abstract / Medicine / Doctoral / Doctor of Philosophy

Thesis (M. Med. Sc.)--University of Hong Kong, 2006.

Thesis (Ed. Spec.)--University of Wisconsin--Stout, 2009. / Includes bibliographical references.

Thesis (Ph. D.)--York University, 1999. Graduate Programme in Philosophy. / Typescript. Includes bibliographical references (leaves 81-87). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ43457.

Introduction: Cognitive impairment (CI) in older adults refers to impairment in cognition function beyond normal aging. Previous studies have reported the effect of dietary antioxidants, especially flavonoids on cognitive function in older adults, suggesting that high dietary flavonoids intake may reduce the risk of cognitive impairment. However, most of these studies were reported in Caucasian older populations in Western countries. Moreover, some studies were positive, which others were negative studies. There was no previous study regarding dietary flavonoids and cognitive impairment among Chinese older adults. Objectives: The objectives of this study were to explore the association between dietary intake flavonoids and the risk of cognitive impairment in Chinese older adults, and to identify the independent factors associated with the risk of cognitive impairment in Chinese older adults. Method: This study was a retrospective cross-sectional study, 200 patients who fulfilled the inclusion and exclusion criteria and gave written informed consent were recruited from the Geriatric clinics in Queen Mary Hospital, Hong Kong, from 11th July to 31st October 2011. All recruited subjects were invited to attend face-to-face interviews. Brief cognitive assessments by the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were done for all subjects. Every subject also answered a detailed questionnaire on socio-demographic, type and frequency of diet items (food frequency questionnaire) and co-morbid diseases. Main outcome measure: The primary outcome measure was cognitive function, using an education-adjusted MMSE cut-off s to categorize the subjects into two groups (i.e. normal cognitive group and cognitively impaired group). Results: 200 subjects were recruited, 104 participants (37 males and 67 females) were in the normal cognitive group and 96 subjects (22 males and 74 females) were in the cognitively impaired group. The mean amount of dietary flavonoids intake of the cognitively normal group was higher than that of the cognitively impaired group (i.e. 291.84 grams/day and 240.92 grams/day respectively; p=0.006 Mann-Whitney U test). Other common dietary nutrients were also compared between the two groups. The dietary carbohydrate (p<0.001), total sugar (p<0.001), vitamin C (p=0.001) and folic acid (p<0.001) intakes were significantly related to cognitive impairment (using chi-square statistics). After adjustment for age, gender, education, exercise pattern, the dietary flavonoids intake was not independently associated with cognitive impairment. However, after adjustment for age, education level, exercise pattern and BMI, the higher to highest quartile of dietary carbohydrate intake (184.184-1176.703g/d), high total sugar intake (0.166-35.102g/d), highest quartile of vitamin C intake (139.803-900.952mg/d), the third and fourth quartiles of folic acid intake (208.899-1544.418mcg/d) were significantly associated with reduced risks of cognitive impairment. Older adults who had regular exercise (both less and more than 30 minutes per day) had lower risk of cognitive impairment than those who never did exercise (OR= 0.361, 95% confidence interval=0.167-0.784 for less than 30 minutes/d; OR=0.137, 95% confidence interval=0.048-0.396 for more than 30 minutes/d). We also found high BMI was associated with a reduced risk of cognitive impairment with an OR of 0.897 (95% confidence interval=0.816-0.987). Besides, the increasing age was also associated with cognitive impairment (OR=1.059, 95% confidence interval=1.007-1.115). Conclusion: In summary, the present study demonstrated that the dietary flavonoids intake was not significantly associated with the risk of cognitive impairment in Chinese older adults in Hong Kong. / published_or_final_version / Medicine / Master / Master of Medical Sciences

Advances in the field of neonatal-perinatal medicine and interventions of the 1960's have resulted in decreased mortality rates for infants suffering a variety of perinatal insults. However, it has been estimated that 25% of the survivors of high risk births will go on to have serious lifetime diabilities (Behrman, 1977). Resulting neurological morbidity may be expressed in major cognitive disabilities (i.e., cerebral palsy, mental retardation, learning disorders and the like). Early identification of these children seems Parmalee, Sigman, & Beckwith, 1982). However, the prediction of neurological outcomes remains problematic.Recognizing the psychometric concerns associated with. perinatal risk measures currently used (Crawford, 1965: Bobbin, 1963: Wenar, 1963), the Transition Scale was created as a potentially reliable measure of perinatal risks observed at the time of birth. With a sample of 116 newborn subjects, the present investigation evaluated the stability and underlying constructs of the newly created measure. In addition, comparisons were made with information obtained critical to prevention and early intervention (Cohen, from the medical chart (i.e., Apgar Score).The percentage of agreement between the two independent raters for individual items of the Transition Scale ranged from .95 to 1.00, with the overall interrater agreement calculated as .98. Similarly, an examination of the agreement between each individual rater's responses and the medical chart information revealed percentages ranging from .90 to 1.00, with overall percentages of .96 and .97. Furthermore, the results of a factor analysis indicated that the Transition Scale offers substantial construct validity.Overall, the present investigation recommends the Transition Scale as a reliable research instrument with potential clinical utility. In addition, an examination of the underlying constructs of the measure point to the potential of the Transition Scale as a valid predictor of neurological morbidity. Further research using a high risk sample of infants is recommended. / Department of Educational Psychology

Thesis PlanB (M.S.)--University of Wisconsin--Stout, 2007. / Includes bibliographical references.

Thesis (Psy.D.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 113-129).

Thesis (M.B.A.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 67-73)

Thesis (Ph.D.)--Victoria University (Melbourne, Vic.), 2007.