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Metabolic Health and Cognitive Function: The Roles of Lifestyle and Shift Work
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.ORCID iD: 0000-0003-2747-1606
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The risk of cognitive impairment and metabolic disturbances increases during aging. Healthy lifestyle habits, such as a regular intake of fatty fish and adherence to the Mediterranean diet (MeDi), have been shown to slow age-related cognitive decline and decrease the risk of metabolic disturbances. Conversely, poor lifestyle habits including habitual short sleep duration as well as irregular work schedules (e.g. night shift work) have been correlated with lower cognitive performance and increased risk of having metabolic syndrome (MetS). However evidence is not conclusive regarding the above mentioned associations. The aim of this thesis was to investigate associations of diet, sleep, and shift work with metabolic health or cognitive performance in two Swedish cohorts.

In Paper I and II we examined whether the dietary intake of omega-3 fatty acids and adherence to MeDi were related to measures of brain health in elderly subjects. To this aim, we used scores from the 7-minute cognitive screening test (7MS) and brain volume determined by magnetic resonance imaging. In Paper I, self-reported dietary intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) at age 70 was positively associated with cognitive performance and global gray matter volume at age 75. In Paper II, the fully-adjusted main analysis revealed that the MeDi score was not linked to measures of brain health. However, low intake of the MeDi component meat and meat products was associated with better performance on the 7MS and larger total brain volume.

Paper III and IV included subjects aged 45-75 years. In Paper III we demonstrated that current and recent former shift workers (including shifts outside traditional working hours during the past 5 years at the time of the survey) performed worse on the trail making test (TMT) than non-shift workers. The TMT is a test evaluating executive cognitive function, and the performance on this test decreases with age. In Paper IV, sleep duration, sleep disturbances, and sleep-disordered breathing were all linked to an increased prevalence of MetS. Some of the observed associations were age-specific. For example, whereas both short and long sleep durations were linked to a higher prevalence of MetS in younger individuals (<65 years), only long sleep duration did so in the older participants. Collectively, the findings of this thesis suggest that maintaining healthy dietary habits, having high-quality sleep, and following a regular work schedule may be recommended strategies to mitigate age-related morbidities.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. , p. 58
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1532
Keywords [en]
cognitive function, Mediterranean diet, omega-3 fatty acids, MRI, shift work history, sleep, metabolic syndrome
National Category
Medical and Health Sciences
Research subject
Epidemiology; Medical Science
Identifiers
URN: urn:nbn:se:uu:diva-368737ISBN: 978-91-513-0557-8 (print)OAI: oai:DiVA.org:uu-368737DiVA, id: diva2:1280030
Public defence
2019-03-07, A1:107a, BMC, Husargatan 3, Uppsala, 10:00 (English)
Opponent
Supervisors
Available from: 2019-02-14 Created: 2019-01-17 Last updated: 2019-02-18
List of papers
1. Dietary intake of eicosapentaenoic and docosahexaenoic acids is linked to gray matter volume and cognitive function in elderly
Open this publication in new window or tab >>Dietary intake of eicosapentaenoic and docosahexaenoic acids is linked to gray matter volume and cognitive function in elderly
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2013 (English)In: Age (Omaha), ISSN 0161-9152, E-ISSN 1574-4647, Vol. 35, no 4, p. 1495-1505Article in journal (Refereed) Published
Abstract [en]

In the present study, we tested whether elderly with a high dietary intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) would have higher cognitive test scores and greater brain volume than those with low dietary intake of these fatty acids. Data were obtained from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. The dietary intake of EPA and DHA was determined by a 7-day food protocol in 252 cognitively healthy elderly (122 females) at the age of 70 years. At age 75, participants' global cognitive function was examined, and their brain volumes were measured by magnetic resonance imaging (MRI). Three different multivariate linear regression models were applied to test our hypothesis: model A (adjusted for gender and age), model B (additionally controlled for lifestyle factors, e.g., education), and model C (further controlled for cardiometabolic factors, e.g., systolic blood pressure). We found that the self-reported 7-day dietary intake of EPA and DHA at the age of 70 years was positively associated with global gray matter volume (P < 0.05, except for model C) and increased global cognitive performance score (P < 0.05). However, no significant associations were observed between the dietary intake of EPA and DHA and global white matter, total brain volume, and regional gray matter, respectively. Further, no effects were observed when examining cognitively impaired (n = 27) elderly as separate analyses. These cross-sectional findings suggest that dietary intake of EPA and DHA may be linked to improved cognitive health in late life but must be confirmed in patient studies.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-181452 (URN)10.1007/s11357-012-9453-3 (DOI)000321547300038 ()22791395 (PubMedID)
Available from: 2012-09-24 Created: 2012-09-24 Last updated: 2019-01-17Bibliographically approved
2. Mediterranean diet habits in older individuals: Associations with cognitive functioning and brain volumes
Open this publication in new window or tab >>Mediterranean diet habits in older individuals: Associations with cognitive functioning and brain volumes
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2013 (English)In: Experimental Gerontology, ISSN 0531-5565, E-ISSN 1873-6815, Vol. 48, no 12, p. 1443-1448Article in journal (Refereed) Published
Abstract [en]

To examine the association between dietary habits, cognitive functioning and brain volumes in older individuals, data from 194 cognitively healthy individuals who participated in the Prospective Investigation of the Vasculature in Uppsala Seniors cohort were used. At age 70, participants kept diaries of their food intake for 1week. These records were used to calculate a Mediterranean diet (MeDi) score (comprising dietary habits traditionally found in Mediterranean countries, e.g. high intake of fruits and low intake of meat), with higher scores indicating more pronounced MeDi-like dietary habits. Five years later, participants' cognitive capabilities were examined by the seven minute screening (7MS) (a cognitive test battery used by clinicians to screen for dementia), and their brain volumes were measured by volumetric magnetic resonance imaging. Multivariate linear regression analyses were constructed to examine the association between the total MeDi score and cognitive functioning and brain volumes. In addition, possible associations between MeDi's eight dietary features and cognitive functioning and brain volumes were investigated. From the eight dietary features included in the MeDi score, pertaining to a low consumption of meat and meat products was linked to a better performance on the 7MS test (P=0.001) and greater total brain volume (P=0.03), i.e. the sum of white and gray matter. Integrating all dietary features of MeDi into score did not explain additional variance. These observational findings suggest that keeping to a low meat intake could prove to be an impact-driven public health policy to support healthy cognitive aging, when confirmed by longitudinal studies. Further, they suggest that the MeDi score is a construct that may mask possible associations of single MeDi features with brain health domains in elderly populations.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-209899 (URN)10.1016/j.exger.2013.10.002 (DOI)000327489800009 ()24126083 (PubMedID)
Available from: 2013-10-28 Created: 2013-10-28 Last updated: 2019-01-17Bibliographically approved
3. Association between shift work history and performance on the trail making test in middle-aged and elderly humans: the EpiHealth study
Open this publication in new window or tab >>Association between shift work history and performance on the trail making test in middle-aged and elderly humans: the EpiHealth study
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2016 (English)In: Neurobiology of Aging, ISSN 0197-4580, E-ISSN 1558-1497, Vol. 45, p. 23-29Article in journal (Refereed) Published
Abstract [en]

Shift work has been proposed to promote cognitive disturbances in humans; however, conflicting evidence is also present. By using data from 7143 middle-aged and elderly humans (45-75 years) who participated in the Swedish EpiHealth cohort study, the present analysis sought to investigate whether self-reported shift work history would be associated with performance on the trail making test (TMT). The TMT has been proposed to be a useful neuropsychological tool to evaluate humans' executive cognitive function, which is known to decrease with age. After adjustment for potential confounders (e.g., age, education, and sleep duration), it was observed that current and recent former shift workers (worked shifts during the past 5 years) performed worse on the TMT than nonshift workers. In contrast, performance on the TMT did not differ between past shift workers (off from shift work for more than 5 years) and nonshift workers. Collectively, our results indicate that shift work history is linked to poorer performance on the TMT in a cohort of middle-aged and elderly humans.

Keywords
Shift work history, Trail making test, Cohort study
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-303263 (URN)10.1016/j.neurobiolaging.2016.05.007 (DOI)000381092900003 ()27459922 (PubMedID)
Funder
Swedish Research CouncilThe Swedish Brain FoundationNovo Nordisk
Available from: 2016-10-05 Created: 2016-09-15 Last updated: 2019-01-17Bibliographically approved
4. Associations Between the Prevalence of Metabolic Syndrome and Sleep Parameters Vary by Age
Open this publication in new window or tab >>Associations Between the Prevalence of Metabolic Syndrome and Sleep Parameters Vary by Age
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2018 (English)In: Frontiers in Endocrinology, ISSN 1664-2392, E-ISSN 1664-2392, Vol. 9, article id 234Article in journal (Refereed) Published
Abstract [en]

Objective: To examine whether the relationship between the metabolic syndrome (MetS) and various sleep parameters [sleep duration, symptoms of sleep-disordered breathing (SDB), and sleep disturbances] varies by age. Methods: Waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting glucose were used to determine MetS status in a cohort (N = 19,691) of middle-aged (aged 45-64 years) and older (aged >= 65 years) subjects. Habitual sleep duration (short, <= 6 h/day; normal, 7-8 h/day; and long >= 9 h/day), sleep disturbances (such as problems with falling and staying asleep), and symptoms of sleep-disordered breathing (SDB, such as snoring and sleep apneas) were measured by questionnaires. Results: Among the participants, 4,941 subjects (25.1%) fulfilled the criteria for MetS. In the entire sample, both short and long sleep durations were associated with higher prevalence of MetS as compared to normal sleep duration. When stratified by age, a similar pattern was observed for middle-aged subjects (<65 years old; prevalence ratio (PR) [95% CI], 1.13 [1.06-1.22] for short sleep and 1.26 [1.06-1.50] for long sleep duration). In contrast, in older individuals (>= 65 years old), only long sleep duration was linked to a higher prevalence of MetS (1.26 [1.12-1.42]; P < 0.01 for sleep duration x age). In the entire cohort, having at least one SDB symptom >= 4 times per week was linked to an increased prevalence of MetS; however, the PR was higher in middle-aged subjects compared with older subjects (1.50 [1.38-1.63] vs. 1.36 [1.26-1.47], respectively; P < 0.001 for SDB x age). Finally, independent of subjects' age, reports of sleep disturbances (i.e., at least one symptom >= 4 times per week) were associated with a higher likelihood of having MetS (1.12 [1.06-1.18]; P > 0.05 for sleep disturbance x age). Conclusion: Our results suggest that age may modify the associations between some sleep parameters and the prevalence of MetS.

Keywords
sleep duration, sleep disturbance, sleep-disordered breathing, metabolic syndrome, age
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-356873 (URN)10.3389/fendo.2018.00234 (DOI)000431867800001 ()29867766 (PubMedID)
Funder
Swedish Research Council, 2015-03100The Swedish Brain FoundationNovo Nordisk, NNF14OC0009349
Available from: 2018-08-09 Created: 2018-08-09 Last updated: 2019-03-15Bibliographically approved

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