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      Association between change in lifestyle and cognitive functions among elderly Koreans: findings from the Korean longitudinal study of aging (2006–2016)

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          Abstract

          Background

          South Korea is an aged society that continues to age rapidly. Therefore, the purpose of this study was to investigate the association between changes in lifestyle and cognitive functions in the South Korean elderly using a nationally representative survey.

          Methods

          We analyzed data from the Korean Longitudinal Study of Aging (KLoSA) 2006–2016, a biannual panel survey. Multiple linear regression analysis was performed with repeated measurements data to examine the association between lifestyle change and cognitive functions over 2 years. Lifestyle combined the scores of four factors (smoking status, alcohol drinking status, body weight, and exercise), and then categorized them into four groups (Good→Good, Bad→Good, Good→Bad, and Bad→Bad) according to the two-year change. Cognitive functions were set according to the scores measured through the Korean Mini-Mental State Examination (K-MMSE).

          Results

          Among females, the K-MMSE score was the highest in the Bad→Good group compared to the reference group, Bad→Bad (β = 0.914; SD = 3.744; p < .0001). The next highest scores were in the Good→Good group (β = 0.813; SD = 4.654; p = 0.0005) and the Good→Bad group (β = 0.475; SD = 4.542; p = 0.0481). Among males, only the K-MMSE of the Good→Good group was statistically significant (β = 0.509; SD = 3.245; p = 0.0077). The results of subgroup analysis showed that the K-MMSE scores of females who did not participate in any social activities were more affected by their lifestyle (Good-Good: β = 1.614; SD = 4.270; p = 0.0017, Bad-Good: β = 1.817; SD = 3.945; p < .0001). Subgroup analysis showed that females who started drinking more than a moderate amount of alcohol had lower K-MMSE scores (Good-Bad: β = − 2.636; SD = 2.915; p = 0.0011). Additionally, in both sexes, exercising, among the four lifestyle options, had a strong and significant association with higher K-MMSE scores.

          Conclusions

          Following a healthy lifestyle or improving an unhealthy lifestyle can help people prevent or slow down cognitive decline. Regularly engaging in an adequate amount of exercise can help the cognitive function of the elderly. Females, specifically, can experience positive effects on their cognitive function if they participate in social activities while maintaining healthy lifestyles, in particular not drinking too much alcohol.

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          Most cited references26

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          Dementia prevention, intervention, and care

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            The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review

            Background Social relationships, which are contingent on access to social networks, promote engagement in social activities and provide access to social support. These social factors have been shown to positively impact health outcomes. In the current systematic review, we offer a comprehensive overview of the impact of social activities, social networks and social support on the cognitive functioning of healthy older adults (50+) and examine the differential effects of aspects of social relationships on various cognitive domains. Methods We followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, and collated data from randomised controlled trials (RCTs), genetic and observational studies. Independent variables of interest included subjective measures of social activities, social networks, and social support, and composite measures of social relationships (CMSR). The primary outcome of interest was cognitive function divided into domains of episodic memory, semantic memory, overall memory ability, working memory, verbal fluency, reasoning, attention, processing speed, visuospatial abilities, overall executive functioning and global cognition. Results Thirty-nine studies were included in the review; three RCTs, 34 observational studies, and two genetic studies. Evidence suggests a relationship between (1) social activity and global cognition and overall executive functioning, working memory, visuospatial abilities and processing speed but not episodic memory, verbal fluency, reasoning or attention; (2) social networks and global cognition but not episodic memory, attention or processing speed; (3) social support and global cognition and episodic memory but not attention or processing speed; and (4) CMSR and episodic memory and verbal fluency but not global cognition. Conclusions The results support prior conclusions that there is an association between social relationships and cognitive function but the exact nature of this association remains unclear. Implications of the findings are discussed and suggestions for future research provided. Systematic review registration PROSPERO 2012: CRD42012003248. Electronic supplementary material The online version of this article (10.1186/s13643-017-0632-2) contains supplementary material, which is available to authorized users.
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              Gender differences in risk factors and consequences for alcohol use and problems.

              Women drink less alcohol and have fewer alcohol-related problems than men. Women appear to be less likely than men to manifest certain risk factors for alcohol use and problems and are more likely to have certain protective factors against these problems: women perceive greater social sanctions for drinking; women are less likely to have characteristics associated with excessive drinking including aggressiveness, drinking to reduce distress, behavioral undercontrol, sensation-seeking and antisociality; and women are more likely to have desirable feminine traits (e.g., nurturance) protective against excessive drinking. In addition, consequences of heavy alcohol use, or alcohol use disorders, appear to be more negative for women than men, at least in some domains: women suffer alcohol-related physical illnesses at lower levels of exposure to alcohol than men, and some studies suggest women suffer more cognitive and motor impairment due to alcohol than men; women may be more likely than men to suffer physical harm and sexual assault when they are using alcohol; heavy alcohol use in women is associated with a range of reproductive problems. Implications of these findings for future research and public health education campaigns are discussed.
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                Author and article information

                Contributors
                JANGSI@yuhs.ac
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                31 August 2020
                31 August 2020
                2020
                : 20
                : 317
                Affiliations
                [1 ]GRID grid.15444.30, ISNI 0000 0004 0470 5454, Department of Public Health, Graduate School, , Yonsei University, ; Seoul, Republic of Korea
                [2 ]GRID grid.15444.30, ISNI 0000 0004 0470 5454, Institute of Health Services Research, Yonsei University, ; 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
                [3 ]GRID grid.251916.8, ISNI 0000 0004 0532 3933, Department of Preventive Medicine and Public Health, , Ajou University College of Medicine, ; Suwon, Republic of Korea
                [4 ]GRID grid.15444.30, ISNI 0000 0004 0470 5454, Department of Preventive Medicine, , Yonsei University College of Medicine, ; Seoul, Republic of Korea
                Article
                1693
                10.1186/s12877-020-01693-7
                7457530
                32867702
                6cbd277a-3d8b-40c6-86ea-b96d24a12736
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 7 October 2019
                : 10 August 2020
                Funding
                Funded by: Yonsei University College of Medicine (KR)
                Award ID: 6-2018-0174 and 6-2017-0157
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Geriatric medicine
                aging,cognitive function,elderly people,health behavior,lifestyle
                Geriatric medicine
                aging, cognitive function, elderly people, health behavior, lifestyle

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