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Lin FR, Pike JR, Albert MS, Arnold M, Burgard S, Chisolm T, Couper D, Deal JA, Goman AM, Glynn NW, Gmelin T, Gravens-Mueller L, Hayden KM, Huang AR, Knopman D, Mitchell CM, Mosley T, Pankow JS, Reed NS, Sanchez V, Schrack JA, Windham BG, Coresh J. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet 2023; 402:786-797. [PMID: 37478886 PMCID: PMC10529382 DOI: 10.1016/s0140-6736(23)01406-x] [Citation(s) in RCA: 72] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Hearing loss is associated with increased cognitive decline and incident dementia in older adults. We aimed to investigate whether a hearing intervention could reduce cognitive decline in cognitively healthy older adults with hearing loss. METHODS The ACHIEVE study is a multicentre, parallel-group, unmasked, randomised controlled trial of adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment that took place at four community study sites across the USA. Participants were recruited from two study populations at each site: (1) older adults participating in a long-standing observational study of cardiovascular health (Atherosclerosis Risk in Communities [ARIC] study), and (2) healthy de novo community volunteers. Participants were randomly assigned (1:1) to a hearing intervention (audiological counselling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed up every 6 months. The primary endpoint was 3-year change in a global cognition standardised factor score from a comprehensive neurocognitive battery. Analysis was by intention to treat. This trial was registered at ClinicalTrials.gov, NCT03243422. FINDINGS From Nov 9, 2017, to Oct 25, 2019, we screened 3004 participants for eligibility and randomly assigned 977 (32·5%; 238 [24%] from ARIC and 739 [76%] de novo). We randomly assigned 490 (50%) to the hearing intervention and 487 (50%) to the health education control. The cohort had a mean age of 76·8 years (SD 4·0), 523 (54%) were female, 454 (46%) were male, and most were White (n=858 [88%]). Participants from ARIC were older, had more risk factors for cognitive decline, and had lower baseline cognitive scores than those in the de novo cohort. In the primary analysis combining the ARIC and de novo cohorts, 3-year cognitive change (in SD units) was not significantly different between the hearing intervention and health education control groups (-0·200 [95% CI -0·256 to -0·144] in the hearing intervention group and -0·202 [-0·258 to -0·145] in the control group; difference 0·002 [-0·077 to 0·081]; p=0·96). However, a prespecified sensitivity analysis showed a significant difference in the effect of the hearing intervention on 3-year cognitive change between the ARIC and de novo cohorts (pinteraction=0·010). Other prespecified sensitivity analyses that varied analytical parameters used in the total cohort did not change the observed results. No significant adverse events attributed to the study were reported with either the hearing intervention or health education control. INTERPRETATION The hearing intervention did not reduce 3-year cognitive decline in the primary analysis of the total cohort. However, a prespecified sensitivity analysis showed that the effect differed between the two study populations that comprised the cohort. These findings suggest that a hearing intervention might reduce cognitive change over 3 years in populations of older adults at increased risk for cognitive decline but not in populations at decreased risk for cognitive decline. FUNDING US National Institutes of Health.
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Affiliation(s)
- Frank R Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
| | - James R Pike
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michelle Arnold
- Department of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, USA
| | - Sheila Burgard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Theresa Chisolm
- Department of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, USA
| | - David Couper
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Adele M Goman
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Nancy W Glynn
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Theresa Gmelin
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Lisa Gravens-Mueller
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Alison R Huang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Christine M Mitchell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nicholas S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Victoria Sanchez
- Department of Otolaryngology-Head & Neck Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - B Gwen Windham
- The MIND Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kucharska-Newton AM, Pike JR, Chen J, Coresh J, Sharret AR, Mosley T, Palta P. Association of Childhood and Midlife Neighborhood Socioeconomic Position With Cognitive Decline. JAMA Netw Open 2023; 6:e2327421. [PMID: 37540511 PMCID: PMC10403777 DOI: 10.1001/jamanetworkopen.2023.27421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/24/2023] [Indexed: 08/05/2023] Open
Abstract
Importance Early-life socioeconomic adversity may be associated with poor cognitive health over the life course. Objective To examine the association of childhood and midlife neighborhood socioeconomic position (nSEP) with cognitive decline. Design, Setting, and Participants This cohort study included 5711 men and women enrolled in the community-based Atherosclerosis Risk in Communities (ARIC) Study with repeated cognitive data measured over a median 27.0 years (IQR, 26.0-27.9 years) (1990-2019). Statistical analysis was performed from December 2022 through March 2023. Exposure Residence addresses for ARIC Study cohort participants were obtained at midlife (1990-1993) and as recalled addresses at 10 years of age (childhood). A composite nSEP z score was created as a sum of z scores for US Census-based measures of median household income; median value of owner-occupied housing units; percentage of households receiving interest, dividend, or net rental income; percentage of adults with a high school degree; percentage of adults with a college degree; and percentage of adults in professional, managerial, or executive occupations. Childhood nSEP and midlife nSEP were modeled as continuous measures and discretized into tertiles. Main Outcomes and Measures A factor score for global cognition was derived from a battery of cognitive tests administered at 5 in-person visits from baseline to 2019. The rate of cognitive decline from 50 to 90 years of age was calculated by fitting mixed-effects linear regression models with age as the time scale and adjusted for race, sex, birth decade, educational level, and presence of the apolipoprotein E ε4 allele. Results Among 5711 ARIC Study participants (mean [SD] baseline age, 55.1 [4.7] years; 3372 women [59.0%]; and 1313 Black participants [23.0%]), the median rate of cognitive decline was -0.33 SDs (IQR, -0.49 to -0.20 SDs) per decade. In adjusted analyses, each 1-SD-higher childhood nSEP score was associated with a slower (β, -9.2%; 95% CI, -12.1% to -6.4%) rate of cognitive decline relative to the sample median. A comparable association was observed when comparing the highest tertile with the lowest tertile of childhood nSEP (β, -17.7%; 95% CI, -24.1% to -11.3%). Midlife nSEP was not associated with the rate of cognitive decline. Conclusions and Relevance In this cohort study of contextual factors associated with cognitive decline, childhood nSEP was inversely associated with trajectories of cognitive function throughout adulthood.
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Affiliation(s)
- Anna M. Kucharska-Newton
- Department of Epidemiology, University of North Carolina at Chapel Hill
- Department of Epidemiology, University of Kentucky, Lexington
| | - James Russell Pike
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Jinyu Chen
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - A. Richey Sharret
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Thomas Mosley
- Department of Neurology, University of Mississippi Medical Center, Jackson
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Priya Palta
- Department of Neurology, University of North Carolina at Chapel Hill
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Dexter M, Ossmy O. The effects of typical ageing on cognitive control: recent advances and future directions. Front Aging Neurosci 2023; 15:1231410. [PMID: 37577352 PMCID: PMC10416634 DOI: 10.3389/fnagi.2023.1231410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Cognitive control is one of the most fundamental aspects of human life. Its ageing is an important contemporary research area due to the needs of the growing ageing population, such as prolonged independence and quality of life. Traditional ageing research argued for a global decline in cognitive control with age, typically characterised by slowing processing speed and driven by changes in the frontal cortex. However, recent advances questioned this perspective by demonstrating high heterogeneity in the ageing data, domain-specific declines, activity changes in resting state networks, and increased functional connectivity. Moreover, improvements in neuroimaging techniques have enabled researchers to develop compensatory models of neural reorganisation that helps negate the effects of neural losses and promote cognitive control. In this article on typical ageing, we review recent behavioural and neural findings related to the decline in cognitive control among older adults. We begin by reviewing traditional perspectives and continue with how recent work challenged those perspectives. In the discussion section, we propose key areas of focus for future research in the field.
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Affiliation(s)
| | - Ori Ossmy
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
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Pentikäinen E, Kimppa L, Pitkäniemi A, Lahti O, Särkämö T. Longitudinal effects of choir singing on aging cognition and wellbeing: a two-year follow-up study. Front Hum Neurosci 2023; 17:1174574. [PMID: 37545597 PMCID: PMC10398963 DOI: 10.3389/fnhum.2023.1174574] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction While increasing evidence points toward the benefits of musical activities in promoting cognitive and emotional well-being in older adults, more longitudinal studies are needed to establish their long-term effects and uncover the mechanisms through which musical activities affect well-being. Most previous research has focused on instrumental musical activities, but little is currently known about the long-term effects of singing, even though neuroimaging evidence suggests that it is a versatile activity for the brain, involving a multitude of neural processes that are potentially beneficial for well-being. Methods We conducted a 2-year follow-up study to assess aging-related changes in cognitive functioning and emotional and social well-being with self-report questionnaires and standardized tests in 107 older adult choir singers and 62 demographically matched non-singers. Data were collected at baseline (T1), and at 1-year (T2) and 2-year (T3) follow-ups using questionnaires on subjective cognitive functioning, depression, social engagement, and quality of life (QOL) in all participants and neuropsychological tests in a subgroup of participants (45 choir singers and 41 non-singers). Results The results of linear mixed model analysis showed that in verbal flexibility (phonemic fluency task), the choir singers had higher scores already at T1 and showed no change over time, whereas the non-singers showed enhancement from T1 to T3. Furthermore, active retrieval of word knowledge (WAIS-IV Vocabulary task) showed significantly different changes from T1 to T2 between the groups (enhancement in choir singers and decline in non-singers), however lacking significant change within groups. Similar opposite trajectories of QOL related to social inclusion and safety of the environment (WHOQOL-Bref Environmental subscale) were significant from T1 to T3, but these changes were not significant within groups or at each timepoint. Within the choir singers, shorter experience in choir singing was associated with greater improvement in the vocabulary task over the follow-up period, suggesting that initiation of choir singing at older age induces some verbal benefits. There were no group differences in any other questionnaire or neuropsychological measure over time. Discussion In conclusion, our results suggest that choir singing at older age is associated with a sustained enhancement of phonemic fluency, while the effects on other verbal skills and quality of life are less clear.
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Affiliation(s)
- Emmi Pentikäinen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Music, Mind, Body, and Brain, University of Helsinki, Helsinki, Finland
| | - Lilli Kimppa
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anni Pitkäniemi
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Music, Mind, Body, and Brain, University of Helsinki, Helsinki, Finland
| | - Outi Lahti
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Seinäjoki Central Hospital, Geriatric Outpatient Clinic, Rehabilitation Analysis Clinic, Seinäjoki, Finland
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Music, Mind, Body, and Brain, University of Helsinki, Helsinki, Finland
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Irqsusi M, Schenk Zu Schweinsberg T, Johnson FA, Dielmann K, Ramzan R, Vogt S, Mirow N, Rastan AJ. Prediction of stroke reconvalescence after coronary bypass surgery indicated by CT scan parameters. J Card Surg 2022; 37:3133-3147. [PMID: 35904236 DOI: 10.1111/jocs.16797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/22/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Stroke in the postoperative time course after heart surgery remains a serious risk. Cranial computer tomography (CCT) is the first line option to detect severe intracranial damage. However, only few data are available to predict neurological outcome. Using visual rating scales (VRSs), this study addresses reliability and effectivity to indicate neurological status and likelyhood of improvement. METHODS In a single-center retrospective evaluation, 3719 patients underwent coronary bypass surgery. Because of a delayed recovery phase and neurologic deficits after cardiac surgery 109 patients had a cranial CT scan in the early postoperative period. The incidence of clinically relevant findings within the imaging was rated by an experienced neuroradiologist using two VRS, that is, the age-related white matter changes (ARWMCs) and the Mendes-Ribeiro visual rating scale (MRVRS). Both are computer-assisted measurement schemes to detect stroke-related intracranial damage. Follow-up was investigated with regard to clinical outcome and patient-related risk profiles. RESULTS Of 109 patients with postoperative cranial CT scans due to prolonged recovery phases or proven neurological damage 44.5% had one cerebral defect in CCT imaging scans only. The others showed multiple defects. During hospital stay, 92.3% experienced neurological improvement exposing reduced ARWMC, while 7.1% had no improvement and correlating high scores. Of both scales, the ARWMC-VRS demonstrated superior accuracy and discrimination. The preoperative ejection fraction (EF), arteriosclerotic degeneration of carotid arteries, and reduced glomerular filtration rate were found to have a high correlation (r = 0.0005) with the latter group. In-hospital mortality of this cohort was 8.18%. CONCLUSION Both the ARWMC and MRVRS were found to be appropriate. They reliably discriminate the groups of stroke patients after coronary artery bypass grafting (CABG) in the analysis of CCT images. When applied at the onset of neurological symptoms both scales are able to predict neurological reconvalescence upon hospital dismission. The ARWMC scale appeared superior as it demonstrated better accuracy and discrimination. The use of both VRS in patients with suspected stroke after CABG surgery can give insightful information toward a progression of neurological dysfunction or postoperative improvement.
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Affiliation(s)
- Marc Irqsusi
- Department of Cardiothoracic Surgery, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Titus Schenk Zu Schweinsberg
- Department of Diagnostic and Interventional Radiology, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Felix Allendorff Johnson
- Department of Cardiothoracic Surgery, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Kai Dielmann
- Department of Anesthesiology and Intensive Care, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Rabia Ramzan
- Department of Cardiothoracic Surgery, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Sebastian Vogt
- Department of Cardiothoracic Surgery, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Nikolas Mirow
- Department of Cardiothoracic Surgery, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Ardawan J Rastan
- Department of Cardiothoracic Surgery, University Hospital Marburg, Philipps University, Marburg, Germany
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Palta P, Albert MS, Gottesman RF. Heart health meets cognitive health: evidence on the role of blood pressure. Lancet Neurol 2021; 20:854-867. [PMID: 34536406 DOI: 10.1016/s1474-4422(21)00248-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/28/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
The enormous societal and financial burden of Alzheimer's disease and related dementias requires the identification of risk factors and pathways to reduce dementia risk. Blood pressure (BP) management and control is one promising area, in which data have been inconclusive. Accumulating evidence over the past 5 years shows the effectiveness of BP management interventions among older individuals at risk, most notably from the SPRINT-MIND trial. These findings have been coupled with longitudinal observational data. However, to date, the results do not concur on the optimal timing and target of BP lowering, and further study in diverse populations is needed. Given the long preclinical phase of dementia and data supporting the importance of BP control earlier in the lifecourse, long-term interventional and observational studies in ethnically and racially diverse populations, with novel imaging and blood-based biomarkers of neurodegeneration and vascular cognitive impairment to understand the pathophysiology, are needed to advance the field.
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Affiliation(s)
- Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Program, National Institutes of Health, Bethesda, MD, USA
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Rooney MR, Norby FL, Maheshwari A, Lutsey PL, Dudley SC, Soliman EZ, Loehr LR, Mosley TH, Coresh J, Alonso A, Chen LY. Frequent Premature Atrial Contractions Are Associated With Poorer Cognitive Function in the Atherosclerosis Risk in Communities (ARIC) Study. Mayo Clin Proc 2021; 96:1147-1156. [PMID: 33840519 PMCID: PMC8106627 DOI: 10.1016/j.mayocp.2021.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 12/07/2020] [Accepted: 01/13/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the association of premature atrial contraction (PAC) frequency with cognitive test scores and prevalence of dementia or mild cognitive impairment (MCI). MATERIALS AND METHODS We conducted a cross-sectional analysis using Atherosclerosis Risk in Communities study visit 6 (January 1, 2016, through December 31, 2017) data. We included 2163 participants without atrial fibrillation (AF) (age mean ± SD, 79±4 years; 1273 (58.9%) female; and 604 (27.97.0% Black) who underwent cognitive testing and wore a leadless, ambulatory electrocardiogram monitor for 14 days. We categorized PAC frequency based on the percent of beats: less than 1%, minimal; 1% to <5%, occasional; greater than or equal to 5%, frequent. We derived cognitive domain-specific factor scores (memory, executive function, language, and global z-score). Dementia and MCI were adjudicated. RESULTS During a mean analyzable time of 12.6±2.6 days, 339 (15.7%) had occasional PACs and 107 (4.9%) had frequent PACs. Individuals with frequent PACs (vs minimal) had lower executive function factor scores by 0.30 (95% CI, -0.46 to -0.14) and lower global factor scores by 0.20 (95% CI, -0.33 to -0.07) after multivariable adjustment. Individuals with frequent PACs (vs minimal) had higher odds of prevalent dementia or MCI after multivariable adjustment (odds ratio, 1.74; 95% CI, 1.09 to 2.79). These associations were unchanged with additional adjustment for stroke. CONCLUSION In community-dwelling older adults without AF, frequent PACs were cross-sectionally associated with lower executive and global cognitive function and greater prevalence of dementia or MCI, independently of stroke. Our findings lend support to the notion that atrial cardiomyopathy may be a driver of AF-related outcomes. Further research to confirm these associations prospectively and to elucidate underlying mechanisms is warranted.
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Affiliation(s)
- Mary R Rooney
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
| | - Faye L Norby
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Ankit Maheshwari
- Heart and Vascular Institute, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Samuel C Dudley
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center, Wake Forest University, Winston-Salem, NC
| | - Laura R Loehr
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC
| | - Thomas H Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson, MS
| | - Josef Coresh
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
| | - Alvaro Alonso
- Department of Epidemiology, Emory University, Atlanta, GA
| | - Lin Y Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN
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Hill JE, Harrison J, Harris C, Twamley J. Virtual reality, the COVID-19 pandemic and rehabilitation for community-dwelling older adults. Br J Community Nurs 2021; 26:196-198. [PMID: 33797968 DOI: 10.12968/bjcn.2021.26.4.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Joanna Harrison
- Research Fellow in Evidence Summary, University of Central Lancashire
| | | | - Jacqueline Twamley
- Senior Academic Research Nurse, Lancashire Teaching Hospitals NHS Foundation Trust
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Orellano-Colón EM, Abdalla-Mukhaimer N, Rodríguez-Ramos BA, Rodríguez-Robles R, Rivero-Méndez M, Lizama-Troncoso M, Jutai JW, Jiménez-Velázquez IZ, Varas-Díaz N, Hallman-Navarro D. Self-Management Strategies Used by Older Hispanic Women to Overcome Functional Disabilities. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2020.1788691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Elsa M. Orellano-Colón
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Nelly Abdalla-Mukhaimer
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Bryan A. Rodríguez-Ramos
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Rebecca Rodríguez-Robles
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Marta Rivero-Méndez
- School of Nursing, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Mauricio Lizama-Troncoso
- Puerto Rico Assistive Technology Program, Central Administration, University of Puerto Rico, San Juan, Puerto Rico
| | - Jeffrey W. Jutai
- Interdisciplinary School of Science, University of Ottawa, Ottawa, Canada
| | | | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, Florida, USA
| | - Deanna Hallman-Navarro
- School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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Evans IEM, Martyr A, Collins R, Brayne C, Clare L. Social Isolation and Cognitive Function in Later Life: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2020; 70:S119-S144. [PMID: 30372678 PMCID: PMC6700717 DOI: 10.3233/jad-180501] [Citation(s) in RCA: 234] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND There is some evidence to suggest that social isolation may be associated with poor cognitive function in later life. However, findings are inconsistent and there is wide variation in the measures used to assess social isolation. OBJECTIVE We conducted a systematic review and meta-analysis to investigate the association between social isolation and cognitive function in later life. METHODS A search for longitudinal studies assessing the relationship between aspects of social isolation (including social activity and social networks) and cognitive function (including global measures of cognition, memory, and executive function) was conducted in PsycInfo, CINAHL, PubMed, and AgeLine. A random effects meta-analysis was conducted to assess the overall association between measures of social isolation and cognitive function. Sub-analyses investigated the association between different aspects of social isolation and each of the measures of cognitive function. RESULTS Sixty-five articles were identified by the systematic review and 51 articles were included in the meta-analysis. Low levels of social isolation characterized by high engagement in social activity and large social networks were associated with better late-life cognitive function (r = 0.054, 95% CI: 0.043, 0.065). Sub-analyses suggested that the association between social isolation and measures of global cognitive function, memory, and executive function were similar and there was no difference according to gender or number of years follow-up. CONCLUSIONS Aspects of social isolation are associated with cognitive function in later life. There is wide variation in approaches to measuring social activity and social networks across studies which may contribute to inconsistencies in reported findings.
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Affiliation(s)
- Isobel E M Evans
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Anthony Martyr
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Rachel Collins
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK.,University of Exeter Medical School, Exeter, UK.,Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK.,Centre for Research Excellence in Promoting Cognitive Health, University of New South Wales, Sydney, Australia
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11
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Peng Y, Zhu Q, Wang B, Ren J. A cross-sectional study on interference control: age affects reactive control but not proactive control. PeerJ 2020; 8:e8365. [PMID: 32025368 PMCID: PMC6991132 DOI: 10.7717/peerj.8365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 12/06/2019] [Indexed: 12/25/2022] Open
Abstract
Background Working memory updating (WMU), a controlled process to continuously adapt to the changing task demand and environment, is crucial for cognitive executive function. Although previous studies have shown that the elderly were more susceptible to cognitive interference than the youngsters, the picture of age-related deterioration of WMU is incomplete due to lack of study on people at their middle ages. Thus, the present study investigated the impact of age on the WMU among adults by a cross-sectional design to verify whether inefficiency interference control accounts for the aging of WMU. Methods In total, 112 healthy adults were recruited for this study; 28 old adults (21 female) ranging from 60 to 78 years of age; 28 middle-age adults (25 female) ranging from 45 to 59 years of age; 28 adults (11 female) ranging from 26 to 44 years of age; and 28 young adults (26 female) ranging from 18 to 25 years of age. Each participant completed a 1-back task. The inverse efficiency score was calculated in various sequences of three trials in a row to quantify the performance of WMU for adults of various ages. Results Inverse efficiency score of both young groups (young adult and adult) were significantly shorter than the old group in both Repeat-Alternate (RA, including □□○ and ○○□) and Alternate-Alternate (AA, including ○□○ and □○□) sequential patterns and they were additionally better than the middle-age group in AA sequential pattern. Conclusion With the increase of difficulty in the task, the difference in reactive interference control between young and middle age was gradually revealed, while the difference between young and old remained to apparent. The degradation of WMU aging may begin from middle-age and presents selective impairment in that only reactive interference control, but not proactive interference control, shows pronounced age-related decline. The preliminary results can inform future studies to further explore the whole lifespan trajectories of cognitive functions.
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Affiliation(s)
- Yanfang Peng
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, Shanghai, China.,School of Sport Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qin Zhu
- Division of Kinesiology and Health, University of Wyoming, Laramie, WY, USA
| | - Biye Wang
- School of Sport Science, Yangzhou University, Yangzhou, Jiangsu, China
| | - Jie Ren
- China Table Tennis College, Shanghai University of Sport, Shanghai, Shanghai, China
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12
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Validation of the Chinese version of the memory binding test for distinguishing amnestic mild cognitive impairment from cognitively normal elderly individuals. Int Psychogeriatr 2019; 31:1721-1730. [PMID: 31658921 DOI: 10.1017/s1041610219001649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Episodic memory starts to decline very early in the development of Alzheimer's disease (AD). Subtle impairments in memory binding may be detected in mild cognitive impairment (MCI). This study aims to examine the psychometric properties of the Chinese version of the memory binding test (MBT). METHODS One hundred and sixty-four subjects (26 individuals with AD, 67 individuals with amnestic MCI (aMCI), 30 individuals with subjective cognitive impairment (SCI), and 41 cognitively normal elderly individuals (NC)) participated in the study. Twenty-two subjects repeated the assessment of the MBT within 6 weeks (± 2 weeks). Pearson correlation was used to calculate the convergent validity. The test--retest reliability was determined by the calculation of the intraclass correlation coefficient (ICC). Discriminative validity was calculated to evaluate the receiver-operating characteristic curves. The optimal index was chosen by comparing the area under the curve for specificity and sensitivity ≥ 0.80. The optimal cutoff score of the index was chosen to maximize the sum of sensitivity and specificity. RESULTS The absolute value of the convergent validity of the direct indexes of MBT ranged from 0.443 to 0.684. The ICC for each of direct indexes was 0.887-0.958. Total delayed paired recall (TDPR) was the optimal index for discriminating aMCI from NC. The cutoff score for TDPR was ≤25 to distinguish aMCI from NC (sensitivity = 0.896, specificity = 0.707). CONCLUSION The Chinese version of MBT is a valid and reliable instrument to detect MCI.
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13
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Fällman K, Lundgren L, Wressle E, Marcusson J, Classon E. Normative data for the oldest old: Trail Making Test A, Symbol Digit Modalities Test, Victoria Stroop Test and Parallel Serial Mental Operations. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:567-580. [PMID: 31382824 DOI: 10.1080/13825585.2019.1648747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Normative data for evaluating cognitive function in the oldest old, aged 85 years and above, are currently sparse. The normative values used in clinical practice are often derived from younger old persons, from small sample sizes or from broad age spans (e.g. >75 years) resulting in a risk of misjudgment in assessments of cognitive decline. This longitudinal study presents normative values for the Trail Making Test A (TMT-A), the Symbol Digit Modalities Test (SDMT), the Victoria Stroop Test (VST) and the Parallel Serial Mental Operations (PaSMO) from cognitively intact Swedes aged 85 years and above. 207 participants, born in 1922, were tested at 85, 90 (n = 68) and 93 (n = 35) years of age with a cognitive screening test battery. The participants were originally recruited for participation in the Elderly in Linköping Screening Assessment. Normative values are presented as mean values and standard deviations, with and without adjustment for education. There were no clinically important differences between genders, but education had a significant effect on test results for the 85-year-olds. Age effects emerged in analyses of those participants who completed the entire study and were evident for TMT-A, SDMT, VST1 and PaSMO. When comparisons can be made, our results are in accordance with previous data for TMT-A, SDMT and VST, and we present new normative values for PaSMO.
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Affiliation(s)
- Katarina Fällman
- Department of Acute Internal Medicine and Geriatrics, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Lina Lundgren
- Department of Geriatric Medicine, and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
| | - Ewa Wressle
- Department of Acute Internal Medicine and Geriatrics, and Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Jan Marcusson
- Department of Acute Internal Medicine and Geriatrics, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Elisabet Classon
- Department of Acute Internal Medicine and Geriatrics, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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14
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Sejunaite K, Lanza C, Riepe MW. Everyday Memory in Healthy Aging: Porous but Not Distorted. Front Aging Neurosci 2019; 11:153. [PMID: 31293413 PMCID: PMC6604723 DOI: 10.3389/fnagi.2019.00153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/11/2019] [Indexed: 01/10/2023] Open
Abstract
Most studies targeting age-association of memory functions report a decline in recognition hits and an increase in false alarms. The goal of the present study was to assess these findings in tasks with day-to-day relevance. We investigated healthy young (YA; age 26.90 ± 3.55 years) and old (OA; age 69.80 ± 5.85 years) adults. Participants were asked to watch six news and six commercials and complete a recognition task relating to the information presented in the videos. OA had a lower hit rate in both news and commercials compared to YA. However, the number of false alarms (FA) was the same in both age groups. Applying signal detection theory, we found age differences in discriminability for both news and commercials paradigm. The groups showed no differences in bias and both chose a liberal answering tendency. We interpret our finding as a result of complex recognition items in an ecologically valid task. Multi-feature items offer an advantage in correct rejection—it is enough to know that at least one feature of an item is false. This benefit does not extend to hits, where all features of an item need to be recognized. This indicates that recognition memory of naturalistic stimuli in OA is porous, but not distorted.
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Affiliation(s)
- Karolina Sejunaite
- Department of Psychiatry and Psychotherapy II, Division of Mental Health & Old Age Psychiatry, University of Ulm, Ulm, Germany
| | - Claudia Lanza
- Department of Psychiatry and Psychotherapy II, Division of Mental Health & Old Age Psychiatry, University of Ulm, Ulm, Germany
| | - Matthias W Riepe
- Department of Psychiatry and Psychotherapy II, Division of Mental Health & Old Age Psychiatry, University of Ulm, Ulm, Germany
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15
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Terhoeven V, Nikendei C, Cranz A, Weisbrod M, Geis N, Raake PW, Katus HA, Herzog W, Friederich HC, Schultz JH, Pleger ST. Effects of MitraClip on cognitive and psychological function in heart failure patients: the sicker the better. Eur J Med Res 2019; 24:14. [PMID: 30791961 PMCID: PMC6385405 DOI: 10.1186/s40001-019-0371-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/04/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose Cognitive impairment and reduced quality of life is a common condition in patients with heart failure (HF). Percutaneous mitral valve repair using (PMVR) MitraClip (MC) has emerged as a promising interventional tool, reducing all-cause mortality and hospitalization as well as increasing cognitive functioning and quality of life. However, the benefit of HF patients with severely depressed cognitive functioning remains unknown. Methods We assessed cognitive functioning (figural memory—FGT, executive function—TOL, TMT B), psychosocial functioning (depression—PHQ-9, quality of life—SF36), and clinical parameters (echocardiography, 6-min walk test distance, and cardiac biomarkers) 1 day before (t0) and 6 weeks after (t1) MC intervention in HF patients (n = 40). First, paired sample t tests were conducted to uncover improvements in cognitive functioning post-MC intervention. Second, the COGBAT Norm-sample, a representative age-matched healthy sample, was used to compare participants’ individual scores. Third, bivariate linear regressions were calculated for all key predictors of the detected improvements in cognitive functioning post-MC intervention (t1–t0). Results Following the MC intervention, we found significant improvements in figural memory, executive functioning, and psychosocial functioning. Most of the patients with depressed executive functioning before the MC intervention showed post-intervention test scores within the normal range (> 50th percentile; t0 22.5% vs. t1 60%) as compared to the normative COGBAT sample. Regression analyses revealed that lower baseline scores in planning ability before the MC intervention (t0) were associated with greater planning ability (TOL; B = − 0.78, 95% CI − 1.04 to − 0.53), figural memory (FGT; B = − 0.26, 95% CI − 0.44 to − 0.07), and cognitive flexibility (TMT B; B = − 0.36, 95% CI − 0.50 to − 0.23) improvement post-MC intervention (t1–t0). Psychosocial functioning and age were not associated with these improvements. Conclusions Patients with depressed executive functioning showed the greatest benefit from the MC intervention regarding cognitive functioning. Age and psychological functioning seem less important for cognitive performance improvements post-MC intervention. Hence, severely depressed cognitive functioning in patients is not a contraindication for PMVR using MitraClip.
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Affiliation(s)
- Valentin Terhoeven
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstrasse 4, 69115, Heidelberg, Germany
| | - Christoph Nikendei
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstrasse 4, 69115, Heidelberg, Germany.
| | - Anna Cranz
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstrasse 4, 69115, Heidelberg, Germany
| | - Matthias Weisbrod
- Center of Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Voßstrasse 2, 69115, Heidelberg, Germany.,Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Guttmannstrasse 1, 76307, Karlsbad-Langensteinbach, Germany
| | - Nicolas Geis
- Department of Cardiology, Angiology, Pneumology, Medical Hospital, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Philip W Raake
- Department of Cardiology, Angiology, Pneumology, Medical Hospital, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Hugo A Katus
- Department of Cardiology, Angiology, Pneumology, Medical Hospital, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Wolfgang Herzog
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstrasse 4, 69115, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstrasse 4, 69115, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstrasse 4, 69115, Heidelberg, Germany
| | - Sven T Pleger
- Department of Cardiology, Angiology, Pneumology, Medical Hospital, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
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16
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Palta P, Sharrett AR, Deal JA, Evenson KR, Gabriel KP, Folsom AR, Gross AL, Windham BG, Knopman D, Mosley TH, Heiss G. Leisure-time physical activity sustained since midlife and preservation of cognitive function: The Atherosclerosis Risk in Communities Study. Alzheimers Dement 2018; 15:273-281. [PMID: 30321503 DOI: 10.1016/j.jalz.2018.08.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/25/2018] [Accepted: 08/21/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION We tested the hypotheses that higher levels of and persistence of midlife leisure-time physical activity (LTPA) are associated long-term with lower cognitive decline and less incident dementia. METHODS A total of 10,705 participants (mean age: 60 years) had LTPA (no, low, middle, or high) measured in 1987-1989 and 1993-1995. LTPA was assessed in relation to incident dementia and 14-year change in general cognitive performance. RESULTS Over a median follow-up of 17.4 years, 1063 dementia cases were observed. Compared with no LTPA, high LTPA in midlife was associated with lower incidence of dementia (hazard ratio [95% confidence interval], 0.71 [0.61, 0.86]) and lower declines in general cognitive performance (-0.07 standard deviation difference [-0.12 to -0.04]). These associations were stronger when measured against persistence of midlife LTPA over 6 years. DISCUSSION LTPA is a readily modifiable factor associated inversely with long-term dementia incidence and cognitive decline.
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Affiliation(s)
- Priya Palta
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kelley Pettee Gabriel
- Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, Austin, TX, USA; Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, TX, USA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - B Gwen Windham
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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17
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Norby FL, Chen LY, Soliman EZ, Gottesman RF, Mosley TH, Alonso A. Association of left ventricular hypertrophy with cognitive decline and dementia risk over 20 years: The Atherosclerosis Risk In Communities-Neurocognitive Study (ARIC-NCS). Am Heart J 2018; 204:58-67. [PMID: 30077834 PMCID: PMC6214738 DOI: 10.1016/j.ahj.2018.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 07/08/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Left ventricular hypertrophy (LVH) is an indicator of organ damage largely due to hypertension. We assessed whether LVH was associated with dementia and cognitive function in the Atherosclerosis Risk in Communities study. METHODS Our analysis included 12,665 individuals (23% black race, 56% female, mean age 57) who attended visit 2 in 1990-1992. Cornell voltage (SV3 + RaVL) was derived from 12-lead electrocardiograms and dichotomized as LVH using sex-specific criteria (>28 mm men; >22 mm women). Incident dementia was defined by expert review using a predetermined algorithm, and cognitive function was measured longitudinally using 3 tests. A Cox model was used to evaluate the association between time-dependent LVH and dementia adjusted for time-varying covariates from 1990 to 2013. Linear regression models fit with generalized estimating equations were used to evaluate LVH with cognitive function. RESULTS During a mean follow-up of 18 years, we identified 544 participants with LVH and 1,195 dementia cases. LVH was associated with a higher risk of dementia: multivariable hazard ratio = 1.90; 95% CI: 1.47-2.44. Those with LVH had lower cognitive scores at baseline; however, there was no difference in the rate of cognitive decline over 20 years in those with LVH versus those without LVH. CONCLUSIONS In this population-based study, LVH measured during midlife was associated with an increased risk of incident dementia; however, LVH was not associated with additional cognitive decline. These results underscore the need for hypertension control to prevent subclinical brain injury.
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Affiliation(s)
- Faye L Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Lin Y Chen
- Cardiac Arrhythmia Center, Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Elsayed Z Soliman
- Department of Epidemiology, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Rebecca F Gottesman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi, Jackson, MS
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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18
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O'Connor MK, Kraft ML, Daley R, Sugarman MA, Clark EL, Scoglio AAJ, Shirk SD. The Aging Well through Interaction and Scientific Education (AgeWISE) Program. Clin Gerontol 2018; 41:412-423. [PMID: 29220623 DOI: 10.1080/07317115.2017.1387212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We conducted a randomized controlled trial of the Aging Well through Interaction and Scientific Education (AgeWISE) program, a 12-week manualized cognitive rehabilitation program designed to provide psychoeducation to older adults about the aging brain, lifestyle factors associated with successful brain aging, and strategies to compensate for age related cognitive decline. METHODS Forty-nine cognitively intact participants ≥ 60 years old were randomly assigned to the AgeWISE program (n = 25) or a no-treatment control group (n = 24). Questionnaire data were collected prior to group assignment and post intervention. Two-factor repeated-measures analyses of covariance (ANCOVAs) were used to compare group outcomes. RESULTS Upon completion, participants in the AgeWISE program reported increases in memory contentment and their sense of control in improving memory; no significant changes were observed in the control group. Surprisingly, participation in the group was not associated with significant changes in knowledge of memory aging, perception of memory ability, or greater use of strategies. CONCLUSIONS The AgeWISE program was successfully implemented and increased participants' memory contentment and their sense of control in improving memory in advancing age. CLINICAL IMPLICATIONS This study supports the use of AgeWISE to improve perspectives on healthy cognitive aging.
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Affiliation(s)
- Maureen K O'Connor
- a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , Massachusetts , USA.,b Boston University School of Medicine , Boston , Massachusetts , USA
| | - Malissa L Kraft
- a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , Massachusetts , USA
| | - Ryan Daley
- a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , Massachusetts , USA
| | - Michael A Sugarman
- a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , Massachusetts , USA
| | - Erika L Clark
- c Massachusetts General Hospital and Home Base , A Red Sox Foundation and Massachusetts General Hospital Program , Boston , Massachusetts , USA
| | - Arielle A J Scoglio
- a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , Massachusetts , USA
| | - Steven D Shirk
- a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , Massachusetts , USA
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19
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Change in Cognitive Performance From Midlife Into Old Age: Findings from the Midlife in the United States (MIDUS) Study. J Int Neuropsychol Soc 2018; 24:805-820. [PMID: 30019663 PMCID: PMC6170692 DOI: 10.1017/s1355617718000425] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES A substantial body of research has documented age-related declines in cognitive abilities among adults over 60, yet there is much less known about changes in cognitive abilities during midlife. The goal was to examine longitudinal changes in multiple cognitive domains from early midlife through old age in a large national sample, the Midlife in the United States (MIDUS) study. METHODS The Brief Test of Adult Cognition by Telephone (BTACT) was administered on two occasions (MIDUS 2, MIDUS 3), an average of 9 years apart. At MIDUS 3, those with the cognitive assessment (N=2518) ranged in age from 42 to 92 years (M=64.30; SD=11.20) and had a mean education of 14.68 years (SD=2.63). The BTACT includes assessment of key aging-sensitive cognitive domains: immediate and delayed free recall, number series, category fluency, backward digit span, processing speed, and reaction time for attention switching and inhibitory control, which comprise two factors: episodic memory and executive functioning. RESULTS As predicted, all cognitive subtests and factors showed very small but significant declines over 9 years, with differences in the timing and extent of change. Processing speed showed the earliest and steepest decrements. Those with higher educational attainment scored better on all tests except reaction time. Men had better executive functioning and women performed better on episodic memory. CONCLUSIONS Examining cognitive changes in midlife provides opportunities for early detection of cognitive impairments and possibilities for preventative interventions. (JINS, 2018, 24, 805-820).
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20
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Ryan MC, Kochunov P, Sherman PM, Rowland LM, Wijtenburg SA, Acheson A, Hong LE, Sladky J, McGuire S. Miniature pig magnetic resonance spectroscopy model of normal adolescent brain development. J Neurosci Methods 2018; 308:173-182. [PMID: 30099002 DOI: 10.1016/j.jneumeth.2018.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND We are developing the miniature pig (Sus scrofa domestica), an in-vivo translational, gyrencephalic model for brain development, as an alternative to laboratory rodents/non-human primates. We analyzed longitudinal changes in adolescent pigs using proton magnetic resonance spectroscopy (1H-MRS) and examined the relationship with white matter (WM) integrity derived from diffusion weighted imaging (DWI). NEW METHOD Twelve female Sinclair™ pigs underwent three imaging/spectroscopy sessions every 23.95 ± 3.73 days beginning at three months of age using a clinical 3 T scanner. 1H-MRS data were collected using 1.2 × 1.0 × 3.0 cm voxels placed in left and right hemisphere WM using a Point Resolved Spectroscopy sequence (TR = 2000 ms, TE = 30 ms). Concentrations of N-acetylaspartate, myo-inositol (MI), glutamate + glutamine, choline, creatine, and macromolecules (MM) 09 and 14 were averaged from both hemispheres. DWI data were collected using 15 shells of b-values (b = 0-3500 s/mm2) with 32 directions/shell and fit using the WM Tract Integrity model to calculate fractional anisotropy (FA), kurtosis anisotropy (KA) and permeability-diffusivity index. RESULTS MI and MM09 significantly declined with age. Increased FA and KA significantly correlated with decline in MI and MM09. Correlations lost significance once corrected for age. COMPARISON WITH EXISTING METHODS MRI scanners/protocols can be used to collect 1H-MRS and DWI data in pigs. Pigs have a larger, more complex, gyrencephalic brain than laboratory rodents but are less complex than non-human primates, thus satisfying the "replacement" principle of animal research. CONCLUSIONS Longitudinal effects in MRS measurements were similar to those reported in adolescent humans. MRS changes correlated with diffusion measurements indicating ongoing WM myelination/maturation.
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Affiliation(s)
- Meghann C Ryan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, 55 Wade Avenue, Catonsville, MD 21228, United States.
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, 55 Wade Avenue, Catonsville, MD 21228, United States.
| | - Paul M Sherman
- U.S. Air Force School of Aerospace Medicine, Aeromedical Research Department, 2510 5th Street, Building 840, Wright-Patterson AFB, OH 45433-7913, United States; Department of Radiology, 59thMedical Wing, 1100 Wilford Hall Loop, Bldg 4551, Joint Base San Antonio, TX, 78236, United States.
| | - Laura M Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, 55 Wade Avenue, Catonsville, MD 21228, United States.
| | - S Andrea Wijtenburg
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, 55 Wade Avenue, Catonsville, MD 21228, United States.
| | - Ashley Acheson
- Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W Markham St., Little Rock, AR, 72205, United States.
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, 55 Wade Avenue, Catonsville, MD 21228, United States.
| | - John Sladky
- U.S. Air Force School of Aerospace Medicine, Aeromedical Research Department, 2510 5th Street, Building 840, Wright-Patterson AFB, OH 45433-7913, United States; Department of Neurology, 59th Medical Wing, 1100 Wilford Hall Loop, Bldg 4551, Joint Base San Antonio, Lackland AFB, TX, 78236, United States.
| | - Stephen McGuire
- Department of Neurology, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
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21
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Palta P, Chen H, Deal JA, Sharrett AR, Gross A, Knopman D, Griswold M, Heiss G, Mosley TH. Olfactory function and neurocognitive outcomes in old age: The Atherosclerosis Risk in Communities Neurocognitive Study. Alzheimers Dement 2018; 14:1015-1021. [PMID: 29605223 PMCID: PMC6097922 DOI: 10.1016/j.jalz.2018.02.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 12/06/2017] [Accepted: 02/07/2018] [Indexed: 12/27/2022]
Abstract
INTRODUCTION We tested the hypothesis that poor sense of smell is associated with lower cognitive function and higher mild cognitive impairment (MCI) prevalence. METHODS Olfaction, measured by the Sniffin' Sticks test, was categorized as olfactory impairment (OI) (score ≤6) or no OI (score >6). MCI was adjudicated based on review of a neuropsychological examination. Linear regression estimated the mean difference in cognitive factor scores, and log-binomial regression quantified MCI prevalence among participants with versus without OI. RESULTS Participants with OI had lower mean factor scores (memory: -0.27 standard deviation [SD], 95% confidence interval [CI]: -0.35 to -0.19; language: -0.24 SD, 95% CI: -0.30 to -0.17; executive function/processing speed: -0.09 SD, 95% CI: -0.12 to -0.06; and general cognitive performance: -0.25 SD, 95% CI: -0.30 to -0.20). OI was also associated with MCI (n = 204; prevalence ratio = 1.56, 95% CI: 1.37, 1.78). DISCUSSION An impaired sense of smell may serve as a readily accessible early marker of neurodegeneration and improve upon the prevailing delayed diagnoses and underascertainment of MCI/dementia.
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Affiliation(s)
- Priya Palta
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Alden Gross
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Michael Griswold
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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22
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van der Leeuw G, Leveille SG, Dong Z, Shi L, Habtemariam D, Milberg W, Hausdorff JM, Grande L, Gagnon P, McLean RR, Bean JF. Chronic Pain and Attention in Older Community-Dwelling Adults. J Am Geriatr Soc 2018; 66:1318-1324. [PMID: 29876923 DOI: 10.1111/jgs.15413] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To examine the cross-sectional relationship between chronic pain and complex attention in a population of community-living older adults. DESIGN Prospective cross-sectional cohort study. SETTING Population-based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study II. PARTICIPANTS Individuals aged 71 to 101 (N=354). MEASUREMENTS Chronic pain was measured using the pain severity and interference subscales of the Brief Pain Inventory. Four subscales of the Test of Everyday Attention were used to measure domains of attention switching and selective, sustained, and divided attention. RESULTS Before and after multivariable adjustment, pain severity was associated with poorer scores on measures of selective and sustained attention. Pain interference scores also were significantly inversely associated with selective attention. CONCLUSION Chronic pain is associated with poorer performance in selective and sustained attention in community-dwelling older adults. Further research is needed to determine whether effective pain management could lead to better attentional performance in older adults. Older adults who live with chronic pain, often undertreated, are potentially at risk of cognitive difficulties and related functional consequences.
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Affiliation(s)
- Guusje van der Leeuw
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts.,Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Zhiyong Dong
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ling Shi
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | | | - William Milberg
- New England Geriatric, Research, Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts.,Department of Psychiatry, School of Medicine, Harvard University, Boston, Massachusetts
| | - Jeffrey M Hausdorff
- Center for Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Laura Grande
- Psychology Service, Veterans Affairs Boston Healthcare System, Boston, Massachusetts.,Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts
| | - Peggy Gagnon
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
| | - Robert R McLean
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Department of Medicine, School of Medicine, Harvard University, Boston, Massachusetts
| | - Jonathan F Bean
- New England Geriatric, Research, Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, School of Medicine, Harvard University, Boston, Massachusetts.,Spaulding Rehabilitation Hospital, Boston, Massachusetts
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23
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Park SK. Trajectories of change in cognitive function in people with chronic obstructive pulmonary disease. J Clin Nurs 2018; 27:1529-1542. [DOI: 10.1111/jocn.14285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/29/2022]
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24
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Naumczyk P, Sawicka AK, Brzeska B, Sabisz A, Jodzio K, Radkowski M, Czachowska K, Winklewski PJ, Finc K, Szurowska E, Demkow U, Szarmach A. Cognitive Predictors of Cortical Thickness in Healthy Aging. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1116:51-62. [PMID: 30267304 DOI: 10.1007/5584_2018_265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
This study seeks to define the role of predictive values of the motor speed, inhibition control, and fluid and crystallized intelligence in estimating the cortical thickness in healthy elderly. Forty-six older healthy subjects (37 women, 9 men) over 60 years of age were included in the study. The participants were examined on 3.0 T MRI scanners. The protocol included standard anatomical sequences, to exclude brain pathology, and a high-resolution T1-weighted sequence used to estimate the cortical thickness. The neuropsychological protocol included fluid intelligence assessment (Raven Progressive Matrices), crystalized intelligence assessment (information or vocabulary subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R)), and executive functioning (Color Traits Test). The findings unraveled several interdependencies. The higher the intelligence, the thicker was the grey matter in nine regions of both hemispheres, but also some paradoxical reversed associations were found in four areas; all of them were localized along different sections of the cingulate gyrus in both hemispheres. An inverse association was found between crystallized intelligence and the thickness of the pars opecularis of the right hemisphere. The better the executive functioning, the thicker was the grey matter of a given region. The better the motor performance, the thicker was the grey matter of the rostral middle frontal area of the left hemisphere and the lingual gyrus of both hemispheres. In conclusion, the associations unraveled demonstrate that the neural mechanisms underlying healthy aging are complex and heterogenic across different cognitive domains and neuroanatomical regions. No brain aging theory seems to provide a suitable interpretative framework for all the results. A novel, more integrative approach to the brain aging should be considered.
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Affiliation(s)
| | - Angelika K Sawicka
- Department of Bioenergetics and Nutrition, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Beata Brzeska
- Department of Biology and Pharmaceutical Botany, Faculty of Pharmacy, Gdansk Medical University, Gdansk, Poland.,Department of Human Physiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland.,Second Department of Radiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland
| | - Agnieszka Sabisz
- Second Department of Radiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland
| | | | - Marek Radkowski
- Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland
| | - Karolina Czachowska
- Department of Human Physiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland
| | - Paweł J Winklewski
- Department of Human Physiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland.,Second Department of Radiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland.,Department of Clinical Anatomy and Physiology, Faculty of Health Sciences, Pomeranian University in Slupsk, Slupsk, Poland
| | - Karolina Finc
- Center for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Torun, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland
| | - Urszula Demkow
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, Warsaw, Poland
| | - Arkadiusz Szarmach
- Second Department of Radiology, Faculty of Health Sciences, Gdansk Medical University, Gdansk, Poland
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25
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Vásquez E, Strizich G, Isasi CR, Echeverria SE, Sotres-Alvarez D, Evenson KR, Gellman MD, Palta P, Qi Q, Lamar M, Tarraf W, González HM, Kaplan R. Is there a relationship between accelerometer-assessed physical activity and sedentary behavior and cognitive function in US Hispanic/Latino adults? The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med 2017; 103:43-48. [PMID: 28765082 PMCID: PMC5798874 DOI: 10.1016/j.ypmed.2017.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 06/01/2017] [Accepted: 07/24/2017] [Indexed: 01/08/2023]
Abstract
Normative changes in cognitive function are expected with increasing age. Research on the relationship between normative cognitive decline and moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SED) needs further investigation in Hispanic/Latinos adults. We assessed the cross-sectional association between accelerometer assessed MVPA and SED with cognitive function in 7,478 adults aged 45-74years from the Hispanic Community Health Study/Study of Latinos. At baseline, cognitive tests included two executive function tests (Digit Symbol Substitution Test (DSST), a test of language (Word Fluency), and a test of memory (Spanish English Verbal Learning Test). Multiple regression models were used to examine associations of time spent in MVPA and SED with cognitive function by age groups, adjusted for age, education, sex, acculturation, and field center. Mean time spent in sedentary behaviors was 12.3h/day in females and 11.9 h/day in males (75% and 77% of accelerometer wear time, respectively). Higher SED, but not MVPA, was associated with lower DSST raw scores (β -0.03 with each 10-min increment in SED; P<0.05), indicating lower performance in executive function in all age groups. No associations were observed for MVPA and SED with tests of language or memory tests. Our findings suggest a distinct association of SED but not MVPA on executive functioning in middle-aged and older Latino adults. Longitudinal studies are needed to more conclusively determine causal links.
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Affiliation(s)
- Elizabeth Vásquez
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States.
| | - Garrett Strizich
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Carmen R Isasi
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Sandra E Echeverria
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Daniela Sotres-Alvarez
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Kelly R Evenson
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Marc D Gellman
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Priya Palta
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Qibin Qi
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Melissa Lamar
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Wassim Tarraf
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Hector M González
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Robert Kaplan
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
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26
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Reas ET, Laughlin GA, Bergstrom J, Kritz-Silverstein D, Barrett-Connor E, McEvoy LK. Effects of Sex and Education on Cognitive Change Over a 27-Year Period in Older Adults: The Rancho Bernardo Study. Am J Geriatr Psychiatry 2017; 25:889-899. [PMID: 28433548 PMCID: PMC5522346 DOI: 10.1016/j.jagp.2017.03.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/10/2017] [Accepted: 03/11/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study investigated how cognitive function changes with age and whether rates of decline vary by sex or education in a large, homogenous longitudinal cohort characterized by high participation rates, long duration of follow-up, and minimal loss to follow-up. DESIGN/SETTING/PARTICIPANTS Between 1988 and 2016, 2,225 community-dwelling participants of the Rancho Bernardo Study, aged 31 to 99 years at their initial cognitive assessment, completed neuropsychological testing approximately every 4 years, over a maximum 27-year follow-up. MEASUREMENTS Linear mixed effects regression models defined sex-specific cognitive trajectories, adjusting for education and retest effects. RESULTS Significant decline across all cognitive domains began around age 65 years and accelerated after age 80 years. Patterns of decline were generally similar between sexes, although men declined more rapidly than women on the global function test. Higher education was associated with slower decline on the tests of executive and global functions. After excluding 517 participants with evidence of cognitive impairment, accelerating decline with age remained for all tests, and women declined more rapidly than men on the executive function test. CONCLUSIONS Accelerating decline with advancing age occurs across multiple cognitive domains in community-dwelling older adults, with few differences in rates of decline between men and women. Higher education may provide some protection against executive and global function decline with age. These findings better characterize normal cognitive aging, a critical prerequisite for identifying individuals at risk for cognitive impairment, and lay the groundwork for future studies of health and behavioral factors that affect age-related decline in this cohort.
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Affiliation(s)
- Emilie T Reas
- Departments of Radiology, University of California, San Diego, CA.
| | - Gail A Laughlin
- Family Medicine and Public Health, University of California, San Diego, CA
| | - Jaclyn Bergstrom
- Family Medicine and Public Health, University of California, San Diego, CA
| | | | | | - Linda K McEvoy
- Departments of Radiology, University of California, San Diego, CA; Family Medicine and Public Health, University of California, San Diego, CA
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27
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Nowrangi MA, Rosenberg PB, Leoutsakos JMS. Subtle changes in daily functioning predict conversion from normal to mild cognitive impairment or dementia: an analysis of the NACC database. Int Psychogeriatr 2016; 28:2009-2018. [PMID: 27585497 PMCID: PMC5628501 DOI: 10.1017/s1041610216000995] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There are relatively small but observable changes in functional ability in those without Mild cognitive impairment (MCI) or dementia. The present study seeks to understand whether these individuals go on to develop MCI or dementia by assessing the association between baseline Functional Activities Questionnaire (FAQ) and conversion independent and after adjustment for cognitive tests. METHODS The NACC database was used to conduct the analysis of which 7,625 participants were initially identified as having more than one visit and who were cognitively normal at their first visit. Cox proportional hazards were used to fit three models that controlled for executive and non-executive cognitive domains. A similar model was used to assess the effect of FAQ subcategories on conversion. RESULTS Of these individuals, 1,328 converted to either MCI or dementia by visit 10. Converters had a total visit 1 FAQ score significantly higher than non-converters indicating more functional impairment at baseline. After adjustment for cognitive tests, the association between visit 1 FAQ and subsequent conversion was not attenuated. Doing taxes, remembering dates, and traveling were individually identified as significant predictors of conversion. CONCLUSIONS The FAQ can be used as an indirect measure of functional ability and is associated with conversion to MCI or dementia. There is a selective and significant association between changes in financial ability and conversion that is in accordance with other research of financial capacity.
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Affiliation(s)
- Milap A Nowrangi
- Department of Psychiatry and Behavioral Sciences,Johns Hopkins University School of Medicine,Baltimore,Maryland,USA
| | - Paul B Rosenberg
- Department of Psychiatry and Behavioral Sciences,Johns Hopkins University School of Medicine,Baltimore,Maryland,USA
| | - Jeannie-Marie S Leoutsakos
- Department of Psychiatry and Behavioral Sciences,Johns Hopkins University School of Medicine,Baltimore,Maryland,USA
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28
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Bornschlegl M, Fischer R, Petermann F. Erfolgreiches kognitives Altern: Zusammenhang der kognitiven Leistungen mit Aktivität und Zufriedenheit. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2016. [DOI: 10.1024/1016-264x/a000184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Für erfolgreiches Altern sind Kognition, Zufriedenheit und tägliche Aktivitäten relevante Faktoren. In dieser Studie werden Zusammenhänge zwischen diesen Faktoren aufgedeckt. Bei 167 Senioren (60 bis 98 Jahre) wurden Aktivität und Zufriedenheit in einem Interview, Kognition durch die Neuropsychological Assessment Battery (dt. Version) erfasst. Alle Faktoren zeigen eine negative Altersentwicklung. Aktivitäten korrelieren mit allen Faktoren; insbesondere stehen Alltagsaktivitäten und kognitive Aktivitäten positiv mit Kognition im Zusammenhang, soziale Aktivität ist davon unabhängig. Die kognitiven Funktionsbereiche Aufmerksamkeit, Sprache und exekutive Funktionen variieren mit Aktivität und Zufriedenheit, Gedächtnis nur mit kognitiven Aktivitäten, Wahrnehmung ist davon unabhängig. Dies könnte bedeuten, dass kognitive Aktivitäten spezifisch mit der kognitiven Leistung und soziale Aktivitäten spezifisch mit der emotionalen Bewertung zusammenhängen und als Schutzfaktoren während der Entwicklung wirken könnten.
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Affiliation(s)
- Mona Bornschlegl
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Rico Fischer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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29
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Relations between Concurrent Longitudinal Changes in Cognition, Depressive Symptoms, Self-Rated Health and Everyday Function in Normally Aging Octogenarians. PLoS One 2016; 11:e0160742. [PMID: 27551749 PMCID: PMC4995030 DOI: 10.1371/journal.pone.0160742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 07/24/2016] [Indexed: 11/19/2022] Open
Abstract
Ability to predict and prevent incipient functional decline in older adults may help prolong independence. Cognition is related to everyday function and easily administered, sensitive cognitive tests may help identify at-risk individuals. Factors like depressive symptoms and self-rated health are also associated with functional ability and may be as important as cognition. The purpose of this study was to investigate the relationship between concurrent longitudinal changes in cognition, depression, self-rated health and everyday function in a well-defined cohort of healthy 85 year olds that were followed-up at the age of 90 in the Elderly in Linköping Screening Assessment 85 study. Regression analyses were used to determine if cognitive decline as assessed by global (the Mini-Mental State Examination) and domain specific (the Cognitive Assessment Battery, CAB) cognitive tests predicted functional decline in the context of changes in depressive symptoms and self-rated health. Results showed deterioration in most variables and as many as 83% of these community-dwelling elders experienced functional difficulties at the age of 90. Slowing-down of processing speed as assessed by the Symbol Digits Modality Test (included in the CAB) accounted for 14% of the variance in functional decline. Worsening self-rated health accounted for an additional 6%, but no other variables reached significance. These results are discussed with an eye to possible preventive interventions that may prolong independence for the steadily growing number of normally aging old-old citizens.
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Yaffe K, Peltz CB, Ewing SK, McCulloch CE, Cummings SR, Cauley JA, Hillier TA, Ensrud KE. Long-term Cognitive Trajectories and Mortality in Older Women. J Gerontol A Biol Sci Med Sci 2016; 71:1074-80. [PMID: 26843186 PMCID: PMC4945886 DOI: 10.1093/gerona/glw003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 01/05/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few studies have examined whether change in cognition is linked to mortality. This study examined the relationship between cognitive trajectories in older age and risk of death. METHODS We studied community-dwelling, nondemented women aged 65+ (mean age = 71) enrolled in a prospective study of aging and followed up to 25 years. A modified Mini-Mental State Examination (mMMSE) and Trail Making Task Part B (TMTB) were administered at multiple visits during follow-up. We examined the association between cognitive trajectories (analyzed by quintiles) from baseline to age 80 (n = 7,477 for mMMSE and n = 6,503 for TMTB) and all-cause mortality after age 80 using Cox regression models, both unadjusted and adjusted for education, physical activity, alcohol, depression score, current smoking and history of hypertension and diabetes. Cause of death was determined from death certificates, classified as cardiovascular, cancer and other. RESULTS Women with greater rate of decline were older, less educated, less physically active, had higher depression score and were more likely to have a history of hypertension and diabetes (all p < .01). Participants with the greatest decline (quintile 1) had an increased risk of death (mMMSE hazard ratio [HR] = 1.28; TMTB HR = 1.43] and those with the least decline (quintile 5) had a decreased risk of death (mMMSE HR = 0.73; TMTB HR = 0.61) compared with intermediate decliners (quintiles 2-4). Cognitive trajectories were associated with cardiovascular mortality and other causes of death, but not cancer deaths. CONCLUSIONS Our study suggests that greater decline in general cognition or executive function is associated with higher rates of mortality in oldest-old women.
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Affiliation(s)
- Kristine Yaffe
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco. Department of Mental Health, San Francisco VA Medical Center, California
| | - Carrie B Peltz
- Department of Mental Health, San Francisco VA Medical Center, California. NCIRE-The Veterans Health Research Institute, San Francisco, California.
| | - Susan K Ewing
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco
| | - Charles E McCulloch
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco
| | - Steve R Cummings
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Teresa A Hillier
- Kaiser Permanente Center for Health Research Northwest/Hawaii, Portland, Oregon
| | - Kristine E Ensrud
- School of Public Health, University of Minnesota, Minneapolis. Department of Medicine, Minneapolis VA Health Care System, Minnesota
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31
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Li K, Laird AR, Price LR, McKay DR, Blangero J, Glahn DC, Fox PT. Progressive Bidirectional Age-Related Changes in Default Mode Network Effective Connectivity across Six Decades. Front Aging Neurosci 2016; 8:137. [PMID: 27378909 PMCID: PMC4905965 DOI: 10.3389/fnagi.2016.00137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/27/2016] [Indexed: 12/31/2022] Open
Abstract
The default mode network (DMN) is a set of regions that is tonically engaged during the resting state and exhibits task-related deactivation that is readily reproducible across a wide range of paradigms and modalities. The DMN has been implicated in numerous disorders of cognition and, in particular, in disorders exhibiting age-related cognitive decline. Despite these observations, investigations of the DMN in normal aging are scant. Here, we used blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) acquired during rest to investigate age-related changes in functional connectivity of the DMN in 120 healthy normal volunteers comprising six, 20-subject, decade cohorts (from 20–29 to 70–79). Structural equation modeling (SEM) was used to assess age-related changes in inter-regional connectivity within the DMN. SEM was applied both using a previously published, meta-analytically derived, node-and-edge model, and using exploratory modeling searching for connections that optimized model fit improvement. Although the two models were highly similar (only 3 of 13 paths differed), the sample demonstrated significantly better fit with the exploratory model. For this reason, the exploratory model was used to assess age-related changes across the decade cohorts. Progressive, highly significant changes in path weights were found in 8 (of 13) paths: four rising, and four falling (most changes were significant by the third or fourth decade). In all cases, rising paths and falling paths projected in pairs onto the same nodes, suggesting compensatory increases associated with age-related decreases. This study demonstrates that age-related changes in DMN physiology (inter-regional connectivity) are bidirectional, progressive, of early onset and part of normal aging.
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Affiliation(s)
- Karl Li
- Research Imaging Institute, University of Texas Health Science Center San Antonio San Antonio, TX, USA
| | - Angela R Laird
- Department of Physics, Florida International University Miami, FL, USA
| | - Larry R Price
- Department of Mathematics and College of Education, Texas State University San Marcos, TX, USA
| | - D Reese McKay
- Department of Psychiatry, Yale University School of MedicineNew Haven, CT, USA; Olin Neuropsychiatry Research Center, Institute of Living, Hartford HospitalHartford, CT, USA
| | - John Blangero
- Genomics Computing Center, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine Edinburg, TX, USA
| | - David C Glahn
- Department of Psychiatry, Yale University School of MedicineNew Haven, CT, USA; Olin Neuropsychiatry Research Center, Institute of Living, Hartford HospitalHartford, CT, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center San AntonioSan Antonio, TX, USA; Research Service, South Texas Veterans Health Care SystemSan Antonio, TX, USA; Neuroimaging Laboratory, Shenzhen University School of MedicineShenzhen, Guangdong, China
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Effects of Moderate Aerobic Exercise on Cognitive Abilities and Redox State Biomarkers in Older Adults. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:2545168. [PMID: 27195073 PMCID: PMC4852338 DOI: 10.1155/2016/2545168] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 03/23/2016] [Indexed: 01/26/2023]
Abstract
We used a moderate aerobic exercise program for 24 weeks to measure the positive impact of physical activity on oxidative stress and inflammatory markers and its association with cognitive performance in healthy older adults. A total of 100 healthy subjects (65–95 Yrs) were randomly classified into two groups: control group (n = 50) and exercise group (n = 50). Cognitive functioning, physical activity score, MDA, 8-OHdG, TAC, and hs-CRP were assessed using LOTCA battery, prevalidated PA questionnaire, and immunoassay techniques. LOTCA 7-set scores of cognitive performance showed a significant correlation with physical activity status and the regulation of both oxidative stress free radicals and inflammatory markers in all older subjects following 24 weeks of moderate exercise. Physically active persons showed a higher cognitive performance along with reduction in the levels of MDA, 8-OHdG, and hs-CRP and increase in TAC activity compared with sedentary participants. Cognitive performance correlated positively with the increase in TAC activity and physical fitness scores and negatively with MDA, 8-OHdG, and hs-CRP, respectively. There was a significant improvement in motor praxis, vasomotor organization, thinking operations, and attention and concentration among older adults. In conclusion, moderate aerobic training for 24 weeks has a positive significant effect in improving cognitive functions via modulating redox and inflammatory status of older adults.
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Miller IN, Himali JJ, Beiser AS, Murabito JM, Seshadri S, Wolf PA, Au R. Normative Data for the Cognitively Intact Oldest-Old: The Framingham Heart Study. Exp Aging Res 2016. [PMID: 26214098 DOI: 10.1080/0361073x.2015.1053755] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: The number of individuals who reach extreme age is quickly increasing. Much of the current literature focuses on impaired cognition in extreme age, and debate continues regarding what constitutes "normal" cognition in extreme age. This study aimed to provide oldest-old normative data and to compare cognitive performances of cognitively intact elderly individuals from the Framingham Heart Study. METHODS A total of 1302 individuals aged 65+ years from the Framingham Heart Study were separated into 5-year age bands and compared on cognitive tests. Multivariate linear regression analyses were conducted, adjusting for gender, the Wide Range Achievement Test-Third Edition (WRAT-III) Reading score, and cohort. Analyses also included comparisons between 418 individuals aged 80+ and 884 individuals aged 65-79, and comparisons within oldest-old age bands. RESULTS Normative data for all participants are presented. Significant differences were found on most tests between age groups in the overall analysis between young-old and oldest-old, and analysis of oldest-old age bands also revealed select significant differences (all ps <.05). CONCLUSION As aging increases, significant cognitive differences and increased variability in performances are evident. These results support the use of age-appropriate normative data for oldest-old individuals.
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Affiliation(s)
- Ivy N Miller
- a Department of Psychology , Minneapolis VA Healthcare System , Minneapolis , Minnesota , USA
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Bier N, Belchior PDC, Paquette G, Beauchemin É, Lacasse-Champagne A, Messier C, Pellerin ML, Petit M, Mioshi E, Bottari C. The Instrumental Activity of Daily Living Profile in Aging: A Feasibility Study. J Alzheimers Dis 2016; 52:1361-71. [PMID: 27079703 DOI: 10.3233/jad-150957] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dysfunctions in complex activities of daily living (ADLs) are a normal part of the aging process. However, differentiating functional decline associated with healthy aging from the subtle decline experienced by individuals with mild cognitive impairment and early dementia constitutes a challenge. Finding an appropriate tool that can capture these subtle but important functional changes represents a priority. OBJECTIVES The aims of this study were to evaluate the feasibility of using the Instrumental Activities of Daily Living Profile (IADL Profile) with elderly participants and to describe their level of difficulty encountered in each task. METHODS The tool was administered to a group of 40 elderly participants living in the community. RESULTS The IADL Profile was found to be feasible to use in older individuals; the tool also showed sensitivity to the difficulties experienced by this population in everyday functioning. CONCLUSION The IADL Profile is a promising ecological tool to evaluate independence in aging and may help to identify individuals with MCI. This tool may also contribute to the development of tailored interventions to enhance everyday functioning in the older population.
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Affiliation(s)
- Nathalie Bier
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Patricia da Cunha Belchior
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Guillaume Paquette
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Émilie Beauchemin
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Chantal Messier
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Line Pellerin
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marisol Petit
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Eneida Mioshi
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,Centre de Recherche Interdisciplinaire en Réadaptation - site Lucie-Bruneau, Montreal, QC, Canada
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van der Leeuw G, Eggermont LHP, Shi L, Milberg WP, Gross AL, Hausdorff JM, Bean JF, Leveille SG. Pain and Cognitive Function Among Older Adults Living in the Community. J Gerontol A Biol Sci Med Sci 2016; 71:398-405. [PMID: 26433218 PMCID: PMC5013972 DOI: 10.1093/gerona/glv166] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 08/31/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. METHODS We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. RESULTS Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. CONCLUSIONS Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults.
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Affiliation(s)
| | - Laura H P Eggermont
- Department of Clinical Neuropsychology, Vrije University, Amsterdam, The Netherlands
| | - Ling Shi
- College of Nursing and Health Sciences, University of Massachusetts Boston
| | - William P Milberg
- Geriatric Neuropsychology Laboratory, Geriatric, Research, Education and Clinical Center, Brockton/West Roxbury Department of Veterans Affairs Medical Center, Boston, Massachusetts. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins Center on Aging and Health, Baltimore, Maryland
| | - Jeffrey M Hausdorff
- Laboratory for Gait and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Israel. Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Jonathan F Bean
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts. New England Geriatric, Research, Education and Clinical Center, Boston Veterans Administration Health System, Massachusetts. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston. Department of Medicine, Harvard Medical School, Boston, Massachusetts. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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Díaz-Venegas C, Reistetter TA, Wang CY, Wong R. The progression of disability among older adults in Mexico. Disabil Rehabil 2016; 38:2016-27. [PMID: 26729017 DOI: 10.3109/09638288.2015.1111435] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This paper seeks to document the progression of disability in a developing country and to examine gender differences in this process. METHODS The data come from the Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults. An ordinal logistic regression (n = 3283) is used to measure the progression of disability that considers: (1) no disability, (2) mobility problems, (3) mobility problems with IADLs limitations, (4) mobility problems with ADLs limitations, (5) combinations of the latter three and (6) death. RESULTS Approximately 43% of the sample remained in the same level of disability after 2 years. The patterns of progression with two disabilities differ for men and women. CONCLUSIONS Our model reflects the importance of separating ADLs and IADLs in the study of disability progression in Mexico. Varying risk profiles and cultural differences might influence the divergent disability paths followed by each gender. Implications for Rehabilitation The disablement process involving transitions from mobility impairments to IADL and ADL limitations seen in developed countries differs for older adults in Mexico. Cultural differences may influence the progression from non-disabled to becoming disabled in different ways for females in developing countries like Mexico. One-fifth of individuals showed greater function and independence over time, suggesting that the disablement process is reversible. This finding highlights the need to focus on improving mobility, ADL, and IADL skills to facilitate successful aging. Although disability is often conceptualised as a combination of ADL and IADL limitations, gender differences seen in Mexico indicate the need to separate ADL and IADL when developing approaches to prevent or ameliorate disability.
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Affiliation(s)
- Carlos Díaz-Venegas
- a Rehabilitation Sciences Academic Division & Research Center , University of Texas Medical Branch , Galveston , TX , USA
| | - Timothy A Reistetter
- b Department of Physical Therapy , University of Texas Medical Branch , Galveston , TX , USA
| | - Ching-Yi Wang
- c School of Physical Therapy, Chung Shan Medical University , Taichung City , Taiwan
| | - Rebeca Wong
- d Preventive Medicine & Community Health, University of Texas Medical Branch , Galveston , TX , USA
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Palmer RF, Royall DR. Future Dementia Severity is Almost Entirely Explained by the Latent Variable δ's Intercept and Slope. J Alzheimers Dis 2016; 49:521-9. [PMID: 26444763 DOI: 10.3233/jad-150254] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Structural equation models (SEM) can explicitly distinguish dementia-relevant variance in cognitive task performance. The resulting latent construct "δ" (for dementia) provides a relatively "error free" continuously varying dementia-specific phenotype. OBJECTIVE To estimate δ's change over time (Δδ) and determine Δδ's predictive validity using future dementia status as an outcome. METHODS Data from n = 2,191 participants of the Texas Alzheimer's Research and Care Consortium (TARCC) were used to construct a latent growth curve model of longitudinal change over four years using five cognitive measures and one measure of Instrumental Activities of Daily Living. Four final latent factors, including baseline δ and Δδ, were simultaneously entered as predictors of wave 4 dementia severity, as estimated by the Clinical Dementia Rating Scale "sum of boxes" (CDR). RESULTS All observed measures exhibited significant change [χ2 = 1,152 (df = 229); CFI = 0.968; RMSEA = 0.043]. The final model demonstrated excellent fit to the data [χ2 = 543 (df = 245); CFI = 0.991; RMSEA = 0.023]. All latent indicator loadings were significant, yielding four distinct factors. After adjustment for demographic covariates and baseline CDR scores, d and Δd were significantly independently associated with CDR4, explaining 25% and 49% of its variance, respectively. The latent variable g' significantly explained 3% of CDR4 variance independently of d and Δd. Δg' was not significantly associated with CDR4. Baseline CDR explained 16% of CDR4 variance. CONCLUSIONS Future dementia severity is almost entirely explained by the latent construct δ's intercept and slope.
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Affiliation(s)
- Raymond F Palmer
- Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center, San Antonio, TX, USA
- Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA
| | - Donald R Royall
- Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
- Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA
- Department of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
- South Texas Veterans' Health System, Audie L. Murphy Division GRECC, San Antonio, TX, USA
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Morris JN, Howard EP, Steel K, Perlman C, Fries BE, Garms-Homolová V, Henrard JC, Hirdes JP, Ljunggren G, Gray L, Szczerbińska K. Updating the Cognitive Performance Scale. J Geriatr Psychiatry Neurol 2016; 29:47-55. [PMID: 26251111 DOI: 10.1177/0891988715598231] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 06/24/2015] [Indexed: 01/10/2023]
Abstract
This study presents the first update of the Cognitive Performance Scale (CPS) in 20 years. Its goals are 3-fold: extend category options; characterize how the new scale variant tracks with the Mini-Mental State Examination; and present a series of associative findings. Secondary analysis of data from 3733 older adults from 8 countries was completed. Examination of scale dimensions using older and new items was completed using a forward-entry stepwise regression. The revised scale was validated by examining the scale's distribution with a self-reported dementia diagnosis, functional problems, living status, and distress measures. Cognitive Performance Scale 2 extends the measurement metric from a range of 0 to 6 for the original CPS, to 0 to 8. Relating CPS2 to other measures of function, living status, and distress showed that changes in these external measures correspond with increased challenges in cognitive performance. Cognitive Performance Scale 2 enables repeated assessments, sensitive to detect changes particularly in early levels of cognitive decline.
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Affiliation(s)
- John N Morris
- Hebrew SeniorLife, Institute for Aging Research, Boston, MA, USA
| | | | - Knight Steel
- Hackensack University Medical Center, Hackensack, NJ, USA
| | - Christopher Perlman
- School of Public Health and Health System, University of Waterloo, Waterloo, Ontario, Canada
| | - Brant E Fries
- Institute of Gerontology and Geriatric Research, Education and Clinical Center, Ann Arbor VA Healthcare Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Jean-Claude Henrard
- Versailles-Saint Quentin, En Yvelines (UVSQ) University, Laboratoire Santé, Environment Vieillissement, Paris, France
| | - John P Hirdes
- Ontario Home Care Research and Knowledge Exchange Chair, University of Waterloo, Waterloo, Ontario, Canada
| | - Gunnar Ljunggren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden Public Healthcare Services Committee Administration, Stockholm County Council, Stockholm, Sweden
| | - Len Gray
- Centre for Research in Geriatric Medicine, Centre for Online Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Katarzyna Szczerbińska
- Unit for Research on Aging Society, Department of Sociology of Medicine, at The Chair of Epidemiology and Preventive Medicine, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
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Alghadir AH, Gabr SA, Al-Eisa ES. Assessment of the effects of glutamic acid decarboxylase antibodies and trace elements on cognitive performance in older adults. Clin Interv Aging 2015; 10:1901-7. [PMID: 26664103 PMCID: PMC4671766 DOI: 10.2147/cia.s95974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Homeostatic imbalance of trace elements such as iron (Fe), copper (Cu), and zinc (Zn) demonstrated adverse effects on brain function among older adults. Objective The present study aimed to investigate the effects of trace elements and the presence of anti-glutamic acid decarboxylase antibodies (GADAs) in human cognitive abilities among healthy older adults. Methods A total of 100 healthy subjects (65 males, 35 females; age range; 64–96 years) were recruited for this study. Based on Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score, the participants were classified according to cognitive performance into normal (n=45), moderate (n=30), and severe (n=25). Cognitive functioning, leisure-time physical activity (LTPA), serum trace elements – Fe, Cu, Zn, Zn/Cu, and GADAs were assessed using LOTCA battery, pre-validated physical activity (PA) questionnaire, atomic absorption, and immunoassay techniques, respectively. Results Approximately 45% of the study population (n=45) had normal distribution of cognitive function and 55% of the study population (n=55) had abnormal cognitive function; they were classified into moderate (score 62–92) and severe (score 31–62). There was a significant reduction in the level of Zn and Zn/Cu ratio along with an increase in the level of Fe, Cu, and anti-GADAs in subjects of severe (P=0.01) and moderate (P=0.01) cognitive performance. LOTCA-cognitive scores correlated positively with sex, HbA1c, Fe, Cu, Zn, and Zn/Cu ratio, and negatively with age, PA, body mass index, and anti-GADAs. Significant inter-correlation was reported between serum trace element concentrations and anti-GADAs which suggest producing a cognitive decline via oxidative and neural damage mechanism. Conclusion This study found significant associations among trace elements, anti-GADAs, and cognitive function in older adults. The homeostatic balance of trace elements should be recommended among older adults for better cognitive performance.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia ; Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Einas S Al-Eisa
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Han L, Gill TM, Jones BL, Allore HG. Cognitive Aging Trajectories and Burdens of Disability, Hospitalization and Nursing Home Admission Among Community-living Older Persons. J Gerontol A Biol Sci Med Sci 2015; 71:766-71. [PMID: 26511011 DOI: 10.1093/gerona/glv159] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/17/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The course of cognitive aging has demonstrated substantial heterogeneity. This study attempted to identify distinctive cognitive trajectories and examine their relationship with burdens of disability, hospitalization, and nursing home admission. METHODS Seven hundred and fifty-four community-living persons aged 70 years or older in the Yale Precipitating Events Project were assessed with the Mini-Mental State Examination every 18 months for up to 108 months. A group-based trajectory model was used to determine cognitive aging trajectories while adjusting for age, sex, and education. Cumulative burden of disabilities, hospitalizations, and nursing home admissions over 141 months associated with the cognitive trajectories were evaluated using a generalized estimating equation Poisson model. RESULTS Five distinct cognitive trajectories were identified, with about a third of participants starting with high baseline cognitive function and demonstrating No decline during the follow-up period. The remaining participants diverged with Minimal (prevalence 41%), Moderate (16%), Progressive (8%), and Rapid (3%) cognitive decline. Participants with No decline incurred the lowest incidence rates (per 1,000 person-months) of disability in activities of daily living (ADL; 75, 95% confidence intervals: 60-95) and instrumental ADL (492, 453-535), hospitalization (29, 26-33) and nursing home admission (18, 12-27), whereas participants on the Rapid trajectory experienced the greatest burden of ADL disability (612, 595-758) and those on the Progressive trajectory had the highest nursing home admission (363, 292-451). CONCLUSIONS Community-living older persons follow distinct cognitive aging trajectories and experience increasing burdens of disability, hospitalization, and nursing home placement as they age, with greater burdens for those on a declining cognitive trajectory.
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Affiliation(s)
- Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Bobby L Jones
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Heather G Allore
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
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The aging brain shows less flexible reallocation of cognitive resources during dual-task walking: A mobile brain/body imaging (MoBI) study. Neuroimage 2015; 117:230-42. [PMID: 25988225 DOI: 10.1016/j.neuroimage.2015.05.028] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 05/11/2015] [Accepted: 05/11/2015] [Indexed: 11/23/2022] Open
Abstract
Aging is associated with reduced abilities to selectively allocate attention across multiple domains. This may be particularly problematic during everyday multitasking situations when cognitively demanding tasks are performed while walking. Due to previous limitations in neuroimaging technology, much remains unknown about the cortical mechanisms underlying resource allocation during locomotion. Here, we utilized an EEG-based mobile brain/body imaging (MoBI) technique that integrates high-density event-related potential (ERP) recordings with simultaneously acquired foot-force sensor data to monitor gait patterns and brain activity concurrently. To assess effects of motor load on cognition we evaluated young (N=17; mean age=27.2) and older adults (N=16; mean age=63.9) and compared behavioral and ERP measures associated with performing a Go/No-Go response inhibition task as participants sat stationary or walked on a treadmill. Stride time and variability were also measured during task performance and compared to stride parameters obtained without task performance, thereby assessing effects of cognitive load on gait. Results showed that older, but not young adults' accuracy dropped significantly when performing the inhibitory task while walking. Young adults revealed ERP modulations at relatively early (N2 amplitude reduction) and later (earlier P3 latency) stages within the processing stream as motor load increased while walking. In contrast, older adults' ERP modulations were limited to later processing stages (increased P3 amplitude) of the inhibitory network. The relative delay and attenuation of ERP modulations accompanied by behavioral costs in older participants might indicate an age-associated loss in flexible resource allocation across multiple tasks. Better understanding of the neural underpinnings of these age-related changes may lead to improved strategies to reduce fall risk and enhance mobility in aging.
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Saczynski JS, Kiefe CI. Dawning of a new era: understanding the functional outcomes of cardiovascular disease. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES 2014; 7:812-4. [PMID: 25387774 DOI: 10.1161/circoutcomes.114.001427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jane S Saczynski
- From the Department of Medicine (J.S.S.) and Department of Quantitative Health Sciences (J.S.S, C.I.K.), University of Massachusetts Medical School, Worcester, MA; and Meyers Primary Care Institute, Worcester, MA (J.S.S.).
| | - Catarina I Kiefe
- From the Department of Medicine (J.S.S.) and Department of Quantitative Health Sciences (J.S.S, C.I.K.), University of Massachusetts Medical School, Worcester, MA; and Meyers Primary Care Institute, Worcester, MA (J.S.S.)
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Salazar R, Velez CE, Royall DR. Telephone screening for mild cognitive impairment in hispanics using the Alzheimer's questionnaire. Exp Aging Res 2014; 40:129-39. [PMID: 24625043 DOI: 10.1080/0361073x.2014.882189] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: There is a need for a simple and reliable screening test to detect individuals with mild cognitive impairment (MCI). The authors analyzed the relationship between performance of the Alzheimer's Questionnaire (AQ), an informant-rated measure of dementia-related behaviors, relative to the Telephone Interview for Cognitive Status-modified (TICS-m), Memory Impairment Scale-telephone version (MIS-t), and the Telephone Executive Assessment (TEXAS) as predictors of MCI. METHODS Comparative cross-sectional design, with data collected from participants in the Texas Alzheimer's Research and Care Consortium's (TARCC) San Antonio site. One-hundred percent of our sample was Hispanic. The San Antonio subset of TARCC sample is highly enriched with Mexican Americans (MAs). Fifty-five percent of the interviews were conducted in Spanish. Of the 184 persons enrolled, 124 were normal controls (NCs), and 60 participants had MCI. MCI status and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) were determined through clinical consensus and performed blind to telephone assessments. Controlling for age, gender, education, and language of interview, the association between telephone measures and CDR-SOB was evaluated by multivariate regression. RESULTS AQ scores were not affected by education, gender, and language of interview, but subject's age did show a positive correlation with informant AQ ratings. The AQ predicted CDR-SOB independently of the cognitive measures, adding variance above and beyond demographics. The TICS-m and the TEXAS appear to have additive value in improving the detection of cognitively impaired patients. The MIS-t failed to contribute significantly to CDR-SOB, independent of the other measures. CONCLUSION The AQ may have utility as a culture-fair telephone screening for MCI. The AQ was able to modestly distinguish MCI from NCs. The TEXAS adds variance to a model of dementia severity independent of the AQ, suggesting that the latter may weakly assess that cognitive domain (executive control function). On the other hand, the AQ attenuates the MIS-t effect. This suggests a prominent AQ bias in favor of detecting memory impairment. Additional studies are required to determine if the AQ can distinguish between amnestic and dysexecutive MCI subtypes, or between MCI and Alzheimer's disease in Hispanics.
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Affiliation(s)
- Ricardo Salazar
- a Department of Psychiatry , The University of Texas Health Science Center at San Antonio , San Antonio , Texas , USA
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Royall DR, Palmer RF. "Executive functions" cannot be distinguished from general intelligence: two variations on a single theme within a symphony of latent variance. Front Behav Neurosci 2014; 8:369. [PMID: 25386125 PMCID: PMC4208406 DOI: 10.3389/fnbeh.2014.00369] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 10/06/2014] [Indexed: 11/16/2022] Open
Abstract
The empirical foundation of executive control function (ECF) remains controversial. We have employed structural equation models (SEM) to explicitly distinguish domain-specific variance in executive function (EF) performance from memory (MEM) and shared cognitive performance variance, i.e., Spearman's “g.” EF does not survive adjustment for both MEM and g in a well fitting model of data obtained from non-demented older persons (N = 193). Instead, the variance in putative EF measures is attributable only to g, and related to functional status only through a fraction of that construct (i.e., “d”). d is a homolog of the latent variable δ, which we have previously associated specifically with the Default Mode Network (DMN). These findings undermine the validity of EF and its putative association with the frontal lobe. ECF may have no existence independent of general intelligence, and no functionally salient association with the frontal lobe outside of that structure's contribution to the DMN.
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Affiliation(s)
- Donald R Royall
- Department of Psychiatry, The University of Texas Health Science Center, San Antonio San Antonio, TX, USA ; Department of Medicine, The University of Texas Health Science Center, San Antonio San Antonio, TX, USA ; Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio San Antonio, TX, USA ; The South Texas Veterans' Health System Audie L. Murphy Division, Geriatric Research Education and Clinical Center San Antonio, TX, USA
| | - Raymond F Palmer
- Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio San Antonio, TX, USA
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Royall DR, Palmer RF, Chiodo LK, Polk MJ. Towards an Aging-Specific Cognitive Phenotype: The Freedom House Study. Exp Aging Res 2014; 40:245-65. [DOI: 10.1080/0361073x.2014.896665] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dixon RA, de Frias CM. Cognitively elite, cognitively normal, and cognitively impaired aging: neurocognitive status and stability moderate memory performance. J Clin Exp Neuropsychol 2014; 36:418-30. [PMID: 24742143 DOI: 10.1080/13803395.2014.903901] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Although recent theories of brain and cognitive aging distinguish between normal, exceptional, and impaired groups, further empirical evidence is required. We adapted and applied standard procedures for classifying groups of cognitively impaired (CI) and cognitively normal (CN) older adults to a third classification: cognitively healthy, exceptional, or elite (CE) aging. We then examined concurrent and two-wave longitudinal performance on composite variables of episodic, semantic, and working memory. METHOD We began with a two-wave source sample from the Victoria Longitudinal Study (VLS; source n = 570; baseline age = 53-90 years). The goals were to: (a) apply standard and objective classification procedures to discriminate three cognitive status groups, (b) conduct baseline comparisons of memory performance, (c) develop two-wave status stability and change subgroups, and (d) compare of stability subgroup differences in memory performance and change. RESULTS As expected, the CE group performed best on all three memory composites. Similarly, expected status stability effects were observed: (a) stable CE and CN groups performed memory tasks better than their unstable counterparts, and (b) the stable (and chronic) CI group performed worse than its unstable (variable) counterpart. These stability group differences were maintained over two waves. CONCLUSION New data validate the expectations that (a) objective clinical classification procedures for cognitive impairment can be adapted for detecting cognitively advantaged older adults, and (b) performance in three memory systems is predictably related to the tripartite classification.
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Affiliation(s)
- Roger A Dixon
- a Department of Psychology , University of Alberta , Edmonton , AB , Canada
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Dhamoon MS, Moon YP, Paik MC, Sacco RL, Elkind MSV. Diabetes predicts long-term disability in an elderly urban cohort: the Northern Manhattan Study. Ann Epidemiol 2014; 24:362-368.e1. [PMID: 24485410 DOI: 10.1016/j.annepidem.2013.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 12/11/2013] [Accepted: 12/24/2013] [Indexed: 02/04/2023]
Abstract
PURPOSE There are limited data on vascular predictors of long-term disability in Hispanics. We hypothesized that (1) functional status declines over time and (2) vascular risk factors predict functional decline. METHODS The Northern Manhattan Study contains a population-based study of 3298 stroke-free individuals aged 40 years or older, followed for median 11 years. The Barthel Index (BI) was assessed annually. Generalized estimating equations and Cox models were adjusted for demographic, medical, and social risk factors. Stroke and myocardial infarction occurring during follow-up were censored in sensitivity analysis. Secondarily, motor and nonmotor domains of the BI were analyzed. RESULTS Mean age (standard deviation) of the cohort (n = 3298) was 69.2 (10) years, 37% were male, 52% Hispanic, 22% diabetic, and 74% hypertensive. There was a mean annual decline of 1.02 BI points (P < .0001). Predictors of decline in BI included age, female sex, diabetes, depression, and normocholesterolemia. Results did not change with censoring. We found similar predictors of BI for motor and nonmotor domains. CONCLUSION In this large, population-based, multiethnic study with long-term follow-up, we found a 1% mean decline in function per year that did not change when vascular events were censored. Diabetes predicted functional decline in the absence of clinical vascular events.
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Affiliation(s)
- Mandip S Dhamoon
- Department of Neurology, Mount Sinai School of Medicine, New York, NY.
| | - Yeseon Park Moon
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Myunghee C Paik
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Ralph L Sacco
- Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, FL; Department of Public Health Sciences and Human Genetics, Miller School of Medicine, University of Miami, FL; Department of Human Genetics, Miller School of Medicine, University of Miami, FL
| | - Mitchell S V Elkind
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
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Abstract
OBJECTIVE To examine basic and everyday cognitive predictors of older adults' self-reported instrumental activities of daily living (IADL). METHOD Basic and everyday cognitive predictors of self-reported IADL were examined in a sample of healthy, community-dwelling older adults (n = 698) assessed over 5 years of measurement. RESULTS Multilevel longitudinal analyses revealed linear and quadratic change trends for self-reported IADL function, with steeper declines at higher ages. Within-person, when participants exhibited lower cognitive performance, they also reported more IADL impairment. Everyday cognition remained a significant unique predictor of self-reported IADL after controlling for attrition, resampling effects, temporal gradients, and baseline levels and changes in demographic, sensory, functional, and basic cognitive measures. DISCUSSION By itself, everyday cognition appears to be an important predictor of self-reported IADL, and maintains a unique predictive contribution after many covariates are controlled. Future research should consider the inclusion of everyday cognitive measures in functional assessment batteries.
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Affiliation(s)
- Anna Yam
- University of Florida, Gainesville, FL, USA
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Tumkaya S, Karadag F, Mueller ST, Ugurlu TT, Oguzhanoglu NK, Ozdel O, Atesci FC, Bayraktutan M. Situation awareness in obsessive-compulsive disorder. Psychiatry Res 2013; 209:579-88. [PMID: 23537845 DOI: 10.1016/j.psychres.2013.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 02/04/2013] [Accepted: 02/07/2013] [Indexed: 11/25/2022]
Abstract
Past studies have suggested that OCD patients suffer memory impairment on tasks using complex stimuli that require memory for combined elements to be maintained, but not for more simplistic memory tests. We tested this with 42 OCD patients and 42 healthy controls performed a computerized situation awareness task. In addition, participants completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Maudsley Obsessive-Compulsive Inventory (MOCI). The OCD patients had poorer accuracy in integration/comprehension and perception levels than controls. There were significant correlations between situational awareness scores (i.e., visuo-spatial monitoring and processing) and Y-BOCS obsession-compulsion and slowness and doubt scores of MOCI in OCD patients. In addition, there were also significant correlations between situational awareness and controlling, cleaning, slowness, rumination and total scores of MOCI in control group. Results indicated that (I) OCD patients have problems of perception, integration, and comprehension of complex visual perceptions; (II) situation awareness deficits associated with severity and prevalence of obsessions and compulsions.
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Affiliation(s)
- Selim Tumkaya
- Pamukkale University Medicine Faculty Psychiatry Department, Doktorlar Cd, 20100 Denizli, Turkey.
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Serrani Azcurra D. Spanish translation and validation of an Executive Battery 25 (EB25) and its shortened version (ABE12) for executive dysfunction screening in dementia. NEUROLOGÍA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.nrleng.2013.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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