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Mather MA, Ho EH, Bedjeti K, Karpouzian-Rogers T, Rogalski EJ, Gershon R, Weintraub S. Measuring Multidimensional Aspects of Health in the Oldest Old Using the NIH Toolbox: Results From the ARMADA Study. Arch Clin Neuropsychol 2024; 39:535-546. [PMID: 38216151 PMCID: PMC11269891 DOI: 10.1093/arclin/acad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/27/2023] [Accepted: 11/20/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE The percentage of older adults living into their 80s and beyond is expanding rapidly. Characterization of typical cognitive performance in this population is complicated by a dearth of normative data for the oldest old. Additionally, little attention has been paid to other aspects of health, such as motor, sensory, and emotional functioning, that may interact with cognitive changes to predict quality of life and well-being. The current study used the NIH Toolbox (NIHTB) to determine age group differences between persons aged 65-84 and 85+ with normal cognition. METHOD Participants were recruited in two age bands (i.e., 65-84 and 85+). All participants completed the NIHTB Cognition, Motor, Sensation, and Emotion modules. Independent-samples t-tests determined age group differences with post-hoc adjustments using Bonferroni corrections. All subtest and composite scores were then regressed on age and other demographic covariates. RESULTS The 65-84 group obtained significantly higher scores than the 85+ group across all cognitive measures except oral reading, all motor measures except gait speed, and all sensation measures except pain interference. Age remained a significant predictor after controlling for covariates. Age was not significantly associated with differences in emotion scores. CONCLUSIONS Results support the use of the NIHTB in persons over 85 with normal cognition. As expected, fluid reasoning abilities and certain motor and sensory functions decreased with age in the oldest old. Inclusion of motor and sensation batteries is warranted when studying trajectories of aging in the oldest old to allow for multidimensional characterization of health.
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Affiliation(s)
- Molly A Mather
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily H Ho
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katy Bedjeti
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tatiana Karpouzian-Rogers
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Richard Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Shankar A, Tanner JC, Mao T, Betzel RF, Prakash RS. Edge-Community Entropy Is a Novel Neural Correlate of Aging and Moderator of Fluid Cognition. J Neurosci 2024; 44:e1701232024. [PMID: 38719449 PMCID: PMC11209649 DOI: 10.1523/jneurosci.1701-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 02/28/2024] [Accepted: 03/27/2024] [Indexed: 06/21/2024] Open
Abstract
Decreased neuronal specificity of the brain in response to cognitive demands (i.e., neural dedifferentiation) has been implicated in age-related cognitive decline. Investigations into functional connectivity analogs of these processes have focused primarily on measuring segregation of nonoverlapping networks at rest. Here, we used an edge-centric network approach to derive entropy, a measure of specialization, from spatially overlapping communities during cognitive task fMRI. Using Human Connectome Project Lifespan data (713 participants, 36-100 years old, 55.7% female), we characterized a pattern of nodal despecialization differentially affecting the medial temporal lobe and limbic, visual, and subcortical systems. At the whole-brain level, global entropy moderated declines in fluid cognition across the lifespan and uniquely covaried with age when controlling for the network segregation metric modularity. Importantly, relationships between both metrics (entropy and modularity) and fluid cognition were age dependent, although entropy's relationship with cognition was specific to older adults. These results suggest entropy is a potentially important metric for examining how neurological processes in aging affect functional specialization at the nodal, network, and whole-brain level.
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Affiliation(s)
- Anita Shankar
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210
| | - Jacob C Tanner
- Cognitive Science Program, Indiana University, Bloomington, Indiana 47401
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, Indiana 47401
| | - Tianrui Mao
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210
| | - Richard F Betzel
- Cognitive Science Program, Indiana University, Bloomington, Indiana 47401
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana 47401
- Program in Neuroscience, Indiana University, Bloomington, Indiana 47401
- Network Science Institute, Indiana University, Bloomington, Indiana 47401
| | - Ruchika S Prakash
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210
- Center for Cognitive and Behavioral Brain Imaging, The Ohio State University, Columbus, Ohio 43210
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Tyner CE, Boulton AJ, Slotkin J, Cohen ML, Weintraub S, Gershon RC, Tulsky DS. Exploring symptom clusters in mild cognitive impairment and dementia with the NIH Toolbox. J Int Neuropsychol Soc 2024:1-12. [PMID: 38361424 DOI: 10.1017/s1355617724000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Symptom clustering research provides a unique opportunity for understanding complex medical conditions. The objective of this study was to apply a variable-centered analytic approach to understand how symptoms may cluster together, within and across domains of functioning in mild cognitive impairment (MCI) and dementia, to better understand these conditions and potential etiological, prevention, and intervention considerations. METHOD Cognitive, motor, sensory, emotional, and social measures from the NIH Toolbox were analyzed using exploratory factor analysis (EFA) from a dataset of 165 individuals with a research diagnosis of either amnestic MCI or dementia of the Alzheimer's type. RESULTS The six-factor EFA solution described here primarily replicated the intended structure of the NIH Toolbox with a few deviations, notably sensory and motor scores loading onto factors with measures of cognition, emotional, and social health. These findings suggest the presence of cross-domain symptom clusters in these populations. In particular, negative affect, stress, loneliness, and pain formed one unique symptom cluster that bridged the NIH Toolbox domains of physical, social, and emotional health. Olfaction and dexterity formed a second unique cluster with measures of executive functioning, working memory, episodic memory, and processing speed. A third novel cluster was detected for mobility, strength, and vision, which was considered to reflect a physical functioning factor. Somewhat unexpectedly, the hearing test included did not load strongly onto any factor. CONCLUSION This research presents a preliminary effort to detect symptom clusters in amnestic MCI and dementia using an existing dataset of outcome measures from the NIH Toolbox.
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Affiliation(s)
- Callie E Tyner
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | - Aaron J Boulton
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | - Jerry Slotkin
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | - Matthew L Cohen
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
- Department of Communication Sciences & Disorders, University of Delaware, Newark, DE, USA
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark, DE, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Richard C Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
- Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
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Ho BD, Gullett JM, Anton S, Franchetti MK, Bharadwaj PK, Raichlen DA, Alexander GE, Rundek T, Levin B, Visscher K, Woods AJ, Cohen RA. Associations between physical exercise type, fluid intelligence, executive function, and processing speed in the oldest-old (85 +). GeroScience 2024; 46:491-503. [PMID: 37523033 PMCID: PMC10828155 DOI: 10.1007/s11357-023-00885-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND While much is known about the effects of physical exercise in adult humans, literature on the oldest-old (≥ 85 years old) is sparse. The present study explored the relationship between self-reported engagement in physical exercise and cognition in the oldest-old. METHODS The sample included 184 cognitively healthy participants (98 females, MoCA mean score = 24.81) aged 85 to 99 years old (mean = 88.49 years). Participants completed the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and a cognitive battery including NIH-TB, Coding, Symbol Search, Letter Fluency, and Stroop task. Three groups of participants - sedentary (n = 58; MoCA mean score = 24; 36 females; mean age = 89.03), cardio (n = 60; MoCA mean score = 25.08; 29 females; mean age = 88.62), and cardio + strength training (n = 66; MoCA mean score = 25.28; 33 females; mean age = 87.91) - were derived from responses on CHAMPS. RESULTS Analyses controlled for years of education, NIH-TB Crystallized Composite, and metabolic equivalent of tasks. The cardio + strength training group had the highest cognitive performances overall and scored significantly better on Coding (p < 0.001) and Symbol Search (p < 0.05) compared to the sedentary group. The cardio + strength training group scored significantly better on Symbol Search, Letter Fluency, and Stroop Color-Word compared to the cardio group (p < 0.05). CONCLUSIONS Our findings suggest self-reported exercise in the oldest-old is linked to better performance on cognitive measures of processing speed and executive functioning, and that there may be a synergistic effect of combining aerobic and resistance training on cognition.
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Affiliation(s)
- Brian Duy Ho
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
| | - Joseph M Gullett
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Stephen Anton
- Institute On Aging, University of Florida, Gainesville, FL, USA
| | | | | | - David A Raichlen
- Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Gene E Alexander
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Tatjana Rundek
- Evelyn F. McKnight Brain Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Bonnie Levin
- Evelyn F. McKnight Brain Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Kristina Visscher
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Ronald A Cohen
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
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Park KS, Buseth L, Hong J, Etnier JL. Music-based multicomponent exercise training for community-dwelling older adults with mild-to-moderate cognitive decline: a feasibility study. Front Med (Lausanne) 2023; 10:1224728. [PMID: 37671396 PMCID: PMC10475546 DOI: 10.3389/fmed.2023.1224728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/24/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction This study explored the feasibility and preliminary efficacy of a music-based, multicomponent exercise intervention among community-dwelling older adults with mild-to-moderate cognitive impairment. Methods 16 older adults aged 85±9 years with mild-to-moderate cognitive impairment received music-based multicomponent exercise training for 20 weeks at an independent living facility. Participants received aerobic, resistance, and balance training paired with beat-accentuated music stimulation. Participants' adherence to the training was tracked down and their cognitive and physical functioning and health-related quality of life were assessed at pre- and post-test. Results 3 participants withdrew due to unexpected issues unrelated to the intervention and thus 13 participants (7 females) attended an average of 4.6 days/week over 20 weeks and reported high satisfaction with the intervention (90.6%). Participants showed significant improvement in global cognition, cognitive processing speed, and walking endurance/aerobic fitness at post-test. Discussion These findings support the feasibility of music-based, multicomponent exercise training for older adults in an independent living facility and set the stage for future studies to test the efficacy of music on physical activity and ensuing health outcomes. We conclude that music-based, multicomponent exercise training can be beneficial for community-dwelling older adults with mild-to-moderate cognitive decline. As a form of rhythmic auditory stimulation, beat-accentuated music can be combined with exercise training to manipulate exercise tempo and may provide a source of motivation to help older adults adhere to exercise.
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Affiliation(s)
- Kyoung Shin Park
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Lake Buseth
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jiyeong Hong
- Freelance Musician, Greensboro, NC, United States
| | - Jennifer L. Etnier
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States
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