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Wu Y, Mao Z, Cui F, Fan J, Yuan Z, Tang L. Neurocognitive Characteristics of Subjective Cognitive Decline and Its Association with Objective Cognition, Negative Emotion, and Sleep Quality in Chinese Elderly. Neuropsychiatr Dis Treat 2023; 19:2261-2270. [PMID: 37905173 PMCID: PMC10613421 DOI: 10.2147/ndt.s430929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/18/2023] [Indexed: 11/02/2023] Open
Abstract
Background and Purpose Subjective cognitive decline (SCD) is recognized as a preclinical indicator of Alzheimer's disease (AD), and this stage provides a valuable time window for ultra-early intervention in AD. The aim of this study was to investigate the neurocognitive characteristics of SCD and its correlation with objective cognition, negative emotion and sleep quality in Chinese elderly. Methods A total of 1200 volunteers aged 60 and older underwent Brief Elderly Cognitive Screening Inventory, Quick Cognitive Screening Scale for the Elderly, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index and Core Neuropsychological Test. According to the examination results, the participants were divided into healthy control (HC) and SCD groups. The neurocognitive function of SCD and its relationship with objective cognition, negative emotion and sleep quality were analyzed. Results Compared with the HC group, the SCD group had similar global cognitive function but slightly impaired neurocognitive function. After adjusting for confounding factors such as age, sex, marriage, education and chronic disease, neurocognitive function (Picture-Symbol Matching: OR=0.167, 95% CI: 0.105-0.266; Word Stem Completion: OR =0.260, 95% CI: 0.131-0.514; Trail Making Test: OR=0.315, 95% CI: 0.178-0.560; Picture Recall: OR =0.278, 95% CI: 0.122-0.636), negative emotion (sub-depressive symptoms: OR=2.287, 95% CI: 1.483-3.527; sub-anxiety symptoms: OR=1.663, 95% CI: 1.079-2.563), and poor sleep quality (OR=2.138, 95% CI: 1.571-2.909) were significantly correlated with the occurrence of SCD. Conclusion The study illustrates that SCD is closely related to objective cognition, negative emotion and sleep quality. Clinical evaluation and follow-up of SCD should fully account for these factors.
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Affiliation(s)
- Yue Wu
- Department of Geriatric Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Zhiqun Mao
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Fengwei Cui
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Jie Fan
- Department of Geriatric Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
| | - Zhouling Yuan
- Department of Psychiatry, Huishan No. 2 People’s Hospital, Wuxi, Jiangsu, People’s Republic of China
| | - Li Tang
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China
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Ball HA, Coulthard E, Fish M, Bayer A, Gallacher J, Ben-Shlomo Y. Predictors and prognosis of population-based subjective cognitive decline: longitudinal evidence from the Caerphilly Prospective Study (CaPS). BMJ Open 2023; 13:e073205. [PMID: 37844990 PMCID: PMC10582873 DOI: 10.1136/bmjopen-2023-073205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES To understand associations between the subjective experience of cognitive decline and objective cognition. This subjective experience is often conceptualised as an early step towards neurodegeneration, but this has not been scrutinised at the population level. An alternative explanation is poor meta-cognition, the extreme of which is seen in functional cognitive disorder (FCD). DESIGN Prospective cohort (Caerphilly Prospective Study). SETTING Population-based, South Wales, UK. PARTICIPANTS This men-only study began in 1979; 1225 men participated at an average age of 73 in 2002-2004, including assessments of simple subjective cognitive decline (sSCD, defined as a subjective report of worsening memory or concentration). Dementia outcomes were followed up to 2012-2014. Data on non-completers was additionally obtained from death certificates and local health records. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was incident dementia over 10 years. Secondary outcome measures included prospective change in objective cognition and cross-sectional cognitive internal inconsistency (the existence of a cognitive ability at some times, and its absence at other times, with no intervening explanatory factors except for focus of attention). RESULTS sSCD was common (30%) and only weakly associated with prior objective cognitive decline (sensitivity 36% (95% CI 30 to 42) and specificity 72% (95% CI 68 to 75)). Independent predictors of sSCD were older age, poor sleep quality and higher trait anxiety. Those with sSCD did not have excess cognitive internal inconsistency, but results suggested a mild attentional deficit. sSCD did not predict objective cognitive change (linear regression coefficient -0.01 (95% CI -0.13 to 0.15)) nor dementia (odds ratio 1.35 (0.61 to 2.99)) 10 years later. CONCLUSIONS sSCD is weakly associated with prior objective cognitive decline and does not predict future cognition. Prior sleep difficulties and anxiety were the most robust predictors of sSCD. sSCD in the absence of objective decline appears to be a highly prevalent example of poor meta-cognition (ie, poor self-awareness of cognitive performance), which could be a driver for later FCD.
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Affiliation(s)
- Harriet A Ball
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Elizabeth Coulthard
- Translational Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Mark Fish
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, Devon, UK
| | - Antony Bayer
- Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Yoav Ben-Shlomo
- Population Health Sciences, University of Bristol, Bristol, UK
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Tang L, Wang YQ, Zhan NN, Li CY, Zhuang Z, Lyu QY, Xiong P. Interaction effect of midday napping duration and depressive symptoms on subjective memory impairment among older people in China: evidence from the China health and retirement longitudinal study database. BMC Public Health 2023; 23:1995. [PMID: 37833684 PMCID: PMC10571240 DOI: 10.1186/s12889-023-16928-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Subjective memory impairment (SMI) is common in older people. The aim of this study was to investigate the factors influencing SMI among older people in China, with specific focus on the interaction effect of midday napping duration and depressive symptoms on the risk of SMI. METHODS Using a dataset representative of the Chinese population from a longitudinal study of health and retirement in China, subjects with SMI were screened using the question "how do you feel about your memory now?" and the Mini-Mental State Examination. A logistic regression model was applied to explore the factors affecting SMI. Additive and multiplicative models were used to analyze the interaction effect of midday napping duration and depressive symptoms on the risk of SMI. RESULTS We enrolled 8,254 subjects included and the incidence of SMI was 63.9%. Depressive symptoms, nap time, and physical activity were influencing factors of SMI. Midday napping duration and depressive symptoms had positive additive interaction effects on the risk of SMI. When extended-length naps and depressive symptoms coexisted, the risk of SMI was 1.06 times greater than that for either alone (RERI, relative excess risk due to interaction = 0.27, 95% CI = 0.07-0.43; AP, attributable proportion = 0.14, 95% CI = 0.01-0.23; S, synergy index = 1.06, 95% CI = 0.57-1.62). When short naps and depressive symptoms coexisted, the risk of SMI was 1.2 times higher than that for either alone (RERI = 0.12, 95% CI=-0.14-0.39; AP = 0.13, 95% CI=-0.07-0.22; S = 1.20, 95% CI = 0.79-1.82). LIMITATIONS Since this was a cross-sectional study, the cause-and-effect relationships between the associated variables cannot be inferred. CONCLUSIONS The interaction effect that exists between nap time and depressive symptoms in older people is important for the identification and early intervention of people at risk for SMI.
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Affiliation(s)
- Li Tang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Ya-Qi Wang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Na-Ni Zhan
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Can-Yang Li
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Zhuang Zhuang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Qi-Yuan Lyu
- School of Nursing, Jinan University, Room 1015, Guangzhou, China.
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, China.
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Chapman S, Rentería MA, Dworkin JD, Garriga SM, Barker MS, Avila-Rieger J, Gonzalez C, Joyce JL, Vonk JMJ, Soto E, Manly JJ, Brickman AM, Mayeux RP, Cosentino SA. Association of Subjective Cognitive Decline With Progression to Dementia in a Cognitively Unimpaired Multiracial Community Sample. Neurology 2023; 100:e1020-e1027. [PMID: 36450605 PMCID: PMC9990861 DOI: 10.1212/wnl.0000000000201658] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/20/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This prospective study seeks to examine the utility of subjective cognitive decline (SCD) as a marker of future progression to dementia in a community-based cohort of non-Latinx White, non-Latinx Black, and Latinx individuals. Debate surrounds the utility of SCD, the subjective perception of decline in one's cognition before such impairment is evident in traditional neuropsychological assessments, as an early indicator of impending Alzheimer disease. Unfortunately, most studies examining SCD have been conducted in non-Latinx White samples and commonly exclude groups of individuals shown to be most vulnerable to dementia. METHODS Participants were enrolled into this cohort study from the Washington Heights-Inwood Columbia Aging Project if they were cognitively unimpaired, had baseline measurement of SCD, and self-identified as non-Latinx White, non-Latinx Black, or Latinx. SCD was measured as a continuous sum of 10 items assessing cognitive complaints. Competing risk models tested the main effects of baseline SCD on progression to dementia. Models were adjusted for age, sex/gender, years of education, medical comorbidity burden, enrollment cohort, and baseline memory test performance with death jointly modelled as a function of race/ethnicity. RESULTS A total of 4,043 (1,063 non-Latinx White, 1,267 non-Latinx Black, and 1,713 Latinx) participants were selected for this study with a mean age of 75 years, 67% women, and with a mean follow-up of 5 years. Higher baseline SCD was associated with increased rates of incident dementia over time in the full sample (hazard ratio [HR] 1.085, CI 1.047-1.125, p < 0.001) and within Latinx (HR 1.084, CI 1.039-1.130, p < 0.001) and non-Latinx Black individuals (HR 1.099, CI 1.012-1.194, p = 0.024). DISCUSSION Overall results of this study support SCD as a prodromal marker of dementia in a multiracial community sample, and in Latinx and non-Latinx Black individuals in particular. Because models examining the risk of dementia were adjusted for baseline memory test performance, the results support the idea that SCD, a subjective reflection of one's own current cognitive functioning, contributes information above and beyond standard memory testing. Current findings highlight the importance of carefully evaluating any memory concerns raised by older adults during routine visits and underscore the potential utility of screening older adults for SCD.
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Affiliation(s)
- Silvia Chapman
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Miguel Arce Rentería
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Jordan D Dworkin
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Stella M Garriga
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Megan S Barker
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Justina Avila-Rieger
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Christopher Gonzalez
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Jillian L Joyce
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Jet M J Vonk
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Elizabeth Soto
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Jennifer J Manly
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Adam M Brickman
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Richard P Mayeux
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands
| | - Stephanie A Cosentino
- From the Cognitive Neuroscience Division (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (S.C., M.A.R., S.M.G., M.S.B., J.A.-R., J.J.M., A.M.B., R.P.M., S.A.C.), Gertrude H. Sergievsky Center (M.A.R., J.A.-R., J.L.J., E.S., J.J.M., A.M.B., R.P.M., S.A.C.), Department of Neurology (M.A.R., J.J.M., A.M.B., R.P.M., S.A.C.), Columbia University Irving Medical Center, New York; New York State Psychiatric Institute (J.D.D.); Departments of Psychiatry and Biostatistics (J.D.D.), Columbia University Irving Medical Center, New York; Department of Psychology (C.G.), Illinois Institute of Technology, Chicago; Memory and Aging Center (J.M.J.V.), Department of Neurology, University of California San Francisco; and Julius Center for Health Sciences and Primary Care (J.M.J.V.), Department of Epidemiology, Utrecht University Medical Centre, the Netherlands.
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5
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Lau SCL, Connor LT, Baum CM. Subjective and objective assessments are associated for physical function but not cognitive function in community-dwelling stroke survivors. Disabil Rehabil 2022; 44:8349-8356. [PMID: 34904503 DOI: 10.1080/09638288.2021.2012845] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the relation between subjectively and objectively assessed cognitive and physical functioning among community-dwelling stroke survivors, and to examine the association of stroke severity with subjectively and objectively assessed cognitive and physical impairments. MATERIALS AND METHODS Secondary data analysis was conducted with 127 community-dwelling stroke survivors. For cognitive functioning, objective measures included the NIH Toolbox Cognition Battery and the Executive Function Performance Test; subjective measures included the Quality of Life in Neurological Disorders Applied Cognition. Objective and subjective physical functioning was measured by the NIH Toolbox 2-Minute Walk Test and the Patient-Reported Outcomes Measurement Information System Physical Function, respectively. RESULTS A positive correlation was observed between subjective and objective physical functioning, whereas the correlation between subjective and objective cognitive functioning was nonsignificant. Stroke severity was associated with objective cognitive impairment and objective and subjective physical impairment, but not subjective cognitive impairment. CONCLUSIONS The lack of association between objective and subjective cognitive functioning challenges the conventional assumption that perceived functioning reflects actual performance. We recommend using both objective and subjective measures to accurately identify cognitive and physical impairment following stroke.Implications for RehabilitationSubjective cognitive functioning is not associated with objective cognitive functioning, suggesting that solely relying on stroke patients' reports is inadequate and may inaccurately estimate patients' actual deficits.Both objective and subjective measures should be used to accurately identify cognitive and physical impairment following stroke.Practitioners should be cognizant of stroke patients' behavioral signs associated with underlying cognitive problems that warrant further evaluation.
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Affiliation(s)
- Stephen C L Lau
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Lisa Tabor Connor
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carolyn M Baum
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
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6
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Robertson FE, Jacova C. A systematic review of subjective cognitive characteristics predictive of longitudinal outcomes in older adults. THE GERONTOLOGIST 2022; 63:700-716. [PMID: 35908232 DOI: 10.1093/geront/gnac109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Subjective cognitive decline (SCD) is a common experience of self-perceived decline without objective cognitive impairment among older adults. SCD has been conceptualized as very early Alzheimer's disease (AD), but the specific SCD features predictive of clinical or cognitive decline remain unclear. This systematic review is the first to characterize specific SCD features and their relation to longitudinal outcomes. RESEARCH DESIGN AND METHODS Multiple electronic databases were searched from inception until August 2021 for longitudinal studies of adults aged >50 (mean>60) and free of dementia, with baseline SCD measurement and clinical or cognitive follow-up. Studies were screened for inclusion criteria and assessed for risk of bias using weight-of-evidence ratings. RESULTS 570 potentially relevant studies were identified, and 52 studies evaluated for eligibility after initial screening. Thirty-three studies with medium to high weight-of-evidence ratings were included and results narratively synthesized. Measurement methods varied substantially across studies: the majority (n=27) assessed SCD symptom types and intensity, and consistently reported that higher symptom burden increased the risk for MCI and dementia. The evidence was less compelling for cognitive outcomes. A handful of studies (n=5) suggested a predictive role for SCD symptom consistency and informant corroboration. DISCUSSION AND IMPLICATIONS SCD symptom intensity emerged from our review as the most reliable predictor of future clinical outcomes. Combinations of SCD-Plus symptoms also had predictive utility. No single symptom was uniquely prognostic. Our findings support the quantitative evaluation of SCD symptoms in the assessment of risk for progression to MCI or dementia.
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Affiliation(s)
| | - Claudia Jacova
- School of Graduate Psychology, Pacific University, Hillsboro, Oregon, USA
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7
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Allemann-Su YY, Vetter M, Koechlin H, Paul SM, Cooper BA, Oppegaard K, Melisko M, Levine JD, Conley Y, Miaskowski C, Katapodi MC. Pre-Surgery Demographic, Clinical, and Symptom Characteristics Associated with Different Self-Reported Cognitive Processes in Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14133281. [PMID: 35805053 PMCID: PMC9265628 DOI: 10.3390/cancers14133281] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 02/01/2023] Open
Abstract
Cancer related cognitive impairment (CRCI) is a common and persistent symptom in breast cancer patients. The Attentional Function Index (AFI) is a self-report measure that assesses CRCI. AFI includes three subscales, namely effective action, attentional lapses, and interpersonal effectiveness, that are based on working memory, inhibitory control, and cognitive flexibility. Previously, we identified three classes of patients with distinct CRCI profiles using the AFI total scores. The purpose of this study was to expand our previous work using latent class growth analysis (LCGA), to identify distinct cognitive profiles for each of the AFI subscales in the same sample (i.e., 397 women who were assessed seven times from prior to through to 6 months following breast cancer surgery). For each subscale, parametric and non-parametric statistics were used to determine differences in demographic, clinical, and pre-surgical psychological and physical symptoms among the subgroups. Three-, four-, and two-classes were identified for the effective action, attentional lapses, and interpersonal effectiveness subscales, respectively. Across all three subscales, lower functional status, higher levels of anxiety, depression, fatigue, and sleep disturbance, and worse decrements in energy were associated with worse cognitive performance. These and other modifiable characteristics may be potential targets for personalized interventions for CRCI.
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Affiliation(s)
- Yu-Yin Allemann-Su
- Department of Clinical Research, University of Basel, 4055 Basel, Switzerland;
| | - Marcus Vetter
- Department of Oncology, Cantonal Hospital Basel-Land, 4410 Listel, Switzerland;
| | - Helen Koechlin
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, 8050 Zurich, Switzerland;
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, 4055 Basel, Switzerland
- Department of Anaesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Steven M. Paul
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
| | - Bruce A. Cooper
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
| | - Kate Oppegaard
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
| | - Michelle Melisko
- School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA; (M.M.); (J.D.L.)
| | - Jon D. Levine
- School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA; (M.M.); (J.D.L.)
| | - Yvette Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261, USA;
| | - Christine Miaskowski
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
- School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA; (M.M.); (J.D.L.)
| | - Maria C. Katapodi
- Department of Clinical Research, University of Basel, 4055 Basel, Switzerland;
- Correspondence: ; Tel.: +41-61-207-0430
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8
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Pacifico D, Sabatini S, Fiordelli M, Albanese E. The role of disability and depressive symptoms in the relation between objective cognitive performance and subjective cognitive decline. Front Psychiatry 2022; 13:963703. [PMID: 36506437 PMCID: PMC9729556 DOI: 10.3389/fpsyt.2022.963703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Subjective cognitive decline (SCD) and subjective memory decline (SMD) are common among older people. Evidence linking SCD and SMD with cognitive and memory impairment is inconsistent. Moreover, little is known about the associations of SCD and SMD with disability. We aimed to explore the associations of SCD and SMD with objective cognitive and memory performance, disability, and depressive symptoms. MATERIALS AND METHODS In a cross-sectional study we conducted face to face interviews in a randomized sample of people aged ≥65 years living in the Canton of Ticino, southern Switzerland, between May 2021 and April 2022. We measured subjective cognitive decline with the MyCog, a subsection of the Subjective Cognitive Decline Questionnaire (SCD-Q); cognitive functioning with the Community Screening Instrument for Dementia; memory with the consortium to establish a registry for alzheimer's disease (CERAD) 10-word list learning task; and disability and depressive symptoms with the world health organization disability assessment schedule 2.0 (WHO-DAS 2.0) and the Euro-Depression (EURO-D) scales, respectively. RESULTS Of the 250 participants 93.6% reported at least one cognitive difficulty, and 40.0% SMD. Both SCD and SMD were associated with poorer objective cognitive/memory performance, and independently with greater disability, and more depressive symptoms. But in participants with high disability and depressive symptoms subjective and objective cognition were no longer associated. Disability fully mediated the associations of poorer objective cognitive and memory performance with subjective cognitive and memory decline. CONCLUSION Routine clinical assessments of cognitive function should include formal enquires about SCD and SMD, and also account for disability and depressive symptoms.
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Affiliation(s)
- Deborah Pacifico
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Serena Sabatini
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
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9
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Vlachos GS, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Tzoulaki I, Georgiou AN, Sakka P, Anastasiou CA, Stefanis L, Scarmeas N. Incidence of mild cognitive impairment in the elderly population in Greece: results from the HELIAD study. Aging Clin Exp Res 2021; 33:2679-2688. [PMID: 33686543 DOI: 10.1007/s40520-021-01819-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are no published data on Mild Cognitive Impairment (MCI) incidence in people over 65 years of age in Greece, relevant literature is scarce for Southern Europe, and reported rates worldwide show great variability. AIMS To investigate the incidence and risk factors of MCI and its subtypes in the elderly population in Greece. METHODS The incidence cohort of the HELIAD study (Hellenic Epidemiological Longitudinal Investigation of Aging and Diet) comprised 955 individuals who received full neurological and neuropsychological evaluation on two separate occasions about three years apart. RESULTS The MCI incidence rate in our cohort is 54.07 new cases per 1000 person-years, standardized by age and sex to 59.99. Each additional year of age over 65 raises the probability of novel MCI by 6.2%, while lower educational attainment more than doubles the risk for incident MCI. Apolipoprotein E-ε4 (APOE-ε4) carriage results in increased risk for MCI by more than 1.7 times. Incidence rates for amnestic MCI are slightly higher than for the non-amnestic subtype, and AD is the most common potential underlying etiology. DISCUSSION The MCI incidence rate in the Greek population over 65 years of age is 54/1000 person-years. Advanced age and APOE-ε4 carriage are predisposing factors, while higher educational attainment was found to exert a protective effect. CONCLUSIONS MCI incidence in people over 65 years-old in Greece is consistent with reported rates around the world. Larger studies encompassing neuroimaging and cerebrospinal fluid biomarkers will hopefully shed more light on MCI epidemiology in Greece in the future.
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Affiliation(s)
- George S Vlachos
- 1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece.
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Georgios Hadjigeorgiou
- School of Medicine, University of Thessaly, Larissa, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Andrea N Georgiou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | | | - Leonidas Stefanis
- 1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece
- The Gertrude H. Sergievsky Center, Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, USA
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10
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Crouch A, Champion VL, Von Ah D. Comorbidity, cognitive dysfunction, physical functioning, and quality of life in older breast cancer survivors. Support Care Cancer 2021; 30:359-366. [PMID: 34287690 PMCID: PMC8636409 DOI: 10.1007/s00520-021-06427-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/11/2021] [Indexed: 11/04/2022]
Abstract
Purpose Older breast cancer survivors (BCS) may be at greater risk for cognitive dysfunction and other comorbidities; both of which may be associated with physical and emotional well-being. This study will seek to understand these relationships by examining the association between objective and subjective cognitive dysfunction and physical functioning and quality of life (QoL) and moderated by comorbidities in older BCS. Methods A secondary data analysis was conducted on data from 335 BCS (stages I–IIIA) who were ≥ 60 years of age, received chemotherapy, and were 3–8 years post-diagnosis. BCS completed a one-time questionnaire and neuropsychological tests of learning, delayed recall, attention, working memory, and verbal fluency. Descriptive statistics and separate linear regression analyses testing the relationship of each cognitive assessment on physical functioning and QoL controlling for comorbidities were conducted. Results BCS were on average 69.79 (SD = 3.34) years old and 5.95 (SD = 1.48) years post-diagnosis. Most were stage II (67.7%) at diagnosis, White (93.4%), had at least some college education (51.6%), and reported on average 3 (SD = 1.81) comorbidities. All 6 physical functioning models were significant (p < .001), with more comorbidities and worse subjective attention identified as significantly related to decreased physical functioning. One model found worse subjective attention was related to poorer QoL (p < .001). Objective cognitive function measures were not significantly related to physical functioning or QoL. Conclusions A greater number of comorbidities and poorer subjective attention were related to poorer outcomes and should be integrated into research seeking to determine predictors of physical functioning and QoL in breast cancer survivors.
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Affiliation(s)
- Adele Crouch
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN, 46202, USA.
| | - Victoria L Champion
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Diane Von Ah
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN, 46202, USA
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11
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Putting memory complaints in context matters. Int Psychogeriatr 2021; 33:645-646. [PMID: 34308816 DOI: 10.1017/s1041610220001672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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12
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Farrell MT, Jia Y, Berkman LF, Wagner RG. Do You See What Eye See? Measurement, Correlates, and Functional Associations of Objective and Self-Reported Vision Impairment in Aging South Africans. J Aging Health 2021; 33:803-816. [PMID: 34029165 DOI: 10.1177/08982643211012839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Our study investigates measurement, correlates, and functional associations of vision impairment (VI) in an aging population in rural South Africa. Methods: 1582 participants aged 40-69 reported on near (NVI) and distance vision impairment (DVI) and completed objective vision tests. Logistic and linear regression were used to evaluate sociodemographic, health, and psychosocial correlates of VI and assess relationships between VI and cognitive and physical function. Results: VI prevalence was considerably higher according to objective testing (56%) versus self-reports (18%). Older adults were especially likely to underreport impairment. Objective VI was associated with age, education, cardiometabolic disease, and female sex. Conversely, self-reported VI was associated with psychosocial factors. Objective NVI and both types of DVI were associated with worse visual cognition and slower gait speed, respectively. Discussion: Self-reported and objective VI measures should not be used interchangeably in this context. Our findings highlight extensive burden of untreated VI in this region.
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Affiliation(s)
- Meagan T Farrell
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Yusheng Jia
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lisa F Berkman
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ryan G Wagner
- University of the Witwatersrand, Johannesburg, South Africa
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13
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Del Pozo Cruz B, Del Pozo-Cruz J. Associations between activity fragmentation and subjective memory complaints in middle-aged and older adults. Exp Gerontol 2021; 148:111288. [PMID: 33667619 DOI: 10.1016/j.exger.2021.111288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/12/2021] [Accepted: 02/15/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Subjective memory complaints (SMC) are often considered a clinical marker of mild cognitive impairment and dementia and could manifest as shortening of activity bouts throughout the day causing daily activity to accumulate in a more fragmented pattern. In the current study we explored the association between activity fragmentation and SMC in middle-aged and older adults. METHODS We used data from 3820 participants in the National Health and Nutrition Examination Survey (2003-2006) with valid accelerometer SMC data. The analyses were conducted in 2020. To calculate activity fragmentation, an active-to-sedentary transition probability was calculated as the number of physical activity bouts (i.e., consecutive minutes registering 100+ counts/min) divided by the total sum of minutes spent in physical activity. A multivariable ordinal logistic regression model was conducted to examine the association between activity fragmentation (scaled) and SMC (yes/no). RESULTS Higher activity fragmentation was associated with an increased likelihood of self-reported SMC in the study population (Odd Ratio [95% Confidence Interval] = 1.335 [1.067, 1.669]; Average Marginal Effect [95%CI] = 0.029 [0.006, 0.052]; p-value = 0.021). This association was independent of total physical activity volume. CONCLUSIONS The findings provide support that studying fragmented activity patterns can be useful in identifying those at risk for SMC, over and above total volume of physical activity. Future longitudinal studies are required to establish causality and the temporal order of the observed association. Nevertheless, activity fragmentation in middle-aged and older adults may reflect pre-clinical signs of future neurodegenerative processes indicating potential targets for modification through intervention.
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Affiliation(s)
- Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark; Motivation and Behavior Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia.
| | - Jesus Del Pozo-Cruz
- Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Departament of Physical Education and Sport, Faculty of Education, University of Seville, Seville, Spain
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14
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Vlachos GS, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Tzoulaki I, Georgiou AN, Sakka P, Anastasiou CA, Stefanis L, Scarmeas N. Dementia Incidence in the Elderly Population of Greece: Results From the HELIAD Study. Alzheimer Dis Assoc Disord 2021; 35:48-54. [PMID: 33009037 DOI: 10.1097/wad.0000000000000407] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/16/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Recently a declining trend in dementia incidence rates has been reported in high-income countries. We investigated dementia incidence in a representative sample of the Greek population in the age group of 65 years and above. METHODS This research is part of the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (HELIAD). The incidence cohort consisted of 1072 participants who were reevaluated after a mean period of 3.09 years. RESULTS The incidence rate of dementia was 19.0 cases per 1000 person-years (age-standardized and sex-standardized incidence: 25.4/1000 person-years), of which 16.3 per 1000 person-years were attributable to Alzheimer disease. Each additional year of age increased dementia risk by 19.3% and each additional year of education decreased dementia risk by 12.1%. Apolipoprotein E (APOE)-ε4 homozygous participants were 18 times more likely to be diagnosed with dementia. A baseline diagnosis of mild cognitive decline (MCI) resulted in a risk for dementia increased by 3.7 times compared with the cognitively normal; in participants with MCI at baseline, APOE-ε4 carriage increased dementia risk by 4.5 times. CONCLUSIONS The incidence rate of dementia in people 65 years and above in Greece is generally consistent with recently published rates in Europe and North America. Advancing age, baseline MCI, and APOE-ε4 homozygosity are risk factors, while higher educational attainment seems protective.
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Affiliation(s)
- George S Vlachos
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki
| | | | | | - Georgios Hadjigeorgiou
- School of Medicine, University of Thessaly, Larissa
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Andrea N Georgiou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | | | - Leonidas Stefanis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Columbia University, New York, NY
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15
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Lee GJ, Do C, Suhr JA. Effects of personal dementia exposure on subjective memory concerns and dementia worry. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:855-870. [DOI: 10.1080/13825585.2020.1836119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Grace J. Lee
- Department of Psychology, Ohio University Athens, OH, USA
| | - Cardinal Do
- Department of Psychology, Ohio University Athens, OH, USA
| | - Julie A. Suhr
- Department of Psychology, Ohio University Athens, OH, USA
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16
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Goda A, Murata S, Nakano H, Shiraiwa K, Abiko T, Nonaka K, Iwase H, Anami K, Horie J. Subjective and Objective Mental and Physical Functions Affect Subjective Cognitive Decline in Community-Dwelling Elderly Japanese People. Healthcare (Basel) 2020; 8:healthcare8030347. [PMID: 32962150 PMCID: PMC7551000 DOI: 10.3390/healthcare8030347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/12/2020] [Accepted: 09/17/2020] [Indexed: 12/15/2022] Open
Abstract
Subjective cognitive decline (SCD) is complex and not well understood, especially among Japanese people. In the present study, we aimed to elucidate the relationships of subjective and objective mental and physical function with SCD among older community-dwelling Japanese adults. SCD was evaluated using the Kihon Checklist: Cognitive Function. Other parameters were evaluated using the Mini-Mental State Examination (MMSE) and the five-item version of the Geriatric Depression Scale (GDS-5), for an objective mental function other than SCD. A timed up-and-go test (TUG) and knee extension strength were used to test objective physical function, and the Mental Component Summary (MCS) and Physical Component Summary (PCS) in the Health-Related Quality of Life survey eight-item short form (SF-8) were used for subjective mental and physical functions. The results of the MMSE, GDS-5, TUG, knee extension strength, and MCS were significantly worse in the SCD group. In addition, logistic regression analysis showed that GDS-5 and MCS were associated with SCD onset. Depressive symptoms and decreased subjective mental function contribute to SCD among community-dwelling Japanese adults. These findings will be useful for planning dementia prevention and intervention programs for older Japanese adults.
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Affiliation(s)
- Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
- Correspondence: ; Tel.: +81-75-574-4313
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Kayoko Shiraiwa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Teppei Abiko
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Koji Nonaka
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan; (K.N.); (K.A.)
| | - Hiroaki Iwase
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Kobe 658-0032, Japan;
| | - Kunihiko Anami
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan; (K.N.); (K.A.)
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
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17
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Um YH, Wang SM, Han KD, Kim NY, Kang DW, Na HR, Lee CU, Lim HK. Differential Impact of Cigarette Smoking on Fracture Risks in Subjective Cognitive Decline and Dementia: A Nationwide Longitudinal Study. Psychiatry Investig 2020; 17:786-795. [PMID: 32750761 PMCID: PMC7449844 DOI: 10.30773/pi.2020.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/05/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE We aimed to explore the differential impact of cigarette smoking on fracture risks in SCD and dementia. METHODS A nationwide population-based cohort study design was used. Out of all the people aged 66 (n=1,555,103) who went through the National Screening Program from 2009-2014, 968,240 participants with eligible data were included in the study. Time-to-event was calculated as the duration between the NSPTA and fracture incidence. Cox proportional-hazard regression analyses were conducted to evaluate the risk of fractures. RESULTS Increased risk of all [adjusted hazard ratio (aHR)=1.184; 95% confidence interval (CI)=1.184, 1.093-1.283], hip (aHR=1.518; 95% CI=1.168-4.972), vertebral (aHR=1.235; 95% CI=1.101-1.386) fractures were increased in current smokers with more than 20 or more pack years (≥20 py) of SCD group, after adjusting for all relevant confounding factors. In dementia group, however, current smokers ≥20 py were at reduced risk of hip fractures (aHR=0.249; 95% CI=0.089-0.97). CONCLUSION There was a disparate influence of cigarette smoking on the fracture risks in SCD and dementia group. Further studies are warranted to explicate this phenomenon, and personalized preventive measures according to one's cognitive status are imperative, since risk factors of fractures can exert disparate influence on patients at different stage of cognitive trajectory.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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18
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Sullivan KW, Law WA, Loyola L, Knoll MA, Shub DE, French LM. A Novel Intervention Platform for Service Members With Subjective Cognitive Complaints: Implementation, Patient Participation, and Satisfaction. Mil Med 2020; 185:326-333. [DOI: 10.1093/milmed/usz218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
ABSTRACT
Introduction
Program overview of a novel cognitive training platform at Walter Reed National Military Medical Center (WRNMMC) for service members with subjective cognitive complaints: analysis of patient participation, satisfaction with the program, and perceived areas of improvement.
Materials and Method
Retrospective review of 1,030 participants from November 2008 through May 2017. Data were obtained within an approved protocol (WRNMMC-EDO-2017-0004/# 876230).
Results
The program has shown growth in numbers of referrals, types of patient populations served, and patient visits. Patients report satisfaction with the program and endorse improvements in cognitive functions.
Conclusions
This program model may benefit other military facilities looking to provide and assess novel therapeutic approaches.
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Affiliation(s)
- Katherine W Sullivan
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889
- National Intrepid Center of Excellence, 4860 South Palmer Road, Bethesda, MD 20889
- Defense and Veterans Brain Injury Center, 1335 East West Highway, Silver Spring, MD 20910
| | - Wendy A Law
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889
- National Intrepid Center of Excellence, 4860 South Palmer Road, Bethesda, MD 20889
- Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
| | - Laura Loyola
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889
- National Intrepid Center of Excellence, 4860 South Palmer Road, Bethesda, MD 20889
- Defense and Veterans Brain Injury Center, 1335 East West Highway, Silver Spring, MD 20910
| | - Martin A Knoll
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889
- National Intrepid Center of Excellence, 4860 South Palmer Road, Bethesda, MD 20889
| | - Daniel E Shub
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889
| | - Louis M French
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889
- National Intrepid Center of Excellence, 4860 South Palmer Road, Bethesda, MD 20889
- Defense and Veterans Brain Injury Center, 1335 East West Highway, Silver Spring, MD 20910
- Center for Neuroscience and Regenerative Medicine, 4301 Jones Bridge Rd., Bethesda, MD 20814
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19
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McWhirter L, Ritchie C, Stone J, Carson A. Functional cognitive disorders: a systematic review. Lancet Psychiatry 2020; 7:191-207. [PMID: 31732482 DOI: 10.1016/s2215-0366(19)30405-5] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022]
Abstract
Cognitive symptoms are common, and yet many who seek help for cognitive symptoms neither have, nor go on to develop, dementia. A proportion of these people are likely to have functional cognitive disorders, a subtype of functional neurological disorders, in which cognitive symptoms are present, associated with distress or disability, but caused by functional alterations rather than degenerative brain disease or another structural lesion. In this Review, we have systematically examined the prevalence and clinical associations of functional cognitive disorders, and related phenotypes, within the wider cognitive disorder literature. Around a quarter of patients presenting to memory clinics received diagnoses that might indicate the presence of functional cognitive disorders, which were associated with affective symptoms, negative self-evaluation, negative illness perceptions, non-progressive symptom trajectories, and linguistic and behavioural differences during clinical interactions. Those with functional cognitive disorder phenotypes are at risk of iatrogenic harm because of misdiagnosis or inaccurate prediction of future decline. Further research is imperative to improve diagnosis and identify effective treatments for functional cognitive disorders, and better understanding these phenotypes will also improve the specificity of diagnoses of prodromal degenerative brain disease.
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Affiliation(s)
- Laura McWhirter
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Craig Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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20
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Vlachos GS, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Stefanis L, Scarmeas N. Prevalence of Mild Cognitive Impairment in the Elderly Population in Greece: Results From the HELIAD Study. Alzheimer Dis Assoc Disord 2020; 34:156-162. [DOI: 10.1097/wad.0000000000000361] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Lee J, Sung J, Choi M. The factors associated with subjective cognitive decline and cognitive function among older adults. J Adv Nurs 2019; 76:555-565. [PMID: 31713894 DOI: 10.1111/jan.14261] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/11/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022]
Abstract
AIMS To explore the risk factors for subjective cognitive decline and cognitive function among older adults in South Korea. DESIGN This study employed a descriptive cross-sectional design. METHODS A convenience sample of 182 patients was recruited from a senior welfare center in Seoul. The mean age of the participants was 78.4 years (SD 5.91). Among them, 64.3% were women. The data were collected by a trained research assistant using structured questionnaires from September 2016-February 2017. Demographic characteristics, comorbidities, depression, physical and cognitive activity levels, instrumental activities of daily living, subjective cognitive decline, and cognitive function were assessed. Student's t tests, chi-square tests, and hierarchical multiple regression analyses were used for statistical analyses. RESULTS The findings revealed that 37.4% of the participants were not cognitively intact. Depression, perceived health status, and cognitive function were significantly associated with subjective cognitive decline (F = 7.10, p < .001, adjusted R2 = 25.3). Age, educational level, perceived health status, and subjective cognitive decline were significantly related to cognitive function (F = 20.98, p < .001, adjusted R2 = 47.0). After controlling for these variables, cognitive activity was significantly and independently related to cognitive function. CONCLUSION The results suggest that for the maintenance of cognitive function, cognitive activity should be encouraged. In addition, older adults who complain of subjective cognitive decline and have risk factors such as depression need therapeutic interventions to prevent actual decrease of cognitive function. IMPACT The present findings advance prior knowledge by considering variables such as physical and cognitive activity levels to provide novel evidence that can be used to develop interventions for community-dwelling older adults. Thus, to be effective, nursing interventions must seek to improve cognitive function through intellectual stimulation.
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Affiliation(s)
- JuHee Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Jooyoun Sung
- Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - MoonKi Choi
- Department of Nursing, College of Nursing, Kangwon National University, Chuncheon-si, Republic of Korea
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22
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Older Adults With Subjective Cognitive Decline Worry About the Emotional Impact of Cognitive Test Results. Alzheimer Dis Assoc Disord 2019; 34:135-140. [DOI: 10.1097/wad.0000000000000354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Keilp JG, Corbera K, Gorlyn M, Oquendo MA, Mann JJ, Fallon BA. Neurocognition in Post-Treatment Lyme Disease and Major Depressive Disorder. Arch Clin Neuropsychol 2019; 34:466-480. [PMID: 30418507 DOI: 10.1093/arclin/acy083] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/10/2018] [Accepted: 10/26/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Neurocognitive dysfunction in patients with residual or emergent symptoms after treatment for Lyme Disease is often attributed to comorbid depression. In this study, patients with Post-Treatment Lyme Disease Syndrome (PTLDS) were compared to patients with Major Depressive Disorder (MDD), as well as healthy comparison subjects (HC), on neurocognitive measures administered through the same laboratory, to determine if patterns of performance were similar. METHODS Two analyses were conducted. First, performance on the Wechsler Adult Intelligence Scale (WAIS-III) and on subtests from the Wechsler Memory Scale (WMS-III) was compared among the groups. Second, comparable subgroups of PTLDS and MDD patients with at least one low WMS-III score were compared on an additional set of measures assessing motor function, psychomotor performance, attention, memory, working memory, and language fluency, to determine if the overall profile of performance was similar in the two subgroups. RESULTS In the first analysis, PTLDS patients performed more poorly than both MDD and HC on tasks assessing verbal abilities, working memory, and paragraph learning. Processing speed in the two patient groups, however, was equally reduced. In the second analysis, MDD patients with low WMS-III exhibited concomitantly greater difficulties in psychomotor speed and attention, while low-WMS-III PTLDS patients exhibited greater difficulties in language fluency. CONCLUSIONS MDD and PTLDS can be confused neuropsychologically because both exhibit similar levels of psychomotor slowing. However, problems on memory-related tasks, though mild, are more pronounced in PTLDS. PTLDS patients with poorer memory also exhibit poorer language fluency, and less deficit in processing speed and attention compared to MDD.
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Affiliation(s)
- John G Keilp
- Lyme Disease Research Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Kathy Corbera
- Lyme Disease Research Center, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Marianne Gorlyn
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Maria A Oquendo
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J John Mann
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Brian A Fallon
- Lyme Disease Research Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
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24
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Vlachos GS, Cosentino S, Kosmidis MH, Anastasiou CA, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Scarmeas N. Prevalence and determinants of subjective cognitive decline in a representative Greek elderly population. Int J Geriatr Psychiatry 2019; 34:846-854. [PMID: 30714214 DOI: 10.1002/gps.5073] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/25/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES We studied the prevalence of subjective cognitive decline (SCD) and its determinants in a sample of 1456 cognitively normal Greek adults ≥65 years old. METHODS/DESIGN Subjects were evaluated by a multidisciplinary team on their neurological, medical, neuropsychological, and lifestyle profile to reach consensus diagnoses. We investigated various types of SCD, including single-question, general memory decline, specific subjective memory decline based on a list of questions and three types of subjective naming, orientation, and calculation decline. RESULTS In a single general question about memory decline, 28.0% responded positively. The percentage of our sample that reported at least one complaint related to subjective memory decline was 76.6%. Naming difficulties were also fairly common (26.0%), while specific deficits in orientation (5.4%) and calculations/currency handling (2.6%) were rare. The majority (84.2%) of the population reported subjective deficits in at least one cognitive domain. Genetic predisposition to dementia increased the odds for general memory decline by more than 1.7 times. For each one-unit reduction in the neuropsychological composite score (a mean of memory, executive, language, visuospatial, and attention-speed composite scores), the odds for decline in orientation increased by 40.3%. Depression/anxiety and increased cerebrovascular risk were risk factors for almost all SCD types. CONCLUSIONS SCD regarding memory is more frequent than non-memory decline in the cognitively normal Greek elderly population. Genetic predisposition to dementia, lower cognitive performance, affective symptoms, and increased cerebrovascular risk are associated with prevalent SCD. Further prospective research is needed to improve understanding of the evolution of SCD over time.
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Affiliation(s)
- George S Vlachos
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, First Department of Neurology, Aeginition University Hospital, Athens, Greece
| | - Stephanie Cosentino
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Georgios Hadjigeorgiou
- School of Medicine, University of Thessaly, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | - Eva Ntanasi
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, First Department of Neurology, Aeginition University Hospital, Athens, Greece.,Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | - Nikolaos Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, First Department of Neurology, Aeginition University Hospital, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
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25
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Costello MC, Sizemore SJ, O’Brien KE, Manning LK. Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults. GEROPSYCH 2019. [DOI: 10.1024/1662-9647/a000202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.
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Affiliation(s)
| | - Shane J. Sizemore
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Kimberly E. O’Brien
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Lydia K. Manning
- Division of Human Services/Gerontology, Concordia University, River Forest, IL, USA
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26
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Lee MJ, Varadaraj V, Ramulu PY, Whitson HE, Deal JA, Swenor BK. Memory and Confusion Complaints in Visually Impaired Older Adults: An Understudied Aspect of Well-Being. Gerontol Geriatr Med 2019; 5:2333721418818944. [PMID: 30671493 PMCID: PMC6328951 DOI: 10.1177/2333721418818944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/17/2022] Open
Abstract
Objective: To determine the prevalence of cognitive (memory or confusion) complaints in older adults with visual impairment (VI). Method: We assessed the relationship between VI (corrected visual acuity [VA] < 20/40) and self-reported confusion or problems with memory among participants aged 60 years to 85 years in the 1999-2006 cycles of National Health and Nutrition Examination Survey (n = 5,795). Prevalence estimates of cognitive complaints were calculated using Current Population Surveys. Results: Memory/confusion complaints were reported in 22% of the VI group and 11% of the no VI group (p < .001). In individuals aged ≥ 80 years, 30% of those with VI reported cognitive complaints, as compared with 19% with no VI (p = .003). In fully adjusted models, individuals with VI were more likely (OR = 1.3, p = .049) to report cognitive complaints as compared with those without VI. Conclusion: Subjective reports of memory or confusion are highly prevalent in older individuals with VI.
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Affiliation(s)
- Moon Jeong Lee
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Varshini Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Heather E Whitson
- Duke University Medical Center, Durham, NC, USA.,Durham VA Medical Center, NC, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins, Bloomberg School of Public Health, Baltimore, MD, USA.,The Johns Hopkins Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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27
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Yang R, Tracy EL, Wang H. Longitudinal associations of depressive symptoms, subjective memory decline, and cognitive functioning among Chinese older adults: Between-person and within-person perspective. Arch Gerontol Geriatr 2018; 81:105-110. [PMID: 30529803 DOI: 10.1016/j.archger.2018.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/01/2018] [Accepted: 12/02/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We examined between- and within-person associations between depressive symptoms and cognitive functioning among Chinese older adults (aged 60+) over time. Furthermore, we also investigated whether subjective memory decline (SMD) is uniquely associated with cognitive functioning above and beyond depressive symptoms for both between-person and within-person associations. METHODS About 7385 older adults from the China Health and Retirement Longitudinal Study reported their demographic and health status, and completed self-report measures of depressive symptoms and SMD, as well as a battery of cognitive tests, every two years at three times between 2011 and 2015. RESULTS There were significant between-person and within-person associations between depressive symptoms and cognitive functioning. Furthermore, SMD was uniquely associated with cognitive functioning for both within-person and between-person associations after controlling for depressive symptoms. CONCLUSIONS The results highlight the importance of careful screening and monitoring of depressive symptoms and SMD for the benefits of cognitive functioning among Chinese older adults. More importantly, SMD has practical implications for the care of Chinese older adults given significant cultural stigma attached to mental illness within Chinese culture.
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Affiliation(s)
- Rumei Yang
- University of Utah College of Nursing, Salt Lake City, UT, United States.
| | - Eunjin Lee Tracy
- University of Utah Department of Psychology, Salt Lake City, UT, United States
| | - Haocen Wang
- School of Nursing, University of Wisconsin-Madison, 701 Highland Ave., Madiosn, WI, 53705, United States
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