Subjective cognitive decline in Brazil: Prevalence and association with dementia modifiable risk factors in a population-based study

Modifiable dementia risk factors associated with objective and subjective cognition

INTRODUCTION

Early detection of both objective and subjective cognitive impairment is important. Subjective complaints in healthy individuals can precede objective deficits. However, the differential associations of objective and subjective cognition with modifiable dementia risk factors are unclear.

METHODS

We gathered a large cross-sectional sample (N = 3327, age 18 to 84) via a smartphone app and quantified the associations of 13 risk factors with subjective memory problems and three objective measures of executive function (visual working memory, cognitive flexibility, model-based planning).

RESULTS

Depression, socioeconomic status, hearing handicap, loneliness, education, smoking, tinnitus, little exercise, small social network, stroke, diabetes, and hypertension were all associated with impairments in at least one cognitive measure. Subjective memory had the strongest link to most factors; these associations persisted after controlling for depression. Age mostly did not moderate these associations.

DISCUSSION

Subjective cognition was more sensitive to self-report risk factors than objective cognition. Smartphones could facilitate detecting the earliest cognitive impairments.

HIGHLIGHTS

Smartphone assessments of cognition were sensitive to dementia risk factors. Subjective cognition had stronger links to most factors than did objective cognition. These associations were not fully explained by depression. These associations were largely consistent across the lifespan.

Exploring Spoken Discourse and Its Neural Correlates in Women With Alzheimer's Disease With Low Levels of Education and Socioeconomic Status

PURPOSE

Early impairments in spoken discourse abilities have been identified in Alzheimer's disease (AD). However, the impact of AD on spoken discourse and the associated neuroanatomical correlates have mainly been studied in populations with higher levels of education, although preliminary evidence seems to indicate that socioeconomic status (SES) and level of education have an impact on spoken discourse. The purpose of this study was to analyze microstructural variables in spoken discourse in people with AD with low-to-middle SES and low level of education and to study their association with gray matter (GM) density.

METHOD

Nine women with AD and 10 matched (age, SES, and education) women without brain injury (WWBI) underwent a neuropsychological assessment, which included two spoken discourse tasks, and structural magnetic resonance imaging. Microstructural variables were extracted from the discourse samples using NILC-Metrix software. Brain density, measured by voxel-based morphometry, was compared between groups and then correlated with the differentiating microstructural variables.

RESULTS

The AD group produced a lower diversity of verbal time moods and fewer words and sentences than WWBI but a greater diversity of pronouns, prepositions, and lexical richness. At the neural level, the AD group presented a lower GM density bilaterally in the hippocampus, the inferior temporal gyrus, and the anterior cingulate gyrus. Number of words and sentences produced were associated with GM density in the left parahippocampal gyrus, whereas the diversity of verbal moods was associated with the basal ganglia and the anterior cingulate gyrus bilaterally.

CONCLUSIONS

The present findings are mainly consistent with previous studies conducted in groups with higher levels of SES and education, but they suggest that atrophy in the left inferior temporal gyrus could be critical in AD in populations with lower levels of SES and education. This research provides evidence on the importance of pursuing further studies including people with various SES and education levels.

WHAT IS ALREADY KNOWN ON THIS SUBJECT

Spoken discourse has been shown to be affected in Alzheimer disease, but most studies have been conducted on individuals with middle-to-high SES and high educational levels.

WHAT THIS STUDY ADDS

The study reports on microstructural measures of spoken discourse in groups of women in the early stage of AD and healthy women, with low-to-middle SES and lower levels of education.

CLINICAL IMPLICATIONS OF THIS STUDY

This study highlights the importance of taking into consideration the SES and education level in spoken discourse analysis and in investigating the neural correlates of AD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24905046.

Association of cardiometabolic multimorbidity with motoric cognitive risk syndrome in older adults

INTRODUCTION

Motoric cognitive risk syndrome (MCR) is a predementia syndrome that is characterized by cognitive complaints and slow gait. Cardiometabolic multimorbidity (CMM) is associated with an increased risk of dementia. However, the relationship between CMM and MCR is still unclear.

METHODS

We included 4744 participants (aged 65+ years) without MCR at baseline from the National Health and Aging Trends Study (NHATS), who were followed-up from 2011 to 2018. CMM was defined as the presence of two or more cardiometabolic diseases (including diabetes mellitus, heart disease, and stroke).

RESULTS

CMM was significantly associated with an increased risk of MCR (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.13-1.75) in fully adjusted models. Consistent results were observed from stratified analyses of different subgroups. Increasing numbers of cardiometabolic diseases were dose-dependently associated with increased MCR risk (HR 1.33, 95% CI 1.20-1.48).

DISCUSSION

CMM is associated with an increased risk of MCR in older adults.

HIGHLIGHTS

Motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by slow gait speed and cognitive complaints.Cardiometabolic multimorbidity was associated with an increased MCR risk.An increased number of cardiometabolic diseases were dose-dependently associated with increased MCR risk.