Research Paper Volume 12, Issue 17 pp 17257—17270

Inactive bowel movement and stroke are associated with increased risks of mild cognitive impairment among community-living Singapore elderly

Kai-Yong Huang1, *, , Xian-Yan Tang2, *, , Li Yang1, *, , Zhi-Yong Zhang1,3, , Kaisy Xinhong Ye4, , Qing-Feng Shen5, , Xiu Wang6, , Xiang-Hua Zhu5, , Xiao-Wei Huang7, , Guo-Dong Lu7,8, , Lei Feng4,9, ,

  • 1 Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
  • 2 Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
  • 3 School of Public Health, Guilin Medical University, Guilin, Guangxi Province, P.R. China
  • 4 Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 5 Xuzhou Oriental People's Hospital, Xuzhou, Jiangsu Province, P.R. China
  • 6 Department of Neurology, Beijing Chuiyangliu Hospital, Beijing, P.R. China
  • 7 Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
  • 8 The Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
  • 9 Centre for Healthy Longevity, National University Health System, Singapore
* Equal contribution

Received: January 3, 2020       Accepted: June 29, 2020       Published: September 9, 2020      

https://doi.org/10.18632/aging.103674
How to Cite

Copyright: © 2020 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Mild cognitive impairment (MCI), as a preclinical phase of dementia, provides an invaluable time window for intervention. Besides several proposed modifiable risk factors, the associations of MCI with dietary habits and bowel movement are not well clarified. We thus conducted a cross-sectional study of community-living Singapore elderly and focused on the relationship of clinically diagnosed MCI with dietary habits and bowel movement frequencies. The multiple logistic regression results showed that frequent (≥4 days per week) fruit consumption (P = 0.004), active (≥4 days per week) bowel movement within 10 minutes (P = 0.027), and years of schooling were negatively associated with MCI occurrence. In contrast, medical comorbidities including hypertension, stroke, and cataract/glaucoma were found to be risk factors. Furthermore, a Bayesian network model of causal inference detected five hypothesized causal-association paths leading to MCI, namely bowel movement, stroke, years of schooling via fruit consumption, hypertension via stroke and hypertension via cataract/glaucoma. The combination of the two direct factors (inactive bowel movement and stroke) reached a maximum conditional probability of 60.00% for MCI occurrence. Taken together, this study was the first to link bowel movement with MCI occurrence. In addition, it suggested five modifiable hypothesized causal-association paths to MCI.

Abbreviations

MCI: mild cognitive impairment; PD: Parkinson’s disease; DaHA: Diet and Healthy Aging; AOR: adjusted odds ratios; AD: Alzheimer’s disease; ANOVA: analysis of variance; CI: confidence interval; MMSE: Mini-Mental State Examination; MoCA: Montreal Cognitive Assessment; DSM: Diagnostic and Statistical Manual of Mental Disorders; SD: standard deviation; SPSS: Statistic Package for Social Science; SEM: structural equation model; DAG: directed acyclic graph; TAN: Tree Augmented Naïve.