pressure (BP) is controversial. We performed a meta-analysis of randomised controlled trials to determine the changes in systolic and diastolic BP due to the intake of black and green tea. A systematic search was conducted in MEDLINE, EMBASE and the Cochrane Controlled Trials Register up to May 2014. The weighted mean difference was calculated for net changes in systolic and diastolic BP using fixed-effects or random-effects models. Previously defined subgroup analyses were performed to explore the influence of study characteristics. A total of twenty-five eligible studies with 1476 subjects were selected. The acute intake of tea had no effects on systolic and diastolic BP. However, after long-term tea intake, the pooled mean systolic and diastolic BP were lower by - 1·8 (95 % CI - 2·4, - 1·1) and - 1·4 (95 % CI - 2·2, - 0·6) mmHg, respectively. When stratified by type of tea, green tea significantly reduced systolic BP by 2·1 (95 % CI - 2·9, - 1·2) mmHg and decreased diastolic BP by 1·7 (95 % CI - 2·9, - 0·5) mmHg, and black tea showed a reduction in systolic BP of 1·4 (95 % CI - 2·4, - 0·4) mmHg and a decrease in diastolic BP of 1·1 (95 % CI - 1·9, - 0·2) mmHg. The subgroup analyses showed that the BP-lowering effect was apparent in subjects who consumed tea more than 12 weeks (systolic BP - 2·6 (95 % CI - 3·5, - 1·7) mmHg and diastolic BP - 2·2 (95 % CI - 3·0, - 1·3) mmHg, both P< 0·001). The present findings suggest that long-term ( ≥ 12 weeks) ingestion of tea could result in a significant reduction in systolic and diastolic BP.
To examine the association between tea consumption and depressive symptoms in Chinese older people and to explore the mediating role of cerebrovascular disease in the association.
Population-based cross-sectional study.
A rural community near Qufu in Shandong, China.
Community-dwelling individuals aged 60 and older (mean 68.6; 59.3% female) from the Confucius Hometown Aging Project (N = 1,368).
Data were collected through interviews, clinical examinations, and psychological testing, following a standard procedure. Presence of high depressive symptoms was defined as a score of 5 or greater on the 15-item Geriatric Depression Scale.
Of the 1,368 participants, 165 (12.1%) were weekly and 489 (35.7%) were daily tea consumers. Compared with no or irregular tea consumption, controlling for age, sex, education, leisure activities, number of comorbidities, and Mini-Mental State Examination score, the odds ratios of having high depressive symptoms were 0.86 (95% confidence interval (CI) = 0.56-1.32) for weekly and 0.59 (95% CI = 0.43-0.81) for daily tea consumption (P for linear trend = .001); the linear trend of the association remained statistically significant when further controlling for history of stroke, transient ischemic attacks, and presence of carotid plaques.
Daily tea consumption is associated with a lower likelihood of depressive symptoms in Chinese older people living in a rural community. The association appears to be independent of cerebrovascular disease and atherosclerosis.
To investigate the association between tea consumption and mortality in the oldest-old Chinese.
Population-based longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed using a Cox semiparametric proportional hazard model.
Six hundred thirty-one randomly selected counties and cities of China's 22 provinces.
Individuals aged 80 and older (N = 9,093) who provided complete data in the baseline survey (1998).
Self-reported current frequency of tea drinking and past frequency at approximately age 60 were ascertained at baseline survey; a follow-up survey was conducted 2000, 2002, and 2005.
In the oldest-old Chinese, tea consumption was associated with lower risk of mortality after adjusting for demographic characteristics, socioeconomic status, health practices, and health status. Compared with non-tea drinkers, the adjusted hazard ratio (HR) was 0.90 (95% confidence interval (CI) = 0.84-0.96) for daily tea drinkers (at the baseline survey, 1998) and 1.00 (95% CI = 1.01-1.07) for occasional tea drinkers (P for linear trend .003). Similar results were found when tea drinking status at age 60 was used in the analysis. Further analysis showed that subjects who reported frequent tea drinking at age 60 and at the baseline survey had a 10% lower risk of mortality than subjects who reported infrequent tea drinking at age 60 and at the baseline survey (HR = 0.90, 95% CI = 0.84-0.97).
Tea consumption is associated with lower risk of mortality in the oldest-old Chinese.
This review aims to address issues unique to older adults with anxiety disorders in order to inform potential changes in the DSM-V. Prevalence and symptom expression of anxiety disorders in late life, as well as risk factors, comorbidity, cognitive decline, age of onset, and treatment efficacy for older adults are reviewed. Overall, the current literature suggests: (a) anxiety disorders are common among older age individuals, but less common than in younger adults; (b) overlap exists between anxiety symptoms of younger and older adults, although there are some differences as well as limitations to the assessment of symptoms among older adults; (c) anxiety disorders are highly comorbid with depression in older adults; (d) anxiety disorders are highly comorbid with a number of medical illnesses; (e) associations between cognitive decline and anxiety have been observed; (f) late age of onset is infrequent; and (g) both pharmacotherapy and CBT have demonstrated efficacy for older adults with anxiety. The implications of these findings are discussed and recommendations for the DSM-V are provided, including extending the text section on age-specific features of anxiety disorders in late life and providing information about the complexities of diagnosing anxiety disorders in older adults. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc.
Experimental models of stroke provide consistent evidence of smaller stroke volumes in animals ingesting tea components or tea extracts. To assess whether a similar association of black or green tea consumption with reduced risk is evident in human populations, we sought to identify and summarize all human clinical and observational data on tea and stroke.
We searched PubMed and Web of Science for all studies on stroke and tea consumption in humans with original data, including estimation or measurement of tea consumption and outcomes of fatal or nonfatal stroke. Data from 9 studies involving 4378 strokes among 194 965 individuals were pooled. The main outcome was the occurrence of fatal or nonfatal stroke. We tested for heterogeneity and calculated the summary effect estimate associated with consumption of >or=3 cups of tea (green or black) per day using random-effects and fixed-effects models for the homogeneous studies. Publication bias was also evaluated.
Regardless of their country of origin, individuals consuming >or=3 cups of tea per day had a 21% lower risk of stroke than those consuming <1 cup per day (absolute risk reduction, 0.79; CI, 0.73 to 0.85). The proportion of heterogeneity not explained by chance alone was 23.8%.
Although a randomized clinical trial would be necessary to confirm the effect, this meta-analysis suggests that daily consumption of either green or black tea equaling 3 cups per day could prevent the onset of ischemic stroke.
The purpose of this study was to examine the hypothesis that tea and coffee consumption have a protective effect against development of digestive tract cancers.
A comparative case-referent study was conducted using Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC) data from 1990 to 1995 in Nagoya, Japan. This study comprised 1,706 histologically diagnosed cases of digestive tract cancers (185 esophagus, 893 stomach, 362 colon, 266 rectum) and a total of 21,128 non-cancer outpatients aged 40 years and over. Logistic regression was used to analyze the data, adjusting for gender; age; year and season at hospital-visit; habitual smoking and alcohol drinking; regular physical exercise; fruit, rice, and beef intake; and beverage intake.
The odds ratio (OR) of stomach cancer decreased to 0.69 (95 percent confidence interval [CI] = 0.48-1.00) with high intake of green tea (seven cups or more per day). A decreased risk was also observed for rectal cancer with three cups or more daily intake of coffee (OR = 0.46, CI = 0.26-0.81).
The results suggest the potential for protective effect against site-specific digestive tract cancer by consumption of green tea and coffee, although most associations are limited only to the upper category of intake and have no clear explanation for site-specificity.
Green tea catechins, including (-)-epicatechin (EC), (-)-epicatechin gallate (ECG), (-)-epigallocatechin (EGC) and (-)-epigallocatechin gallate (EGCG), are oxidized and dimerized during the manufacture of black tea and oolong tea to form orange-red pigments, theaflavins (TF), a mixture of theaflavin (TF1), theaflavin-3-gallate (TF2A), theaflavin-3'-gallate (TF2B) and theaflavin-3,3'-digallate (TF3). The present study was designed to compare the antioxidant activities of individual TF with that of each catechin using human LDL oxidation as a model. All catechins and TF tested inhibited Cu(+2)-mediated LDL oxidation. Analysis of the thiobarbituric acid-reactive substances (TBARS) and conjugated dienes produced during LDL oxidation revealed that the antioxidant activity was in the order: TF3 > ECG > EGCG > or = TF2B > or = TF2A > TF1 > or = EC > EGC. Four TF derivatives also demonstrated a dose-dependent antioxidant activity in Cu(+2)-mediated LDL oxidation at concentrations of 5-40 micromol/L. These results demonstrate that the TF present in black tea possess at least the same antioxidant potency as catechins present in green tea, and that the conversion of catechins to TF during fermentation in making black tea does not alter significantly their free radical-scavenging activity.
This meta-analysis of tea consumption in relation to stroke, myocardial infarction, and all coronary heart disease is based on 10 cohort studies and seven case-control studies. The study-specific effect estimates for stroke and coronary heart disease were too heterogeneous to be summarized (homogeneity p < 0.02 for stroke, p < 0.001 for coronary heart disease). Only the relative risk estimates for myocardial infarction (seven studies) appeared reasonably homogeneous (homogeneity p = 0.20). The incidence rate of myocardial infarction is estimated to decrease by 11% with an increase in tea consumption of 3 cups per day (fixed-effects relative risk estimate = 0.89, 95% confidence interval: 0.79, 1.01) (1 cup = 237 ml). However, evidence of bias toward preferential publication of smaller studies that suggest protective effects urges caution in interpreting this result. The geographic region where the studies were conducted appeared to explain much of the heterogeneity among coronary heart disease, myocardial infarction, and probably stroke results. With increasing tea consumption, the risk increased for coronary heart disease in the United Kingdom and for stroke in Australia, whereas the risk decreased in other regions, particularly in continental Europe.
Consumption of caffeine, an adenosine receptor antagonist, was found to be inversely associated with the incidence of Alzheimer's disease. Moreover, caffeine protects cultured neurons against beta-amyloid-induced toxicity, an effect mimicked by adenosine A(2A) but not A(1) receptor antagonists. We now tested if caffeine administration would prevent beta-amyloid-induced cognitive impairment in mice and if this was mimicked by A(2A) receptor blockade. One week after icv administration of the 25-35 fragment of beta-amyloid (Abeta, 3 nmol), mice displayed impaired performance in both inhibitory avoidance and spontaneous alternation tests. Prolonged treatment with caffeine (1 mg/ml) had no effect alone but prevented the Abeta-induced cognitive impairment in both tasks when associated with acute caffeine (30 mg/kg) 30 min treatment before Abeta administration. The same protective effect was observed after subchronic (4 days) treatment with daily injections of either caffeine (30 mg/kg) or the selective adenosine A(2A) receptor antagonist SCH58261 (0.5 mg/kg). This provides the first direct in vivo evidence that caffeine and A(2A) receptor antagonists afford a protection against Abeta-induced amnesia, which prompts their interest for managing Alzheimer's disease.
The Geriatric Depression Scale (GDS) is widely used for screening and assessment of major depressive disorder (MDD). Screening scales are often culture-specific and should be evaluated for item response bias (synonymously differential item functioning, DIF) before use in clinical practice and research in a different population. In this study, we examined DIF associated with age, gender, ethnicity and chronic illness in a heterogeneous Asian population in Singapore.
The GDS-15 and Structured Clinical Interview for DSM-IV diagnosis of MDD were independently administered by interviewers on 4253 non-institutionalized community living elderly subjects aged 60 years and above who were users of social service agencies. Multiple Indicator Multiple Cause latent variable modelling was used to identify DIF.
We found evidence of significant DIF associated with age, gender, ethnicity and chronic illness for 8 items: dropped many activities and interests, afraid something bad is going to happen, prefer staying home to going out, more problems with memory than most, think it is (not) wonderful to be alive, feel pretty worthless, feel (not) full of energy, feel that situation is hopeless.
The smaller number of minority Indian and Malay subjects and the self-report of chronic medical illnesses.
In a heterogeneous mix of respondents in Singapore, eight items of the GDS-15 showed DIF for age, gender, ethnicity and chronic illness. The awareness and identification of DIF in the GDS-15 provides a rational basis for its use in diverse population groups and guiding the derivation of abbreviated scales.
Tea is the most widely consumed beverage in the world after water. Tea is known to be a rich source of flavonoid antioxidants. However tea also contains a unique amino acid, L-theanine that may modulate aspects of brain function in humans. Evidence from human electroencephalograph (EEG) studies show that it has a direct effect on the brain (Juneja et al. Trends in Food Science & Tech 1999;10;199-204). L-theanine significantly increases activity in the alpha frequency band which indicates that it relaxes the mind without inducing drowsiness. However, this effect has only been established at higher doses than that typically found in a cup of black tea (approximately 20mg). The aim of the current research was to establish this effect at more realistic dietary levels. EEG was measured in healthy, young participants at baseline and 45, 60, 75, 90 and 105 minutes after ingestion of 50mg L-theanine (n=16) or placebo (n=19). Participants were resting with their eyes closed during EEG recording. There was a greater increase in alpha activity across time in the L-theanine condition (relative to placebo (p+0.05). A second study replicated this effect in participants engaged in passive activity. These data indicate that L-theanine, at realistic dietary levels, has a significant effect on the general state of mental alertness or arousal. Furthermore, alpha activity is known to play an important role in critical aspects of attention, and further research is therefore focussed on understanding the effect of L-theanine on attentional processes.