Jiaqi Yu’s research while affiliated with Peking University and other places

Providing the necessary supportive environment is important for promoting healthy ageing and ensuring the well-being of older adults. However, whether social support could buffer the detrimental effect of reversible cognitive frailty (RCF) on health outcomes among older adults has not been empirically examined. To examine the moderating effect of three dimensions of social support on the relationship between RCF and health outcomes, including functional ability (FA) and health-related quality of life (HRQoL). This was a cross-sectional study with 1171 community-dwelling older adults. Social support was assessed using the Social Support Rating Scale. RCF was identified by the Frailty Phenotype and simplified subjective cognitive decline questionnaire. As for FA, the Katz index and the Lawton Scale were used to measure activities of daily living (ADL) and instrumental ADL (IADL), respectively. HRQoL was measured by the Short Form Health Survey. Hierarchical linear regression analysis was implemented to test the moderating effects. Support utilization buffered the effect of RCF on IADL ability while subjective support buffered the effect of RCF on physical HRQoL. However, objective support had no significant moderating effect on the relationship between RCF and any health outcomes. The moderating effect of social support on the relationship between RCF and health outcomes varies by support types and by specific health outcomes. Effective interventions should target the perception and utilization of available support among older adults with RCF to maintain their functional independence and HRQoL.

Subjective support-focused cognitive behavioral therapy (SS-CBT) could increase subjective support among (pre)frail community-dwelling older adults, however, the underlying mechanisms remain unclear. We conducted a randomized controlled trial, in which the SS-CBT group (n = 50) received SS-CBT once a week for eight weeks and the wait-list control group (n = 50) received no intervention. The dependent variable was subjective support, and potential mediators included self-esteem, gratitude, cognitive distortions, interpersonal competence and rumination. Measurements took place before and after the intervention. We found that interpersonal competence mediated the effectiveness of SS-CBT on both perceived support availability (β = 2.030, 95%CI = 1.164, 3.081) and perceived support adequacy (β = 6.37, 95%CI = 3.52, 9.74), while self-esteem only mediated the effectiveness of SS-CBT on perceived support availability (β = 1.621, 95%CI = 0.502, 2.843). Gratitude, cognitive distortions, and rumination neither mediated the effectiveness of SS-CBT on perceived support availability nor on perceived support adequacy. These findings highlight self-esteem and interpersonal competence as the mechanisms through which SS-CBT increases subjective support, especially perceived support availability. This implicates that the SS-CBT should exclusively emphasize the apparent active ingredients (self-esteem and interpersonal competence) to promote its efficiency.

Objectives: To investigate whether baseline depressive symptoms impacted the effectiveness of an exercise intervention among (pre)frail older adults. Methods: This is a subanalysis of a stepped-wedge cluster randomized trial implementing an exercise intervention, with an application of the integration of the Health Belief Model, Theory of Planned Behavior, and Health Action Process Approach, among 149 community-dwelling (pre)frail older adults. The intervention effectiveness was examined by baseline depressive symptoms (depressive symptoms (n = 40) and non-depressive symptoms (n = 109). Results: Intervention effects were observed among (pre)frail older adults regardless of baseline depressive symptoms on frailty, social function, as well as physical and mental quality of life (QoL). (Pre)frail people with depressive symptoms, compared to those without depressive symptoms, were likely to benefit more in muscle mass, muscle strength, lower extremity function, activities of daily living (ADLs), cognitive function, depressive symptoms, and physical QoL, but less in dynamic balance, instrumental ADLs (IADLs), and mental QoL. Conclusions: These findings implicate that cognitive and psychological strategies should be integrated into exercise interventions among (pre)frail people with depressive symptoms to improve their functional independence and well-being. Clinical implications: Interventions that accommodate depressive symptoms may result in improved outcomes for (pre)frail people with depressive symptoms.

Purpose Two-sample Mendelian randomization methods were used to explore the causal effects of cognitive reserve proxies, such as educational attainment, occupational attainment, and physical activity (PA), on biological (leukocyte telomere length), phenotypic (sarcopenia-related features), and functional (frailty index and cognitive performance) aging levels. Results Educational attainment had a potential protective effect on the telomere length ( β = 0.10, 95% CI: 0.08–0.11), sarcopenia-related features ( β = 0.04–0.24, 95% CI: 0.02–0.27), frailty risk ( β = −0.31, 95% CI: −0.33 to −0.28), cognitive performance ( β = 0.77, 95% CI: 0.75–0.80). Occupational attainment was causally related with sarcopenia-related features ( β = 0.07–0.10, 95% CI: 0.05–0.14), and cognitive performance ( β = 0.30, 95% CI: 0.24–0.36). Device-measured PA was potentially associated with one sarcopenia-related feature ( β = 0.14, 95% CI: 0.03–0.25). Conclusions Our findings support the potential causality of educational attainment on biological, phenotypic, and functional aging outcomes, of occupational attainment on phenotypic and functional aging-related outcomes, and of PA on phenotypic aging-related outcomes.

This study aimed to develop and validate prediction models for incident reversible cognitive frailty (RCF) based on social-ecological predictors. Older adults aged ≥60 years from China Health and Retirement Longitudinal Study (CHARLS) 2011–2013 survey were included as training set ( n = 1230). The generalized linear mixed model (GLMM), eXtreme Gradient Boosting, support vector machine, random forest, and Binary Mixed Model forest were used to develop prediction models. All models were evaluated internally with 5-fold cross-validation and evaluated externally via CHARLS 2013–2015 survey ( n = 1631). Only GLMM showed good discrimination (AUC = 0.765, 95% CI = 0.736, 0.795) in training set, and all models showed fair discrimination (AUC = 0.578–0.667, 95% CI = 0.545, 0.725) in internal and external validation. All models showed acceptable calibration, overall prediction performance, and clinical usefulness in training and validation sets. Older adults were divided into three groups using risk score based on GLMM, which could assist healthcare providers to predict incident RCF, facilitating early identification of high-risk population.