1.Potential profile analysis of cognitive impairment in the elderly population with mild cognitive impairment
Qing PAN ; Miao WANG ; Xuting DONG ; Hui XU ; Lei XU ; Han CAI
Chinese Journal of Geriatrics 2025;44(7):951-956
Objective:To explore the latent profiles of cognitive function in older adults with mild cognitive impairment(MCI)and to analyze the influencing factors, as well as to develop targeted interventions.Methods:The data for this study were obtained from a cross-sectional study conducted from May to December 2023.Peterson's criteria and the Chinese guidelines for the diagnosis and treatment of dementia and cognitive impairment(V)were employed to screen for MCI among 1, 650 elderly individuals aged 60 and above in a specific community.The Montreal Cognitive Assessment Scale(MoCA)and the Centre for Epidemiological Studies Depression Scale(CES-D)were utilized to assess cognitive ability and depression levels, respectively.Serum vitamin D3 levels were measured using mass spectrometry.Potential profile models of cognitive function in MCI patients were analyzed using Mplus 8.3, and the influencing factors of the latent profiles were identified through multivariate logistic regression.Results:A total of 327 older adults with MCI were initially screened, revealing a prevalence rate of 19.82%.Out of these, 295 patients were ultimately included in the study.The cognitive impairment of these participants was categorized into three profiles: the mild low-cognitive group(49.15%), the mild low-cognitive with severely low-abstraction group(41.70%), and the severely low-cognitive group(9.15%).Logistic regression analysis identified several independent predictors for the severely low-cognitive group among older adults with MCI: education level(primary and below compared to high school and above: OR=7.343, P<0.001; junior high compared to high school and above: OR=1.689, P=0.004), depression level( OR=1.120, P=0.002), and napping habits(with napping habits compared to without: OR=0.255, P=0.006).Additionally, education level( OR=3.535, P<0.001), depression level( OR=1.125, P<0.001), and serum vitamin D3 levels( OR=0.811, P=0.035)were found to be independent predictors for the mild low-cognitive with severely low-abstraction group in older adults with MCI. Conclusions:Cognitive impairment in older adults with MCI exhibits heterogeneity, which can be categorized into three potential profiles.Targeted interventions should be implemented based on the characteristics and influencing factors of each category to mitigate cognitive decline among older adults with MCI.
2.Mediating effect of sleep quality on the relationship between serum vitamin D3 level and depressive symptoms in community-dwelling elderly people with mild cognitive impairment
Xuting DONG ; Han CAI ; Xiaohu WANG ; Hui XU ; Shixia LI
Journal of Shenyang Medical College 2025;27(4):369-374
Objective:To explore the mediating effect of sleep quality on the relationship between serum vitamin D3 level and depressive symptoms in community-dwelling elderly people with mild cognitive impairment(MCI).Methods:A total of 480 elderly people with MCI meeting inclusion criteria in a community health service center from Jan 2023 to Dec 2023 were selected as the research objects.The general information questionnaire,mini-mental state examination(MMSE),activity of daily living scale(ADL),Center for Epidemiological Studies Depression Scale(CES-D)and Pittsburgh sleep quality index(PSQI)were used to investigate the subjects.Serum vitamin D3 level was detected within 1 week.Spearson correlation analysis was used to explore the correlation between sleep quality,serum vitamin D3 level and depressive symptoms.The mediating effect model was tested by Model 4 in the Process plug-in.Results:Among the 480 MCI elderly,the average score of depression was(12.28±4.75),the average serum vitamin D3 level was(25.81±7.09)ng/ml,and the average score of sleep quality was(7.17±2.71).Depression severity was positively correlated with sleep quality score(r=0.294,P<0.01),and negatively correlated with serum vitamin D3 level(r=-0.237,P<0.01).Serum vitamin D3 level was negatively correlated with sleep quality score(r=-0.225,P<0.01).Bootstrap analysis showed that the mediating effect of sleep quality between serum vitamin D3 level and depression level was-0.064(95%CI:-0.115--0.023),accounting for 26.57%of the total effect.Conclusion:Sleep quality partially mediates the relationship between serum vitamin D3 level and depressive symptoms in the elderly with MCI in the community.
3.Mediating effect of sleep quality on the relationship between serum vitamin D3 level and depressive symptoms in community-dwelling elderly people with mild cognitive impairment
Xuting DONG ; Han CAI ; Xiaohu WANG ; Hui XU ; Shixia LI
Journal of Shenyang Medical College 2025;27(4):369-374
Objective:To explore the mediating effect of sleep quality on the relationship between serum vitamin D3 level and depressive symptoms in community-dwelling elderly people with mild cognitive impairment(MCI).Methods:A total of 480 elderly people with MCI meeting inclusion criteria in a community health service center from Jan 2023 to Dec 2023 were selected as the research objects.The general information questionnaire,mini-mental state examination(MMSE),activity of daily living scale(ADL),Center for Epidemiological Studies Depression Scale(CES-D)and Pittsburgh sleep quality index(PSQI)were used to investigate the subjects.Serum vitamin D3 level was detected within 1 week.Spearson correlation analysis was used to explore the correlation between sleep quality,serum vitamin D3 level and depressive symptoms.The mediating effect model was tested by Model 4 in the Process plug-in.Results:Among the 480 MCI elderly,the average score of depression was(12.28±4.75),the average serum vitamin D3 level was(25.81±7.09)ng/ml,and the average score of sleep quality was(7.17±2.71).Depression severity was positively correlated with sleep quality score(r=0.294,P<0.01),and negatively correlated with serum vitamin D3 level(r=-0.237,P<0.01).Serum vitamin D3 level was negatively correlated with sleep quality score(r=-0.225,P<0.01).Bootstrap analysis showed that the mediating effect of sleep quality between serum vitamin D3 level and depression level was-0.064(95%CI:-0.115--0.023),accounting for 26.57%of the total effect.Conclusion:Sleep quality partially mediates the relationship between serum vitamin D3 level and depressive symptoms in the elderly with MCI in the community.
4.Potential profile analysis of cognitive impairment in the elderly population with mild cognitive impairment
Qing PAN ; Miao WANG ; Xuting DONG ; Hui XU ; Lei XU ; Han CAI
Chinese Journal of Geriatrics 2025;44(7):951-956
Objective:To explore the latent profiles of cognitive function in older adults with mild cognitive impairment(MCI)and to analyze the influencing factors, as well as to develop targeted interventions.Methods:The data for this study were obtained from a cross-sectional study conducted from May to December 2023.Peterson's criteria and the Chinese guidelines for the diagnosis and treatment of dementia and cognitive impairment(V)were employed to screen for MCI among 1, 650 elderly individuals aged 60 and above in a specific community.The Montreal Cognitive Assessment Scale(MoCA)and the Centre for Epidemiological Studies Depression Scale(CES-D)were utilized to assess cognitive ability and depression levels, respectively.Serum vitamin D3 levels were measured using mass spectrometry.Potential profile models of cognitive function in MCI patients were analyzed using Mplus 8.3, and the influencing factors of the latent profiles were identified through multivariate logistic regression.Results:A total of 327 older adults with MCI were initially screened, revealing a prevalence rate of 19.82%.Out of these, 295 patients were ultimately included in the study.The cognitive impairment of these participants was categorized into three profiles: the mild low-cognitive group(49.15%), the mild low-cognitive with severely low-abstraction group(41.70%), and the severely low-cognitive group(9.15%).Logistic regression analysis identified several independent predictors for the severely low-cognitive group among older adults with MCI: education level(primary and below compared to high school and above: OR=7.343, P<0.001; junior high compared to high school and above: OR=1.689, P=0.004), depression level( OR=1.120, P=0.002), and napping habits(with napping habits compared to without: OR=0.255, P=0.006).Additionally, education level( OR=3.535, P<0.001), depression level( OR=1.125, P<0.001), and serum vitamin D3 levels( OR=0.811, P=0.035)were found to be independent predictors for the mild low-cognitive with severely low-abstraction group in older adults with MCI. Conclusions:Cognitive impairment in older adults with MCI exhibits heterogeneity, which can be categorized into three potential profiles.Targeted interventions should be implemented based on the characteristics and influencing factors of each category to mitigate cognitive decline among older adults with MCI.
5.Mediating effects of self-efficacy and loneliness on health promoting behavior and frailty in elderly patients with proliferative diabetic retinopathy
Xuting DONG ; Fang XU ; Yonghong SHENG ; Guoping WANG ; Xiaohu WANG
Journal of Shenyang Medical College 2024;26(1):25-29,94
Objective:To investigate the relationship between health promoting behavior and frailty in elderly patients with proliferative diabetic retinopathy(PDR),and the mediating effects of self-efficacy and loneliness.Methods:In an eye hospital of Anhui Province,214 elderly patients with PDR were selected from May 2021 to Nov 2022 by convenient sampling method.The Frailty Scale,Chinese Version of Health-Promoting Lifestyle Profile-Ⅱ,Self-Efficacy Scale and Simplified Loneliness Scale were used in this survey.Bootstrap method of Process software was used to analyze the mediating effect of self-efficacy on the relationship between health promoting behaviors and frailty in elderly PDR patients and the moderating effect of loneliness on the relationship between self-efficacy and frailty.Results:A total of 220 questionnaires were distributed and 214 valid questionnaires were returned,with valid response rate of 97.27% .Moderated mediation effect analysis suggested that health-promoting behaviors negatively predicted frailty(β=-0.508,P<0.01).Health promoting behaviors and self-efficacy had significant predictive effects on frailty(β=-0.191 and-0.433,P<0.01),and health promoting behaviors also had a significant predictive effect on self-efficacy(β=0.063,P<0.01).Self-efficacy played a partially mediating role between health promoting behaviors and frailty,and the mediating effect accounted for 14.76% of the total effect.The product term of loneliness and self-efficacy significantly predicted frailty(β=0.255,P<0.01),the mediating effect of self-efficacy on frailty was moderated by loneliness.Conclusions:The health-promoting behaviors of elderly patients with PDR affect frailty through self-efficacy,and loneliness moderates the relationship between self-efficacy and frailty.The moderated mediation model is established.
6.The role and mechanism of low-dose aspirin with IFN-α in inhibiting growth and metastasis of hepatocellular carcinoma
Tao LI ; Xuting ZHI ; Jianwei ZHOU ; Zhaoru DONG ; Hui QU ; Haihua YU ; Lu WANG ; Zhaoyou TANG
Chinese Journal of Hepatobiliary Surgery 2012;18(1):50-53
ObjectiveTo study the role and mechanism of low-dose aspirin with IFN-α in inhibiting growth and metastasis of hepatocellular carcinoma (HCC).MethodsMHCC97L cells were cultured and a metastatic model of human HCC was established by orthotopic implantation of histologically intact human HCC tissue into the liver of nude (nu/nu) mice.After administration of different doses of Aspirin and IFN-α for 40 days,the mice bearing xenografts in liver were killed,and the tumor volume and lung metastasis were evaluated.Cell proliferation and MMP-2 activity were measured by MTT and gelatin zymography,respectively.The expressions of VEGF and MMP-2 were measured by western blot and ELISA.ResultsCompared to the control group,there were no significant differences in the high-dose Aspirin [45 mg/(kg · d)] treated group regarding tumor volume [(1.89 ±0.88) cm3 vs (3.12±0.85) cm3,P>0.05] and incidence of lung metastases (58.3% vs 66.7%,P>0.05),but the tumor volume and incidence of lung metastasis were significantly inhibited in the highdose IFN-α group [1.5 × 107/(kg · d)],the high-dose IFN-α combined with high-dose Aspirin group,and the low-dose IFN-α [7.5 × 106 / (kg · d) ] combined with low-dose Aspirin [15 mg/(kg · d] group (P<0.05).2 mmol/L Aspirin did not inhibit the proliferation of MHCC97 cells (P>0.05),but inhibited the activities and expressions of MMP-2 and VEGF.Low-dose IFN-α combined with low-dose Aspirin significantly decreased the expressions of MMP-2 and VEGF in nude mice (P<0.05).ConclusionLow-dose Aspirin combined with low-dose IFN-α significantly inhibited the growth and metastasis of HCC through suppressing the expressions of MMP-2 and VEGF.
7.The role and mechanism of low-dose aspirin and IFN-α in inducing hepatocellular carcinoma apoptosis in BEL-7402 cells
Zhaoru DONG ; Tao LI ; Sifeng QU ; Lixi LUO ; Chun ZHANG ; Gangpu WANG ; Zeting CHEN ; Xiaowei LI ; Xuting ZHI
Chinese Journal of Hepatobiliary Surgery 2012;18(4):292-295
Objective To investigate the role and mechanism of low-dose aspirin concurrent with IFN-a in inducing hepatocellular carcinoma apoptosis in BEL-7402 cells. Methods BEL-7402 cells were cultured and treated with IFN-α,or low dose aspirin or both.MTT and flow cytometry were used to measure the cell proliferation and apoptosis after treatment with a singular drug or the combined regiment.The expressions of the apoptosis-related proteins were detected by Western blot.Results MTT assay revealed after IFN α administration alone or combined with aspirin treatment for 48 h,the proliferation ratio of the IFN-α or aspirin group were 82.45% ± 1.71% and 83.22% ±2.26 %,compared with the control group.The group which received the combined therapy had a proliferation ratio of 69.84 % ±1.18 %,which was significantly lower than the single groups (P<0.05).The flow cytometry revealed that the apoptosis ratio in IFN-α group and aspirin group were 14.78 % ±1.93% and 14.00%±0.61%,respectively,while the IFN-α + aspirin group was 21.68%±1.28%,which was also significantly higher than that of the single groups (P<0.05).Western blot detected that IFN-α and aspirin (1 mmol/L) could promote caspase-3 and caspase-9 protein expressions,and when the two drugs were combined,caspase-3 and caspase-9 were also significantly activated.IFN-α alone or combined with aspirin can promote the expression of pro-apoptotic protein Bax (P<0.05),while the anti-apoptotic proteins expression of Bcl-2 and Bcl-xl did not change significantly (P>0.05).Conclusions Low-dose aspirin can cooperate with IFN-α in inhibiting the BEL-7402 cell growth and inducing the cell apoptosis by activating and increasing caspase-3 and caspase-9 levels,which may be related to the increased expression of pro-apoptotic protein Bax.
8.Clinicopathological characteristics and prognostic factors of hepatolithiasis associated with intrahepatic cholangiocarcinoma
Chun ZHANG ; Tao LI ; Zhaoru DONG ; Lixi LUO ; Gangpu WANG ; Zhichao JIANG ; Xiangyu WANG ; Xuting ZHI
Chinese Journal of Hepatobiliary Surgery 2012;(12):893-897
Objective To investigate the clinicopathological characteristics and prognostic factors of hepatolithiasis associated with intrahepatic cholangiocarcinoma (HLAIHCC).Method A ret rospective study was conducted on 36 patients who suffered from histopathologically confirmed HLAIHCC.These patients received surgical resection of the tumor from June 2006 to September 2009.Results The overall 1,3,5 year survival rates for patients with HLAIHCC were not significantly better than those patients with ICC (63.6%,36.4%,and 30.3i% vs.65.4%,34.3%,and 28.6%,P=0.57).For the patients who received curative resection,the 1-,3-,and 5-year survival rates (81.4 %,61.7 %,and 58.6 %) were significantly better than those who received palliative resections (x2 =20.426,P<0.001).The white blood cell count was significantly higher in the HLAIHCC group than in the ICC group (x2 =19.70,P<0.001) and tumor size was significantly smaller in the ICC group than in the HLAIHCC group (P=0.04).Serum CA19-9 level (P=0.049) and resection margin (P=0.019) were independent risk factors of prognosis.Conclusions This study showed HLAIHCC to have different clinicopathological characteristics from ICC.Curative resection was the optimal surgical treatment for HLAIHCC.Serum CA19-9 level and resection margin were independent risk factors of prognosis.

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