Association between body mass index and cognitive impairment in Chinese older adults.

Background: The association between body mass index (BMI) and the risk of cognitive impairment remains uncertain. Relatively few studies have analyzed the dose-response relationship between BMI and cognitive impairment. This article utilized nationally representative longitudinal data to assess the association between BMI and cognitive impairment in Chinese older adults. Objective: The present study aimed to analyze the association between BMI and cognitive impairment in Chinese older people, including an investigation of gender differences and the dose-response relationship. Methods: Data were obtained from the China Health and Retirement Longitudinal Study database in 2015 and 2018. The present study used logistic regression to analyze the relationship between baseline BMI and cognitive impairment, and adopted a restricted cubic spline model to plot dose-response curves for baseline BMI and prevalence of risk of cognitive impairment. Results: The mean BMI of the survey population was 23.48 ± 3.66 kg/m2, and the detection rate of cognitive impairment was 34.2%. Compared to the normal weight group (18.5 ≤ BMI < 23.9 kg/m2), the odds ratio (OR) for cognitive impairment was 1.473 (95% CI: 1.189-1.823) in the underweight group (BMI < 18.5 kg/m2), whereas the corresponding OR was 0.874 (95% CI: 0.776-0.985) for the overweight or obese group (BMI ≥ 24.0 kg/m2) after adjusting for confounders. Gender subgroup analysis showed that overweight or obese older women were less likely to develop cognitive impairment (OR = 0.843; 95% CI: 0.720-0.987). The results of the restricted cubic spline analysis revealed a curvilinear L-shaped relationship between BMI and the risk of cognitive impairment (P non-linearity <0.05). In particular, the risk of cognitive impairment was higher at a lower baseline BMI. In contrast, BMI in the range of 23.2-27.8 kg/m2 was associated with a decreased risk of cognitive impairment. Conclusion: BMI is a dose-dependent related factor for cognitive impairment in Chinese older adults. Being underweight is a risk factor for the development of cognitive impairment, while being overweight or obese is less likely to have cognitive impairment, particularly in female older people. Keeping BMI ranging from 23.2-27.8 kg/m2 in older adults can help maintain cognitive function.

Prevalence and influencing factors of lower urinary tract symptoms in female nurses: a cross-sectional study based on TARGET.

Background: Even though occupational women have a high incidence of lower urinary tract symptoms (LUTS), which seriously affect their daily work life, few large scale sample studies have provided empirical evidence to support this phenomenon among female nurses in China. Consequently, this article investigated female nurses who was presupposed to have a high prevalence of LUTS, which adversely exposes their health and patient safety to these risks. Additionally, it is considered important to explore the factors associated with LUTS in female nurses for patient care safety and nurse bladder health practice. Objectives: The purpose of this study was to assess the incidence of LUTS and symptoms-related risk factors among female nurses, to provide evidence for the prevention and control of LUTS. Methods: An online survey recruiting 23,066 participants was carried out in a multicenter cross-sectional study in 42 hospitals from December 2020 to November 2022. Stepwise multivariate logistic regression analysis and nomogram were used to identify the factors associated with lower urinary tract symptoms. Besides, SPSS version 26.0, R version 4.2.2, and GraphPad Prism Version 8.3 software packages were used for statistical analysis. Results: Based on the completion rate of the questionnaire which was 84.1% (n = 19,393), it was found that among 19,393 female nurses, the prevalence of LUTS was 67.71% and this rate was influenced by age, Body Mass Index (BMI), marital status, years of working, menstrual status, mode of delivery, history of breastfeeding, history of miscarriage, history of alcohol and coffee or tea consumption (p < 0.05). Interestingly, we also find that in addition to the above mentioned factors, anxiety, depression, and perceived stress were also related to LUTS in female nurses (p < 0.05). Conclusion: Given the high prevalence of LUTS among female nurses and their potential influencing factors, female nurses should focus on their reproductive health and develop good lifestyle habits. Thus, nursing managers should provide a warm and harmonious work environment and sensitize female nurses to increase their awareness about the importance of drinking clean water and urinating during work in a hygienic environment.

Prospective association between standing balance and cognitive function in middle-aged and older Chinese adults.

Objective: To investigate the association of standing balance with cognitive functions and the rate of cognitive decline among middle-aged and older Chinese adults. Methods: Participants were selected from China's Health and Retirement Longitudinal Study. A total of 8,499 subjects aged ≥45 years who participated in wave 1 to wave 3 surveys were included in the final analysis. Standing balance was measured using the tandem test, and participants were categorized into two groups according to their ability to maintain standing balance. Cognitive functions were assessed in three domains: episodic memory, mental status, and global cognition. The associations between standing balance scores, cognitive scores, and the rate of cognitive decline were evaluated using linear regression and linear mixed models. Results: Compared with participants who successfully completed the standing balance test, those who were unable to complete the test had lower scores on episodic memory [ß = -0.18; 95% confidence interval (CI): -0.24, -0.11], mental status (ß = -0.28; 95% CI: -0.37, -0.19), and global cognition (ß = -0.51; 95% CI: -0.65, -0.38) after 4 years of follow-up. In addition, the rate of decline in mental status and global cognition increased by 0.10 (ß = 0.10; 95% CI: 0.07, 0.13) and 0.08 (ß = 0.08; 95% CI: 0.04, 0.12) units, respectively, in participants who were unable to complete the test compared with their counterparts. Conclusion: Good standing balance was significantly associated with higher cognitive function and a lower decline in mental status and global cognition in middle-aged and older Chinese adults.

Effect of ß2-microglobulin in evaluating the severity and prognosis of brain injury: a clinical study.

BACKGROUND: ß2-microglobulin has been showing to be vital that associated with brain function and neurological diseases. This study aimed to explore the expressions of ß2-microglobulin in blood and urine of the patients with brain injury, and the effect of hyperbaric oxygen therapy on the content of ß2-microglobulin. METHODS: This prospective study included 54 patients with brain injury and 11 healthy controls. The patients were further assigned to two groups: the conscious disturbance group (n = 32) and the non-conscious disturbance group (n = 22) depending on the Glasgow Coma Scale (GCS). The patients received routine treatment and two courses of hyperbaric oxygen therapy (2.0ATA, 60 min, once a day, 10 days for a course). In the brain injury group, blood ß2-microglobulin (ß2MG) and urine ß2-microglobulin (ß2MU) were detected respectively before and after hyperbaric oxygen therapy (HBOT). Consciousness and cognitive scores were performed, correspondingly. RESULTS: Compared with those of the control group, levels of ß2MG and ß2MU in the brain injury group were significantly increased before HBOT (P < 0.05). Whether it was before or after HBOT, ß2MG's content in the conscious disturbance group was higher than that in the non-conscious disturbance group, while ß2MU's content was obviously higher than that of the non-conscious disturbance group only before HBOT (P < 0.05). Besides, the ß2MU's content in the conscious disturbance group was negatively correlated with GCS score (R = -0.351, P < 0.05) and ß2MG's content in the non-conscious disturbance group was positively correlated with the MMSE score grade (R = 0.598, P < 0.05). The ROC curve was used to assess the evaluation of ß2MG and ß2MU for patients with impaired consciousness with the area under the curve (AUC) of ß2MG and ß2MU were 0.775 and 0.796, respectively. CONCLUSION: The concentrations of blood ß2-microglobulin and urinary ß2-microglobulin were significantly increased in patients with brain injury. The concentrations of ß2-microglobulin were correlated with the degree of consciousness and cognitive function. The changes tendency of ß2-microglobulin may be considered as clinical monitoring index to evaluate the patient's disturbance of consciousness and cognitive degree, and provide a basis for early assessment of prognosis.