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Original Article
Association of the Korean-specific food-based index of dietary inflammatory potential with the risk of mild cognitive impairment in Korean older adults
Se Yeon Hwang, Chong-Su Kim, Mi Kyung Kim, Yoonkyoung Yang, Yoon Jung Yang
Epidemiol Health. 2024;46:e2024067.   Published online July 25, 2024
DOI: https://doi.org/10.4178/epih.e2024067
  • 2,094 View
  • 80 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to examine the association between the food-based index of dietary inflammatory potential (FBDI) and the risk of mild cognitive impairment (MCI) in Korean older adults.
METHODS
The subjects were 798 Korean adults aged 60 years and older. The FBDI was calculated based on the intake of 7 anti-inflammatory and 3 inflammatory food groups. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. A general linear model and multiple logistic regression were applied to assess the association between FBDI and the risk of MCI.
RESULTS
As the FBDI increased, the intake of white rice, cookies/candies, and sweetened drinks tended to increase, but the intake of niacin, β-carotene, calcium, and potassium tended to decrease (p for trend<0.05). The highest FBDI group had a higher MCI risk (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.01 to 2.52) than the lowest FBDI group, adjusted for gender, age, and education level; and this trend was significant in a fully adjusted model (p for trend=0.039). No significant associations were found in men after adjusting for confounding factors. Among women, MCI risk increased as the FBDI increased (p for trend=0.007); and the highest FBDI group had a higher MCI risk (OR, 2.22; 95% CI, 1.04 to 4.74) than the lowest FBDI group in a fully adjusted model.
CONCLUSIONS
These results suggest that the appropriate intake of anti-inflammatory foods and nutrients may be associated with a reduced risk of MCI among older adults.
Summary
Korean summary
본 연구는 60세 이상 노인을 대상으로 한국인 맞춤형 식이 염증 지표와 경도인지장애 위험 사이의 연관성을 조사하였다. 식이 염증 지표 점수는 7개의 항염증 식품 그룹과 3개의 염증 식품 그룹의 섭취를 기반으로 계산하였는데, 식이 염증 지표 점수가 높은 노인들은 경도인지장애 위험이 더 높은 경향이 있음이 확인되었다. 이러한 연구 결과는 염증을 억제하는 식품과 영양소의 적절한 섭취가 경도인지장애 위험 감소와 연관되어 있음을 시사한다.
Key Message
Our study investigated the association between the Korean-specific food-based index of dietary inflammatory potential (FBDI) and risk of mild cognitive impairment (MCI) in adults aged 60 and older. The FBDI was calculated based on the intake of 7 anti-inflammatory and 3 inflammatory food groups. The result showed that older adults with a higher FBDI tended to have a higher risk of MCI. These findings suggest that the appropriate intake of anti- inflammatory foods and nutrients may be associated with a reduced risk of MCI among older adults.
COVID-19: Original Article
The bounds of meta-analytics and an alternative method
Ramalingam Shanmugam, Mohammad Tabatabai, Derek Wilus, Karan P. Singh
Epidemiol Health. 2024;46:e2024016.   Published online January 7, 2024
DOI: https://doi.org/10.4178/epih.e2024016
  • 3,770 View
  • 85 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Meta-analysis is a statistical appraisal of the data analytic implications of published articles (Y), estimating parameters including the odds ratio and relative risk. This information is helpful for evaluating the significance of the findings. The Higgins I2 index is often used to measure heterogeneity among studies. The objectives of this article are to amend the Higgins I2 index score in a novel and innovative way and to make it more useful in practice.
METHODS
Heterogeneity among study populations can be affected by many sources, including the sample size and study design. They influence the Cochran Q score and, thus, the Higgins I2 score. In this regard, the I2 score is not an absolute indicator of heterogeneity. Q changes by bound as Y increases unboundedly. An innovative methodology is devised to show the conditional and unconditional probability structures.
RESULTS
Various properties are derived, including showing that a zero correlation between Q and Y does not necessarily mean that they are independent. A new alternative statistic, S2, is derived and applied to mild cognitive impairment and coronavirus disease 2019 vaccination for meta-analysis.
CONCLUSIONS
A hidden shortcoming of the Higgins I2 index is overcome in this article by amending the Higgins I2 score. The usefulness of the proposed methodology is illustrated using 2 examples. The findings have potential health policy implications.
Summary
Key Message
An approach to overcome the hidden shortcomings of Higgens I2 in meta-analysis. The approach has potential health policy implications.

Citations

Citations to this article as recorded by  
  • Practicing Meta-Analytics with Rectification
    Ramalingam Shanmugam, Karan P. Singh
    Publications.2025; 13(1): 2.     CrossRef
Original Articles
Effect of chemotherapy and radiotherapy on cognitive impairment in colorectal cancer: evidence from Korean National Health Insurance Database Cohort
Kwanghyun Kim, Chang Woo Kim, Aesun Shin, Hyunseok Kang, Sun Jae Jung
Epidemiol Health. 2021;43:e2021093.   Published online November 2, 2021
DOI: https://doi.org/10.4178/epih.e2021093
  • 12,106 View
  • 202 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the risk of chemotherapy-related and radiotherapy-related cognitive impairment in colorectal cancer patients.
METHODS
Medical use data of colorectal cancer patients were obtained from the Korean National Health Insurance Database from 2004 to 2018. We randomly selected 40% of all colorectal cancer patients (n=148,848). Cognitive impairment was defined as having 1 or more International Classification of Diseases, 10th revision diagnostic codes for dementia or mild cognitive impairment. Patients aged 18 years or younger, patients diagnosed with cognitive impairment before colorectal cancer diagnosis (n=8,225), and patients who did not receive primary resection (n=45,320) were excluded. The effects of individual chemotherapy regimens on cognitive impairment were estimated. We additionally estimated the effect of radiotherapy in rectal cancer patients. Time-dependent competing risk Cox regression was conducted to estimate the overall and age-specific hazard ratios (HR) separately for colon and rectal cancer. Landmark analyses with different lag times were conducted as sensitivity analyses.
RESULTS
Chemotherapy did not increase the risk of cognitive impairment in colorectal cancer patients (colon cancer: HR, 0.92; 95% confidence interval [CI], 0.83 to 1.03; rectal cancer: HR, 0.88; 95% CI, 0.75 to 1.04), while radiotherapy was negatively associated with cognitive impairment in rectal cancer patients (HR, 0.01; 95% CI, 0.84 to 0.99). Varying directions of the associations between regimens and cognitive impairment were detected. The adverse effect of certain chemotherapy regimens on cognition was more prominent in older adults.
CONCLUSIONS
Chemotherapy and radiotherapy did not increase the risk of cognitive impairment. Older patients with low cognitive reserve could be affected by the adverse cognitive effects of chemotherapy.
Summary
Korean summary
- 대장암 환자를 대상으로 한 항암화학요법 및 방사선요법은 인지기능저하의 위험을 높이지 않았다 - 일부 항암화학요법의 경우 고령의 대장암 환자에서 인지기능저하의 위험을 증가시킬 수 있다
Key Message
Results from nationwide cohort of Korea showed that chemotherapy and radiotherapy did not increase the risk of cognitive impairment in colorectal cancer patients.

Citations

Citations to this article as recorded by  
  • Research Progress: Exploring the Long-term Survival Status of Colorectal Cancer Survivors
    Zhaobei Cai, Qianqian Chen, Enqiang Linghu
    Clinical Cancer Investigation Journal.2024; 13(2): 34.     CrossRef
  • Real-World Data-Derived Pharmacovigilance on Drug-Induced Cognitive Impairment Utilizing a Nationwide Spontaneous Adverse Reporting System
    Yongjun Sunwoo, Sae Hyun Eom, Ji Seong Yun, Yujin Kim, Jeongmin Lee, Soo Hyeon Lee, Sooyoung Shin, Yeo Jin Choi
    Medicina.2024; 60(7): 1028.     CrossRef
  • Resting-State Brain Function Alteration in Colorectal Cancer Patients
    Yanan Xu, Zihan Ma, Jieyu Chen, Huiyan Zhang, Guo Shen, Gang Huang, Wenwen Zhang, Lianping Zhao
    Journal of Integrative Neuroscience.2024;[Epub]     CrossRef
  • Predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer: a retrospective analysis
    Jing Xu, Yuelan Yang, Die Hu
    PeerJ.2023; 11: e15405.     CrossRef
  • Soluble HSPG and HS relaying neuroinflammation contribute to behavioral comorbidities associated with cancer located outside the central nervous system
    Yue-peng Liu, Yan-jun Yang
    Medical Hypotheses.2023; 177: 111113.     CrossRef
  • Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study
    Siwen Liu, Yesong Guo, Jie Ni, Na Yin, Chenchen Li, Xuan Pan, Rong Ma, Jianzhong Wu, Shengwei Li, Xiaoyou Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Association between multimorbidity status and incident dementia: a prospective cohort study of 245,483 participants
    He-Ying Hu, Ya-Ru Zhang, Qiaolifan Aerqin, Ya-Nan Ou, Zuo-Teng Wang, Wei Cheng, Jian-Feng Feng, Lan Tan, Jin-Tai Yu
    Translational Psychiatry.2022;[Epub]     CrossRef
Self-rated health as a predictor of mortality according to cognitive impairment: findings from the Korean Longitudinal Study of Aging (2006-2016)
Goun Park, Wankyo Chung
Epidemiol Health. 2021;43:e2021021.   Published online April 7, 2021
DOI: https://doi.org/10.4178/epih.e2021021
  • 12,667 View
  • 304 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Self-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably.
METHODS
This study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging (2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the Korean Mini Mental State Examination score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status.
RESULTS
For cognitively intact individuals, the adjusted hazard ratios (aHR) of mortality were 2.00 (95% confidence interval [CI], 1.18 to 3.41, model 4) for those with ‘bad’ self-rated health and 2.40 (95% CI, 1.35 to 4.25, model 4) for those with ‘very bad’ self-rated heath, respectively, compared with those with ‘very good’ health. The results remain statistically significant even after adjusting for socio-demographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the aHR of mortality was statistically significant for those with ‘very bad’ self-rated health, compared with those with ‘very good’ health, when socio-demographic factors were accounted for (aHR, 3.03; 95% CI, 1.11 to 8.28, model 2).
CONCLUSIONS
Self-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.
Summary
Korean summary
본 연구는 인지 저하 여부에 따라 주관적 건강의 사망예측력이 달라지는지 확인하기 위해 K-MMSE 로 인지 저하 여부를 나누고 콕스 비례위험모델을 사용하여 분석을 시행하였다. 그 결과, 인지 저하군이 평가한 주관적 건강은 사망을 통계적으로 유의하게 예측하였다. 인구의 고령화로 지역 사회 내에서 인지 저하자가 지속적으로 증가하고 있는 상황에서 주관적 건강은 유효한 사망예측 인자이며 신뢰할 만한 건강지표이다.
Key Message
This study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably. We used the Cox proportional hazard models for analysis. Cognitive status was classified based on the K-MMSE score. We found that self-rated health by cognitively impaired individuals remains useful in predicting mortality.

Citations

Citations to this article as recorded by  
  • Factores sociodemográficos y de bienestar mediadores y moderadores de la relación entre la depresión y la demencia
    Maria del Pilar Santacruz-Ortega, Bertha Lucia Avendaño, Maria Fernanda Cobo, Silvia Mejia-Arango
    Neurología Argentina.2023; 15(3): 149.     CrossRef
  • Impact of urban green space on self-rated health: Evidence from Beijing
    Dongsheng Zhan, Qianyun Zhang, Mei-Po Kwan, Jian Liu, Bochuan Zhan, Wenzhong Zhang
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Association of the number of teeth and self-rated mastication with self-rated health in community-dwelling Japanese aged 40 years and older: the Yamagata cohort study
    Shigeo Ishikawa, Tsuneo Konta, Shinji Susa, Kenichi Ishizawa, Naohiko Makino, Yoshiyuki Ueno, Naoki Okuyama, Mitsuyoshi Iino
    Scientific Reports.2022;[Epub]     CrossRef
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