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Martinec Nováková L, Georgi H, Vlčková K, Kopeček M, Babuská A, Havlíček J. Small effects of olfactory identification and discrimination on global cognitive and executive performance over 1 year in aging people without a history of age-related cognitive impairment. Physiol Behav 2024; 282:114579. [PMID: 38710351 DOI: 10.1016/j.physbeh.2024.114579] [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: 01/25/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/08/2024]
Abstract
Olfactory and cognitive performance share neural correlates profoundly affected by physiological aging. However, whether odor identification and discrimination scores predict global cognitive status and executive function in healthy older people with intact cognition is unclear. Therefore, in the present study, we set out to elucidate these links in a convenience sample of 204 independently living, cognitively intact healthy Czech adults aged 77.4 ± 8.7 (61-97 years) over two waves of data collection (one-year interval). We used the Czech versions of the Montreal Cognitive Assessment (MoCA) to evaluate global cognition, and the Prague Stroop Test (PST), Trail Making Test (TMT), and several verbal fluency (VF) tests to assess executive function. As a subsidiary aim, we aimed to examine the contribution of olfactory performance towards achieving a MoCA score above vs. below the published cut-off value. We found that the MoCA scores exhibited moderate associations with both odor identification and discrimination. Furthermore, odor identification significantly predicted PST C and C/D scores. Odor discrimination significantly predicted PST C/D, TMT B/A, and standardized composite VF scores. Our findings demonstrate that olfaction, on the one hand, and global cognition and executive function, on the other, are related even in healthy older people.
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Affiliation(s)
- Lenka Martinec Nováková
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Pátkova 2137/5, 182 00 Prague 8 - Libeň, Czech Republic; Department of Chemical Education and Humanities, University of Chemistry and Technology, Prague, Technická 5, 166 28 Prague 6 - Dejvice, Czech Republic.
| | - Hana Georgi
- Prague College of Psychosocial Studies, Hekrova 805, 149 00 Prague 4, Czech Republic
| | - Karolína Vlčková
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10 - Vršovice, Czech Republic; Thomayer Teaching Hospital, Vídeňská 800, 140 59 Prague 4 - Krč, Czech Republic
| | - Miloslav Kopeček
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10 - Vršovice, Czech Republic; National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
| | - Anna Babuská
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 00 Prague 2, Czech Republic
| | - Jan Havlíček
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 00 Prague 2, Czech Republic
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Mejía-Guevara I, Periyakoil VS. Diverging Patterns of Cognitive Decline by Sex and Race-Ethnicity in Seriously Ill Older Americans. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.27.24309609. [PMID: 38978668 PMCID: PMC11230332 DOI: 10.1101/2024.06.27.24309609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Objectives Differences in Cognitive decline are common in older adults in the last years of life, but differences across sex and race-ethnicity are poorly understood. This study investigated if sex and/or race-ethnicity moderated changes in cognitive function in older adults in the last years of life. Methods Data from the Health and Retirement Study (HRS) from 1993 to 2016 were used to analyze imputed cognition summary scores for total word recall and mental status of older adults aged 60-99. Loss of cognitive function was estimated using a multilevel mixed-effects model and accelerated cognitive decline was approximated by incorporating a change-point model using a restricted sample of decedent respondents who died aged 65-99. Results Notable disparities were seen in the rates of cognitive decline across sex and race-ethnic groups in the last years of life. Women consistently scored lower than men in word recall but higher in mental status, regardless of race-ethnicity. Non-Hispanic White respondents, men and women, consistently outperformed Hispanic and Black respondents in word recall tasks and mental status. Conclusions Our study shows that sex and race-ethnicity moderate cognitive decline in older adults during the last years of life. Older adults from underserved communities are at higher risk of cognitive decline. Our study could inform clinical practice and policy focused on mitigating the adverse impact of cognitive decline experienced by marginalized populations of older adults in the last years of life.
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Rajagopal SK, Beltz AM, Hampstead BM, Polk TA. Estimating individual trajectories of structural and cognitive decline in mild cognitive impairment for early prediction of progression to dementia of the Alzheimer's type. Sci Rep 2024; 14:12906. [PMID: 38839800 PMCID: PMC11153588 DOI: 10.1038/s41598-024-63301-7] [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: 12/27/2023] [Accepted: 05/27/2024] [Indexed: 06/07/2024] Open
Abstract
Only a third of individuals with mild cognitive impairment (MCI) progress to dementia of the Alzheimer's type (DAT). Identifying biomarkers that distinguish individuals with MCI who will progress to DAT (MCI-Converters) from those who will not (MCI-Non-Converters) remains a key challenge in the field. In our study, we evaluate whether the individual rates of loss of volumes of the Hippocampus and entorhinal cortex (EC) with age in the MCI stage can predict progression to DAT. Using data from 758 MCI patients in the Alzheimer's Disease Neuroimaging Database, we employ Linear Mixed Effects (LME) models to estimate individual trajectories of regional brain volume loss over 12 years on average. Our approach involves three key analyses: (1) mapping age-related volume loss trajectories in MCI-Converters and Non-Converters, (2) using logistic regression to predict progression to DAT based on individual rates of hippocampal and EC volume loss, and (3) examining the relationship between individual estimates of these volumetric changes and cognitive decline across different cognitive functions-episodic memory, visuospatial processing, and executive function. We find that the loss of Hippocampal volume is significantly more rapid in MCI-Converters than Non-Converters, but find no such difference in EC volumes. We also find that the rate of hippocampal volume loss in the MCI stage is a significant predictor of conversion to DAT, while the rate of volume loss in the EC and other additional regions is not. Finally, individual estimates of rates of regional volume loss in both the Hippocampus and EC, and other additional regions, correlate strongly with individual rates of cognitive decline. Across all analyses, we find significant individual variation in the initial volumes and the rates of changes in volume with age in individuals with MCI. This study highlights the importance of personalized approaches in predicting AD progression, offering insights for future research and intervention strategies.
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Affiliation(s)
| | - Adriene M Beltz
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin M Hampstead
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Thad A Polk
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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Divandari N, Bird ML, Vakili M, Jaberzadeh S. The association between dynamic balance and executive function: Which dynamic balance test has the strongest association with executive function? A systematic review and meta-analysis. Curr Neurol Neurosci Rep 2024; 24:151-161. [PMID: 38730213 PMCID: PMC11143012 DOI: 10.1007/s11910-024-01340-3] [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] [Accepted: 04/02/2024] [Indexed: 05/12/2024]
Abstract
AIM The aging global population poses increasing challenges related to falls and dementia. Early identification of cognitive decline, particularly before noticeable symptoms manifest, is crucial for effective intervention. This review aims to determine the dynamic balance test most closely associated with executive function, potentially serving as a biomarker for cognitive decline. RECENT FINDINGS Based on recent reviews, inhibitory control, a component of executive function, holds significance in influencing balance performance. Studies suggest that the strength of the correlation between cognition and balance tends to be domain-specific and task-specific. Despite these findings, inconclusive evidence remains regarding the connection between executive function and various dynamic balance assessments. Our review identifies a significant association between all dynamic balance tests and executive function, albeit with varying strengths. Notably, a medium effect size is observed for the Timed Up and Go and Functional Reach Test, a small effect size for balance scales, and a strong effect size for postural sway. This review underscores a clear relationship between dynamic balance task performance and executive function. Dynamic posturography holds potential as a clinical biomarker for early detection of cognitive decline, with a note of caution due to observed heterogeneity and limited studies.
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Affiliation(s)
- Nahid Divandari
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia.
| | - Marie-Louise Bird
- School of Health Sciences, University of Tasmania, Newnham Tasmania, 7248, Australia
| | | | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia
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Tokaj A, Lehrner J. Drawing a line?-Visuo-constructive function as discriminator between healthy individuals, subjective cognitive decline, mild cognitive impairment and Alzheimer's disease and predictor of disease progress compared to a multimodal approach. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:71-81. [PMID: 36723802 PMCID: PMC11143003 DOI: 10.1007/s40211-022-00455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/16/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE One cognitive domain impaired in Alzheimer's disease (AD) is visuo-construction. The Vienna Visuo-constructional Test 3.0 Screening (VVT 3.0 Screening) measures this cognitive domain. This study examines how it works in the differentiation of AD from healthy controls (HC) and the prodromal stages subjective cognitive decline (SCD) and mild cognitive impairment (MCI) and also how it performs in prediction of progress compared to the Mini Mental State Examination (MMSE) and the Sunderland Clock Drawing Test (CDT). METHODS Data from 622 patients (33 HC, 68 SCD, 301 MCI, 220 AD) who completed all three tests were obtained. Furthermore, 117 patients were examined in a follow-up. Data were analyzed in a retrospective analysis comparing the validity of tests in diagnosis and prediction using receiver operator characteristic (ROC) curves and multinominal logistic regression. RESULTS The VVT 3.0 Screening shows some ability to discriminate between AD and all other participants (sensitivity: 62.1%, specificity: 83.1%), while of the three examined tests none was able to predict membership to all experimental groups or to predict disease-progress adequately. As the VVT 3.0 Screening is short, easy to apply and largely language independent, it can be considered an alternative to the MMSE in certain situations. CONCLUSIONS The VVT 3.0 Screening is useful to discriminate between AD and all other participants and can be an alternative to the MMSE in certain situations.
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Affiliation(s)
- Amelie Tokaj
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria.
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Jonaitis EM, Hermann BP, Mueller KD, Clark LR, Du L, Betthauser TJ, Cody K, Gleason CE, Christian BT, Asthana S, Chappell RJ, Chin NA, Johnson SC, Langhough RE. Longitudinal normative standards for cognitive tests and composites using harmonized data from two Wisconsin AD-risk-enriched cohorts. Alzheimers Dement 2024; 20:3305-3321. [PMID: 38539269 PMCID: PMC11095443 DOI: 10.1002/alz.13774] [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: 11/09/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Published norms are typically cross-sectional and often are not sensitive to preclinical cognitive changes due to dementia. We developed and validated demographically adjusted cross-sectional and longitudinal normative standards using harmonized outcomes from two Alzheimer's disease (AD) risk-enriched cohorts. METHODS Data from the Wisconsin Registry for Alzheimer's Prevention and the Wisconsin Alzheimer's Disease Research Center were combined. Quantile regression was used to develop unconditional (cross-sectional) and conditional (longitudinal) normative standards for 18 outcomes using data from cognitively unimpaired participants (N = 1390; mean follow-up = 9.25 years). Validity analyses (N = 2456) examined relationships between percentile scores (centiles), consensus-based cognitive statuses, and AD biomarker levels. RESULTS Unconditional and conditional centiles were lower in those with consensus-based impairment or biomarker positivity. Similarly, quantitative biomarker levels were higher in those whose centiles suggested decline. DISCUSSION This study presents normative standards for cognitive measures sensitive to pre-clinical changes. Future directions will investigate potential clinical applications of longitudinal normative standards. HIGHLIGHTS Quantile regression was used to construct longitudinal norms for cognitive tests. Poorer percentile scores were related to concurrent diagnosis and Alzheimer's disease biomarkers. A ShinyApp was built to display test scores and norms and flag low performance.
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Affiliation(s)
- Erin M. Jonaitis
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Bruce P. Hermann
- Department of NeurologySchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Kimberly D. Mueller
- Department of Communication Sciences and DisordersUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Lindsay R. Clark
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
| | - Lianlian Du
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Karly Cody
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Carey E. Gleason
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Bradley T. Christian
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Waisman CenterUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of Medical PhysicsSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Richard J. Chappell
- Department of StatisticsSchool of ComputerData and Information SciencesUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of Biostatistics and Medical InformaticsSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Rebecca E. Langhough
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
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Siennicki-Lantz A, André-Petersson L, Elmståhl S. Longitudinal trajectories of cognitive decline and cerebral blood flow abnormalities in octogenarian men with normal global cognition. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100220. [PMID: 38523604 PMCID: PMC10957372 DOI: 10.1016/j.cccb.2024.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
Aims Cognitive and perfusion changes have been previously observed in older men with Mini Mental State Examination scores>24 points. We aimed to investigate time change in cognitive domains in a cohort of non-demented men between age 68 and 82, and how they are expressed in regional defects estimated by Cerebral Blood Flow (rCBF). Methods 103 men at age 81 with MMSE scores >24 (mean 28.4 ± 1.7), no dementia or stroke, were examined with the same cognitive test battery at age 68 and age 81: Synonyms (SRB-1), Block design (SRB-3), Paired Associates, Digit Symbol Substitution and Benton Visual Retention test. rCBF was estimated using 99mTc-HMPAO SPECT at age 82. Results Between ages 68 and 82 we observed a relative decline (Δ%) of cognitive test scores: SRB-3 and Benton tests, -33.7 % (SD 16,8) and -25.8 % (SD 23.9) respectively, followed by Digit Symbol test: -22,6 % (SD 15,6). The cluster of men (46 %) could be detected, grouped on the largest test score decline and highest overall test predictors' importance in decreasing order: Δ% SRB-3, Δ% Paired Associates, Δ% Digit Symbol, Δ% Benton VR and Δ% SRB-1. Compared to the cluster with stable cognitive functions, it expressed lower rCBF in frontal and parietal lobes, and in subcortical areas. Conclusion Nearly half of the studied, community-dwelling cohort of non-demented, octogenarian men with MMSE > 24, had a combination of decreasing visuospatial ability and episodic memory during preceding years, expressed by widespread rCBF changes in fronto-subcortical areas.
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Affiliation(s)
- Arkadiusz Siennicki-Lantz
- Section of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, SWEDEN
| | - Lena André-Petersson
- Section of Neurology, Department of Clinical Sciences in Malmö, Lund University, Malmö, SWEDEN
| | - Sölve Elmståhl
- Section of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, SWEDEN
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Páez A, Frimpong E, Mograss M, Dang-Vu TT. The effectiveness of exercise interventions targeting sleep in older adults with cognitive impairment or Alzheimer's disease and related dementias (AD/ADRD): A systematic review and meta-analysis. J Sleep Res 2024:e14189. [PMID: 38462491 DOI: 10.1111/jsr.14189] [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: 11/09/2023] [Revised: 01/30/2024] [Accepted: 02/16/2024] [Indexed: 03/12/2024]
Abstract
Sleep loss is associated with reduced health and quality of life, and increased risk of Alzheimer's disease and related dementias. Up to 66% of persons with Alzheimer's disease and related dementias experience poor sleep, which can predict or accelerate the progression of cognitive decline. Exercise is a widely accessible intervention for poor sleep that can protect against functional and cognitive decline. No previous systematic reviews have investigated the effectiveness of exercise for sleep in older adults with mild cognitive impairment or Alzheimer's disease and related dementias. We systematically reviewed controlled interventional studies of exercise targeting subjectively or objectively (polysomnography/actigraphy) assessed sleep in persons with mild cognitive impairment or Alzheimer's disease and related dementias. We conducted searches in PubMed, Embase, Scopus and Cochrane-Library (n = 6745). Nineteen randomised and one non-randomised controlled interventional trials were included, representing the experiences of 3278 persons with mild cognitive impairment or Alzheimer's disease and related dementias. Ten had low-risk, nine moderate-risk, and one high-risk of bias. Six studies with subjective and eight with objective sleep outcomes were meta-analysed (random-effects model). We found moderate- to high-quality evidence for the beneficial effects of exercise on self-reported and objectively-measured sleep outcomes in persons with mild cognitive impairment or Alzheimer's disease and related dementias. However, no studies examined key potential moderators of these effects, such as sex, napping or medication use. Our results have important implications for clinical practice. Sleep may be one of the most important modifiable risk factors for a range of health conditions, including cognitive decline and the progression of Alzheimer's disease and related dementias. Given our findings, clinicians may consider adding exercise as an effective intervention or adjuvant strategy for improving sleep in older persons with mild cognitive impairment or Alzheimer's disease and related dementias.
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Affiliation(s)
- Arsenio Páez
- Sleep, Cognition and Neuroimaging Laboratory, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Nuffield Department for Primary Care Health Sciences, University of Oxford, Oxford, UK
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, Quebec, Canada
| | - Emmanuel Frimpong
- Sleep, Cognition and Neuroimaging Laboratory, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Melodee Mograss
- Sleep, Cognition and Neuroimaging Laboratory, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Thien Thanh Dang-Vu
- Sleep, Cognition and Neuroimaging Laboratory, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, Quebec, Canada
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Wang XL, Feng HL, Xu XZ, Liu J, Han X. Relationship between cognitive function and weight-adjusted waist index in people ≥ 60 years old in NHANES 2011-2014. Aging Clin Exp Res 2024; 36:30. [PMID: 38334839 PMCID: PMC10857983 DOI: 10.1007/s40520-023-02649-8] [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: 08/03/2023] [Accepted: 12/04/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Widespread attention has been given to the detrimental effects of obesity on cognitive function. However, there is no evidence on the connection between low cognitive performance and the WWI (weight-adjusted waist index). This study looked into the connection between poor cognitive performance and the WWI in senior Americans. METHODS A cross-sectional research study was carried out with information from the NHANES 2011-2014. With multivariate linear regression models, the pertinence between the WWI and low cognitive function in persons older than 60 years was examined. The nonlinear link was described using threshold effect analyses and fitted smoothed curves. Interaction tests and subgroup analysis were also conducted. RESULTS The study had 2762 individuals in all, and subjects with higher WWI values were at greater risk for low cognitive function. In the completely adjusted model, the WWI was positively connected with low cognitive performance assessed by CERAD W-L (OR = 1.22, 95% CI 1.03-1.45, p = 0.0239), AFT (OR = 1.30, 95% CI 1.09-1.54, p = 0.0029), and DSST (OR = 1.59, 95% CI 1.30-1.94, p < 0.0001). The effect of each subgroup on the positive correlation between the WWI and low cognitive performance was not significant. The WWI and low cognitive performance as determined by CERAD W-L and AFT had a nonlinear connection (log-likelihood ratio < 0.05). CONCLUSION Among older adults in the United States, the risk of low cognitive performance may be positively related to the WWI.
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Affiliation(s)
- Xue-Li Wang
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hong-Lin Feng
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiao-Zhuo Xu
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Liu
- First Clinic Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xu Han
- Geriatric Department, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, China.
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Park S, Park KH, Han W. The Effects of Music-Based Auditory Training on Hearing-Impaired Older Adults With Mild Cognitive Impairment. Clin Exp Otorhinolaryngol 2024; 17:26-36. [PMID: 38062716 PMCID: PMC10933806 DOI: 10.21053/ceo.2023.00815] [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: 06/13/2023] [Revised: 11/04/2023] [Accepted: 12/08/2023] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVES The present study aimed to determine the effect of music-based auditory training on older adults with hearing loss and decreased cognitive ability, which are common conditions in the older population. METHODS In total, 20 older adults diagnosed with both mild-to-moderately severe hearing loss and mild cognitive impairment (MCI) participated. Half of this group were randomly assigned to the auditory training group (ATG), and the other half were designated as the control group (CG). For the ATG, a 40-minute training session (10 minutes for singing a song, 15 minutes for playing instruments, and 15 minutes for playing games with music discrimination) was conducted twice a week for 8 weeks (for a total of 16 sessions). To confirm the training effects, all participants were given tests pre- and post-training, and then a follow-up test was administered 2 weeks after the training, using various auditory and cognitive tests and a self-reporting questionnaire. RESULTS The ATG demonstrated significant improvement in all auditory test scores compared to the CG. Additionally, there was a notable enhancement in cognitive test scores post-training, except for the digit span tests. However, there was no statistically significant difference in the questionnaire scores between the two groups, although the ATG did score higher post-training. CONCLUSION The music-based auditory training resulted in a significant improvement in auditory function and a partial enhancement in cognitive ability among elderly patients with hearing loss and MCI. We anticipate that this music-based approach will be adopted for auditory training in clinical settings due to its engaging and easy-to-follow nature.
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Affiliation(s)
- Sihun Park
- Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea
| | - Kyoung Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woojae Han
- Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea
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Pourhadi N, Janbek J, Jensen‐Dahm C, Gasse C, Laursen TM, Waldemar G. Proton pump inhibitors and dementia: A nationwide population-based study. Alzheimers Dement 2024; 20:837-845. [PMID: 37795826 PMCID: PMC10917029 DOI: 10.1002/alz.13477] [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: 04/20/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Proton pump inhibitors (PPIs) may increase dementia risk. However, it is currently unknown whether timing of exposure or age at dementia diagnosis influence the risk. METHODS We assessed associations between cumulative PPI use and dementia at different ages in a nationwide Danish cohort of 1,983,785 individuals aged 60 to 75 years between 2000 and 2018. RESULTS During follow-up, there were 99,384 all-cause dementia incidences. Incidence rate ratio (IRR) of dementia with PPI ever-use compared with never-use was 1.36 (95% CI, 1.29 to 1.43) for age 60 to 69 years at diagnosis, 1.12 (1.09 to 1.15) for 70 to 79 years, 1.06 (1.03 to 1.09) for 80 to 89 years, and 1.03 (0.91 to 1.17) for 90+ years. Longer treatment duration yielded increasing IRRs. For cases below 90 years, increased dementia rate was observed regardless of treatment initiation up to >15 years before diagnosis. DISCUSSION Regardless of timing of treatment initiation, PPI use was associated with increased dementia rate before age 90 years. Dementia rates increased with younger age at diagnosis. HIGHLIGHTS After following 1,983,785 individuals for a median of 10 years, 99,384 developed dementia PPIs were used by 21.2% of cases and 18.9% of controls PPI use was associated with increased dementia rate regardless of time of treatment onset Magnitude of associations increased with younger age at diagnosis PPI use was not associated with dementia occurring after age 90 years.
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Affiliation(s)
- Nelsan Pourhadi
- Danish Dementia Research CentreDepartment of NeurologyCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Janet Janbek
- Danish Dementia Research CentreDepartment of NeurologyCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Christina Jensen‐Dahm
- Danish Dementia Research CentreDepartment of NeurologyCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Christiane Gasse
- Department of Affective DisordersAarhus University Hospital PsychiatryAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Thomas Munk Laursen
- National Centre for Register‐Based ResearchAarhus UniversityAarhusDenmark
- Centre for Integrated Register‐based ResearchAarhus UniversityAarhusDenmark
| | - Gunhild Waldemar
- Danish Dementia Research CentreDepartment of NeurologyCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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12
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Stojanovic M, Mikula C, John S, Kiselica A. Clinical importance in Alzheimer's disease: effects of anchor agreement and disease severity. Aging Clin Exp Res 2024; 36:5. [PMID: 38265507 PMCID: PMC10808396 DOI: 10.1007/s40520-023-02643-0] [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: 06/02/2023] [Accepted: 12/14/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Methods of evaluating clinically meaningful decline are critical in research on Alzheimer's disease. A common method of quantifying clinically meaningful change is to calculate an anchor-based minimal clinically important difference (MCID) score. In this approach, individuals who report a meaningful change serve as the "anchors", and the mean level of change for this group serves as the MCID. In research on Alzheimer's disease, there are several possible anchors, including patients, knowledgeable observers (e.g., a family member), and clinicians. The goal of this study was to examine the extent to which agreement among anchors impacts MCID estimation and whether this relationship is moderated by cognitive severity status. METHODS Analyses were completed on a longitudinal sample of 2247 adults, aged 50-103, from the Uniform Data Set. Outcome measures included the Montreal Cognitive Assessment, Clinical Dementia Rating-Sum of Boxes, and Functional Activities Questionnaire. RESULTS For all of the outcomes, the MCID estimate was significantly higher when meaningful decline was endorsed by all of the anchors compared to when there was disagreement among the anchors. In addition, the MCID estimate was higher with increasing severity of cognitive impairment. Finally, cognitive severity status moderated the influence of agreement among anchors on MCID estimation; as disease severity increased, anchor agreement demonstrated less influence on the MCID. CONCLUSIONS MCID estimates based on one anchor may underestimate meaningful change, and researchers should consider the viewpoints of multiple anchors in constructing MCIDs, particularly in the early stages of cognitive decline.
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Affiliation(s)
- Marta Stojanovic
- Department of Psychological and Brain Sciences, Washington University in St. Louis, One Brookings Drive, Box 1125, St. Louis, MO, 63130, USA.
| | - Cynthia Mikula
- Institute of Human Nutrition, Columbia University, New York, NY, 10032, USA
| | - Samantha John
- Department of Brain Health, University of Nevada-Las Vegas, Las Vegas, Nevada, 89154, USA
| | - Andrew Kiselica
- Department of Health Psychology, University of Missouri-Columbia, Columbia, MO, 65211, USA
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13
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Stolz E, Mayerl H, Muniz-Terrera G, Gill TM. Terminal Decline in Physical Function in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glad119. [PMID: 37148208 PMCID: PMC10733182 DOI: 10.1093/gerona/glad119] [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: 11/21/2022] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND It is currently unclear whether (and when) physical function exhibits a terminal decline phase, that is, a substantial acceleration of decline in the very last years before death. METHODS 702 deceased adults aged 70 years and older from the Yale PEP Study provided 4 133 measurements of physical function (Short Physical Performance Battery, SPPB) up to 20 years before death. In addition, continuous gait and chair rise subtest scores (in seconds) were assessed. Generalized mixed regression models with random change points were used to estimate the onset and the steepness of terminal decline in physical function. RESULTS Decline accelerated in the last years of life in all 3 measures of physical function. The onset of terminal decline occurred 1 year before death for the SPPB, and at 2.5 and 2.6 years before death for chair rise and gait speed test scores, respectively. Terminal declines in physical function were 6-8 times steeper than pre-terminal declines. Relative to those whose condition leading to death was frailty, participants who died from dementia and cancer had an up to 6 months earlier and 3 months later onset of terminal decline in SPPB, respectively. CONCLUSIONS Terminal decline in physical function among older adults is comparable to the more established terminal decline phenomenon in cognition. Our results provide additional evidence of late-life rapid decline in physical function due to impending death.
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Affiliation(s)
- Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Hannes Mayerl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Graciela Muniz-Terrera
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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14
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Ferreira VR, Metting E, Schauble J, Seddighi H, Beumeler L, Gallo V. eHealth tools to assess the neurological function for research, in absence of the neurologist - a systematic review, part I (software). J Neurol 2024; 271:211-230. [PMID: 37847293 PMCID: PMC10770248 DOI: 10.1007/s00415-023-12012-6] [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: 06/28/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Neurological disorders remain a worldwide concern due to their increasing prevalence and mortality, combined with the lack of available treatment, in most cases. Exploring protective and risk factors associated with the development of neurological disorders will allow for improving prevention strategies. However, ascertaining neurological outcomes in population-based studies can be both complex and costly. The application of eHealth tools in research may contribute to lowering the costs and increase accessibility. The aim of this systematic review is to map existing eHealth tools assessing neurological signs and/or symptoms for epidemiological research. METHODS Four search engines (PubMed, Web of Science, Scopus & EBSCOHost) were used to retrieve articles on the development, validation, or implementation of eHealth tools to assess neurological signs and/or symptoms. The clinical and technical properties of the software tools were summarised. Due to high numbers, only software tools are presented here. FINDINGS A total of 42 tools were retrieved. These captured signs and/or symptoms belonging to four neurological domains: cognitive function, motor function, cranial nerves, and gait and coordination. An additional fifth category of composite tools was added. Most of the tools were available in English and were developed for smartphone device, with the remaining tools being available as web-based platforms. Less than half of the captured tools were fully validated, and only approximately half were still active at the time of data collection. INTERPRETATION The identified tools often presented limitations either due to language barriers or lack of proper validation. Maintenance and durability of most tools were low. The present mapping exercise offers a detailed guide for epidemiologists to identify the most appropriate eHealth tool for their research. FUNDING The current study was funded by a PhD position at the University of Groningen. No additional funding was acquired.
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Affiliation(s)
- Vasco Ribeiro Ferreira
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands.
| | - Esther Metting
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
- University Medical College Groningen, Groningen, The Netherlands
| | - Joshua Schauble
- Department of Knowledge Infrastructure, University of Groningen, Campus Fryslân, Leeuwarden, The Netherlands
| | - Hamed Seddighi
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
- Department of Psychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Lise Beumeler
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
- Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Valentina Gallo
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
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15
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Freed SA, Sprague BN, Ross LA. Does the association between objective and subjective memory vary by age among healthy older adults? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:249-262. [PMID: 36353743 PMCID: PMC10166764 DOI: 10.1080/13825585.2022.2143471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
Abstract
Subjective memory is commonly used as an indicator of older adults' objective memory in clinical screening; however, the correspondence between subjective and objective memory across different ages is unclear. The current study examined age-varying associations between subjective and objective memory in a cross-sectional sample of healthy older adults from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (N = 2,496). Time varying effects modeling (TVEM) models the association between variables as a function of time-varying metrics including age without imposing linear assumptions. TVEM was used to examine relationship magnitude fluctuations between subjective and objective memory across ages 65 to 85. Better subjective memory was weakly associated with better objective memory, even after controlling for gender, depressive symptoms, and education. The association was stable across all ages. There is a stable weak correspondence between subjective and objective memory in older adulthood across age, supporting the use of linear age as an appropriate time metric for examinations of objective and subjective memory among healthy older adults. Future work should examine the correspondence between subjective and objective memory in a larger age range. Longitudinal designs can also provide insights on whether the accuracy of subjective memory ratings change within a person over time.
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Affiliation(s)
- Sara A. Freed
- TransAnalytics, LLC, Quakertown, United States of America
| | - Briana N. Sprague
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, United States of America
| | - Lesley A. Ross
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, United States of America
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16
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Chen G, McKay NS, Gordon BA, Liu J, Joseph-Mathurin N, Schindler SE, Hassenstab J, Aschenbrenner AJ, Wang Q, Schultz SA, Su Y, LaMontagne PJ, Keefe SJ, Massoumzadeh P, Cruchaga C, Xiong C, Morris JC, Benzinger TLS. Predicting cognitive decline: Which is more useful, baseline amyloid levels or longitudinal change? Neuroimage Clin 2023; 41:103551. [PMID: 38150745 PMCID: PMC10788301 DOI: 10.1016/j.nicl.2023.103551] [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: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/29/2023]
Abstract
The use of biomarkers for the early detection of Alzheimer's disease (AD) is crucial for developing potential therapeutic treatments. Positron Emission Tomography (PET) is a well-established tool used to detect β-amyloid (Aβ) plaques in the brain. Previous studies have shown that cross-sectional biomarkers can predict cognitive decline (Schindler et al.,2021). However, it is still unclear whether longitudinal Aβ-PET may have additional value for predicting time to cognitive impairment in AD. The current study aims to evaluate the ability of baseline- versus longitudinal rate of change in-11C-Pittsburgh compound B (PiB) Aβ-PET to predict cognitive decline. A cohort of 153 participants who previously underwent PiB-PET scans and comprehensive clinical assessments were used in this study. Our analyses revealed that baseline Aβ is significantly associated with the rate of change in cognitive composite scores, with cognition declining more rapidly when baseline PiB Aβ levels were higher. In contrast, no signification association was identified between the rate of change in PiB-PET Aβ and cognitive decline. Additionally, the ability of the rate of change in the PiB-PET measures to predict cognitive decline was significantly influenced by APOE ε4 carrier status. These results suggest that a single PiB-PET scan is sufficient to predict cognitive decline and that longitudinal measures of Aβ accumulation do not improve the prediction of cognitive decline once someone is amyloid positive.
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Affiliation(s)
- Gengsheng Chen
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nicole S McKay
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Jingxia Liu
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nelly Joseph-Mathurin
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Qing Wang
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Stephanie A Schultz
- Department of Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Pamela J LaMontagne
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Sarah J Keefe
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Parinaz Massoumzadeh
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Divison of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
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17
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Du L, Hermann BP, Jonaitis EM, Cody KA, Rivera-Rivera L, Rowley H, Field A, Eisenmenger L, Christian BT, Betthauser TJ, Larget B, Chappell R, Janelidze S, Hansson O, Johnson SC, Langhough R. Harnessing cognitive trajectory clusterings to examine subclinical decline risk factors. Brain Commun 2023; 5:fcad333. [PMID: 38107504 PMCID: PMC10724051 DOI: 10.1093/braincomms/fcad333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/23/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023] Open
Abstract
Cognitive decline in Alzheimer's disease and other dementias typically begins long before clinical impairment. Identifying people experiencing subclinical decline may facilitate earlier intervention. This study developed cognitive trajectory clusters using longitudinally based random slope and change point parameter estimates from a Preclinical Alzheimer's disease Cognitive Composite and examined how baseline and most recently available clinical/health-related characteristics, cognitive statuses and biomarkers for Alzheimer's disease and vascular disease varied across these cognitive clusters. Data were drawn from the Wisconsin Registry for Alzheimer's Prevention, a longitudinal cohort study of adults from late midlife, enriched for a parental history of Alzheimer's disease and without dementia at baseline. Participants who were cognitively unimpaired at the baseline visit with ≥3 cognitive visits were included in trajectory modelling (n = 1068). The following biomarker data were available for subsets: positron emission tomography amyloid (amyloid: n = 367; [11C]Pittsburgh compound B (PiB): global PiB distribution volume ratio); positron emission tomography tau (tau: n = 321; [18F]MK-6240: primary regions of interest meta-temporal composite); MRI neurodegeneration (neurodegeneration: n = 581; hippocampal volume and global brain atrophy); T2 fluid-attenuated inversion recovery MRI white matter ischaemic lesion volumes (vascular: white matter hyperintensities; n = 419); and plasma pTau217 (n = 165). Posterior median estimate person-level change points, slopes' pre- and post-change point and estimated outcome (intercepts) at change point for cognitive composite were extracted from Bayesian Bent-Line Regression modelling and used to characterize cognitive trajectory groups (K-means clustering). A common method was used to identify amyloid/tau/neurodegeneration/vascular biomarker thresholds. We compared demographics, last visit cognitive status, health-related factors and amyloid/tau/neurodegeneration/vascular biomarkers across the cognitive groups using ANOVA, Kruskal-Wallis, χ2, and Fisher's exact tests. Mean (standard deviation) baseline and last cognitive assessment ages were 58.4 (6.4) and 66.6 (6.6) years, respectively. Cluster analysis identified three cognitive trajectory groups representing steep, n = 77 (7.2%); intermediate, n = 446 (41.8%); and minimal, n = 545 (51.0%) cognitive decline. The steep decline group was older, had more females, APOE e4 carriers and mild cognitive impairment/dementia at last visit; it also showed worse self-reported general health-related and vascular risk factors and higher amyloid, tau, neurodegeneration and white matter hyperintensity positive proportions at last visit. Subtle cognitive decline was consistently evident in the steep decline group and was associated with generally worse health. In addition, cognitive trajectory groups differed on aetiology-informative biomarkers and risk factors, suggesting an intimate link between preclinical cognitive patterns and amyloid/tau/neurodegeneration/vascular biomarker differences in late middle-aged adults. The result explains some of the heterogeneity in cognitive performance within cognitively unimpaired late middle-aged adults.
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Affiliation(s)
- Lianlian Du
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Bruce P Hermann
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
| | - Erin M Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Karly Alex Cody
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Leonardo Rivera-Rivera
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
| | - Howard Rowley
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Aaron Field
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Laura Eisenmenger
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Bradley T Christian
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Bret Larget
- Department of Statistics, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Rick Chappell
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund 205 02, Sweden
| | - Sterling C Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Rebecca Langhough
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
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Guo HF, Wu Y, Li J, Pan FF. Analysis of the relationship between blood pressure variability and subtle cognitive decline in older adults. World J Psychiatry 2023; 13:872-883. [DOI: 10.5498/wjp.v13.i11.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/18/2023] [Accepted: 10/23/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Blood pressure variability (BPV) has been shown to be related to mild cognitive impairment and Alzheimer's disease in a number of studies. However, the relationship between BPV and subtle cognitive decline (SCD) has received minimal attention in this field of research to date and has rarely been reported.
AIM To examine whether SCD is independently associated with changes in BPV in older adults.
METHODS Participants were selected based on having participated in cognitive function evaluation and ambulatory blood pressure measurement at the Shanghai Sixth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine between June 2020 and August 2022. The participants included 182 individuals with SCD as the experimental group and 237 with normal cognitive function as the control group. The basic data, laboratory examinations, scale tests, and ambulatory blood pressure test results of the two groups were analyzed retrospectively, and the relationship between SCD and BPV was subsequently evaluated.
RESULTS Significant differences were observed between the two groups of participants (P < 0.05) in terms of age, education level, prevalence rate of diabetes, fasting blood glucose level, 24-h systolic blood pressure standard deviation and coefficient of variation, 24-h diastolic blood pressure standard deviation and coefficient of variation. The scale monitoring results showed significant differences in the scores for memory, attention, and visual space between the experimental and control groups. Logistic regression analysis indicated that age, education level, blood sugar level, and BPV were factors influencing cognitive decline. Linear regression analysis showed that there was an independent correlation between blood pressure variation and SCD, even after adjusting for related factors. Each of the above differences was still significant.
CONCLUSION This study suggests that increased BPV is associated with SCD.
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Affiliation(s)
- Hui-Feng Guo
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yi Wu
- Prenatal Diagnosis Center, International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jie Li
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Feng-Feng Pan
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
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19
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Han F, Hu Y, Feng Y, Qian L, Sun J. Validation of the mild cognitive impairment health literacy assessment scale (MCI-HLA scale) in middle-aged and older adults. Asian J Psychiatr 2023; 89:103771. [PMID: 37757537 DOI: 10.1016/j.ajp.2023.103771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVES Health literacy (HL) is associated with early prevention of mild cognitive impairment (MCI), but a targeted comprehensive assessment tool is lacking. This study aims to psychometrically evaluate the MCI-HLA scale. METHODS This observational study was conducted in a tertiary-level hospital's physical examination center from October to December 2020. The middle-aged and older adults (N = 550, aged 41-80 years) completed the MCI-HLA questionnaire online. The validity of the MCI-HLA scale was assessed through content validity, exploratory factor analysis, confirmatory factor analysis (CFA), convergent validity, and discriminant validity. The internal reliability was measured using Cronbach's alpha, McDonald's Omega coefficient, and split-half reliability. RESULTS 5 factors emerged, naming: Function (7 items), Knowledge (8 items), Practice (8 items), Attitude (4 items), and Motivation (3 items), explaining 72.42% of variance. The CFA revealed that five factors of the MCI-HLA scale fit well (χ2/df=4.076, RMSEA=0.078, SRMR=0.057, CFI=0.904, TLI=0.894). Good convergent validity was suggested by the Average Variance Extracted (AVE) values exceeding 0.50. Discriminant validity was demonstrated for all the square root AVE were higher than the correlation between the two factors. Internal consistency was high (Cronbach's alpha=0.875, McDonald's Omega coefficient=0.910, split-half reliability=0.949). CONCLUSIONS The MCI-HLA scale takes on high reliability and validity, suitable for assessing MCI-related health literacy in middle-aged and older adults. The MCI-HLA scale could enhance MCI health literacy assessment and supports tailored interventions for improved outcomes.
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Affiliation(s)
- Fengping Han
- Laboratory Center, School of Nursing, Peking University, Beijing, China
| | - Yang Hu
- Department of Community Nursing, School of Nursing, Peking University, Beijing, China
| | - Ying Feng
- Cadre Health Care Division, Peking University Third Hospital, Beijing, China
| | - Li Qian
- Editorial Department, Chinese Journal of Modern Nursing, Beijing, China
| | - Jing Sun
- Department of Community Nursing, School of Nursing, Peking University, Beijing, China.
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20
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O’Keefe P, Muniz-Terrera G, Voll S, Clouston S, Wanström L, Mann FD, Lee Rodgers J, Hofer SM. Cohort Changes and Sex Differences After Age 50 in Cognitive Variables in the English Longitudinal Study of Ageing. J Gerontol B Psychol Sci Soc Sci 2023; 78:1636-1641. [PMID: 37326391 PMCID: PMC10561880 DOI: 10.1093/geronb/gbad089] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVES This paper models cognitive aging, across mid and late life, and estimates birth cohort and sex differences in both initial levels and aging trajectories over time in a sample with multiple cohorts and a wide span of ages. METHODS The data used in this study came from the first 9 waves of the English Longitudinal Study of Ageing, spanning 2002-2019. There were n = 76,014 observations (proportion male 45%). Dependent measures were verbal fluency, immediate recall, delayed recall, and orientation. Data were modeled using a Bayesian logistic growth curve model. RESULTS Cognitive aging was substantial in 3 of the 4 variables examined. For verbal fluency and immediate recall, males and females could expect to lose about 30% of their initial ability between the ages of 52 and 89. Delayed recall showed a steeper decline, with males losing 40% and females losing 50% of their delayed recall ability between ages 52 and 89 (although females had a higher initial level of delayed recall). Orientation alone was not particularly affected by aging, with less than a 10% change for either males or females. Furthermore, we found cohort effects for initial ability level, with particularly steep increases for cohorts born between approximately 1930 and 1950. DISCUSSION These cohort effects generally favored later-born cohorts. Implications and future directions are discussed.
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Affiliation(s)
- Patrick O’Keefe
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Stacey Voll
- Institute in Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
| | - Sean Clouston
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Linda Wanström
- Department of Computer and Information Science, Linkoping University, Linköping, Sweden
| | - Frank D Mann
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Joseph Lee Rodgers
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
| | - Scott M Hofer
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
- Institute in Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
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21
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Kim SK, Jang JW, Hwang YS, Lee OE, Jo HS. Investigating the effectiveness of Socially Assistive Robot on Depression and Cognitive Functions of Community Dwelling Older Adults with Cognitive Impairments. Assist Technol 2023:1-9. [PMID: 37459459 DOI: 10.1080/10400435.2023.2237554] [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: 12/05/2022] [Revised: 04/17/2023] [Accepted: 07/10/2023] [Indexed: 08/23/2023] Open
Abstract
We evaluated a socially assistive robot (SAR) named Hyodol during a six-week intervention. This study enrolled 69 older adults with cognitive decline. To screen the eligibility, we have used the following three criteria, namely Korean-Mini-Mental Status Exam score ≤ 26). Clinical Dementia Rating 0.5-2), and Diagnostics and Statistical Manual V. Participants were divided into three groups based on their cognitive function (i.e. very mild cognitive impairment (vMCI), mild cognitive impairment (MCI), and moderate cognitive impairment (MOCI). The groups were instructed to use Hyodol at home for a six-week period. Baseline and post-intervention surveys were performed after six weeks to examine the changes in perceived health, depression, and cognitive function. The vMCI group showed a reduction in the depression score after the intervention (t = -2.447, p = 0.040), in comparison to their peers in the control group. Further, the MCI group showed an improvement in the cognitive function score after the intervention (t = 2.690, p = 0.021). No significant improvement was found among MOCI participants who used the SARs. The significance of this study was to examine whether participants with different levels of cognitive functioning would diverge after a period of intervention using the Hyodol SARs. Moreover, it presented preliminary data for services and policies for home care treatment targeted to cognitive decline in older adults.
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Affiliation(s)
- Su Kyoung Kim
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon University Hospital, Chuncheon, Korea
| | - Yu Seong Hwang
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Othelia EunKyoung Lee
- College of Health and Human Services, The University of North Carolina, Charlotte, North Carolina, US
| | - Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
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22
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Zuber S, Bechtiger L, Bodelet JS, Golin M, Heumann J, Kim JH, Klee M, Mur J, Noll J, Voll S, O’Keefe P, Steinhoff A, Zölitz U, Muniz-Terrera G, Shanahan L, Shanahan MJ, Hofer SM. An integrative approach for the analysis of risk and health across the life course: challenges, innovations, and opportunities for life course research. DISCOVER SOCIAL SCIENCE AND HEALTH 2023; 3:14. [PMID: 37469576 PMCID: PMC10352429 DOI: 10.1007/s44155-023-00044-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
Life course epidemiology seeks to understand the intricate relationships between risk factors and health outcomes across different stages of life to inform prevention and intervention strategies to optimize health throughout the lifespan. However, extant evidence has predominantly been based on separate analyses of data from individual birth cohorts or panel studies, which may not be sufficient to unravel the complex interplay of risk and health across different contexts. We highlight the importance of a multi-study perspective that enables researchers to: (a) Compare and contrast findings from different contexts and populations, which can help identify generalizable patterns and context-specific factors; (b) Examine the robustness of associations and the potential for effect modification by factors such as age, sex, and socioeconomic status; and (c) Improve statistical power and precision by pooling data from multiple studies, thereby allowing for the investigation of rare exposures and outcomes. This integrative framework combines the advantages of multi-study data with a life course perspective to guide research in understanding life course risk and resilience on adult health outcomes by: (a) Encouraging the use of harmonized measures across studies to facilitate comparisons and synthesis of findings; (b) Promoting the adoption of advanced analytical techniques that can accommodate the complexities of multi-study, longitudinal data; and (c) Fostering collaboration between researchers, data repositories, and funding agencies to support the integration of longitudinal data from diverse sources. An integrative approach can help inform the development of individualized risk scores and personalized interventions to promote health and well-being at various life stages.
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Affiliation(s)
- Sascha Zuber
- Institute On Aging & Lifelong Health, University of Victoria, Victoria, BC Canada
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | | | - Marta Golin
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | - Jens Heumann
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | - Jung Hyun Kim
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Matthias Klee
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Jure Mur
- University of Edinburgh, Edinburgh, Scotland
| | - Jennie Noll
- Pennsylvania State University, State College, PA USA
| | - Stacey Voll
- Institute On Aging & Lifelong Health, University of Victoria, Victoria, BC Canada
| | - Patrick O’Keefe
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ulf Zölitz
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | | | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
- Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Michael J. Shanahan
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
- Department of Sociology, University of Zürich, Zürich, Switzerland
| | - Scott M. Hofer
- Institute On Aging & Lifelong Health, University of Victoria, Victoria, BC Canada
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
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23
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Sommerlad A, Kivimäki M, Larson EB, Röhr S, Shirai K, Singh-Manoux A, Livingston G. Social participation and risk of developing dementia. NATURE AGING 2023; 3:532-545. [PMID: 37202513 DOI: 10.1038/s43587-023-00387-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/22/2023] [Indexed: 05/20/2023]
Abstract
The increasing number of people with dementia globally illustrates the urgent need to reduce dementia's scale and impact. Lifetime social participation may affect dementia risk by increasing cognitive reserve, and through brain maintenance by reducing stress and improving cerebrovascular health. It may therefore have important implications for individual behavior and public health policy aimed at reducing dementia burden. Observational study evidence indicates that greater social participation in midlife and late life is associated with 30-50% lower subsequent dementia risk, although some of this may not be causal. Social participation interventions have led to improved cognition but, partly due to short follow-up and small numbers of participants, no reduction in risk of dementia. We summarize the evidence linking social participation with dementia, discuss potential mechanisms by which social participation is likely to reduce and mitigate the impact of neuropathology in the brain, and consider the implications for future clinical and policy dementia prevention interventions.
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Affiliation(s)
- Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK.
- Camden and Islington NHS Foundation Trust, London, UK.
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- University of Washington Schools of Medicine and Public Health, Seattle, WA, USA
| | - Susanne Röhr
- School of Psychology, Massey University, Manawatu, New Zealand
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Kokoro Shirai
- Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK
- Université Paris Cité, Inserm, U1153, Paris, France
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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24
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Manera U, D'Ovidio F, Cabras S, Torrieri MC, Canosa A, Vasta R, Palumbo F, Grassano M, De Marchi F, Mazzini L, Mora G, Moglia C, Calvo A, Chiò A. Amyotrophic lateral sclerosis regional progression intervals change according to time of involvement of different body regions. Eur J Neurol 2023; 30:872-880. [PMID: 36617536 DOI: 10.1111/ene.15674] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/25/2022] [Accepted: 12/30/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE The prediction of disease course is one of the main targets of amyotrophic lateral sclerosis (ALS) research, particularly considering its wide phenotypic heterogeneity. Despite many attempts to classify patients into prognostic categories according to the different spreading patterns at diagnosis, a precise regional progression rate and the time of involvement of each region has yet to be clarified. The aim of our study was to evaluate the functional decline in different body regions according to their time of involvement during disease course. METHODS In a population-based dataset of ALS patients, we analysed the functional decline in different body regions according to time and order of regional involvement. We calculated the regional progression intervals (RPIs) between initial involvement and severe functional impairment using the ALS Functional Rating Scale revised (ALSFRS-r) subscores for the bulbar, upper limb, lower limb and respiratory/thoracic regions. Time-to-event analyses, adjusted for age, sex, ALSFRS-r pre-slope (ΔALSFRS-R), cognitive status, and mutational status were performed. RESULTS The duration of RPI differed significantly among ALS phenotypes, with the RPI of the first region involved being significantly longer than the RPIs of regions involved later. Cox proportional hazard models showed that in fact a longer time between disease onset and initial regional involvement was related to a reduced duration of the RPI duration in each different body region (bulbar region: hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.06-1.16, p < 0.001; upper limb region: HR 1.16, 95% CI 1.06-1.28, p = 0.002; lower limb region: HR 1.11, 95% CI 1.03-1.19, p = 0.009; respiratory/thoracic region: HR 1.10, 95% CI 1.06-1.14, p = 0.005). CONCLUSIONS We found that the progression of functional decline accelerates in regions involved later during disease course. Our findings can be useful in patient management and prognosis prediction.
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Affiliation(s)
- Umberto Manera
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
- Neurology 1, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Fabrizio D'Ovidio
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Sara Cabras
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Maria Claudia Torrieri
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Antonio Canosa
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
- Neurology 1, AOU Città della Salute e della Scienza di Torino, Turin, Italy
- Institute of Cognitive Sciences and Technologies, C.N.R., Rome, Italy
| | - Rosario Vasta
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Francesca Palumbo
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Maurizio Grassano
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Fabiola De Marchi
- ALS Center, Department of Neurology, Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy
| | - Letizia Mazzini
- ALS Center, Department of Neurology, Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy
| | - Gabriele Mora
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Cristina Moglia
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
- Neurology 1, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Andrea Calvo
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
- Neurology 1, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Adriano Chiò
- ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
- Neurology 1, AOU Città della Salute e della Scienza di Torino, Turin, Italy
- Institute of Cognitive Sciences and Technologies, C.N.R., Rome, Italy
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25
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Aung HL, Siefried KJ, Gates TM, Brew BJ, Mao L, Carr A, Cysique LA. Meaningful cognitive decline is uncommon in virally suppressed HIV, but sustained impairment, subtle decline and abnormal cognitive aging are not. EClinicalMedicine 2023; 56:101792. [PMID: 36618901 PMCID: PMC9813694 DOI: 10.1016/j.eclinm.2022.101792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND High antiretroviral therapy (ART) coverage and viral suppression among people with HIV (PWH) in Australia provide a unique context to study individual cognitive trajectories, cognitive aging and factors associated with longitudinal cognitive function during chronic and stable HIV disease. METHODS Participants from the Predictors of Adherence to Antiretroviral Therapy study (n = 457, recruited between September 2013 and November 2015, median age = 52 years, and all with HIV RNA <50 copies mL) completed a cognitive assessment with CogState Computerized Battery (CCB) at baseline, Month-12, and Month-24. Demographics, psycho-social and socioeconomic factors, healthcare seeking behaviors, HIV disease characteristics and comorbidities were assessed. The CCB data were corrected for age, sex and practice effect and averaged into a global z-score (GZS). Cognitive impairment was defined with the global deficit score method (GDS>0.5). Meaningful cognitive change was statistically defined (decline or improvement versus stability, i.e., 90% CI, that is p < 0.05, 2-tailed) using a novel evidence-based change score: the linear mixed-effect regression (LMER)-based GZS change score. A separate LMER model with a top-down variable selection approach identified the independent effects of age and other demographic, HIV disease characteristics, socioeconomic and health-related factors on the demographically corrected GZS. The combined definitions of change and cross-sectional impairment enabled the identification of cognitive trajectories. FINDINGS At Month-12 and Month-24, 6% and 7% showed meaningful cognitive decline and 4% and 3% improved respectively. Only 1% showed sustained decline. Incident impairment due to subtle cognitive decline (i.e., below the threshold of meaningful cognitive decline) was 31% and 25% at Month-12 and Month-24, while 14% showed sustained impairment (i.e., cognitively impaired at all study visits). Older age (≥50 years) and time interaction was associated with lower demographically corrected GZS (β = -0.31, p < 0.001). Having a regular relationship, excellent English proficiency, and perceived stigma (avoidance) were associated with higher GZS (all p < 0.05). Relying on government subsidy, severe depression, and lower belief in ART necessity and higher concerns were associated with lower GZS (all p < 0.05). No HIV disease characteristics had a significant effect. INTERPRETATIONS Meaningful cognitive decline was not different from normal expectation in chronic stable HIV disease. Despite this, subtle cognitive decline, sustained cognitive impairment, and greater than normative-age cognitive aging were evident. FUNDING Funding for the PAART study was provided in part by unrestricted educational grants from Gilead Sciences (www.gilead.com) (Grant Number: IN-AU-264- 0131), the Balnaves Foundation (www.balnavesfoundation.com), the Victorian Department of Health and Human Services (Australia) (www.dhs.vic.gov.au/home), Western Australia Health (www.health.wa.gov.au), the ACT Ministry of Health (Australia) (www.health.act.gov.au), and in-kind support from the Queensland Department of Health (Australia) (www.health.qld.gov.au), and NHMRC Partnership grant APP1058474 (PI: Carr, Andrew).
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Affiliation(s)
- Htein Linn Aung
- St Vincent's Centre for Applied Medical Research, Sydney, Australia
- Faculty of Medicine, UNSW, Australia
| | - Krista J. Siefried
- St Vincent's Centre for Applied Medical Research, Sydney, Australia
- Immunology and HIV Unit, St Vincent's Hospital, Sydney, Australia
- The National Centre for Clinical Research on Emerging Drugs, Sydney, Australia
| | - Thomas M. Gates
- St Vincent's Centre for Applied Medical Research, Sydney, Australia
- Departments of Neurology and HIV Medicine, St Vincent's Hospital, Australia
| | - Bruce J. Brew
- St Vincent's Centre for Applied Medical Research, Sydney, Australia
- Faculty of Medicine, UNSW, Australia
- Departments of Neurology and HIV Medicine, St Vincent's Hospital, Australia
- Faculty of Medicine, University of Notre Dame, Sydney, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW, Sydney, Australia
| | - Andrew Carr
- St Vincent's Centre for Applied Medical Research, Sydney, Australia
- Immunology and HIV Unit, St Vincent's Hospital, Sydney, Australia
| | - Lucette A. Cysique
- St Vincent's Centre for Applied Medical Research, Sydney, Australia
- Departments of Neurology and HIV Medicine, St Vincent's Hospital, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Corresponding author. School of Psychology, The University of New South Wales, Matthews Building, Room 1012, 11 Botany Street, Sydney, NSW, 2052, Australia.
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26
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Mann FD, Clouston SA, Cuevas A, Waszczuk MA, Kuan PF, Carr MA, Docherty AR, Shabalin AA, Gandy SE, Luft BJ. Genetic Liability, Exposure Severity, and Post-Traumatic Stress Disorder Predict Cognitive Impairment in World Trade Center Responders. J Alzheimers Dis 2023; 92:701-712. [PMID: 36776056 PMCID: PMC10648279 DOI: 10.3233/jad-220892] [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] [Indexed: 02/12/2023]
Abstract
BACKGROUND There is a high incidence of cognitive impairment among World Trade Center (WTC) responders, comorbid with post-traumatic stress disorder (PTSD). Yet, it remains unknown whether genetic liability for Alzheimer's disease, PTSD, educational attainment, or for a combination of these phenotypes, is associated with cognitive impairment in this high-risk population. Similarly, whether the effects of genetic liability are comparable to PTSD and indicators of exposure severity remains unknown. OBJECTIVE In a study of 3,997 WTC responders, polygenic scores for Alzheimer's disease, PTSD, and educational attainment were used to test whether genome-wide risk for one or more of these phenotypes is associated with cognitive impairment, controlling for population stratification, while simultaneously estimating the effects of demographic factors and indicators of 9/11 exposure severity, including symptoms of PTSD. RESULTS Polygenic scores for Alzheimer's disease and educational attainment were significantly associated with an increase and decrease, respectively, in the hazard rate of mild cognitive impairment. The polygenic score for Alzheimer's disease was marginally associated with an increase in the hazard rate of severe cognitive impairment, but only age, exposure severity, and symptoms of PTSD were statistically significant predictors. CONCLUSION These results add to the emerging evidence that many WTC responders are suffering from mild cognitive impairments that resemble symptoms of Alzheimer's disease, as genetic liability for Alzheimer's disease predicted incidence of mild cognitive impairment. However, compared to polygenic scores, effect sizes were larger for PTSD and the type of work that responders completed during rescue and recovery efforts.
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Affiliation(s)
- Frank D. Mann
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University
| | - Sean A.P. Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University
| | | | - Monika A. Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science
| | - Pei-Fen Kuan
- Department of Applied Mathematics and Statistics, Stony Brook University
| | - Melissa A. Carr
- World Trade Center Program Clinical Center of Excellence, Renaissance School of Medicine at Stony Brook University
| | | | | | | | - Benjamin J. Luft
- World Trade Center Program Clinical Center of Excellence, Renaissance School of Medicine at Stony Brook University
- Department of Medicine, Renaissance School of Medicine at Stony Brook University
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27
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Kleineidam L, Wolfsgruber S, Weyrauch AS, Zulka LE, Forstmeier S, Roeske S, van den Bussche H, Kaduszkiewicz H, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Brettschneider C, König HH, Weeg D, Bickel H, Luppa M, Rodriguez FS, Freiesleben SD, Erdogan S, Unterfeld C, Peters O, Spruth EJ, Altenstein S, Lohse A, Priller J, Fliessbach K, Kobeleva X, Schneider A, Bartels C, Schott BH, Wiltfang J, Maier F, Glanz W, Incesoy EI, Butryn M, Düzel E, Buerger K, Janowitz D, Ewers M, Rauchmann BS, Perneczky R, Kilimann I, Görß D, Teipel S, Laske C, Munk MHJ, Spottke A, Roy N, Brosseron F, Heneka MT, Ramirez A, Yakupov R, Scherer M, Maier W, Jessen F, Riedel-Heller SG, Wagner M. Midlife occupational cognitive requirements protect cognitive function in old age by increasing cognitive reserve. Front Psychol 2022; 13:957308. [PMID: 36571008 PMCID: PMC9773841 DOI: 10.3389/fpsyg.2022.957308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them. Methods We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the O*NET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE). Results Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM. Discussion Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.
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Affiliation(s)
- Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,*Correspondence: Luca Kleineidam
| | | | - Anne-Sophie Weyrauch
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Linn E. Zulka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,Department of Psychology and Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Simon Forstmeier
- Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Medical Faculty, Institute of General Practice, University of Kiel, Kiel, Germany
| | - Birgitt Wiese
- Center for Information Management, Hannover Medical School, Hanover, Germany
| | - Siegfried Weyerer
- Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
| | - Jochen Werle
- Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
| | - Angela Fuchs
- Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
| | - Michael Pentzek
- Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Weeg
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Melanie Luppa
- Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Francisca S. Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Silka Dawn Freiesleben
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Selin Erdogan
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Chantal Unterfeld
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Benjamin Franklin, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Eike J. Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Lohse
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Josef Priller
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany,University of Edinburgh and UK DRI, Edinburgh, United Kingdom
| | - Klaus Fliessbach
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Xenia Kobeleva
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anja Schneider
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Björn H. Schott
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany,Department of Medical Sciences, Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Franziska Maier
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Enise I. Incesoy
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany,Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, United Kingdom,Sheeld Institute for Translational Neuroscience (SITraN), University of Sheeld, Sheeld, United Kingdom
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Doreen Görß
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Matthias H. J. Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany,Department of Biology, Technische Universität Darmstadt, Darmstadt, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Department of Neurology, University of Bonn, Bonn, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Michael T. Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Alfredo Ramirez
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany,Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Steffi G. Riedel-Heller
- Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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Duan J, Sam NB, Wang SJ, Liu Y. Exploring the association between cognitive decline and all-cause mortality with blood pressure as a potential modifier in oldest old individuals. Sci Rep 2022; 12:17108. [PMID: 36224279 PMCID: PMC9556626 DOI: 10.1038/s41598-022-21487-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 09/28/2022] [Indexed: 01/04/2023] Open
Abstract
Few studies have systematically explored the association between cognitive decline and all-cause mortality among oldest old individuals (above 80 years old), and there is limited evidence of blood pressure (BP) as a potential effect modifier. Therefore, this study included 14,891 oldest old individuals (mean age: 90.3 ± 7.5 years); 10,904 deaths and 34,486 person-years were observed. Cognitive scores were calculated using the Chinese version of the Mini-Mental State Examination (MMSE). Cognitive decline was stratified into ten categories (C0-C9). Continuous cognitive scores were used to assess the interactions of modifiers of the cognitive decline and all-cause mortality association and potentially modifiable factors. Potential effect modifiers were explored by age, sex, BP status and hypertension. Cox proportional hazards models were used to evaluate the relationship between cognitive decline and all-cause mortality after adjustments for demographic characteristics, socioeconomic status, lifestyle factors, leisure activities and health conditions. Participants who progressed to severe cognitive impairment from high normal cognitive function (C3), low normal cognitive function (C6), or mild cognitive impairment (C8) had 55%, 56%, and 63% higher mortality risks, respectively, than those who maintained high normal cognitive function (C0). The multivariate-adjusted model indicated that oldest old individuals with a decrease of more than one point in the MMSE score per year had an approximately 4% all-cause mortality risk. The relationship between cognitive decline and mortality was statistically influenced by sex (P = 0.013), high BP in nonagenarians (P = 0.003), and hypertension (P = 0.004) but not by age (P = 0.277). Our findings suggest that periodic screening for cognitive decline and strengthening BP management may be necessary for public health.
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Affiliation(s)
- Jun Duan
- grid.440601.70000 0004 1798 0578Department of Medical Record Statistics, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036 China
| | - Napoleon Bellua Sam
- grid.442305.40000 0004 0441 5393Department of Medical Research and Innovation, School of Medicine, University for Development Studies, Tamale, N/R Ghana
| | - Shi-Jia Wang
- grid.440601.70000 0004 1798 0578Department of Cardiovascular Medicine, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yan Liu
- grid.440601.70000 0004 1798 0578Department of Medical Record Statistics, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036 China
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29
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Kadyrov M, Whiley L, Brown B, Erickson KI, Holmes E. Associations of the Lipidome with Ageing, Cognitive Decline and Exercise Behaviours. Metabolites 2022; 12:metabo12090822. [PMID: 36144226 PMCID: PMC9505967 DOI: 10.3390/metabo12090822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
One of the most recognisable features of ageing is a decline in brain health and cognitive dysfunction, which is associated with perturbations to regular lipid homeostasis. Although ageing is the largest risk factor for several neurodegenerative diseases such as dementia, a loss in cognitive function is commonly observed in adults over the age of 65. Despite the prevalence of normal age-related cognitive decline, there is a lack of effective methods to improve the health of the ageing brain. In light of this, exercise has shown promise for positively influencing neurocognitive health and associated lipid profiles. This review summarises age-related changes in several lipid classes that are found in the brain, including fatty acyls, glycerolipids, phospholipids, sphingolipids and sterols, and explores the consequences of age-associated pathological cognitive decline on these lipid classes. Evidence of the positive effects of exercise on the affected lipid profiles are also discussed to highlight the potential for exercise to be used therapeutically to mitigate age-related changes to lipid metabolism and prevent cognitive decline in later life.
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Affiliation(s)
- Maria Kadyrov
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia
- Correspondence: (M.K.); (B.B.); (E.H.)
| | - Luke Whiley
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
| | - Belinda Brown
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia
- School of Medical Sciences, Sarich Neuroscience Research Institute, Edith Cowan University, Nedlands, WA 6009, Australia
- Correspondence: (M.K.); (B.B.); (E.H.)
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL 32804, USA
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Elaine Holmes
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Harry Perkins Building, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Division of Integrative Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
- Correspondence: (M.K.); (B.B.); (E.H.)
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30
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Payton NM, Marseglia A, Grande G, Fratiglioni L, Kivipelto M, Bäckman L, Laukka EJ. Trajectories of cognitive decline and dementia development: A 12-year longitudinal study. Alzheimers Dement 2022; 19:857-867. [PMID: 35715929 DOI: 10.1002/alz.12704] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/09/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Mapping the preclinical dementia phase is important for early detection and evaluation of interventions. We assessed the trajectories of cognitive decline in preclinical dementia over 12 years and investigated whether being a fast decliner across 6 years is associated with increased risk of dementia the following 6 years. METHODS Rates of cognitive decline were determined using mixed-effects models for 1646 participants from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) cohort. Cox regression was used to assess the future likelihood of dementia for fast decliners (declining ≥1.5 standard deviations [SDs] faster than the age-specific rates). RESULTS Participants in a preclinical phase of dementia showed increased rates of decline in all cognitive tests compared to the no-dementia group, particularly closer (0-6 years) to diagnosis. Participants declining fast in three or more cognitive tests 12-6 years before diagnosis demonstrated a high risk of dementia 6 years later (hazard ratio [HR] 3.90, 95% confidence interval [CI] 2.28-6.69). DISCUSSION Being a fast decliner is linked to increased risk of future dementia.
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Affiliation(s)
- Nicola M Payton
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anna Marseglia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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31
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Roberts AL, Liu J, Lawn RB, Jha SC, Sumner JA, Kang JH, Rimm EB, Grodstein F, Kubzansky LD, Chibnik LB, Koenen KC. Association of Posttraumatic Stress Disorder With Accelerated Cognitive Decline in Middle-aged Women. JAMA Netw Open 2022; 5:e2217698. [PMID: 35771577 PMCID: PMC9247738 DOI: 10.1001/jamanetworkopen.2022.17698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Posttraumatic stress disorder (PTSD) has been hypothesized to lead to impaired cognitive function. However, no large-scale studies have assessed whether PTSD is prospectively associated with cognitive decline in middle-aged adults. OBJECTIVE To assess the association between PTSD and decline in cognitive function over time. DESIGN, SETTING, AND PARTICIPANTS This cohort study included participants from the Nurses' Health Study II, an ongoing longitudinal cohort study involving community-dwelling middle-aged female nurses residing in the US who had at least a 2-year nursing degree at the time of enrollment in 1989. The present study included 12 270 trauma-exposed women who were enrolled in the PTSD substudy of the Nurses' Health Study II and completed 1 to 5 cognitive assessments. Data were collected from March 1, 2008, to July 30, 2019. EXPOSURES Lifetime PTSD symptoms, assessed using a validated questionnaire between March 1, 2008, and February 28, 2010. MAIN OUTCOMES AND MEASURES The main outcome was evaluated using the Cogstate Brief Battery, a self-administered online cognitive battery. Cognitive function was measured by a psychomotor speed and attention composite score and a learning and working memory composite score. Women completed the Cogstate Brief Battery every 6 or 12 months (up to 24 months) from October 3, 2014, to July 30, 2019. Linear mixed-effects models were used to evaluate the association of PTSD symptoms with the rate of change in cognition over follow-up, considering a broad range of relevant covariates, including the presence of depression symptoms and history of clinician-diagnosed depression. The rate of cognitive change was adjusted for potential practice effects (ie, potential changes in test results that occur when a test is taken more than once) by including indicators for the number of previous tests taken. RESULTS Among 12 270 women, the mean (SD) age at the baseline cognitive assessment was 61.1 (4.6) years; 125 women (1.0%) were Asian, 75 (0.6%) were Black, 156 (1.3%) were Hispanic, 11 767 (95.9%) were non-Hispanic White, and 147 (1.2%) were of other race and/or ethnicity. A higher number of PTSD symptoms was associated with worse cognitive trajectories. Compared with women with no PTSD symptoms, women with the highest symptom level (6-7 symptoms) had a significantly worse rate of change in both learning and working memory (β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and psychomotor speed and attention (β = -0.05 SD/y; 95% CI, -0.09 to -0.01 SD/y; P = .02), adjusted for demographic characteristics. Associations were unchanged when additionally adjusted for behavioral factors (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and health conditions (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and were partially attenuated but still evident when further adjusted for practice effects (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.10 to -0.03 SD/y; P < .001) and comorbid depression (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.11 to -0.03 SD/y; P < .001). CONCLUSIONS AND RELEVANCE In this large-scale prospective cohort study, PTSD was associated with accelerated cognitive decline in middle-aged women, suggesting that earlier cognitive screening among women with PTSD may be warranted. Given that cognitive decline is strongly associated with subsequent Alzheimer disease and related dementias, better understanding of this association may be important to promote healthy aging.
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Affiliation(s)
- Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jiaxuan Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rebecca B. Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shaili C. Jha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lori B. Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
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Vásquez PM, Tarraf W, Li Y, Jenkins D, Soria-Lopez J, Zlatar ZZ, Marquine MJ, Stickel AM, Estrella ML, Gallo LC, Lipton RB, Isasi CR, Cai J, Zeng D, Daviglus ML, Schneiderman N, González HM. Concordance Between Self-Reported Medical Diagnosis of Mild Cognitive Impairment/Dementia and Neurocognitive Function Among Middle-Aged and Older Hispanic/Latino Adults: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). J Alzheimers Dis 2022; 88:45-55. [PMID: 35599477 DOI: 10.3233/jad-215060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Population-based studies typically rely on self-reported medical diagnosis (SRMD) of mild cognitive impairment (MCI)/dementia; however, links to objective neurocognitive function have not been established. Objective: Examine the association between SRMD of MCI/dementia and objective neurocognitive function among Hispanic/Latino adults. Methods: We conducted a case-control study using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) baseline data and its ancillary SOL-Investigation of Neurocognitive Aging (SOL-INCA) at visit 2. Hispanic/Latino adults aged 50 years and older (n = 593) were administered neurocognitive tests: the Six-Item Screener (SIS), Brief-Spanish English Verbal Learning Test (B-SVELT Sum), B-SVELT Recall, Word Fluency Test (WF), Digit Symbol Substitution Test (DSS), and Trail Making Test A and B. Individual and global neurocognitive function scores were used for analyses. Propensity matching techniques and survey generalized linear regression models were used to compare SRMD of MCI/dementia with demographic, psychological, and cardiovascular risk matched controls. Complex survey design methods were applied. Results: There were 121 cases of SRMD of MCI/dementia and 472 propensity matched controls. At baseline, compared to matched controls, cases showed no differences in neurocognitive function (p > 0.05). At SOL-INCA visit 2, cases had poorer scores in global neurocognitive function (p < 0.05), B-SEVLT Sum, B-SEVLT Recall, WF, DSS, and Trail A (p < 0.01). Conclusion: Observed differences in neurocognitive test scores between SRMD of MCI/dementia cases and matched controls were present at visit 2, but not at baseline in middle-aged and older Hispanic/Latino adults. These findings present initial evidence of the potential utility of SRMD of MCI/dementia in epidemiologic studies, where obtaining confirmation of diagnosis may not be feasible.
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Affiliation(s)
- Priscilla M. Vásquez
- Charles R. Drew University of Medicine and Science, Department of Urban Public Health, Los Angeles, CA, USA
| | - Wassim Tarraf
- Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Yuyi Li
- Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Derek Jenkins
- Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Jose Soria-Lopez
- University of California San Diego, Department of Neurosciences, La Jolla, CA, USA
| | - Zvinka Z. Zlatar
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Maria J. Marquine
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- University of California San Diego, Department of Medicine, La Jolla, CA, USA
| | - Ariana M. Stickel
- University of California San Diego, Department of Neurosciences, La Jolla, CA, USA
| | - Mayra L. Estrella
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago, IL, USA
| | - Linda C. Gallo
- San Diego State University, Department of Psychology, San Diego, CA, USA
| | - Richard B. Lipton
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, Bronx, NY, USA
| | - Carmen R. Isasi
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, Bronx, NY, USA
| | - Jianwei Cai
- University of North Carolina at Chapel Hill, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Dongling Zeng
- University of North Carolina at Chapel Hill, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Martha L. Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago, IL, USA
| | - Neil Schneiderman
- University of Miami, Department of Psychology, Coral Gables, FL, USA
| | - Hector M. González
- University of California San Diego, Department of Neurosciences, La Jolla, CA, USA
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Nagaratnam JM, Sharmin S, Diker A, Lim WK, Maier AB. Trajectories of Mini-Mental State Examination Scores over the Lifespan in General Populations: A Systematic Review and Meta-Regression Analysis. Clin Gerontol 2022; 45:467-476. [PMID: 32374211 DOI: 10.1080/07317115.2020.1756021] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives: Over the lifespan cumulative changes to the brain lead to cognitive decline and eventually to dementia in 20-25% of adults 85 years and older. A commonly used screening tool for cognitive function is the Standard 30 point Mini-Mental State Examination (MMSE). Though the MMSE is used to screen for dementia, little is known about the changes in scores over the lifespan in general populations.Method: A systematic search was conducted using Cochrane, EMBASE, MEDLINE and PsycINFO for articles published from January 1, 2007 to May 25, 2017. Articles were included if they had a longitudinal design reporting at least two MMSE scores. A mixed-effect meta-regression analysis was conducted to examine the influence of age on MMSE score followed by a change-point regression analysis determining the age at which MMSE declines.Results: 45 articles including 58,939 individuals (age range 18-108 years, 61.2% female) summarized 222 MMSE point estimates from 35 cohorts. The meta-regression demonstrated a significant decrease in MMSE scores with higher age (regression coefficient of age: -0.10 (Confidence Interval (CI) -0.15, -0.05)). The average annual decline in MMSE scores identified by the change-point analysis at the age of 41 years and 84 years were -0.04 (95% CI: -0.05, -0.03) and -0.53 (95% CI: -0.55, -0.50), respectively.Conclusions: Between the age of 29 and 105 years MMSE scores decline, with the highest decline between age 84 and 105 years.Clinical Implementations: The use of MMSE should be restricted to higher age categories in aging general populations.
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Affiliation(s)
- Julius M Nagaratnam
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Sifat Sharmin
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Clinical Outcomes Research Unit, Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Aaron Diker
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Wen Kwang Lim
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Liberatore MJ, Wagner WP. The Impact of Age on User Performance: A Field Experiment. JOURNAL OF COMPUTER INFORMATION SYSTEMS 2022. [DOI: 10.1080/08874417.2022.2065552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Eubank JM, Oberlin DJ, Alto A, Sahyoun NR, Asongwed E, Monroe-Lord L, Harrison EA. Effects of Lifestyle Factors on Cognition in Minority Population of Older Adults: A Review. Front Nutr 2022; 9:841070. [PMID: 35369047 PMCID: PMC8966895 DOI: 10.3389/fnut.2022.841070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
The onset of dementia and Alzheimer's disease (AD) is projected to expand over the next several decades in the United States as the population ages. However, the cognitive health burden is not equally distributed among the population, as Hispanics and African Americans are at higher risk of AD when compared with Non-Hispanic Whites. There is some evidence to indicate that cognitive decline may be associated with lifestyle factors and that interventions in these domains may prevent or delay this decline. These lifestyle factors include social engagement, physical activity, both aerobic and strength training, dietary intake, sleep and stress. This review summarizes, in general, what is known about the relationship between risk factors and cognition and, in particular what is known about this relationship in minority populations. The results show that the relationship between these risk factors and cognitive decline is stronger for some of the factors such as physical activity and dietary intake and weaker for the other factors depending on what is measured and in what populations. It does appear, however, that the studies in minority populations is limited and warrants more targeted research and interventions.
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Affiliation(s)
- Jacob M. Eubank
- Lehman College, City University of New York, New York, NY, United States
- *Correspondence: Jacob M. Eubank ; orcid.org/0000-0003-1806-9308
| | - Douglas J. Oberlin
- Lehman College, City University of New York, New York, NY, United States
| | - Andrew Alto
- Lehman College, City University of New York, New York, NY, United States
| | - Nadine R. Sahyoun
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD, United States
| | - Elmira Asongwed
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
| | - Lillie Monroe-Lord
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
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Abstract
Alzheimer’s disease (AD) is prevalent throughout the world and is the leading cause of dementia in older individuals (aged ≥ 65 years). To gain a deeper understanding of the recent literature on the epidemiology of AD and its progression, we conducted a review of the PubMed-indexed literature (2014–2021) in North America, Europe, and Asia. The worldwide toll of AD is evidenced by rising prevalence, incidence, and mortality due to AD—estimates which are low because of underdiagnosis of AD. Mild cognitive impairment (MCI) due to AD can ultimately progress to AD dementia; estimates of AD dementia etiology among patients with MCI range from 40% to 75% depending on the populations studied and whether the MCI diagnosis was made clinically or in combination with biomarkers. The risk of AD dementia increases with progression from normal cognition with no amyloid-beta (Aβ) accumulation to early neurodegeneration and subsequently to MCI. For patients with Aβ accumulation and neurodegeneration, lifetime risk of AD dementia has been estimated to be 41.9% among women and 33.6% among men. Data on progression from preclinical AD to MCI are sparse, but an analysis of progression across the three preclinical National Institute on Aging and Alzheimer’s Association (NIA-AA) stages suggests that NIA-AA stage 3 (subtle cognitive decline with AD biomarker positivity) could be useful in combination with other tools for treatment decision-making. Factors shown to increase risk include lower Mini-Mental State Examination (MMSE) score, higher Alzheimer’s Disease Assessment Scale (ADAS-cog) score, positive APOE4 status, white matter hyperintensities volume, entorhinal cortex atrophy, cerebrospinal fluid (CSF) total tau, CSF neurogranin levels, dependency in instrumental activities of daily living (IADL), and being female. Results suggest that use of biomarkers alongside neurocognitive tests will become an important part of clinical practice as new disease-modifying therapies are introduced.
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Kok FK, van Leerdam SL, de Lange ECM. Potential Mechanisms Underlying Resistance to Dementia in Non-Demented Individuals with Alzheimer's Disease Neuropathology. J Alzheimers Dis 2022; 87:51-81. [PMID: 35275527 PMCID: PMC9198800 DOI: 10.3233/jad-210607] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Alzheimer’s disease (AD) is the most common form of dementia and typically characterized by the accumulation of amyloid-β plaques and tau tangles. Intriguingly, there also exists a group of elderly which do not develop dementia during their life, despite the AD neuropathology, the so-called non-demented individuals with AD neuropathology (NDAN). In this review, we provide extensive background on AD pathology and normal aging and discuss potential mechanisms that enable these NDAN individuals to remain cognitively intact. Studies presented in this review show that NDAN subjects are generally higher educated and have a larger cognitive reserve. Furthermore, enhanced neural hypertrophy could compensate for hippocampal and cingulate neural atrophy in NDAN individuals. On a cellular level, these individuals show increased levels of neural stem cells and ‘von Economo neurons’. Furthermore, in NDAN brains, binding of Aβ oligomers to synapses is prevented, resulting in decreased glial activation and reduced neuroinflammation. Overall, the evidence stated here strengthens the idea that some individuals are more resistant to AD pathology, or at least show an elongation of the asymptomatic state of the disease compared to others. Insights into the mechanisms underlying this resistance could provide new insight in understanding normal aging and AD itself. Further research should focus on factors and mechanisms that govern the NDAN cognitive resilience in order to find clues on novel biomarkers, targets, and better treatments of AD.
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Affiliation(s)
- Frédérique K Kok
- Predictive Pharmacology, Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre of Drug Research, Leiden University, Leiden, The Netherlands
| | - Suzanne L van Leerdam
- Predictive Pharmacology, Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre of Drug Research, Leiden University, Leiden, The Netherlands
| | - Elizabeth C M de Lange
- Predictive Pharmacology, Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre of Drug Research, Leiden University, Leiden, The Netherlands
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Liang F, Fu J, Moore JB, Zhang X, Xu Y, Qiu N, Wang Y, Li R. Body Mass Index, Waist Circumference, and Cognitive Decline Among Chinese Older Adults: A Nationwide Retrospective Cohort Study. Front Aging Neurosci 2022; 14:737532. [PMID: 35330705 PMCID: PMC8940526 DOI: 10.3389/fnagi.2022.737532] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/14/2022] [Indexed: 01/10/2023] Open
Abstract
Background The reported associations between body mass index (BMI), waist circumference (WC), and cognitive decline are not consistent, especially in older adults. Objective This study aims to investigate the longitudinal associations of BMI, WC, and their change values with cognitive decline among Chinese adults aged 60 years and older and to examine the potential moderating effect of sex on these relationships. Methods The participants in this study were from waves one to four (2011–2018) of the China Health and Retirement Longitudinal Study (CHARLS). Cognition function, BMI, and WC were measured at four examinations over 7 years. The interview-based cognitive assessments of memory, orientation and attention, and visuospatial ability were recorded. Standardized global cognitive scores were generated. BMI and WC were objectively measured. Mixed-effects models were performed to evaluate the associations. Results A final sample of 3,035 Chinese older adults [mean (SD) age, 66.94 (5.43) years; 40.16% (n = 1,219) women] were included. Higher BMI (estimate = 0.0107; SE = 0.0024; p < 0.0001) and WC (estimate = 0.0019; SE = 0.0006; p = 0.0037) were associated with slower cognition score decline over a 7-year follow-up, while greater BMI variability (estimate = −0.0365; SE = 0.0116; p = 0.0017) was related to faster cognition score decline. The results were not modified by sex. BMI-defined overweight (estimate = 0.0094; SE = 0.0043; p = 0.0298) was associated with a slower cognition score decline, and both large weight gain (estimate = −0.0266; SE = 0.0074; p = 0.0003) and large WC loss (estimate = −0.0668; SE = 0.0329; p = 0.0426) were associated with faster cognition score decline. Conclusion Among Chinese older adults, higher BMI, higher WC, and overweight are related to slower cognitive decline, while greater BMI variability, large weight gain, and large WC loss are associated with faster cognitive decline.
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Affiliation(s)
- Fang Liang
- School of Public Health, Wuhan University, Wuhan, China
| | - Jialin Fu
- School of Public Health, Wuhan University, Wuhan, China
| | - Justin B. Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Xinge Zhang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China
| | - Yijia Xu
- School of Public Health, Wuhan University, Wuhan, China
| | - Nan Qiu
- School of Public Health, Wuhan University, Wuhan, China
| | - Yechuang Wang
- School of Public Health, Wuhan University, Wuhan, China
| | - Rui Li
- School of Public Health, Wuhan University, Wuhan, China
- School of Nursing, Wuhan University, Wuhan, China
- *Correspondence: Rui Li
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Jester DJ, Vyhnálek M, Andel R, Marková H, Nikolai T, Laczó J, Matusková V, Cechová K, Sheardova K, Hort J. Progression from Subjective Cognitive Decline to Mild Cognitive Impairment or Dementia: The Role of Baseline Cognitive Performance. J Alzheimers Dis 2022; 86:1763-1774. [DOI: 10.3233/jad-215291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Older adults with subjective cognitive decline (SCD) are at an increased risk of progression to mild cognitive impairment (MCI) or dementia. However, few have examined the specific cognitive tests that are associated with progression. Objective: This study examined performance on 18 neuropsychological tests among participants with SCD who later progressed to MCI or dementia. Methods: We included 131 participants from the Czech Brain Aging Study that had SCD at baseline. They completed a comprehensive neuropsychological battery including cognitive tests from the Uniform Data Set 2.0 enriched by the verbal memory test Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure Test (ROCFT). Results: Fifty-five participants progressed: 53% to non-amnestic MCI (naMCI), 44% to amnestic MCI (aMCI), and 4% to dementia. Scoring one SD below the mean at baseline on the RAVLT 1 and RAVLT 1–5 was associated with 133% (RAVLT 1; HR: 2.33 [1.50, 3.62]) and 122% (RAVLT 1–5; HR: 2.22 [1.55, 3.16]) greater risk of progression to MCI or dementia over 3.84 years on average. Worse performance on the RAVLT 5, RAVLT 1–5, RAVLT 30, and ROCFT–Recall was associated with progression to aMCI whereas worse performance on the RAVLT 1, TMT B, and Boston Naming Test was associated with progression to naMCI. Conclusion: At baseline, lower verbal memory performance was most strongly associated with progression to aMCI whereas lower executive or language performance was most strongly associated with progression to naMCI.
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Affiliation(s)
- Dylan J. Jester
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Martin Vyhnálek
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Ross Andel
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Hana Marková
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Tomás Nikolai
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Veronika Matusková
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Katerina Cechová
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Katerina Sheardova
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- First Department of Neurology, St. Anne’s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
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Baker ZG, Gustavson AM, Mitchell LL, Gaugler JE. Open science in dementia care embedded pragmatic clinical trials. Psychol Aging 2022; 37:51-59. [PMID: 35113614 PMCID: PMC8827495 DOI: 10.1037/pag0000644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Few dementia care interventions have been translated to healthcare contexts for those who need them. Embedded pragmatic clinical trials (ePCTs) are one design that can expedite the timeframe of research translation to clinical practice. As the National Institutes of Health (NIH) and other funders commit immense new resources to increasing the nation's capacity to conduct dementia care ePCTs, we call on psychologists to employ their extensive expertise in open science to improve the quality of dementia care ePCTs. This article provides several recommendations to enhance the transparency and reporting rigor of ePCTs in dementia care and other chronic disease contexts. We illustrate these recommendations in the context of a recent pilot pragmatic trial known as the Porchlight Project. Porchlight provided training to volunteers who serve clients and caregivers to help them provide more "dementia capable" support. Notably this trial did not include a special effort to make use of open science practices. We discuss the benefits and costs had the Porchlight Project incorporated open science principles. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Zachary G. Baker
- Division of Health Policy and Management, University of Minnesota
| | - Allison M. Gustavson
- Veterans Affairs Health Services Research and Development Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System
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Saunders S, Ritchie CW, Russ TC, Muniz-Terrera G, Milne R. Assessing and disclosing test results for ‘mild cognitive impairment’: the perspective of old age psychiatrists in Scotland. BMC Geriatr 2022; 22:50. [PMID: 35022025 PMCID: PMC8754072 DOI: 10.1186/s12877-021-02693-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/15/2021] [Indexed: 03/11/2023] Open
Abstract
Abstract
Background
Mild cognitive impairment (MCI) is a condition that exists between normal healthy ageing and dementia with an uncertain aetiology and prognosis. This uncertainty creates a complex dynamic between the clinicians’ conception of MCI, what is communicated to the individual about their condition, and how the individual responds to the information conveyed to them. The aim of this study was to explore clinicians’ views around the assessment and communication of MCI in memory clinics.
Method
As part of a larger longitudinal study looking at patients’ adjustment to MCI disclosure, we interviewed Old Age Psychiatrists at the five participating sites across Scotland. The study obtained ethics approvals and the interviews (carried out between Nov 2020–Jan 2021) followed a semi-structured schedule focusing on [1] how likely clinicians are to use the term MCI with patients; [2] what tests clinicians rely on and how much utility they see in them; and [3] how clinicians communicate risk of progression to dementia. The interviews were voice recorded and were analysed using reflective thematic analysis.
Results
Initial results show that most clinicians interviewed (Total N = 19) considered MCI to have significant limitations as a diagnostic term. Nevertheless, most clinicians reported using the term MCI (n = 15/19). Clinical history was commonly described as the primary aid in the diagnostic process and also to rule out functional impairment (which was sometimes corroborated by Occupational Therapy assessment). All clinicians reported using the Addenbrooke’s Cognitive Examination-III as a primary assessment tool. Neuroimaging was frequently found to have minimal usefulness due to the neuroradiological reports being non-specific.
Conclusion
Our study revealed a mixture of approaches to assessing and disclosing test results for MCI. Some clinicians consider the condition as a separate entity among neurodegenerative disorders whereas others find the term unhelpful due to its uncertain prognosis. Clinicians report a lack of specific and sensitive assessment methods for identifying the aetiology of MCI in clinical practice. Our study demonstrates a broad range of views and therefore variability in MCI risk disclosure in memory assessment services which may impact the management of individuals with MCI.
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Reinke C, Buchmann N, Fink A, Tegeler C, Demuth I, Doblhammer G. Diabetes duration and the risk of dementia: a cohort study based on German health claims data. Age Ageing 2022; 51:6454655. [PMID: 34923587 PMCID: PMC8753043 DOI: 10.1093/ageing/afab231] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/14/2021] [Indexed: 01/21/2023] Open
Abstract
Objective Diabetes is a risk factor for dementia but little is known about the impact of diabetes duration on the risk of dementia. We investigated the effect of type 2 diabetes duration on the risk of dementia. Design Prospective cohort study using health claims data representative for the older German population. The data contain information about diagnoses and medical prescriptions from the in- and outpatient sector. Methods We performed piecewise exponential models with a linear and a quadratic term for time since first type 2 diabetes diagnosis to predict the dementia risk in a sample of 13,761 subjects (2,558 dementia cases) older than 65 years. We controlled for severity of diabetes using the Adopted Diabetes Complications Severity Index. Results We found a U-shaped dementia risk over time. After type 2 diabetes diagnosis the dementia risk decreased (26% after 1 year) and reached a minimum at 4.75 years, followed by an increase through the end of follow-up. The pattern was consistent over different treatment groups, with the strongest U-shape for insulin treatment and for those with diabetes complications at the time of diabetes diagnosis. Conclusions We identified a non-linear association of type 2 diabetes duration and the risk of dementia. Physicians should closely monitor cognitive function in diabetic patients beyond the first few years after diagnosis, because the later increase in dementia occurred in all treatment groups.
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Affiliation(s)
- Constantin Reinke
- Institute for Sociology and Demography, University of Rostock, 18057 Rostock, Germany
| | - Nikolaus Buchmann
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Biology of Aging working group, 13353 Berlin, Germany
| | - Anne Fink
- German Center for Neurodegenerative Diseases, 53127 Bonn, Germany
| | - Christina Tegeler
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Biology of Aging working group, 13353 Berlin, Germany
- MSB Medical School Berlin, Department of Psychology, 14197 Berlin, Germany
| | - Ilja Demuth
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Biology of Aging working group, 13353 Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
| | - Gabriele Doblhammer
- Institute for Sociology and Demography, University of Rostock, 18057 Rostock, Germany
- German Center for Neurodegenerative Diseases, 53127 Bonn, Germany
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Cruitt PJ, Hill PL, Oltmanns TF. Personality pathology predicts increased informant-reported, but not performance-based, cognitive decline: Findings from two samples. Personal Disord 2022; 13:30-40. [PMID: 33507791 PMCID: PMC8475501 DOI: 10.1037/per0000434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Research on the relationship between normal-range personality and cognitive aging has demonstrated consistent, modest effects. The current investigation increases our understanding of unhealthy cognitive aging by testing whether personality disorders (PDs), specifically borderline, avoidant, and obsessive-compulsive PDs, show prospective associations with the onset of cognitive problems. Interpersonal stressful life events and social support were expected to mediate these relationships. The current investigation used data from 2 longitudinal studies of older adulthood: the Alzheimer's disease Research Center cohort (ADRC, N = 434, Mage = 69.95, 56% women) and the St. Louis Personality and Aging Network study (SPAN, N = 1,058, Mage = 65.92, 54% women). The ADRC study administered a battery of neuropsychological tests to assess cognitive ability/memory. Borderline PD was measured with a composite from the NEO Five-Factor Inventory. The SPAN study administered self-, informant, and interview measures of the three PDs; a free-recall task; and an informant report measure of cognitive problems. Borderline PD features exhibited cross-sectional correlations with memory (ADRC: r = -.11; SPAN: all rs = -.08), general cognitive ability (ADRC: r = -.11), and informant-reported cognitive problems (rs ranged from .15 to .39). Most importantly, borderline PD features predicted an increase in informant-reported cognitive problems in SPAN participants (standardized bs = .13 and .15) over a 2-year period, but they did not predict a deterioration in the performance-based cognitive measures in either study. Avoidant and obsessive-compulsive PDs exhibited little association with cognitive aging. Neither interpersonal variable mediated any of these effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Patrick J. Cruitt
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO.,Psychology Doctoral Internship Program, Minneapolis VA Health Care System, Minneapolis, MN
| | - Patrick L. Hill
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO
| | - Thomas F. Oltmanns
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO
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Bowland GB, Weyrich LS. The Oral-Microbiome-Brain Axis and Neuropsychiatric Disorders: An Anthropological Perspective. Front Psychiatry 2022; 13:810008. [PMID: 35432038 PMCID: PMC9005879 DOI: 10.3389/fpsyt.2022.810008] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
In the 21st century, neuropsychiatric disorders (NPDs) are on the rise, yet the causal mechanisms behind this global epidemic remain poorly understood. A key to these unknowns may lie within the vast communities of bacteria, fungi, and viruses in the body (microbiota), which are intimately linked with health and disease. NPDs were recently shown to be connected to gut microbiota, which can communicate with and influence the brain through the Gut-Brain-Axis (GBA). Parallel studies examining oral microbiota and their connections to the brain also suggest that microbes in the mouth can similarly influence NPD outcomes. However, the mechanisms and pathways that illuminate how oral microbiota and brain communicate in NPDs remain unknown. Here, we review identified mechanisms and pathways that oral microbiota use to engage the brain, and we lay the theoretical foundation for an oral-microbiota-brain axis (OMBA). Specifically, we examine established neuroinflammatory and immune system activation responses that underpin interactions between the oral microbiota and the central nervous system (CNS), detailing four specific mechanisms: (1) microbial and metabolite escape, (2) neuroinflammation, (3) CNS signaling, and (4) response to neurohormones. We then scrutinize why including the OMBA, in addition to the GBA, is critically needed to elucidate specific causal relationships between microbial dysbiosis and observed NPD development and progression. Furthermore, we argue for comprehensive, interdisciplinary approaches that integrate lab-based microbiome research and population-level studies that examine the OMBA to improve NPDs. We specifically identify key anthropological perspectives that integrate sociocultural, epidemiological, genetic, and environmental factors that shape the oral microbiome and its interactions with NPDs. Together, future studies of the OMBA in conjunction with interdisciplinary approaches can be used to identify NPD risks and improve outcomes, as well as develop novel intervention and treatment strategies.
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Affiliation(s)
- Grace B Bowland
- Department of Anthropology, Pennsylvania State University, University Park, PA, United States
| | - Laura S Weyrich
- Department of Anthropology, Pennsylvania State University, University Park, PA, United States.,Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, United States
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Gómez-Soria I, Ferreira C, Oliván Blazquez B, Magallón Botaya RM, Calatayud E. Short-term memory, attention, and temporal orientation as predictors of the cognitive impairment in older adults: A cross-sectional observational study. PLoS One 2021; 16:e0261313. [PMID: 34928983 PMCID: PMC8687627 DOI: 10.1371/journal.pone.0261313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
Late-life cognitive decline ranges from the mildest cases of normal, age-related change to mild cognitive impairment to severe cases of dementia. Dementia is the largest global burden for the 21st century welfare and healthcare systems. The aim of this study was to analyze the neuropsychological constructs (temporal orientation (TO), spatial orientation (SO), fixation memory (FM), attention (A), calculation (C), short-term memory (STM), language (L), and praxis (P)), semantic fluency, level of functionality, and mood that reveal the greatest deficit in the different stages ranging from normal cognition (NC) to cognitive impairment in older adults in a primary healthcare setting. The study included 337 participants (102 men, 235 women), having a mean age of 74 ± 6 years. According to their scores on the Spanish version of the Mini-Mental State Examination (MEC-35), subjects were divided into 4 groups: no deterioration (ND) (score 32-35), subtle cognitive impairment (SCI) (score 28-31), level deterioration (LD) (score 24-27) and moderate deterioration (MD) (score 20-23). The ND group revealed significant differences in TO, STM, C, A, L, P, and S-T as compared to the other groups. The MD group (in all the neuropsychological constructs) and the ND and SCI groups showed significant differences on the Yesavage geriatric depression scale (GDS-15). All except the FM neuropsychological construct were part of the MEC-35 prediction model and all of the regression coefficients were significant for these variables in the model. Furthermore, the highest average percentage of relative deterioration occurs between LD and MD and the greatest deterioration is observed in the STM for all groups, including A and TO for the LD and MD groups. Based on our findings, community programs have been implemented that use cognitive stimulation to prevent cognitive decline and to maintain the neuropsychological constructs.
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Affiliation(s)
- Isabel Gómez-Soria
- Faculty of Health Sciences, Department of Physiatry and Nursing,
University of Zaragoza, Zaragoza, Spain
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
| | - Chelo Ferreira
- Faculty of Veterinary Sciences, Department of Applied Mathematics and
IUMA, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván Blazquez
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
- Faculty of Social and Labor Sciences, Department of Psychology and
Sociology, University of Zaragoza, Zaragoza, Spain
| | - Rosa Mª Magallón Botaya
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
- Faculty of Medicine, Department of Medicine, Psychiatry and Dermatology,
University of Zaragoza, Zaragoza, Spain
| | - Estela Calatayud
- Faculty of Health Sciences, Department of Physiatry and Nursing,
University of Zaragoza, Zaragoza, Spain
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
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Moret-Tatay C, Iborra-Marmolejo I, Jorques-Infante MJ, Esteve-Rodrigo JV, Schwanke CHA, Irigaray TQ. Can Virtual Assistants Perform Cognitive Assessment in Older Adults? A Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121310. [PMID: 34946255 PMCID: PMC8704479 DOI: 10.3390/medicina57121310] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 01/24/2023]
Abstract
Community-dwelling older adults have raised the scientific community’s interest during the COVID-19 era as their chronic conditions might be aggravated by the consequences of confinement. Digital devices in this field to monitor cognitive impairment are an emerging reality of an innovative nature. However, some groups may not have benefited from these developments as much as, for example, younger people. The aim of this manuscript is to carry out a review on the development of digital devices, and specifically virtual assistants, for the detection of cognitive impairment in older adults. After a screening process, eight studies were found under the given criteria, and this number was even smaller for those using virtual assistants. Given the opportunities offered by virtual assistants through techniques such as natural language processing, it seems imperative to take advantage of this opportunity for groups such as older adults.
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Affiliation(s)
- Carmen Moret-Tatay
- Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Burjassot, 46100 Valencia, Spain; (I.I.-M.); (M.J.J.-I.); (J.V.E.-R.)
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
| | - Isabel Iborra-Marmolejo
- Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Burjassot, 46100 Valencia, Spain; (I.I.-M.); (M.J.J.-I.); (J.V.E.-R.)
| | - María José Jorques-Infante
- Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Burjassot, 46100 Valencia, Spain; (I.I.-M.); (M.J.J.-I.); (J.V.E.-R.)
| | - José Vicente Esteve-Rodrigo
- Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Burjassot, 46100 Valencia, Spain; (I.I.-M.); (M.J.J.-I.); (J.V.E.-R.)
| | - Carla H. A. Schwanke
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, Brazil;
- Institute of Geriatrics and Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, Brazil
| | - Tatiana Q. Irigaray
- Programa de Pós Graduação em Paicologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre 90619-900, Brazil;
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Abstract
PURPOSE OF REVIEW Metabolic syndrome (MetS) is a cluster of cardiovascular disease risk factors that are related to several adverse health outcomes, including poor cognitive function. This review seeks to summarize and critically review select recent findings on the association between MetS and cognition. RECENT FINDINGS MetS was associated with lower domain-specific and global cognitive function in most cross-sectional studies, but findings from longitudinal studies are not consistent. The associations varied depending on age, sex, cognitive test, genetic susceptibility, and the duration of follow-up in prospective studies. MetS was associated with a higher risk of mild cognitive impairment (MCI) and progression from MCI to dementia, particularly vascular dementia. Among MetS components, high blood pressure, high waist circumference, and hyperglycemia were the strongest predictors of cognitive function. MetS is associated with higher risk of cognitive impairment. Research is needed on how preventing or treating MetS affects cognition.
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Prigatano GP, Salins N. End of Life Neuropsychological Impairments and Psychological Care of Persons With Advanced Parkinsonism. Am J Hosp Palliat Care 2021; 39:962-965. [PMID: 34607486 DOI: 10.1177/10499091211049798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Decline in executive functioning, before frank dementia occurs, has been reported in patients with a history of stroke and malignant brain tumors. This may also be true in patients with advanced Parkinson's disease (PD). In this paper, we summarize the limited research on the motor and cognitive predictors of mortality in advanced PD. We then provide 2 case vignettes of patients with end of life advanced PD who demonstrated a substantial decline in working memory and speech festination. We contrast these patients' neuropsychological features to a third patient with advanced PD who shows no signs of impending death. Monitoring neuropsychological signs of executive dysfunction, explaining the neuropsychological dysfunctions to the patient and spouse while recognizing the past and retained cognitive competencies of the person is an important component of end of life psychological care. In the context of this type of consultation, the patient may experience an opportunity to communicate their emotional concerns prior to death which further reduces the anxiety associated with death.
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Affiliation(s)
- George P Prigatano
- Department of Clinical Neuropsychology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Naomi Salins
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
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Valencia N, Lehrner J. Assessing visuo-constructive functions in patients with subjective cognitive decline, mild cognitive impairment and Alzheimer’s disease with the Vienna Visuo-Constructional Test 3.0 (VVT 3.0). NEUROPSYCHIATRIE 2021; 35:147-155. [PMID: 33507487 PMCID: PMC8429385 DOI: 10.1007/s40211-021-00385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
Background Visuo-Constructive functions have considerable potential for the early diagnosis and monitoring of disease progression in Alzheimer’s disease. Objectives Using the Vienna Visuo-Constructional Test 3.0 (VVT 3.0), we measured visuo-constructive functions in subjective cognitive decline (SCD), mild cognitive impairment (MCI), Alzheimer’s disease (AD), and healthy controls to determine whether VVT performance can be used to distinguish these groups. Materials and methods Data of 671 participants was analyzed comparing scores across diagnostic groups and exploring associations with relevant clinical variables. Predictive validity was assessed using Receiver Operator Characteristic curves and multinomial logistic regression analysis. Results We found significant differences between AD and the other groups. Identification of cases suffering from visuo-constructive impairment was possible using VVT scores, but these did not permit classification into diagnostic subgroups. Conclusions In summary, VVT scores are useful indicators for visuo-constructive impairment but face challenges when attempting to discriminate between several diagnostic groups.
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Affiliation(s)
- Noel Valencia
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria.
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50
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Clouston SAP, Muñiz Terrera G, Rodgers JL, O'Keefe P, Mann F, Lewis NA, Wänström L, Kaye J, Hofer SM. Cohort and Period Effects as Explanations for Declining Dementia Trends and Cognitive Aging. POPULATION AND DEVELOPMENT REVIEW 2021; 47:611-637. [PMID: 36937313 PMCID: PMC10021404 DOI: 10.1111/padr.12409] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Studies have reported that the age-adjusted incidence of cognitive impairment and dementia may have decreased over the past two decades. Aging is the predominant risk factor for Alzheimer's disease and related dementias and for neurocognitive decline. However, aging cannot explain changes in overall age-adjusted incidence of dementia. The objective of this position paper was to describe the potential for cohort and period effects in cognitive decline and incidence of dementia. Cohort effects have long been reported in demographic literature, but starting in the early 1980s, researchers began reporting cohort trends in cognitive function. At the same time, period effects have emerged in economic factors and stressors in early and midlife that may result in reduced cognitive dysfunction. Recognizing that aging individuals today were once children and adolescents, and that research has clearly noted that childhood cognitive performance is a primary determinant of old-age cognitive performance, this is the first study that proposes the need to connect known cohort effects in childhood cognition with differences in late-life functioning.
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Affiliation(s)
- Sean A P Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Graciela Muñiz Terrera
- Biostatistics and Epidemiology, Center for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Joseph Lee Rodgers
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Frank Mann
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Nathan A Lewis
- Department of Psychology, University of Victoria, Victoria, BC
| | - Linda Wänström
- Department of Computer and Informational Science, Linköping University, Linköping, Sweden
| | - Jeffrey Kaye
- Oregon Center for Aging and Technology, Oregon Health and Sciences University, and NIA-Layton Aging & Alzheimer's Disease Center, Portland, OR, USA
| | - Scott M Hofer
- Department of Psychology, University of Victoria, Victoria, BC
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