Mild cognitive impairment and its management in older people

Virtual Reality Interventions for Older Adults With Mild Cognitive Impairment: Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Alzheimer disease is incurable, but it is possible to intervene and slow down the progression of dementia during periods of mild cognitive impairment (MCI) through virtual reality (VR) technology.

OBJECTIVE

This study aimed to analyze the effects of VR interventions on older adults with MCI. The examined outcomes include cognitive abilities, mood, quality of life, and physical fitness, including general cognitive function, memory performance, attention and information processing speed, executive function, language proficiency, visuospatial abilities, depression, daily mobility of individuals, muscle performance, and gait and balance.

METHODS

A total of 4 web-based databases (Web of Science, PubMed, Embase, and Ovid) were searched up to December 30, 2023, for randomized controlled trials assessing the self-reported outcomes of VR-based technology on cognition, mood, quality of life, and physical fitness in older adults (aged ≥55 years) with MCI. Two reviewers independently screened the search results and reference lists of the identified papers and related reviews. Data on the intervention components and delivery and behavioral change techniques used were extracted. A meta-analysis, risk-of-bias sensitivity analysis, and subgroup analysis were performed where appropriate to explore potential moderators. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the quality of evidence.

RESULTS

This review analyzed 18 studies involving 722 older adults with MCI. VR was delivered through different immersion levels with VR cognitive training, VR physical training, or VR cognitive-motor dual-task training. VR interventions showed significant improvements in memory (standardized mean difference [SMD] 0.2, 95% CI 0.02-0.38), attention and information processing speed (SMD 0.25, 95% CI 0.06-0.45), and executive function (SMD 0.22, 95% CI 0.02-0.42). VR without therapist involvement improved memory as well as attention and information processing speed. VR cognitive training also resulted in significant improvements in attention and information processing speed in older adults with MCI (SMD 0.31, 95% CI 0.05-0.58). In addition, immersive VR had a significant impact on improving attention and information processing speed (SMD 0.25; 95% CI 0.01-0.50) and executive function (SMD 0.25; 95% CI 0.00-0.50). However, the effects of the intervention were very small in terms of general cognitive function, language proficiency, visuospatial abilities, depression, daily living ability, muscle performance, and gait and balance. Quality of evidence varied, with moderate ratings for certain cognitive functions and low ratings for others, based on the GRADE approach.

CONCLUSIONS

VR interventions can improve memory, attention and information processing speed, and executive function in older adults with MCI. The quality of evidence is moderate to low, and further research is needed to confirm these findings and explore additional health-related outcomes.

Association of plasma BDNF and MMP-9 levels with mild cognitive impairment: a matched case-control study

The prevalence of Alzheimer's disease (AD) is on the rise globally, and everyone who develops AD eventually experiences mild cognitive impairment (MCI) first. Timely intervention at an early stage of the disease may mitigate disease progression. Recent studies indicate that BDNF and MMP-9 play a significant role in the pathogenesis of AD. Therefore, this study aims to ascertain whether there are differences in plasma BDNF and MMP-9 levels between individuals with mild cognitive impairment due to AD and those with normal cognition, and to analyze the factors influencing mild cognitive impairment.This case-control study included 102 individuals with mild cognitive impairment and 102 controls, matched by age and sex. Participants completed a series of questionnaires, neuropsychological assessments, and clinical examinations. Plasma concentrations of BDNF and MMP-9 of the participants were quantified using ELISA. Subsequently, the factors influencing MCI were analyzed using univariate and multivariate logistic regression. The differences in plasma BDNF levels, MOCA total scores, and scores in various cognitive domains (including visuospatial and executive abilities, abstract thinking, attention, language, naming, and delayed memory) between the MCI and the control groups showed statistically significant (p < 0.05). Logistic regression analysis revealed that plasma BDNF levels and years of formal education were significantly negatively associated with MCI. This study indicates that plasma BDNF and years of formal education are protective factors influencing cognitive function.

Prevalence of cognitive impairment and its related factors among Chinese older adults: an analysis based on the 2018 CHARLS data

Background

Cognitive impairment is a major public health concern in aging societies. This study aimed to investigate the prevalence of cognitive impairment and its associated factors among Chinese adults aged 60 years and older using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS).

Methods

Utilizing data from the 2018 wave of CHARLS, we assessed participants' cognitive status using the Mini-Mental State Examination (MMSE), and the influencing factors related to cognitive impairment were analyzed by using the chi-square test and multifactor logistic regression. The prevalence of cognitive impairment was stratified by gender, education level, residence, marital status, daytime napping, and nighttime sleep duration, and the trend of cognitive impairment prevalence with age was observed.

Results

9,804 participants were finally included in the study and the overall prevalence of cognitive impairment was 44.04% (95%CI, 43.02-45.06%). The prevalence was significantly higher in females (50.8%) than males (37.1%), and increased with age, from 41.5% in those aged 60-64 years to 57.7% in those aged ≥75 years. Lower educational level, rural residence, and being divorced/ widowed/unmarried were associated with a higher prevalence of cognitive impairment (all p < 0.001). Multifactor logistic regression indicated that older age (OR = 1.51, 95%CI, 1.33-1.73 for ≥75 vs. 60-64 years), female gender (OR = 1.54, 95%CI, 1.35-1.77), higher education (OR = 0.46, 95%CI, 0.42-0.51 for primary school and below vs. illiteracy), rural areas (OR = 2.35, 95%CI, 2.07-2.65 for village vs. the center of city/town), divorced/ widowed/unmarried status (OR = 1.40, 95%CI, 1.25-1.57) and participation in physical activity (OR = 0.80, 95%CI, 0.73-0.87) were significantly associated with cognitive impairment.

Conclusion

Cognitive impairment is highly prevalent among older adults in China with substantial demographic disparities. Targeted interventions and public health strategies are needed to promote cognitive health in this rapidly aging population.

Identification of circulating risk biomarkers for cognitive decline in a large community-based population in Chongqing China

INTRODUCTION

This study aims to investigate the relationship between blood-based pathologies and established risk factors for cognitive decline in the community-based population of Chongqing, a region with significant aging.

METHODS

A total of 26,554 residents aged 50 years and older were recruited. Multinomial logistic regression models were applied to assess the risk factors of cognition levels. Propensity score matching and linear mixed effects models were used to evaluate the relationship between key risk factors and the circulating biomarkers.

RESULTS

Shared and distinct risk factors for MCI and dementia were identified. Age, lower education, medical history of stroke, hypertension, and epilepsy influenced mild cognitive impairment (MCI) progression to dementia. Correlations between key risk factors and circulating neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), amyloid β protein (Aβ)40, and Aβ42/Aβ40 ratio suggest underlying mechanisms contributing to cognitive impairment.

DISCUSSION

The common and distinct risk factors across cognitive decline stages emphasize the need for tailored interventions. The correlations with blood biomarkers provide insights into potential management targets.

HIGHLIGHTS

From a large community-based cohort study on the residents in Chongqing, we have identified that mild cognitive impairment (MCI) and dementia share several common risk factors, including age, female gender, rural living, lower education levels, and a medical history of stroke. However, each condition also has its own unique risk factors. Several factors contribute to the progression of MCI into dementia including age, education levels, occupation, and a medical history of hypertension and epilepsy. We discover the correlations between the risk factors for dementia and blood biomarkers that indicate the presence of axonal damage, glial activation, and Aβ pathology.

Progress in lung cancer study coupled with cognitive frailty in elderly individuals

Cognitive frailty is increasingly prevalent among elderly patients, heightening the risks of dementia, disability, and mortality. This demographic also faces a rising incidence of lung cancer, and cognitive frailty complicates rehabilitation efforts. Research on cognitive frailty in elderly lung cancer patients is still emerging. This review examines the definition and assessment of cognitive frailty, its the current prevalence in this population, and nursing management strategies. While tools for assessing cognitive frailty are not standardized, the incidence remains high, leading to adverse health outcomes. Comprehensive interventions for elderly lung cancer patients with cognitive frailty are insufficient, highlighting the need for more effective strategies to mitigate this issue. The goal is to enhance both research and clinical practices in identifying and diagnosing cognitive frailty in this vulnerable population.

Exploration of demographic prevalence of mild cognitive impairment using Montreal cognitive assessment: A cross-sectional pilot study in the Cape Coast Metropolis, Ghana

Background

The Global prevalence of dementia is projected to rise, particularly in low and middle-income countries like Ghana. Mild cognitive impairment (MCI), an intermediate phase between normal cognitive aging and dementia, is characterized by an objective and subjective decline in cognitive abilities. Individuals with MCI have a greater likelihood of progression to dementia.

Purpose

There is a paucity of studies focused on assessing the prevalence, risk factors and characteristics of mild cognitive impairment within the Ghanaian population. This study assessed the prevalence of mild cognitive impairment and explored its relationship with various sociodemographic factors.

Methods

A prospective cross-sectional analytical study within Cape Coast, Ghana, evaluating the cognition of 100 participants using the Montreal Cognitive Assessment (MoCA) tool. The prevalence of MCI was determined using simple descriptive measures. The two-way ANOVA was used to determine risk factors for developing MCI. The Pearson correlation coefficient was used to determine the relationship between educational level and MoCA score.

Results

A majority (65.4 %) of participants within the age group 40-49 years had mild cognitive impairment. 42.86 % of male and 40.54 % of female participants had MCI (MoCA score < 26). There was a significant correlation (r= 0.608, p= 0.0001) between the educational level of participants and the MoCA score. Participants classified as having MCI based on their MoCA score, performed significantly poorer in visuospatial, attention, language, abstraction and delayed recall domains compared to those with normal cognition.

Conclusion

The MoCA tool is a useful for detecting MCI, particularly among Ghanaians with at least 7 years of formal education. The prevalence of MCI among individuals aged 40-49 years in the Cape Coast Metropolis represents an important health burden.

Mediating role of gut microbiota on Baduanjin for cognitive function in community-dwelling older adults with mild cognitive impairment: a study protocol for a cluster randomised controlled trial

INTRODUCTION

The gut microbiome plays an important role in maintaining both cognitive and physical functions in older adults, and gut dysbiosis is an important pathophysiological mechanism of mild cognitive impairment (MCI) in older adults. As a typical traditional Chinese mind-body exercise, regular Baduanjin training has been shown to improve cognitive function and modulate the gut microbiome in community-dwelling older adults. However, the potential role of the gut microbiome in the benefits of Baduanjin on cognitive function remains unclear. The aim of this study is to investigate the mediating effect of gut microbiome between regular Baduanjin training and improvement in cognitive function in community-dwelling older adults with MCI.

METHODS AND ANALYSIS

This is a two-arm, randomised, parallel-controlled, single-blinded trial. Four residential communities (clusters) with a total of 64 eligible participants (16 participants in each residential community) will be randomised 1:1 to either the 24-week Baduanjin exercise intervention group (60 min per session, four sessions per week) or the no specific exercise intervention control group. Global cognitive function and the subdimensions of cognition including executive function, visuospatial function, language function and memory function will be assessed using the Montreal Cognitive Assessment Scale, Trail Making Test, Auditory Verbal Learning Test, Boston Naming Test-30 and Clock-Drawing Test, while the gut microbiome and its metabolomics will be detected using 16S rRNA and ultra-high-performance liquid chromatography-tandem mass spectrometry at baseline and at the end of 24-week intervention. The intervention effect of Baduanjin exercise and mediating role of gut microbiota will be analysed using linear mixed models and the bootstrapping method in the Hayes process.

ETHICS AND DISSEMINATION

This study conforms to Declaration of Helsinki principles and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of the Shanghai University of Medicine and Health Sciences (approval number: 2023-GZR-011). Written informed consent will be obtained from all participants. Results will be disseminated to relevant groups in peer-reviewed journal(s), and at relevant international or national scientific conferences. Key findings will also be shared with social media, healthcare providers, participants or community-dwelling older adults to support access for non-research audiences.

TRIAL REGISTRATION NUMBER

ChiCTR2300078147.

Using three statistical methods to analyze the associations between a mixture of multi-nutrients and risk of mild cognitive impairment in an elderly population in Northern China

Few studies have considered nutrients as a mixture and their impact on Mild Cognitive Impairment (MCI). The generalized linear regression (GLM), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models are fitted to estimate the association between intake of a mixture of nutrients and MCI. Comparing the results from these three models, vitamin E and vitamin B6 were identified as the most important factors associated with the risk of MCI. Considering the characteristics of BKMR, it may be more advantageous to use BKMR to estimate the combined the joint effects of nutrients mixture. In the future, studies need to move from a "one nutrient at a time" approach to simultaneous analyses of multiple nutrients intakes in order to understand and quantify the joint effect of nutrients mixture on health.

The effects of different types of exercises on cognition in older persons with mild cognitive impairment: A systematic review and meta-analysis

PURPOSE

This systematic review with meta-analysis aims to analyze the effects of different types of exercise on cognition, neuroprotective and neuroinflammatory blood markers in older adults with mild cognitive impairment (MCI).

METHODS

Relevant studies were identified using PubMED, SPORTDiscuss, Web of Science, Scopus, and PsycInfo databases. Methodological quality assessment of the studies was done with modified Downs and Black checklist. Data obtained from the included studies was analyzed using Comprehensive Meta-Analysis 4.0 software and results were reported using the random effects method.

RESULTS

A total of twenty-three studies were identified. The findings were summarized as change in cognitive function after the exercise interventions in general and after each type of exercise. On average, the exercise intervention revealed an effect size (ES): 1.165; 0.741 to 1.589 (95% Confidence Interval (CI); p < 0.001); aerobic exercise ES: 1.442; 0.624 to 2.260 (95 %CI); p = 0.001; Multimodal ES: 0,856; 0.366 to 1.346 (95 % CI); p = 0.001 and resistance exercise ES: 1.229; 0.339 to 2.120 (95 % CI); p = 0.007. In addition, we observed significant small ES: -0.475; -0.817 to -0.134 (95 %CI); p = 0.006, I2= 0 %; τ2 = 0 of exercise effects on Tumor Necrosis Factor-α (TNF-α) and non-significant large ES:0.952; -0.238 to 2.142 (95 %CI); p = 0.117 on Brain Derived Neurotrophic Factor (BDNF) in persons with MCI.

CONCLUSION

The present study revealed the existence of a large positive effect of overall exercise intervention on cognitive function and a small effect on TNF-α in old people with MCI. Additionally, this study demonstrates that aerobic and resistance exercises had similar larger positive effects and were better than multimodal exercise on increasing cognition in older persons with MCI.

Impact of different gastric acid suppressants on chronic unpredictable mild stress-induced cognitive impairment in rats: A possible involvement of gut dysbiosis

Recently, clinical evidence indicates that gastric acid suppressants are associated with an increased risk of the development of cognitive impairment and dementia, especially in elderly patients and those with mild cognitive impairment. Therefore, the aim of this research was to explore the impact of different gastric acid suppressants use, famotidine (Famo), esomeprazole (Esome) and vonoprazan (Vono) in the absence or the presence of chronic unpredictable mild stress (CUMS) on several memory tasks with examination of the role of gut dysbiosis. In the present study, rats received famotidine (3.7 mg/kg/day, p.o.) or esomeprazole (3.7 mg/kg/day, p.o.) or vonoprazan (1.85 mg/kg/day, p.o.) for 7 weeks with or without exposure to CUMS. Remarkably, CUMS with different acid suppressants caused a significant decrease in all memory tasks in late CUMS in the current investigation. CUMS with acid suppressants also revealed a marked alteration in the fecal Firmicutes/Bacteroidetes ratio compared to CUMS alone. This gut microbiome alteration was associated with an alteration in gut membrane integrity, as revealed by colonic histopathology and an elevation of systemic inflammatory markers. Besides, upregulation of hippocampal amyloid β and p-tau proteins and modification of brain histopathology were noticed. Our findings support the detrimental effect of gastric acid suppressants, especially proton pump inhibitors, on cognitive impairment in the presence of stress, with the possible involvement of gut dysbiosis.

Effects of Creatine Monohydrate Supplementation on Muscle, Bone and Brain- Hope or Hype for Older Adults?

PURPOSE OF REVIEW

Sarcopenia, generally characterized by the age-related reduction in muscle strength, lean/muscle mass and functional ability, is also associated with reduced bone mass and strength and impaired brain health and function. One potential intervention which has received much 'hype' over the past few decades to countermeasure these negative consequences of biological aging is creatine monohydrate supplementation.

RECENT FINDINGS

From a skeletal muscle perspective, the combination of creatine monohydrate supplementation and resistance training provides 'hope' for older adults as it improves measures of lean mass, regional (limb) muscle thickness, upper- and lower-body muscle strength and functional ability. Further, there is some evidence that creatine (supplementation or habitual diet) provides a ray of 'hope' for improving some aspects of cognitive function. The majority of research suggests that creatine is more 'hype' than 'hope' for improving measures of bone mass in older adults. Creatine monohydrate supplementation provides some anti-sarcopenic benefits for older adults.

Transcranial photobiomodulation increases cognition and serum BDNF levels in adults over 50 years: A randomized, double-blind, placebo-controlled trial

BACKGROUND

There is a significant lack of therapeutic options for mild cognitive impairment (MCI), which is rapidly becoming a global epidemic due to aging. Transcranial photobiomodulation (t-PBM) involves delivering near-infrared light (NIR) to the scalp, targeting cortical areas of the brain. NIR t-PBM has recently emerged as a potential therapy for various neurodegenerative conditions, including memory issues.

AIMS

This study aimed to evaluate cognition scores (primary outcome), depression, anxiety, resilience scores, neuroplasticity, and neurodegeneration biomarkers (secondary outcomes) in individuals with MCI undergoing t-PBM therapy or receiving a placebo.

MATERIALS AND METHODS

A total of 93 older adult individuals with MCI were randomly assigned to either a t-PBM (n = 47) or Placebo (n = 46) group. Clinical assessments were conducted at baseline, 60 days post-treatment, and a 150-day follow-up. We also measured serum levels of brain-derived neurotrophic factor (BDNF), a neuroplasticity biomarker, as well as neuron-specific enolase (NSE) and calcium-binding protein B (S100B), which are neurodegeneration biomarkers. Intervention effects were analyzed using repeated measures (RM) two-way ANOVA followed by Tukey post hoc test. Fischer's exact test and Generalized Estimating Equations (GEE) were also applied.

RESULTS

Of the 93 older adults individuals invited to participate, 76 (t-PBM: 40, placebo: 36) completed the study. The t-PBM significantly improved cognition as measured by the Montreal Cognitive Assessment (MoCA) compared to placebo (p = 0.0301). The delta values for MoCA scores were 3.20 in the t-PBM group and 1.97 in the placebo group. This effect persisted until the three-month follow-up, accompanied by increased BDNF levels in the t-PBM group but not in the placebo group (p = 0.0046). The delta values for BDNF were 821.94 in the t-PBM group and 359.41 in the placebo group. t-PBM did not alter depression, anxiety, resilience scores, nor the levels of NSE and S100B in individuals with MCI.

CONCLUSION

The t-PBM increases cognitive function and BDNF levels in adults with MCI. Its application as an adjunctive treatment may play a crucial role in preventing neurodegenerative diseases.

Challenges for Family Caregivers of Persons With Mild Cognitive Impairment: A Qualitative Longitudinal Study

Family caregivers of persons with mild cognitive impairment attempt to understand the behavioural and functional changes exhibited by their relative. However, how caregivers respond to initial changes and changes over time has not been explored. The purpose of this qualitative study was to explore the experience of family caregivers responding to changes in their relative's memory, behaviours, and physical functions over 2 years. Eleven family caregivers of a relative with mild cognitive impairment were purposively recruited from neurological clinics in Taiwan. Face-to-face semi-structured interviews were conducted within 6-months of referral; three follow-ups were conducted at 6-month intervals. Content analysis of 41 transcribed audio-recorded interviews revealed the longitudinal changes in their relative with cognitive impairment was made caregiving challenging. Three themes described the challenges: (1) Changes related to their relative's cognitive impairment, which included increases in mood fluctuations, erratic behaviours, and reductions in physical abilities; (2) changes in their relative's comorbidities, which included adapting to new symptoms and treatments for a chronic disease, monitoring medication adherence and drug interactions; and (3) changes in caregiver burden, which increased levels of stress, uncertainty, and anxiety resulting in greater role strain. Caregiving became more challenging with time, especially caregivers whose relative developed dementia during the study period. These findings offer insight into the trajectory of the experience of family caregivers attempting to understand changes in cognition, behaviours, and physical functions for their relative with mild cognitive impairment over 2 years, which could help mental healthcare providers develop support services to reduce caregiver role strain.

A feasibility and usability study of a virtual reality tool (VESPA 2.0) for cognitive rehabilitation in patients with mild cognitive impairment: an ecological approach

Introduction

Mild cognitive impairment (MCI) or "mild neurocognitive disorder" represents an intermediate status between normality and dementia. It is characterized by cognitive decline that does not significantly interfere with normal daily living activities. Virtual reality (VR) is the new frontier of rehabilitation.

Methods

We enrolled 50 MCI patients who underwent a neuropsychological evaluation and participated in 40 sessions of cognitive treatment using the Virtual Environment for a Superior Neuro-Psychiatry, Second Generation (VESPA 2.0) System. This preliminary study highlights the role of VR tools for cognitive rehabilitation (CR) for the recovery of cognitive functions and consequent better management of MCI condition. Our study demonstrated that the VESPA 2.0 System is a valuable tool in a context that closely resembles real-life situations rather than controlled, artificial environments as traditional cognitive training methods.

Results

The results showed that the patient group had significant improvements between T0 and T1 (assessment), in particular, in the global cognitive profile, visuospatial skills, and executive functions after treatment with the VESPA 2.0 System.

Discussion

Our findings contribute with new evidence of understanding the impact of using simulations of the Activities of Daily Living (ADL) scale in the CR.

The potential of Terminalia chebula in alleviating mild cognitive impairment: a review

Terminalia chebula Retz. (T. Chebula, ཨ་རུ་ར།) is highly utilized in ethnic medicine. Its medicinal value is gradually being recognized and shows great potential in the improvement of mild cognitive impairment (MCI) disorders. Tibetan medicine theory classifies this type of disease as one of the "Jie Xie Syndrome (བརྗེད་བྱེད།)." The role of T. Chebula in such diseases has been increasingly studied. This work aimed to elucidate the research progress of T. Chebula in alleviating MCI. The review offers a critical update on the current understanding of the effect of T. Chebula on MCI and highlights new opportunities for exploring its therapeutic potential. This review discusses the role of T. Chebula in alleviating MCI and provides a comprehensive overview of the traditional medicinal uses, chemical composition, toxicology, and quality control aspects of T. Chebula. This review covers 171 chemical constituents and 11 active constituents targeting MCI, such as flavonoids, which can alleviate MCI, primarily through its antioxidative, anti-inflammatory, and neuroprotective properties. T. Chebula shows potential as a natural medicine for the treatment and prevention of MCI. As an important part of ethnomedicinal resources, this work offers valuable insights for future research on T. Chebula-containing ethnomedicines. Research on traditional drug treatments, optimized treatment standards, improved societal knowledge about MCI, and development of an early detection system is essential to the diagnosis and treatment of MCI. These efforts will provide better treatment resources for patients with MCI.

Development Trends and Prospects of Technology-Based Solutions for Health Challenges in Aging Over the Past 25 Years: Bibliometric Analysis

BACKGROUND

As the global population ages, we witness a broad scientific and technological revolution tailored to meet the health challenges of older adults. Over the past 25 years, technological innovations, ranging from advanced medical devices to user-friendly mobile apps, are transforming the way we address these challenges, offering new avenues to enhance the quality of life and well-being of the aging demographic.

OBJECTIVE

This study aimed to systematically review the development trends in technology for managing and caring for the health of older adults over the past 25 years and to project future development prospects.

METHODS

We conducted a comprehensive bibliometric analysis of literatures related to technology-based solutions for health challenges in aging, published up to March 18, 2024. The search was performed using the Web of Science Core Collection, covering a span from 1999 to 2024. Our search strategy was designed to capture a broad spectrum of terms associated with aging, health challenges specific to older adults, and technological interventions.

RESULTS

A total of 1133 publications were found in the Web of Science Core Collection. The publication trend over these 25 years showed a gradual but fluctuating increase. The United States was the most productive country and participated in international collaboration most frequently. The predominant keywords identified through this analysis included "dementia," "telemedicine," "older-adults," "telehealth," and "care." The keywords with citation bursts included "telemedicine" and "digital health."

CONCLUSIONS

The scientific and technological revolution has significantly improved older adult health management, particularly in chronic disease monitoring, mobility, and social connectivity. The momentum for innovation continues to build, with future research likely to focus on predictive analytics and personalized health care solutions, further enhancing older adults' independence and quality of life.

A study on the impact of acute exercise on cognitive function in Alzheimer's disease or mild cognitive impairment patients: A narrative review

This narrative review follows the JBI approach and comprehensively explores the effects and mechanisms of acute exercise on cognitive function in Alzheimer's disease (AD) and Mild cognitive impairment (MCI) patients. The results showed that the combination of acute exercise and cognitive training improved the cognitive function of AD patients better than aerobic exercise or resistance training alone. For patients with MCI, moderate intensity acute aerobic exercise and resistance exercise were beneficial to enhance Inhibitory control (IC), but high-intensity acute exercise was adverse to improve IC; Brain-derived neurotrophic factor (BDNF) and Insulin-like growth factor 1 (IGF-1) may assume the potential mediating mechanism of acute exercise on cognitive function in AD and MCI patients, but more research is needed to further confirm this mechanism.

Does personality affect the cognitive decline in aging? A systematic review

Cognitive decline is a natural consequence of aging, but several genetic, environmental, and psychological factors can influence its trajectories. Among the most enduring factors, the Big Five personality traits - defined as relatively stable tendencies to think, behave, and react to the environment - can influence both directly (e.g., by physiological correlates) and indirectly (e.g., healthy or risky behaviors) the risk of developing dementia and mild cognitive impairment (MCI) - a preclinical form of cognitive decline. Despite the great amount of studies focusing on the relationship between personality and cognitive decline, an updated systematic synthesis of the results including a broader range of study designs is still lacking. This systematic review aims to summarize the findings of studies investigating: (i) differences in personality traits between groups of healthy individuals and those with MCI, (ii) the impact of personality traits on the risk for both MCI and dementia, and (iii) changes in personality traits among individuals progressing from normal cognition to MCI. Neuroticism emerged as a significant risk factor for MCI and dementia; Conscientiousness and Openness appear to offer protection against dementia and moderate cognitive decline. Overall, these findings suggest a pivotal role of personality structure in shaping cognitive outcomes on the long run.

DiADEM-Dance against Dementia-Effect of a Six-Month Dance Intervention on Physical Fitness in Older Adults with Mild Cognitive Impairment: A Randomized, Controlled Trial

Background: Preserving health and physical fitness is critical to ensure independent living across the lifespan. Lower levels of physical fitness are associated with age-related cognitive decline and a higher prevalence of mild cognitive impairment (MCI). Thus, this study investigates the influence of a six-month dance intervention on selected measures of physical fitness in older adults with MCI. Methods: In this randomized controlled trial, 55 patients with MCI were randomized into a sportive dance training (IG; n = 26; age: 70.7 ± 5.6 years; 62% female) or an inactive control group (CG; n = 24; age: 69.1 ± 6.8 years; 46% female). The dance group received two 90 min dance training sessions per week over a duration of six-months, which focused on learning dance movement patterns. During the training sessions, heart rate was measured to control exercise intensity. Physical fitness was assessed using cardiopulmonary exercise testing (CPET), lower limb functional fitness via sit-to-stand test, handgrip strength, and heart rate variability (HRV). Results: We observed that the dance intervention preserved the cardiorespiratory fitness as measured by maximal oxygen uptake (VO2max) during CPET, which decreased in the CG. Furthermore, participants in the IG demonstrated increases in leg and handgrip strength, although these were not statistically significant. HRV displayed a non-significant decrease following the intervention. Conclusions: The results of this randomized controlled trial suggest that sportive dance training can preserve elements of physical fitness (i.e., cardiorespiratory fitness) in older adults with MCI. Although improvements in the other parameters (i.e., leg and handgrip strength) were statistically non-significant, likely due to the small sample size, stabilizing muscular fitness and preventing age-related decline in older adults with MCI is important for maintaining functional independence. For future studies, we recommend a longer training duration paired with precise control of regular physical activity levels, an important confounding factor.

Automatic detection of cognitive impairment in patients with white matter hyperintensity and causal analysis of related factors using artificial intelligence of MRI

PURPOSE

White matter hyperintensity (WMH) is a common feature of brain aging, often linked with cognitive decline and dementia. This study aimed to employ deep learning and radiomics to develop models for detecting cognitive impairment in WMH patients and to analyze the causal relationships among cognitive impairment and related factors.

MATERIALS AND METHODS

A total of 79 WMH patients from hospital 1 were randomly divided into a training set (62 patients) and a testing set (17 patients). Additionally, 29 patients from hospital 2 were included as an independent testing set. All participants underwent formal neuropsychological assessments to determine cognitive status. Automated identification and segmentation of WMH were conducted using VB-net, with extraction of radiomics features from cortex, white matter, and nuclei. Four machine learning classifiers were trained on the training set and validated on the testing set to detect cognitive impairment. Model performances were evaluated and compared. Causal analyses were conducted among cortex, white matter, nuclei alterations, and cognitive impairment.

RESULTS

Among the models, the logistic regression (LR) model based on white matter features demonstrated the highest performance, achieving an AUC of 0.819 in the external test dataset. Causal analyses indicated that age, education level, alterations in cortex, white matter, and nuclei were causal factors of cognitive impairment.

CONCLUSION

The LR model based on white matter features exhibited high accuracy in detecting cognitive impairment in WMH patients. Furthermore, the possible causal relationships among alterations in cortex, white matter, nuclei, and cognitive impairment were elucidated.

A methodological and reporting quality assessment of systematic reviews/meta-analyses on exercise interventions for cognitive function in older adults with mild cognitive impairment

Objective

To assess the methodological quality of meta-analytic literature on exercise interventions for cognitive function in patients with mild cognitive impairment (MCI) and the certainty of evidence for its outcome indicators, and to provide clinicians and researchers with more reliable data for making decisions.

Methods

Meta-analytic literature related to the effect of exercise intervention on cognitive function in patients with mild cognitive impairment was searched through PubMed, Cochrane Library, Embase, Scopus, Physiotherapy Evidence Database and Web of Science, all with a search period frame of each database until June 1, 2024. The AMSTAR2 scale was used to evaluate the methodological quality of the included studies.

Results

Seventeen meta-analyses were included. The AMSTAR2 scale evaluation results showed that there was one medium-quality studies (5.55%), seven low-quality studies (38.88%), and 10 very low-quality studies (55.55%). Methodological deficiencies included failure to prepare a plan and provide a registration number, literature screening, data extraction, reasons for exclusion not described in detail, poor implementation process for systematic evaluation, and failure to describe the source of funding for the included studies or relevant conflicts of interest.

Conclusion

The overall methodological quality of the meta-analytic literature is low, and the certainty of evidence is low. We encourage the conduction of high-quality randomized trials to generate stronger evidence. Subsequent systematic reviews can then synthesize this evidence to inform future research and clinical guidelines.

Deficits of Facial Emotion Recognition in Elderly Individuals with Mild Cognitive Impairment

INTRODUCTION

The study of facial emotion recognition is under-explored in subjects with mild cognitive impairment (MCI). We investigated whether deficits in facial emotion recognition are present in patients with MCI. We also analyzed the relationship between facial emotion recognition and different domains of cognitive function.

METHODS

This study included 300 participants aged 60 years or older with cognitive decline. We evaluated 181 MCI and 119 non-MCI subjects using the Seoul Neuropsychological Screening Battery-Core (SNSB-C) and facial emotion recognition task using six facial expressions (anger, disgust, fear, happiness, sadness and surprise). A Generalized Linear Model (GLM) was used to assess the association between cognitive performance and accuracy of facial emotion recognition and to compare facial emotion recognition in the MCI group based on the impairment of five different domains of cognitive function. The model was adjusted for age, sex, years of education, and depressive symptoms.

RESULTS

Patients with MCI had a lower score for accurately recognizing total facial emotion (0.48 vs. 0.53; ρ = 0.0003) and surprise (0.73 vs. 0.81; ρ = 0.0215) when compared to cognitively healthy subjects. We also discovered that frontal/executive function domain (Digit Symbol Coding [DSC, 0.38 vs. 0.49; p < 0.0001], Controlled Oral Word Association Test [COWAT, 0.42 vs. 0.49; p = 0.0001], Korean-Trail Making Test [K-TMT, 0.37 vs. 0.48; p = 0.0073], Korean-Color Word Stroop Test [K-CWST, 0.43 vs. 0.49; p = 0.0219]) and language domain (Korean-Boston Naming Test [S-K-BNT, 0.46 vs. 0.47; p = 0.003]) were statistically associated with the deficits of facial emotion recognition in patients with MCI.

CONCLUSION

We observed a significant association between deficits in facial emotion recognition and cognitive impairment in elderly individuals.

Very high high-density lipoprotein cholesterol may be associated with higher risk of cognitive impairment in older adults

BACKGROUND

Previous studies have shown that high-density lipoprotein cholesterol (HDL-C) levels are positively associated with cognitive function across a range of concentrations. However, recent studies have suggested that very high HDL-C levels may lead to poorer outcomes. Therefore, we aimed to investigate the relationship between different concentrations of HDL-C and cognitive impairment risk.

METHODS

We collected data from 3632 participants aged over 60 years from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014 to assess the relationship between HDL-C and cognitive function. Cognitive function was evaluated with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, the animal fluency test (AFT), and the digit symbol substitution test (DSST). We used restricted cubic spline models and logistic regression to examine the association between HDL-C and cognitive function.

RESULTS

A U-shaped was observed between HDL-C and cognitive outcomes, individuals with higher risk in those with both low and very high HDL-C levels compared with those with midrange values. Very high HDL-C levels (≥ 2.50 mmol/L) were associated with increased risk of cognitive impairment (OR = 2.19; 95% CI, 1.12-4.28) compared with those with HDL-C levels in the range of 1.50 to 1.99 mmol/L in older adults after adjustment for confounding factors. Interaction test demonstrated that relationship between very high HDL-C and the risk of cognitive impairment was not changed in different sex and race group (P for interaction > 0.05).

CONCLUSIONS

Very high HDL-C levels were associated with an increased risk of cognitive impairment. HDL-C may not be a protective factor for maintaining brain health in older adults at very high levels.

The Role of Depression and Anxiety in the Relationship Between Arthritis and Cognitive Impairment in Chinese Older Adults

BACKGROUND

Mental disorders and cognitive impairment are common in older patients with arthritis. While it is recognized that mental conditions may play a role in the connection between arthritis and cognitive impairment, the precise underlying relationship remains uncertain.

METHODS

The data was derived from the baseline survey of the Guangdong Mental Health Survey in South China, involving a sample of 3,764 citizens aged 65 and older. An array of aspects were explored, including socio-demographics, lifestyle behaviors, self-reported chronic conditions, depression, anxiety, and cognitive impairment. Logistic regression analyses examined the association between arthritis and cognitive impairment after adjustment for potential confounders. Serial mediation models were used to examine whether depression or anxiety played a mediating role in the arthritis-cognitive impairment linkage.

RESULTS

The prevalence rates of cognitive impairment and arthritis of the older adults were 28.9% and 12.1%, respectively. Compared to those without arthritis, participants with arthritis were at a higher risk of cognitive impairment (OR = 1.322, 95%CI: 1.022-1.709) after adjustment for socio-demographics, lifestyle behaviors, and mental health conditions. Serial mediation analyses indicated that depressive and anxiety symptoms co-played a serial mediating role in the association between arthritis and cognitive impairment (B1 = 0.025, 95%CI: 0.005-0.052; B2 = 0.050, 95%CI: 0.021-0.086).

CONCLUSIONS

Arthritis may heighten cognitive impairment risk in Chinese older adults, and the relationship was potentially mediated by depressive and anxiety symptoms. Future interventions should be considered, integrating mental health assessments into arthritis care frameworks and being alert to possible cognitive impairment.

Burden and positive aspects of caregiving: cluster profiles of dementia caregiving experiences

OBJECTIVES

Although caregiver burden is common in the context of dementia caregiving, the caregiving role is linked to beneficial outcomes too. Individuals reporting higher positive aspects of caregiving tend to exhibit lower burden relative to those reporting few. The goal of this retrospective review of outpatient memory clinic medical records was to demonstrate whether and how constructs of burden and positive aspects of caregiving coexist within individual caregivers, and to explore potential contributors to caregiver profiles created based upon these constructs.

METHOD

Cluster analyses were conducted on 1160 caregivers from an initial intake interview meeting criteria on primary measures of Positive Aspects of Caregiving and the Zarit Burden Interview and repeated with 225 caregivers meeting inclusion criteria on all measures. Samples were compared for similarity, and the smaller sample (n = 225) was deemed appropriately representative. Multinomial logistic regressions examined cluster predictors in sample with 225 caregivers.

RESULTS

Results suggested a three-cluster solution: a High Burden group, a High Positive Experiences group, and a Low-Moderate Experiences group showing low burden and moderate positive experiences. Greater behavioral problems predicted belonging to the High Burden cluster. Greater care recipient dependence predicted belonging to the High Positive Experiences cluster while greater independence predicted the Low-Moderate Experiences cluster.

CONCLUSION

Findings suggest that burden and positive aspects of caregiving do not simultaneously present in caregivers at high levels. Supportive caregiver interventions might be tailored to profiles demonstrated here. Future research should investigate other potential contributors to experiences of burden and positive aspects of caregiving.

The Role of Physical Exercise in Cognitive Preservation: A Systematic Review

Dementia, or major neurocognitive disorder, is one of the most common causes of disability and dependency in older adults with far-reaching social, physical, and economic impacts. In the absence of adequate treatment, much research has been directed towards prevention. Physical exercise has been shown to increase cerebral blood flow, amplify production of neurotrophic factors, and enhance brain volume. Whether these changes on a structural and cellular level result in cognitive preservation is less clear. This systematic review synthesizes findings from seventeen randomized controlled trials that examine the effects of physical activity on global cognition, memory, and executive function in older adults. Cognitive benefits of exercise are strongest for those who are cognitively intact or with mild cognitive impairment. In studies with long-term follow up, cognitive gains tended to decay after cessation of physical intervention suggesting that sustained physical exercise may be required to preserve cognitive function in older adults prior to onset of dementia.

Neuropsychological Assessment for Early Detection and Diagnosis of Dementia: Current Knowledge and New Insights

Dementia remains an underdiagnosed syndrome, and there is a need to improve the early detection of cognitive decline. This narrative review examines the role of neuropsychological assessment in the characterization of cognitive changes associated with dementia syndrome at different states. The first section describes the early indicators of cognitive decline and the major barriers to their identification. Further, the optimal cognitive screening conditions and the most widely accepted tests are described. The second section analyzes the main differences in cognitive performance between Alzheimer's disease and other subtypes of dementia. Finally, the current challenges of neuropsychological assessment in aging/dementia and future approaches are discussed. Essentially, we find that current research is beginning to uncover early cognitive changes that precede dementia, while continuing to improve and refine the differential diagnosis of neurodegenerative disorders that cause dementia. However, neuropsychology faces several barriers, including the cultural diversity of the populations, a limited implementation in public health systems, and the adaptation to technological advances. Nowadays, neuropsychological assessment plays a fundamental role in characterizing cognitive decline in the different stages of dementia, but more efforts are needed to develop harmonized procedures that facilitate its use in different clinical contexts and research protocols.

Mild cognitive impairment predicts the onset of Sarcopenia: a longitudinal analysis from the English Longitudinal Study on Ageing

BACKGROUND

Mild cognitive impairment (MCI) and sarcopenia are two common conditions in older people. It is not widely known if MCI could predict the onset of sarcopenia. Therefore, we aimed to investigate whether MCI could predict the occurrence of sarcopenia in a population of older adults.

METHODS

In the ELSA (English Longitudinal Study on Ageing), MCI was defined as the absence of dementia, preserved functional capacity and low performance in three objective cognitive tests. Sarcopenia was diagnosed as having low handgrip strength and low skeletal muscle mass index during follow-up. The longitudinal association between MCI at the baseline and incident sarcopenia was assessed using a multivariable logistic regression model, reporting the data as adjusted odds ratios (OR) and 95% confidence intervals (95%CI).

RESULTS

3,106 participants (mean age of 63.1 years; 55.3% males) were included. People with MCI reported significantly lower mean handgrip strength values and Skeletal Mass Index (SMI), as well as a higher prevalence of obesity at baseline. At baseline, 729 people had MCI and during the ten years follow-up period, 12.1% of the initial population included had sarcopenia. On multivariate analysis, adjusted for 18 potential confounders, the presence of MCI (OR = 1.236; 95%CI: 1.090-1.596, p = 0.01) significantly predicted the onset of sarcopenia during follow-up.

CONCLUSION

The presence of MCI at baseline was associated with a higher incidence of sarcopenia at ten-years follow-up, demonstrating a likely role of MCI as a predictor of the onset of sarcopenia in older people.

Association of low muscle mass with cognitive function and mortality in USA seniors: results from NHANES 1999-2002

BACKGROUND

Sarcopenia and cognitive impairment have been linked in prior research, and both are linked to an increased risk of mortality in the general population. Muscle mass is a key factor in the diagnosis of sarcopenia. The relationship between low muscle mass and cognitive function in the aged population, and their combined impact on the risk of death in older adults, is currently unknown. This study aimed to explore the correlation between low muscle mass and cognitive function in the older population, and the relationship between the two and mortality in older people.

METHODS

Data were from the National Health and Nutrition Examination Survey 1999-2002. A total of 2540 older adults aged 60 and older with body composition measures were included. Specifically, 17-21 years of follow-up were conducted on every participant. Low muscle mass was defined using the Foundation for the National Institute of Health and the Asian Working Group for Sarcopenia definitions: appendicular lean mass (ALM) (< 19.75 kg for males; <15.02 kg for females); or ALM divided by body mass index (BMI) (ALM: BMI, < 0.789 for males; <0.512 for females); or appendicular skeletal muscle mass index (ASMI) (< 7.0 kg/m2 for males; <5.4 kg/m2 for females). Cognitive functioning was assessed by the Digit Symbol Substitution Test (DSST). The follow-up period was calculated from the NHANES interview date to the date of death or censoring (December 31, 2019).

RESULTS

We identified 2540 subjects. The mean age was 70.43 years (43.3% male). Age-related declines in DSST scores were observed. People with low muscle mass showed lower DSST scores than people with normal muscle mass across all age groups, especially in the group with low muscle mass characterized by ALM: BMI (60-69 years: p < 0.001; 70-79 years: p < 0.001; 80 + years: p = 0.009). Low muscle mass was significantly associated with lower DSST scores after adjusting for covariates (ALM: 43.56 ± 18.36 vs. 47.56 ± 17.44, p < 0.001; ALM: BMI: 39.88 ± 17.51 vs. 47.70 ± 17.51, p < 0.001; ASMI: 41.07 ± 17.89 vs. 47.42 ± 17.55, p < 0.001). At a mean long-term follow-up of 157.8 months, those with low muscle mass were associated with higher all-cause mortality (ALM: OR 1.460, 95% CI 1.456-1.463; ALM: BMI: OR 1.452, 95% CI 1.448-1.457); ASMI: OR 3.075, 95% CI 3.063-3.088). In the ALM: BMI and ASMI-defined low muscle mass groups, participants with low muscle mass and lower DSST scores were more likely to incur all-cause mortality ( ALM: BMI: OR 0.972, 95% CI 0.972-0.972; ASMI: OR 0.957, 95% CI 0.956-0.957).

CONCLUSIONS

Low muscle mass and cognitive function impairment are significantly correlated in the older population. Additionally, low muscle mass and low DSST score, alone or in combination, could be risk factors for mortality in older adults.

Digital exclusion and cognitive impairment in older people: findings from five longitudinal studies

OBJECTIVES

Older people are more likely to have digital exclusion, which is associated with poor health. This study investigated the relationship between digital exclusion and cognitive impairment in older adults from 23 countries across five longitudinal surveys.

DESIGN AND MEASUREMENTS

Digital exclusion is defined as self-reported non-use of the Internet. We assessed cognitive impairment on three dimensions: orientation, memory, and executive function. We used generalized estimation equations fitting binary logistic regression with exchangeable correlations to study the relationship between digital exclusion and cognitive impairment, and apply the minimum sufficiently adjusted set of causally directed acyclic graphs as the adjusted variable.

SETTING AND PARTICIPANTS

We pooled a nationally representative sample of older adults from five longitudinal studies, including the China Health and Retirement Longitudinal study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS), the Mexican Health and Ageing Study (MHAS) and the Survey of Health, Ageing and Retirement in European (SHARE).

RESULTS

We included 62,413 participants from five longitudinal studies. Digital exclusion varied by country, ranging from 21.69% (SHARE) in Denmark to 97.15% (CHARLS) in China. In the original model, digital exclusion was significantly associated with cognitive impairment in all five studies. In the adjusted model, these associations remained statistically significant: CHARLS (Odds ratio [OR] = 2.81, 95% confidence interval [CI] 1.84-4.28, ELSA (1.92 [1.70-2.18]), HRS(2.48[2.28-2.71), MHAS (1.92 [1.74-2.12]), and SHARE (2.60 [2.34-2.88]).

CONCLUSION

Our research shows that a significant proportion of older people suffer from digital exclusion, especially in China. Digital exclusion was positively correlated with cognitive impairment. These findings suggest that digital inclusion could be an important strategy to improve cognitive function and reduce the risk of cognitive impairment in older adults.

Effect of emotional stimulus on response inhibition in people with mild cognitive impairment: an event-related potential study

Background

A few studies are emerging to explore the issue of how aging promotes emotional response inhibition. However, there is a lack of empirical study concerning the impact of pathological cognitive impairment on emotional response inhibition. The present study investigated the effect of emotion on response inhibition in people with mild cognitive impairment, the stage of cognitive impairment before dementia.

Methods

We used two emotional stop-signal tasks to explore whether the dual competition framework considering limited cognitive resources could explain the relationship between emotion and response inhibition in mild cognitive impairment.

Results

The results showed that negative emotions prolonged N2 latency. The Go trial accuracy was reduced in the high-arousal negative conditions and the stop-signal reaction time was prolonged under high-arousal conditions. This study also verified impaired response inhibition in mild cognitive impairment and found that negative emotions prolonged P3 latency in mild cognitive impairment.

Conclusion

Emotional information interferes with response inhibition in mild cognitive impairment populations, possibly because emotional information captures more attentional resources, thus interfering with response inhibition that relies on common-pool resources.

Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition

This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.

Effects of movement training based on rhythmic auditory stimulation in cognitive impairment: a meta-analysis of randomized controlled clinical trial

Objective

According to the World Alzheimer's Disease Report in 2015,there were 9.9 million new cases of dementia in the world every year. At present, the number of patients suffering from dementia in China has exceeded 8 million, and it may exceed 26 million by 2040.Mild cognitive impairment (MCI) refers to the pathological state of pre-dementia with the manifestation of the progressive decline of memory or other cognitive functions but without decline of activities of daily life. It is particularly important to prevent or prolong the development of MCI into dementia. Research showing effects of rhythmic auditory stimulation based-movement training(RASMT) interventions on cognitive function is also emerging. Therefore, the present meta-analysis briefly summarize findings regarding the impacts of RASMT programs on cognitive impairment.

Methods

Data from Pubmed, Embase, and Cochrane Library were utilized. The impact of RASMT on cognitive functions was evaluated using indicators such as overall cognitive status, memory, attention, and executive functions. The REVMAN5.3 software was employed to analyze bias risks integrated into the study and the meta-analysis results for each indicator.

Results

A total of 1,596 studies were retrieved, of which 1,385 non-randomized controlled studies and 48 repetitive studies were excluded. After reviewing titles and abstracts of the remaining 163 articles, 133 irrelevant studies were excluded, 30 studies were downloaded and read the full text. Among 30 articles, 18 articles that did not meet the inclusion criteria were excluded, the other 12 studies were included in this meta-analysis. Utilizing the Cochrane Collaborative Network Bias Risk Assessment Scale, it was found that 11 studies explained the method of random sequence generation, nine studies did not describe allocation concealment, four were single-blinded to all researchers, and eight reported single-blinding in the evaluation of experimental results. In the meta-analysis, the main outcomes showed statistically significant differences in overall cognitive status [MD = 1.19, 95%CI (0.09, 2.29), (p < 0.05)], attention [MD = -1.86, 95%CI (-3.53, -0.19), (p < 0.05)], memory [MD = 0.71, 95%CI (0.33, 1.09), (p < 0.01)], and executive function [MD = -0.23, 95% CI (-0.44, -0.02), (p < 0.05)]. Secondary outcomes indicated no statistically significant differences in verbal fluency [MD = -0.51, 95%CI (-1.30, 0.27), (p = 0.20)], while depression [MD = -0.29, 95% CI (-0.42, -0.16), (p < 0.01)] and anxiety [MD = 0.19, 95% CI (0.06, 0.32), (p < 0.01)] exhibited statistically significant differences. The GRADEpro GDT online tool assessed the quality of evidence for the outcome measures, revealing one low-quality outcome, two moderate-quality outcomes, and one high-quality outcome in this review.

Conclusion

This study shows that RASMT can improve the general cognitive status, memory, attention and executive function of patients with cognitive impairment. The quality of evidence revealed that MMSE was low, attention and memory were moderate, and executive function was high. The RAMST program (type of exercise: play percussion instruments; time of exercise: 30-60 min; frequency of exercise: 2-3 times/week; duration of exercise: more than 12 weeks) was proved to be more effective in improving cognitive function. However, the sample size is relatively insufficient, the future needs further study.

Systematic review registration

PROSPERO, identifier: CRD42023483561.

Cognitive Decline: Current Intervention Strategies and Integrative Therapeutic Approaches for Alzheimer's Disease

Alzheimer's disease (AD) represents a pressing global health challenge, with an anticipated surge in diagnoses over the next two decades. This progressive neurodegenerative disorder unfolds gradually, with observable symptoms emerging after two decades of imperceptible brain changes. While traditional therapeutic approaches, such as medication and cognitive therapy, remain standard in AD management, their limitations prompt exploration into novel integrative therapeutic approaches. Recent advancements in AD research focus on entraining gamma waves through innovative methods, such as light flickering and electromagnetic fields (EMF) stimulation. Flickering light stimulation (FLS) at 40 Hz has demonstrated significant reductions in AD pathologies in both mice and humans, providing improved cognitive functioning. Additionally, recent experiments have demonstrated that APOE mutations in mouse models substantially reduce tau pathologies, with microglial modulation playing a crucial role. EMFs have also been demonstrated to modulate microglia. The exploration of EMFs as a therapeutic approach is gaining significance, as many recent studies have showcased their potential to influence microglial responses. Th article concludes by speculating on the future directions of AD research, emphasizing the importance of ongoing efforts in understanding the complexities of AD pathogenesis through a holistic approach and developing interventions that hold promise for improved patient outcomes.

Exploring relevant factors of cognitive impairment in the elderly Chinese population using Lasso regression and Bayesian networks

Older adults are highly susceptible to developing cognitive impairment(CI). Various factors contribute to the prevalence of CI, but the potential relationships among these factors remain unclear. This study aims to explore the relevant factors associated with CI in Chinese older adults and analyze the potential relationships between CI and these factors.We analyzed the data on 6886 older adults aged≥60 from the China Health and Retirement Longitudinal Study (CHARLS) 2018. Lasso regression was initially used to screening variables. Bayesian Networks(BNs) were used to identify the correlates of CI and potential associations between factors. After screening with Lasso regression, 11 variables were finally included in the BNs. The BNs, by establishing a complex network relationship, revealed that age, education, and indoor air pollution were the direct correlates affecting the occurrence of CI in older adults. It also indicated that marital status indirectly influenced CI through age, and residence indirectly linked to CI through two pathways: indoor air pollution and education.Our findings underscore the effectiveness of BNs in unveiling the intricate network linkages among CI and its associated factors, holding promising applications. It can serve as a reference for public health departments to address the prevention of CI in the elderly.

Is the Montreal cognitive assessment culturally valid in a diverse geriatric primary care setting? Lessons from the Bronx

BACKGROUND

Efficacy and validity of the MoCA for cognitive screening in ethnoculturally and linguistically diverse settings is unclear. We sought to examine the utility and discriminative validity of the Spanish and English MoCA versions to identify cognitive impairment among diverse community-dwelling older adults.

METHODS

Participants aged ≥65 with cognitive concerns attending outpatient primary care in Bronx, NY, were recruited. MoCA and neuropsychological measures were administered in Spanish or English, and a neuropsychologist determined cognitive status (normal with subjective cognitive concerns [SCC], mild cognitive impairment [MCI], and dementia). One-way ANOVA compared cognitive statuses. ROC analyses identified optimal MoCA cutpoints for discriminating possible cognitive impairment.

RESULTS

There were 231 participants, with mean age 73, 72% women, 43% Hispanic; 39% Black/African American; 113 (49%) completed testing in English and 118 (51%) in Spanish. Overall MoCA mean was 17.7 (SD = 4.3). Neuropsychological assessment identified 90 as cognitively normal/SCC, average MoCA 19.9 (SD = 4.1), 133 with MCI, average MoCA 16.6 (SD = 3.7), and 8 with dementia, average MoCA 10.6 (SD = 3.1). Mean English MoCA average was 18.6 (SD = 4.1) versus Spanish 16.7 (SD = 4.3). The published cutpoint ≤23 for MCI yielded a high false-positive rate (79%). ROC analyses identified ≤18.5 as the score to identify MCI or dementia using the English MoCA (65% sensitivity; 77% specificity) and ≤16.5 for the Spanish MoCA (64% sensitivity;73% specificity) in this sample of older adults with cognitive concerns.

CONCLUSIONS

Current MoCA cutpoints were inappropriately high in a culturally/linguistically diverse urban setting, leading to a high false-positive rate. Lower Spanish and English MoCA cutpoints may improve diagnostic accuracy for identifying cognitive impairment in this group, highlighting the need for the creation and validation of accurate cognitive screeners for ethnoculturally and linguistically diverse older adults.

Association between chronic pain classes and cognitive function in older adults: A cross-sectional study based on latent class analysis

The purpose of this study was to identify latent classes of chronic pain in older adults based on perceptual, cognitive, behavioral, emotional and social factors, and to explore the associations between each class of chronic pain and different cognitive domains. A total of 629 participants were included. Three classes of chronic pain were identified: "episodic recurrent mild pain with good psychosocial state" (class 1), "episodic recurrent moderate pain with general psychosocial state" (class 2) and "continuous multilocational severe pain with attacks accompanied by poor psychosocial state and avoidance of activity" (class 3). After adjusting for relevant confounders, chronic pain presenting as class 1 was associated with worse memory; class 2 was associated with worse global cognitive function, memory, information processing speed, and executive function; and class 3 was additionally associated with worse attention compared to class 2. The findings contribute to the development of targeted programs for treating pain and improving cognitive functioning.

The longitudinal relationship between levels of cognitively stimulating leisure activity and positive and negative affect among older adults with MCI

BACKGROUND

The purpose of this study was to investigate the longitudinal relationship between different levels of cognitively stimulating leisure activity (CSLA) participation and different levels of positive and negative affect among older adults with mild cognitive impairment (MCI).

METHODS

Using a repeated-measured multivariate analysis of covariance (RM-MANCOVA), this study analyzed the Health and Retirement Study (HRS) data from 2012 to 2020 (N = 5932).

RESULTS

The results presented the following. (a) The high CSLA group showed higher positive affect and lower negative affect than the mid and low groups. Also, the mid-CSLA group presented higher positive affect and lower negative affect than the low CSLA group. (b) Both positive and negative affect showed significant differences between years and indicated a continuously declining slope year by year without exceptions. (c) The high CSLA group not only presented higher positive affect and lower negative affect during the period but also solely showed a rebounding feature in the declining slope on both emotions.

CONCLUSIONS

The findings of this study provide valuable support for the design and implementation of CSLA participation programs and clinical guidelines for older adults with MCI. The results highlight the importance of determining the optimal level of CSLA engagement that is required to promote emotional health and cognitive function in this population. Healthcare professionals and clinical practitioners can leverage the insights gained from this study to develop and deliver effective CSLA interventions tailored to the specific needs and capacities of older adults with MCI.

A molecular container providing supramolecular protection against acetylcholine hydrolysis

Alzheimer's disease (AD) is characterized by cognitive decline, often attributed to the deficiency of acetylcholine, which can undergo hydrolysis by acetylcholinesterase (AChE) within the biological milieu. Here, we report a supramolecular strategy that takes advantage of confinement effects to inhibit such a hydrolysis process, shedding some light on AD therapy. A water-soluble and bowl-shaped molecule, hexacarboxylated tribenzotriquinacene (TBTQ-C6), was employed to shield acetylcholine (G1) from enzymatic degradation through host-guest binding interactions. Our study revealed highly efficient host-guest interactions with a binding ratio of 1 : 3, resulting in a significant reduction in acetylcholine hydrolysis from 91.1% to 7.4% in the presence of AChE under otherwise identical conditions. Furthermore, TBTQ-C6 showed potential for attenuating the degradation of butyrylcholine (G2) by butyrylcholinesterase (BChE). The broader implications of this study extend to the potential use of molecular containers in various biochemical and pharmacological applications, opening new avenues for research in the field of neurodegenerative diseases.

Pain in the Context of Virtual Neuropsychological Assessment of Older Adults

OBJECTIVE

Pain and cognitive impairment are prevalent and often co-occur in older adults. Because pain may negatively affect cognitive test performance, identification of pain in the context of neuropsychological evaluation is important. However, pain detection based on self-report presents challenges, and pain is often under-detected in this population. Alternative methods (e.g., video-based automatic coding of facial biomarkers of pain) may facilitate pain identification and thus enhance interpretation of neuropsychological evaluation results.

METHOD

The current study examined pain in the context of virtual neuropsychological assessment in 111 community-dwelling older adults, first seeking to validate the use of software developed to automatically code biomarkers of pain. Measures of pain, including self-report of acute and chronic pain and automatic coding of pain, were compared while participants completed neuropsychological testing.

RESULTS

Self-reported pain was negatively associated with poorer performance on a measure of executive function (both acute and chronic pain) and a global cognitive screening measure (acute pain only). However, self-reported acute and chronic pain did not correlate significantly with most neuropsychological tests. Automatic coding of pain did not predict self-report of pain or performance on neuropsychological tests beyond the influence of demographic factors and psychological symptoms.

CONCLUSIONS

Though results were largely not significant, correlations warrant further exploration of the influence of pain on neuropsychological test performance in this context to ensure that pain does not influence test performance in individuals with higher levels of pain and in other samples.

Effect of Polyphenol Supplementation on Memory Functioning in Overweight and Obese Adults: A Systematic Review and Meta-Analysis

Negative health consequences of obesity include impaired neuronal functioning and cell death, thus bringing the risk of impaired cognitive functioning. Antioxidant properties of polyphenols offer a possible intervention for overweight people, but evidence for their effectiveness in supporting cognitive functioning is mixed. This review examined evidence from randomized controlled trials concerning the effect of polyphenols on tasks requiring either immediate or delayed retrieval of learned information, respectively, thus controlling for differences in cognitive processes and related neural substrates supporting respective task demands. Searches of the PubMed/Medline, PsycInfo, and Scopus databases identified 24 relevant primary studies with N = 2336 participants having a BMI ≥ 25.0 kg/m2. The participants' mean age for the 24 studies exceeded 60 years. Respective meta-analyses produced a significant summary effect for immediate retrieval but not for delayed retrieval. The present findings support a potential positive effect of chronic supplementation with polyphenols, most notably flavonoids, on immediate retrieval in participants aged over 60 years with obesity being a risk factor for cognitive impairment. We recommend further investigation of this potential positive effect in participants with such risk factors. Future research on all populations should report the phenolic content of the supplementation administered and be specific regarding the cognitive processes tested.

Smartphone-Based Cognitive Telerehabilitation: A Usability and Feasibility Study Focusing on Mild Cognitive Impairment

The implementation of cognitive health apps in patients with mild cognitive impairment (MCI) is challenging because of their cognitive, age, and other clinical characteristics. In this project, we aimed to evaluate the usability and feasibility of the Rehastart app tested in MCI patients. Eighteen subjects affected by MCI due to neurodegenerative disorders (including Parkinson's disease, multiple sclerosis, and amnestic/multidomain MCI) and eighteen healthcare professionals were recruited to this study. Patients were registered on the app by clinicians and they were assigned a protocol of specific cognitive exercises. The recruitment was conducted in the period between March and June 2023. The trial testing of the app consisted of three sessions per week for three weeks, with each session lasting about 30 min. After three weeks, the participants as well as medical personnel were invited to rate the usability and feasibility of the Rehastart mobile application. The instruments employed to evaluate the usability and feasibility of the app were the System Usability Scale (SUS), The Intrinsic Motivation Inventory (IMI) and the Client Satisfaction Questionnaire (CSQ). We did not find statistically significant differences on the SUS (p = 0.07) between healthcare professionals and patients. In addition, we found promising results on subscales of the Intrinsic Motivation Inventory, suggesting high levels of interest and enjoyment when using the Rehastart app. Our study demonstrated that smartphone-based telerehabilitation could be a suitable tool for people with MCI due to neurodegenerative disorders, since the Rehastart app was easy to use and motivating for both patients and healthy people.

The Effect of Levels of Leisure-Time Physical Activity on Cognitive Functions Among Older Adults with Mild Cognitive Impairment: A Longitudinal Analysis

One dementia prevention strategy that is effective for older adults is frequent participation in leisure time physical activity. However, research gaps exist in our understanding of the longitudinal relationship between different levels of leisure time physical activity participation and the cognitive function of older adults with mild cognitive impairment. Thus, we investigated this relationship using Health and Retirement Study data from 2012 to 2020. Results from Repeated Measures Multivariate Analysis of Covariance indicated that both the mid (Mean Difference = -0.45) and high level (Mean Difference = -0.82) leisure time physical activity groups showed higher levels of memory function compared to the low-level leisure time physical activity group. Additionally, the mid (Mean Difference = -0.21) and high level (Mean Difference = -0.37) leisure time physical activity groups reported better working memory function, and the mid (Mean Difference = -0.02) and high level (Mean Difference = -0.02) leisure time physical activity groups showed higher levels of attention and processing speed than the low-level leisure time physical activity group. These findings suggest that older adults with mild cognitive impairment who engage either vigorously or moderately in leisure time physical activity (more than three times a week) experience improvements in cognitive function compared to those who do not. This study provides valuable insights for clinicians on the optimal level of leisure time physical activity required to mitigate cognitive decline in older adults with mild cognitive impairment.

Investigating Sex Differences in Risk and Protective Factors in the Progression of Mild Cognitive Impairment to Dementia: A Systematic Review

BACKGROUND

Developing effective strategies for reducing dementia risk requires a detailed understanding of the risk and protective factors associated with the progression of mild cognitive impairment (MCI) to dementia.

OBJECTIVE

We aimed to systematically review the evidence for sex differences in these factors.

METHODS

Five online databases (PubMed/CINAHL/EMBASE/PsycINFO/Cochrane) were searched from inception until 17 October 2022 for cohort studies that focused on sex differences in risk and protective factors in the progression of MCI to dementia.

RESULTS

A total of 2,972 studies were identified, of which 12 studies from five countries were included in the systematic review. There was substantial variability in study designs, study populations and outcome measures. Sex differences were present in the associations of sociodemographic, health, psychological factors, genetic and other biomarkers with the progression of MCI to dementia. APOE ɛ4 status and depression appeared to increase the risk of progression for females, whereas history of stroke, MRI markers and cerebrospinal fluid biomarkers appeared to increase the risk of progression for males. APOE ɛ2 status and marital status (unmarried) were observed to reduce risk of progression in males and females, respectively.

CONCLUSIONS

The ability of studies to accurately detail risk factors for dementia are likely limited when solely controlling for the effects of sex. Although the heterogeneity and underpowered nature of the studies made it difficult to synthesize the findings for each risk factor, this study highlights the apparent need for further research examining risk factors for dementia in males and females with MCI separately.

Heart Rate and its Variability From Short-Term ECG Recordings as Potential Biomarkers for Detecting Mild Cognitive Impairment

Background: Alterations in Heart Rate (HR) and Heart Rate Variability (HRV) reflect autonomic dysfunction associated with neurodegeneration making them biomarkers suitable for detecting Mild Cognitive Impairment (MCI). Methods: The study involves 297 urban Indian participants [48.48% (144) were male and 51.51% (153) were female]. MCI was detected in 19.19% (57) of participants and the rest, 80.8% (240) of them were healthy. ECG recordings spanning 10 s were collected and R-peaks were detected. Machine learning algorithms like were employed to further validate the features. Results: The mean of R-to-R (NN) intervals (P = .0021), the RMS of NN intervals (P = .0014), the SDNN (P = .0192) and the RMSSD (P = .0206) values differ significantly between MCI and non-MCI. Machine learning classifiers, SVM, DA, and NB show a high accuracy of 80.801% on RMS feature input. Conclusion: HR and its variability can be considered potential biomarkers for detecting MCI.

Evaluation of health factors on artificial intelligence and the internet of things-based older adults healthcare programmes

Objective

This study evaluates Artificial intelligence and the Internet of Things-based older adults' healthcare programmes (AI·IoT-OAHPs), which offer non-face-to-face and face-to-face health management to older adults for health promotion.

Methods

The study involved 146 participants, adults over 60 who had registered in AI·IoT-OAHPs. This study assessed the health factors as the outcome of pre- and post-health screening and health management through AI·IoT-OAHPs for six months.

Results

Preand post-health screening and management through AI·IoT-OAHPs were evaluated as significant outcomes in 14 health factors. Notably, the benefits of post-cognitive function showed a twofold increase in older female adults through AI·IoT-OAHPs. Adults over 70 showed a fourfold increase in post-walking days, a threefold in post-dietary practice, and a twofold in post-cognitive function in the post-effects compared with pre via AI·IoT-OAHPs.

Conclusions

AI·IoT-OAHPs seem to be an effective program in the realm of face-to-face and non-face-to-face AI·IoT-based older adults' healthcare initiatives in the era of COVID-19. Consequently, the study suggests that AI·IoT-OAHPs contribute to the upgrade in health promotion of older adults. In future studies, the effectiveness of AI·IoT-OAHPs can be evaluated as a continuous project every year in the short term and every two years in the long term.

Virtual reality and cognitive rehabilitation for older adults with mild cognitive impairment: A systematic review

Virtual Reality (VR) has been gaining increasing attention as a potential ecological and effective intervention system for treating Mild Cognitive Impairment (MCI). However, it remains unclear the efficacy and effectiveness of VR-based cognitive rehabilitation therapy (VR-CRT) in comparison with cognitive rehabilitation therapy (CRT). Consequently, a systematic review on Pubmed, Scopus, PsycInfo, and Web Of Science was conducted to assess the state of the art of the literature published between 2003 and April 2023. Only articles that adopted CRT as control group and that included some measure of at least one domain among overall cognitive function, executive function and functional status were included. Participants needed to be older adults aged 65 or over with a diagnosis of MCI. The risk of bias and the quality of evidence were assessed using the Version 2 of the Cochrane risk-of-bias tool for randomized trials. Initially, 6503 records were considered and screened after removing duplicates (n = 1321). Subsequently, 81 full texts were assessed for eligibility. Four articles met the inclusion criteria but 2 of them were merged as they were describing different outcomes of the same research project. Consequently, 3 overall studies with a total of 130 participants were included in the final analysis. Due to the high heterogeneity in the methodology and outcome measures employed, it was not possible to conduct a meta-analysis. Included studies used semi-immersive (k = 2) and full-immersive (k = 1) VR systems in their research. Two articles evaluated overall cognitive function through the MoCA together with specific tests for executive functions (n = 69), while one study adopted a comprehensive neuropsychological battery to evaluate both cognitive function and executive function (n = 61). Finally, one study evaluated functional status through instrumental activities of daily living (n = 34). A However, the limited number of studies, the small sample size, and the potential issues with the quality and methodology of these studies that emerged from the risk of bias assessment may raise doubts about the reliability of their results. Nevertheless, although scarce, results of the present review suggest that VR-CRT may be paramount in treating MCI for its additional ecological and adaptive advantages, as all of the studies highlighted that it was at least as effective as conventional CRT for all the outcome measures. Therefore, more rigorous research that compares VR-CRT and CRT is needed to understand the degree to which VR-CRT is effective with older adults with MCI and the potential role of immersion to influence its efficacy. Indeed, these preliminary findings highlight the need for the development of standardized VR protocols, as the integration of such technology into clinical practice may help improve the quality of life and cognitive outcomes for this growing demographic.

Speech changes in old age: Methodological considerations for speech-based discrimination of healthy ageing and Alzheimer's disease

BACKGROUND

Recent evidence suggests that speech substantially changes in ageing. As a complex neurophysiological process, it can accurately reflect changes in the motor and cognitive systems underpinning human speech. Since healthy ageing is not always easily discriminable from early stages of dementia based on cognitive and behavioural hallmarks, speech is explored as a preclinical biomarker of pathological itineraries in old age. A greater and more specific impairment of neuromuscular activation, as well as  a specific cognitive and linguistic impairment in dementia, unchain discriminating changes in speech. Yet, there is no consensus on such discriminatory speech parameters, neither on how they should be elicited and assessed.

AIMS

To provide a state-of-the-art on speech parameters that allow for early discrimination between healthy and pathological ageing; the aetiology of these parameters; the effect of the type of experimental stimuli on speech elicitation and the predictive power of different speech parameters; and the most promising methods for speech analysis and their clinical implications.

METHODS & PROCEDURES

A scoping review methodology is used in accordance with the PRISMA model. Following a systematic search of PubMed, PsycINFO and CINAHL, 24 studies are included and analysed in the review.

MAIN CONTRIBUTION

The results of this review yield three key questions for the clinical assessment of speech in ageing. First, acoustic and temporal parameters are more sensitive to changes in pathological ageing and, of these two, temporal variables are more affected by cognitive impairment. Second, different types of stimuli can trigger speech parameters with different degree of accuracy for the discrimination of clinical groups. Tasks with higher cognitive load are more precise in eliciting higher levels of accuracy. Finally, automatic speech analysis for the discrimination of healthy and pathological ageing should be improved for both research and clinical practice.

CONCLUSIONS & IMPLICATIONS

Speech analysis is a promising non-invasive tool for the preclinical screening of healthy and pathological ageing. The main current challenges of speech analysis in ageing are the automatization of its clinical assessment and the consideration of the speaker's cognitive background during evaluation.

WHAT THIS PAPER ADDS

What is already known on the subject Societal aging  goes hand in hand with the rising incidence of ageing-related neurodegenerations, mainly Alzheimer's disease (AD). This is particularly noteworthy in countries with longer life expectancies. Healthy ageing and early stages of AD share a set of cognitive and behavioural characteristics. Since there is no cure for dementias, developing methods for accurate discrimination of healthy ageing and early AD is currently a priority. Speech has been described as one of the most significantly impaired features in AD. Neuropathological alterations in motor and cognitive systems would underlie specific speech impairment in dementia. Since speech can be evaluated quickly, non-invasively and inexpensively, its value for the clinical assessment of ageing itineraries may be particularly high. What this paper adds to existing knowledge Theoretical and experimental advances in the assessment of speech as a marker of AD have developed rapidly over the last decade. Yet, they are not always known to clinicians. Furthermore, there is a need to provide an updated state-of-the-art on which speech features are discriminatory to AD, how they can be assessed, what kind of results they can yield, and how such results should be interpreted. This article provides an updated overview of speech profiling, methods of speech measurement and analysis, and the clinical power of speech assessment for early discrimination of AD as the most common cause of dementia. What are the potential or actual clinical implications of this work? This article provides an overview of the predictive potential of different speech parameters in relation to AD cognitive impairment. In addition, it discusses the effect that the cognitive state, the type of elicitation task and the type of assessment method may have on the results of the speech-based analysis in ageing.

Association of Advanced Glycation End Products with Cognitive Function: HealthyDance Study

Background

The current research on advanced glycosylation end products (AGEs) and cognitive function is limited.

Objective

We aimed to investigate the relationship between multiple plasma AGEs and cognitive function and mild cognitive impairment (MCI).

Methods

Baseline data from The Lifestyle and Healthy Aging of Chinese Square Dancer Study was used in this cross-sectional study. Ultra-high-performance liquid chromatography tandem mass spectrometry was used to determine plasma levels of carboxymethyl lysine (CML), carboxyethyl lysine (CEL), and methyl imidazolinone (MG-H1). Four cognitive tests were used to obtain the four cognitive domain scores and the composite z scores. The Petersen criteria were used to diagnose MCI. The data were analyzed by multivariable linear and logistic regression models.

Results

This study included 1,018 participants (median age 61.0 years, 87.3% female). After multivariate adjustment, the βs of the highest quartile of CML and CEL compared to the lowest quartile were -0.28 (-0.38, -0.17) and -0.13 (-0.23, -0.03), respectively, for the composite z score. For the four cognitive domains, CML was negatively correlated with memory, attention, and executive function, and CEL was negatively associated with memory and language function. In addition, higher CML was associated with a higher odds of MCI. MG-H1 was not associated with cognitive function.

Conclusions

High plasma AGE levels were correlated with poorer cognitive function, particularly CML and CEL, higher levels of CML were also associated with higher odds of MCI. To clarify the effects of different AGEs on cognitive function and the underlying mechanisms, further longitudinal and experimental studies are needed.

Speed of aging of populations by socioeconomics subgroups in China: A cross-sectional study of cognitive performance

Objectives

Although there is an association between socioeconomic factors and cognition, there are shortcomings in terms of examining the age of onset of decline between people with varying social backgrounds. This study aims to present the disparities in cognitive performance among older adults by simultaneously integrating health status, social characteristics, and age into an understandable metric.

Study design

This study is cross-sectional.

Methods

A sample of 3422 adults aged at least 60 was utilised from the 2015 wave of the China Health and Nutrition Survey to analyse the trajectories of cognitive ageing through the Characteristics approach. This approach generates an age-differential schedule whereby, as a hypothetical example, the cognition level Z of an individual aged 60 who has not completed schooling is demonstrated at age 66 by someone who has completed secondary schooling.

Results

There was an increasing advantage with cognitive performance as the level of education completed increased; men aged 61.9 with a primary level of schooling and those aged 67.8 with postsecondary qualifications exhibit the same cognition performance as those aged 60 with no completed schooling. The observation also suggested that cognition advantages diminish through age. In terms of income, the age-differential schedule follows a similar pattern. albeit lower outcomes, to that of education differentials.

Conclusion

When comparing education and income levels and their respective impacts on cognitive functioning, the former has been noted to have a larger effect. Education's effect has continuity in that it can influence opportunities until later ages.