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Rodrigues EA, Christie GJ, Cosco T, Farzan F, Sixsmith A, Moreno S. A Subtype Perspective on Cognitive Trajectories in Healthy Aging. Brain Sci 2024; 14:351. [PMID: 38672003 PMCID: PMC11048421 DOI: 10.3390/brainsci14040351] [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: 02/17/2024] [Revised: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
Cognitive aging is a complex and dynamic process characterized by changes due to genetics and environmental factors, including lifestyle choices and environmental exposure, which contribute to the heterogeneity observed in cognitive outcomes. This heterogeneity is particularly pronounced among older adults, with some individuals maintaining stable cognitive function while others experience complex, non-linear changes, making it difficult to identify meaningful decline accurately. Current research methods range from population-level modeling to individual-specific assessments. In this work, we review these methodologies and propose that population subtyping should be considered as a viable alternative. This approach relies on early individual-specific detection methods that can lead to an improved understanding of changes in individual cognitive trajectories. The improved understanding of cognitive trajectories through population subtyping can lead to the identification of meaningful changes and the determination of timely, effective interventions. This approach can aid in informing policy decisions and in developing targeted interventions that promote cognitive health, ultimately contributing to a more personalized understanding of the aging process within society and reducing the burden on healthcare systems.
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Affiliation(s)
- Emma A. Rodrigues
- School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC V3T 0A3, Canada
| | | | - Theodore Cosco
- Department of Gerontology, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
| | - Faranak Farzan
- School of Mechatronics and Systems Engineering, Simon Fraser University, Surrey, BC V3T 0A3, Canada
| | - Andrew Sixsmith
- Department of Gerontology, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
| | - Sylvain Moreno
- School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC V3T 0A3, Canada
- Circle Innovation, Simon Fraser University, Surrey, BC V3T 0A3, Canada
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2
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Fernández I, Tomás JM, Bethmann A. Latent trajectories of recent and delayed memory and their predictors: evidence from SHARE. Int Psychogeriatr 2024; 36:210-220. [PMID: 36756761 DOI: 10.1017/s1041610222001016] [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] [Indexed: 02/10/2023]
Abstract
OBJECTIVES Cognitive decline is common in the old age, but some evidence suggests it may already occur during adulthood. Previous studies have linked age, gender, educational attainment, depression, physical activity, and social engagement to better cognitive performance over time. However, most studies have used global measures of cognition, which could mask subtle changes in specific cognitive domains. The aim of this study is to examine trajectories of recent and delayed memory recall from a variable-centered perspective, in order to elucidate the impact of age, gender, educational attainment, depression, physical activity, and social engagement on recent and delayed memory both at initial time and across a 10-year period. DESIGN AND PARTICIPANTS The sample was formed by 56,616 adults and older adults that participated in waves 4 to 8 of the Survey of Health, Aging and Retirement in Europe (SHARE). ANALYSES We used latent growth modeling to establish latent recent and delayed memory trajectories, and then tested the effects of the aforementioned covariates on the latent intercept and slopes. RESULTS Results showed that both recent and delayed recall display a quadratic trajectory of decline. All covariates significantly explained initial levels of immediate and delayed recall, but only a few had statistically significant effects on the slope terms. CONCLUSIONS We discuss differences between present results and those previously reported in studies using a person-centered approach. This study provides evidence of memory decline during adulthood and old adulthood. Further, results provide support for the neural compensation reserve theory.
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Affiliation(s)
- Irene Fernández
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - José M Tomás
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - Arne Bethmann
- Technical University of Munich/Munich Center for the Economics of Aging, Max Planck Institute for Social Law and Social Policy, Germany
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Fan YC, Lin SF, Chou CC, Bai CH. Developmental Trajectories and Predictors of Incident Dementia among Elderly Taiwanese People: A 14-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3065. [PMID: 36833763 PMCID: PMC9962520 DOI: 10.3390/ijerph20043065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to identify dementia trajectories and their associated predictors among elderly Taiwanese people over a 14-year period using a nationwide representative longitudinal study. This retrospective cohort study was performed using the National Health Insurance Research Database. Group-based trajectory modeling (GBTM) was used to distinguish the specific trajectory groups of incident dementia during 2000-2013. All 42,407 patients were classified by GBTM to identify the trajectory of incident dementia, which included high- (n = 11,637, 29.0%), moderate- (n = 19,036, 44.9%), and low-incidence (n = 11,734, 26.1%) groups. Those diagnosed with hypertension (adjusted odds ratio [aOR] = 1.43; 95% confidence interval [CI] = 1.35-1.52), stroke (aOR = 1.45, 95% CI = 1.31-1.60), coronary heart disease (aOR = 1.29, 95% CI = 1.19-1.39), heart failure (aOR = 1.62, 95% CI = 1.36-1.93), and chronic obstructive pulmonary disease (aOR = 1.10, 95% CI = 1.02-1.18) at baseline revealed tendencies to be classified into high-incidence groups in dementia risk. The results from a 14-year longitudinal study identified three distinct trajectories of incident dementia among elderly Taiwanese people: patients with cardiovascular disease risk factors and cardiovascular disease events tended to be classified into high-incidence dementia groups. Early detection and management of these associated risk factors in the elderly may prevent or delay the deterioration of cognitive decline.
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Affiliation(s)
- Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Sheng-Feng Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Chia-Chi Chou
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100025, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 204201, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
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4
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Linear Mixed Model Analysis of Polygenic Hazard Score on Verbal Memory Decline in Alzheimer's Disease. Nurs Res 2023; 72:66-73. [PMID: 36097266 DOI: 10.1097/nnr.0000000000000623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a chronic, progressive, degenerative disease characterized by cognitive dysfunction, including verbal memory loss. Studies were lacking in examining the longitudinal effect of polygenic hazard score on the Rey Auditory Verbal Learning Test-Delayed Total (AVDELTOT) score (a common measure of verbal memory). A key step in analyzing longitudinal changes in cognitive measures using a linear mixed model (LMM) is choosing a suitable covariance structure. OBJECTIVES The study aims to determine the association between the polygenic hazard score and the AVDELTOT score accounting for repeated measures (the covariance structure). METHODS The AVDELTOT scores were collected at baseline, 12 months, 24 months, 36 months, and 48 months from 283 participants with AD, 347 with cognitive normal, and 846 with mild cognitive impairment in the Alzheimer's Disease Neuroimaging Initiative. The Bayesian information criterion statistic was used to select the best covariance structure from 10 covariance structures in longitudinal analysis of AVDELTOT scores. The multivariable LMM was used to investigate the effect of polygenic hazard score status (low vs. medium vs. high) on changes in AVDELTOT scores while adjusted for age, gender, education, APOE-ε4 genotype, and baseline Mini-Mental State Examination score. RESULTS One-way analysis of variance revealed significant differences in AVDELTOT scores, Mini-Mental State Examination scores, and polygenic hazard scores among AD diagnoses at baseline. Bayesian information criterion favored the compound symmetry covariance structure in the LMM analysis. Using the multivariate LMM, the APOE-ε4 allele and high polygenic hazard score value was significantly associated with AVDELTOT declines. Significant polygenic hazard score status by follow-up visit interactions was discovered. CONCLUSION Our findings provide the first evidence of the effect of polygenic hazard score status and APOE-ε4 allele on declines in verbal memory in people with AD.
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Gao Y, Felsky D, Reyes-Dumeyer D, Sariya S, Rentería MA, Ma Y, Klein HU, Cosentino S, De Jager PL, Bennett DA, Brickman AM, Schellenberg GD, Mayeux R, Barral S. Integration of GWAS and brain transcriptomic analyses in a multiethnic sample of 35,245 older adults identifies DCDC2 gene as predictor of episodic memory maintenance. Alzheimers Dement 2022; 18:1797-1811. [PMID: 34873813 PMCID: PMC9170841 DOI: 10.1002/alz.12524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/03/2021] [Accepted: 10/12/2021] [Indexed: 01/28/2023]
Abstract
Identifying genes underlying memory function will help characterize cognitively resilient and high-risk declining subpopulations contributing to precision medicine strategies. We estimated episodic memory trajectories in 35,245 ethnically diverse older adults representing eight independent cohorts. We conducted apolipoprotein E (APOE)-stratified genome-wide association study (GWAS) analyses and combined individual cohorts' results via meta-analysis. Three independent transcriptomics datasets were used to further interpret GWAS signals. We identified DCDC2 gene significantly associated with episodic memory (Pmeta = 3.3 x 10-8 ) among non-carriers of APOE ε4 (N = 24,941). Brain transcriptomics revealed an association between episodic memory maintenance and (1) increased dorsolateral prefrontal cortex DCDC2 expression (P = 3.8 x 10-4 ) and (2) lower burden of pathological Alzheimer's disease (AD) hallmarks (paired helical fragment tau P = .003, and amyloid beta load P = .008). Additional transcriptomics results comparing AD and cognitively healthy brain samples showed a downregulation of DCDC2 levels in superior temporal gyrus (P = .007) and inferior frontal gyrus (P = .013). Our work identified DCDC2 gene as a novel predictor of memory maintenance.
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Affiliation(s)
- Yizhe Gao
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA
| | - Daniel Felsky
- Krembil Centre for Neuroinformatics, Centre for Addiction
and Mental Health, Toronto, ON, Canada.,Department of Psychiatry & Institute of Medical
Science, University of Toronto, Toronto, ON, Canada
| | - Dolly Reyes-Dumeyer
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,G.H. Sergievsky Center, Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA.,Department of Neurology, Vagelos College of Physicians and
Surgeons, New York-Presbyterian Hospital, Columbia University Medical Center, New
York, NY, USA
| | - Sanjeev Sariya
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA
| | - Miguel Arce Rentería
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,Department of Neurology, Vagelos College of Physicians and
Surgeons, New York-Presbyterian Hospital, Columbia University Medical Center, New
York, NY, USA
| | - Yiyi Ma
- Center for Translational & Computational
Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center,
New York, NY, 10032, USA
| | - Hans-Ulrich Klein
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,Center for Translational & Computational
Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center,
New York, NY, 10032, USA
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,G.H. Sergievsky Center, Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA.,Department of Neurology, Vagelos College of Physicians and
Surgeons, New York-Presbyterian Hospital, Columbia University Medical Center, New
York, NY, USA
| | - Philip L. De Jager
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,Center for Translational & Computational
Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center,
New York, NY, 10032, USA.,Cell Circuits Program, Broad Institute, Cambridge, MA,
USA
| | - David A. Bennett
- Rush University Medical Center, Rush Alzheimer’s
Disease Center, Chicago, IL, USA.,Rush University Medical Center, Department of Neurological
Sciences, Chicago, IL, USA
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,G.H. Sergievsky Center, Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA.,Department of Neurology, Vagelos College of Physicians and
Surgeons, New York-Presbyterian Hospital, Columbia University Medical Center, New
York, NY, USA
| | - Gerard D. Schellenberg
- Department of Pathology and Laboratory Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,G.H. Sergievsky Center, Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA.,Department of Neurology, Vagelos College of Physicians and
Surgeons, New York-Presbyterian Hospital, Columbia University Medical Center, New
York, NY, USA
| | - Sandra Barral
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia
University, New York, NY, USA.,G.H. Sergievsky Center, Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA.,Department of Neurology, Vagelos College of Physicians and
Surgeons, New York-Presbyterian Hospital, Columbia University Medical Center, New
York, NY, USA
| | -
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
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Pirani A, Nasreddine Z, Neviani F, Fabbo A, Rocchi MB, Bertolotti M, Tulipani C, Galassi M, Belvedere Murri M, Neri M. MoCA 7.1: Multicenter Validation of the First Italian Version of Montreal Cognitive Assessment. J Alzheimers Dis Rep 2022; 6:509-520. [PMID: 36186724 PMCID: PMC9484132 DOI: 10.3233/adr-210053] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 07/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The early detection of neurocognitive disorders, especially when mild, is a key issue of health care systems including the Italian Dementia National Plan. The Mini-Mental State Examination (MMSE), i.e., the reference screening tool for dementia in Italian Memory Clinics, has low sensitivity in detecting mild cognitive impairment (MCI) or mild dementia. Objective: Availability of a 10-minute screening test sensitive to MCI and mild dementia, such as the Montreal Cognitive Assessment (MoCA), is relevant in the field. This study presents initial validity and reliability data for the Italian version of MoCA 7.1 that is being collected as part of a large ongoing longitudinal study to evaluate the rate of incident MCI and dementia in older adults. Methods: MoCA 7.1 and MMSE were administered to cognitive impaired patients (n = 469; 214 with MCI, 255 with dementia; mean age: 75.5; 52% females,) and healthy older adults (n = 123, mean age: 69.7, 64 % females). Results: Test-retest (0.945, p < 0.001) and inter-rater (0.999, p < 0.001) reliability of MoCA 7.1, assessed on randomly selected participants with normal cognition, MCI, dementia, were significant. MoCA 7.1 showed adequate sensitivity (95.3%) and specificity (84.5%) in detecting MCI compared to MMSE (sensitivity: 53.8%; specificity: 87.5%). The Area Under the Curve of MoCA 7.1 was significantly greater than that of MMSE (0.963 versus 0.742). MoCA 7.1 showed similar results in detecting both MCI and dementia. Conclusion: MoCA 7.1 is a reliable and useful tool that can aid in the diagnosis of MCI and dementia in the Italian population.
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Affiliation(s)
- Alessandro Pirani
- Center for Cognitive Disorders and Dementia, Health County of Ferrara, Cento, Italy
- Alzheimer’s Association “Francesco Mazzuca”, Cento, (Fe), Italy
| | | | - Francesca Neviani
- Center for Cognitive Disorders and Dementia. Chair of Geriatrics, University of Modenaand Reggio Emilia, Italy
| | - Andrea Fabbo
- Dementia Program, HealthTrust, Health County of Modena, Italy
| | | | - Marco Bertolotti
- Division of Geriatric Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia and University Hospital of Modena, Modena, Italy
- Center for Gerontological Evaluation and Research, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Tulipani
- Center for Cognitive Disorders and Dementia, Health County of Ferrara, Cento, Italy
- Alzheimer’s Association “Francesco Mazzuca”, Cento, (Fe), Italy
| | - Matteo Galassi
- Center for Cognitive Disorders and Dementia. Chair of Geriatrics, University of Modenaand Reggio Emilia, Italy
| | - Martino Belvedere Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Mirco Neri
- Center for Cognitive Disorders and Dementia. Chair of Geriatrics, University of Modenaand Reggio Emilia, Italy
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Won J, Nielson KA, Smith JC. Subjective Well-Being and Bilateral Anterior Insula Functional Connectivity After Exercise Intervention in Older Adults With Mild Cognitive Impairment. Front Neurosci 2022; 16:834816. [PMID: 35620672 PMCID: PMC9128803 DOI: 10.3389/fnins.2022.834816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/19/2022] [Indexed: 11/29/2022] Open
Abstract
While it is well known that exercise training is associated with improvement in subjective well-being among older adults, it is unclear if individuals with cognitive impairment experience the same effects elicited by exercise on subjective well-being. We further explored whether the bilateral anterior insula network may be an underlying neural mechanism for the exercise training-related improvements in subjective well-being. We investigated the effects of exercise training on subjective well-being in older adults (78.4 ± 7.1 years) with mild cognitive impairment (MCI; n = 14) and a cognitively normal (CN; n = 14) control group. We specifically assessed the relationship between changes in subjective well-being and changes in functional connectivity (FC) with the bilateral anterior insula from before to after exercise training. Cardiorespiratory fitness, subjective well-being, and resting-state fMRI were measured before and after a 12-week moderate-intensity walking intervention. A seed-based correlation analysis was conducted using the bilateral anterior insula as a priori seed regions of interest. The associations between bilateral anterior insula FC with other brain regions and subjective well-being were computed before and after exercise training, respectively, and the statistical difference between the correlations (before vs after exercise training) was evaluated. There was a significant Group (MCI vs CN) × Time (before vs after exercise training) interaction for subjective well-being, such that while those with MCI demonstrated significantly increased subjective well-being after exercise training, no changes in subjective well-being were observed in CN. Participants with MCI also showed an exercise training-related increase in the bilateral anterior insula FC. While there was no significant correlation between subjective well-being and bilateral anterior insula FC before exercise training, a positive association between subjective well-being and bilateral anterior insula FC was found in the MCI group after exercise training. Our findings indicate that 12 weeks of exercise training may enhance subjective well-being in older adults diagnosed with MCI and, further, suggest that increased bilateral anterior insula FC with other cortical regions may reflect neural network plasticity associated with exercise training-related improvements in subjective well-being.
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Affiliation(s)
- Junyeon Won
- Department of Kinesiology, University of Maryland, College Park, MD, United States
| | - Kristy A. Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, United States
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - J. Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD, United States
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States
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Alviarez-Schulze V, Cattaneo G, Pachón-García C, Solana-Sánchez J, Tormos JM, Pascual-Leone A, Bartrés-Faz D. Validation and Normative Data of the Spanish Version of the Rey Auditory Verbal Learning Test and Associated Long-Term Forgetting Measures in Middle-Aged Adults. Front Aging Neurosci 2022; 14:809019. [PMID: 35221995 PMCID: PMC8865334 DOI: 10.3389/fnagi.2022.809019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/10/2022] [Indexed: 01/06/2023] Open
Abstract
Rey Auditory Verbal Learning Test (RAVLT) is an episodic memory helpful measure to detect changes associated with abnormal aging. There is a lack of RAVLT validation and normalization studies in Spain. The aim was to determine its psychometric properties and explore long-term forgetting (LTF) performance through 1-week delayed recall under three different modes of administration. The RAVLT was administered to 602 cognitively healthy volunteers, aged between 41 and 65 years, of whom 251 completed the LTF assessment. Findings reveal a factorial structure of four components, with satisfactory goodness of fit, and adequate convergent and divergent validity. We also demonstrated the differential effect of three methodologies used in LTF assessment, supporting that test expectancy positively influences long-term storage. Finally, normative data were generated according to age, sex, and education. The test, including the LTF measure, is a promising tool to estimate memory in middle-aged adults and develop predictive brain aging models.
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Affiliation(s)
- Vanessa Alviarez-Schulze
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Departamento de Ciencias del Comportamiento, Escuela de Psicología, Universidad Metropolitana, Caracas, Venezuela
- *Correspondence: Vanessa Alviarez-Schulze,
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Catherine Pachón-García
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology and Harvard Medical School, Boston, MA, United States
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
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9
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Kim SJ, Woo SY, Kim YJ, Jang H, Kim HJ, Na DL, Kim S, Seo SW, the Alzheimer's Disease Neuroimaging Initiative. Development of prediction models for distinguishable cognitive trajectories in patients with amyloid positive mild cognitive impairment. Neurobiol Aging 2022; 114:84-93. [DOI: 10.1016/j.neurobiolaging.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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10
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Drouin SM, McFall GP, Dixon RA. Subjective memory concerns, poor vascular health, and male sex predict exacerbated memory decline trajectories: An integrative data-driven class and prediction analysis. Neuropsychology 2022; 36:128-139. [PMID: 34793183 PMCID: PMC9991483 DOI: 10.1037/neu0000784] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Subjective memory decline (SMD) has been identified as a potential early marker of nonnormal and accelerated cognitive decline. We performed data-driven analyses that integrated trajectory classification with prediction modeling to test declining trajectory class prediction by SMD facets, pulse pressure (PP; i.e., a robust proxy for vascular health), and sex. METHOD The longitudinal design featured memory trajectories across a 40-year band (55-95 years) of nondemented aging (N = 580; Mage = 70.2 years; 65% female) from the Victoria Longitudinal Study. First, latent class growth analyses identified distinct classes of memory trajectories. Second, we used the three-step method (R3STEP) to predict membership in the declining memory classes using six measures: memory complaints, memory concerns, memory compensation, memory self-efficacy, PP, and sex. RESULTS First, we identified four classes of memory aging trajectories: (a) stable memory aging (STABLE), (b) typical memory aging (TYPICAL), (c) slowly declining memory aging (SLOW), and (d) rapidly declining memory aging (RAPID). Second, more memory concerns predicted membership in the SLOW and RAPID classes. Higher PP predicted membership in the SLOW class. Male sex predicted membership in the declining (TYPICAL, SLOW, RAPID) classes. CONCLUSION Among SMD facets, memory concerns represent the most severe degree of apprehension about subjectively experienced memory losses. The present integrative data-driven analysis indicated that such concerns predicted membership in declining memory trajectory classes in addition to worse vascular health (higher PP) and sex (male). In nondemented aging, concerns about increasing memory failures may be veridical indicators of memory loss, especially when coupled with vascular comorbidity and being male. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Shannon M. Drouin
- Department of Psychology, University of Alberta, Edmonton AB T6G 2E1 Canada
| | - G. Peggy McFall
- Department of Psychology, University of Alberta, Edmonton AB T6G 2E1 Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton AB T6G 2E1 Canada
| | - Roger A. Dixon
- Department of Psychology, University of Alberta, Edmonton AB T6G 2E1 Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton AB T6G 2E1 Canada
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11
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Maziero MP, Belan AFR, Camargo MVZDA, Silagi ML, Forlenza OV, Radanovic M. Textual Inference Comprehension in Mild Cognitive Impairment: The Influence of Semantic Processing and Verbal Episodic Memory. Front Aging Neurosci 2021; 13:735633. [PMID: 34675798 PMCID: PMC8524675 DOI: 10.3389/fnagi.2021.735633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022] Open
Abstract
Language complaints, especially in complex tasks, may occur in mild cognitive impairment (MCI). Various language measures have been studied as cognitive predictors of MCI conversion to Alzheimer's type dementia. Understanding textual inferences is considered a high-demanding task that recruits multiple cognitive functions and, therefore, could be sensitive to detect decline in the early stages of MCI. Thus, we aimed to compare the performance of subjects with MCI to healthy elderly in a textual inference comprehension task and to determine the best predictors of performance in this ability considering one verbal episodic memory and two semantic tasks. We studied 99 individuals divided into three groups: (1) 23 individuals with amnestic mild cognitive impairment (aMCI), (2) 42 individuals with non-amnestic mild cognitive impairment (naMCI), (3), and (4) 34 cognitively healthy individuals for the control group (CG). A reduced version of The Implicit Management Test was used to assess different types of inferential reasoning in text reading. MCI patients performed poorer than healthy elderly, and there were no differences between MCI subgroups (amnestic and non-amnestic). The best predictors for inference-making were verbal memory in the aMCI and semantic tasks in the naMCI group. The results confirmed that the failure to understand textual inferences can be present in MCI and showed that different cognitive skills like semantic knowledge and verbal episodic memory are necessary for inference-making.
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Affiliation(s)
- Maria Paula Maziero
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Marcela Lima Silagi
- Department of Speech, Language and Hearing Sciences, Federal University of São Paulo, São Paulo, Brazil
| | | | - Marcia Radanovic
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
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12
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Boenniger MM, Staerk C, Coors A, Huijbers W, Ettinger U, Breteler MMB. Ten German versions of Rey's auditory verbal learning test: Age and sex effects in 4,000 adults of the Rhineland Study. J Clin Exp Neuropsychol 2021; 43:637-653. [PMID: 34636711 DOI: 10.1080/13803395.2021.1984398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Detecting early pathological cognitive decline is critical for dementia and aging-related research and clinical diagnostics. Rey's Auditory Verbal Learning Test (AVLT) is commonly used to measure episodic verbal memory. The test requires participants to learn a list of 15 words over several trials. Since multiple testing is often required to detect cognitive decline, but repeating the same test can bias results, we developed 10 German AVLT word lists. METHOD We randomly assigned the lists to 4,000 participants (aged 30-94 years) from a population-based cohort to test their comparability, as well as aging effects and sex differences. RESULTS Nine lists were highly comparable, with only one being slightly more difficult. Recall performance decreased on average by 0.6-1.1 words per trial per decade of age. Perseveration errors decreased with increasing age. Women remembered on average between 0.8 and 1.5 words per trial more than men, regardless of age. Women also outperformed men in the sum of Trials 1-5, learning over trials, retroactive inhibition, and false-positive and interference errors. Proactive inhibition remained stable across age and was unaffected by sex. CONCLUSION This German AVLT version presents comparable lists including detailed age and sex references and therefore allows test repetition excluding training effects. These versions are a valuable resource for research and clinical application.
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Affiliation(s)
- Meta M Boenniger
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Christian Staerk
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Annabell Coors
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Willem Huijbers
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
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13
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Wang X, Younan D, Petkus AJ, Beavers DP, Espeland MA, Chui HC, Resnick SM, Gatz M, Kaufman JD, Wellenius GA, Whitsel EA, Manson JE, Chen JC. Ambient Air Pollution and Long-Term Trajectories of Episodic Memory Decline among Older Women in the WHIMS-ECHO Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:97009. [PMID: 34516296 PMCID: PMC8437247 DOI: 10.1289/ehp7668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Episodic memory decline varies by age and underlying neuropathology. Whether ambient air pollution contributes to the heterogeneity of episodic memory decline in older populations remains unclear. OBJECTIVES We estimated associations between air pollution exposures and episodic memory decline according to pollutant, exposure time window, age, and latent class subgroups defined by episodic memory trajectories. METHODS Participants were from the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes. Older women (n = 2,056 ; 74-92 years of age) completed annual (2008-2018) episodic memory assessments using the telephone-based California Verbal Learning Test (CVLT). We estimated 3-y average fine particulate matter [PM with an aerodynamic diameter of ≤ 2.5 μ m (PM 2.5 )] and nitrogen dioxide (NO 2 ) exposures at baseline and 10 y earlier (recent and remote exposures, respectively), using regionalized national universal kriging. Separate latent class mixed models were used to estimate associations between interquartile range increases in exposures and CVLT trajectories in women ≤ 80 and > 80 years of age , adjusting for covariates. RESULTS Two latent classes were identified for women ≤ 80 years of age (n = 828 ), "slow-decliners" {slope = - 0.12 / y [95% confidence interval (CI): - 0.23 , - 0.01 ] and "fast-decliners" [slope = - 1.79 / y (95% CI: - 2.08 , - 1.50 )]}. In the slow-decliner class, but not the fast-decliner class, PM 2.5 exposures were associated with a greater decline in CVLT scores over time, with a stronger association for recent vs. remote exposures [- 0.16 / y (95% CI: - 2.08 , - 0.03 ) per 2.88 μ g / m 3 and - 0.11 / y (95% CI: - 0.22 , 0.01) per 3.27 μ g / m 3 , respectively]. Among women ≥ 80 years of age (n = 1,128 ), the largest latent class comprised "steady-decliners" [slope = - 1.35 / y (95% CI: - 1.53 , - 1.17 )], whereas the second class, "cognitively resilient", had no decline in CVLT on average. PM 2.5 was not associated with episodic memory decline in either class. A 6.25 -ppb increase in recent NO 2 was associated with nonsignificant acceleration of episodic memory decline in the ≤ 80 -y-old fast-decliner class [- 0.21 / y (95% CI: - 0.45 , 0.04)], and in the > 80 -y-old cognitively resilient class [- 0.10 / y (95% CI: - 0.24 , 0.03)] and steady-decliner class [- 0.11 / y (95% CI: - 0.27 , 0.05)]. Associations with recent NO 2 exposure in women > 80 years of age were stronger and statistically significant when 267 women with incident probable dementia were excluded [e.g., - 0.12 / y (95% CI: - 0.22 , - 0.02 ) for the cognitively resilient class]. In contrast with changes in CVLT over time, there were no associations between exposures and CVLT scores during follow-up in any subgroup. DISCUSSION In a community-dwelling U.S. population of older women, associations between late-life exposure to ambient air pollution and episodic memory decline varied by age-related cognitive trajectories, exposure time windows, and pollutants. https://doi.org/10.1289/EHP7668.
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Affiliation(s)
- Xinhui Wang
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Diana Younan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Andrew J. Petkus
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Daniel P. Beavers
- Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Mark A. Espeland
- Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Helena C. Chui
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Department of Health and Human Services, Baltimore, Maryland, USA
| | - Margaret Gatz
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Joel D. Kaufman
- Departments of Environmental & Occupational Health Sciences, Medicine (General Internal Medicine), and Epidemiology, University of Washington, Seattle, Washington, USA
| | - Gregory A. Wellenius
- Department of Environmental Health, Boston University, Boston, Massachusetts, USA
| | - Eric A. Whitsel
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - JoAnn E. Manson
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jiu-Chiuan Chen
- Department of Neurology, University of Southern California, Los Angeles, California, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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14
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Wu Z, Woods RL, Wolfe R, Storey E, Chong TTJ, Shah RC, Orchard SG, McNeil JJ, Murray AM, Ryan J. Trajectories of cognitive function in community-dwelling older adults: A longitudinal study of population heterogeneity. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12180. [PMID: 33969173 PMCID: PMC8088593 DOI: 10.1002/dad2.12180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study aimed to investigate cognitive aging trajectories, the associated sociodemographic characteristics, and the association of these trajectories with dementia. METHODS Generally healthy older adults (n = 19,114) were followed for up to 7 years, with regular cognitive assessments. Group-based trajectory modeling identified distinct cognitive trajectories. RESULTS Four to seven trajectories were identified per cognitive domain. Stable trajectories were observed across domains. Improvement in verbal fluency and minor psychomotor slowing were common. Substantial decline in global cognition and episodic memory were observed in a small proportion of individuals. Older, less educated participants and men were more common in lower-functioning trajectories (p < .001). The highest proportions of dementia cases were in trajectories with major decline in global cognition (56.9%) and memory (33.2%). DISCUSSION Inter-individual variability in cognitive trajectories was observed across all domains. Some individuals appear resilient to cognitive decline even with advancing age. Further research into factors promoting cognitive resilience is needed.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Robyn L. Woods
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Rory Wolfe
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Elsdon Storey
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Trevor T. J. Chong
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia
- Department of NeurologyAlfred HealthMelbourneAustralia
- Department of Clinical NeurosciencesSt. Vincent's HospitalMelbourneAustralia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Suzanne G. Orchard
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - John J. McNeil
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical ResearchMinneapolisMinnesotaUSA
| | - Joanne Ryan
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
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15
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Callow DD, Won J, Pena GS, Jordan LS, Arnold-Nedimala NA, Kommula Y, Nielson KA, Smith JC. Exercise Training-Related Changes in Cortical Gray Matter Diffusivity and Cognitive Function in Mild Cognitive Impairment and Healthy Older Adults. Front Aging Neurosci 2021; 13:645258. [PMID: 33897407 PMCID: PMC8060483 DOI: 10.3389/fnagi.2021.645258] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Individuals with Mild Cognitive Impairment (MCI) are at an elevated risk of dementia and exhibit deficits in cognition and cortical gray matter (GM) volume, thickness, and microstructure. Meanwhile, exercise training appears to preserve brain function and macrostructure may help delay or prevent the onset of dementia in individuals with MCI. Yet, our understanding of the neurophysiological effects of exercise training in individuals with MCI remains limited. Recent work suggests that the measures of gray matter microstructure using diffusion imaging may be sensitive to early cognitive and neurophysiological changes in the aging brain. Therefore, this study is aimed to determine the effects of exercise training in cognition and cortical gray matter microstructure in individuals with MCI vs. cognitively healthy older adults. Fifteen MCI participants and 17 cognitively intact controls (HC) volunteered for a 12-week supervised walking intervention. Following the intervention, MCI and HC saw improvements in cardiorespiratory fitness, performance on Trial 1 of the Rey Auditory Verbal Learning Test (RAVLT), a measure of verbal memory, and the Controlled Oral Word Association Test (COWAT), a measure of verbal fluency. After controlling for age, a voxel-wise analysis of cortical gray matter diffusivity showed individuals with MCI exhibited greater increases in mean diffusivity (MD) in the left insular cortex than HC. This increase in MD was positively associated with improvements in COWAT performance. Additionally, after controlling for age, the voxel-wise analysis indicated a main effect of Time with both groups experiencing an increase in left insular and left and right cerebellar MD. Increases in left insular diffusivity were similarly found to be positively associated with improvements in COWAT performance in both groups, while increases in cerebellar MD were related to gains in episodic memory performance. These findings suggest that exercise training may be related to improvements in neural circuits that govern verbal fluency performance in older adults through the microstructural remodeling of cortical gray matter. Furthermore, changes in left insular cortex microstructure may be particularly relevant to improvements in verbal fluency among individuals diagnosed with MCI.
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Affiliation(s)
- Daniel D Callow
- Department of Kinesiology, University of Maryland, College Park, MD, United States.,Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States
| | - Junyeon Won
- Department of Kinesiology, University of Maryland, College Park, MD, United States
| | - Gabriel S Pena
- Department of Kinesiology, University of Maryland, College Park, MD, United States
| | - Leslie S Jordan
- Department of Kinesiology, University of Maryland, College Park, MD, United States.,Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States
| | | | - Yash Kommula
- Department of Kinesiology, University of Maryland, College Park, MD, United States.,Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States
| | - Kristy A Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, United States.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - J Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD, United States.,Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States
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16
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Williams BD, Pendleton N, Chandola T. Does the association between cognition and education differ between older adults with gradual or rapid trajectories of cognitive decline? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2021; 29:1-21. [PMID: 33683174 DOI: 10.1080/13825585.2021.1889958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
Education is associated with improved baseline cognitive performance in older adults, but the association with maintenance of cognitive function is less clear. Education may be associated with different types of active cognitive reserve in those following different cognitive trajectories. We used data on n = 5642 adults aged >60 from the English Longitudinal Study of Aging (ELSA) over 5 waves (8 years). We used growth mixture models to test if the association between educational attainment and rate of change in verbal fluency or immediate recall varied by latent class trajectory. For recall, 91.5% (n = 5164) of participants were in a gradual decline class and 8.5% (n = 478) in a rapid decline class. For fluency, 90.0% (n = 4907) were in a gradual decline class and 10.0% (n = 561) were in a rapid decline class. Educational attainment was associated with improved baseline performance for both verbal fluency and recall. In the rapidly declining classes, educational attainment was not associated with rate of change for either outcome. In the verbal fluency gradual decline class, education was associated with higher (an additional 0.05-0.38 words per 2 years) or degree level education (an additional 0.04-0.42 words per 2 years) when compared to those with no formal qualifications. We identified no evidence of a protective effect of education against rapid cognitive decline. There was some evidence of active cognitive reserve for verbal fluency but not recall, which may reflect a small degree of domain-specific protection against age-related cognitive decline.
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Affiliation(s)
| | - Neil Pendleton
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Tarani Chandola
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
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17
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Karanth SD, Schmitt FA, Nelson PT, Katsumata Y, Kryscio RJ, Fardo DW, Harp JP, Abner EL. Four Common Late-Life Cognitive Trajectories Patterns Associate with Replicable Underlying Neuropathologies. J Alzheimers Dis 2021; 82:647-659. [PMID: 34057090 PMCID: PMC8316292 DOI: 10.3233/jad-210293] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Late-life cognitive function is heterogeneous, ranging from no decline to severe dementia. Prior studies of cognitive trajectories have tended to focus on a single measure of global cognition or individual tests scores, rather than considering longitudinal performance on multiple tests simultaneously. OBJECTIVE The current study aimed to examine cognitive trajectories from two independent datasets to assess whether similar patterns might describe longitudinal cognition in the decade preceding death, as well as what participant characteristics were associated with trajectory membership. METHODS Data were drawn from autopsied longitudinally followed participants of two cohorts (total N = 1,346), community-based cohort at the University of Kentucky Alzheimer's Disease Research Center (n = 365) and National Alzheimer's Coordinating Center (n = 981). We used group-based multi-trajectory models (GBMTM) to identify cognitive trajectories over the decade before death using Mini-Mental State Exam, Logical Memory-Immediate, and Animal Naming performance. Multinomial logistic and Random Forest analyses assessed characteristics associated with trajectory groups. RESULTS GBMTM identified four similar cognitive trajectories in each dataset. In multinomial models, death age, Braak neurofibrillary tangles (NFT) stage, TDP-43, and α-synuclein were associated with declining trajectories. Random Forest results suggested the most important trajectory predictors were Braak NFT stage, cerebral atrophy, death age, and brain weight. Multiple pathologies were most common in trajectories with moderate or accelerated decline. CONCLUSION Cognitive trajectories associated strongly with neuropathology, particularly Braak NFT stage. High frequency of multiple pathologies in trajectories with cognitive decline suggests dementia treatment and prevention efforts must consider multiple diseases simultaneously.
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Affiliation(s)
- Shama D Karanth
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Frederick A Schmitt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - Peter T Nelson
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Pathology, University of Kentucky, Lexington, KY, USA
| | - Yuriko Katsumata
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - Richard J Kryscio
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
- Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - David W Fardo
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - Jordan P Harp
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - Erin L Abner
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
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18
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Wu Z, Phyo AZZ, Al-Harbi T, Woods RL, Ryan J. Distinct Cognitive Trajectories in Late Life and Associated Predictors and Outcomes: A Systematic Review. J Alzheimers Dis Rep 2020; 4:459-478. [PMID: 33283167 PMCID: PMC7683100 DOI: 10.3233/adr-200232] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Cognitive aging is a dynamic process in late life with significant heterogeneity across individuals. Objective To review the evidence for latent classes of cognitive trajectories and to identify the associated predictors and outcomes. Methods A systematic search was performed in MEDLINE and EMBASE for articles that identified two or more cognitive trajectories in adults. The study was conducted following the PRISMA statement. Results Thirty-seven studies were included, ranging from 219 to 9,704 participants, with a mean age of 60 to 93.4 years. Most studies (n = 30) identified distinct cognitive trajectories using latent class growth analysis. The trajectory profile commonly consisted of three to four classes with progressively decreasing baseline and increasing rate of decline-a 'stable-high' class characterized as maintenance of cognitive function at high level, a 'minor-decline' class or 'stable-medium' class that declines gradually over time, and a 'rapid-decline' class with the steepest downward slope. Generally, membership of better classes was predicted by younger age, being female, more years of education, better health, healthier lifestyle, higher social engagement and lack of genetic risk variants. Some factors (e.g., education) were found to be associated with cognitive function over time only within individual classes. Conclusion Cognitive aging in late life is a dynamic process with significant inter-individual variability. However, it remains unclear whether similar patterns of cognitive aging are observed across all cognitive domains. Further research into unique factors which promote the maintenance of high-cognitive function is needed to help inform public policy.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Tagrid Al-Harbi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,PSNREC, Univ Montpellier, INSERM, Montpellier, France
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19
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吴 玉, 林 岚, 王 婧, 吴 水. [Application of semantic segmentation based on convolutional neural network in medical images]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2020; 37:533-540. [PMID: 32597097 PMCID: PMC10319567 DOI: 10.7507/1001-5515.201906067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Indexed: 11/03/2022]
Abstract
With the rapid development of network structure, convolutional neural networks (CNN) consolidated its position as a leading machine learning tool in the field of image analysis. Therefore, semantic segmentation based on CNN has also become a key high-level task in medical image understanding. This paper reviews the research progress on CNN-based semantic segmentation in the field of medical image. A variety of classical semantic segmentation methods are reviewed, whose contributions and significance are highlighted. On this basis, their applications in the segmentation of some major physiological and pathological anatomical structures are further summarized and discussed. Finally, the open challenges and potential development direction of semantic segmentation based on CNN in the area of medical image are discussed.
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Affiliation(s)
- 玉超 吴
- 北京工业大学 生命科学与生物工程学院(北京 100124)College of Life Science and Bio-engineering, Beijing University of Technology, Beijing 100124, P.R.China
| | - 岚 林
- 北京工业大学 生命科学与生物工程学院(北京 100124)College of Life Science and Bio-engineering, Beijing University of Technology, Beijing 100124, P.R.China
| | - 婧璇 王
- 北京工业大学 生命科学与生物工程学院(北京 100124)College of Life Science and Bio-engineering, Beijing University of Technology, Beijing 100124, P.R.China
| | - 水才 吴
- 北京工业大学 生命科学与生物工程学院(北京 100124)College of Life Science and Bio-engineering, Beijing University of Technology, Beijing 100124, P.R.China
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