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JARLIFE Vol 14, 2025
EDITORIAL: BUILDING A BRAIN WATCH: CRAFTING ACCURATE AND HIGH-PRECISION PERSONALIZED PLANS FOR OPTIMAL BRAIN PERFORMANCE AND SUSTAINED FUNCTIONALITY
Ara S. Khachaturian
J Aging Res & Lifestyle 2025;14
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CITATION:
Ara S. Khachaturian (2025): Editorial: Building a brain watch: Crafting Accurate and High-Precision Personalized Plans for Optimal Brain Performance and Sustained Functionality. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100013
REGULAR CAFFEINE CONSUMPTION & SUBJECTIVE SLEEP QUALITY: A SYSTEMATIC REVIEW
Duc Minh Phan (Tommy), My Yen Lam, Minh Nguyet Trang
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryCaffeine, the world's most consumed stimulant, is commonly used to combat fatigue, This review examined the unclear relationship between long-term caffeine consumption and subjective sleep quality, defined as satisfaction with sleep based on personal perception. Screening 6,908 studies, 10 were included. Results showed limited statistically significant associations, hindered by variability in study quality, data, and assessment methods. Influencing factors such as individual differences and study heterogeneity were identified. The review highlights the need for standardized tools and methodologies, urging future research to explore genetic, cultural, and timing factors to better understand caffeine's impact on sleep quality.
CITATION:
Duc Minh Phan (Tommy) ; My Yen Lam ; Minh Nguyet Trang (2025): Regular caffeine consumption & subjective sleep quality: A systematic review. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100005
ADHERENCE AND AEROBIC EXERCISE INTENSITY IN LIVE ONLINE EXERCISE SESSIONS FOR OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT: INSIGHTS FROM THE JAPAN-MULTIMODAL INTERVENTION TRIAL FOR THE PREVENTION OF DEMENTIA
Taiki Sugimoto, Kazuaki Uchida, Yoko Yokoyama, Ayaka Onoyama, Kosuke Fujita, Yujiro Kuroda, Keigo Hinakura, Susumu Ogawa, Hiroyuki Suzuki, Yoshinori Fujiwara, Paul K Crane, Hidenori Arai, Takashi Sakurai, J-MINT study group
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryBACKGROUND: Intervention adherence is crucial to ensure cognitive benefits in trials designed to prevent cognitive decline. During the coronavirus disease 2019 (COVID-19) pandemic, the Japan-Multimodal Intervention Trial for the Prevention of Dementia offered live online exercise sessions to older adults with mild cognitive impairment (MCI).
OBJECTIVES: To assess adherence and aerobic exercise intensity through live online exercise sessions in older adults with MCI.
DESIGN: Posthoc analysis of the 18-month, multi-center, randomized controlled trial.
SETTING: The study was conducted across five institutions in Japan.
PARTICIPANTS: Older adults aged 65–85 years who were assigned to the intervention group and completed the intervention. Participants were stratified by region (Aichi and Tokyo), where the state of emergency duration due to COVID-19 varied.
INTERVENTIONS: The intervention group participated in multidomain interventions, including 90-minute group-based physical exercise sessions held weekly for 78 sessions. During the state of emergency, live online sessions were conducted via video conferencing.
MEASUREMENTS: Attendance rates and aerobic exercise intensity (based on heart rates) during online and onsite sessions were compared using the Wilcoxon signed-rank test.
RESULTS: A total of 207 participants were analyzed. Over 18 months, 78 exercise sessions were conducted, including live online sessions. In the Aichi region, 2 online sessions were held, while in the Tokyo region, 24 online sessions were conducted. In the Tokyo region, adherence was higher in online sessions compared to onsite sessions (92 % vs. 86 %, p = 0.046), while exercise intensity showed no significant difference (49 % vs. 52 %, p = 0.279). No adverse events were reported.
CONCLUSIONS: Live online exercise sessions were safe, feasible, and demonstrated adherence and intensity comparable to onsite sessions.
CITATION:
Taiki Sugimoto ; Kazuaki Uchida ; Yoko Yokoyama ; Ayaka Onoyama ; Kosuke Fujita ; Yujiro Kuroda ; Keigo Hinakura ; Susumu Ogawa ; Hiroyuki Suzuki ; Yoshinori Fujiwara ; Paul K Crane ; Hidenori Arai ; Takashi Sakurai ; J-MINT study group (2025): Adherence and aerobic exercise intensity in live online exercise sessions for older adults with mild cognitive impairment: Insights from the Japan-Multimodal Intervention Trial for the Prevention of Dementia. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100003
CONTRIBUTION OF PHYSICAL ACTIVITY TO INTRINSIC CAPACITY DIFFERS IN USA, UK, EUROPE AND CHINA
Z Huang, ETC Lai, J Woo
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryBACKGROUND: Within-country studies show that physical activity is associated with better intrinsic capacity.
OBJECTIVES: To examine whether the contribution of physical activity to intrinsic capacity varies between countries due to varying social determinants, and whether physical activity associates differently with only certain domains of intrinsic capacity.
DESIGN: Prospective cohort studies.
SETTING: Populations of the USA, UK, Europe, and China.
PARTICIPANTS: Nationally representative samples of middle-aged and older adults who were interviewed every two or three years.
MEASUREMENTS: Intrinsic capacity was assessed according to the following domains: locomotor, vitality, cognition, vision and hearing, and psychological health. Physical activity was defined as taking part in vigorous or moderate physical activity was more than weekly.
RESULTS: Physical activity was associated with better intrinsic capacity in both genders in USA, UK, and Europe, but not in China. In these developed countries, physical activity was associated with all domains of intrinsic capacity, except for cognition in men in the UK. The largest effect sizes were observed in the domains of locomotion, psychological health, and vitality. In China, physical activity was significantly and positively associated with two domains of intrinsic capacity (vitality and locomotion) for men and women only in rural areas.
CONCLUSIONS: Physical activity may contribute differently to intrinsic capacity, perhaps as a result of cultural and economic differences between countries.
CITATION:
Z Huang ; ETC Lai ; J Woo (2025): Contribution of physical activity to intrinsic capacity differs in USA, UK, Europe and China. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100007
INCREMENTAL PREDICTIVE VALUE OF INTRINSIC CAPACITY AND ENVIRONMENTAL CHARACTERISTICS IN THE RISK PREDICTION OF INCIDENT DISABILITY
Ruby Yu, Grace Leung, Derek Lai, Lok-yan Tam, Clara Cheng, Sara Kong, Cecilia Tong, Jean Woo
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryOBJECTIVE: To examine the incremental value of intrinsic capacity (IC) and environmental characteristics in the risk prediction of disability.
METHODS: Secondary analysis was performed on a longitudinal sample of individuals aged 50 years or above. The selected subsample was ambulant and cognitively intact, and did not have any disabilities in instrumental activities of daily living (IADL) at baseline. A set of 18 indicators were first used to assess conditions associated with declines in IC and environmental characteristics. Participants were then followed up for approximately one year, and the IADL status (i.e., disabled or not) was treated as the outcome variable in the logistic regression models. The incremental predictive value of IC was examined by comparing the baseline model that only included traditional risk factors (e.g., health conditions and lifestyle factors), against the full model that also included the aforementioned 18 indicators. The comparison was performed using the change in area under the receiver operating characteristic curve (ROCAUC) and the continuous net reclassification index (NRI).
RESULTS: Among 10,993 participants (mean age = 73.3, 82.1 % women), 680 (6.2 %) developed disability during the concerned period. The full model significantly outperformed the baseline model, with the ROCAUC improving from 0.707 to 0.729 (change = 0.021; 95 % CI: 0.013–0.030). The continuous NRI was 0.361 (95 % bootstrap CI: 0.280–0.450).
CONCLUSIONS: Measurements of IC and environmental characteristics have a significant incremental value in predicting disability. In practice, the full model can be implemented as a calculator for identifying older populations at risk of disability in the community settings.
CITATION:
Ruby Yu ; Grace Leung ; Derek Lai ; Lok-yan Tam ; Clara Cheng ; Sara Kong ; Cecilia Tong ; Jean Woo (2025): Incremental predictive value of intrinsic capacity and environmental characteristics in the risk prediction of incident disability. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100004
PRE-SURGICAL MEMORY IMPAIRMENT IS ASSOCIATED WITH RISK OF POSTOPERATIVE COGNITIVE DYSFUNCTION IN A LARGE GERIATRIC COHORT
Kiri T. Granger, Claudia Spies, Sheryl Caswell, Daniel Hadzidiakos, Saya Speidel, Arjen JC Slooter, Ilse Kant, Sophie K Piper, Simone JT van Montfort, Jennifer H. Barnett, Paula M. Moran, Friedrich Borchers
J Aging Res & Lifestyle 2025;14
Show summaryHide summarySome patients undergoing surgical procedures display long-term post-surgery cognitive impairment (post-operative cognitive dysfunction; POCD), which may precipitate progression to dementia. We investigated whether preoperative cognitive impairment defined using specific cognitive tests (Paired-Associates Learning and Spatial-Span from the Cambridge Neuropsychological Test Automated Battery, (CANTAB) was associated with increased risk of POCD. N = 590 patients >65years and a matched control group n=114 comprised the final sample. Patients were classified as impaired if a composite memory-score derived from two tests from the CANTAB test battery (spatial working memory and paired-associate learning) scored 1 SD below norms derived from a normative database. Risk of developing POCD 3 months post-surgery was higher [odds ratio 2.048 (95% CI 1.027 – 4.087)] for those with pre-surgical cognitive impairment compared to those with no impairment. This suggests that impairment on hippocampus-based tasks spatial-span memory and paired-associates learning is associated with increased risk for POCD in older surgical patients.
CITATION:
Kiri T. Granger ; Claudia Spies ; Sheryl Caswell ; Daniel Hadzidiakos ; Saya Speidel ; Arjen JC Slooter ; Ilse Kant ; Sophie K Piper ; Simone JT van Montfort ; Jennifer H. Barnett ; Paula M. Moran ; Friedrich Borchers (2025): Pre-surgical memory impairment is associated with risk of postoperative cognitive dysfunction in a large geriatric cohort. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100002
COMPARISON OF BODY COMPOSITION CHANGES AND NUTRITIONAL STATUS AFTER SURGERY BETWEEN OLDER JAPANESE PATIENTS WITH UPPER AND LOWER GASTROINTESTINAL CANCER
Eiko Takano, Tsukasa Aritake, Kakeru Hashimoto, Yumi Suzuki, Yuichi Kitagawa, Ken Fujishiro, Yasuji Kawabata, Shinichirou Kobayashi, Izumi Kondo
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryINTRODUCTION: Postoperative changes in body composition and nutritional challenges are significant concerns for older patients undergoing gastrointestinal (GI) cancer surgery. This study compared body composition changes and nutritional outcomes between patients with upper gastrointestinal (UGI) and lower gastrointestinal (LGI) cancers over 12 months to identify tailored postoperative care needs.
METHODS: This retrospective study included 55 Japanese patients (≥65 years) who underwent curative GI cancer surgery at the National Center for Geriatrics and Gerontology between 2018 and 2022. Patients were categorized as UGI (n = 17) or LGI (n = 38). Body composition parameters, including body mass index (BMI), fat-free mass (FFM), and body fat mass (BFM), were measured preoperatively and at 1, 3, 6, and 12 months postoperatively using bioelectrical impedance analysis. Two-way repeated-measures ANOVA was conducted, adjusting for age, sex, surgical method, operation time, blood loss, infection rates, and MMSE scores to minimize bias.
RESULTS: UGI patients showed significant reductions in weight, BMI, FFM, and BFM postoperatively, indicating a higher risk of malnutrition and muscle loss. In contrast, LGI patients exhibited stable or increasing trends in these parameters. Significant time and interaction effects were observed for FFM and BFM (p<0.05), underscoring differential recovery patterns between groups.
CONCLUSIONS: UGI patients face a higher risk of postoperative malnutrition and muscle loss compared to LGI patients, who showed more favorable recovery trajectories. Early, intensive nutritional interventions and personalized rehabilitation strategies are essential for mitigating muscle wasting and improving outcomes in UGI patients.
CITATION:
Eiko Takano ; Tsukasa Aritake ; Kakeru Hashimoto ; Yumi Suzuki ; Yuichi Kitagawa ; Ken Fujishiro ; Yasuji Kawabata ; Shinichirou Kobayashi ; Izumi Kondo (2025): Comparison of body composition changes and nutritional status after surgery between older Japanese patients with upper and lower gastrointestinal cancer.The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100006
IS LATE-LIFE VULNERABILITY TO CARDIOVASCULAR DISEASE RISK ASSOCIATED WITH LONGITUDINAL TAU ACCUMULATION IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT?
M. A Dratva, J.M. Diaz, M.L. Thomas, Q. Shen, A.A. Tsiknia, K.A. Rostowsky, E.E. Sundermann, S.J. Banks, Alzheimer\'s Disease Neuroimaging Initiative
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryBACKGROUND: Older females have higher Alzheimer's Disease (AD) risk and tau burden, especially in early disease stages, compared to males. Overlapping cardiovascular disease (CVD) and dementia risk factors, like the apolipoprotein (APOE)-ε4 allele, show mixed sex-specific results. We previously found that late-life CVD risk related more strongly to tau at a single timepoint in cognitively normal, older female APOE-ε4 carriers than in males.
OBJECTIVES: Do composite and component CVD risk factors explain sex differences in tau accumulation in older adults with mild cognitive impairment (MCI) and underlying amyloid-beta (Aβ) pathology?
DESIGN: Longitudinal analysis in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort.
SETTING: ADNI is a multi-site longitudinal study across the United States and Canada.
PARTICIPANTS: n = 52 older adults (aged 60–90), designated as both Aβ-positive and MCI.
MEASUREMENTS: CVD risk was measured by body mass index (BMI) and FRS, which includes age, systolic blood pressure (BP), high-density lipoprotein (HDL), total cholesterol, hypertension treatment, smoking, and diabetes. Regional standardized uptake value ratios (SUVRs) were extracted at each tau-PET timepoint. Composite SUVRs for Braak34 and Braak56 were calculated. Statistical models examined the separate and interactive effects of sex and APOE-ε4 on tau accumulation, and moderating effects of FRS, its components, or BMI, on tau accumulation.
RESULTS: Females accumulated more tau than males in bilateral Braak34 and right Braak56, while APOE-ε4 carriers trended toward more tau accumulation in left Braak56. FRS and its components did not relate to tau accumulation, nor influence sex effects, although they attenuated APOE-ε4 effects. In left Braak56, higher baseline BMI in males showed a trend toward greater tau accumulation.
CONCLUSIONS: In MCI and Aβ-positive older adults, females accumulated more tau than males, and late-life vascular risk did not explain this relationship. Higher BMI related to more tau accumulation in males only, suggesting sex-specific vulnerability to BMI on brain health. Although replication in larger and more representative cohorts is needed, these findings corroborate accelerated tau progression in older females, independent of CVD risk, and suggest that vascular health has limited influence on tau progression once AD pathology is established in the brain.
CITATION:
M. A Dratva ; J.M. Diaz ; M.L. Thomas ; Q. Shen ; A.A. Tsiknia ; K.A. Rostowsky ; E.E. Sundermann ; S.J. Banks ; Alzheimer's Disease Neuroimaging Initiative (2025): Is late-life vulnerability to cardiovascular disease risk associated with longitudinal tau accumulation in older adults with mild cognitive impairment?. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100001
FACTORS AFFECTING PARTICIPATION IN WEB-BASED ALZHEIMER\'S QUESTIONNAIRE SURVEYS: LESSONS FROM THE JAPANESE TRIAL-READY COHORT
Saki Nakashima, Kenichiro Sato, Yoshiki Niimi, Tatsushi Toda, Takeshi Iwatsubo
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryBACKGROUND: Web-based approach is considered helpful for the research focused on screening and early detection of individuals with preclinical Alzheimer's disease (AD); obtaining sufficient responses is critical to the success of such online study.
OBJECTIVES: This study examined factors influencing response rates to an online survey about disease-modifying drugs for AD among participants in the Japanese Trial-Ready Cohort (J-TRC) webstudy.
DESIGN: This was a retrospective observational study.
SETTINGS: Online survey in Japan using Google Forms.
PARTICIPANTS: We enrolled the eligible J-TRC webstudy participants who had registered before September 2023. We sent them an invitation e-mail including a questionnaire web address on November-December 2023, in order to conduct an online survey regarding their perceptions of disease-modifying therapy drug that was approved in July 2023, Japan.
MEASUREMENTS: We analyzed the impact of mailed day of the week (DOW), participant gender, age, employment status, and educational background with/without response to the invitation, quantified by the odds ratio of response.
RESULTS: Among approximately 10,400 J-TRC web study participants who sent invitation emails, the overall response rate was approximately 20 %, without significant influence depending on the DOW when the survey invitation was sent. Individuals who were older (50s–70s), retired, or had higher education levels were significantly more likely to respond, regardless of the DOW. Differences in response rates by sex/gender were observed, but were largely influenced by the employment status.
CONCLUSIONS: In order to improve response rates and enhance data quality, these findings provide valuable insights for optimizing the design of future online studies/surveys in the field of AD and dementia, particularly for targeting cognitively unimpaired middle-aged and older populations.
CITATION:
Saki Nakashima ; Kenichiro Sato ; Yoshiki Niimi ; Tatsushi Toda ; Takeshi Iwatsubo (2025): Factors affecting participation in web-based Alzheimer's questionnaire surveys: Lessons from the Japanese trial-ready cohort. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100008
CENTENARIAN PHYSICAL FUNCTIONING EVOLUTION AND COVID-19 IMPACT: A STUDY IN JAPAN
Xinyu Zhang, Jean-Marie Robine, Yasuyuki Gondo
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryBACKGROUND: Studies show that centenarians' physical function and activities of daily living (ADL) levels improved recently. However, it is unclear whether this positive impact has been altered due to COVID-19, causing reduced ADL. This study had two objectives: 1) to investigate whether the physical function of Japanese centenarians has improved over time, and 2) to examine the impact of COVID-19 on centenarians.
METHODS: The data were collected from research conducted in Kyotango City from 2014 to the present. Kyotango City Hall collected data, including the functional status of all centenarians who reached 100 years of age every year. In this study, we divided nine-year cohort into three periods: 2014–2016 (P1), 2017–2019 (P2), and 2020–2022 (P3). The participation rates were 89 % (n = 100), 78 % (n = 90), and 74 % (n = 114), respectively.
RESULTS: The centenarians’ ability to perform activities of daily living (ADL) declined as the cohort aged. For basic activities of daily living (BADL), the proportion of participants classified as independent increased from P1 to P2 and then decreased from P2 to P3 among female centenarians. However, this trend was not observed in male centenarians. Concerning mobility, only the proportion of bedridden centenarians decreased over the three periods. Statistically significant differences in the trends of female centenarians with robust mobility and those with weak mobility were obtained in the three periods.
CONCLUSION: The proportion of independent female centenarians in both BADL and mobility declined as the cohort aged. The opposite is true for male centenarians. This phenomenon was not affected by COVID-19.
CITATION:
Xinyu Zhang ; Jean-Marie Robine ; Yasuyuki Gondo (2025): Centenarian physical functioning evolution and COVID-19 impact: A study in Japan. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100009
LIVING LONGER AND LIFESTYLE: A REPORT ON THE OLDEST OF THE OLD IN THE ADVENTIST HEALTH STUDY-2
Hildemar Dos Santos, Alaa Alabadi-Bierman, Michael Paalani, Sen Luu Padilla, Abel Alvarez, W. Lawrence Beeson, Gary E. Fraser
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryOBJECTIVE: This investigation aimed to evaluate and describe the health profile and dietary patterns of the oldest Adventists (individuals aged 80 years and older).
DESIGN: Cross-sectional investigation.
SETTING: Self-administered lifestyle questionnaire in Adventist congregations in North America.
PARTICIPANTS: 7192 individuals aged 80 years of age or older enrolled in the Adventist Health Study-2.
MEASUREMENTS: Dietary intakes for participants were evaluated using a self-administered quantitative food frequency questionnaire. Selected health outcomes data were assessed with the baseline self-administered medical history questionnaire.
RESULTS: Our cohort of the old adults Adventists had a predominant female participation (62 %), and the percentage of vegetarians was 52.7 %. Based on classification into respective dietary patterns, 7.8 % of the study population were vegan, 29.2 % of the participants were lacto-ovo vegetarians, 10.2 % were pesco-vegetarians, 5.5 % were semi-vegetarians, and 47.3 % were non-vegetarians. Regarding the assessment of prevalent conditions, non-vegetarians were more likely to report having hypertension than other dietary patterns. Semi-vegetarians and non-vegetarians were more likely to report high cholesterol. A large number of participants reported never smoking (78.5 %) and never drinking alcoholic beverages (57.8 %), and non-vegetarians reported the poorest health perception (20 %) compared to vegans (11.4 %).
CONCLUSION: Our Adventist Health oldest of the old cohort shared many of the characteristics observed among the individuals that make up the long-living cohorts worldwide as well as younger aged Adventist participants. This observation indicates the importance of non-smoking, abstinence from alcohol consumption, daily engagement in regular physical activity, avoidance of disease in older ages, and following a plant-based diet concerning the potential for successful aging.
CITATION:
Hildemar Dos Santos ; Alaa Alabadi-Bierman ; Michael Paalani ; Sen Luu Padilla ; Abel Alvarez ; W. Lawrence Beeson ; Gary E. Fraser (2025): Living longer and lifestyle: A report on the oldest of the old in the Adventist Health Study-2. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100010
ASSOCIATION OF PSYCHOLOGICAL STRESS AND SUBJECTIVE COGNITIVE DECLINE
Manju Ramakrishnan, Nikhila Gandrakota, Yash Kamdar, Ambar Kulshreshtha
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryPsychological stress is associated with several long-term consequences, including cognitive decline. Our study examined the relationship between psychological stress levels and subjective cognitive decline (SCD) using cross-sectional data from CDC's Behavioral Risk Factor Surveillance System (BRFSS 2020–2022) for participants aged 45 years and older. Among 881,479 participants, 7.5 % were African American, and 10.7 % reported high psychological stress, with 29 % experiencing SCD. High psychological stress had a 3-fold risk of SCD compared to low psychological stress (OR: 3.3; 95 % CI: 2.8, 4.0). A significant interaction between psychological stress and BMI was found in their association with SCD (p = 0.013). Individuals with high psychological stress and a BMI ≥ 25 had 4.3 times higher SCD risk (OR: 4.3; 95 % CI: 3.9, 4.7) compared to those with low psychological stress and a BMI < 25 (OR: 0.23, 95 % CI: 0.2, 0.3). These results highlight the importance of addressing stress to prevent cognitive decline.
CITATION:
Manju Ramakrishnan ; Nikhila Gandrakota ; Yash Kamdar ; Ambar Kulshreshtha (2025): Association of psychological stress and subjective cognitive decline. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100012
MEDIATING ROLE OF THE BODY MASS INDEX IN THE PROSPECTIVE ASSOCIATION BETWEEN A HEALTHY DIET AND EVOLUTION OF ASTHMA SYMPTOMS IN ELDERLY WOMEN
Wassila Ait-hadad, Annabelle Bédard, Laurent Orsi, Sébastien Chanoine, Orianne Dumas, Nasser Laouali, Nicole Le Moual, Bénédicte Leynaert, Valérie Siroux, Marie-Christine Boutron-Ruault, Raphaëlle Varraso
J Aging Res & Lifestyle 2025;14
Show summaryHide summaryOBJECTIVES: Diet and obesity exhibit complex interrelationships with asthma, particularly among elderly women. We aimed to clarify the impact of healthy diet assessed by the Alternate Healthy Eating Index-2010 (AHEI-2010) on: 1) the incidence of asthma symptoms, and 2) among women with symptoms in 2011, the change in asthma symptoms, while accounting for the potential mediating role of BMI.
DESIGN: A nested case-control study on asthma with follow-up data.
SETTING: Within the French E3N cohort.
PARTICIPANTS: 8621 elderly women (62 years on average in 1993).
MEASUREMENTS: Dietary data were collected in 1993 and 2005 using semi-quantitative questionnaires. Using the validated asthma symptom score assessed in 2011 and 2018, asthma symptom incidence among women with no asthma symptom in 2011 (n = 5700) and change in asthma symptoms (reduced, stable, increased) among those with asthma symptoms in 2011 (n = 2921) were defined. BMI was calculated in 2008. Marginal structural models were used to estimate total, direct and indirect effects mediated by BMI.
RESULTS: After adjustment for potential confounders, we found a significant indirect effect of healthier diet on lower risk of asthma symptoms incidence mediated by lower BMI (OR for AHEI-2010 quintile 5 vs quintile 1 = 0.95 (0.92–0.97)), without significant total (OR=0.87 (0.66–1.10)) nor direct (OR=0.92 (0.71–1.15)) effects. Among women with asthma symptoms, we also found a significant indirect effect of healthier diet on reduced asthma symptoms mediated by lower BMI (OR for AHEI-2010 >median vs ≤median=1.02 (1.00–1.03)) without significant total (OR=1.12 (0.94–1.34)) nor direct effects (OR=1.10 (0.93–1.31)).
CONCLUSION: A healthy diet was associated with reduced risk of asthma symptoms over time, partly through a lower BMI.
CITATION:
Wassila Ait-hadad ; Annabelle Bédard ; Laurent Orsi ; Sébastien Chanoine ; Orianne Dumas ; Nasser Laouali ; Nicole Le Moual ; Bénédicte Leynaert ; Valérie Siroux ; Marie-Christine Boutron-Ruault ; Raphaëlle Varraso (2025): Mediating role of the body mass index in the prospective association between a healthy diet and evolution of asthma symptoms in elderly women. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100011