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Sample records for cognitively intact older

  1. ENDURANCE AND STRENGTH TRAINING OUTCOMES ON COGNITIVELY IMPAIRED AND COGNITIVELY INTACT OLDER ADULTS: A META-ANALYSIS

    PubMed Central

    HEYN, P.C.; JOHNSON, K.E.; KRAMER, A. F.

    2010-01-01

    Background Dementia is a common syndrome in the geriatric population. Subsequent impairment of cognitive functioning impacts the patient’s mobility, ADLs, and IADLs. It is suggested that older persons with lower levels of cognition are less likely to achieve independence in ADLs and ambulation (1–2). Frequently, nursing home residents are viewed as too frail or cognitively impaired to benefit from exercise rehabilitation. Often, persons with Mini Mental State Score (MMSE) score below 25 are excluded from physical rehabilitation programs. However, Diamond (3) and Goldstein (4) concluded that geriatric patients with mild to moderate cognitive impairment were just as likely as cognitively intact patients to improve in functional abilities as a result of participation in exercise rehabilitation programs. Purpose The objective of this study is to compare, through a meta-analysis endurance and strength outcomes of Cognitively Impaired (MMSE <23) and Cognitively Intact (MMSE >24) older adults who participate in similar exercise programs. Methods Published articles were identified by using electronic and manual searches. Key search words included exercise, training, strength, endurance, rehabilitation, cognitive impairment, cognition, Mini Mental State Exam (MMSE), older adult, aged, and geriatrics. Articles were included if the were from RCTs or well-designed control studies. Results A total of 41 manuscripts met the inclusion criteria. We examined 21 exercise trials with cognitively impaired individuals (CI=1411) and 20 exercise trials with cognitively intact individuals (IN=1510). Degree of cognitive impairment is based on the reported MMSE score. Moderate to large effect sizes (ES = dwi, Hedges gi) were found for strength and endurance outcomes for the CI groups (dwi = .51, 95% CI=. 42–.60), and for the IN groups (dwi =. 49, 95% CI=. 40 –.58). No statistically significant difference in ES was found between the CI and IN studies on strength (t=1.675, DF= 8, P

  2. The impact of sleep on neuropsychological performance in cognitively intact older adults using a novel in-home sensor-based sleep assessment approach.

    PubMed

    Seelye, Adriana; Mattek, Nora; Howieson, Diane; Riley, Thomas; Wild, Katherine; Kaye, Jeffrey

    2015-01-01

    The relationship between recent episodes of poor sleep and cognitive testing performance in healthy cognitively intact older adults is not well understood. In this exploratory study we examined the impact of recent sleep disturbance, sleep duration, and sleep variability on cognitive performance in 63 cognitively intact older adults using a novel unobtrusive in-home sensor-based sleep assessment methodology. Specifically, we examined the impact of sleep the night prior, the week prior, and the month prior to a neuropsychological evaluation on cognitive performance. Results showed that mildly disturbed sleep the week prior and month prior to cognitive testing was associated with reduced working memory on cognitive evaluation. One night of mild sleep disturbance was not associated with decreased cognitive performance the next day. Sleep duration was unrelated to cognition. In-home, unobtrusive, sensor monitoring technologies provide a novel method for objective, long-term, and continuous assessment of sleep behavior and other everyday activities that might contribute to decreased or variable cognitive performance in healthy older adults. PMID:25642948

  3. A Randomized Trial to Measure the Impact of a Community-Based Cognitive Training Intervention on Balance and Gait in Cognitively Intact Black Older Adults

    PubMed Central

    Smith-Ray, Renae L.; Makowski-Woidan, Beth; Hughes, Susan L.

    2015-01-01

    Introduction Fall prevention is important for maintaining mobility and independence into old age. Approaches for reducing falls include exercise, tai chi, and home modifications; however, causes of falling are multifactorial and include not just physical but cognitive factors. Cognitive decline occurs with age, but older adults with the greatest declines in executive function experience more falls. The purpose of this study was twofold: to demonstrate the feasibility of a community-based cognitive training program for cognitively intact Black older adults and to analyze its impact on gait and balance in this population. Method This pilot study used a pretest/posttest randomized trial design with assignment to an intervention or control group. Participants assigned to the intervention completed a computer-based cognitive training class that met 2 days a week for 60 min over 10 weeks. Classes were held at senior/community centers. Primary outcomes included balance as measured by the Berg Balance Scale (BBS), 10-meter gait speed, and 10-meter gait speed under visuospatial dual-task condition. All measures were assessed at baseline and immediately post-intervention. Results Participants were community-dwelling Black adults with a mean age of 72.5 and history of falls (N = 45). Compared to controls, intervention participants experienced statistically significant improvements in BBS and gait speed. Mean performance on distracted gait speed also improved more for intervention participants compared to controls. Conclusion Findings from this pilot randomized trial demonstrate the feasibility of a community-based cognitive training intervention. They provide initial evidence that cognitive training may be an efficacious approach toward improving balance and gait in older adults known to have a history of falls. PMID:25274713

  4. Functional Changes in the Language Network in Response to Increased Amyloid β Deposition in Cognitively Intact Older Adults.

    PubMed

    Adamczuk, Katarzyna; De Weer, An-Sofie; Nelissen, Natalie; Dupont, Patrick; Sunaert, Stefan; Bettens, Karolien; Sleegers, Kristel; Van Broeckhoven, Christine; Van Laere, Koen; Vandenberghe, Rik

    2016-01-01

    Word finding symptoms are frequent early in the course of Alzheimer's disease and relate principally to functional changes in left posterior temporal cortex. In cognitively intact older adults, we examined whether amyloid load affects the network for language and associative-semantic processing. Fifty-six community-recruited subjects (52-74 years), stratified for apolipoprotein E and brain-derived neurotrophic factor genotype, received a neurolinguistic assessment, (18)F-flutemetamol positron emission tomography, and a functional MRI of the associative-semantic system. The primary measure of amyloid load was the cerebral-to-cerebellar gray matter standardized uptake value ratio in a composite cortical volume of interest (SUVR(comp)). The primary outcome analysis consisted of a whole-brain voxelwise linear regression between SUVR(comp) and fMRI response during associative-semantic versus visuoperceptual processing. Higher activity in one region, the posterior left middle temporal gyrus, correlated positively with increased amyloid load. The correlation remained significant when only the word conditions were contrasted but not for pictures. According to a stepwise linear regression analysis, offline naming reaction times correlated positively with SUVR(comp). A binary classification into amyloid-positive and amyloid-negative cases confirmed our findings. The left posterior temporal activity increase may reflect higher demands for semantic control in the presence of a higher amyloid burden. PMID:25452579

  5. Nutritional status in cognitively intact older people receiving home care services--a pilot study.

    PubMed

    Soini, H; Routasalo, P; Lagstrom, H

    2005-01-01

    Older adults are a potentially vulnerable group for malnutrition. This cross-sectional pilot study aims to assess the nutritional status of elderly patients living at home and receiving home health care services. The data were collected from patient care plans, the Mini Nutritional Assessment (MNA), and a questionnaire on eating problems. In addition, serum nutritional status indicators were measured, and an oral examination including quantitative saliva measurement was carried out. Out of 71 eligible patients 51 (72%) patients aged 76-93 years participated. MNA results showed that 47% were at risk of malnutrition. Care plans for 26 patients made reference to questions of nutrition but provided no detailed forward planning. The mean serum albumin value was 39.1 +/- 3.8 g/l, seven patients had a value lower than 35 g/l. MNA scores were significantly lower for female patients with haemoglobin values lower than 120 g/l (p = 0.027). The dentist's estimation of dry mouth and subjective problems in energy intake were significantly associated with lower MNA scores (p = 0.049 and p = 0.015). Subjects with functioning natural dentition had higher body mass index (BMI) scores than others (p = 0.0485). The results point at the importance of using screening tools such as the MNA for purposes of nutritional assessment, the estimation of oral problems such as dry mouth, chewing and swallowing problems, and advance planning in nutritional issues within the field of home care. PMID:15980925

  6. A Randomized Trial to Measure the Impact of a Community-Based Cognitive Training Intervention on Balance and Gait in Cognitively Intact Black Older Adults

    ERIC Educational Resources Information Center

    Smith-Ray, Renae L.; Makowski-Woidan, Beth; Hughes, Susan L.

    2014-01-01

    Introduction: Fall prevention is important for maintaining mobility and independence into old age. Approaches for reducing falls include exercise, tai chi, and home modifications; however, causes of falling are multifactorial and include not just physical but cognitive factors. Cognitive decline occurs with age, but older adults with the greatest…

  7. What physical performance measures predict incident cognitive decline among intact older adults? A 4.4year follow up study.

    PubMed

    Veronese, Nicola; Stubbs, Brendon; Trevisan, Caterina; Bolzetta, Francesco; De Rui, Marina; Solmi, Marco; Sartori, Leonardo; Musacchio, Estella; Zambon, Sabina; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

    2016-08-01

    Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in the MMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time. Multinomial logistic regression revealed that slow gait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the follow-up. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI. PMID:27235850

  8. Symptoms of depression, sadness and sense of coherence (coping) among cognitively intact older people with cancer living in nursing homes—a mixed-methods study

    PubMed Central

    Eide, Geir Egil; Hauge, Solveig

    2016-01-01

    Background: Symptoms of depression are often reported among patients with a cancer diagnosis. Strong sense of coherence (SOC) is shown to be associated with less depression in the general older population and among nursing homes (NH) residents in particular. Knowledge about mixed-methods perspectives that examine symptoms of depression and SOC among cognitively intact NH residents with cancer is scarce. Aim: To investigate symptoms of depression and SOC among NH residents who are cognitively intact and have cancer. Methods: We used a quantitatively driven mixed-methods design with sequential supplementary qualitative components. We facilitated the collection of quantitative survey data of 60 NH residents (≥ 65 years) with cancer using the Geriatric Depression Scale (GDS) and SOC scale. The supplementary psychosocial component comprised qualitative research interviews about experiences related to depression with nine respondents from the same cohort. Results: In fully adjusted multiple regression analysis of the sociodemographic variables, the GDS was significantly correlated with SOC (P < 0.001). The experience of sadness was identified by the following theme: sadness. Coping with the experience of symptoms of depression was dominated by coping with sadness. Conclusion: More than half the NH residents reported symptoms of depression, and the SOC was associated with reduced symptoms. A mixed-methods design contributed to nuanced and detailed information about the meaning of depression, and the supplementary component informs and supports the core component. To improve the situation of NH residents with cancer, more attention should be paid to the residents’ experience of symptoms of depression and their SOC. PMID:27330859

  9. Psychometric Evaluation of the Revised Iowa Pain Thermometer (IPT-R) in a Sample of Diverse Cognitively Intact and Impaired Older Adults: A Pilot Study.

    PubMed

    Ware, Laurie Jowers; Herr, Keela A; Booker, Staja Star; Dotson, Kelley; Key, Jennifer; Poindexter, Norma; Pyles, Gia; Siler, Bobbie; Packard, Abbot

    2015-08-01

    Self-report pain assessment tools are commonly used in clinical settings to determine patients' pain intensity. The Iowa Pain Thermometer (IPT) is a tool that was developed for research, but also can be used in clinical settings. However, its utility in clinical settings is challenging because it uses a 13-point scale (0-12 scale) that does not align with common electronic pain scoring metrics. Therefore, this study evaluated the psychometric properties of an 11-point (0-10 scale) adaptation of the Iowa Pain Thermometer (IPT-R) to evaluate the psychometric properties of the IPT-R and to determine patient preference for a self-report pain assessment tool. A descriptive, correlational design was employed. The IPT-R was compared with the original IPT and a numeric rating scale (NRS). This study was conducted in the southeastern United States with 75 adults ranging in age from 65-95 years with varying levels of cognition. Participants were primarily representative of black and white backgrounds. Participants were asked to rate current pain, worst pain during the past week, and reassessment of current pain after 10-minute intervals using three scales (IPT-R, IPT, and NRS) presented in random order. Participants were asked to identify the tool preferred (the easiest to use and that best represented their pain intensity). Spearman-rank correlations were performed to determine convergent validity and test-retest reliability. Based on the results of this preliminary study, the IPT-R has good validity and reliability. The participants in this sample preferred the IPT-R over the original IPT (0-12 scale) and the traditional NRS (0-10 scale). Clinicians may consider using this tool with diverse older patients to assess pain intensity. PMID:26256217

  10. Assessing Fatigability in Mobility-Intact Older Adults

    PubMed Central

    Simonsick, Eleanor M.; Schrack, Jennifer A.; Glynn, Nancy W.; Ferrucci, Luigi

    2014-01-01

    OBJECTIVES Evaluate criterion validity of two measures of fatigability defined as performance deterioration or perceived effort to perform a standardized task. DESIGN Cross-sectional analysis of data from the Baltimore Longitudinal Study of Aging (BLSA). SETTING National Institute on Aging, Intramural Research Program, Clinical Research Unit, Baltimore, Maryland. PARTICIPANTS Six hundred five men (53.7%) and women (aged 65–97) participating in the BLSA eligible for endurance walk testing without a walking aid. MEASUREMENTS Fatigability was assessed using (1) completion status and lap times from a 400m-walk performed “as quickly as possible” and (2) perceived exertion rating using the Borg scale (range 6–20) following 5 minutes of treadmill walking at 1.5mph (0.67m/s). Criterion measures include self-report of tiredness, level of weakness and energy in past month and walking ability and objective measures of usual and fast gait speed, time to complete 10 chair stands and grip strength. Co-variates include age, race, sex, obesity, smoking status and walking activity. RESULTS Among mobility intact older persons, 23% exhibited performance deterioration (i.e., slowed or stopped) during the 400m-walk and1/3 reported more than very light exertion following a 5-minute slow walk. Slowing was strongly associated with self-reported fatigue and walking ability, but weakly associated with performance-based mobility measures. High perceived exertion was associated with tiredness and weakness and reported and observed mobility deficits. CONCLUSION Slowing down may have low sensitivity for identifying fatigability in older persons, but ascertaining perceived exertion during a defined workload shows promise. In seemingly healthy, motivated individuals, fatigue and fatigability were common and may impact socially meaningful mobility behaviors. Assessment of fatigability in well-elderly examinations may help identify threats to independent functioning earlier in the decline

  11. Association between Cognitive Activity and Cognitive Function in Older Hispanics

    PubMed Central

    Marquine, María J.; Segawa, Eisuke; Wilson, Robert S.; Bennett, David A.; Barnes, Lisa L.

    2012-01-01

    There is limited research on the association between participation in cognitively stimulating activity and cognitive function in older Hispanics. The main purpose of the present study was to explore whether frequency of cognitive activity and its association with cognitive function in Hispanics is comparable to that of non-Hispanics. In a multiethnic cohort of 1571 non-demented older adults, we assessed past and current cognitive activity, availability of cognitive resources in the home in childhood and middle age, and five domains of cognitive function. The measures of cognitive activity and cognitive resources had adequate reliability and validity in our subset of Hispanic participants (n = 81). Hispanics reported lower levels of education, lower frequency of cognitive activity and less cognitive resources than non-Hispanic White (n = 1102) and non-Hispanic Black (n = 388) participants. Despite these differences the strength of the association between cognitive activity and cognitive function was comparable across ethnic groups. Because Hispanics have lower frequency of cognitive activity, the benefit of cognitive activity to late life cognitive function may be potentially larger in this segment of the population. Thus, interventions aimed at increasing frequency of participation in cognitively stimulating activity may offer a potential target to reduce cognitive impairment in Hispanics. PMID:22676914

  12. Pain Assessment with Cognitively Impaired Older People in the Acute Hospital Setting

    PubMed Central

    2011-01-01

    Research reveals that older people continue to experience much suffering from acute and chronic pain conditions. People with cognitive impairment receive less analgesia than their cognitively intact peers. Postoperative pain assessment with older people in the acute hospital setting remains a challenge. Context and culture have a significant impact of pain assessment practices. Due to a paucity of research exploring how pain assessment and management practices with cognitively impaired older people may be realised in the acute hospital setting, there is a need for further research to be conducted. PMID:26524985

  13. Cognitive Interventions for Older Diabetics.

    ERIC Educational Resources Information Center

    Black, Sheila; Scogin, Forrest

    1998-01-01

    Older diabetic adults should receive memory training to improve their compliance with medication taking. The intervention should include comprehensible medical instructions, assistance with remembering the nutritional values of food, and higher order skills for disease management. (SK)

  14. Do Older Professional Musicians Have Cognitive Advantages?

    PubMed Central

    Hasher, Lynn; Trehub, Sandra E.; Wong, Yukwal

    2013-01-01

    The current study investigates whether long-term music training and practice are associated with enhancement of general cognitive abilities in late middle-aged to older adults. Professional musicians and non-musicians who were matched on age, education, vocabulary, and general health were compared on a near-transfer task involving auditory processing and on far-transfer tasks that measured spatial span and aspects of cognitive control. Musicians outperformed non-musicians on the near-transfer task, on most but not all of the far-transfer tasks, and on a composite measure of cognitive control. The results suggest that sustained music training or involvement is associated with improved aspects of cognitive functioning in older adults. PMID:23940774

  15. Do older professional musicians have cognitive advantages?

    PubMed

    Amer, Tarek; Kalender, Beste; Hasher, Lynn; Trehub, Sandra E; Wong, Yukwal

    2013-01-01

    The current study investigates whether long-term music training and practice are associated with enhancement of general cognitive abilities in late middle-aged to older adults. Professional musicians and non-musicians who were matched on age, education, vocabulary, and general health were compared on a near-transfer task involving auditory processing and on far-transfer tasks that measured spatial span and aspects of cognitive control. Musicians outperformed non-musicians on the near-transfer task, on most but not all of the far-transfer tasks, and on a composite measure of cognitive control. The results suggest that sustained music training or involvement is associated with improved aspects of cognitive functioning in older adults. PMID:23940774

  16. Hippocampal volume and integrity as predictors of cognitive decline in intact elderly.

    PubMed

    Bruno, Davide; Ciarleglio, Adam; Grothe, Michel J; Nierenberg, Jay; Bachman, Alvin H; Teipel, Stefan J; Petkova, Eva; Ardekani, Babak A; Pomara, Nunzio

    2016-08-01

    The risk of Alzheimer's disease can be predicted by volumetric analyses of MRI data in the medial temporal lobe. The present study compared a volumetric measurement of the hippocampus with a novel measure of hippocampal integrity (HI) derived from the ratio of parenchyma volume over total volume. Participants were cognitively intact and aged 60 years or older at baseline, and were tested twice, roughly 3 years apart. Participants had been recruited for a study on late-life major depression (LLMD) and were evenly split between depressed patients and controls. Linear regression models were applied to the data with a cognitive composite score as the outcome, and HI and volume, together or separately, as predictors. Subsequent cognitive performance was predicted well by models that included an interaction between HI and LLMD status, such that lower HI scores predicted more cognitive decline in depressed patients. More research is needed, but tentative results from this study appear to suggest that the newly introduced measure HI is an effective tool for the purpose of predicting future changes in general cognitive ability, and especially so in individuals with LLMD. PMID:27306593

  17. THE OLDER ADULT DRIVER WITH COGNITIVE IMPAIRMENT

    PubMed Central

    Carr, David B.; Ott, Brian R.

    2010-01-01

    Although automobiles remain the transportation of choice for older adults, late life cognitive impairment and dementia often impair the ability to drive safely. There is, however, no commonly utilized method of assessing dementia severity in relation to driving, no consensus on the assessment of older drivers with cognitive impairment, and no gold standard for determining driving fitness. Yet, clinicians are called upon by patients, their families, other health professionals, and often the Department of Motor Vehicles (DMV) to assess their patients' fitness-to-drive and to make recommendations about driving privileges. Using the case of Mr W, we describe the challenges of driving with cognitive impairment for both the patient and caregiver, summarize the literature on dementia and driving, discuss evidenced-based assessment of fitness-to-drive, and address important ethical and legal issues. We describe the role of physician assessment, referral to neuropsychology, functional screens, dementia severity tools, driving evaluation clinics, and DMV referrals that may assist with evaluation. Finally, we discuss mobility counseling (eg, exploration of transportation alternatives) since health professionals need to address this important issue for older adults who lose the ability to drive. The application of a comprehensive, interdisciplinary approach to the older driver with cognitive impairment will have the best opportunity to enhance our patients' social connectedness and quality of life, while meeting their psychological and medical needs and maintaining personal and public safety. PMID:20424254

  18. Less Daily Computer Use is Related to Smaller Hippocampal Volumes in Cognitively Intact Elderly

    PubMed Central

    Silbert, Lisa C.; Dodge, Hiroko H.; Lahna, David; Promjunyakul, Nutta-on; Austin, Daniel; Mattek, Nora; Erten-Lyons, Deniz; Kaye, Jeffrey A.

    2016-01-01

    Background: Computer use is becoming a common activity in the daily life of older individuals and declines over time in those with mild cognitive impairment (MCI). The relationship between daily computer use (DCU) and imaging markers of neurodegeneration is unknown. Objective:The objective of this study was to examine the relationship between average DCU and volumetric markers of neurodegeneration on brain MRI. Methods: Cognitively intact volunteers enrolled in the Intelligent Systems for Assessing Aging Change study underwent MRI. Total in-home computer use per day was calculated using mouse movement detection and averaged over a one-month period surrounding the MRI. Spearman’s rank order correlation (univariate analysis) and linear regression models (multivariate analysis) examined hippocampal, gray matter (GM), white matter hyperintensity (WMH), and ventricular cerebral spinal fluid (vCSF) volumes in relation to DCU. A voxel-based morphometry analysis identified relationships between regional GM density and DCU. Results: Twenty-seven cognitively intact participants used their computer for 51.3 minutes per day on average. Less DCU was associated with smaller hippocampal volumes (r = 0.48, p = 0.01), but not total GM, WMH, or vCSF volumes. After adjusting for age, education, and gender, less DCU remained associated with smaller hippocampal volume (p = 0.01). Voxel-wise analysis demonstrated that less daily computer use was associated with decreased GM density in the bilateral hippocampi and temporal lobes. Conclusions: Less daily computer use is associated with smaller brain volume in regions that are integral to memory function and known to be involved early with Alzheimer’s pathology and conversion to dementia. Continuous monitoring of daily computer use may detect signs of preclinical neurodegeneration in older individuals at risk for dementia. PMID:26967228

  19. Recognition of Famous Names Predicts Episodic Memory Decline in Cognitively Intact Elders

    PubMed Central

    Seidenberg, Michael; Kay, Christina; Woodard, John L.; Nielson, Kristy A.; Smith, J. Carson; Kandah, Cassandra; Guidotti Breting, Leslie M.; Novitski, Julia; Lancaster, Melissa; Matthews, Monica; Hantke, Nathan; Butts, Alissa; Rao, Stephen M.

    2013-01-01

    Objective: Semantic memory impairment is common in both Mild Cognitive Impairment (MCI) and early Alzheimer’s disease (AD), and the ability to recognize familiar people is particularly vulnerable. A time-limited temporal gradient (TG) in which well known people from decades earlier are better recalled than those learned recently is also reported in both AD and MCI. In this study, we hypothesized that the TG pattern on a famous name recognition task (FNRT) administered to cognitively intact elders would predict future episodic memory decline, and would also show a significant correlation with hippocampal volume. Methods: 78 healthy elders (ages 65-90) with normal cognition and episodic memory at baseline were administered a FNRT. Follow-up episodic memory testing 18 months later produced two groups: Declining (≥ 1 SD reduction in episodic memory) and Stable (< 1 SD). Results: The Declining group (N=27) recognized fewer recent famous names than the Stable group (N=51), while recognition for remote names was comparable. Baseline MRI volumes for both the left and right hippocampus was significantly smaller in the Declining group than the Stable group. Smaller baseline hippocampal volume was also significantly correlated with poorer performance for recent, but not remote famous names. Logistic regression analyses indicated that baseline TG performance was a significant predictor of group status (Declining versus Stable) independent of chronological age and APOE ε4 inheritance. Conclusions: Famous name recognition may serve as an early pre-clinical cognitive marker of episodic memory decline in older individuals. PMID:23688215

  20. Folic acid and cognition in older persons.

    PubMed

    Schneider, Julie A; Tangney, Christy C; Morris, Martha Clare

    2006-07-01

    Folic acid supplementation has drawn much attention in recent years for the prevention of Alzheimer's disease and cognitive decline. In this review, the authors describe how current evidence does not support the use of folic acid supplements to protect against cognitive decline. Although a few studies suggest that folic acid supplementation may provide neuroprotection among persons who are folate deficient, there is also data to indicate that supplementation in persons without folate deficiency may pose a risk to neurological function. Vitamin B12 deficiency is common in old age and may not be easy to recognise. Folic acid supplementation may mask the anaemia associated with vitamin B12 deficiency and, therefore, may delay treatment while allowing progression of neurological symptoms. Whether or not folic acid supplementation exacerbates neurological symptoms of vitamin B12 deficiency is not clear. Further studies are needed to determine the possible risks and benefits of folic acid supplementation in older persons. PMID:16774490

  1. Change in Cognitive Abilities in Older Latinos.

    PubMed

    Wilson, Robert S; Capuano, Ana W; Marquez, David X; Amofa, Priscilla; Barnes, Lisa L; Bennett, David A

    2016-01-01

    The aim of this study was to compare patterns of cognitive decline in older Latinos and non-Latinos. At annual intervals for a mean of 5.7 years, older Latino (n=104) and non-Latino (n=104) persons of equivalent age, education, and race completed a battery of 17 cognitive tests from which previously established composite measures of episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability were derived. In analyses adjusted for age, sex, and education, performance declined over time in each cognitive domain, but there were no ethnic group differences in initial level of function or annual rate of decline. There was evidence of retest learning following the baseline evaluation, but neither the magnitude nor duration of the effect was related to Latino ethnicity, and eliminating the first two evaluations, during which much of retest learning occurred, did not affect ethnic group comparisons. Compared to the non-Latino group, the Latino group had more diabetes (38.5% vs. 25.0; χ2[1]=4.4; p=.037), fewer histories of smoking (24.0% vs. 39.4%, χ2[1]=5.7; p=.017), and lower childhood household socioeconomic level (-0.410 vs. -0.045, t[185.0]=3.1; p=.002), but controlling for these factors did not affect results. Trajectories of cognitive aging in different abilities are similar in Latino and non-Latino individuals of equivalent age, education, and race. (JINS, 2016, 22, 58-65). PMID:26553103

  2. Automated Video Analysis of Handwashing Behavior as a Potential Marker of Cognitive Health in Older Adults.

    PubMed

    Ashraf, Ahmed; Taati, Babak

    2016-03-01

    The identification of different stages of cognitive impairment can allow older adults to receive timely care and plan for the level of caregiving. People with existing diagnosis of cognitive impairment go through episodic phases of dementia requiring different levels of care at different times. Monitoring the cognitive status of existing patients is, thus, critical to deciding the level of care required by older adults. In this paper, we present a system to assess the cognitive status of older adults by monitoring a common activity of daily living, namely handwashing. Specifically, we extract features from handwashing trials of participants diagnosed with different levels of dementia ranging from cognitively intact to severe cognitive impairment, as assessed by the mini-mental state exam (MMSE). Based on videos of handwashing trials, we extract two classes of features: one characterizing the occupancy of different sink regions by the participant, and the other capturing the path tortuosity of the motion trajectory of participant's hands. We perform correlation analysis to assess univariate capacity of individual features to predict MMSE scores. To assess multivariate performance, we use machine learning methods to train models that predict the cognitive status (aware, mild, moderate, severe), as well as the MMSE scores. We present results demonstrating that features derived from hand washing behavior can be potential surrogate markers of a person's dementia, which can be instrumental in developing automated tools for continuously monitoring the cognitive status of older adults. PMID:25794404

  3. Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture: a multicenter exploratory study.

    PubMed

    Fry, Margaret; Arendts, Glenn; Chenoweth, Lynn; MacGregor, Casimir

    2014-08-27

    ABSTRACT Background: Older people who present to the emergency department (ED) often experience a significant delay to analgesia. This study compares the time to analgesia for cognitively impaired and cognitively intact older people diagnosed with a long bone fracture. Methods: The aim of the study was to determine if cognitive impairment is associated with a delayed analgesic response. A 12-month exploratory study, using patient data, was conducted across four EDs. Medical records of 264 patients with long bone fractures were randomly selected. Results: The majority of patients waited longer than 60 minutes for analgesia. The median time to analgesia was longer for the cognitively impaired (149 minutes) compared with cognitively intact (72 minutes; Mann-Whitney U test: p < 0.001). Conclusions: This study suggests that cognitive impairment is a significant risk factor for delayed analgesia response in the ED. PMID:25162158

  4. Understanding cognition in older patients with cancer.

    PubMed

    Karuturi, Meghan; Wong, Melisa L; Hsu, Tina; Kimmick, Gretchen G; Lichtman, Stuart M; Holmes, Holly M; Inouye, Sharon K; Dale, William; Loh, Kah P; Whitehead, Mary I; Magnuson, Allison; Hurria, Arti; Janelsins, Michelle C; Mohile, Supriya

    2016-07-01

    Cancer and neurocognitive disorders, such as dementia and delirium, are common and serious diseases in the elderly that are accompanied by high degree of morbidity and mortality. Furthermore, evidence supports the under-diagnosis of both dementia and delirium in older adults. Complex questions exist regarding the interaction of dementia and delirium with cancer, beginning with guidelines on how best measure disease severity, the optimal screening test for either disorder, the appropriate level of intervention in the setting of abnormal findings, and strategies aimed at preventing the development or progression of either process. Ethical concerns emerge in the research setting, pertaining to the detection of cognitive dysfunction in participants, validity of consent, disclosure of abnormal results if screening is pursued, and recommended level of intervention by investigators. Furthermore, understanding the ways in which comorbid cognitive dysfunction and cancer impact both cancer and non-cancer-related outcomes is essential in guiding treatment decisions. In the following article, we will discuss what is presently known of the interactions of pre-existing cognitive impairment and delirium with cancer. We will also discuss identified deficits in our knowledge base, and propose ways in which innovative research may address these gaps. PMID:27282296

  5. Understanding cognition in older patients with cancer

    PubMed Central

    Karuturi, Meghan; Wong, Melisa L.; Hsu, Tina; Kimmick, Gretchen G.; Lichtman, Stuart M.; Holmes, Holly M.; Inouye, Sharon K.; Dale, William; Loh, Kah P.; Whitehead, Mary I.; Magnuson, Allison; Hurria, Arti; Janelsins, Michelle C.; Mohile, Supriya

    2016-01-01

    Cancer and neurocognitive disorders, such as dementia and delirium, are common and serious diseases in the elderly that are accompanied by high degree of morbidity and mortality. Furthermore, evidence supports the under-diagnosis of both dementia and delirium in older adults. Complex questions exist regarding the interaction of dementia and delirium with cancer, beginning with guidelines on how best measure disease severity, the optimal screening test for either disorder, the appropriate level of intervention in the setting of abnormal findings, and strategies aimed at preventing the development or progression of either process. Ethical concerns emerge in the research setting, pertaining to the detection of cognitive dysfunction in participants, validity of consent, disclosure of abnormal results if screening is pursued, and recommended level of intervention by investigators. Furthermore, understanding the ways in which comorbid cognitive dysfunction and cancer impact both cancer and non-cancer-related outcomes is essential in guiding treatment decisions. In the following article, we will discuss what is presently known of the interactions of pre-existing cognitive impairment and delirium with cancer. We will also discuss identified deficits in our knowledge base, and propose ways in which innovative research may address these gaps. PMID:27282296

  6. RELATIONSHIP BETWEEN INSULIN-RESISTANCE PROCESSING SPEED AND SPECIFIC EXECUTIVE FUNCTION PROFILES IN NEUROLOGICALLY-INTACT OLDER ADULTS

    PubMed Central

    Frazier, Darvis T.; Bettcher, Brianne M.; Dutt, Shubir; Patel, Nihar; Mungas, Dan; Miller, Joshua; Green, Ralph; Kramer, Joel H.

    2016-01-01

    Objective This study investigated the relationship between insulin-resistance and constituent components of executive function in a sample of neurologically-intact older adult subjects using the homeostasis model assessment (HOMA-IR) and latent factors of working memory, cognitive control and processing speed derived from confirmatory factor analysis. Low-density lipoprotein (LDL), mean arterial pressure (MAP), along with body mass index (BMI) and white matter hypointensity (WMH) were used to control for vascular risk factors, adiposity and cerebrovascular injury. Methods The study included 119 elderly subjects recruited from the University of California, San Francisco Memory and Aging Center. Subjects underwent neuropsychological assessment, fasting blood draw and brain magnetic resonance imaging (MRI). Partial correlations and linear regression models were used to examine the HOMA-IR-executive function relationship. Results Pearson correlation adjusting for age showed a significant relationship between HOMA-IR and working memory (rp=−.18, p=.047), a trend with cognitive control (rp=−.17, p=.068), and no relationship with processing speed (rp=.013, p=.892). Linear regression models adjusting for demographic factors (age, education and gender), LDL, MAP, BMI and WMH indicated that HOMA-IR was negatively associated with cognitive control (r=−.256; p=.026) and working memory (r=−.234; p=.054). Conclusions These results suggest a greater level of peripheral insulin-resistance is associated with decreased cognitive control and working memory. After controlling for demographic factors, vascular risk, adiposity and cerebrovascular injury, HOMA-IR remained significantly associated with cognitive control, with working memory showing a trend. These findings substantiate the insulin-resistance-executive function hypothesis and suggest a complex interaction, demonstrated by the differential impact of insulin-resistance on processing speed and specific aspects of

  7. Relationship between Insulin-Resistance Processing Speed and Specific Executive Function Profiles in Neurologically Intact Older Adults.

    PubMed

    Frazier, Darvis T; Bettcher, Brianne M; Dutt, Shubir; Patel, Nihar; Mungas, Dan; Miller, Joshua; Green, Ralph; Kramer, Joel H

    2015-09-01

    This study investigated the relationship between insulin-resistance and constituent components of executive function in a sample of neurologically intact older adult subjects using the homeostasis model assessment (HOMA-IR) and latent factors of working memory, cognitive control and processing speed derived from confirmatory factor analysis. Low-density lipoprotein (LDL), mean arterial pressure (MAP), along with body mass index (BMI) and white matter hypointensity (WMH) were used to control for vascular risk factors, adiposity and cerebrovascular injury. The study included 119 elderly subjects recruited from the University of California, San Francisco Memory and Aging Center. Subjects underwent neuropsychological assessment, fasting blood draw and brain magnetic resonance imaging (MRI). Partial correlations and linear regression models were used to examine the HOMA-IR-executive function relationship. Pearson correlation adjusting for age showed a significant relationship between HOMA-IR and working memory (rp = -.18; p = .047), a trend with cognitive control (rp = -.17; p = .068), and no relationship with processing speed (rp = .013; p = .892). Linear regression models adjusting for demographic factors (age, education, and gender), LDL, MAP, BMI, and WMH indicated that HOMA-IR was negatively associated with cognitive control (r = -.256; p = .026) and working memory (r = -.234; p = .054). These results suggest a greater level of peripheral insulin-resistance is associated with decreased cognitive control and working memory. After controlling for demographic factors, vascular risk, adiposity and cerebrovascular injury, HOMA-IR remained significantly associated with cognitive control, with working memory showing a trend. These findings substantiate the insulin-resistance-executive function hypothesis and suggest a complex interaction, demonstrated by the differential impact of insulin-resistance on processing speed and specific aspects of executive function. PMID

  8. Chemotherapy-related cognitive impairment in older patients with cancer

    PubMed Central

    Loh, Kah Poh; Janelsins, Michelle C.; Mohile, Supriya G.; Holmes, Holly M.; Hsu, Tina; Inouye, Sharon K.; Karuturi, Meghan S.; Kimmick, Gretchen G.; Lichtman, Stuart M.; Magnuson, Allison; Whitehead, Mary I.; Wong, Melisa L.; Ahles, Tim A.

    2016-01-01

    Chemotherapy-related cognitive impairment (CRCI) can occur during or after chemotherapy and represents a concern for many patients with cancer. Among older patients with cancer, in whom there is little clinical trial evidence examining side effects like CRCI, many unanswered questions remain regarding risk for and resulting adverse outcomes from CRCI. Given the rising incidence of cancer with age, CRCI is of particular concern for older patients with cancer who receive treatment. Therefore, research related to CRCI in older patients with cancers is a high priority. In this manuscript, we discuss current gaps in research highlighting the lack of clinical studies of CRCI in older adults, the complex mechanisms of CRCI, and the challenges in measuring cognitive impairment in older patients with cancer. Although we focus on CRCI, we also discuss cognitive impairment related to cancer itself and other treatment modalities. We highlight several research priorities to improve the study of CRCI in older patients with cancer. PMID:27197918

  9. Gender Differences in Cognition among Older Adults in China

    ERIC Educational Resources Information Center

    Lei, Xiaoyan; Hu, Yuqing; McArdle, John J.; Smith, James P.; Zhao, Yaohui

    2012-01-01

    In this paper, we model gender differences in cognitive ability in China using a new sample of middle-aged and older Chinese respondents. Modeled after the American Health and Retirement Study (HRS), the CHARLS Pilot survey respondents are 45 years and older in two quite distinct provinces--Zhejiang, a high-growth industrialized province on the…

  10. Antecedents of Intact Cognition and Dementia at Age 90: A Prospective Study

    PubMed Central

    Vaillant, George E.; Okereke, Olivia I; Mukamal, Kenneth; Waldinger, Robert J.

    2014-01-01

    Objectives To examine the possible antecedents of both dementia and sustained intact cognition at age 90 among men who underwent a prospective, multidisciplinary assessment from age 19 to 90, with little attrition. Methods A prospective 20-year reassessment of the 196 (out of 268) former Harvard College sophomores who survived until age 70. Begun in 1939 the Study gathered measurements of childhood environment, dominant personality traits, and objective mental and physical health over time, smoking in pack years, alcohol abuse and depression. Questionnaires were obtained every two years and physical exams every five years. Cognitive status was assessed at ages 80, 85 and 90. Results Despite addressing a wide variety health, behavioral and social factors over the lifespan, we observed few predictors with strong association with either intact cognition at age 90 (n = 40) or dementia (n = 44). Univariate analysis revealed seven suggestive predictors of intact cognition at age 90 or of dementia: warm childhood relationship with mother, exercise at age 60, high maternal education, young age of mother at subject’s birth, low BMI, good physical health at 60, and late retirement. Only the first 3 variables: warm childhood relationship with mother, exercise at age 60, and high maternal education remained significant with logistic regression. Conclusions In this prospective study of long-lived, highly educated men several well-known putative predictors of AD did not distinguish those who over the next 20 years developed dementia from those with unimpaired cognition until age 90. PMID:24733646

  11. Adapting Homework for an Older Adult Client with Cognitive Impairment

    ERIC Educational Resources Information Center

    Coon, David W.; Thompson, Larry W.; Gallagher-Thompson, Dolores

    2007-01-01

    There is growing evidence that psychosocial treatments incorporating behavioral intervention strategies can be effective in the treatment of depression in older adults with cognitive impairment. However, less work with such cases has focused on the use of cognitive interventions in tandem with these behavioral intervention strategies. This case…

  12. Walking and the Preservation of Cognitive Function in Older Populations

    ERIC Educational Resources Information Center

    Prohaska, Thomas R.; Eisenstein, Amy R.; Satariano, William A.; Hunter, Rebecca; Bayles, Constance M.; Kurtovich, Elaine; Kealey, Melissa; Ivey, Susan L.

    2009-01-01

    Purpose: This cross-sectional study takes a unique look at the association between patterns of walking and cognitive functioning by examining whether older adults with mild cognitive impairment differ in terms of the community settings where they walk and the frequency, intensity, or duration of walking. Design and Methods: The sample was based on…

  13. Cognitive Style Predictors of Affect Change in Older Adults

    ERIC Educational Resources Information Center

    Isaacowitz, Derek M.; Seligman, Martin E. P.

    2002-01-01

    Cognitive styles are the lenses through which individuals habitually process information from their environment. In this study, we evaluated whether different cognitive style individual difference variables, such as explanatory style and dispositional optimism, could predict changes in affective state over time in community-dwelling older adults.…

  14. Exercise and fitness modulate cognitive function in older adults.

    PubMed

    Chu, Chien-Heng; Chen, Ai-Guo; Hung, Tsung-Min; Wang, Chun-Chih; Chang, Yu-Kai

    2015-12-01

    This study investigated the effects of acute exercise on cognitive function and the modulatory role of fitness in the relationship between exercise and cognition. Forty-six healthy older adults, categorized into higher or lower fitness groups, completed the Stroop test after both 30 min of aerobic exercise and a reading control with a counterbalanced order. Our findings demonstrated that acute exercise leads to general improvements in 2 types of cognitive functions and to specific improvements in executive function. Additionally, older adults with initially higher fitness levels experienced greater beneficial effects from acute exercise. PMID:26652724

  15. Factors associated with cognitive function in older adults in Mexico

    PubMed Central

    Miu, Jenny; Negin, Joel; Salinas-Rodriguez, Aarón; Manrique-Espinoza, Betty; Sosa-Ortiz, Ana Luisa; Cumming, Robert; Kowal, Paul

    2016-01-01

    Background As populations age, cognitive decline and dementia pose significant burdens for societies and health care systems, including low- and middle-income countries such as Mexico. Minor age-related declines in cognitive function appear to represent a stable but heterogeneous phase in the continuum between normal cognitive ageing and dementia. Loss of cognitive function has impacts at societal and individual levels and understanding the risk factors can help provide a framework for health policies and interventions to target at-risk groups. Design A cohort of older Mexican adults (50+) from the World Health Organization's Study on global AGEing and adult health (WHO SAGE) was used to examine cognitive function, including a total of 2315 respondents, with 325 respondents aged 80 years and older. Cognition was objectively evaluated using verbal recall, verbal fluency, forward digit span and backward digit span, with differences in an overall cognitive score assessed against sociodemographic variables, and associated factors using linear regression. Results The most significant predictors of poorer cognitive function were found to be older age (β=−13.88), rural living (β=−2.25), low income (β=−8.28), self-reported severe or extreme memory difficulties (β=−6.62), and difficulty with two or more activities of daily living (β=−2.02). Conclusions These findings can inform public health initiatives to address cognitive impairment in ageing populations in Mexico and other middle-income countries. PMID:27032808

  16. Genetic risk for Alzheimer's disease alters the five-year trajectory of semantic memory activation in cognitively intact elders.

    PubMed

    Rao, Stephen M; Bonner-Jackson, Aaron; Nielson, Kristy A; Seidenberg, Michael; Smith, J Carson; Woodard, John L; Durgerian, Sally

    2015-05-01

    Healthy aging is associated with cognitive declines typically accompanied by increased task-related brain activity in comparison to younger counterparts. The Scaffolding Theory of Aging and Cognition (STAC) (Park and Reuter-Lorenz, 2009; Reuter-Lorenz and Park, 2014) posits that compensatory brain processes are responsible for maintaining normal cognitive performance in older adults, despite accumulation of aging-related neural damage. Cross-sectional studies indicate that cognitively intact elders at genetic risk for Alzheimer's disease (AD) demonstrate patterns of increased brain activity compared to low risk elders, suggesting that compensation represents an early response to AD-associated pathology. Whether this compensatory response persists or declines with the onset of cognitive impairment can only be addressed using a longitudinal design. The current prospective, 5-year longitudinal study examined brain activation in APOE ε4 carriers (N=24) and non-carriers (N=21). All participants, ages 65-85 and cognitively intact at study entry, underwent task-activated fMRI, structural MRI, and neuropsychological assessments at baseline, 18, and 57 months. fMRI activation was measured in response to a semantic memory task requiring participants to discriminate famous from non-famous names. Results indicated that the trajectory of change in brain activation while performing this semantic memory task differed between APOE ε4 carriers and non-carriers. The APOE ε4 group exhibited greater activation than the Low Risk group at baseline, but they subsequently showed a progressive decline in activation during the follow-up periods with corresponding emergence of episodic memory loss and hippocampal atrophy. In contrast, the non-carriers demonstrated a gradual increase in activation over the 5-year period. Our results are consistent with the STAC model by demonstrating that compensation varies with the severity of underlying neural damage and can be exhausted with the onset

  17. Understanding reported cognitive dysfunction in older adults with cardiovascular disease

    PubMed Central

    Gunstad, John; Cohen, Ronald A; Paul, Robert H; Tate, David F; Hoth, Karin F; Poppas, Athena

    2006-01-01

    Older adults with cardiovascular disease (CVD) often report experiencing significant cognitive dysfunction in everyday life and exhibit deficits on neuropsychological testing. However, the relationship between subjective and objective cognitive dysfunction is inconsistent across studies and requires closer examination. Participants included 84 older adults with documented CVD and no history of neurological or severe psychiatric disorder. All participants underwent echocardiogram and neuropsychological assessment and completed self-report measures of perceived cognitive dysfunction, depression, and health-related quality of life. Results showed that concerns regarding distractibility and sustained attention were most common. Level of reported cognitive dysfunction was significantly related to depressive symptoms, quality of life, and performance on multiple cognitive tests. Exploratory regression analyses showed that depressive symptoms, physical health-related quality of life, and speeded sustained attention predicted reports of cognitive dysfunction, whereas demographic variables, cardiac output, and other cognitive tests did not. Should they be replicated, these findings suggest that reports of cognitive dysfunction in older adults with CVD largely reflect depressive symptoms and reduced quality of life. PMID:19412466

  18. Prospective Study of Arterial Stiffness and Subsequent Cognitive Decline Among Community-Dwelling Older Japanese

    PubMed Central

    Taniguchi, Yu; Fujiwara, Yoshinori; Nofuji, Yu; Nishi, Mariko; Murayama, Hiroshi; Seino, Satoshi; Tajima, Rika; Matsuyama, Yutaka; Shinkai, Shoji

    2015-01-01

    Background Brachial-ankle pulse wave velocity (baPWV) is inversely associated with cognitive function. However, it is not known whether baPWV predicts cognitive decline (CD) in later life. We examined whether or not baPWV is an independent risk marker of subsequent CD in a population of older Japanese. Methods Among 982 adults aged 65 years or older who participated in a baseline survey, 526 cognitively intact adults (Mini-Mental State Examination [MMSE] score ≥24; mean [SD] age, 71.7 [5.6] years; women, 57.8%) were followed for a period of up to 5 years. Pulse wave velocity was determined using an automated waveform analyser. Cognition was assessed by the MMSE, and CD was defined as a decrease of two points or more on the MMSE. Results During an average follow-up of 3.4 years, 85 participants (16.2%) developed CD. After controlling for important confounders, the odds ratios for CD in the highest and middle tertiles of baPWV, as compared with the lowest tertile, were 2.95 (95% confidence interval, 1.29–6.74) and 2.39 (95% confidence interval, 1.11–5.15), respectively. Conclusions High baPWV was an independent predictor of CD in a general population of older adults and may be useful in the clinical evaluation of elders. PMID:26235455

  19. The Effect of Self-Transcendence on Depression in Cognitively Intact Nursing Home Patients

    PubMed Central

    Haugan, Gørill; Innstrand, Siw Tone

    2012-01-01

    Aims. This study's aim was to test the effects of self-transcendence on depression among cognitively intact nursing home patients. Background. Depression is considered the most frequent mental disorder among the elderly population. Specifically, the depression rate among nursing home patients is three to four times higher than that among community-dwelling elderly. Therefore, finding new and alternative ways to prevent and decrease depression is of great importance for nursing home patients' well-being. Self-transcendence is related to spiritual as well as nonspiritual factors, and it is described as a correlate and resource for well-being among vulnerable populations and at the end of life. Methods. A two-factor construct of the self-transcendence scale (interpersonal and intrapersonal) and the hospital anxiety and depression scale (HADS) was applied. A sample of 202 cognitively intact nursing home patients in central Norway was selected to respond to the questionnaires in 2008/2009. Results. A hypothesized SEM model demonstrated significant direct relationships and total effects of self-transcendence on depression. Conclusion and Implication for Practice. Facilitating patients' self-transcendence, both interpersonally and intrapersonally, might decrease depression among cognitively intact nursing home patients. PMID:23738199

  20. Which psychosocial factors best predict cognitive performance in older adults?

    PubMed

    Zahodne, Laura B; Nowinski, Cindy J; Gershon, Richard C; Manly, Jennifer J

    2014-05-01

    Negative affect (e.g., depression) is associated with accelerated age-related cognitive decline and heightened dementia risk. Fewer studies examine positive psychosocial factors (e.g., emotional support, self-efficacy) in cognitive aging. Preliminary reports suggest that these variables predict slower cognitive decline independent of negative affect. No reports have examined these factors in a single model to determine which best relate to cognition. Data from 482 individuals 55 and older came from the normative sample for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Negative and positive psychosocial factors, executive functioning, working memory, processing speed, and episodic memory were measured with the NIH Toolbox Emotion and Cognition modules. Confirmatory factor analysis and structural equation modeling characterized independent relations between psychosocial factors and cognition. Psychosocial variables loaded onto negative and positive factors. Independent of education, negative affect and health status, greater emotional support was associated with better task-switching and processing speed. Greater self-efficacy was associated with better working memory. Negative affect was not independently associated with any cognitive variables. Findings support the conceptual distinctness of negative and positive psychosocial factors in older adults. Emotional support and self-efficacy may be more closely tied to cognition than other psychosocial variables. PMID:24685143

  1. Cognitive benefits of computer games for older adults.

    PubMed

    Zelinski, Elizabeth M; Reyes, Ricardo

    2009-01-01

    The purpose of this paper is to develop a basis for the hypothesis that digital action games may produce cognitive benefits for older adults. First, a discussion of the relationship between cognitive and physical health shows the increasing weight given to the role of declines in cognition in the development of dependency in older adult population studies. Second, evidence that cognitive training produces 'far transfer' in elders is presented. The key issue is that one approach, known as extended practice training, has been successful in producing far transfer to memory and other processes. Its principles, which are consistent with those associated with positive brain plasticity effects, are identified. Those principles are then related to the mechanics of digital action games, which also have the important added feature of producing the experiences of presence, engagement, and flow, the subjective elements of game play that are likely to sustain interest and emotional investment in the skills practiced so that the play produces cognitive benefits. The specific cognitive abilities proposed to be improved by different types of game genres are outlined, and recent developments in game and interface design that may affect the willingness of older adults to play are described. PMID:25126043

  2. Cognitive benefits of computer games for older adults

    PubMed Central

    Zelinski, Elizabeth M.; Reyes, Ricardo

    2010-01-01

    The purpose of this paper is to develop a basis for the hypothesis that digital action games may produce cognitive benefits for older adults. First, a discussion of the relationship between cognitive and physical health shows the increasing weight given to the role of declines in cognition in the development of dependency in older adult population studies. Second, evidence that cognitive training produces ‘far transfer’ in elders is presented. The key issue is that one approach, known as extended practice training, has been successful in producing far transfer to memory and other processes. Its principles, which are consistent with those associated with positive brain plasticity effects, are identified. Those principles are then related to the mechanics of digital action games, which also have the important added feature of producing the experiences of presence, engagement, and flow, the subjective elements of game play that are likely to sustain interest and emotional investment in the skills practiced so that the play produces cognitive benefits. The specific cognitive abilities proposed to be improved by different types of game genres are outlined, and recent developments in game and interface design that may affect the willingness of older adults to play are described. PMID:25126043

  3. Gene by Neuroticism Interaction and Cognitive Function among Older Adults

    PubMed Central

    Dar-Nimrod, Ilan; Chapman, Benjamin P.; Robbins, John A.; Porsteinsson, Anton; Mapstone, Mark; Duberstein, Paul R.

    2012-01-01

    Objectives Both ApoE (apolipoprotein E) ε-4 allele(s) and elevated trait neuroticism, the tendency to experience distress, are associated with cognitive function among older adults. We predicted that neuroticism moderates the association between ApoE and cognitive function and also explored whether other personality dimensions (openness to experience, agreeableness, extraversion, and conscientiousness) affect the association between ApoE status and cognitive function. Method Five-hundred and ninety-seven older adults (mean age of 78) enrolled in the Ginkgo Evaluation of Memory (GEM) study completed the NEO-Five Factor Inventory of personality. Cognitive function was assessed via the cognitive portion of the Alzheimer’s Disease Assessment Scale (ADAS-cog), and a blood sample for ApoE genotyping was drawn. Results As hypothesized, regression analysis indicated that neuroticism moderated the relationship between the presence of ApoE ε-4 and cognitive function. Individuals with high neuroticism scores had significantly lower ADAS-cog scores compared with individual with low neuroticism scores, but this was true only among carriers of ApoE ε-4 (interaction effect β = .124, p = .028). There was scant evidence that other personality dimensions moderate the association between ApoE ε-4 and cognitive function. Conclusions Cognitive function may be affected by ApoE and neuroticism acting in tandem. Research on the underlying physiological mechanisms by which neuroticism amplifies the effect of ApoE ε-4 is warranted. The study of genotype by phenotype interactions provides an important and useful direction for the study of cognitive function among older adults and for the development of novel prevention programs. PMID:23042108

  4. Relationship between Auditory and Cognitive Abilities in Older Adults

    PubMed Central

    Sheft, Stanley

    2015-01-01

    Objective The objective was to evaluate the association of peripheral and central hearing abilities with cognitive function in older adults. Methods Recruited from epidemiological studies of aging and cognition at the Rush Alzheimer’s Disease Center, participants were a community-dwelling cohort of older adults (range 63–98 years) without diagnosis of dementia. The cohort contained roughly equal numbers of Black (n=61) and White (n=63) subjects with groups similar in terms of age, gender, and years of education. Auditory abilities were measured with pure-tone audiometry, speech-in-noise perception, and discrimination thresholds for both static and dynamic spectral patterns. Cognitive performance was evaluated with a 12-test battery assessing episodic, semantic, and working memory, perceptual speed, and visuospatial abilities. Results Among the auditory measures, only the static and dynamic spectral-pattern discrimination thresholds were associated with cognitive performance in a regression model that included the demographic covariates race, age, gender, and years of education. Subsequent analysis indicated substantial shared variance among the covariates race and both measures of spectral-pattern discrimination in accounting for cognitive performance. Among cognitive measures, working memory and visuospatial abilities showed the strongest interrelationship to spectral-pattern discrimination performance. Conclusions For a cohort of older adults without diagnosis of dementia, neither hearing thresholds nor speech-in-noise ability showed significant association with a summary measure of global cognition. In contrast, the two auditory metrics of spectral-pattern discrimination ability significantly contributed to a regression model prediction of cognitive performance, demonstrating association of central auditory ability to cognitive status using auditory metrics that avoided the confounding effect of speech materials. PMID:26237423

  5. Literacy Independent Cognitive Assessment: Assessing Mild Cognitive Impairment in Older Adults with Low Literacy Skills

    PubMed Central

    Shim, YongSoo; Ryu, Hui Jin; Lee, Dong Woo; Lee, Jun-Young; Jeong, Jee Hyang; Choi, Seong Hye; Han, Seol-Heui

    2015-01-01

    Objective Comprehensive neuropsychological tests are important in the diagnosis and follow-up of patients with MCI; however, most were developed without consideration of illiteracy. We developed the Literacy Independent Cognitive Assessment (LICA) as a comprehensive neuropsychological assessment battery applicable to older adults who are either literate or illiterate. This study aimed to assess the reliability and validity of the LICA for diagnosis of MCI. Methods Normal controls (n=634) and patients with MCI (n=128) were recruited from 13 centers were included in this study. Participants were divided into illiterate or literate groups, based on their performance on a brief reading and writing test. The LICA, Korean Mini-Mental State Examination (K-MMSE), and Seoul Neuropsychological Screening Battery (SNSB) were administered. Results Total LICA scores distinguished MCI patients from controls (p<0.001). They were closely and positively correlated to the K-MMSE scores (r=0.632, p<0.001) but negatively correlated to clinical dementia rating (CDR) (r=-0.358, p<0.001) and CDR sum of boxes (r=-0.339, p<0.001). Area under the receiver operating characteristic curve for patients with MCI by total LICA score was 0.827 (0.783-0.870), superior to that presented by the K-MMSE. For the classification of MCI subtypes, inter-method reliability of LICA with the SNSB was good (κ 0.773; 0.679-0.867, p<0.001). Conclusion The results of this study show that the LICA may be reliably used to distinguish MCI patients from cognitively intact adults, to identify MCI subtypes and monitor progression toward dementia, regardless of illiteracy. PMID:26207127

  6. Cognitive spare capacity in older adults with hearing loss

    PubMed Central

    Mishra, Sushmit; Stenfelt, Stefan; Lunner, Thomas; Rönnberg, Jerker; Rudner, Mary

    2014-01-01

    Individual differences in working memory capacity (WMC) are associated with speech recognition in adverse conditions, reflecting the need to maintain and process speech fragments until lexical access can be achieved. When working memory resources are engaged in unlocking the lexicon, there is less Cognitive Spare Capacity (CSC) available for higher level processing of speech. CSC is essential for interpreting the linguistic content of speech input and preparing an appropriate response, that is, engaging in conversation. Previously, we showed, using a Cognitive Spare Capacity Test (CSCT) that in young adults with normal hearing, CSC was not generally related to WMC and that when CSC decreased in noise it could be restored by visual cues. In the present study, we investigated CSC in 24 older adults with age-related hearing loss, by administering the CSCT and a battery of cognitive tests. We found generally reduced CSC in older adults with hearing loss compared to the younger group in our previous study, probably because they had poorer cognitive skills and deployed them differently. Importantly, CSC was not reduced in the older group when listening conditions were optimal. Visual cues improved CSC more for this group than for the younger group in our previous study. CSC of older adults with hearing loss was not generally related to WMC but it was consistently related to episodic long term memory, suggesting that the efficiency of this processing bottleneck is important for executive processing of speech in this group. PMID:24904409

  7. Social cognition is not associated with cognitive reserve in older adults.

    PubMed

    Lavrencic, Louise M; Kurylowicz, Lisa; Valenzuela, Michael J; Churches, Owen F; Keage, Hannah A D

    2016-01-01

    Social and general cognitive abilities decline in late life. Those with high cognitive reserve display better general cognitive performance in old age; however, it is unknown whether this is also the case for social cognition. A total of 115 healthy older adults, aged 60-85 years (m = 44, f = 71) were assessed using The Awareness of Social Inference Test (TASIT-R; social cognition), the Lifetime of Experiences Questionnaire (LEQ; cognitive reserve), and the Wechsler Abbreviated Scale of Intelligence (WASI-II; general cognitive ability). The LEQ did not predict performance on any TASIT-R subtest: Emotion Evaluation Test (β = -.097, p = .325), Social Inference - Minimal (β = -.004, p = .972), or Social Inference - Enriched (β = -.016, p = .878). Sensitivity analyses using two alternative cognitive reserve measures, years of education and the National Adult Reading Test, supported these effects. Cognitive reserve was strongly related to WASI-II performance. Unlike general cognitive ability, social cognition appears unaffected by cognitive reserve. Findings contribute to the emerging understanding that cognitive reserve differentially affects individual cognitive domains, which has implications for the theoretical understanding of cognitive reserve and its brain correlates. Cognitive measures unbiased by cognitive reserve may serve as best indicators of brain health, free of compensatory mechanisms. PMID:25989367

  8. Oxidative stress and hippocampal synaptic protein levels in elderly cognitively intact individuals with Alzheimer's disease pathology.

    PubMed

    Scheff, Stephen W; Ansari, Mubeen A; Mufson, Elliott J

    2016-06-01

    Neuritic amyloid plaques and neurofibrillary tangles are hallmarks of Alzheimer's disease (AD) and are major components used for the clinical diagnosis of this disorder. However, many individuals with no cognitive impairment (NCI) also present at autopsy with high levels of these AD pathologic hallmarks. In this study, we evaluated 15 autopsy cases from NCI individuals with high levels of AD-like pathology (high pathology no cognitive impairment) and compared them to age- and postmortem-matched cohorts of individuals with amnestic mild cognitive impairment and NCI cases with low AD-like pathology (low pathology no cognitive impairment [LPNCI]). Individuals classified as high pathology no cognitive impairment or amnestic mild cognitive impairment had a significant loss of both presynaptic and postsynaptic proteins in the hippocampus compared with those in the LPNCI cohort. In addition, these 2 groups had a significant increase in 3 different markers of oxidative stress compared with that in the LPNCI group. The changes in levels of synaptic proteins are strongly associated with levels of oxidative stress. These data suggest that cognitively older subjects without dementia but with increased levels of AD-like pathology may represent a very early preclinical stage of AD. PMID:27143416

  9. Computerized cognitive training with older adults: a systematic review.

    PubMed

    Kueider, Alexandra M; Parisi, Jeanine M; Gross, Alden L; Rebok, George W

    2012-01-01

    A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy older adults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer's disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported older adults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative. PMID:22792378

  10. Assessing cognitive function and capacity in older adults with cancer.

    PubMed

    McKoy, June M; Burhenn, Peggy S; Browner, Ilene S; Loeser, Kari L; Tulas, Katrina M; Oden, Megan R; Rupper, Randall W

    2014-01-01

    The number of older individuals with cancer is increasing exponentially, mandating that oncologists contemplate more comprehensive and multidisciplinary approaches to treatment of this cohort. Recruitment of assessment instruments validated in older patients can be invaluable for guiding treatment and decision-making by both patients and providers, and can arguably contribute to improving outcomes and health-related quality of life. The Comprehensive Geriatric Assessment is one such validated instrument that can be used by oncologists to assess patient readiness and appropriateness for prescribed cancer therapy. As a multidisciplinary diagnostic and treatment process, it comprises functional status, cognitive status, social support, and advance care preferences, and is an ideal instrument for evaluating complex older individuals. It is well established that many older individuals with cancer travel with multiple comorbid illnesses, including cognitive impairment, and when presented with a cancer diagnosis struggle to choose from multiple treatment options. In addition to the complete medical history, the ability of patients to decide on a course of therapy in concert with their oncologist is critically important. Alternatively, many oncologists are conflicted as to whether true informed consent for treatment can be obtained from many older patients. Having a roadmap to decision-making capacity is therefore an inescapable imperative in geriatric oncology, because careful attention must be directed at identifying older patients with cancer who might benefit from these assessments and the individualized treatment plans that emerge. PMID:24453297

  11. Perceived Discrimination and Cognition in Older African Americans

    PubMed Central

    Barnes, L.L.; Lewis, T.T.; Begeny, C.T.; Yu, L.; Bennett, D.A.; Wilson, R.S.

    2012-01-01

    Existing evidence suggests that psychosocial stress is associated with cognitive impairment in older adults. Perceived discrimination is a persistent stressor in African Americans that has been associated with several adverse mental and physical health outcomes. To our knowledge, the association of discrimination with cognition in older African Americans has not been examined. In a cohort of 407 older African Americans without dementia (mean age = 72.9; SD = 6.4), we found that a higher level of perceived discrimination was related to poorer cognitive test performance, particularly episodic memory (estimate = −0.03; SE = .013; p < .05) and perceptual speed tests (estimate = −0.04; SE = .015; p < .05). The associations were unchanged after adjusting for demographics and vascular risk factors, but were attenuated after adjustment for depressive symptoms (Episodic memory estimate = −0.02; SE = 0.01; Perceptual speed estimate = −0.03; SE = 0.02; both p’s = .06). The association between discrimination and several cognitive domains was modified by level of neuroticism. The results suggest that perceived discrimination may be associated with poorer cognitive function, but does not appear to be independent of depressive symptoms. PMID:22595035

  12. Cognitive Decline in Older Persons Initiating Anticholinergic Medications

    PubMed Central

    Shah, Raj C.; Janos, Alicia L.; Kline, Julia E.; Yu, Lei; Leurgans, Sue E.; Wilson, Robert S.; Wei, Peter; Bennett, David A.; Heilman, Kenneth M.; Tsao, Jack W.

    2013-01-01

    Background This study examines the effect of initiating medications with anticholinergic activity on the cognitive functions of older persons. Methods Participants were 896 older community-dwelling, Catholic clergy without baseline dementia. Medication data was collected annually. The Anticholinergic Cognitive Burden Scale was utilized to identify use of a medication with probable or definite anticholinergic activity. Participants had at least two annual cognitive evaluations. Results Over a mean follow-up of 10 years, the annual rate of global cognitive function decline for never users, prevalent users, and incident users was −0.062 (SE = 0.005), −0.081(SE = 0.011), and −0.096 (SE = 0.007) z-score units/year, respectively. Compared to never users, incident users had a more rapid decline (difference = −0.034 z-score units/year, SE = 0.008, p<0.001) while prevalent users did not have a significantly more rapid decline (p = 0.1). Conclusions Older persons initiating a medication with anticholinergic activity have a steeper annual decline in cognitive functioning than those who are not taking these medications. PMID:23741303

  13. Cognitive Impairment and Disability in Older Japanese Adults

    PubMed Central

    Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Suzuki, Takao

    2016-01-01

    The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20–23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years) enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs), MCIs with GCI, MCI multiple domain (MCIm), and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8%) experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs) were determined: MCIs (HR, 2.04; 95% CI, 1.39–3.00), MCIs with GCI (HR, 2.10; 95% CI, 1.21–3.62), MCIm (HR, 2.32; 95% CI, 1.39–3.85), and MCIm with GCI (HR, 4.23; 95% CI, 2.73–6.57). These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons. PMID:27415430

  14. Cognitive style predictors of affect change in older adults.

    PubMed

    Isaacowitz, Derek M; Seligman, Martin E P

    2002-01-01

    Cognitive styles are the lenses through which individuals habitually process information from their environment. In this study, we evaluated whether different cognitive style individual difference variables, such as explanatory style and dispositional optimism, could predict changes in affective state over time in community-dwelling older adults. Based on previous research, we hypothesized that an optimistic explanatory style would be adaptive except when combined with life stressors, but that dispositional optimism would predict positive affective states regardless of life events. We found that older adults with a more optimistic explanatory style for health/cognitive events actually appeared to develop more depressive symptoms over six months of follow-up. However, dispositional optimism and orientation toward the future predicted a better affective profile over time. PMID:12148688

  15. Cognitive plasticity in older adults: effects of cognitive training and physical exercise.

    PubMed

    Bherer, Louis

    2015-03-01

    Cognitive training, physical activity, and exercise have often been reported to improve cognitive performance in older adults. This paper reviews some seminal and recent studies using these approaches to improve cognition and physical functioning in healthy older adults and in patients suffering from non-neurological chronic medical conditions. Results from cognitive training studies suggest that despite performance improvement in trained tasks, transfer effects appeared very limited. Surprisingly though, computerized dual-task training has been shown to improve balance and postural control in tests of physical functioning, suggesting that broad transfer can sometimes be observed. Physical exercise intervention studies generally found significant and large improvements in physical capacity, in some cognitive domains, and in quality of life. The benefits seem to be equivalent between frail and nonfrail participants. Overall, results reviewed here support the notion that cognitive plasticity for attentional control, as induced by cognitive training or physical activity and exercise, is preserved in late adulthood. Moreover, results of studies with patients at risk of cognitive decline also suggest that cognitive training and exercise interventions are promising nonpharmaceutical tools to help improve cognition in older at-risk individuals. PMID:25773610

  16. Global perceived stress predicts cognitive change among older adults.

    PubMed

    Munoz, Elizabeth; Sliwinski, Martin J; Scott, Stacey B; Hofer, Scott

    2015-09-01

    Research on stress and cognitive aging has primarily focused on examining the effects of biological and psychosocial indicators of stress, with little attention provided to examining the association between perceived stress and cognitive aging. We examined the longitudinal association between global perceived stress (GPS) and cognitive change among 116 older adults (M(age) = 80, SD = 6.40, range = 67-96) in a repeated measurement burst design. Bursts of 6 daily cognitive assessments were repeated every 6 months over a 2-year period, with self-reported GPS assessed at the start of every burst. Using a double-exponential learning model, 2 parameters were estimated: (a) asymptotic level (peak performance), and (b) asymptotic change (the rate at which peak performance changed across bursts). We hypothesized that greater GPS would predict slowed performance in tasks of attention, working memory, and speed of processing and that increases in GPS across time would predict cognitive slowing. Results from latent growth curve analyses were consistent with our first hypothesis and indicated that level of GPS predicted cognitive slowing across time. Changes in GPS did not predict cognitive slowing. This study extends previous findings by demonstrating a prospective association between level of GPS and cognitive slowing across a 2-year period, highlighting the role of psychological stress as a risk factor for poor cognitive function. PMID:26121285

  17. The Test of Memory Malingering (TOMM): normative data from cognitively intact, cognitively impaired, and elderly patients with dementia.

    PubMed

    Teichner, Gordon; Wagner, Mark T

    2004-04-01

    This research adds to the psychometric validation of the Test of Memory Malingering (TOMM) by providing data for samples of elderly patients who are cognitively intact, cognitively impaired (non-dementia), and with dementia. Subjects were 78 individuals referred for evaluation of memory complaints. Significant group differences emerged between the dementia group and the two other groups (normals and cognitively impaired), although the latter two did not differ from each other. One hundred percent of normals and 92.7% of the cognitively impaired group made fewer than five errors (the suggested cut-off) on Trial 2 or the Retention trial of the TOMM, yielding an overall correct classification rate of 94.7%. However, the rate of misclassification for persons with dementia was high whether using a cut-point score of five, eight, or ten errors. This investigation extends the validity and clinical utility of this instrument. Results suggest that the TOMM is an useful index for detecting the malingering of memory deficits, even in patients with cognitive impairment, but only when dementia can be ruled out. PMID:15033228

  18. Estimating in-home walking speed distributions for unobtrusive detection of mild cognitive impairment in older adults.

    PubMed

    Akl, Ahmad; Mihailidis, Alex

    2015-01-01

    Timely recognition of cognitive impairment such as Alzheimer's disease is of great significance. Many smart systems, developed to continuously monitor older adults' health and cognition, use a number of predefined measures associated with the older adults' activity in their homes. However, this approach has been demonstrated to focus on idiosyncratic nuances of the individual subjects, and thus could potentially not perform as well when tested on new subjects. In this paper, we address this problem by building proper statistical models of older adults' in-home walking speed. Using the data pertaining to 15 older adults monitored for an average period of 3 years, we used linear regression with a Gaussian likelihood to model the subjects' in-home walking speed, and we used dynamic time warping to demonstrate significant difference between the walking speed distributions of the subjects when cognitively intact and when having mild cognitive impairment (MCI). Using a simple thresholding approach of the dynamic time warping costs, we were able to detect MCI in older adults with areas under the ROC curve and the precision-recall curve of 0.906 and 0.790, respectively, using a time frame of 12 weeks. PMID:26737457

  19. Hair cortisol and cognitive performance in healthy older people.

    PubMed

    Pulopulos, Matias M; Hidalgo, Vanesa; Almela, Mercedes; Puig-Perez, Sara; Villada, Carolina; Salvador, Alicia

    2014-06-01

    Worse cognitive performance in older people has been associated with hypothalamic-pituitary-adrenal axis dysregulation (in particular, higher cortisol levels). Analysis of hair cortisol concentrations (HCC) is a novel method to measure long-term cortisol exposure, and its relationship with cognition in healthy older people has not yet been studied. We investigated whether HCC (measured in hair scalp) and diurnal salivary cortisol levels (awakening, 30min after awakening, and evening, across two days) were related to cognitive performance (assessed with the Trail-making Test A and B, Digit Span Forward and Backward, word list-RAVLT and Stories subtest of the Rivermead) in 57 healthy older people (mean age=64.75 years, SD=4.17). Results showed that lower HCC were consistently related to worse working memory, learning, short-term verbal memory (RAVLT first trial and immediate recall) and long-term verbal memory. In contrast, higher mean levels and higher diurnal area under the curve of diurnal salivary cortisol were related to worse attention and short-term verbal memory (immediate story recall), respectively. Interestingly, a higher ratio of mean levels of diurnal salivary cortisol over HCC were related to worse performance on working memory and short-term verbal memory, suggesting that those individuals with lower long-term cortisol exposure might be more vulnerable to the negative effect of HPA-axis dysregulation on these cognitive processes. Our findings suggest that both low long-term cortisol exposure and a possible dysregulation of the diurnal rhythm of the HPA-axis may account, at least in part, for the inter-individual variability in cognitive performance in healthy older people. PMID:24767624

  20. Cognitive Inconsistency and Practice-Related Learning in Older Adults

    PubMed Central

    Dzierzewski, Joseph M.; Marsiske, Michael; Morgan, Adrienne Aiken; Buman, Mathew P.; Giacobbi, Peter R.; Roberts, Beverly; McCrae, Christina S.

    2013-01-01

    The current study examined predictors of individual differences in the magnitude of practice-related improvements achieved by 87 older adults (meanage 63.52 years) over 18-weeks of cognitive practice. Cognitive inconsistency in both baseline trial-to-trial reaction times and week-to-week accuracy scores was included as predictors of practice-related gains in two measures of processing speed. Conditional growth models revealed that both reaction time and accuracy level and rate-of-change in functioning were related to inconsistency, even after controlling for mean-level, but that increased inconsistency was negatively associated with accuracy versus positively associated with reaction time improvement. Cognitive inconsistency may signal dysregulation in the ability to control cognitive performance or may be indicative of adaptive attempts at functioning. PMID:24319428

  1. Cognitive Inconsistency and Practice-Related Learning in Older Adults.

    PubMed

    Dzierzewski, Joseph M; Marsiske, Michael; Morgan, Adrienne Aiken; Buman, Mathew P; Giacobbi, Peter R; Roberts, Beverly; McCrae, Christina S

    2013-09-01

    The current study examined predictors of individual differences in the magnitude of practice-related improvements achieved by 87 older adults (meanage 63.52 years) over 18-weeks of cognitive practice. Cognitive inconsistency in both baseline trial-to-trial reaction times and week-to-week accuracy scores was included as predictors of practice-related gains in two measures of processing speed. Conditional growth models revealed that both reaction time and accuracy level and rate-of-change in functioning were related to inconsistency, even after controlling for mean-level, but that increased inconsistency was negatively associated with accuracy versus positively associated with reaction time improvement. Cognitive inconsistency may signal dysregulation in the ability to control cognitive performance or may be indicative of adaptive attempts at functioning. PMID:24319428

  2. Prevalence of Cognitive Impairment in Community-Dwelling Older Adults

    PubMed Central

    Rashedi, Vahid; Rezaei, Mohammad; Gharib, Masoud

    2014-01-01

    Introduction Mild cognitive impairment can be considered as an intermediate clinical state between normal cognitive aging and mild dementia. Elderly people with this impairment represent an at-risk group for the development of dementia. The aim of this study was to investigate the prevalence of cognitive impairment in community-dwelling older adults by Mini-Mental State Examination (MMSE) and its relationship with socio-demographic variables. Methods In this analytical-descriptive study, 212 subjects admitted to Hamadan’s day care centers were selected through simple random sampling method. To gather the data, MMSE was used as well as a questionnaire containing demographic variables. Data analysis was completed through SPSS-16. Results The sample consisted of 17.9% male, 59.4% of whom were married. According to the results, 96 cases (45.3%) suffered from mild (MMSE≥22), 110 cases (51.9%) from moderate (11≤MMSE≤21) and 6 cases (2.8%) from severe cognitive disorder (MMSE≤10). As findings revealed, factors such as age (Pv = 0.005, r = -0.491) and schooling (Pv < 0.001) are of significant relationship with MMSE score. Discussion Prevalence of cognitive decline in community-dwelling older adults was of normal range. Hence, familial relations and social support can decrease mental status disorder. PMID:25436081

  3. A study on the specificity of the association between hippocampal volume and delayed primacy performance in cognitively intact elderly individuals

    PubMed Central

    Bruno, Davide; Grothe, Michel J.; Nierenberg, Jay; Zetterberg, Henrik; Blennow, Kaj; Teipel, Stefan J.; Pomara, Nunzio

    2015-01-01

    Delayed recall at the primacy position (first few items on a list) has been shown to predict cognitive decline in cognitively intact elderly participants, with poorer delayed primacy performance associated with more pronounced generalized cognitive decline during follow-up. We have previously suggested that this association is due to delayed primacy performance indexing memory consolidation, which in turn is thought to depend upon hippocampal function. Here, we test the hypothesis that hippocampal size is associated with delayed primacy performance in cognitively intact elderly individuals. Data were analyzed from a group (N=81) of cognitively intact participants, aged 60 or above. Serial position performance was measured with the Buschke selective reminding test (BSRT). Hippocampal size was automatically measured via MRI, and unbiased voxel-based analyses were also conducted to explore further regional specificity of memory performance. We conducted regression analyses of hippocampus volumes on serial position performance; other predictors included age, family history of Alzheimer's disease (AD), APOE ε4 status, education, and total intracranial volume. Our results collectively suggest that there is a preferential association between hippocampal volume and delayed primacy performance. These findings are consistent with the hypothesis that delayed primacy consolidation is associated with hippocampal size, and shed light on the relationship between delayed primacy performance and generalized cognitive decline in cognitively intact individuals, suggesting that delayed primacy consolidation may serve as a sensitive marker of hippocampal health in these individuals. PMID:25613646

  4. Cognitive Aging in Older Black and White Persons

    PubMed Central

    Wilson, Robert S.; Capuano, Ana W.; Sytsma, Joel; Bennett, David A.; Barnes, Lisa L.

    2015-01-01

    During a mean of 5.2 years of annual follow-up, older Black (n=647) and White (n=647) persons of equivalent age and education completed a battery of 17 cognitive tests from which composite measures of 5 abilities were derived. Baseline level of each ability was lower in the Black subgroup. Decline in episodic and working memory was not related to race. Decline in semantic memory, perceptual speed, and visuospatial ability was slower in Black persons than White persons, and in semantic memory and perceptual speed this effect was stronger in older than younger participants. Racial differences persisted after adjustment for retest effects. The results suggest subtle cognitive aging differences between Black persons and White persons. PMID:25961876

  5. High blood pressure in older subjects with cognitive impairment.

    PubMed

    Mossello, Enrico; Simoni, David

    2016-01-01

    High blood pressure and cognitive impairment often coexist in old age, but their pathophysiological association is complex. Several longitudinal studies have shown that high blood pressure at midlife is a risk factor for cognitive impairment and dementia, although this association is much less clear in old age. The effect of blood pressure lowering in reducing the risk of dementia is only borderline significant in clinical trials of older subjects, partly due to the insufficient follow-up time. Conversely, dementia onset is associated with a decrease of blood pressure values, probably secondary to neurodegeneration. Prognostic effect of blood pressure values in cognitively impaired older subjects is still unclear, with aggressive blood pressure lowering being potentially harmful in this patients category. Brief cognitive screening, coupled with simple motor assessment, are warranted to identify frail older subjects who need a more cautious approach to antihypertensive treatment. Values obtained with ambulatory blood pressure monitoring seem more useful than clinical ones to predict the outcome of cognitively impaired older subjects. Future studies should identify the most appropriate blood pressure targets in older subjects with cognitive impairment. RiassuntoIpertensione arteriosa e decadimento cognitivo spesso coesistono in età avanzata, sebbene la loro associazione sia complessa dal punto di vista fisiopatologico. Diversi studi longitudinali hanno mostrato che elevati valori pressori in età adulta rappresentano un fattore di rischio per decadimento cognitivo e demenza, sebbene tale associazione sia molto meno chiara in età avanzata. L'effetto della terapia antiipertensiva è risultato ai limiti della significatività statistica nel ridurre il rischio di demenza negli studi di intervento su soggetti anziani, in parte a causa della durata insufficiente del follow-up. D'altra parte, l'insorgenza di demenza è associata con una riduzione dei valori pressori

  6. Nutritional habits and cognitive performance of older adults.

    PubMed

    Mallidou, Anastasia; Cartie, Mario

    2015-06-01

    Healthy nutritional habits, including drinking plenty of water and maintaining hydration, are fundamental components for sustaining life, health and wellbeing. Evidence has suggested that certain dietary patterns and lifestyles could help delay the ageing process and reduce the risk of Alzheimer's disease. This article explores the potential association between nutritional habits and the cognitive performance of older adults and identifies research gaps that could be filled by future studies on healthy ageing. PMID:26014793

  7. Alcohol consumption and cognitive impairment in older men

    PubMed Central

    Hankey, Graeme J.; Yeap, Bu B.; Golledge, Jonathan; Flicker, Leon

    2014-01-01

    Objective: To determine whether alcohol consumption is causally associated with cognitive impairment in older men as predicted by mendelian randomization. Methods: Retrospective analysis of a cohort study of 3,542 community-dwelling men aged 65 to 83 years followed for 6 years. Cognitive impairment was established by a Mini-Mental State Examination score of 23 or less. Participants provided detailed information about their use of alcohol during the preceding year and were classified as abstainers, occasional drinkers, and regular drinkers: mild (<15 drinks/wk), moderate (15–27 drinks/wk), heavy (28–34 drinks/wk), and abusers (≥35 drinks/wk). We genotyped the rs1229984 G→A variant of the alcohol dehydrogenase 1B (ADH1B) gene, which is associated with lower prevalence of alcohol abuse and dependence. Other measures included age, education, marital status, smoking and physical activity, body mass index, diabetes, hypertension, and cardiovascular diseases. Results: At study entry, rs1229984 G→A polymorphism was associated with lower prevalence of regular use of alcohol and decreased consumption among regular users. Six years later, 502 men (14.2%) showed evidence of cognitive impairment. Abstainers and irregular drinkers had higher odds of cognitive impairment than regular drinkers (odds ratio [OR] = 1.23, 95% confidence interval [CI] = 1.00–1.51, after adjustment for other measured factors). The rs1229984 G→A polymorphism did not decrease the odds of cognitive impairment (AA/GG OR = 1.35, 95% CI = 0.29–6.27; GA/GG OR = 1.05, 95% CI = 0.71–1.55). Conclusions: Alcohol consumption, including heavy regular drinking and abuse, is not a direct cause of cognitive impairment in later life. Our results are consistent with the possibility, but do not prove, that regular moderate drinking decreases the risk of cognitive impairment in older men. PMID:24553426

  8. Cognitive associations of subcortical white matter lesions in older people.

    PubMed

    O'Brien, John T; Wiseman, Rebecca; Burton, Emma J; Barber, Bob; Wesnes, Keith; Saxby, Brian; Ford, Gary A

    2002-11-01

    Hyperintense lesions (HL), as visualized on T2-weighted or FLAIR MRI, are a common finding in older people, but their clinical significance and influence on cognitive function remain to be clarified. We investigated the relationship between HL in deep white and gray matter structures and cognition in older subjects. We recruited 154 nondemented (Mini-Mental State Examination > 24) subjects (79 males) over the age of 70 from primary care (103 subjects with mild hypertension and 51 normotensive subjects). All subjects underwent FLAIR and proton density and T2-weighted axial 1.5-tesla MRI scans (slice thickness: 5 mm). The scans were rated for the presence and distribution of HL in the subcortical gray matter (caudate, putamen, globus pallidus, thalamus) and associated white matter tracts (internal/external capsule). Subjects (n = 149) underwent a comprehensive cognitive assessment involving tests of attention, processing speed, episodic memory, working memory, and executive function. Partial correlations (correcting for age, systolic blood pressure, and New Adult Reading Test [NART] score) were performed to investigate the relationship between cognition and white matter change. HL were found in 49% of subjects. HL in both the gray (thalamus and caudate) and white matter were significantly associated with impaired cognitive function in tasks involving processing speed and/or executive function, but showed no associations with episodic or working memory. HL in both subcortical gray matter structures and associated fiber tracts correlate with impairments in attention, executive function and processing, and memory retrieval speed in nondemented older community-dwelling subjects. Such lesions may be an important cause of age-related attentional and executive dysfunction in the elderly, as well as temporal lobe and hippocampal changes that have previously been reported to be associated with impairments to the ability to actually store and retrieve information from memory

  9. Neuroprotective Pathways: Lifestyle activity, brain pathology and cognition in cognitively normal older adults

    PubMed Central

    Wirth, Miranka; Haase, Claudia M.; Villeneuve, Sylvia; Vogel, Jacob; Jagust, William J.

    2014-01-01

    This study used path analysis to examine effects of cognitive activity and physical activity on cognitive functioning in older adults, through pathways involving beta-amyloid (Aβ) burden, cerebrovascular lesions, and neural injury within brain regions affected in Alzheimer’s disease (AD). Ninety-two cognitively normal older adults (75.2±5.6 years) reported lifetime cognitive activity and current physical activity using validated questionnaires. For each participant, we evaluated cortical Aβ burden (using PIB-PET), cerebrovascular lesions (using MRI-defined white matter lesion (WML)), and neural integrity within AD regions (using a multimodal biomarker). Path models (adjusted for age, gender, and education) indicated that higher lifetime cognitive activity and higher current physical activity was associated with fewer WMLs. Lower WML volumes were in turn related to higher neural integrity and higher global cognitive functioning. As shown previously, higher lifetime cognitive activity was associated with lower PIB retention, which itself moderated the impact of neural integrity on cognitive functioning. Lifestyle activity may thus promote cognitive health in aging by protecting against cerebrovascular pathology and Aβ pathology thought to be relevant to AD development. PMID:24656834

  10. Intracellular cytokine production and cognition in healthy older adults.

    PubMed

    Simpson, Ellen E A; Hodkinson, Claire F; Maylor, Elizabeth A; McCormack, Jacqueline M; Rae, Gordon; Strain, Sean; Alexander, H Denis; Wallace, Julie M W

    2013-10-01

    Elevated concentrations of the pro-inflammatory cytokines IL-1β and IL-6 have been associated with impaired cognitive performance. There are, however, few studies that have examined the relationship between cytokine production and specific aspects of cognition in healthy older individuals. Two-colour flow cytometry was used to determine intracellular cytokine production by activated monocytes, and neuropsychological tests were performed using the Cambridge Neuropsychological Test Automated Battery (CANTAB) in 93 apparently healthy men and women aged 55-70 years. A series of hierarchical regression analyses was carried out to examine the contribution of IL-1β and IL-6 (% expression and production (antibody binding capacity (ABC))) to recognition, attention and working memory, after controlling for socio-demographic variables (age, sex and social class). IL-1β% expression and IL-6 production predicted aspects of working memory. Recognition memory was found to be sensitive to the affects of age and social class. The current study suggests that higher intracellular cytokine production by activated monocytes may be predictive of lower cognitive performance in working memory in healthy older individuals. These findings indicate that utilization of models for in vivo cytokine production upon immune challenge may be useful in studying specific aspects of memory affected during inflammatory responses, for example in individuals at risk for cognitive decline owing to age-related inflammatory disorders. PMID:23664267

  11. Sex differences in cognitive trajectories in clinically normal older adults.

    PubMed

    McCarrey, Anna C; An, Yang; Kitner-Triolo, Melissa H; Ferrucci, Luigi; Resnick, Susan M

    2016-03-01

    Age effects on cognitive functioning are well-documented, but effects of sex on trajectories of cognitive aging are less clear. We examined cognitive ability across a variety of measures for 1,065 to 2,127 participants (mean baseline age 64.1 to 69.7 years) from the Baltimore Longitudinal Study of Aging who were repeatedly tested over a mean follow-up interval of 3.0 to 9.0 years with a mean of 2.3 to 4.4 assessments. Memory and other cognitive tests were administered at each visit, assessing mental status, verbal learning and memory, figural memory, language, attention, perceptuomotor speed and integration, executive function, and visuospatial ability. Importantly, participants free from cognitive impairment at all time points were used in the analyses. Results showed that for all tests, higher age at baseline was significantly associated with lower scores, and performance declined over time. In addition, advancing age was associated with accelerated longitudinal declines in performance (trend for mental status). After adjusting for age, education, and race, sex differences were observed across most tests of specific cognitive abilities examined. At baseline, males outperformed females on the 2 tasks of visuospatial ability, and females outperformed males in most other tests of cognition. Sex differences in cognitive change over time indicated steeper rates of decline for men on measures of mental status, perceptuomotor speed and integration, and visuospatial ability, but no measures on which women showed significantly steeper declines. Our results highlight greater resilience to age-related cognitive decline in older women compared with men. PMID:26796792

  12. Self-rated driving habits among older adults with clinically-defined mild cognitive impairment, clinically-defined dementia, and normal cognition.

    PubMed

    O'Connor, Melissa L; Edwards, Jerri D; Bannon, Yvonne

    2013-12-01

    Older adults with clinically-defined dementia may report reducing their driving more than cognitively normal controls. However, it is unclear how these groups compare to individuals with clinically-defined mild cognitive impairment (MCI) in terms of driving behaviors. The current study investigated self-reported driving habits among adults age 60 and older with clinical MCI (n=41), clinical mild dementia (n=40), and normal cognition (n=43). Participants reported their driving status, driving frequency (days per week), and how often they avoided accessing the community, making left turns, driving at night, driving in unfamiliar areas, driving on high-traffic roads, and driving in bad weather. After adjusting for education, a MANCOVA revealed that participants with MCI and dementia avoided unfamiliar areas and high-traffic roads significantly more than normal participants. Participants with dementia also avoided left turns and accessing the community more than those with normal cognition and MCI (p<0.05 for all). The other driving variables did not significantly differ between groups. Thus, older adults with clinically-defined MCI, as well as those with dementia, avoided some complex driving situations more than cognitively intact adults. However, all diagnostic groups had similar rates of driving cessation and frequency. Future research should examine the safety implications of such findings. PMID:23769114

  13. Effects of Cognitive Training Interventions With Older Adults

    PubMed Central

    Ball, Karlene; Berch, Daniel B.; Helmers, Karin F.; Jobe, Jared B.; Leveck, Mary D.; Marsiske, Michael; Morris, John N.; Rebok, George W.; Smith, David M.; Tennstedt, Sharon L.; Unverzagt, Frederick W.; Willis, Sherry L.

    2010-01-01

    Context Cognitive function in older adults is related to independent living and need for care. However, few studies have addressed whether improving cognitive functions might have short- or long-term effects on activities related to living independently. Objective To evaluate whether 3 cognitive training interventions improve mental abilities and daily functioning in older, independent-living adults. Design Randomized, controlled, single-blind trial with recruitment conducted from March 1998 to October 1999 and 2-year follow-up through December 2001. Setting and Participants Volunteer sample of 2832 persons aged 65 to 94 years recruited from senior housing, community centers, and hospital/clinics in 6 metropolitan areas in the United States. Interventions Participants were randomly assigned to 1 of 4 groups: 10-session group training for memory (verbal episodic memory; n=711), or reasoning (ability to solve problems that follow a serial pattern; n=705), or speed of processing (visual search and identification; n=712); or a no-contact control group (n=704). For the 3 treatment groups, 4-session booster training was offered to a 60% random sample 11 months later. Main Outcome Measures Cognitive function and cognitively demanding everyday functioning. Results Thirty participants were incorrectly randomized and were excluded from the analysis. Each intervention improved the targeted cognitive ability compared with baseline, durable to 2 years (P<.001 for all). Eighty-seven percent of speed-, 74% of reasoning-, and 26% of memory-trained participants demonstrated reliable cognitive improvement immediately after the intervention period. Booster training enhanced training gains in speed (P<.001) and reasoning (P<.001) interventions (speed booster, 92%; no booster, 68%; reasoning booster, 72%; no booster, 49%), which were maintained at 2-year follow-up (P<.001 for both). No training effects on everyday functioning were detected at 2 years. Conclusions Results support the

  14. Autonomous Unobtrusive Detection of Mild Cognitive Impairment in Older Adults

    PubMed Central

    Taati, Babak; Mihailidis, Alex

    2015-01-01

    The current diagnosis process of dementia is resulting in a high-percentage of cases with delayed detection. To address this problem, in this paper we explore the feasibility of autonomously detecting mild cognitive impairment (MCI) in the older adult population. We implement a signal processing approach equipped with a machine learning paradigm to process and analyze real world data acquired using home-based unobtrusive sensing technologies. Using the sensor and clinical data pertaining to 97 subjects, acquired over an average period of 3 years, a number of measures associated with the subjects' walking speeds and general activity in the home were calculated. Different time spans of these measures were used to generate feature vectors to train and test two machine learning algorithms namely support vector machines and random forests. We were able to autonomously detect MCI in older adults with an area under the ROC curve of 0.97 and an area under the precision-recall curve of 0.93 using a time window of 24 weeks. This work is of great significance since it can potentially assist in the early detection of cognitive impairment in older adults. PMID:25585407

  15. Mild cognitive impairment and its management in older people

    PubMed Central

    Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Mun, Chan Yoke; Ng, Chee Kyun

    2015-01-01

    Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals’ daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%–15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide. PMID:25914527

  16. Rich Club Organization and Cognitive Performance in Healthy Older Participants.

    PubMed

    Baggio, Hugo C; Segura, Barbara; Junque, Carme; de Reus, Marcel A; Sala-Llonch, Roser; Van den Heuvel, Martijn P

    2015-09-01

    The human brain is a complex network that has been noted to contain a group of densely interconnected hub regions. With a putative "rich club" of hubs hypothesized to play a central role in global integrative brain functioning, we assessed whether hub and rich club organizations are associated with cognitive performance in healthy participants and whether the rich club might be differentially involved in cognitive functions with a heavier dependence on global integration. A group of 30 relatively older participants (range = 39-79 years of age) underwent extensive neuropsychological testing, combined with diffusion-weighted magnetic resonance imaging to reconstruct individual structural brain networks. Rich club connectivity was found to be associated with general cognitive performance. More specifically, assessing the relationship between the rich club and performance in two specific cognitive domains, we found rich club connectivity to be differentially associated with attention/executive functions-known to rely on the integration of distributed brain areas-rather than with visuospatial/visuoperceptual functions, which have a more constrained neuroanatomical substrate. Our findings thus provide first empirical evidence of a relevant role played by the rich club in cognitive processes. PMID:25941870

  17. Mild cognitive impairment and its management in older people.

    PubMed

    Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Mun, Chan Yoke; Ng, Chee Kyun

    2015-01-01

    Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals' daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%-15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide. PMID:25914527

  18. Finances in the Older Patient with Cognitive Impairment

    PubMed Central

    Widera, Eric; Steenpass, Veronika; Marson, Daniel; Sudore, Rebecca

    2013-01-01

    Financial capacity is the ability to manage money and financial assets in ways that meet a person’s needs and which are consistent with his/her values and self-interest. Financial capacity is essential for an individual to function independently in our society; however, dementia eventually leads to a complete loss of financial capacity. Many patients with cognitive impairment and their families turn to their primary care clinician for help with financial impairment, yet most clinicians do not understand their role or how to help. We review the prevalence and impact of financial incapacity in older adults with cognitive impairment. We also articulate the role of the primary clinician which includes: (1) educating older adult patients and families about the need for advance financial planning; (2) recognizing signs of possible impaired financial capacity; (3) assessing financial impairments in cognitively impaired adults; (4) recommending interventions to help patients maintain financial independence; and (5) knowing when and to whom to make medical and legal referrals. Clearly delineating the clinician’s role in financial impairment can lead to the establishment of effective financial protections and can limit the economic, psychological, and legal hardships of financial incapacity on patients with dementia and their families. PMID:21325186

  19. Video game training enhances cognitive control in older adults.

    PubMed

    Anguera, J A; Boccanfuso, J; Rintoul, J L; Al-Hashimi, O; Faraji, F; Janowich, J; Kong, E; Larraburo, Y; Rolle, C; Johnston, E; Gazzaley, A

    2013-09-01

    Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitations. It is clear that multitasking behaviour has become ubiquitous in today's technologically dense world, and substantial evidence has accrued regarding multitasking difficulties and cognitive control deficits in our ageing population. Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months. Furthermore, age-related deficits in neural signatures of cognitive control, as measured with electroencephalography, were remediated by multitasking training (enhanced midline frontal theta power and frontal-posterior theta coherence). Critically, this training resulted in performance benefits that extended to untrained cognitive control abilities (enhanced sustained attention and working memory), with an increase in midline frontal theta power predicting the training-induced boost in sustained attention and preservation of multitasking improvement 6 months later. These findings highlight the robust plasticity of the prefrontal cognitive control system in the ageing brain, and provide the first evidence, to our knowledge, of how a custom-designed video game can be used to assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and serve as a powerful tool

  20. Studying nursing interventions in acutely ill, cognitively impaired older adults

    PubMed Central

    McCauley, Kathleen; Bradway, Christine; Hirschman, Karen B; Naylor, Mary D

    2015-01-01

    Background Between one and two of every five hospitalized older adults have cognitive deficits, often not accurately assessed or well managed. Cognitive impairment adds substantially to the complexity of these patients’ care, places them at high risk for poor outcomes and increases the cost of health care. Methods We describe three evidence-based interventions, each capitalizing on the unique contributions of nurses and designed to improve outcomes of hospitalized older adults who have cognitive deficits. Interventions of varying intensity were compared across three hospitals (Phase I) and subsequently within the same hospitals (Phase II). All enrolled patients were screened during their index hospitalizations and cognitive deficits were communicated to relevant health care team members (Augmented Standard Care-ASC, lowest intensity). At one hospital, ASC was the only intervention. Patients at a second hospital also had care influenced by specially prepared registered nurses (Resource Nurse Care-RNC, medium intensity). Finally, patients at third hospital also received advanced practice nurse coordinated care (Transitional Care Model-TCM, higher intensity). In Phase II, newly enrolled patients at these same hospitals all received the TCM. We summarize major themes from review of multiple data sources and researcher recollections related to facilitators and barriers to implementing a complex research study. Findings Effective implementation of the three intervention strategies depended on clinician engagement and communication; degree of participation by nurses in the educational program with subsequent practice improvement; and success of advanced practice nurses in implementing the TCM with both with patients, family caregivers and clinicians. Implications Based on lessons learned in implementing complex research studies within the “real world” of clinical practice settings, recommendations focus on strengthening facilitators, minimizing barriers and gaining

  1. Gender differences in older adults’ everyday cognitive collaboration

    PubMed Central

    Margrett, Jennifer A.; Marsiske, Michael

    2010-01-01

    Collaborative cognition research has demonstrated that social partners can positively impact individuals’ thinking and problem-solving performance. Research in adulthood and aging has been less clear about dyadic effects, such as partner gender, on collaborative cognition. The current study examined the objective and subjective experiences of older men and women’s collaboration on three everyday problems. Tasks included comprehension of everyday printed materials, a social dilemma task, and an errand-planning task. A sample of 98 older married couples (N = 196) worked both collaboratively and individually with either their spouse (N = 52 dyads) or a stranger of the other gender (N = 46 dyads). Analyses conducted using the actor-partner methodology (e.g., Gonzalez & Griffin, 1997; Kenny, 1996) suggest that men tended to be more influential during dyadic problem solving, particularly on more ambiguous tasks. Subjective appraisals of collaboration also varied between male and female partners, with familiarity of partner playing a large role in expectations of collaboration. Most notably, women assigned to work with an unfamiliar male partner tended to rate their satisfaction with collaborative teamwork less positively. Both self and partner-rated subjective appraisals, particularly expectations of competitiveness, were predictive of collaborative performance. PMID:20657668

  2. Gender differences in older adults' everyday cognitive collaboration.

    PubMed

    Margrett, Jennifer A; Marsiske, Michael

    2002-01-01

    Collaborative cognition research has demonstrated that social partners can positively impact individuals' thinking and problem-solving performance. Research in adulthood and aging has been less clear about dyadic effects, such as partner gender, on collaborative cognition. The current study examined the objective and subjective experiences of older men and women's collaboration on three everyday problems. Tasks included comprehension of everyday printed materials, a social dilemma task, and an errand-planning task. A sample of 98 older married couples (N = 196) worked both collaboratively and individually with either their spouse (N = 52 dyads) or a stranger of the other gender (N = 46 dyads). Analyses conducted using the actor-partner methodology (e.g., Gonzalez & Griffin, 1997; Kenny, 1996) suggest that men tended to be more influential during dyadic problem solving, particularly on more ambiguous tasks. Subjective appraisals of collaboration also varied between male and female partners, with familiarity of partner playing a large role in expectations of collaboration. Most notably, women assigned to work with an unfamiliar male partner tended to rate their satisfaction with collaborative teamwork less positively. Both self and partner-rated subjective appraisals, particularly expectations of competitiveness, were predictive of collaborative performance. PMID:20657668

  3. Emotional instability but intact spatial cognition in adenosine receptor 1 knock out mice.

    PubMed

    Lang, Undine E; Lang, Florian; Richter, Kerstin; Vallon, Volker; Lipp, Hans-Peter; Schnermann, Jürgen; Wolfer, David P

    2003-10-17

    Several lines of evidence point to the involvement of adenosine in the regulation of important central mechanisms such as cognition, arousal, aggression and anxiety. In order to elucidate the involvement of the adenosine A1 receptor (A1AR) in spatial learning and the control of exploratory behaviour, we assessed A1AR knockout mice (A1AR-/-) and their wild-type littermates (A1AR+/+) in a place navigation task in the water maze and in a battery of forced and free exploration tests. In the water maze, A1AR-/- mice showed normal escape latencies and were indistinguishable from controls with respect to measures of spatial performance during both training and probe trial. But despite normal performance they showed increased wall hugging, most prominently after the relocation of the goal platform for reversal training. Quantitative analysis of strategy choices indicated that wall hugging was increased mainly at the expense of chaining and passive floating, whereas the frequency of trials characterised as direct swims or focal searching was normal in A1AR-/- mice. These results indicate intact spatial cognition, but mildly altered emotional reactions to the water maze environment. In line with this interpretation, A1AR-/- mice showed normal levels and patterns of activity, but a mild increase of some measures of anxiety in our battery of forced and free exploration paradigms. These results are in line with findings published using a genetically similar line, but demonstrate that the magnitude of the changes and the range of affected behavioural measures may vary considerably depending on the environmental conditions during testing. PMID:14529816

  4. Associations Between Alzheimer Disease Biomarkers, Neurodegeneration, and Cognition in Cognitively Normal Older People

    PubMed Central

    Wirth, Miranka; Villeneuve, Sylvia; Haase, Claudia M.; Madison, Cindee M.; Oh, Hwamee; Landau, Susan M.; Rabinovici, Gil D.; Jagust, William J.

    2016-01-01

    Importance Criteria for preclinical Alzheimer disease (AD) propose β-amyloid (Aβ) plaques to initiate neurodegeneration within AD-affected regions. However, some cognitively normal older individuals harbor neural injury similar to patients with AD, without concurrent Aβ burden. Such findings challenge the proposed sequence and suggest that Aβ-independent precursors underlie AD-typical neurodegenerative patterns. Objective To examine relationships between Aβ and non-Aβ factors as well as neurodegeneration within AD regions in cognitively normal older adults. The study quantified neurodegenerative abnormalities using imaging biomarkers and examined cross-sectional relationships with Aβ deposition; white matter lesions (WMLs), a marker of cerebrovascular disease; and cognitive functions. Design, Setting, and Participants Cross-sectional study in a community-based convenience sample of 72 cognitively normal older individuals (mean [SD] age, 74.9 [5.7] years; 48 women; mean [SD] 17.0 [1.9] years of education) of the Berkeley Aging Cohort. Intervention Each individual underwent a standardized neuropsychological test session, magnetic resonance imaging, and positron emission tomography scanning. Main Outcomes and Measures For each individual, 3 AD-sensitive neurodegeneration biomarkers were measured: hippocampal volume, glucose metabolism, and gray matter thickness, the latter 2 sampled from cortical AD-affected regions. To quantify neurodegenerative abnormalities, each biomarker was age adjusted, dichotomized into a normal or abnormal status (using cutoff thresholds derived from an independent AD sample), and summarized into 0, 1, or more than 1 abnormal neurodegenerative biomarker. Degree and topographic patterns of neurodegenerative abnormalities were assessed and their relationships with cognitive functions, WML volume, and Aβ deposition (quantified using carbon 11-labeled Pittsburgh compound B positron emission tomography). Results Of our cognitively normal

  5. Requirements of older adults for a daily use of an internet-based cognitive training platform.

    PubMed

    Haesner, Marten; O'Sullivan, Julie L; Gövercin, Mehmet; Steinhagen-Thiessen, Elisabeth

    2015-03-01

    A decline of cognitive abilities is a part of normal human ageing. However, recent research has demonstrated that an enriched environment can have a beneficial impact on cognitive function in old age. Accordingly, mentally and socially active lifestyles are associated with less cognitive decline in old age. Specific interventions such as computerized cognitive training programs for older adults are also known to have a positive effect on the level of cognitive functioning. Therefore, online platforms combining cognitive training with web 2.0 features may yield multiple benefits for older users. However, to date only little research exists on technological acceptance and media use in this age-group especially for cognitively-impaired seniors. Therefore, in order to assess specific preferences and potential barriers of older adults regarding a web-based platform for cognitive training, we conducted qualitative interviews with 12 older adults. Half of the participants were diagnosed with mild cognitive impairment (MCI). Most importantly, our results show that cognitive exercises should incorporate themes and topics older adults are interested in. Additional communication features could serve as ideal methods for increasing user motivation. Furthermore, we derived eight critical requirements of older adults concerning daily use of a web-based cognitive training platform. Implications for future research and development are discussed. PMID:24725153

  6. Upper-Extremity Dual-Task Function: An Innovative Method to Assess Cognitive Impairment in Older Adults

    PubMed Central

    Toosizadeh, Nima; Najafi, Bijan; Reiman, Eric M.; Mager, Reine M.; Veldhuizen, Jaimeson K.; O’Connor, Kathy; Zamrini, Edward; Mohler, Jane

    2016-01-01

    Background: Difficulties in orchestrating simultaneous tasks (i.e., dual-tasking) have been associated with cognitive impairments in older adults. Gait tests have been commonly used as the motor task component for dual-task assessments; however, many older adults have mobility impairments or there is a lack of space in busy clinical settings. We assessed an upper-extremity function (UEF) test as an alternative motor task to study the dual-task motor performance in older adults. Methods: Older adults (≥65 years) were recruited, and cognitive ability was measured using the Montreal cognitive assessment (MoCA). Participants performed repetitive elbow flexion with their maximum pace, once single-task, and once while counting backward by one (dual-task). Single- and dual-task gait tests were also performed with normal speed. Three-dimensional kinematics was measured both from upper-extremity and lower-extremity using wearable sensors to determine UEF and gait parameters. Parameters were compared between the cognitively impaired and healthy groups using analysis of variance tests, while controlling for age, gender, and body mass index (BMI). Correlations between UEF and gait parameters for dual-task and dual-task cost were assessed using linear regression models. Results: Sixty-seven older adults were recruited (age = 83 ± 10 years). Based on MoCA, 10 (15%) were cognitively impaired. While no significant differences were observed in the single-task condition, within the dual-task condition, the cognitively impaired group showed significantly less arm flexion speed (62%, d = 1.51, p = 0.02) and range of motion (27%, d = 0.93, p = 0.04), and higher speed variability (88%, d = 1.82, p < 0.0001) compared to the cognitively intact group, when adjusted with age, gender, and BMI. Significant correlations were observed between UEF speed parameters and gait stride velocity for dual-task condition (r = 0.55, p < 0.0001) and dual-task cost (r = 0.28, p = 0.03). Conclusion: We

  7. Genetic risk for Alzheimer’s disease alters the five-year trajectory of semantic memory activation in cognitively intact elders

    PubMed Central

    Rao, Stephen M.; Bonner-Jackson, Aaron; Nielson, Kristy A.; Seidenberg, Michael; Smith, J. Carson; Woodard, John L.; Durgerian, Sally

    2015-01-01

    Healthy aging is associated with cognitive declines typically accompanied by increased task-related brain activity in comparison to younger counterparts. The Scaffolding Theory of Aging and Cognition (STAC) (Park and Reuter-Lorenz, 2009; Reuter-Lorenz and Park, 2014) posits that compensatory brain processes are responsible for maintaining normal cognitive performance in older adults, despite accumulation of aging-related neural damage. Cross-sectional studies indicate that cognitively intact elders at genetic risk for Alzheimer’s disease (AD) demonstrate patterns of increased brain activity compared to low risk elders, suggesting that compensation represents an early response to AD-associated pathology. Whether this compensatory response persists or declines with the onset of cognitive impairment can only be addressed using a longitudinal design. The current prospective, 5-year longitudinal study examined brain activation in APOE ε4 carriers (N=24) and non-carriers (N=21). All participants, ages 65–85 and cognitively intact at study entry, underwent task-activated fMRI, structural MRI, and neuropsychological assessments at baseline, 18, and 57 months. fMRI activation was measured in response to a semantic memory task requiring participants to discriminate famous from non-famous names. Results indicated that the trajectory of change in brain activation while performing this semantic memory task differed between APOE ε4 carriers and non-carriers. The APOE ε4 group exhibited greater activation than the Low Risk group at baseline, but they subsequently showed a progressive decline in activation during the follow-up periods with corresponding emergence of episodic memory loss and hippocampal atrophy. In contrast, the non-carriers demonstrated a gradual increase in activation over the 5-year period. Our results are consistent with the STAC model by demonstrating that compensation varies with the severity of underlying neural damage and can be exhausted with the

  8. Treatment of PTSD in older adults: Do cognitive-behavioral interventions remain viable?

    PubMed Central

    Clapp, Joshua D.; Beck, J. Gayle

    2011-01-01

    The literature examining trauma among older adults is growing, but little is known about the efficacy of empirically supported interventions for PTSD within this population. Clinical writing on this topic often implies that cognitive-behavioral treatments may be ineffective or inappropriate for older adults with PTSD given physical and/or cognitive vulnerabilities. Review of the limited research in this area, however, provides little support for the claim that cognitive-behavioral interventions are ineffective in treating PTSD among the elderly. In an effort to explicate specific issues related to treatment process and outcome among older survivors of trauma, a case series is presented outlining the treatment of three older adults within the context of a structured, cognitive-behavioral group intervention. Observations from this case series suggests that cognitive-behavioral interventions continue to be useful in treating PTSD with this population. Specific treatment issues unique to older adults are explored and recommendations for future research are discussed. PMID:22383863

  9. The PACE Study: A randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI)

    PubMed Central

    2009-01-01

    Background Research evidence from observational studies suggests that cognitive activity reduces the risk of cognitive impairment in later life as well as the rate of cognitive decline of people with dementia. The Promoting Healthy Ageing with Cognitive Exercise (PACE) study has been designed to determine whether a cognitive activity intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment (MCI). Methods/Design The study will recruit 160 community-dwelling men and women aged 65 years of age or over with mild cognitive impairment (MCI). Participants will be randomly allocated to two treatment groups: non-specific education and cognitive activity. The intervention will consist of ten 90-minute sessions delivered twice per week over a period of five weeks. The primary outcome measure of the study is the change from baseline in the total score on the Cambridge Cognitive Score (CAMCOG). Secondary outcomes of interest include changes in memory, attention, executive functions, mood and quality of life. Primary endpoints will be collected 12, 52 and 104 weeks after the baseline assessment. Discussion The proposed project will produce the best available evidence on the merits of increased cognitive activity as a strategy to prevent cognitive decline among older adults with MCI. We anticipate that the results of this study will have implications for the development of evidence-based preventive strategies to reduce the rate of cognitive decline amongst older people at risk of dementia. Trial registration ACTRN12608000556347 PMID:20003398

  10. Associations Between Dehydration, Cognitive Impairment, and Frailty in Older Hospitalized Patients: An Exploratory Study.

    PubMed

    McCrow, Judy; Morton, Margaret; Travers, Catherine; Harvey, Keren; Eeles, Eamonn

    2016-05-01

    patients. 2. Identify risk and management strategies related to dehydration in older hospitalized patients. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. The current exploratory study (a) assessed the prevalence of dehydration in older adults (age ≤60 years) with and without cognitive impairment (CI) admitted to the hospital; and (b) examined associations between dehydration, CI, and frailty. Forty-four patients participated and dehydration was assessed within 24 hours of admission and at Day 4 or discharge (whichever occurred first). Patients' cognitive function and frailty statuses were assessed using validated instruments. Twenty-seven (61%) patients had CI and 61% were frail. Prevalence of dehydration at admission was 29% (n = 12) and 19% (n = 6) at study exit, and dehydration status did not differ according to CI or frailty status. However, within the non-CI group, significantly more frail than fit patients were dehydrated at admission (p = 0.03). Findings indicate dehydration is common among older hospitalized patients and that frailty may increase the risk for dehydration in cognitively intact older adults. [Journal of Gerontological Nursing, 42(5), 19-27.]. PMID:26870985

  11. Associations among Fluid and Crystallized Cognition and Daily Stress Processes in Older Adults

    PubMed Central

    Stawski, Robert S.; Mogle, Jacqueline A.; Sliwinski, Martin J.

    2013-01-01

    The current study examined associations among fluid and crystallized cognition, and daily stress processes in older adults. Older adults (N=107) completed measures of daily stressors, and affect on six occasions over two weeks, as well as measures of fluid and crystallized cognition. Higher crystallized cognition was associated with a greater likelihood of exposure to daily stressors, including arguments and avoided arguments. Higher fluid cognition was associated with diminished emotional reactivity to daily stressors for negative but not positive affect. Discussion focuses on the roles of fluid and crystallized cognition for understanding daily stress processes, daily activity and lifestyle, and health. PMID:22946522

  12. Nutrition and Cognition in Older Adults With Heart Failure: A Systematic Review.

    PubMed

    Stewart, Mara W; Traylor, Abigail C; Bratzke, Lisa C

    2015-11-01

    Cognitive impairment is commonly observed in older adults with heart failure; nutrition is a possible contributing factor. The purpose of the current systematic review is to examine the relationship between nutrition and cognition in older adults with heart failure. A literature review was performed through August 2015 that examined published, peer-reviewed studies from PubMed, PsycINFO, CINAHL, and Web of Science. Four articles were selected for inclusion. Findings revealed that poorer nutritional habits were associated with poorer attention, executive functioning, and memory in older adults with heart failure. Nutritional biomarkers, including anemia, hyponatremia, hypokalemia, hyperglycemia, and hypoalbuminemia, were also associated with cognitive impairment. More research is needed to explore the relationship between nutrition and cognition in this population. Descriptive studies will inform scientists as they design and test nutritional interventions to optimize cognitive function in older adults with heart failure. PMID:26505248

  13. Estimating In-home Walking Speed Distributions for Unobtrusive Detection of Mild Cognitive Impairment in Older Adults*

    PubMed Central

    Akl, Ahmad; Mihailidis, Alex

    2016-01-01

    Timely recognition of cognitive impairment such as Alzheimer’s disease is of great significance. Many smart systems, developed to continuously monitor subjects’ health and cognition, use a number of predefined measures associated with the subjects’ activity in their homes. However, this approach has been demonstrated to focus on the idiosyncratic nuances of the individual subjects and thus could potentially not perform as well on new subjects. In this paper, we address this problem by building proper statistical models of the subjects’ in-home walking speed. Using the data pertaining to 15 older adults monitored for an average period of 3 years, we used linear regression with a Gaussian likelihood to model the in-home walking speed of the subjects, and we used dynamic time warping to demonstrate significant difference between the walking speed distributions of the subjects when cognitively intact and when suffering from MCI. Using a simple thresholding approach of the dynamic time warping costs, we were able to detect MCI in older adults with an area under the ROC curve and an area under the precision-recall curve of 0.906 and 0.790, respectively, using a time frame of 12 weeks. PMID:26737457

  14. Cognitive factors and the experience of pain and suffering in older persons.

    PubMed

    Gibson, S J; Helme, R D

    2000-04-01

    Cognitive factors are thought to play an important mediational role between pain and consequent levels of suffering, yet there has been little investigation of these issues in older chronic pain patients. The present study sought to examine the reliability and validity of the Pain Locus of Control (PLOC) scale when used with older patients, to explore age differences in PLOC orientation, and examine the relationship between cognitive beliefs and levels of pain and suffering. 169 older patients attending a pain management clinic completed a comprehensive psychometric battery prior to admission. Principal components analysis replicated the original factor structure of the PLOC previously identified in young adult samples, suggesting that older patients adopt the same underlying constructs of control. The internal item consistency of the 36 item scale was shown to be very good to excellent. Older adults endorsed a higher chance locus of control, but this orientation was amenable to change following a cognitive-behavioural treatment program. PLOC orientation was related to use of coping strategies, levels of pain and depression, functional and psychosocial impact as well as compliance with treatment protocols. Stepwise regression analysis revealed that self perceived interference from pain and internal PLOC were the best predictors of depressive symptoms in older adults. In combination, these findings suggest that cognitive factors are of importance in older chronic pain patients and extend the relevance of cognitive-behavioural models of pain across the entire adult age spectrum. PMID:10781910

  15. Relationships of exercise with frailty, depression, and cognitive function in older women.

    PubMed

    Jeoung, Bog Ja

    2014-10-01

    The purpose of the present study was to provide basic data to identify which types of exercise promote health of older adults. To this end, this study investigated how exercise affects frailty, depression, and cognitive functions in older adults. Frailty, depression, and cognitive function assessed in the exercise participants, 164 older adult women. Results revealed that participants' frailty and depression varied according to exercise participation time and frequency. In particular, dancing was more effective than other types of exercise in reducing frailty and depression. Exercise duration and frequency did not influence cognitive function, but results indicated that table tennis exerted a greater influence on cognitive function than other types of exercise did. In addition, cognitive function differed according to the degree of frailty participants displayed. PMID:25426466

  16. Attitudes about Aging Well among a Diverse Group of Older Americans: Implications for Promoting Cognitive Health

    ERIC Educational Resources Information Center

    Laditka, Sarah B.; Corwin, Sara J.; Laditka, James N.; Liu, Rui; Tseng, Winston; Wu, Bei; Beard, Renee L.; Sharkey, Joseph R.; Ivey, Susan L.

    2009-01-01

    Purpose: To examine perceptions about aging well in the context of cognitive health among a large and diverse group of older adults. Design and Methods: Forty-two focus groups were conducted with older adults living in the community ( N = 396; White, African American, American Indian, Chinese, Vietnamese, and Hispanic). Participant descriptions …

  17. Cognitive-Behavioral Therapy for Depression in an Older Gay Man: A Clinical Case Study

    ERIC Educational Resources Information Center

    Satterfield, Jason M.; Crabb, Rebecca

    2010-01-01

    Although strong evidence supports cognitive-behavioral therapy for late-life depression and depression in racial and ethnic minorities, there are no empirical studies on the treatment of depression in older sexual minorities. Three distinct literatures were tapped to create a depression treatment protocol for an older gay male. Interventions were…

  18. Adapting Choral Singing Experiences for Older Adults: The Implications of Sensory, Perceptual, and Cognitive Changes

    ERIC Educational Resources Information Center

    Yinger, Olivia Swedberg

    2014-01-01

    As people age, they naturally experience sensory, perceptual, and cognitive changes. Many of these changes necessitate adaptations in designing programs for older adults. Choral singing is an activity that has many potential benefits for older adults, yet the rehearsal environment, presentation style, and content of material presented may need to…

  19. National Economic Development Status May Affect the Association between Central Adiposity and Cognition in Older Adults

    PubMed Central

    Maharani, Asri; Tampubolon, Gindo

    2016-01-01

    Background Obesity is becoming a global problem, rather than one found only in developed countries. Although recent studies have suggested a detrimental effect of obesity on cognition, studies of the relationship between obesity and cognition among older adults have been limited to developed countries. We aimed to examine the associations between central obesity, as measured by waist circumference, and cognition level in adults aged 50 years and older in England and Indonesia. Methods We used linear regression models to analyse these associations and multiple imputation to manage missing data. The 2006 English Longitudinal Study of Ageing Wave 3 is the source of data from England, while data from Indonesia is sourced from the 2007 Indonesian Family Life Survey Wave 4. Findings Centrally obese respondents had lower cognition levels than non-centrally obese respondents in England. In contrast, central adiposity had a statistically significant positive association with cognition in Indonesia. Higher levels of education and higher economic status were associated with higher cognitive ability, while age was associated with lower cognition in both countries. Elevated C-reactive protein (CRP) concentrations and smoking behaviour, both linked to higher risk of obesity, were negatively associated with cognitive ability among older adults in England, but they had no statistically significant association with cognition among Indonesians. Interpretation The contradictory findings on obesity and cognition in England and Indonesia not only create a puzzle, but they may also have different policy implications in these countries. Reducing the prevalence of obesity may be the main focus in England and other developed countries to maintain older adults’ cognition. However, Indonesia and other developing countries should place more emphasis on education, in addition to continued efforts to tackle the double burden of malnutrition, in order to prevent cognitive impairment among

  20. Social Cognition in Tourette's Syndrome: Intact Theory of Mind and Impaired Inhibitory Functioning

    ERIC Educational Resources Information Center

    Channon, Shelley; Sinclair, Elizabeth; Waller, Denise; Healey, Louise; Robertson, Mary M.

    2004-01-01

    Although associations between social cognition involving theory of mind and non-social executive skills have frequently been reported, dissociations in performance have also been found. The present study was designed to examine social and non-social cognition in uncomplicated Tourette Syndrome (TS). Adult TS participants without comorbid diagnoses…

  1. Kicking Back Cognitive Ageing: Leg Power Predicts Cognitive Ageing after Ten Years in Older Female Twins

    PubMed Central

    Steves, Claire J.; Mehta, Mitul M.; Jackson, Stephen H.D.; Spector, Tim D.

    2016-01-01

    Background Many observational studies have shown a protective effect of physical activity on cognitive ageing, but interventional studies have been less convincing. This may be due to short time scales of interventions, suboptimal interventional regimes or lack of lasting effect. Confounding through common genetic and developmental causes is also possible. Objectives We aimed to test whether muscle fitness (measured by leg power) could predict cognitive change in a healthy older population over a 10-year time interval, how this performed alongside other predictors of cognitive ageing, and whether this effect was confounded by factors shared by twins. In addition, we investigated whether differences in leg power were predictive of differences in brain structure and function after 12 years of follow-up in identical twin pairs. Methods A total of 324 healthy female twins (average age at baseline 55, range 43-73) performed the Cambridge Neuropsychological Test Automated Battery (CANTAB) at two time points 10 years apart. Linear regression modelling was used to assess the relationships between baseline leg power, physical activity and subsequent cognitive change, adjusting comprehensively for baseline covariates (including heart disease, diabetes, blood pressure, fasting blood glucose, lipids, diet, body habitus, smoking and alcohol habits, reading IQ, socioeconomic status and birthweight). A discordant twin approach was used to adjust for factors shared by twins. A subset of monozygotic pairs then underwent magnetic resonance imaging. The relationship between muscle fitness and brain structure and function was assessed using linear regression modelling and paired t tests. Results A striking protective relationship was found between muscle fitness (leg power) and both 10-year cognitive change [fully adjusted model standardised β-coefficient (Stdβ) = 0.174, p = 0.002] and subsequent total grey matter (Stdβ = 0.362, p = 0.005). These effects were robust in discordant

  2. Aerobic and Cognitive Exercise (ACE) Pilot Study for Older Adults: Executive Function Improves with Cognitive Challenge While Exergaming.

    PubMed

    Barcelos, Nicole; Shah, Nikita; Cohen, Katherine; Hogan, Michael J; Mulkerrin, Eamon; Arciero, Paul J; Cohen, Brian D; Kramer, Arthur F; Anderson-Hanley, Cay

    2015-11-01

    Dementia cases are increasing worldwide; thus, investigators seek to identify interventions that might prevent or ameliorate cognitive decline in later life. Extensive research confirms the benefits of physical exercise for brain health, yet only a fraction of older adults exercise regularly. Interactive mental and physical exercise, as in aerobic exergaming, not only motivates, but has also been found to yield cognitive benefit above and beyond traditional exercise. This pilot study sought to investigate whether greater cognitive challenge while exergaming would yield differential outcomes in executive function and generalize to everyday functioning. Sixty-four community based older adults (mean age=82) were randomly assigned to pedal a stationary bike, while interactively engaging on-screen with: (1) a low cognitive demand task (bike tour), or (2) a high cognitive demand task (video game). Executive function (indices from Trails, Stroop and Digit Span) was assessed before and after a single-bout and 3-month exercise intervention. Significant group × time interactions were found after a single-bout (Color Trails) and after 3 months of exergaming (Stroop; among 20 adherents). Those in the high cognitive demand group performed better than those in the low cognitive dose condition. Everyday function improved across both exercise conditions. Pilot data indicate that for older adults, cognitive benefit while exergaming increased concomitantly with higher doses of interactive mental challenge. PMID:26581789

  3. Distinct neural correlates of emotional and cognitive empathy in older adults

    PubMed Central

    Moore, Raeanne C.; Dev, Sheena I.; Jeste, Dilip V.; Dziobek, Isabel; Eyler, Lisa T.

    2014-01-01

    Empathy is thought to be a mechanism underlying prosocial behavior across the lifespan, yet little is known about how levels of empathy relate to individual differences in brain functioning among older adults. In this exploratory study, we examined the neural correlates of affective and cognitive empathy in older adults. Thirty older adults (M=79 years) underwent fMRI scanning and neuropsychological testing and completed a test of affective and cognitive empathy. Brain response during processing of cognitive and emotional stimuli was measured by fMRI in a priori and task-related regions and was correlated with levels of empathy. Older adults with higher levels of affective empathy showed more deactivation in the amygdala and insula during a working memory task, whereas those with higher cognitive empathy showed greater insula activation during a response inhibition task. Our preliminary findings suggest that brain systems linked to emotional and social processing respond differently among older adults with more or less affective and cognitive empathy. That these relationships can be seen both during affective and non-emotional tasks of “cold” cognitive abilities suggests that empathy may impact social behavior through both emotional and cognitive mechanisms. PMID:25770039

  4. Distinct neural correlates of emotional and cognitive empathy in older adults.

    PubMed

    Moore, Raeanne C; Dev, Sheena I; Jeste, Dilip V; Dziobek, Isabel; Eyler, Lisa T

    2015-04-30

    Empathy is thought to be a mechanism underlying prosocial behavior across the lifespan, yet little is known about how levels of empathy relate to individual differences in brain functioning among older adults. In this exploratory study, we examined the neural correlates of affective and cognitive empathy in older adults. Thirty older adults (M=79 years) underwent fMRI scanning and neuropsychological testing and completed a test of affective and cognitive empathy. Brain response during processing of cognitive and emotional stimuli was measured by fMRI in a priori and task-related regions and was correlated with levels of empathy. Older adults with higher levels of affective empathy showed more deactivation in the amygdala and insula during a working memory task, whereas those with higher cognitive empathy showed greater insula activation during a response inhibition task. Our preliminary findings suggest that brain systems linked to emotional and social processing respond differently among older adults with more or less affective and cognitive empathy. That these relationships can be seen both during affective and non-emotional tasks of "cold" cognitive abilities suggests that empathy may impact social behavior through both emotional and cognitive mechanisms. PMID:25770039

  5. Alzheimer's disease neurodegenerative biomarkers are associated with decreased cognitive function but not β-amyloid in cognitively normal older individuals.

    PubMed

    Wirth, Miranka; Madison, Cindee M; Rabinovici, Gil D; Oh, Hwamee; Landau, Susan M; Jagust, William J

    2013-03-27

    β-Amyloid (Aβ) plaque deposition and neurodegeneration within temporoparietal and hippocampal regions may indicate increased risk of Alzheimer's disease (AD). This study examined relationships between AD biomarkers of Aβ and neurodegeneration as well as cognitive performance in cognitively normal older individuals. Aβ burden was quantified in 72 normal older human subjects from the Berkeley Aging Cohort (BAC) using [(11)C] Pittsburgh compound B (PIB) positron emission tomography. In the same individuals, we measured hippocampal volume, as well as glucose metabolism and cortical thickness, which were extracted from a template of cortical AD-affected regions. The three functional and structural biomarkers were merged into a highly AD-sensitive multimodality biomarker reflecting neural integrity. In the normal older individuals, there was no association between elevated PIB uptake and either the single-modality or the multimodality neurodegenerative biomarkers. Lower neural integrity within the AD-affected regions and a control area (the visual cortex) was related to lower scores on memory and executive function tests; the same association was not found with PIB retention. The relationship between cognition and the multimodality AD biomarker was stronger in individuals with the highest PIB uptake. The findings indicate that neurodegeneration occurs within AD regions regardless of Aβ deposition and accounts for worse cognition in cognitively normal older people. The impact of neural integrity on cognitive functions is, however, enhanced in the presence of high Aβ burden for brain regions that are most affected in AD. PMID:23536070

  6. Effects of strawberry supplementation on mobility and cognition in older adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    During aging, functional changes in the central and peripheral nervous system can alter mobility and cognition - in some cases leading to early cognitive decline, disability, or injurious falls among older adults. Previously, we have shown that two months of dietary supplementation with berry fruit...

  7. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    ERIC Educational Resources Information Center

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…

  8. Mediterranean diet and cognitive function in older age: results from the Women’s Health Study

    PubMed Central

    Samieri, Cécilia; Grodstein, Francine; Rosner, Bernard A.; Kang, Jae H.; Cook, Nancy R.; Manson, JoAnn E.; Buring, Julie E.; Willett, Walter C.; Okereke, Olivia I.

    2013-01-01

    Background Adherence to a Mediterranean diet may help prevent cognitive decline in older age, but studies are limited. We examined the association of adherence to the Mediterranean diet with cognitive function and decline. Methods We included 6,174 participants, aged 65+ years, from the cognitive sub-study of the Women’s Health Study. Women provided dietary information in 1998 and completed a cognitive battery 5 years later, followed by two assessments at 2-year intervals. The primary outcomes were composite scores of global cognition and verbal memory. The alternate Mediterranean diet adherence 9-point-score was constructed based on intakes of: vegetables, fruits, legumes, whole grains, nuts, fish, red and processed meats, moderate alcohol, and the ratio of monounsaturated-to-saturated fats. Results After multivariable adjustment, the alternate Mediterranean diet score was not associated with trajectories of repeated cognitive scores (P-trend across quintiles=0.26 and 0.40 for global cognition and verbal memory, respectively), nor with overall global cognition and verbal memory at older ages, assessed by averaging the three cognitive measures (P-trend=0.63 and 0.44, respectively). Among alternate Mediterranean diet components, higher monounsaturated-to-saturated fats ratio was associated with more favorable cognitive trajectories (P-trend=0.03 and 0.05 for global cognition and verbal memory, respectively). Greater whole grain intake was not associated with cognitive trajectories, but was related to better average global cognition (P-trend=0.02). Conclusions In this large study of older women, we observed no association of the Mediterranean diet with cognitive decline. Relations between individual Mediterranean diet components, particularly whole grains, and cognitive function merit further study. PMID:23676264

  9. Life Course Pathways to Racial Disparities in Cognitive Impairment among Older Americans*

    PubMed Central

    Zhang, Zhenmei; Hayward, Mark D.; Yu, Yan-Liang

    2016-01-01

    Blacks are especially hard hit by cognitive impairment at older ages compared to whites. Here, we take advantage of the Health and Retirement Study (1998–2010) to assess how this racial divide in cognitive impairment is associated with the racial stratification of life course exposures and resources over a 12-year period among 8,946 non-Hispanic whites and blacks aged 65 and older in 1998. We find that blacks suffer from a higher risk of moderate/severe cognitive impairment at baseline and during the follow-up. Blacks are also more likely to report childhood adversity and to have grown up in the segregated South, and these early-life adversities put blacks at a significantly higher risk of cognitive impairment. Adulthood socioeconomic status is strongly associated with the risk of cognitive impairment, net of childhood conditions. However, racial disparities in cognitive impairment, though substantially reduced, are not eliminated when controlling for these life course factors. PMID:27247126

  10. Cognitive Control and Lexical Access in Younger and Older Bilinguals

    ERIC Educational Resources Information Center

    Bialystok, Ellen; Craik, Fergus; Luk, Gigi

    2008-01-01

    Ninety-six participants, who were younger (20 years) or older (68 years) adults and either monolingual or bilingual, completed tasks assessing working memory, lexical retrieval, and executive control. Younger participants performed most of the tasks better than older participants, confirming the effect of aging on these processes. The effect of…

  11. Cognitive Function in Childhood and Lifetime Cognitive Change in Relation to Mental Wellbeing in Four Cohorts of Older People

    PubMed Central

    Gale, Catharine R.; Cooper, Rachel; Craig, Leone; Elliott, Jane; Kuh, Diana; Richards, Marcus; Starr, John M.; Whalley, Lawrence J.; Deary, Ian J.

    2012-01-01

    Background Poorer cognitive ability in youth is a risk factor for later mental health problems but it is largely unknown whether cognitive ability, in youth or in later life, is predictive of mental wellbeing. The purpose of this study was to investigate whether cognitive ability at age 11 years, cognitive ability in later life, or lifetime cognitive change are associated with mental wellbeing in older people. Methods We used data on 8191 men and women aged 50 to 87 years from four cohorts in the HALCyon collaborative research programme into healthy ageing: the Aberdeen Birth Cohort 1936, the Lothian Birth Cohort 1921, the National Child Development Survey, and the MRC National Survey for Health and Development. We used linear regression to examine associations between cognitive ability at age 11, cognitive ability in later life, and lifetime change in cognitive ability and mean score on the Warwick Edinburgh Mental Wellbeing Scale and meta-analysis to obtain an overall estimate of the effect of each. Results People whose cognitive ability at age 11 was a standard deviation above the mean scored 0.53 points higher on the mental wellbeing scale (95% confidence interval 0.36, 0.71). The equivalent value for cognitive ability in later life was 0.89 points (0.72, 1.07). A standard deviation improvement in cognitive ability in later life relative to childhood ability was associated with 0.66 points (0.39, 0.93) advantage in wellbeing score. These effect sizes equate to around 0.1 of a standard deviation in mental wellbeing score. Adjustment for potential confounding and mediating variables, primarily the personality trait neuroticism, substantially attenuated these associations. Conclusion Associations between cognitive ability in childhood or lifetime cognitive change and mental wellbeing in older people are slight and may be confounded by personality trait differences. PMID:22970320

  12. Video game training enhances cognition of older adults: a meta-analytic study.

    PubMed

    Toril, Pilar; Reales, José M; Ballesteros, Soledad

    2014-09-01

    It has been suggested that video game training enhances cognitive functions in young and older adults. However, effects across studies are mixed. We conducted a meta-analysis to examine the hypothesis that training healthy older adults with video games enhances their cognitive functioning. The studies included in the meta-analysis were video game training interventions with pre- and posttraining measures. Twenty experimental studies published between 1986 and 2013, involving 474 trained and 439 healthy older controls, met the inclusion criteria. The results indicate that video game training produces positive effects on several cognitive functions, including reaction time (RT), attention, memory, and global cognition. The heterogeneity test did not show a significant heterogeneity (I(2) = 20.69%) but this did not preclude a further examination of moderator variables. The magnitude of this effect was moderated by methodological and personal factors, including the age of the trainees and the duration of the intervention. The findings suggest that cognitive and neural plasticity is maintained to a certain extent in old age. Training older adults with video games enhances several aspects of cognition and might be a valuable intervention for cognitive enhancement. PMID:25244488

  13. Vitamin D Deficiency with High Intact PTH Levels is More Common in Younger than in Older Women: A Study of Women Aged 39-64 Years.

    PubMed

    Miyamoto, Takeshi; Katsuyama, Eri; Kanagawa, Hiroya; Fujie, Atsuhiro; Miyamoto, Hiroya; Yoshida, Shigeyuki; Mori, Tomoaki; Miyamoto, Kana; Sato, Yuiko; Kobayashi, Tami; Nakamura, Masaya; Matsumoto, Morio; Nishiwaki, Yuji; Hirose, Hiroshi; Kanda, Takeshi; Saito, Ikuo; Toyama, Yoshiaki

    2016-06-25

    Low serum 25-hydroxyvitamin D (25(OH)D) levels are implicated as a risk factor for hip and spine fractures. Studies of the relation between 25(OH)D levels and fractures have primarily involved elderly osteoporosis patients or patients with fractures; however, the serum 25(OH)D and parathyroid hormone (PTH) status in younger adult populations remains largely unknown. We evaluated serum 25(OH)D and intact PTH levels in 411 women aged 39-64 years who were not receiving medication for osteoporosis or other bone diseases. Serum 25(OH)D levels were positively correlated with age (P = 0.019), whereas intact PTH levels were inversely correlated with 25(OH)D levels (P < 0.001). Thus, low vitamin D levels with high intact PTH levels were more common in younger than in older women. Our data show that serum 25(OH)D insufficiency could be a more serious concern in the younger population than had been previously anticipated. Because serum 25(OH)D insufficiency is reportedly a risk factor for hip and spine fracture, the number of fracture patients could increase in the future, suggesting that we may need to correct the serum vitamin D/intact PTH status to prevent future osteoporosis. PMID:26853879

  14. Retrospective lifetime dietary patterns predict cognitive performance in community-dwelling older Australians.

    PubMed

    Hosking, Diane E; Nettelbeck, Ted; Wilson, Carlene; Danthiir, Vanessa

    2014-07-28

    Dietary intake is a modifiable exposure that may have an impact on cognitive outcomes in older age. The long-term aetiology of cognitive decline and dementia, however, suggests that the relevance of dietary intake extends across the lifetime. In the present study, we tested whether retrospective dietary patterns from the life periods of childhood, early adulthood, adulthood and middle age predicted cognitive performance in a cognitively healthy sample of 352 older Australian adults >65 years. Participants completed the Lifetime Diet Questionnaire and a battery of cognitive tests designed to comprehensively assess multiple cognitive domains. In separate regression models, lifetime dietary patterns were the predictors of cognitive factor scores representing ten constructs derived by confirmatory factor analysis of the cognitive test battery. All regression models were progressively adjusted for the potential confounders of current diet, age, sex, years of education, English as native language, smoking history, income level, apoE ɛ4 status, physical activity, other past dietary patterns and health-related variables. In the adjusted models, lifetime dietary patterns predicted cognitive performance in this sample of older adults. In models additionally adjusted for intake from the other life periods and mechanistic health-related variables, dietary patterns from the childhood period alone reached significance. Higher consumption of the 'coffee and high-sugar, high-fat extras' pattern predicted poorer performance on simple/choice reaction time, working memory, retrieval fluency, short-term memory and reasoning. The 'vegetable and non-processed' pattern negatively predicted simple/choice reaction time, and the 'traditional Australian' pattern positively predicted perceptual speed and retrieval fluency. Identifying early-life dietary antecedents of older-age cognitive performance contributes to formulating strategies for delaying or preventing cognitive decline. PMID

  15. Dissociation between Key Processes of Social Cognition in Autism: Impaired Mentalizing but Intact Sense of Agency

    ERIC Educational Resources Information Center

    David, Nicole; Gawronski, Astrid; Santos, Natacha S.; Huff, Wolfgang; Lehnhardt, Fritz-Georg; Newen, Albert; Vogeley, Kai

    2008-01-01

    Deficits in social cognition and interaction, such as in mentalizing and imitation behavior, are hallmark features of autism spectrum disorders. Both imitation and mentalizing are at the core of the sense of agency, the awareness that we are the initiators of our own behavior. Little evidence exists regarding the sense of agency in autism. Thus,…

  16. Cognitive functioning differentially predicts different dimensions of older drivers' on-road safety.

    PubMed

    Aksan, Nazan; Anderson, Steve W; Dawson, Jeffrey; Uc, Ergun; Rizzo, Matthew

    2015-02-01

    The extent to which deficits in specific cognitive domains contribute to older drivers' safety risk in complex real-world driving tasks is not well understood. We selected 148 drivers older than 70 years of age both with and without neurodegenerative diseases (Alzheimer disease-AD and Parkinson disease-PD) from an existing driving database of older adults. Participant assessments included on-road driving safety and cognitive functioning in visuospatial construction, speed of processing, memory, and executive functioning. The standardized on-road drive test was designed to examine multiple facets of older driver safety including navigation performance (e.g., following a route, identifying landmarks), safety errors while concurrently performing secondary navigation tasks ("on-task" safety errors), and safety errors in the absence of any secondary navigation tasks ("baseline" safety errors). The inter-correlations of these outcome measures were fair to moderate supporting their distinctiveness. Participants with diseases performed worse than the healthy aging group on all driving measures and differences between those with AD and PD were minimal. In multivariate analyses, different domains of cognitive functioning predicted distinct facets of driver safety on road. Memory and set-shifting predicted performance in navigation-related secondary tasks, speed of processing predicted on-task safety errors, and visuospatial construction predicted baseline safety errors. These findings support broad assessments of cognitive functioning to inform decisions regarding older driver safety on the road and suggest navigation performance may be useful in evaluating older driver fitness and restrictions in licensing. PMID:25525974

  17. Cluster Analysis of Physical and Cognitive Ageing Patterns in Older People from Shanghai.

    PubMed

    Bandelow, Stephan; Xu, Xin; Xiao, Shifu; Hogervorst, Eef

    2016-01-01

    This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no problems with ADL. Twenty-eight percent of participants needed help with ADL, with the majority of this group being over 80 years of age. Significant predictors of reductions in functional independence included age, balance, global cognitive function (MMSE) and the gait measures. Cluster analysis revealed a protective effect of education on cognitive function that did not appear to extend to physical function. Consistency of such phenotypes of ageing clusters in other cohort studies may provide helpful models for dementia and frailty prevention measures. PMID:26907351

  18. Cluster Analysis of Physical and Cognitive Ageing Patterns in Older People from Shanghai

    PubMed Central

    Bandelow, Stephan; Xu, Xin; Xiao, Shifu; Hogervorst, Eef

    2016-01-01

    This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no problems with ADL. Twenty-eight percent of participants needed help with ADL, with the majority of this group being over 80 years of age. Significant predictors of reductions in functional independence included age, balance, global cognitive function (MMSE) and the gait measures. Cluster analysis revealed a protective effect of education on cognitive function that did not appear to extend to physical function. Consistency of such phenotypes of ageing clusters in other cohort studies may provide helpful models for dementia and frailty prevention measures. PMID:26907351

  19. Cognitive Performance, Driving Behavior, and Attitudes over Time in Older Adults.

    PubMed

    Rapoport, Mark J; Sukhawathanakul, Paweena; Naglie, Gary; Tuokko, Holly; Myers, Anita; Crizzle, Alexander; Korner-Bitensky, Nicol; Vrkljan, Brenda; Bédard, Michel; Porter, Michelle M; Mazer, Barbara; Gélinas, Isabelle; Man-Son-Hing, Malcolm; Marshall, Shawn

    2016-06-01

    We hypothesized that changes over time in cognitive performance are associated with changes in driver perceptions, attitudes, and self-regulatory behaviors among older adults. Healthy older adults (n = 928) underwent cognitive assessments at baseline with two subsequent annual follow-ups, and completed scales regarding their perceptions, attitudes, and driving behaviours. Multivariate analysis showed small but statistically significant relationships between the cognitive tests and self-report measures, with the largest magnitudes between scores on the Trails B cognitive task (seconds), perceptions of driving abilities (β = -0.32), and situational driving avoidance (β = 0.55) (p < 0.05). Cognitive slowing and executive dysfunction appear to be associated with modestly lower perceived driving abilities and more avoidance of driving situations over time in this exploratory analysis. PMID:27021848

  20. The effectiveness of a stimulation program on cognitive capacity among individuals older than 60.

    PubMed

    Karatay, Gülnaz; Akkuş, Yeliz

    2011-02-01

    The purpose of this study was to test the effects of a multistimulant home-based intervention program on cognitive function, anxiety, and depression among older adults with cognitive impairment. This research is quasi-experimental and was designed in an effort to increase the cognitive capacity of individuals above the age of 60 with reduced cognitive capacities. Each senior received a total of seven home visits, including intervention conversation, newspaper/ book reading, painting/handcraft activities, and physical exercise. The Mini Mental State Test scores of the participants statistically increased, whereas the Beck Anxiety and the Geriatric Depression Scale scores showed a decrease (p < .05) after the intervention. Findings demonstrate that the multistimulant approach to improve cognitive capacity among individuals older than 60 years was successful. PMID:20802086

  1. Delirium in older adults: a chronic cognitive disorder?

    PubMed

    Cole, Martin G; Mccusker, Jane

    2016-08-01

    Delirium is defined as a neurocognitive disorder characterized by sudden onset, fluctuating course, and disturbances in level of consciousness, attention, orientation, memory, thought, perception, and behavior (American Psychiatric Association, 2013). It occurs in hyperactive, hypoactive, or mixed forms in up to 50% of older hospital patients (Inouye et al., 2014) and 70% of older long-term care residents (McCusker et al., 2011), many with pre-existing dementia (Fick et al., 2002). PMID:27246118

  2. Cognitive Effects of Cancer Systemic Therapy: Implications for the Care of Older Patients and Survivors

    PubMed Central

    Mandelblatt, Jeanne S.; Jacobsen, Paul B.; Ahles, Tim

    2014-01-01

    The number of patients with cancer who are age 65 years or older (hereinafter “older”) is increasing dramatically. One obvious aspect of cancer care for this group is that they are experiencing age-related changes in multiple organ systems, including the brain, which complicates decisions about systemic therapy and assessments of survivorship outcomes. There is a consistent body of evidence from studies that use neuropsychological testing and neuroimaging that supports the existence of impairment following systemic therapy in selected cognitive domains among some older patients with cancer. Impairment in one or more cognitive domains could have important effects in the daily lives of older patients. However, an imperfect understanding of the precise biologic mechanisms underlying cognitive impairment after systemic treatment precludes development of validated methods for predicting which older patients are at risk. From what is known, risks may include lifestyle factors such as smoking, genetic predisposition, and specific comorbidities such as diabetes and cardiovascular disease. Risk also interacts with physiologic and cognitive reserve, because even at the same chronological age and with the same number of illnesses, older patients vary from having high reserve (ie, biologically younger than their age) to being frail (biologically older than their age). Surveillance for the presence of cognitive impairment is also an important component of long-term survivorship care with older patients. Increasing the workforce of cancer care providers who have geriatrics training or who are working within multidisciplinary teams that have this type of expertise would be one avenue toward integrating assessment of the cognitive effects of cancer systemic therapy into routine clinical practice. PMID:25071135

  3. The effect of D-serine administration on cognition and mood in older adults

    PubMed Central

    Madeira, Caroline; Vargas-Lopes, Charles; Marques, Priscila; Dantas, Camila; Manhães, Alex C.; Leite, Homero; Panizzutti, Rogerio

    2016-01-01

    Background D-serine is an endogenous co-agonist of the N-Methyl D-Aspartate Receptor (NMDAR) that plays a crucial role in cognition including learning processes and memory. Decreased D-serine levels have been associated with age-related decline in mechanisms of learning and memory in animal studies. Here, we asked whether D-serine administration in older adults improves cognition. Results D-serine administration improved performance in the Groton Maze learning test of spatial memory and learning and problem solving (F(3, 38)= 4.74, p = 0.03). Subjects that achieved higher increases in plasma D-serine levels after administration improved more in test performance (r2=−0.19 p = 0.009). D-serine administration was not associated with any significant changes in the other cognitive tests or in the mood of older adults (p > 0.05). Methods Fifty healthy older adults received D-serine and placebo in a randomized, double blind, placebo-controlled, crossover design study. We studied the effect of D-serine administration on the performance of cognitive tests and an analogue mood scale. We also collected blood samples to measure D-serine, L-serine, glutamate and glutamine levels. Conclusions D-serine administration may be a strategy to improve spatial memory, learning and problem solving in healthy older adults. Future studies should evaluate the impact of long-term D-serine administration on cognition in older adults. PMID:26933803

  4. Prevalence and Cognitive Bases of Subjective Memory Complaints in Older Adults: Evidence from a Community Sample

    PubMed Central

    McClendon, McKee J.; Wallendal, Maggie S.; Hyde, Trevor F.; Larsen, Janet D.

    2014-01-01

    Objectives. To estimate the prevalence of subjective memory complaints (SMCs) in a sample of community-dwelling, older adults and to examine cognitive bases of these complaints. Participants. 499 community-dwelling adults, 65 and older. Measurements. A telephone survey consisting of cognitive tests and clinical and sociodemographic variables. SMCs were based on subjects' evaluations and subjects' perceptions of others' evaluations. Analysis. Logistic regression was used to model the risk for SMCs as a function of the cognitive, clinical, and sociodemographic variables. We tested for interactions of the cognitive variables with age, education, and gender. Results. 27.1% reported memory complaints. Among the younger age, better objective memory performance predicted lower risk for SMCs, while among the older age, better memory had no effect on risk. Among the better-educated people, better global cognitive functioning predicted lower risk for SMCs, while among the less-educated people, better global cognitive functioning had no effect on SMC risk. When predicting others' perceptions, better objective memory was associated with lower risk for SMCs. Conclusion. Objective memory performance and global cognitive functioning are associated with lower risk for SMCs, but these relationships are the strongest for the younger age and those with more education, respectively. Age and education may affect the ability to accurately appraise cognitive functioning. PMID:26317004

  5. THE EFFECT OF PLAUSIBILITY ON SENTENCE COMPREHENSION AMONG OLDER ADULTS AND ITS RELATION TO COGNITIVE FUNCTIONS

    PubMed Central

    Yoon, Jungmee; Campanelli, Luca; Goral, Mira; Marton, Klara; Eichorn, Naomi; Obler, Loraine K.

    2016-01-01

    Background/Study Context Older adults show age-related decline in complex-sentence comprehension. This has been attributed to a decrease in cognitive abilities that may support language processing, such as working memory (e.g., Caplan, DeDe, Waters, & Michaud, 2011,Psychology and Aging, 26, 439–450). The authors examined whether older adults have difficulty comprehending semantically implausible sentences and whether specific executive functions contribute to their comprehension performance. Methods Forty-two younger adults (aged 18–35) and 42 older adults (aged 55–75) were tested on two experimental tasks: a multiple negative comprehension task and an information processing battery. Results Both groups, older and younger adults, showed poorer performance for implausible sentences than for plausible sentences; however, no interaction was found between plausibility and age group. A regression analysis revealed that inhibition efficiency, as measured by a task that required resistance to proactive interference, predicted comprehension of implausible sentences in older adults only. Consistent with the compensation hypothesis, the older adults with better inhibition skills showed better comprehension than those with poor inhibition skills. Conclusion The findings suggest that semantic implausibility, along with syntactic complexity, increases linguistic and cognitive processing loads on auditory sentence comprehension. Moreover, the contribution of inhibitory control to the processing of semantic plausibility, particularly among older adults, suggests that the relationship between cognitive ability and language comprehension is strongly influenced by age. PMID:25978447

  6. Neural correlates of auditory-cognitive processing in older adult cochlear implant recipients.

    PubMed

    Henkin, Yael; Yaar-Soffer, Yifat; Steinberg, Meidan; Muchnik, Chava

    2014-01-01

    With the growing number of older adults receiving cochlear implants (CI), there is general agreement that substantial benefits can be gained. Nonetheless, variability in speech perception performance is high, and the relative contribution and interactions among peripheral, central-auditory, and cognitive factors are not fully understood. The goal of the present study was to compare auditory-cognitive processing in older-adult CI recipients with that of older normal-hearing (NH) listeners by means of behavioral and electrophysiologic manifestations of a high-load cognitive task. Auditory event-related potentials (AERPs) were recorded from 9 older postlingually deafened adults with CI (age at CI >60) and 10 age-matched listeners with NH, while performing an auditory Stroop task. Participants were required to classify the speaker's gender (male/female) that produced the words 'mother' or 'father' while ignoring the irrelevant congruent or incongruent word meaning. Older CI and NH listeners exhibited comparable reaction time, performance accuracy, and initial sensory-perceptual processing (i.e. N1 potential). Nonetheless, older CI recipients showed substantially prolonged and less efficient perceptual processing (i.e. P3 potential). Congruency effects manifested in longer reaction time (i.e. Stroop effect), execution time, and P3 latency to incongruent versus congruent stimuli in both groups in a similar fashion; however, markedly prolonged P3 and shortened execution time were evident in older CI recipients. Collectively, older adults (CI and NH) employed a combined perceptual and postperceptual conflict processing strategy; nonetheless, the relative allotment of perceptual resources was substantially enhanced to maintain adequate performance in CI recipients. In sum, the recording of AERPs together with the simultaneously obtained behavioral measures during a Stroop task exposed a differential time course of auditory-cognitive processing in older CI recipients that

  7. The Association Between Mental Health and Cognitive Screening Scores in Older Veterans

    PubMed Central

    Wray, Laura O.; Mavandadi, Shahrzad; Klaus, Johanna R.; Tew, James D.; Oslin, David W.; Sweet, Robert

    2011-01-01

    Objectives To examine overall cognitive screening results and the relationship between of cognitive screen score and sociodemographic characteristics, reason for referral, and clinical outcomes of older Veterans referred by primary care for a behavioral health assessment. Design Cross-sectional, naturalistic study. Setting Primary care clinics affiliated with two VA Medical Centers. Participants The sample included 4,325 older veterans referred to the Behavioral Health Laboratory who completed an initial mental health/substance abuse (MH/SA) assessment. Veterans were categorized into 3 groups based on cognitive status: Within Normal Limits (WNL), Possible Cognitive Impairment (PCI), and Possible Dementia (PD). Measurements Sociodemographic and clinical data on reason for referral, cognitive functioning (i.e., Blessed Orientation-Memory-Concentration (BOMC) Test), and behavioral health assessment outcomes were extracted from patients’ medical records. Data were analyzed using multiple linear and logistic regression. Results Results of cognitive screenings indicated that the majority of the sample was WNL (62.5%), with 25.8%, 8.1%, and 3.6% of patients evidencing PCI, PD, and BOMC scores ≥17, respectively. With regard to reason for referral, patients with greater cognitive impairment were more likely to be identified by the antidepressant casefinder than patients with less impairment. Increased age, non-Caucasian ethnicity, self-perceived inadequate finances, Major Depressive Disorder, and symptoms of psychosis were associated with greater cognitive impairment. Conclusions Findings highlight the importance of evaluating cognitive status in older adults who are referred for a behavioral health assessment and/or receive a new MH/SA diagnosis. Doing so has the potential to improve recognition and treatment of cognitive impairment and dementia, thereby improving quality of care for many older adults. PMID:22251868

  8. Effects of Moderate Aerobic Exercise on Cognitive Abilities and Redox State Biomarkers in Older Adults.

    PubMed

    Alghadir, Ahmad H; Gabr, Sami A; Al-Eisa, Einas S

    2016-01-01

    We used a moderate aerobic exercise program for 24 weeks to measure the positive impact of physical activity on oxidative stress and inflammatory markers and its association with cognitive performance in healthy older adults. A total of 100 healthy subjects (65-95 Yrs) were randomly classified into two groups: control group (n = 50) and exercise group (n = 50). Cognitive functioning, physical activity score, MDA, 8-OHdG, TAC, and hs-CRP were assessed using LOTCA battery, prevalidated PA questionnaire, and immunoassay techniques. LOTCA 7-set scores of cognitive performance showed a significant correlation with physical activity status and the regulation of both oxidative stress free radicals and inflammatory markers in all older subjects following 24 weeks of moderate exercise. Physically active persons showed a higher cognitive performance along with reduction in the levels of MDA, 8-OHdG, and hs-CRP and increase in TAC activity compared with sedentary participants. Cognitive performance correlated positively with the increase in TAC activity and physical fitness scores and negatively with MDA, 8-OHdG, and hs-CRP, respectively. There was a significant improvement in motor praxis, vasomotor organization, thinking operations, and attention and concentration among older adults. In conclusion, moderate aerobic training for 24 weeks has a positive significant effect in improving cognitive functions via modulating redox and inflammatory status of older adults. PMID:27195073

  9. Effects of Moderate Aerobic Exercise on Cognitive Abilities and Redox State Biomarkers in Older Adults

    PubMed Central

    Al-Eisa, Einas S.

    2016-01-01

    We used a moderate aerobic exercise program for 24 weeks to measure the positive impact of physical activity on oxidative stress and inflammatory markers and its association with cognitive performance in healthy older adults. A total of 100 healthy subjects (65–95 Yrs) were randomly classified into two groups: control group (n = 50) and exercise group (n = 50). Cognitive functioning, physical activity score, MDA, 8-OHdG, TAC, and hs-CRP were assessed using LOTCA battery, prevalidated PA questionnaire, and immunoassay techniques. LOTCA 7-set scores of cognitive performance showed a significant correlation with physical activity status and the regulation of both oxidative stress free radicals and inflammatory markers in all older subjects following 24 weeks of moderate exercise. Physically active persons showed a higher cognitive performance along with reduction in the levels of MDA, 8-OHdG, and hs-CRP and increase in TAC activity compared with sedentary participants. Cognitive performance correlated positively with the increase in TAC activity and physical fitness scores and negatively with MDA, 8-OHdG, and hs-CRP, respectively. There was a significant improvement in motor praxis, vasomotor organization, thinking operations, and attention and concentration among older adults. In conclusion, moderate aerobic training for 24 weeks has a positive significant effect in improving cognitive functions via modulating redox and inflammatory status of older adults. PMID:27195073

  10. Sources of priming in text rereading: intact implicit memory for new associations in older adults and in patients with Alzheimer's disease.

    PubMed

    Monti, L A; Gabrieli, J D; Wilson, R S; Beckett, L A; Grinnell, E; Lange, K L; Reminger, S L

    1997-09-01

    The contributions of text meaning, new between-word associations, and single-word repetition to priming in text rereading in younger and older adults, and in patients with Alzheimer's disease. (AD), were assessed in Experiment 1. Explicit recognition memory for text was also assessed. Equivalent single-word and between-word priming was observed for all groups, even though patients with AD showed impaired explicit memory for individual words in the text. The contribution of generalized reading task skill to priming in meaningless text rereading in younger adults was assessed in Experiment 2. Generalized reading task skill was also found to contribute to priming. These results reveal 3 mechanisms of priming: new between-word associations for meaningful and meaningless text, individual word repetition for meaningless text, and general task or skill factors for meaningless text. All priming mechanisms appear to be intact in older adults and in patients with AD. PMID:9308100

  11. Education Desegregation and Cognitive Change in African American Older Adults

    PubMed Central

    Gamaldo, Alyssa A.; Sims, Regina C.; Allaire, Jason C.; Whitfield, Keith E.

    2015-01-01

    Objectives. The present study examined the relationship between desegregated schooling and cognitive change in a sample of 420 community-dwelling African American elders (mean age = 68.6; SD = 9.1). Method. Participants were recruited for the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Cognitive measures from six domains of function were administered at baseline and follow-up 33 months later. Repeated measures multivariate analysis of covariance was conducted; the between subjects factors were schooling type and age cohort, and the within subjects factor was time. Analyses controlled for age, years of education, and sex, and follow-up univariate analyses were used to determine which individual cognitive scores drove the multivariate effects. Results. There were significant multivariate within-group, between-group, and interaction effects (p < .05). Univariate analyses indicated that the desegregated schooling group scored significantly better on Language and Perceptual Speed (p < .01), and the youngest age cohort (50- to 59-year-olds) performed better on measures of Perceptual Speed. There were no significant univariate interactions between schooling group or age cohort and cognitive change over time. Discussion. Overall, these findings suggest a slight advantage of desegregated schooling for cognitive performance, but no advantage of desegregated schooling on the rate of cognitive change over time in this sample. PMID:25361918

  12. Preventing cognitive decline in older African Americans with mild cognitive impairment: design and methods of a randomized clinical trial.

    PubMed

    Rovner, Barry W; Casten, Robin J; Hegel, Mark T; Leiby, Benjamin E

    2012-07-01

    Mild Cognitive Impairment (MCI) affects 25% of older African Americans and predicts progression to Alzheimer's disease. An extensive epidemiologic literature suggests that cognitive, physical, and/or social activities may prevent cognitive decline. We describe the methods of a randomized clinical trial to test the efficacy of Behavior Activation to prevent cognitive decline in older African Americans with the amnestic multiple domain subtype of MCI. Community Health Workers deliver 6 initial in-home treatment sessions over 2-3 months and then 6 subsequent in-home booster sessions using language, materials, and concepts that are culturally relevant to older African Americans during this 24 month clinical trial. We are randomizing 200 subjects who are recruited from churches, senior centers, and medical clinics to Behavior Activation or Supportive Therapy, which controls for attention. The primary outcome is episodic memory as measured by the Hopkins Verbal Learning Test-Revised at baseline and at months 3, 12, 18, and 24. The secondary outcomes are general and domain-specific neuropsychological function, activities of daily living, depression, and quality-of-life. The negative results of recent clinical trials of drug treatments for MCI and Alzheimer's disease suggest that behavioral interventions may provide an alternative treatment approach to preserve cognition in an aging society. PMID:22406101

  13. Combined Cognitive-Psychological-Physical Intervention Induces Reorganization of Intrinsic Functional Brain Architecture in Older Adults

    PubMed Central

    Zheng, Zhiwei; Zhu, Xinyi; Yin, Shufei; Wang, Baoxi; Niu, Yanan; Huang, Xin; Li, Rui; Li, Juan

    2015-01-01

    Mounting evidence suggests that enriched mental, physical, and socially stimulating activities are beneficial for counteracting age-related decreases in brain function and cognition in older adults. Here, we used functional magnetic resonance imaging (fMRI) to demonstrate the functional plasticity of brain activity in response to a combined cognitive-psychological-physical intervention and investigated the contribution of the intervention-related brain changes to individual performance in healthy older adults. The intervention was composed of a 6-week program of combined activities including cognitive training, Tai Chi exercise, and group counseling. The results showed improved cognitive performance and reorganized regional homogeneity of spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signals in the superior and middle temporal gyri, and the posterior lobe of the cerebellum, in the participants who attended the intervention. Intriguingly, the intervention-induced changes in the coherence of local spontaneous activity correlated with the improvements in individual cognitive performance. Taken together with our previous findings of enhanced resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe regions following a combined intervention program in older adults, we conclude that the functional plasticity of the aging brain is a rather complex process, and an effective cognitive-psychological-physical intervention is helpful for maintaining a healthy brain and comprehensive cognition during old age. PMID:25810927

  14. Does combined cognitive training and physical activity training enhance cognitive abilities more than either alone? A four-condition randomized controlled trial among healthy older adults

    PubMed Central

    Shatil, Evelyn

    2013-01-01

    Cognitive training and aerobic training are known to improve cognitive functions. To examine the separate and combined effects of such training on cognitive performance, four groups of healthy older adults embarked on a 4 months cognitive and/or mild aerobic training. A first group [n = 33, mean age = 80 (66–90)] engaged in cognitive training, a second [n = 29, mean age = 81 (65–89)] in mild aerobic training, a third [n = 29, mean age = 79 (70–93)] in the combination of both, and a fourth [n = 31, mean age = 79 (71–92)] control group engaged in book-reading activity. The outcome was a well-validated multi-domain computerized cognitive evaluation for older adults. The results indicate that, when compared to older adults who did not engage in cognitive training (the mild aerobic and control groups) older adults who engaged in cognitive training (separate or combined training groups) showed significant improvement in cognitive performance on Hand-Eye Coordination, Global Visual Memory (GVM; working memory and long-term memory), Speed of Information Processing, Visual Scanning, and Naming. Indeed, individuals who did not engage in cognitive training showed no such improvements. Those results suggest that cognitive training is effective in improving cognitive performance and that it (and not mild aerobic training) is driving the improvement in the combined condition. Results are discussed in terms of the special circumstances of aerobic and cognitive training for older adults who are above 80 years of age. PMID:23531885

  15. Cognitive dysfunction and health-related quality of life among older Chinese

    PubMed Central

    Pan, Chen-Wei; Wang, Xingzhi; Ma, Qinghua; Sun, Hong-Peng; Xu, Yong; Wang, Pei

    2015-01-01

    We aimed to assess the association of cognitive dysfunction with health-related quality of life (HRQOL) among older adults in China. We analyzed community-based cross-sectional data of 5,557 Chinese individuals aged 60 years and above in the Weitang Geriatric Diseases Study. Cognitive dysfunction and HRQOL were assessed using the Abbreviated Mental Test (AMT) and the European Quality of Life-5 dimensions (EQ-5D), respectively. We estimated the impacts of cognitive dysfunction on the EQ-5D index and visual analogue scale (VAS) scores using linear regression models, and the association between cognitive dysfunction and self-reported EQ-5D health problems using logistic regression models. The EQ-5D index and VAS scores were significantly lower for individuals with cognitive dysfunction than their counterparts. After controlling for covariates, the differences in EQ-5D index and VAS scores between individuals with and without cognitive dysfunction were −0.016 (95% confidence interval [CI]: −0.024, −0.008), and −3.4 (95% CI: −4.5, −2.4), respectively. Cognitive dysfunction was associated with reporting of problems in pain/discomfort (odds ration [OR]: 1.37; 95% CI: 1.12, 1.69), and anxiety/depression (OR: 2.13; 95% CI: 1.41, 3.23). The negative impact on HRQOL increased with the severity of cognitive dysfunction. The results indicate cognitive dysfunction was associated with worse HRQOL in older adults. PMID:26601612

  16. Neuropsychological tests for predicting cognitive decline in older adults

    PubMed Central

    Baerresen, Kimberly M; Miller, Karen J; Hanson, Eric R; Miller, Justin S; Dye, Richelin V; Hartman, Richard E; Vermeersch, David; Small, Gary W

    2015-01-01

    Summary Aim To determine neuropsychological tests likely to predict cognitive decline. Methods A sample of nonconverters (n = 106) was compared with those who declined in cognitive status (n = 24). Significant univariate logistic regression prediction models were used to create multivariate logistic regression models to predict decline based on initial neuropsychological testing. Results Rey–Osterrieth Complex Figure Test (RCFT) Retention predicted conversion to mild cognitive impairment (MCI) while baseline Buschke Delay predicted conversion to Alzheimer’s disease (AD). Due to group sample size differences, additional analyses were conducted using a subsample of demographically matched nonconverters. Analyses indicated RCFT Retention predicted conversion to MCI and AD, and Buschke Delay predicted conversion to AD. Conclusion Results suggest RCFT Retention and Buschke Delay may be useful in predicting cognitive decline. PMID:26107318

  17. Investigating the Roles of Knowledge and Cognitive Abilities in Older Adult Information Seeking on the Web

    PubMed Central

    SHARIT, JOSEPH; HERNÁNDEZ, MARIO A.; CZAJA, SARA J.; PIROLLI, PETER

    2009-01-01

    This study investigated the influences of knowledge, particularly Internet, Web browser, and search engine knowledge, as well as cognitive abilities on older adult information seeking on the Internet. The emphasis on aspects of cognition was informed by a modeling framework of search engine information-seeking behavior. Participants from two older age groups were recruited: twenty people in a younger-old group (ages 60–70) and twenty people in an older-old group (ages 71–85). Ten younger adults (ages 18–39) served as a comparison group. All participants had at least some Internet search experience. The experimental task consisted of six realistic search problems, all involving information related to health and well-being and which varied in degree of complexity. The results indicated that though necessary, Internet-related knowledge was not sufficient in explaining information-seeking performance, and suggested that a combination of both knowledge and key cognitive abilities is important for successful information seeking. In addition, the cognitive abilities that were found to be critical for task performance depended on the search problem’s complexity. Also, significant differences in task performance between the younger and the two older age groups were found on complex, but not on simple problems. Overall, the results from this study have implications for instructing older adults on Internet information seeking and for the design of Web sites. PMID:20011130

  18. Blood lead levels in relation to cognitive function in older U.S. adults.

    PubMed

    van Wijngaarden, Edwin; Winters, Paul C; Cory-Slechta, Deborah A

    2011-01-01

    Studies suggest that cumulative exposure to lead, as measured in the bone, is associated with accelerated cognitive decline at older age. It is presently unclear, however, whether current blood lead levels (BLLs) are adversely related to cognitive functioning in older adults. We evaluated BLLs in relation to cognition in the continuous National Health and Nutrition Examination Survey (NHANES). The current study was limited to adults age 60 and older. We examined two measures of cognitive functioning: self-reported functional limitation due to difficulty remembering or periods of confusion (NHANES 1999-2008; n=7277) and performance on the Digit Symbol Substitution Test (DSST; NHANES 1999-2002; n=2299). We evaluated quintiles of BLL (<1.30, 1.79-<2.30, 2.30-<3.20, and ≥3.20μg/dL) in relation to cognitive functioning using logistic (functional limitation) and linear (DSST scores) regression in SUDAAN, adjusting for age, sex, race, poverty-income ratio, education, and self-reported general health status. BLLs were not associated with self-reported confusion or memory problems in crude and adjusted analyses, with adjusted odds ratios and 95% confidence intervals (CI) of 1.0 (ref.), 0.9 (CI=0.7-1.3), 0.8 (CI=0.6-1.2), 1.0 (CI=0.7-1.3), 1.0 (CI=0.7-1.4), respectively, in increasing quintiles. Similarly, there was no clear association between performance on the DSST and BLL after accounting for all covariates. Our findings add to the inconsistent evidence regarding the association between concurrent BLLs and cognitive function in older adults. Early-life or long-term, accumulated lead exposures may be etiologically more relevant to accelerated cognitive decline at older age. PMID:21093481

  19. Pain Reports by Older Hospice Cancer Patients and Family Caregivers: The Role of Cognitive Functioning

    PubMed Central

    Allen, Rebecca S.; Haley, William E.; Small, Brent J.; McMillan, Susan C.

    2009-01-01

    Purpose Prior research in nursing homes has shown that cognitive impairment may reduce self-reported pain, but this relation has not been systematically explored among hospice patients. The assessment and treatment of pain is a primary goal of hospice care, and both disease processes and the use of opioid analgesics may lead to cognitive impairment among hospice patients. However, little is known about how cognitive functioning may impact the self-report of pain or the report of care recipient pain by family caregivers. Design and Methods We explored the associations between pain, cognitive functioning, and gender among cancer patients and their family caregivers (N = 176 dyads) during in-home hospice care. This was a cross-sectional, correlational study. Results Contrary to expectation, care recipients with cognitive impairment reported more intense pain than care recipients with intact cognitive functioning. However, cognitive impairment among care recipients had no impact on the pain report of family caregivers. Care recipient cognitive impairment was related to greater discrepancy in the pain reports of caregivers and care recipients. No gender differences in pain intensity report were found. Implications Measurement issues and implications for assessing self-reported pain among hospice cancer patients with impaired cognitive functioning and the report of care recipient pain by family caregivers are discussed. Specifically, hospice staff must educate family caregivers regarding the potential impact of care recipient cognitive impairment on pain reports in order to facilitate accurate pain assessment and management. PMID:12145378

  20. Life Experience and Demographic Influences on Cognitive Function in Older Adults

    PubMed Central

    Brewster, Paul W. H.; Melrose, Rebecca J.; Marquine, María J.; Johnson, Julene K.; Napoles, Anna; MacKay-Brandt, Anna; Farias, Sarah; Reed, Bruce; Mungas, Dan

    2014-01-01

    Objective We examined the influence of a broad spectrum of life experiences on longitudinal cognitive trajectories in a demographically diverse sample of older adults. Method Participants were 333 educationally, ethnically, and cognitively diverse older adults enrolled in a longitudinal aging study. Mixed-effects regression was used to measure baseline status in episodic memory, executive functioning, and semantic memory and change in a global cognition factor defined by change in these three domain-specific measures. We examined effects of life experience variables (literacy, childhood socioeconomic status, morphometric measures of physical development, life course physical and recreational activity) on longitudinal cognitive trajectories, covarying for age, APOE genotype and demographics (education, ethnicity, language). Results Non-Latino whites had higher baseline cognition, but life experience variables attenuated ethnic differences in cognitive scores. Age, literacy, childhood socioeconomic status and physical activity significantly influenced baseline cognition. Age, APOE ε4 and decline in intellectually and socially stimulating recreational activity from mid to late life were independently associated with increased late life cognitive decline. Higher literacy and late life recreational activity were associated with less decline. Literacy had similar effects for English and Spanish readers/speakers. Bilingual English and Spanish speakers did not differ from English Speakers in cognitive performance. Conclusions Life experience variables, especially literacy level, were strongly related to baseline cognition and substantially attenuated effects of race/ethnicity and education. Cognitive change was best explained by age, APOE ε4, literacy, and current recreational activities. Literacy had robust associations with baseline cognition and cognitive change in both English and Spanish speakers. PMID:24933483

  1. Cognitive Behavioral Therapy for Insomnia in Older Adults

    ERIC Educational Resources Information Center

    Belanger, Lynda; LeBlanc, Melanie; Morin, Charles M.

    2012-01-01

    Insomnia is associated with significant morbidity and is often a persistent problem, particularly in older adults. It is important to attend to this complaint and not assume that it will remit spontaneously. In many cases, unfortunately, insomnia remains unrecognized and untreated, often because it is presumed that insomnia is an inevitable…

  2. Global coherence in younger and older adults: Influence of cognitive processes and discourse type.

    PubMed

    Wright, Heather Harris; Koutsoftas, Anthony D; Capilouto, Gilson J; Fergadiotis, Gerasimos

    2014-01-01

    The purpose of the present research was to examine the influence of cognitive processes on discourse global coherence ability measured across different discourse tasks and collected from younger (n = 40; 20-39 years) and older (n = 40; 70-87 years) cognitively healthy adults. Study participants produced oral language samples in response to five commonly used discourse elicitation tasks and they were analyzed for maintenance of global coherence. Participants also completed memory and attention measures. Group differences on the global coherence scale were found for only one type of discourse-recounts. Across discourse elicitation tasks the lowest global coherence scores were found for recounts compared to the other discourse elicitation tasks. The influence of cognitive processes on maintenance of global coherence differed for the two age groups. For the younger group, there were no observed significant relationships. For the older group, cognitive measures were related to global coherence of stories and procedures. PMID:23656430

  3. Mindfulness-based cognitive therapy with older adults: an exploratory study.

    PubMed

    Foulk, Mariko A; Ingersoll-Dayton, Berit; Kavanagh, Janet; Robinson, Elizabeth; Kales, Helen C

    2014-01-01

    An 8-week mindfulness-based cognitive therapy (MBCT) group for older adults with depression and/or anxiety is described. This article is based on an exploratory study of this therapeutic approach and changes in participants' symptoms associated with participation. Pre-post data from 5 MBCT groups showed significant improvements in reported anxiety, ruminative thoughts, and sleep problems and a reduction in depressive symptoms. Case examples are presented to illustrate these symptom changes. Findings showed that this nonpharmacological intervention is acceptable to older adults and is associated with positive changes. Suggestions are provided for both practitioners and researchers interested in using MBCT with older adults. PMID:24329497

  4. Cumulative Exposure to Lead in Relation to Cognitive Function in Older Women

    PubMed Central

    Weuve, Jennifer; Korrick, Susan A.; Weisskopf, Marc A.; Ryan, Louise M.; Schwartz, Joel; Nie, Huiling; Grodstein, Francine; Hu, Howard

    2009-01-01

    Background Recent data indicate that chronic low-level exposure to lead is associated with accelerated declines in cognition in older age, but this has not been examined in women. Objective We examined biomarkers of lead exposure in relation to performance on a battery of cognitive tests among older women. Methods Patella and tibia bone lead—measures of cumulative exposure over many years—and blood lead, a measure of recent exposure, were assessed in 587 women 47–74 years of age. We assessed their cognitive function 5 years later using validated telephone interviews. Results Mean ± SD lead levels in tibia, patella, and blood were 10.5 ± 9.7 μg/g bone, 12.6 ± 11.6 μg/g bone, and 2.9 ± 1.9 μg/dL, respectively, consistent with community-level exposures. In multivariable-adjusted analyses of all cognitive tests combined, levels of all three lead biomarkers were associated with worse cognitive performance. The association between bone lead and letter fluency score differed dramatically from the other bone lead-cognitive score associations, and exclusion of this particular score from the combined analyses strengthened the associations between bone lead and cognitive performance. Results were statistically significant only for tibia lead: one SD increase in tibia lead corresponded to a 0.051-unit lower standardized summary cognitive score (95% confidence interval: −0.099 to −0.003; p = 0.04), similar to the difference in cognitive scores we observed between women who were 3 years apart in age. Conclusions These findings suggest that cumulative exposure to lead, even at low levels experienced in community settings, may have adverse consequences for women’s cognition in older age. PMID:19440496

  5. Computerized Cognitive Training in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis of Effect Modifiers

    PubMed Central

    Lampit, Amit; Hallock, Harry; Valenzuela, Michael

    2014-01-01

    Background New effective interventions to attenuate age-related cognitive decline are a global priority. Computerized cognitive training (CCT) is believed to be safe and can be inexpensive, but neither its efficacy in enhancing cognitive performance in healthy older adults nor the impact of design factors on such efficacy has been systematically analyzed. Our aim therefore was to quantitatively assess whether CCT programs can enhance cognition in healthy older adults, discriminate responsive from nonresponsive cognitive domains, and identify the most salient design factors. Methods and Findings We systematically searched Medline, Embase, and PsycINFO for relevant studies from the databases' inception to 9 July 2014. Eligible studies were randomized controlled trials investigating the effects of ≥4 h of CCT on performance in neuropsychological tests in older adults without dementia or other cognitive impairment. Fifty-two studies encompassing 4,885 participants were eligible. Intervention designs varied considerably, but after removal of one outlier, heterogeneity across studies was small (I2 = 29.92%). There was no systematic evidence of publication bias. The overall effect size (Hedges' g, random effects model) for CCT versus control was small and statistically significant, g = 0.22 (95% CI 0.15 to 0.29). Small to moderate effect sizes were found for nonverbal memory, g = 0.24 (95% CI 0.09 to 0.38); verbal memory, g = 0.08 (95% CI 0.01 to 0.15); working memory (WM), g = 0.22 (95% CI 0.09 to 0.35); processing speed, g = 0.31 (95% CI 0.11 to 0.50); and visuospatial skills, g = 0.30 (95% CI 0.07 to 0.54). No significant effects were found for executive functions and attention. Moderator analyses revealed that home-based administration was ineffective compared to group-based training, and that more than three training sessions per week was ineffective versus three or fewer. There was no evidence for the effectiveness of WM training, and

  6. Association of cognition with temporal discounting in community based older persons

    PubMed Central

    2012-01-01

    Background The objective of this study was to test the hypothesis that cognitive function is negatively associated with temporal discounting in old age. Methods Participants were 388 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging in the Chicago metropolitan area. Temporal discounting was measured using standard questions in which participants were asked to choose between an immediate, smaller payment and a delayed, larger one. Cognition was measured using a detailed battery including 19 tests. The association between cognition and temporal discounting was examined via mixed models adjusted for age, sex, education, income, and the number of chronic medical conditions. Results Descriptive data revealed a consistent pattern whereby older persons with lower cognitive function were more likely to discount greater but delayed rewards compared to those with higher cognitive function. Further, in a mixed effect model adjusted for age, sex, education, income, and chronic medical conditions, global cognitive function was negatively associated with temporal discounting (estimate = −0.45, SE = 0.18, p = 0.015), such that a person with lower cognition exhibited greater discounting. Finally, in subsequent models examining domain specific associations, perceptual speed and visuospatial abilities were associated with temporal discounting, but episodic memory, semantic memory and working memory were not. Conclusion Among older persons without dementia, a lower level of cognitive function is associated with greater temporal discounting. These findings have implications regarding the ability of older persons to make decisions that involve delayed rewards but maximize well-being. PMID:22938391

  7. Vitamin D, cognitive dysfunction and dementia in older adults.

    PubMed

    Dickens, Andy P; Lang, Iain A; Langa, Kenneth M; Kos, Katarina; Llewellyn, David J

    2011-08-01

    The physiologically active form of vitamin D, 1,25-dihydroxyvitamin D(3), is a fat-soluble steroid hormone with a well established role in skeletal health. A growing body of evidence suggests low vitamin D levels also play a role in the pathogenesis of a wide range of non-skeletal, age-associated diseases including cancer, heart disease, type 2 diabetes mellitus and stroke. Low levels of serum 25-hydroxyvitamin D [25(OH)D], a stable marker of vitamin D status, are also associated with increased odds of prevalent cognitive dysfunction, Alzheimer's disease and all-cause dementia in a number of studies, raising the possibility that vitamin D plays a role in the aetiology of cognitive dysfunction and dementia. To date, the majority of human studies reporting associations between vitamin D and cognition or dementia have been cross-sectional or case-control designs that do not permit us to exclude the possibility that such associations are a result of disease progression rather than being causal. Animal and in vitro experiments have identified a number of neuroprotective mechanisms that might link vitamin D status to cognitive dysfunction and dementia, including vasoprotection and amyloid phagocytosis and clearance, but the clinical relevance of these mechanisms in humans is not currently clear. Two recent, large, prospective studies go some way to establish the temporal relationship with cognitive decline. The relative risk of cognitive decline was 60% higher (relative risk = 1.6, 95% CI 1.2, 2.0) in elderly Italian adults with severely deficient 25(OH)D levels (<25 nmol/L) when compared with those with sufficient levels (≥75 nmol/L). Similarly, the odds of cognitive decline were 41% higher (odds ratio = 1.4, 95% CI 0.9, 2.2) when elderly US men in the lowest quartile (≤49.7 nmol/L) were compared with those in the highest quartile (≥74.4 nmol/L). To our knowledge, no prospective studies have examined the association between 25(OH)D levels and

  8. Trajectories of cognitive decline and functional status in the frail older adults.

    PubMed

    Nikolova, Rossitza; Demers, Louise; Béland, François

    2009-01-01

    This study investigates the implications of different levels of cognitive decline on functional status in frail older adults. Four cognitive trajectories, including two with catastrophic cognitive decline, were defined in a 3-year study. Participants with complete cognitive and functional status data at baseline, 12 and 36 months of follow-up were included in the study (n=456). Data were analysed with repeated measures statistics. Substantial functional deterioration over time was observed for the participants with catastrophic cognitive decline. Catastrophic cognitive decline influenced performance in instrumental activities of daily living (IADL) and activities of daily living (ADL) at 12 months, whereas basic physical and mental actions were affected at 36 months. IADL were found to deteriorate more than ADL. The results have implications on planning appropriate geriatric rehabilitation and long-term care program. PMID:17976840

  9. Does the Cambridge Automated Neuropsychological Test Battery (CANTAB) Distinguish Between Cognitive Domains in Healthy Older Adults?

    PubMed

    Lenehan, Megan E; Summers, Mathew J; Saunders, Nichole L; Summers, Jeffery J; Vickers, James C

    2016-04-01

    The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a semiautomated computer interface for assessing cognitive function. We examined whether CANTAB tests measured specific cognitive functions, using established neuropsychological tests as a reference point. A sample of 500 healthy older (M = 60.28 years, SD = 6.75) participants in the Tasmanian Healthy Brain Project completed battery of CANTAB subtests and standard paper-based neuropsychological tests. Confirmatory factor analysis identified four factors: processing speed, verbal ability, episodic memory, and working memory. However, CANTAB tests did not consistently load onto the cognitive domain factors derived from traditional measures of the same function. These results indicate that five of the six CANTAB subtests examined did not load onto single cognitive functions. These CANTAB tests may lack the sensitivity to measure discrete cognitive functions in healthy populations or may measure other cognitive domains not included in the traditional neuropsychological battery. PMID:25882162

  10. Homocysteine and inflammation: predictors of cognitive decline in older persons?

    PubMed

    van den Kommer, T N; Dik, M G; Comijs, H C; Jonker, C; Deeg, D J H

    2010-10-01

    The aim of the current study was to examine the association between homocysteine and 6-year cognitive decline, and the modifying role of the inflammatory markers Interleukin-6 (IL-6), C-reactive protein (CRP) and alpha-1-antichymotrypsin (ACT). Data were collected within the Longitudinal Aging Study Amsterdam (ages >or=65 years) and analyzed using multiple longitudinal regression models (N=1257 of whom N=1076 had longitudinal data). Cognition was measured with the Mini-Mental State Examination (general cognition), Auditory Verbal Learning Test (memory), Coding Task (information processing speed) and Raven Coloured Progressive Matrices (fluid intelligence). Higher homocysteine at baseline was negatively associated with prolonged lower cognitive functioning and a faster rate of decline in information processing speed and fluid intelligence. The negative association between higher homocysteine and immediate recall was strongest in persons with a high level of IL-6. Only in the highest tertile of CRP, higher homocysteine was negatively associated with retention. In the middle tertile of ACT, higher homocysteine was associated with lower information processing speed and faster decline. Both in the lower and middle tertile of CRP, higher homocysteine was associated with a faster rate of decline in information processing speed. The results implicate that a combination of both risk factors may be used as a marker for cognitive impairment. PMID:19004529

  11. Dietary fat types and 4-year cognitive change in community-dwelling older women

    PubMed Central

    Okereke, Olivia I.; Rosner, Bernard A.; Kim, Dae H.; Kang, Jae H.; Cook, Nancy R.; Manson, JoAnn E.; Buring, Julie E.; Willett, Walter C.; Grodstein, Francine

    2012-01-01

    Objective To relate dietary fat types to cognitive change in healthy community-based elders. Methods Among 6,183 older participants in the Women’s Health Study, we related intake of major fatty acids (FAs) (saturated [SFA], mono-unsaturated [MUFA], total poly-unsaturated [PUFA], trans-unsaturated) to late-life cognitive trajectory. Serial cognitive testing, conducted over 4 years, began 5 years post-dietary assessment. Primary outcomes were global cognition (averaging tests of general cognition, verbal memory and semantic fluency) and verbal memory (averaging tests of recall). We used analyses of response profiles and logistic regression to estimate multivariable-adjusted differences in cognitive trajectory and risk of worst cognitive change (worst 10%) by fat intake. Results Higher SFA intake was associated with worse global cognitive (p-linear-trend=0.008) and verbal memory (p-linear-trend=0.01) trajectories. There was a higher risk of worst cognitive change, comparing highest vs. lowest SFA quintiles: the multivariable-adjusted odds ratio (OR) (95% confidence interval, CI) was 1.64 (1.04,2.58) for global cognition and 1.65 (1.04,2.61) for verbal memory. By contrast, higher MUFA intake was related to better global cognitive (p-linear-trend<0.001) and verbal memory (p-linear-trend=0.009) trajectories, and lower OR (95% CI) of worst cognitive change in global cognition (0.52 [0.31,0.88]) and verbal memory (0.56 [0.34,0.94]). Total fat, PUFA, and trans fat intakes were not associated with cognitive trajectory. Interpretation Higher SFA intake was associated with worse global cognitive and verbal memory trajectories, while higher MUFA intake was related to better trajectories. Thus, different consumption levels of the major specific fat types, rather than total fat intake itself, appeared to influence cognitive aging. PMID:22605573

  12. Concurrent and Longitudinal Relationships Between Cognitive Activity, Cognitive Performance, and Brain Volume in Older Adult Women

    PubMed Central

    Erickson, Kirk I.; Espeland, Mark A.; Smith, J. Carson; Tindle, Hilary A.; Rapp, Stephen R.

    2014-01-01

    Objectives. We investigated (a) cross-sectional associations between cognitive activity, cognitive performance, and MRI measures and (b) longitudinal associations between cognitive activity and change in cognitive performance, using structural equation modeling (SEM). Method. Women’s Health Initiative Memory Study (WHIMS) Extension participants who continued annual neuropsychological assessments by telephone and completed a concurrent questionnaire of cognitive activities and MRI scans were included (mean age = 81.4 years; N = 393). Cognitive performance was measured by tests of attention, working memory, verbal fluency, executive function, and memory. Cognitive activity was measured by self-reported participation in a variety of cognitive activities (e.g., reading books, playing games, computer activities; N = 11 items) during the previous 12 months. MRI measures included gray and white matter normal and white matter lesion volumes. Results. SEM demonstrated a significant association between cognitive activity and baseline cognitive performance but not change over 2–3 years. Gray and white matter was associated with cognitive performance but not cognitive activity. All effects remained significant after modeling covariates (age, education, depressive symptoms, WHIMS intervention assignment, and intracranial volume). Conclusions. Cognitive activity benefits current cognitive performance but is not associated with change over 2–3 years. Cognitive activity and MRI volumes are independently associated with cognitive performance, suggesting distinct cognitive and brain reserve constructs. PMID:25209372

  13. Sleep and Cognition in Community-Dwelling Older Adults: A Review of Literature

    PubMed Central

    Brewster, Glenna S.; Varrasse, Miranda; Rowe, Meredeth

    2015-01-01

    Changes in sleep and cognition occur with advancing age. While both may occur independently of each other, it is possible that alterations in sleep parameters may increase the risk of age-related cognitive changes. This review aimed to understand the relationship between sleep parameters (sleep latency, wake after sleep onset, sleep efficiency, sleep duration, general sleep complaints) and cognition in community-dwelling adults aged 60 years and older without sleep disorders. Systematic, computer-aided searches were conducted using multiple sleep and cognition-related search terms in PubMed, PsycINFO, and CINAHL. Twenty-nine manuscripts met the inclusion criteria. Results suggest an inconsistent relationship between sleep parameters and cognition in older adults and modifiers such as depressive symptoms, undiagnosed sleep apnea and other medical conditions may influence their association. Measures of sleep and cognition were heterogeneous. Future studies should aim to further clarify the association between sleep parameters and cognitive domains by simultaneously using both objective and subjective measures of sleep parameters. Identifying which sleep parameters to target may lead to the development of novel targets for interventions and reduce the risk of cognitive changes with aging. PMID:27066397

  14. Sleep and Cognition in Community-Dwelling Older Adults: A Review of Literature.

    PubMed

    Brewster, Glenna S; Varrasse, Miranda; Rowe, Meredeth

    2015-12-01

    Changes in sleep and cognition occur with advancing age. While both may occur independently of each other, it is possible that alterations in sleep parameters may increase the risk of age-related cognitive changes. This review aimed to understand the relationship between sleep parameters (sleep latency, wake after sleep onset, sleep efficiency, sleep duration, general sleep complaints) and cognition in community-dwelling adults aged 60 years and older without sleep disorders. Systematic, computer-aided searches were conducted using multiple sleep and cognition-related search terms in PubMed, PsycINFO, and CINAHL. Twenty-nine manuscripts met the inclusion criteria. Results suggest an inconsistent relationship between sleep parameters and cognition in older adults and modifiers such as depressive symptoms, undiagnosed sleep apnea and other medical conditions may influence their association. Measures of sleep and cognition were heterogeneous. Future studies should aim to further clarify the association between sleep parameters and cognitive domains by simultaneously using both objective and subjective measures of sleep parameters. Identifying which sleep parameters to target may lead to the development of novel targets for interventions and reduce the risk of cognitive changes with aging. PMID:27066397

  15. Sex on the brain! Associations between sexual activity and cognitive function in older age

    PubMed Central

    Wright, Hayley; Jenks, Rebecca A.

    2016-01-01

    Background: the relationship between cognition and sexual activity in healthy older adults is under-researched. A limited amount of research in this area has shown that sexual activity is associated with better cognition in older men. The current study explores the possible mediating factors in this association in men and women, and attempts to provide an explanation in terms of physiological influences on cognitive function. Methods: using newly available data from Wave 6 of the English Longitudinal Study of Ageing, the current study explored associations between sexual activity and cognition in adults aged 50–89 (n = 6,833). Two different tests of cognitive function were analysed: number sequencing, which broadly relates to executive function, and word recall, which broadly relates to memory. Results: after adjusting for age, education, wealth, physical activity, depression, cohabiting, self-rated health, loneliness and quality of life, there were significant associations between sexual activity and number sequencing and recall in men. However, in women there was a significant association between sexual activity and recall, but not number sequencing. Conclusions: possible mediators of these associations (e.g. neurotransmitters) are discussed. The cross-sectional nature of the analysis is limiting, but provides a promising avenue for future explorations and longitudinal studies. The findings have implications for the promotion of sexual counselling in healthcare settings, where maintaining a healthy sex life in older age could be instrumental in improving cognitive function and well-being. PMID:26826237

  16. The role of auditory abilities in basic mechanisms of cognition in older adults

    PubMed Central

    Grassi, Massimo; Borella, Erika

    2013-01-01

    The aim of this study was to assess age-related differences between young and older adults in auditory abilities and to investigate the relationship between auditory abilities and basic mechanisms of cognition in older adults. Although there is a certain consensus that the participant’s sensitivity to the absolute intensity of sounds (such as that measured via pure tone audiometry) explains his/her cognitive performance, there is not yet much evidence that the participant’s auditory ability (i.e., the whole supra-threshold processing of sounds) explains his/her cognitive performance. Twenty-eight young adults (age <35), 26 young–old adults (65 í age í 75), and 28 old–old adults (age >75) were presented with a set of tasks estimating several auditory abilities (i.e., frequency discrimination, intensity discrimination, duration discrimination, timbre discrimination, gap detection, amplitude modulation detection, and the absolute threshold for a 1 kHz pure tone) and the participant’s working memory, cognitive inhibition, and processing speed. Results showed an age-related decline in both auditory and cognitive performance. Moreover, regression analyses showed that a subset of the auditory abilities (i.e., the ability to discriminate frequency, duration, timbre, and the ability to detect amplitude modulation) explained a significant part of the variance observed in the processing speed of older adults. Overall, the present results highlight the relationship between auditory abilities and basic mechanisms of cognition. PMID:24115932

  17. Lifestyle engagement affects cognitive status differences and trajectories on executive functions in older adults.

    PubMed

    de Frias, Cindy M; Dixon, Roger A

    2014-02-01

    The authors first examined the concurrent moderating role of lifestyle engagement on the relation between cognitive status (cognitively elite, cognitively normal [CN], and cognitively impaired [CI]) and executive functioning (EF) in older adults. Second, the authors examined whether baseline participation in lifestyle activities predicted differential 4.5-year stabilities and transitions in cognitive status. Participants (initial N = 501; 53-90 years) were from the Victoria Longitudinal Study. EF was represented by a 1-factor structure. Lifestyle activities were measured in multiple domains of engagement (e.g., cognitive, physical, and social). Two-wave status stability groups included sustained normal aging, transitional early impairment, and chronic impairment. Hierarchical regressions showed that baseline participation in social activities moderated cognitive status differences in EF. CI adults with high (but not low) social engagement performed equivalently to CN adults on EF. Longitudinally, logistic regressions showed that engagement in physical activities was a significant predictor of stability of cognitive status. CI adults who were more engaged in physical activities were more likely to improve in their cognitive status over time than their more sedentary peers. Participation in cognitive activities was a significant predictor of maintenance in a higher cognitive status group. Given that lifestyle engagement plays a detectable role in healthy, normal, and impaired neuropsychological aging, further research in activity-related associations and interventions is recommended. PMID:24323561

  18. Physical Activity and Cognitive Function in Older Adults: The Mediating Effect of Depressive Symptoms.

    PubMed

    Vance, David E; Marson, Daniel C; Triebel, Kristen L; Ball, Karlene K; Wadley, Virginia G; Cody, Shameka L

    2016-01-01

    Depressive symptoms and social networks may influence the relationship between physical activity and cognition. Using structural equation modeling, depressive symptoms and social networks were examined as mediators between physical activity and cognition in community-dwelling older adults (N = 122), with a range of cognitive abilities (e.g., normal, mild cognitive impairment). The model included age, physical activity, sedentary behavior, sleeping, social networks, depressive symptoms, and cognitive function. A path was observed between physical activity, depressive symptoms, and cognition; specifically, those who were more physically active experienced less depression and better cognitive functioning. No relationship between social networks and cognition was found. This model fits the data well (goodness-of-fit index = .93, adjusted goodness-of-fit index = .90, root mean square error of approximation = .06). Results suggest that physical activity may mitigate depressive symptoms, with beneficial effects on cognitive functioning in both those with and without mild cognitive impairment. Suggestions for managing depression and improving cognitive functioning are provided. PMID:27224681

  19. The interplay of subjective social status and essentialist beliefs about cognitive aging on cortisol reactivity to challenge in older adults.

    PubMed

    Weiss, David; Weiss, Mona

    2016-08-01

    Older adults are more likely than younger adults to experience stress when confronted with cognitive challenges. However, little is known about individual differences that might explain why some older adults exhibit stronger stress responses than others. We examined the interplay of two social-cognitive factors to explain older adults' cortisol reactivity: (1) subjective social status, and (2) essentialist beliefs about cognitive aging. We hypothesized that, depending on whether older adults believe that aging-related cognitive decline is inevitable versus modifiable, low subjective social status should lead to stronger or weaker cortisol reactivity. Using longitudinal data, we assessed the impact of cognitive challenges on stress reactivity in a sample of older adults (N = 389; 61-86 years). As predicted, regression analyses confirmed that 44 min after cognitively challenging tasks, older adults exhibited a significantly different cortisol reactivity depending on their subjective social status and their essentialist beliefs about cognitive aging. Specifically, older adults with low subjective social status and high essentialist beliefs showed a significantly elevated cortisol reactivity. We discuss the role of essentialist beliefs about cognitive aging to predict when and why high versus low subjective social status leads to stress responses in older adults. PMID:27159187

  20. Story Processing Ability in Cognitively Healthy Younger and Older Adults

    ERIC Educational Resources Information Center

    Wright, Heather Harris; Capilouto, Gilson J.; Srinivasan, Cidambi; Fergadiotis, Gerasimos

    2011-01-01

    Purpose: The purpose of the study was to examine the relationships among measures of comprehension and production for stories depicted in wordless pictures books and measures of memory and attention for 2 age groups. Method: Sixty cognitively healthy adults participated. They consisted of two groups--young adults (20-29 years of age) and older…

  1. Association of Lifetime Intellectual Enrichment with Cognitive Decline in the Older Population

    PubMed Central

    Vemuri, Prashanthi; Lesnick, Timothy G.; Przybelski, Scott A.; Machulda, Mary; Knopman, David S.; Mielke, Michelle M.; Roberts, Rosebud O.; Geda, Yonas E.; Rocca, Walter A.; Petersen, Ronald C.; Jack, Clifford R.

    2014-01-01

    IMPORTANCE Intellectual lifestyle enrichment throughout life is increasingly viewed as a protective strategy against commonly observed cognitive decline in the elderly. OBJECTIVE To investigate the association of lifetime intellectual enrichment with baseline cognitive performance and rate of cognitive decline in a non-demented elderly population and to estimate difference (in years) associated with lifetime intellectual enrichment to the onset of cognitive impairment. DESIGN, SETTING, PARTICIPANTS Prospective analysis of subjects enrolled in the Mayo Clinic Study of Aging (MCSA), a longitudinal population-based study of cognitive aging in Olmsted County, Minnesota. We studied 1995 non-demented (1718 cognitively normal, 277 MCI) participants in MCSA who completed intellectual lifestyle measures at baseline and underwent at least one follow-up visit. MAIN OUTCOMES AND MEASURES We studied the effect of lifetime intellectual enrichment by separating the variables into two non-overlapping principal components: education/occupation-score and mid/late-life cognitive activity measure based on self-report questionnaires. A global cognitive Z-score served as our summary cognition measure. We used linear mixed-effects models to investigate the associations of demographic and intellectual enrichment measures with global cognitive Z-score trajectories. RESULTS Baseline cognitive performance was lower in older subjects and in those with lower education/occupation, lower mid/late-life cognitive activity, apolipoprotein E4 (APOE) genotype, and in men. The interaction between the two intellectual enrichment measures was significant such that the beneficial effect of mid/late-life cognitive activity on baseline cognitive performance was reduced with increasing education/occupation. Only baseline age, mid/late-life cognitive activity, and APOE4 genotype were significantly associated with longitudinal change in cognitive performance from baseline. For APOE4 carriers with high

  2. Role of Place in Explaining Racial Heterogeneity in Cognitive Outcomes among Older Adults.

    PubMed

    Liu, Sze Yan; Glymour, M Maria; Zahodne, Laura B; Weiss, Christopher; Manly, Jennifer J

    2015-10-01

    Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We summarized the proportion of variation in outcomes attributable to state of school attendance and compared the magnitude of racial disparities across states. Among WHICAP African Americans, state of school attendance accounted for 9% of the variance in years of schooling, 6% of memory, and 12% of language. Among HRS African Americans, state of school attendance accounted for 13% of the variance in years of schooling and also contributed to variance in cognitive function (7%), memory (2%), and vocabulary (12%). Random slope models indicated state-level African American and white disparities in every Census region, with the largest racial differences in the South. State of school attendance may contribute to racial disparities in cognitive outcomes among older Americans. Despite tremendous within-state heterogeneity, state of school attendance also accounted for some variability in cognitive outcomes. Racial disparities in older Americans may reflect historical patterns of segregation and differential access to resources such as education. PMID:26412671

  3. Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds

    PubMed Central

    de Paula, Jonas J.; Diniz, Breno S.; Bicalho, Maria A.; Albuquerque, Maicon Rodrigues; Nicolato, Rodrigo; de Moraes, Edgar N.; Romano-Silva, Marco A.; Malloy-Diniz, Leandro F.

    2015-01-01

    Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer’s disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity. PMID:26257644

  4. Road Test and Naturalistic Driving Performance in Healthy and Cognitively Impaired Older Adults: Does Environment Matter?

    PubMed Central

    Davis, Jennifer D.; Papandonatos, George D.; Miller, Lindsay A.; Hewitt, Scott D.; Festa, Elena K.; Heindel, William C.; Ott, Brian R.

    2012-01-01

    Background/Objectives The road test is regarded as the gold standard for determining driving competence in older adults, but it is unclear how well the road test relates to naturalistic driving. The study objective was to relate the standardized road test to video recordings of naturalistic driving in older adults with a range of cognitive impairment. Design Cross-sectional observational study. Setting Academic medical center memory disorders clinic. Participants 103 older drivers (44 healthy and 59 with cognitive impairment) who passed a road test. Measurements Error rate and global ratings of safety (pass with and without recommendations, marginal with restrictions or training, or fail) made by a professional driving instructor. Results There was fair agreement between global ratings on the road test and naturalistic driving. More errors were detected in the naturalistic environment, but this did not impact global ratings. Error scores between settings were significantly correlated, and the types of errors made were similar. History of crashes corrected for miles driven per week was related to road test error scores, but not naturalistic driving error scores. Global cognition (MMSE) was correlated with both road test and naturalistic driving errors. In the healthy older adults, younger age was correlated with fewer errors on the road test and greater errors in naturalistic driving. Conclusion Road test performance is a reasonable proxy for estimating fitness to drive in older individuals’ typical driving environments. The differences between performance assessed by these two methods, however, remain poorly understood and deserve further study. PMID:23110378

  5. Exergames: neuroplastic hypothesis about cognitive improvement and biological effects on physical function of institutionalized older persons.

    PubMed

    Monteiro-Junior, Renato Sobral; Vaghetti, César Augusto Otero; Nascimento, Osvaldo José M; Laks, Jerson; Deslandes, Andrea Camaz

    2016-02-01

    Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were (1) to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and (2) to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed. PMID:27073355

  6. Exergames: neuroplastic hypothesis about cognitive improvement and biological effects on physical function of institutionalized older persons

    PubMed Central

    Monteiro-Junior, Renato Sobral; Vaghetti, César Augusto Otero; Nascimento, Osvaldo José M.; Laks, Jerson; Deslandes, Andrea Camaz

    2016-01-01

    Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were (1) to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and (2) to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed. PMID:27073355

  7. A Placebo-Controlled Test of Cognitive-Behavioral Therapy for Comorbid Insomnia in Older Adults

    ERIC Educational Resources Information Center

    Rybarczyk, Bruce; Stepanski, Edward; Fogg, Louis; Lopez, Martita; Barry, Paulette; Davis, Andrew

    2005-01-01

    The present study tested cognitive-behavioral therapy (CBT) for insomnia in older adults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW,…

  8. Languaging as Agent and Constituent of Cognitive Change in an Older Adult: An Example

    ERIC Educational Resources Information Center

    Swain, Merrill; Lapkin, Sharon

    2011-01-01

    Vygotsky's writings have established the critical importance of language in the development of higher mental functions, including memory and attention. One of the processes involved in this development is languaging, the activity of mediating cognitively complex ideas using language (Swain, 2006). The present study of an older adult with mild…

  9. The Effect of Art Therapy on Cognitive Performance among Ethnically Diverse Older Adults

    ERIC Educational Resources Information Center

    Pike, Amanda Alders

    2013-01-01

    This study examined the effect of art therapy on the cognitive performance of a multisite, ethnically diverse sample ("N" = 91) of older adults. Participants were recruited from several U.S. facilities that included a community center, a retirement center, an adult daycare, an assisted living facility, and a skilled nursing facility.…

  10. Gender Differences in Views about Cognitive Health and Healthy Lifestyle Behaviors among Rural Older Adults

    ERIC Educational Resources Information Center

    Wu, Bei; Goins, R. Turner; Laditka, James N.; Ignatenko, Valerie; Goedereis, Eric

    2009-01-01

    Purpose: Research suggests that men and women often differ in knowledge and beliefs about causes and treatments of a variety of diseases. This study examines gender differences in views about cognitive health and behaviors that have been associated with its maintenance, focusing on older adults living in rural areas. Design and Methods: We…

  11. Psychological and Cognitive Effects of an Exercise Program for Community-Residing Older Adults.

    ERIC Educational Resources Information Center

    Emery, Charles F.; Gatz, Margaret

    1990-01-01

    Examined effects of 12-week aerobic exercise program on psychological well-being and cognitive functioning in 48 urban older adults. Subjects were randomly assigned to aerobic group, social activity group, or waiting list group. Results indicated little change in psychological well-being and provided limited support for association of…

  12. Cognitive Therapy for Depression: A Comparison of Individual Psychotherapy and Bibliotherapy for Depressed Older Adults

    ERIC Educational Resources Information Center

    Floyd, Mark; Scogin, Forrest; McKendree-Smith, Nancy L.; Floyd, Donna L.; Rokke, Paul D.

    2004-01-01

    Thirty-one community-residing older adults age 60 or over either received 16 sessions of individual cognitive psychotherapy (Beck, Rush, Shaw, & Emery, 1979) or read Feeling Good (Burns, 1980) for bibliotherapy. Posttreatment comparisons with the delayed-treatment control indicated that both treatments were superior to a delayed-treatment control.…

  13. An Analysis and Evaluation of Research in Cognition and Learning among Older Adults.

    ERIC Educational Resources Information Center

    Wass, Hannelore; Olejnik, Stephen F.

    The research literature on aging was reviewed to determine findings with direct implications for educational programs for older persons and findings with no direct application but that raise further research questions. The focus was on cognition and learning in later life, predominantly on work published during the past two decades in major…

  14. Using the Natural Language Paradigm (NLP) to Increase Vocalizations of Older Adults with Cognitive Impairments

    ERIC Educational Resources Information Center

    LeBlanc, Linda A.; Geiger, Kaneen B.; Sautter, Rachael A.; Sidener, Tina M.

    2007-01-01

    The Natural Language Paradigm (NLP) has proven effective in increasing spontaneous verbalizations for children with autism. This study investigated the use of NLP with older adults with cognitive impairments served at a leisure-based adult day program for seniors. Three individuals with limited spontaneous use of functional language participated…

  15. Iconic Sign Comprehension in Older Adults: The Role of Cognitive Impairment and Text Enhancement

    ERIC Educational Resources Information Center

    Scialfa, Charles; Spadafora, Pat; Klein, Marianne; Lesnik, Agata; Dial, Lindsay; Heinrich, Antje

    2008-01-01

    Sign comprehension is critical for effective driving, responses to warnings, and way-finding. Signs that are poorly comprehended by older people increase accident risk and may compromise independence. This study sought to determine whether iconic sign comprehension suffers in healthy aging and in the presence of cognitive impairment. Additionally,…

  16. Lead exposure and rate of change in cognitive function in older women

    PubMed Central

    Power, Melinda C; Korrick, Susan; Tchetgen Tchetgen, Eric J; Nie, Linda H; Grodstein, Francine; Hu, Howard; Weuve, Jennifer; Schwartz, Joel; Weisskopf, Marc G

    2014-01-01

    Background Higher long-term cumulative lead exposure predicts faster cognitive decline in older men, but evidence of an association in women is lacking. Objective To determine if there is an association between lead exposure and cognitive decline in women. Methods This study considers a sample of 584 women from the Nurses’ Health Study who live in or near Boston, Massachusetts. We quantified lead exposure using biomarkers of lead exposure assessed in 1993–2004 and evaluated cognitive decline by repeated performance on a telephone battery of cognitive tests primarily assessing learning, memory, executive function, and attention completed in 1995–2008. All cognitive test scores were z-transformed for use in analyses. We used linear mixed models with random effects to quantify the association between each lead biomarker and change in cognition overall and on each individual test. Results Consideration of individual tests showed greater cognitive decline with increased tibia lead concentrations, a measure of long-term cumulative exposure, for story memory and category fluency. The estimated excess annual decline in overall cognitive test z-score per SD increase in tibia bone lead concentration was suggestive, although the confidence intervals included the null (0.024 standard units, 95% confidence interval: −0.053 , 0.004 – an additional decline in function equivalent to being 0.33 years older). We found little support for associations between cognitive decline and patella or blood lead, which provide integrated measures of exposure over shorter timeframes. Conclusions Long-term cumulative lead exposure may be weakly associated with faster cognitive decline in community-dwelling women, at least in some cognitive domains. PMID:24529005

  17. Impact of Cognitive Training on Balance and Gait in Older Adults

    PubMed Central

    Hughes, Susan L.; Prohaska, Thomas R.; Little, Deborah M.; Jurivich, Donald A.; Hedeker, Donald

    2015-01-01

    Objectives. Cognitive processing plays an important role in balance and gait and is a contributing factor to falls in older adults. This relationship may be explained by the fact that higher order cognitive functions such as executive functions are called upon while walking. The purpose of this study was to examine whether a cognitive training intervention leads to significant improvements on measures of balance and gait. Method. This randomized trial tested whether cognitive training over 10 weeks improves balance and gait in older adults. Participants were randomly assigned to a computer-based cognitive training intervention or measurement-only control. Outcomes included Timed Up and Go (TUG), gait speed, and gait speed with a cognitive distraction. Data were analyzed using analysis of covariance models with change scores. Results. Participants’ (N = 51) average age was 82.7 for those randomized to intervention and 81.1 for those randomized to control. After 10 weeks, intervention group participants performed significantly better than controls on the TUG. When the cohort was limited to those categorized as slow walkers (baseline 10-m walk ≥ 9 s), intervention participants performed significantly better than controls on TUG and distracted walking. Discussion. Cognitive training slows degradation of balance and improves gait while distracted, rendering it a promising approach to falls prevention. PMID:24192586

  18. A dynamic auditory-cognitive system supports speech-in-noise perception in older adults

    PubMed Central

    Anderson, Samira; White-Schwoch, Travis; Parbery-Clark, Alexandra; Kraus, Nina

    2013-01-01

    Understanding speech in noise is one of the most complex activities encountered in everyday life, relying on peripheral hearing, central auditory processing, and cognition. These abilities decline with age, and so older adults are often frustrated by a reduced ability to communicate effectively in noisy environments. Many studies have examined these factors independently; in the last decade, however, the idea of the auditory-cognitive system has emerged, recognizing the need to consider the processing of complex sounds in the context of dynamic neural circuits. Here, we use structural equation modeling to evaluate interacting contributions of peripheral hearing, central processing, cognitive ability, and life experiences to understanding speech in noise. We recruited 120 older adults (ages 55 to 79) and evaluated their peripheral hearing status, cognitive skills, and central processing. We also collected demographic measures of life experiences, such as physical activity, intellectual engagement, and musical training. In our model, central processing and cognitive function predicted a significant proportion of variance in the ability to understand speech in noise. To a lesser extent, life experience predicted hearing-in-noise ability through modulation of brainstem function. Peripheral hearing levels did not significantly contribute to the model. Previous musical experience modulated the relative contributions of cognitive ability and lifestyle factors to hearing in noise. Our models demonstrate the complex interactions required to hear in noise and the importance of targeting cognitive function, lifestyle, and central auditory processing in the management of individuals who are having difficulty hearing in noise. PMID:23541911

  19. Cognitive functioning differentially predicts different dimensions of older drivers’ on-road safety

    PubMed Central

    Aksan, Nazan; Anderson, Steve W; Dawson, Jeffrey; Uc, Ergun; Rizzo, Matthew

    2015-01-01

    The extent to which deficits in specific cognitive domains contribute to older drivers’ safety risk in complex real-world driving tasks is not well understood. We selected 148 drivers older than 70 years of age both with and without neurodegenerative diseases (Alzheimer disease-AD and Parkinson disease-PD) from an existing driving database of older adults. Participant assessments included on-road driving safety and cognitive functioning in visuospatial construction, speed of processing, memory, and executive functioning. The standardized on-road drive test was designed to examine multiple facets of older driver safety including navigation performance (e.g. following a route, identifying landmarks), safety errors while concurrently performing secondary navigation tasks (“on-task” safety errors), and safety errors in the absence of any secondary navigation tasks (“baseline” safety errors). The inter-correlations of these outcome measures were fair to moderate supporting their distinctiveness. Participants with diseases performed worse than the healthy aging group on all driving measures, and differences between those with AD and PD were minimal. In multivariate analyses, different domains of cognitive functioning predicted distinct facets of driver safety on road. Memory and set-shifting predicted performance in navigation-related secondary tasks, speed of processing predicted on-task safety errors, and visuospatial construction predicted baseline safety errors. These findings support broad assessments of cognitive functioning to inform decisions regarding older driver safety on the road and suggest navigation performance may be useful in evaluating older driver fitness and restrictions in licensing. PMID:25525974

  20. Vitamin K status and cognitive function in healthy older adults.

    PubMed

    Presse, Nancy; Belleville, Sylvie; Gaudreau, Pierrette; Greenwood, Carol E; Kergoat, Marie-Jeanne; Morais, Jose A; Payette, Hélène; Shatenstein, Bryna; Ferland, Guylaine

    2013-12-01

    Evidence is accumulating that vitamin K could have a role in cognition, especially in aging. Using data from the Québec Longitudinal Study on Nutrition and Successful Aging (NuAge), a cross-sectional analysis was conducted to examine the associations between vitamin K status, measured as serum phylloquinone concentrations, and performance in verbal and non-verbal episodic memory, executive functions, and speed of processing. The sample included 320 men and women aged 70 to 85 years who were free of cognitive impairment. After adjustment for covariates, higher serum phylloquinone concentration (log-transformed) was associated with better verbal episodic memory performances (F = 2.43, p = 0.048); specifically with the scores (Z-transformed) on the second (β = 0.47; 95% confidence interval [CI] = 0.13-0.82), third (β = 0.41; 95% CI = 0.06-0.75), and 20-minute delayed (β = 0.47; 95% CI = 0.12-0.82) free recall trials of the RL/RI-16 Free and Cued Recall Task. No associations were found with non-verbal episodic memory, executive functions, and speed of processing. Our study adds evidence to the possible role of vitamin K in cognition during aging, specifically in the consolidation of the memory trace. PMID:23850343

  1. Epidemiological investigation of muscle-strengthening activities and cognitive function among older adults.

    PubMed

    Loprinzi, Paul D

    2016-06-01

    Limited research has examined the association of muscle-strengthening activities and executive cognitive function among older adults, which was this study's purpose. Data from the 1999-2002 NHANES were employed (N = 2157; 60-85 years). Muscle-strengthening activities were assessed via self-report, with cognitive function assessed using the digit symbol substitution test. After adjusting for age, age-squared, gender, race-ethnicity, poverty level, body mass index, C-reactive protein, smoking, comorbid illness and physical activity, muscle-strengthening activities were significantly associated with cognitive function (βadjusted = 3.4; 95% CI: 1.7-5.1; P < 0.001). Compared to those not engaging in aerobic exercise and not meeting muscle-strengthening activity guidelines, those doing 1 (βadjusted = 3.7; 95% CI: 1.9-5.4; P < 0.001) and both (βadjusted = 6.6; 95% CI: 4.8-8.3; P < 0.001) of these behaviors had a significantly higher executive cognitive function score. In conclusion, muscle-strengthening activities are associated with executive cognitive function among older U.S. adults, underscoring the importance of promoting both aerobic exercise and muscle-strengthening activities to older adults. PMID:27048445

  2. Cognitive function is preserved in older adults with a reported history of childhood sexual abuse.

    PubMed

    Feeney, Joanne; Kamiya, Yumiko; Robertson, Ian H; Kenny, Rose Anne

    2013-12-01

    Childhood sexual abuse (CSA) is associated with mood and cognitive deficits in children and young adults. Evidence suggests that the effects of early-life adversity persist throughout adulthood; however, the impact of CSA on cognition in older adults is largely unknown. This study investigated cognitive function in older adults with a reported history of CSA. Data are from a population-based study (The Irish Longitudinal Study on Ageing) of 6,912 adults aged 50 years and older. Participants answered questions about CSA as part of a stressful life events questionnaire. Global cognition, executive function, memory (both objective and self-rated), attention, and processing speed were measured via a comprehensive battery of tests. Anxiety and depression, other childhood adversity, health behaviours, chronic disease, and medication use were also assessed. Of the total sample, 6.5% reported CSA. These individuals were more likely to have experienced other forms of childhood adversity and to exhibit poor mental health compared to those who reported no history of CSA. Multivariate regression analyses revealed, however, that CSA was associated with better global cognition, memory, executive function, and processing speed, despite poorer psychological health in this group. Future studies should aim to investigate possible reasons for this finding. PMID:24265204

  3. LONG-TERM INTAKE OF NUTS IN RELATION TO COGNITIVE FUNCTION IN OLDER WOMEN

    PubMed Central

    O’BRIEN, J.; OKEREKE, O.; DEVORE, E.; ROSNER, B.; BRETELER, M.; GRODSTEIN, F.

    2014-01-01

    Objective Nuts contain nutrients that may benefit brain health; thus, we examined long-term intake of nuts in relation to cognition in older women. Design Population-based prospective cohort study. Setting Academic research using data from the Nurses’ Health Study. Participants Nut intake was assessed in a food-frequency questionnaire beginning in1980, and approximately every four years thereafter. Between 1995–2001, 16,010 women age 70 or older (mean age = 74 years) without a history of stroke were administered 4 repeated telephone-based cognitive interviews over 6 years. Our final sample included 15,467 women who completed an initial cognitive interview and had complete information on nut intake. Main Outcome Measures The Telephone Interview for Cognitive Status (TICS), a global score averaging the results of all tests (TICS, immediate and delayed verbal recall, category fluency, and attention), and a verbal memory score averaging the results of tests of verbal recall. Results In multivariable-adjusted linear regression models, higher long-term total nut intake was associated with better average cognitive status for all cognitive outcomes. For the global composite score combining all tests, women consuming at least 5 servings of nuts/week had higher scores than non-consumers (mean difference=0.08 standard units, 95% confidence interval 0.00–0.15; p-trend=0.003). This mean difference of 0.08 is equivalent to the mean difference we find between women 2 years apart in age. Long-term intake of nuts was not associated with rates of cognitive decline. Conclusions Higher nut intake may be related to better overall cognition at older ages, and could be an easily-modifiable public health intervention. PMID:24886736

  4. Fitness's moderation of the facilitative effect of acute exercise on cognitive flexibility in older women.

    PubMed

    Netz, Yael; Argov, Esther; Inbar, Omri

    2009-04-01

    A recent study indicated that acute aerobic exercise improves cognitive flexibility in adults. The current study assessed age, habitual physical activity, and physical fitness as moderators of this improvement and examined whether the gains still exist an hour after the exercise session. The alternative-uses test, assessing cognitive flexibility, was administered individually to 20 older (age 63.67 +/- 3.55 yr) and 19 young (age 23.9 +/- 1.22) women before, immediately after, and an hour after a single moderate aerobic-exercise session. Results indicated significant improvement in cognitive flexibility in the older group immediately after the exercise but a decrease at the 1-hr follow-up. Further analysis indicated that physical fitness accounted for this improvement (R = -.622, p < .01). No such differences were observed in the young group. Further studies are needed to examine the duration of this effect, as well as the role of physical fitness as a moderator of it. PMID:19451665

  5. Differences in false recollection according to the cognitive reserve of healthy older people.

    PubMed

    Pitarque, Alfonso; Meléndez, Juan; Sales, Alicia; Mayordomo, Teresa; Escudero, Joaquín; Algarabel, Salvador

    2016-09-01

    We present an associative recognition experiment comparing three samples of healthy people (young people, older people with high cognitive reserve [HCR], and older people with low cognitive reserve [LCR], with each sample consisting of 40 people), manipulating stimuli repetition during the study phase. The results show significant differences among the three samples in their overall performance. However, these differences are not due to a different use of familiarity, but rather due to a different way of using recollection: although there are no differences in the hit rates between the HRC and LRC samples, the LCR group makes significantly more recollective false alarms than the HCR group. Moreover, repetition provokes an increase in the recollective false alarms in the LCR group, but this does not occur in the group of young people or in the HCR group. These findings are explained in terms of recollection-based monitoring errors and seem to provide support for the cognitive reserve hypothesis. PMID:26982550

  6. Intraindividual Variability in Psychometrically Defined Mild Cognitive Impairment Status in Older African Americans

    PubMed Central

    Gamaldo, Alyssa A.; Allaire, Jason C.; Whitfield, Keith E.

    2013-01-01

    The current study examines day to day variability in psychometrically defined MCI status and potential predictors of changes in MCI status in an independent-living sample of urban dwelling older adults in Baltimore, Maryland. The participant sample consisted of 50 older adults ranging in age from 50 to 80 years. Participants completed health and cognitive measures (i.e. executive function, language, memory, and global cognition) over 8 occasions within a 2–3 week period. After each testing occasion, a post-hoc classification of MCI status was determined using psychometrically defined criteria based upon cognitive performance. Participants who classified as MCI after one assessment often did not meet MCI criteria at subsequent occasions. Daily fluctuations in sleep duration were associated with an increased risk for MCI classification. These results demonstrate that changes in sleep may explain changes in MCI status, particularly for African Americans. PMID:22708537

  7. Changes in Cognitive Performance Are Associated with Changes in Sleep in Older Adults With Insomnia.

    PubMed

    Wilckens, Kristine A; Hall, Martica H; Nebes, Robert D; Monk, Timothy H; Buysse, Daniel J

    2016-01-01

    The present study examined sleep features associated with cognition in older adults and examined whether sleep changes following insomnia treatment were associated with cognitive improvements. Polysomnography and cognition (recall, working memory, and reasoning) were assessed before and after an insomnia intervention (Brief Behavioral Treatment of Insomnia [BBTI] or information control [IC]) in 77 older adults with insomnia. Baseline wake-after-sleep-onset (WASO) was associated with recall. Greater NREM (nonrapid eye movement) delta power and lower NREM sigma power were associated with greater working memory and reasoning. The insomnia intervention did not improve performance. However, increased absolute delta power and decreased relative sigma power were associated with improved reasoning. Findings suggest that improvements in executive function may occur with changes in NREM architecture. PMID:26322904

  8. Poor Aerobic Fitness May Contribute to Cognitive Decline in HIV-infected Older Adults.

    PubMed

    Mapstone, Mark; Hilton, Tiffany N; Yang, Hongmei; Guido, Joseph J; Luque, Amneris E; Hall, William J; Dewhurst, Stephen; Shah, Krupa

    2013-01-01

    The HIV-infected older adult (HOA) community is particularly vulnerable to cognitive impairment. Previous studies in the general older adult population have reported that lower scores on tests of cognitive function often correlate negatively with aerobic fitness [5-7]. HIV-infected individuals have significantly reduced aerobic fitness and physical function compared to HIV-uninfected individuals. Determining important correlates of cognitive ability may be beneficial in not only detecting precursors to future cognitive impairments, but also target areas for interventions. The purpose of this study was to investigate the relationship between cognitive ability and aerobic fitness in HIV-infected older adults. We conducted a cross-sectional study of HOA on antiretroviral therapy (ART) >50 years of age. Domain specific cognitive function was assessed by means of a neuropsychological battery. Aerobic fitness (VO2peak) was assessed using a graded, progressive treadmill test. Thirty-seven HOA on ART (mean±SD: age 59±6 years, BMI 28±5, CD4 663±337 cells/ml, duration since HIV diagnosis 17±7 years; 81% males) completed the cognitive tests. Several domains of cognition were significantly associated with VO2peak by Spearman correlation analysis (p<0.05). By step-wise adjusted regression VO2peak was most frequently and significantly related to many cognitive domains such as verbal and visual memory, visual perception, and language (p<0.05). We found that participants with higher Vo2peak were less likely to have more severe forms of HIV-associated neurocognitive disorders (HAND) such as mild neurocognitive disorder (OR=0.65; p=0.01) and HIV-associated dementia (OR=0.64; p=0.0006). In HOA and in conclusion, aerobic fitness is related to cognitive performance on various tasks. The likelihood of cognitive impairment increased with lower fitness levels. Therefore, increased fitness may serve an important factor in maintenance of cognition and neural integrity for aging HIV

  9. Relationship of metabolic and endocrine parameters to brain glucose metabolism in older adults: do cognitively-normal older adults have a particular metabolic phenotype?

    PubMed

    Nugent, S; Castellano, C A; Bocti, C; Dionne, I; Fulop, T; Cunnane, S C

    2016-02-01

    Our primary objective in this study was to quantify whole brain and regional cerebral metabolic rates of glucose (CMRg) in young and older adults in order to determine age-normalized reference CMRg values for healthy older adults with normal cognition for age. Our secondary objectives were to--(i) report a broader range of metabolic and endocrine parameters including body fat composition that could form the basis for the concept of a 'metabolic phenotype' in cognitively normal, older adults, and (ii) to assess whether medications commonly used to control blood lipids, blood pressure or thyroxine affect CMRg values in older adults. Cognition assessed by a battery of tests was normal for age and education in both groups. Compared to the young group (25 years old; n = 34), the older group (72 years old; n = 41) had ~14% lower CMRg (μmol/100 g/min) specifically in the frontal cortex, and 18% lower CMRg in the caudate. Lower grey matter volume and cortical thickness was widespread in the older group. These differences in CMRg, grey matter volume and cortical thickness were present in the absence of any known evidence for prodromal Alzheimer's disease (AD). Percent total body fat was positively correlated with CMRg in many brain regions but only in the older group. Before and after controlling for body fat, HOMA2-IR was significantly positively correlated to CMRg in several brain regions in the older group. These data show that compared to a healthy younger adult, the metabolic phenotype of a cognitively-normal 72 year old person includes similar plasma glucose, insulin, cholesterol, triglycerides and TSH, higher hemoglobin A1c and percent body fat, lower CMRg in the superior frontal cortex and caudate, but the same CMRg in the hippocampus and white matter. Age-normalization of cognitive test results is standard practice and we would suggest that regional CMRg in cognitively healthy older adults should also be age-normalized. PMID:26364049

  10. The brief cognitive assessment tool (BCAT): cross-validation in a community dwelling older adult sample.

    PubMed

    MacDougall, Elizabeth E; Mansbach, William E; Clark, Kristen; Mace, Ryan A

    2014-08-13

    ABSTRACT Background: Cognitive impairment is underrecognized and misdiagnosed among community-dwelling older adults. At present, there is no consensus about which cognitive screening tool represents the "gold standard." However, one tool that shows promise is the Brief Cognitive Assessment Tool (BCAT), which was originally validated in an assisted living sample and contains a multi-level memory component (e.g. word lists and story recall items) and complex executive functions features (e.g. judgment, set-shifting, and problem-solving). Methods: The present study cross-validated the BCAT in a sample of 75 community-dwelling older adults. Participants completed a short battery of several individually administered cognitive tests, including the BCAT and the Montreal Cognitive Assessment (MoCA). Using a very conservative MoCA cut score of <26, the base rate of cognitive impairment in this sample was 35%. Results: Adequate internal consistency and strong evidence of construct validity were found. A receiver operating characteristic (ROC) curve was calculated from sensitivity and 1-specificity values for the classification of cognitively impaired versus cognitively unimpaired. The area under the ROC curve (AUC) for the BCAT was .90, p < 0.001, 95% CI [0.83, 0.97]. A BCAT cut-score of 45 (scores below 45 suggesting cognitive impairment) resulted in the best balance between sensitivity (0.81) and specificity (0.80). Conclusions: A BCAT cut-score can be used for identifying persons to be referred to appropriate healthcare professionals for more comprehensive cognitive assessment. In addition, guidelines are provided for clinicians to interpret separate BCAT memory and executive dysfunction component scores. PMID:25115580

  11. Clustering Home Activity Distributions for Automatic Detection of Mild Cognitive Impairment in Older Adults1

    PubMed Central

    Akl, Ahmad; Chikhaoui, Belkacem; Mattek, Nora; Kaye, Jeffrey; Austin, Daniel; Mihailidis, Alex

    2016-01-01

    The public health implications of growing numbers of older adults at risk for dementia places pressure on identifying dementia at its earliest stages so as to develop proactive management plans. The prodromal dementia phase commonly identified as mild cognitive impairment is an important target for this early detection of impending dementia amenable to treatment. In this paper, we propose a method for home-based automatic detection of mild cognitive impairment in older adults through continuous monitoring via unobtrusive sensing technologies. Our method is composed of two main stages: a training stage and a test stage. For training, room activity distributions are estimated for each subject using a time frame of ω weeks, and then affinity propagation is employed to cluster the activity distributions and to extract exemplars to represent the different emerging clusters. For testing, room activity distributions belonging to a test subject with unknown cognitive status are compared to the extracted exemplars and get assigned the labels of the exemplars that result in the smallest normalized Kullbak–Leibler divergence. The labels of the activity distributions are then used to determine the cognitive status of the test subject. Using the sensor and clinical data pertaining to 85 homes with single occupants, we were able to automatically detect mild cognitive impairment in older adults with an F0.5 score of 0.856. Also, we were able to detect the non-amnestic sub-type of mild cognitive impairment in older adults with an F0.5 score of 0.958.

  12. Blood Glucose, Diet-Based Glycemic Load and Cognitive Aging Among Dementia-Free Older Adults

    PubMed Central

    Andel, Ross; McEvoy, Cathy; Dahl Aslan, Anna K.; Finkel, Deborah; Pedersen, Nancy L.

    2015-01-01

    Background. Although evidence indicates that Type II Diabetes is related to abnormal brain aging, the influence of elevated blood glucose on long-term cognitive change is unclear. In addition, the relationship between diet-based glycemic load and cognitive aging has not been extensively studied. The focus of this study was to investigate the influence of diet-based glycemic load and blood glucose on cognitive aging in older adults followed for up to 16 years. Methods. Eight-hundred and thirty-eight cognitively healthy adults aged ≥50 years (M = 63.1, SD = 8.3) from the Swedish Adoption/Twin Study of Aging were studied. Mixed effects growth models were utilized to assess overall performance and change in general cognitive functioning, perceptual speed, memory, verbal ability, and spatial ability as a function of baseline blood glucose and diet-based glycemic load. Results. High blood glucose was related to poorer overall performance on perceptual speed as well as greater rates of decline in general cognitive ability, perceptual speed, verbal ability, and spatial ability. Diet-based glycemic load was related to poorer overall performance in perceptual speed and spatial ability. Conclusion. Diet-based glycemic load and, in particular, elevated blood glucose appear important for cognitive performance/cognitive aging. Blood glucose control (perhaps through low glycemic load diets) may be an important target in the detection and prevention of age-related cognitive decline. PMID:25149688

  13. A consideration of cognitive factors in the learning and education of older adults

    NASA Astrophysics Data System (ADS)

    Fry, Prem S.

    1992-07-01

    The purpose of this paper is to consider the unique cognitive and intellectual factors that influence the learning and education of older adults. With this objective in mind, the paper reviews the empirical literature on patterns of intellectual and cognitive aging, and ends by discussing the implications and applications of these patterns for the practical and effective education of our elderly citizenry. When we consider the aging of intellectual abilities we are concerned with studying the development of fluid, crystallized and practical intelligence and variations in these abilities from adulthood into advanced old age. We are also concerned with looking at changes in cognitive functions such as attention, memory, information retrieval and tolerance for interference in learning capacity. Much recent work has been successful in showing that intellectual and cognitive decline in old age is not necessarily irreversible. While many elderly persons are very able learners, are highly self-directed, and have ample educational and intellectual resources available, others may benefit from assistance or suggestions about how to compensate for some of the cognitive declines in old age. With this objective the implications are discussed for educators and practitioners who must formulate cognitive training programs for older adults.

  14. Relationships between regional cerebellar volume and sensorimotor and cognitive function in young and older adults

    PubMed Central

    Bernard, Jessica A.; Seidler, Rachael D.

    2013-01-01

    The cerebellum has been implicated in both sensorimotor and cognitive function, but is known to undergo volumetric declines with advanced age. Individual differences in regional cerebellar volume may therefore provide insight into performance variability across the lifespan, as has been shown with other brain structures and behaviors. Here, we investigated whether there are regional age differences in cerebellar volume in young and older adults, and whether these volumes explain, in part, individual differences in sensorimotor and cognitive task performance. We found that older adults had smaller cerebellar volume than young adults; specifically, lobules in the anterior cerebellum were more impacted by age. Multiple regression analyses for both age groups revealed associations between sensorimotor task performance in several domains (balance, choice reaction time, and timing) and regional cerebellar volume. There were also relationships with working memory, but none with measures of general cognitive or executive function. Follow-up analyses revealed several differential relationships with age between regional volume and sensorimotor performance. These relationships were predominantly selective to cerebellar regions that have been implicated in cognitive functions. Therefore, it may be the cognitive aspects of sensorimotor task performance that are best explained by individual differences in regional cerebellar volumes. In sum, our results demonstrate the importance of regional cerebellar volume with respect to both sensorimotor and cognitive performance, and we provide additional insight into the role of the cerebellum in age-related performance declines. PMID:23625382

  15. Complexity As Key to Designing Cognitive-Friendly Environments for Older People

    PubMed Central

    Cassarino, Marica; Setti, Annalisa

    2016-01-01

    The lived environment is the arena where our cognitive skills, preferences, and attitudes come together to determine our ability to interact with the world. The mechanisms through which lived environments can benefit cognitive health in older age are yet to be fully understood. The existing literature suggests that environments which are perceived as stimulating, usable and aesthetically appealing can improve or facilitate cognitive performance both in young and older age. Importantly, optimal stimulation for cognition seems to depend on experiencing sufficiently stimulating environments while not too challenging. Environmental complexity is an important contributor to determining whether an environment provides such an optimal stimulation. The present paper reviews a selection of studies which have explored complexity in relation to perceptual load, environmental preference and perceived usability to propose a framework which explores direct and indirect environmental influences on cognition, and to understand these influences in relation to aging processes. We identify ways to define complexity at different environmental scales, going from micro low-level perceptual features of scenes, to design qualities of proximal environments (e.g., streets, neighborhoods), to broad geographical areas (i.e., natural vs. urban environments). We propose that studying complexity at these different scales will provide new insight into the design of cognitive-friendly environments. PMID:27625629

  16. Complexity As Key to Designing Cognitive-Friendly Environments for Older People.

    PubMed

    Cassarino, Marica; Setti, Annalisa

    2016-01-01

    The lived environment is the arena where our cognitive skills, preferences, and attitudes come together to determine our ability to interact with the world. The mechanisms through which lived environments can benefit cognitive health in older age are yet to be fully understood. The existing literature suggests that environments which are perceived as stimulating, usable and aesthetically appealing can improve or facilitate cognitive performance both in young and older age. Importantly, optimal stimulation for cognition seems to depend on experiencing sufficiently stimulating environments while not too challenging. Environmental complexity is an important contributor to determining whether an environment provides such an optimal stimulation. The present paper reviews a selection of studies which have explored complexity in relation to perceptual load, environmental preference and perceived usability to propose a framework which explores direct and indirect environmental influences on cognition, and to understand these influences in relation to aging processes. We identify ways to define complexity at different environmental scales, going from micro low-level perceptual features of scenes, to design qualities of proximal environments (e.g., streets, neighborhoods), to broad geographical areas (i.e., natural vs. urban environments). We propose that studying complexity at these different scales will provide new insight into the design of cognitive-friendly environments. PMID:27625629

  17. A New Comprehensive Educational Group Program for Older Adults with Cognitive Complaints: Background, Content, and Process Evaluation

    ERIC Educational Resources Information Center

    Hoogenhout, Esther M.; de Groot, Renate H. M.; Jolles, Jelle

    2011-01-01

    This paper presents a comprehensive group intervention for older adults with cognitive complaints. It offers psychoeducation about cognitive aging and contextual factors, focuses on skills and compensatory behavior, and incorporates group discussion. The intervention reduced negative emotional reactions towards cognitive functioning in a…

  18. Environmental heat exposure and cognitive performance in older adults: a controlled trial.

    PubMed

    Trezza, Beatriz Maria; Apolinario, Daniel; de Oliveira, Rafaela Sanchez; Busse, Alexandre Leopold; Gonçalves, Fábio Luiz Teixeira; Saldiva, Paulo Hilário Nascimento; Jacob-Filho, Wilson

    2015-06-01

    Thermal stress has a negative effect on the cognitive performance of military personnel and industry workers exposed to extreme environments. However, no studies have investigated the effects of environmental thermal stress on the cognitive functions of older adults. We carried out a controlled trial with 68 healthy older adults (mean age 73.3 years, 69 % female), each of whom has been assessed twice on the same day with selected tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Repeated sessions were conducted with air temperatures set at 24 °C and 32 °C in a balanced order. Our primary analyses did not show significant differences when comparing the cognitive performance of the total sample under the two experimental temperatures. However, interaction analysis has shown that humidity levels modify the effect of temperature on cognitive outcomes. The subgroup exposed to relative humidity greater than the median value (57.8 %) presented worse cognitive performance in the heat session when compared to the control session. Reported exercising frequency explained individual vulnerability to heat stress. Volunteers with lower levels of physical activity (<4 times per week) were more likely to present worsened cognitive performance under heat stress. In a fully adjusted linear regression model, the performance under heat stress remained associated with relative humidity (β = -0.21; p = 0.007) and frequency of exercising (β = 0.18; p = 0.020). Our results indicate that heat stress may have detrimental effects on the cognitive functioning of some subgroups of older adults and under particular circumstances. Further research is needed for exploring a variety of potentially influential factors. PMID:25916595

  19. Motor Variability during Sustained Contractions Increases with Cognitive Demand in Older Adults

    PubMed Central

    Vanden Noven, Marnie L.; Pereira, Hugo M.; Yoon, Tejin; Stevens, Alyssa A.; Nielson, Kristy A.; Hunter, Sandra K.

    2014-01-01

    To expose cortical involvement in age-related changes in motor performance, we compared steadiness (force fluctuations) and fatigability of submaximal isometric contractions with the ankle dorsiflexor muscles in older and young adults and with varying levels of cognitive demand imposed. Sixteen young (20.4 ± 2.1 year: 8 men, 9 women) and 17 older adults (68.8 ± 4.4 years: 9 men, 8 women) attended three sessions and performed a 40 s isometric contraction at 5% maximal voluntary contraction (MVC) force followed by an isometric contraction at 30% MVC until task failure. The cognitive demand required during the submaximal contractions in each session differed as follows: (1) high-cognitive demand session where difficult mental math was imposed (counting backward by 13 from a 4-digit number); (2) low-cognitive demand session which involved simple mental math (counting backward by 1); and (3) control session with no mental math. Anxiety was elevated during the high-cognitive demand session compared with other sessions for both age groups but more so for the older adults than young adults (p  < 0.05). Older adults had larger force fluctuations than young adults during: (1) the 5% MVC task as cognitive demand increased (p  = 0.007), and (2) the fatiguing contraction for all sessions (p  = 0.002). Time to task failure did not differ between sessions or age groups (p  > 0.05), but the variability between sessions (standard deviation of three sessions) was greater for older adults than young (2.02 ± 1.05 vs. 1.25 ± 0.51 min, p  < 0.05). Thus, variability in lower limb motor performance for low- and moderate-force isometric tasks increased with age and was exacerbated when cognitive demand was imposed, and may be related to modulation of synergist and antagonist muscles and an altered neural strategy with age originating from central sources. These data have significant implications for cognitively demanding low-force motor tasks

  20. Structural brain differences and cognitive functioning related to body mass index in older females.

    PubMed

    Walther, Katrin; Birdsill, Alex C; Glisky, Elizabeth L; Ryan, Lee

    2010-07-01

    Little is known about the effect of obesity on brain structures and cognition in healthy older adults. This study examined the association between body mass index (BMI), regional volume differences in gray and white matter measured by magnetic resonance imaging (MRI), and cognitive functioning in older females. Participants included 95 community-dwelling older females (ages 52-92 years) who underwent extensive neuropsychological testing and high-resolution MRI scanning. Optimized voxel-based morphometry techniques were employed to determine the correlation between BMI and regional gray and white matter volumes. Volumes of significant regions were then correlated with cognitive functioning. Higher BMI was associated with decreased gray matter volumes in the left orbitofrontal, right inferior frontal, and right precentral gyri, a right posterior region including the parahippocampal, fusiform, and lingual gyri, and right cerebellar regions, as well as increased volumes of white matter in the frontal, temporal, and parietal lobes, even when hypertension was considered. Compared to normal weight women, obese women performed poorer on tests of executive functioning. Smaller gray matter volume in the left orbitofrontal region was associated with lower executive functioning. Additionally, despite the lack of significant group differences in memory and visuomotor speed, gray and white matter volumes predicted performance on these measures. The results provide additional evidence for a negative link between increased body fat and brain functioning in older females. PMID:19998366

  1. Training Older Adults to Use Tablet Computers: Does It Enhance Cognitive Function?

    PubMed Central

    Chan, Micaela Y.; Haber, Sara; Drew, Linda M.; Park, Denise C.

    2016-01-01

    Purpose of the Study: Recent evidence shows that engaging in learning new skills improves episodic memory in older adults. In this study, older adults who were computer novices were trained to use a tablet computer and associated software applications. We hypothesize that sustained engagement in this mentally challenging training would yield a dual benefit of improved cognition and enhancement of everyday function by introducing useful skills. Design and Methods: A total of 54 older adults (age 60-90) committed 15 hr/week for 3 months. Eighteen participants received extensive iPad training, learning a broad range of practical applications. The iPad group was compared with 2 separate controls: a Placebo group that engaged in passive tasks requiring little new learning; and a Social group that had regular social interaction, but no active skill acquisition. All participants completed the same cognitive battery pre- and post-engagement. Results: Compared with both controls, the iPad group showed greater improvements in episodic memory and processing speed but did not differ in mental control or visuospatial processing. Implications: iPad training improved cognition relative to engaging in social or nonchallenging activities. Mastering relevant technological devices have the added advantage of providing older adults with technological skills useful in facilitating everyday activities (e.g., banking). This work informs the selection of targeted activities for future interventions and community programs. PMID:24928557

  2. Relation of DASH- and Mediterranean-like dietary patterns to cognitive decline in older persons

    PubMed Central

    Li, Hong; Wang, Yamin; Barnes, Lisa; Schneider, Julie A.; Bennett, David A.; Morris, Martha C.

    2014-01-01

    Objectives: We examined whether accordance to the DASH (Dietary Approach to Stop Hypertension) and Mediterranean diets is associated with slower cognitive decline in a prospective Chicago cohort study of older persons, the Memory and Aging Project. Methods: The sample comprised 826 Memory and Aging Project participants (aged 81.5 ± 7.1 years) who completed a 144-item food frequency questionnaire at baseline and 2 or more cognitive assessments over 4.1 years. Dietary scores were computed for accordance to the DASH diet (0–10) and the Mediterranean diet (MedDietScore) (0–55). For both, higher scores reflect greater accordance. Both patterns share at least 3 common food components. Cognitive function was assessed annually with 19 cognitive tests from which global cognitive scores and summary measures are computed. Results: The mean global cognitive score at baseline was 0.12 (range, −3.23 to 1.60) with an overall mean annual change in score of −0.08 standardized units. Only 13 participants had possible dementia. The mean DASH score was 4.1 (range, 1.0–8.5) and the MedDietScore was 31.3 (range, 18–46). In mixed models adjusted for covariates, a 1-unit difference in DASH score was associated with a slower rate of global cognitive decline by 0.007 standardized units (standard error of estimate = 0.003, p = 0.03). Similarly, a 1-unit-higher MedDietScore was associated with a slower rate of global cognitive decline by 0.002 standardized units (standard error of estimate = 0.001, p = 0.01). Conclusions: These findings support the hypothesis that both the DASH and Mediterranean diet patterns are associated with slower rates of cognitive decline in the same cohort of older persons. PMID:25230996

  3. Polygenic Risk of Schizophrenia and Cognition in a Population-Based Survey of Older Adults.

    PubMed

    Liebers, David T; Pirooznia, Mehdi; Seiffudin, Fayaz; Musliner, Katherine L; Zandi, Peter P; Goes, Fernando S

    2016-07-01

    Cognitive impairment is a common feature of the major psychotic disorders, with deficits often present in at risk individuals and unaffected first-degree relatives. Previous studies have suggested that polygenic risk scores (PRS) for schizophrenia (SCZ) are associated with cognitive deficits, but there has been little examination of this association in longitudinal datasets, or comparison with other disorders. We used mixed models to study the association between PRS for 4 adult onset psychiatric disorders with cross-sectional cognitive performance and longitudinal cognitive decline in 8616 older adults from the Health and Retirement Study (HRS), followed for an average of 10 years. PRS were computed for SCZ, bipolar disorder (BD), Major Depressive Disorder (MDD), and Alzheimer's disease (ALZ). SCZ PRS associated with decreased cognitive function (z = -3.00, P = .001, ΔR (2) = 0.04%), which was largely driven by an association with impaired attention and orientation (z = -3.33, P = 4.3×10(-4), ΔR (2) = 0.08%). We found no effect of BD or MDD PRS on cognition, in contrast to a robust effect of the APOE4/TOMM40 locus (z = -5.05, P = 2.2×10(-7), ΔR (2) = 0.36%), which was primarily associated with impaired verbal memory (z = -5.15, P = 1.3×10(-7), ΔR (2) = 0.21%). APOE4/TOMM40 locus and the ALZ PRS, but not the PRS for SCZ, were associated with greater cognitive decline. In summary, using a large, representative sample of older adults, we found evidence for different degrees of association between polygenic risk for SCZ and genetic risk factors for ALZ on cognitive function and decline, highlighting potential differences in the pathophysiology of cognitive deficits seen in SCZ and ALZ. PMID:26873889

  4. Psychometrically matched measures of global cognition, memory, and executive function for assessment of cognitive decline in older persons.

    PubMed

    Mungas, Dan; Reed, Bruce R; Kramer, Joel H

    2003-07-01

    Item response theory methods were used to derive psychometrically sophisticated measures of global cognition, memory, and executive function. Goals were that these measures (a) could be derived from commonly used neuropsychological tests, (b) would have linear measurement properties, and (c) would be psychometrically matched. Scale development was based on a sample of 400 older individuals with cognitive function ranging from normal to demented. Scales were reasonably matched with linear measurement over an ability range relevant to many important clinical applications. Cognitively normal, mild impairment, and dementia participant groups differed on baseline measures and rate of decline. Association of measures with quantitative structural magnetic resonance imaging variables followed expected patterns. This approach to scale development may have applications for other neuropsychological assessment problems. PMID:12959504

  5. Cortisol awakening response and cognitive performance in hypertensive and normotensive older people.

    PubMed

    Pulopulos, Matias M; Hidalgo, Vanesa; Puig-Perez, Sara; Salvador, Alicia

    2016-07-01

    Healthy older people with a cortisol awakening response (CAR) of decreased magnitude show worse frontal cortex-related cognitive performance. Systemic hypertension has been related to a CAR of decreased magnitude. Additionally, worse executive function and processing speed have been observed in older people with systemic hypertension. This is the first study to examine the relationship between the CAR (measured with six saliva samples at home on two consecutive weekdays) and cognitive performance, in both hypertensive (n=26) and normotensive (n=28) older people (from 56 to 78years old). Hypertensive participants showed lower morning cortisol secretion, and they also woke up earlier. No differences in CAR were observed. A CAR of decreased magnitude was related to worse executive function in both hypertensive and normotensive participants, but to slower processing speed only in normotensive participants. Being treated with antihypertensive for a longer period of time was related to a CAR of increased magnitude and better performance on executive function. Our findings suggest that earlier awakening time in hypertensive older people might underlie the lower overall morning cortisol secretion observed in previous studies. Additionally, this study confirms that a dysregulation of the CAR is related to worse executive function, and it extends this association to hypertensive older people. Finally, it is worth noting that hypertension may moderate the relationship between CAR and processing speed. PMID:27208824

  6. Objectively Measured Physical Activity is Related to Cognitive Function in Older Adults

    PubMed Central

    Kerr, Jacqueline; Marshall, Simon J.; Patterson, Ruth E.; Marinac, Catherine R.; Natarajan, Loki; Rosenberg, Dori; Wasilenko, Kari; Crist, Katie

    2013-01-01

    Background/Objectives To explore the relationship between cognitive functioning and the time spent at different intensities of physical activity (PA) in free-living older adults. Design, Setting Cross sectional analyses of participants enrolled in a randomized controlled trial set in continuing care retirement communities. Participants 215 older adults residing in 7 continuing care retirement communities in San Diego County: average age 83 years, 70% female and 35% with graduate level education. Measurements PA was measured objectively by hip worn accelerometers with data aggregated to the minute level. Three cut points were used to assess low-light, high-light, and moderate-to-vigorous intensity PA (MVPA). Trail Making Tests A and B were completed and time for each test (sec) and test B-minus- A time (sec) were used as measures of cognitive functioning. Variables were log transformed and entered into linear regression models adjusting for demographic factors (age, education, gender) and other PA intensity variables. Results Low-light PA was not related to any Trails test score. High-light PA was significantly related to Trails A, B and B-minus-A; but only in unadjusted models. MVPA was related to Trails B and B-minus-A after adjusting for demographic variables. Conclusion These data suggest there may be a dose response between PA intensity and cognitive functioning in older adults. The stronger findings supporting a relationship between MVPA and cognitive functioning are consistent with previous observational and intervention studies. PMID:24219194

  7. Neuropathological associates of multiple cognitive functions in two community-based cohorts of older adults.

    PubMed

    Dowling, N Maritza; Tomaszewski Farias, Sarah; Reed, Bruce R; Sonnen, Joshua A; Strauss, Milton E; Schneider, Julie A; Bennett, David A; Mungas, Dan

    2011-07-01

    Studies of neuropathology-cognition associations are not common and have been limited by small sample sizes, long intervals between autopsy and cognitive testing, and lack of breadth of neuropathology and cognition variables. This study examined domain-specific effects of common neuropathologies on cognition using data (N = 652) from two large cohort studies of older adults. We first identified dimensions of a battery of 17 neuropsychological tests, and regional measures of Alzheimer's disease (AD) neuropathology. We then evaluated how cognitive factors were related to dimensions of AD and additional measures of cerebrovascular and Lewy Body disease, and also examined independent effects of brain weight. All cognitive domains had multiple neuropathology determinants that differed by domain. Neocortical neurofibrillary tangles were the strongest predictors of most domains, while medial temporal tangles showed a weaker relationship with episodic memory. Neuritic plaques had relatively strong effects on multiple domains. Lewy bodies and macroscopic infarcts were associated with all domains, while microscopic infarcts had more limited associations. Brain weight was related to all domains independent of specific neuropathologies. Results show that cognition is complexly determined by multiple disease substrates. Neuropathological variables and brain weight contributed approximately a third to half of the explained variance in different cognitive domains. PMID:21092373

  8. Functional limitations in older adults who have cognitive impairment without dementia

    PubMed Central

    Gure, Tanya Ruff; Langa, Kenneth M.; Fisher, Gwenith G.; Piette, John D.; Plassman, Brenda L.

    2013-01-01

    OBJECTIVE Characterize the prevalence of functional limitations among older adults with cognitive impairment without dementia (CIND). METHODS Secondary data analysis was performed using the Aging, Demographics, and Memory Study (ADAMS) dataset. 856 individuals ≥ 71 years old were assigned to 3 diagnostic cognitive categories. A questionnaire was completed by a proxy informant regarding functional limitations for 744 of 856 respondents. RESULTS Of the 744 subjects, 263 (13.9%) had dementia, 201 (21.3%) had CIND, and 280 (64.8%) had normal cognition. Informants reported ≥ 1 IADL limitation in 45% of subjects with CIND compared to 13% of subjects with normal cognition and 85% of subjects with dementia (p < .001). The ADL impairments among individuals with CIND were primarily attributed to physical health problems (n=41; 40%). CONCLUSIONS Many individuals with CIND have impairment in a range of complex and basic daily activities, largely due to physical health problems. PMID:23559664

  9. Depressive Symptoms, Chronic Diseases, and Physical Disabilities as Predictors of Cognitive Functioning Trajectories in Older Americans

    PubMed Central

    Chodosh, Joshua; Miller-Martinez, Dana; Aneshensel, Carol S.; Wight, Richard G.; Karlamangla, Arun S.

    2010-01-01

    Objectives The concurrent influence of depressive symptoms, medical conditions, and disabilities in activities of daily living (ADL) upon the rates of decline in older Americans’ cognitive function is unknown. Design This study examined a national sample of 6,476 adults born before 1924 to determine differences in cognitive function trajectories by prevalence and incidence of depressive symptoms, chronic diseases, and ADL disabilities. Cognitive performance was tested 5 times between 1993 and 2002 with a multifaceted inventory that we examined as a global measure (range: 0–35, standard deviation (SD) 6.00) and with word recall (range: 0–20, SD 3.84) analyzed separately. Results Baseline prevalence of depressive symptoms, stroke, and ADL limitations were each independently and strongly associated with lower baseline cognition scores, but did not predict future cognitive decline. Each incident depressive symptom was independently associated with 0.06 point reduction (95% confidence interval (CI):0.02–0.10) in recall score, incident stroke with 0.59 point reduction in total score (95% CI:0.20–0.98), each new basic ADL limitation with 0.07 point (95% CI:0.01–0.14) reduction in recall score and 0.16 point reduction in total score (95% CI:0.07–0.25), and each incident instrumental ADL limitation with 0.20 point reduction in recall score (95% CI:0.10–0.30) and 0.52 point reduction in total score (95% CI:0.37–0.67). Conclusion Prevalent and incident depressive symptoms, stroke, and ADL disabilities contribute independently to reductions in cognitive functioning in older Americans, but do not appear to influence rates of future cognitive decline. Therefore, prevention, early identification, and aggressive treatment of these conditions may ameliorate the burdens of cognitive impairment. PMID:21087219

  10. Serum folate, vitamin B-12 and cognitive function in middle and older age: The HAPIEE study

    PubMed Central

    Horvat, Pia; Gardiner, Julian; Kubinova, Ruzena; Pajak, Andrzej; Tamosiunas, Abdonas; Schöttker, Ben; Pikhart, Hynek; Peasey, Anne; Jansen, Eugene; Bobak, Martin

    2016-01-01

    Background Nutrient status of B vitamins, particularly folate and vitamin B-12, may be related to cognitive ageing but epidemiological evidence remains inconclusive. Objective The aim of this study was to estimate the association of serum folate and vitamin B-12 concentrations with cognitive function in middle-aged and older adults from three Central and Eastern European populations. Methods Men and women aged 45–69 at baseline participating in the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study were recruited in Krakow (Poland), Kaunas (Lithuania) and six urban centres in the Czech Republic. Tests of immediate and delayed recall, verbal fluency and letter search were administered at baseline and repeated in 2006–2008. Serum concentrations of biomarkers at baseline were measured in a sub-sample of participants. Associations of vitamin quartiles with baseline (n = 4166) and follow-up (n = 2739) cognitive domain-specific z-scores were estimated using multiple linear regression. Results After adjusting for confounders, folate was positively associated with letter search and vitamin B-12 with word recall in cross-sectional analyses. In prospective analyses, participants in the highest quartile of folate had higher verbal fluency (p < 0.01) and immediate recall (p < 0.05) scores compared to those in the bottom quartile. In addition, participants in the highest quartile of vitamin B-12 had significantly higher verbal fluency scores (β = 0.12; 95% CI = 0.02, 0.21). Conclusions Folate and vitamin B-12 were positively associated with performance in some but not all cognitive domains in older Central and Eastern Europeans. These findings do not lend unequivocal support to potential importance of folate and vitamin B-12 status for cognitive function in older age. Long-term longitudinal studies and randomised trials are required before drawing conclusions on the role of these vitamins in cognitive decline. PMID:26808046

  11. Effects of Transcranial Alternating Current Stimulation on Cognitive Functions in Healthy Young and Older Adults.

    PubMed

    Antonenko, Daria; Faxel, Miriam; Grittner, Ulrike; Lavidor, Michal; Flöel, Agnes

    2016-01-01

    Recently, transcranial alternating current stimulation (tACS) has emerged as a tool to enhance human cognitive processes. Here, we provide a brief summary of the rationale behind tACS-induced effects on task-relevant brain oscillations and associated cognitive functions and review previous studies in young subjects that have applied tACS in cognitive paradigms. Additionally, we present pilot data where we administered theta-tACS (6 Hz) over the temporoparietal cortex and a supraorbital reference for 20 min during implicit language learning in healthy young (mean/SD age: 22/2) and older (mean/SD age: 66/4) adults, in a sham-controlled crossover design. Linear mixed models revealed significantly increased retrieval accuracy following tACS-accompanied associative learning, after controlling for session order and learning success. These data provide the first implementation of tACS during cognitive performance in older adults and support recent studies suggesting that tACS in the theta frequency range may serve as a tool to enhance cognition, possibly through direct modulation of task-relevant brain oscillations. So far, studies have been heterogeneous in their designs, leaving a number of issues to be addressed in future research, including the setup of electrodes and optimal stimulation frequencies to be employed, as well as the interaction with age and underlying brain pathologies in specific patient populations. PMID:27298740

  12. Effects of Transcranial Alternating Current Stimulation on Cognitive Functions in Healthy Young and Older Adults

    PubMed Central

    Antonenko, Daria; Faxel, Miriam; Grittner, Ulrike; Lavidor, Michal; Flöel, Agnes

    2016-01-01

    Recently, transcranial alternating current stimulation (tACS) has emerged as a tool to enhance human cognitive processes. Here, we provide a brief summary of the rationale behind tACS-induced effects on task-relevant brain oscillations and associated cognitive functions and review previous studies in young subjects that have applied tACS in cognitive paradigms. Additionally, we present pilot data where we administered theta-tACS (6 Hz) over the temporoparietal cortex and a supraorbital reference for 20 min during implicit language learning in healthy young (mean/SD age: 22/2) and older (mean/SD age: 66/4) adults, in a sham-controlled crossover design. Linear mixed models revealed significantly increased retrieval accuracy following tACS-accompanied associative learning, after controlling for session order and learning success. These data provide the first implementation of tACS during cognitive performance in older adults and support recent studies suggesting that tACS in the theta frequency range may serve as a tool to enhance cognition, possibly through direct modulation of task-relevant brain oscillations. So far, studies have been heterogeneous in their designs, leaving a number of issues to be addressed in future research, including the setup of electrodes and optimal stimulation frequencies to be employed, as well as the interaction with age and underlying brain pathologies in specific patient populations. PMID:27298740

  13. Socio-cognitive profiles for visual learning in young and older adults.

    PubMed

    Christian, Julie; Goldstone, Aimee; Kuai, Shu-Guang; Chin, Wynne; Abrams, Dominic; Kourtzi, Zoe

    2015-01-01

    It is common wisdom that practice makes perfect; but why do some adults learn better than others? Here, we investigate individuals' cognitive and social profiles to test which variables account for variability in learning ability across the lifespan. In particular, we focused on visual learning using tasks that test the ability to inhibit distractors and select task-relevant features. We tested the ability of young and older adults to improve through training in the discrimination of visual global forms embedded in a cluttered background. Further, we used a battery of cognitive tasks and psycho-social measures to examine which of these variables predict training-induced improvement in perceptual tasks and may account for individual variability in learning ability. Using partial least squares regression modeling, we show that visual learning is influenced by cognitive (i.e., cognitive inhibition, attention) and social (strategic and deep learning) factors rather than an individual's age alone. Further, our results show that independent of age, strong learners rely on cognitive factors such as attention, while weaker learners use more general cognitive strategies. Our findings suggest an important role for higher-cognitive circuits involving executive functions that contribute to our ability to improve in perceptual tasks after training across the lifespan. PMID:26113820

  14. Brain white matter damage in aging and cognitive ability in youth and older age.

    PubMed

    Valdés Hernández, Maria Del C; Booth, Tom; Murray, Catherine; Gow, Alan J; Penke, Lars; Morris, Zoe; Maniega, Susana Muñoz; Royle, Natalie A; Aribisala, Benjamin S; Bastin, Mark E; Starr, John M; Deary, Ian J; Wardlaw, Joanna M

    2013-12-01

    Cerebral white matter hyperintensities (WMH) reflect accumulating white matter damage with aging and impair cognition. The role of childhood intelligence is rarely considered in associations between cognitive impairment and WMH. We studied community-dwelling older people all born in 1936, in whom IQ had been assessed at age 11 years. We assessed medical histories, current cognitive ability and quantified WMH on MR imaging. Among 634 participants, mean age 72.7 (SD 0.7), age 11 IQ was the strongest predictor of late life cognitive ability. After accounting for age 11 IQ, greater WMH load was significantly associated with lower late life general cognitive ability (β = -0.14, p < 0.01) and processing speed (β = -0.19, p < 0.001). WMH were also associated independently with lower age 11 IQ (β = -0.08, p < 0.05) and hypertension. In conclusion, having more WMH is significantly associated with lower cognitive ability, after accounting for prior ability, age 11IQ. Early-life IQ also influenced WMH in later life. Determining how lower IQ in youth leads to increasing brain damage with aging is important for future successful cognitive aging. PMID:23850341

  15. Socio-cognitive profiles for visual learning in young and older adults

    PubMed Central

    Christian, Julie; Goldstone, Aimee; Kuai, Shu-Guang; Chin, Wynne; Abrams, Dominic; Kourtzi, Zoe

    2015-01-01

    It is common wisdom that practice makes perfect; but why do some adults learn better than others? Here, we investigate individuals’ cognitive and social profiles to test which variables account for variability in learning ability across the lifespan. In particular, we focused on visual learning using tasks that test the ability to inhibit distractors and select task-relevant features. We tested the ability of young and older adults to improve through training in the discrimination of visual global forms embedded in a cluttered background. Further, we used a battery of cognitive tasks and psycho-social measures to examine which of these variables predict training-induced improvement in perceptual tasks and may account for individual variability in learning ability. Using partial least squares regression modeling, we show that visual learning is influenced by cognitive (i.e., cognitive inhibition, attention) and social (strategic and deep learning) factors rather than an individual’s age alone. Further, our results show that independent of age, strong learners rely on cognitive factors such as attention, while weaker learners use more general cognitive strategies. Our findings suggest an important role for higher-cognitive circuits involving executive functions that contribute to our ability to improve in perceptual tasks after training across the lifespan. PMID:26113820

  16. Greater cortical thinning in normal older adults predicts later cognitive impairment.

    PubMed

    Pacheco, Jennifer; Goh, Joshua O; Kraut, Michael A; Ferrucci, Luigi; Resnick, Susan M

    2015-02-01

    Cross-sectional studies have shown regional differences in cortical thickness between healthy older adults and patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI). We now demonstrate that participants who subsequently develop cognitive impairment leading to a diagnosis of MCI or AD (n = 25) experience greater cortical thinning in specific neuroanatomic regions compared with control participants who remained cognitively normal (n = 96). Based on 8 years of annual magnetic resonance imaging scans beginning an average of 11 years before onset of cognitive impairment, participants who developed cognitive impairment subsequent to the scanning period had greater longitudinal cortical thinning in the temporal poles and left medial temporal lobe compared with controls. No significant regional cortical thickness differences were found at baseline between the 2 study groups indicating that we are capturing a critical time when brain changes occur before behavioral manifestations of impairment are detectable. Our findings suggest that early events of the pathway that leads to cognitive impairment may involve the temporal lobe and that this increased atrophy could be considered an early biomarker of neurodegeneration predictive of cognitive impairment years later. PMID:25311277

  17. Cognitive-Behavioral Therapy for Depression in an Older Gay Man: A Clinical Case Study

    PubMed Central

    Satterfield, Jason M.; Crabb, Rebecca

    2012-01-01

    Although strong evidence supports cognitive-behavioral therapy for late-life depression and depression in racial and ethnic minorities, there are no empirical studies on the treatment of depression in older sexual minorities. Three distinct literatures were tapped to create a depression treatment protocol for an older gay male. Interventions were deduced from the late-life depression literature, culturally adapted CBT protocols for racial minorities, and the emerging social and developmental psychological theories for lesbian, gay, and bisexual populations. Specific treatment interventions, processes, and outcomes are described to illustrate how these literatures may be used to provide more culturally appropriate and effective health care for the growing, older sexual minority population. PMID:23144559

  18. Vulnerabilities in Older Patients when Cancer Treatment is Initiated: Does a Cognitive Impairment Impact the Two-Year Survival?

    PubMed Central

    Borghgraef, Cindy; Etienne, Anne-Marie; Merckaert, Isabelle; Paesmans, Marianne; Reynaert, Christine; Roos, Myriam; Slachmuylder, Jean-Louis; Vandenbossche, Sandrine; Bron, Dominique; Razavi, Darius

    2016-01-01

    Introduction Dementia is a known predictor of shorter survival times in older cancer patients. However, no empirical evidence is available to determine how much a cognitive impairment shortens survival in older patients when cancer treatment is initiated. Purpose To longitudinally investigate how much a cognitive impairment detected at the initiation of cancer treatment influences survival of older patients during a two-year follow-up duration and to compare the predictive value of a cognitive impairment on patients survival with the predictive value of other vulnerabilities associated with older age. Methods Three hundred and fifty-seven consecutive patients (≥65 years old) admitted for breast, prostate, or colorectal cancer surgeries were prospectively recruited. A cognitive impairment was assessed with the Montreal Cognitive Assessment (MoCA<26). Socio-demographic, disease-related, and geriatric vulnerabilities were assessed using validated tools. Univariate and subsequent multivariate Cox proportional hazards models stratified for diagnosis (breast/prostate cancer versus colorectal cancer) and disease status (metastatic versus non-metastatic) were used. Results A cognitive impairment was detected in 46% (n = 163) of patients. Survival was significantly influenced by a cognitive impairment (HR = 6.13; 95% confidence interval [CI] = 2.07–18.09; p = 0.001), a loss in instrumental autonomy (IADL ≤7) (HR = 3.06; 95% CI = 1.31–7.11; p = 0.009) and fatigue (Mob-T<5) (HR = 5.98; 95% CI = 2.47–14.44; p <0.001). Conclusions During the two years following cancer treatment initiation, older patients with a cognitive impairment were up to six times more likely to die than patients without. Older patients should be screened for cognitive impairments at cancer treatment initiation to enable interventions to reduce morbidity and mortality. Further studies should address processes underlying the relationship between cognitive impairments and an increased risk of dying

  19. Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline.

    PubMed

    Gooding, Amanda L; Choi, Jimmy; Fiszdon, Joanna M; Wilkins, Kirsten; Kirwin, Paul D; van Dyck, Christopher H; Devanand, Davangere; Bell, Morris D; Rivera Mindt, Monica

    2016-10-01

    Cognitive rehabilitation for mild cognitive impairment (MCI) and early Alzheimer's disease is readily available to the geriatric population. Initial evidence suggests that techniques incorporating motivational strategies to enhance treatment engagement may provide more benefit than computerised training alone. Seventy four adults with subclinical cognitive decline were randomly assigned to computerised cognitive training (CCT), Cognitive Vitality Training (CVT), or an Active Control Group (ACG), and underwent neuropsychological evaluations at baseline and four-month follow-up. Significant differences were found in changes in performance on the Modified Mini Mental State Examination (mMMSE) and measures of verbal learning and memory across treatment groups. Experimental groups showed greater preservation of functioning on the mMMSE than the ACG group, the CVT group performed better than the ACG group on one measure of verbal learning and both measures of verbal memory, and the CCT group performed better than the ACG group on one measure of verbal learning and one measure of verbal memory. There were no significant group differences between the CVT and CCT groups on measures of verbal learning or memory. It was concluded that computerised cognitive training may offer the most benefit when incorporated into a therapeutic milieu rather than administered alone, although both appear superior to more generic forms of cognitive stimulation. PMID:26674122

  20. Acculturation and depressive symptoms in latino caregivers of cognitively impaired older adults

    PubMed Central

    Meyer, Oanh L.; Geller, Sue; He, Emily; González, Hector M.; Hinton, Ladson

    2014-01-01

    Background Caregiving for older adults is a growing public health concern because of the negative psychological effects it has on caregivers. Despite the growing Latino caregiver population, little is known regarding how the effects of acculturation on caregiver depressive symptoms might vary by caregiver age. This study aimed to examine the relationship between language acculturation and depressive symptoms in Latino caregivers, and to test whether this relationship was moderated by age. Methods Ninety-four Latino caregivers of cognitively impaired older adults with and without dementia were identified through an ongoing epidemiological cohort study. Caregivers were interviewed in their homes, in either Spanish or English. A Poisson regression was used to analyze the caregiver characteristics associated with caregiver depressive symptoms. Results Language acculturation was positively associated with caregiver depressive symptoms, as was age, female gender, and being married or living with someone. Those with excellent or good health and who had spent more than one year caregiving had lower depressive symptoms. Finally, the positive relationship between language acculturation and depressive symptoms was increased in older caregivers. Conclusions Language acculturation appears to be a risk factor for depressive symptoms in Latino caregivers of cognitively impaired older adults. The relationship between language acculturation and depressive symptoms is complex such that caregiver age and health status further nuance this relationship. Future research should explore the independent and interactive effects of these variables on depressive symptoms. PMID:24717691

  1. Health Literacy, Cognitive Ability, and Functional Health Status among Older Adults

    PubMed Central

    Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S

    2014-01-01

    Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068

  2. Polygenic risk for coronary artery disease is associated with cognitive ability in older adults

    PubMed Central

    Hagenaars, Saskia P; Harris, Sarah E; Clarke, Toni-Kim; Hall, Lynsey; Luciano, Michelle; Fernandez-Pujals, Ana Maria; Davies, Gail; Hayward, Caroline; Starr, John M; Porteous, David J; McIntosh, Andrew M; Deary, Ian J

    2016-01-01

    Background: Coronary artery disease (CAD) is associated with cognitive decrements and risk of later dementia, but it is not known if shared genetic factors underlie this association. We tested whether polygenic risk for CAD was associated with cognitive ability in community-dwelling cohorts of middle-aged and older adults. Methods: Individuals from Generation Scotland: Scottish Family Health Study (GS:SFHS, N = 9865) and from the Lothian Birth Cohorts of 1921 (LBC1921, N = 517) and 1936 (LBC1936, N = 1005) provided cognitive data and genome-wide genotype data. Polygenic risk profile scores for CAD were calculated for all of the cohorts using the largest available genome-wide association studies (GWAS) data set, the CARDIoGRAM consortium (22 233 cases and 64 762 controls). Polygenic risk profile scores for CAD were then tested for their association with cognitive abilities in the presence and absence of manifest cardiovascular disease. Results: A meta-analysis of all three cohorts showed a negative association between CAD polygenic risk and fluid cognitive ability (β = −0.022, P = 0.016), verbal intelligence (β = −0.024, P = 0.011) and memory (β = −0.021, P = 0.028). Conclusions: Increased polygenic risk for CAD is associated with lower cognitive ability in older adults. Common genetic variants may underlie some of the association between age-related cognitive decrements and the risk for CAD. PMID:26822939

  3. Cognitive and perceptual responses during passive heat stress in younger and older adults.

    PubMed

    Schlader, Zachary J; Gagnon, Daniel; Adams, Amy; Rivas, Eric; Cullum, C Munro; Crandall, Craig G

    2015-05-15

    We tested the hypothesis that attention, memory, and executive function are impaired to a greater extent in passively heat-stressed older adults than in passively heat-stressed younger adults. In a randomized, crossover design, 15 older (age: 69 ± 5 yr) and 14 younger (age: 30 ± 4 yr) healthy subjects underwent passive heat stress and time control trials. Cognitive tests (outcomes: accuracy and reaction time) from the CANTAB battery evaluated attention [rapid visual processing (RVP), choice reaction time (CRT)], memory [spatial span (SSP), pattern recognition memory (PRM)], and executive function [one touch stockings of Cambridge (OTS)]. Testing was undertaken on two occasions during each trial, at baseline and after internal temperature had increased by 1.0 ± 0.2°C or after a time control period. For tests that measured attention, reaction time during RVP and CRT was slower (P ≤ 0.01) in the older group. During heat stress, RVP reaction time improved (P < 0.01) in both groups. Heat stress had no effect (P ≥ 0.09) on RVP or CRT accuracy in either group. For tests that measured memory, accuracy on SSP and PRM was lower (P < 0.01) in the older group, but there was no effect of heat stress (P ≥ 0.14). For tests that measured executive function, overall, accuracy on OTS was lower, and reaction time was slower in the older group (P ≤ 0.05). Reaction time generally improved during heat stress, but there was no effect of heat stress on accuracy in either group. These data indicate that moderate increases in body temperature during passive heat stress do not differentially compromise cognitive function in younger and older adults. PMID:25786484

  4. Cognitive and perceptual responses during passive heat stress in younger and older adults

    PubMed Central

    Schlader, Zachary J.; Gagnon, Daniel; Adams, Amy; Rivas, Eric; Cullum, C. Munro

    2015-01-01

    We tested the hypothesis that attention, memory, and executive function are impaired to a greater extent in passively heat-stressed older adults than in passively heat-stressed younger adults. In a randomized, crossover design, 15 older (age: 69 ± 5 yr) and 14 younger (age: 30 ± 4 yr) healthy subjects underwent passive heat stress and time control trials. Cognitive tests (outcomes: accuracy and reaction time) from the CANTAB battery evaluated attention [rapid visual processing (RVP), choice reaction time (CRT)], memory [spatial span (SSP), pattern recognition memory (PRM)], and executive function [one touch stockings of Cambridge (OTS)]. Testing was undertaken on two occasions during each trial, at baseline and after internal temperature had increased by 1.0 ± 0.2°C or after a time control period. For tests that measured attention, reaction time during RVP and CRT was slower (P ≤ 0.01) in the older group. During heat stress, RVP reaction time improved (P < 0.01) in both groups. Heat stress had no effect (P ≥ 0.09) on RVP or CRT accuracy in either group. For tests that measured memory, accuracy on SSP and PRM was lower (P < 0.01) in the older group, but there was no effect of heat stress (P ≥ 0.14). For tests that measured executive function, overall, accuracy on OTS was lower, and reaction time was slower in the older group (P ≤ 0.05). Reaction time generally improved during heat stress, but there was no effect of heat stress on accuracy in either group. These data indicate that moderate increases in body temperature during passive heat stress do not differentially compromise cognitive function in younger and older adults. PMID:25786484

  5. Cognitive Dysfunction Is Associated With Poor Diabetes Control in Older Adults

    PubMed Central

    Munshi, Medha; Capelson, Roberta; Grande, Laura; Lin, Susan; Hayes, Mellody; Milberg, William; Ayres, Darlene; Weinger, Katie; Suhl, Emmy

    2006-01-01

    OBJECTIVE To evaluate the association between cognitive dysfunction and other barriers and glycemic control in older adults with diabetes. RESEARCH DESIGN AND METHODS Patients over the age of 70 years presenting to a geriatric diabetes clinic were evaluated for barriers to successful diabetes management. Patients were screened for cognitive dysfunction with the Mini Mental State Examination (MMSE) and a clock-drawing test (CDT) scored by 1) a method validated by Mendez et al. and 2) a modified CDT (clock in a box [CIB]). Depression was evaluated with the Geriatric Depression Scale. Interview questionnaires surveyed activities of daily living (ADLs) and instrumental ADLs (IADLs), as well as other functional disabilities. RESULTS Sixty patients (age 79 ± 5 years, diabetes duration 14 ± 13 years) were evaluated. Thirty-four percent of patients had low CIB (≤5), and 38% of patients had low CDT (≤13). Both CIB as well as CDT were inversely correlated with HbA1c, suggesting that cognitive dysfunction is associated with poor glycemic control (r = −0.37, P < 0.004 and r = −0.38, P < 0.004, respectively). Thirty-three percent of patients had depressive symptoms with greater difficulty completing the tasks of the IADL survey (5.7 ± 1.7 vs. 4.6 ± 2.0; P < 0.03). These older adults with diabetes had a high incidence of functional disabilities, including hearing impairment (48%), vision impairment (53%), history of recent falls (33%), fear of falls (44%), and difficulty performing IADLs (39%). CONCLUSIONS Older adults with diabetes have a high risk of undiagnosed cognitive dysfunction, depression, and functional disabilities. Cognitive dysfunction in this population is associated with poor diabetes control. PMID:16873782

  6. Long-term Cognitive and Functional Effects of Potentially Inappropriate Medications in Older Women

    PubMed Central

    2014-01-01

    Background. The use of potentially inappropriate medications in older adults can lead to known adverse drug events, but long-term effects are less clear. We therefore conducted a prospective cohort study of older women to determine whether PIM use is associated with risk of functional impairment or low cognitive performance. Methods. We followed up 1,429 community-dwelling women (≥75 years) for a period of 5 years at four clinical sites in the United States. The primary predictor at baseline was PIM use based on 2003 Beers Criteria. We also assessed anticholinergic load using the Anticholinergic Cognitive Burden scale. Outcomes included scores on a battery of six cognitive tests at follow-up and having one or more incident impairments in instrumental activities of daily living. Regression models were adjusted for baseline age, race, education, smoking, physical activity, a modified Charlson Comorbidity Index, and cognitive score. Results. The mean ± SD age of women at baseline was 83.2 ± 3.3. In multivariate models, baseline PIM use and higher ACB scores were significantly associated with poorer performance in category fluency (PIM: p = .01; ACB: p = .02) and immediate (PIM: p = .04; ACB: p = .03) and delayed recall (PIM: p = .04). Both PIM use (odds ratio [OR]: 1.36 [1.05–1.75]) and higher ACB scores (OR: 1.11 [1.04–1.19]) were also strongly associated with incident functional impairment. Conclusions. The results provide suggestive evidence that PIM use and increased anticholinergic load may be associated with risk of functional impairment and low cognitive performance. More cautious selection of medications in older adults may reduce these potential risks. PMID:24293516

  7. Combined Cognitive Training vs. Memory Strategy Training in Healthy Older Adults

    PubMed Central

    Li, Bing; Zhu, Xinyi; Hou, Jianhua; Chen, Tingji; Wang, Pengyun; Li, Juan

    2016-01-01

    As mnemonic utilization deficit in older adults associates with age-related decline in executive function, we hypothesized that memory strategy training combined with executive function training might induce larger training effect in memory and broader training effects in non-memory outcomes than pure memory training. The present study compared the effects of combined cognitive training (executive function training plus memory strategy training) to pure memory strategy training. Forty healthy older adults were randomly assigned to a combined cognitive training group or a memory strategy training group. A control group receiving no training was also included. Combined cognitive training group received 16 sessions of training (eight sessions of executive function training followed by eight sessions of memory strategy training). Memory training group received 16 sessions of memory strategy training. The results partly supported our hypothesis in that indeed improved performance on executive function was only found in combined training group, whereas memory performance increased less in combined training compared to memory strategy group. Results suggest that combined cognitive training may be less efficient than pure memory training in memory outcomes, though the influences from insufficient training time and less closeness between trained executive function and working memory could not be excluded; however it has broader training effects in non-memory outcomes. Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR-OON-16007793. PMID:27375521

  8. Dietary Patterns Derived by Cluster Analysis are Associated with Cognitive Function among Korean Older Adults.

    PubMed

    Kim, Jihye; Yu, Areum; Choi, Bo Youl; Nam, Jung Hyun; Kim, Mi Kyung; Oh, Dong Hoon; Yang, Yoon Jung

    2015-06-01

    The objective of this study was to investigate major dietary patterns among older Korean adults through cluster analysis and to determine an association between dietary patterns and cognitive function. This is a cross-sectional study. The data from the Korean Multi-Rural Communities Cohort Study was used. Participants included 765 participants aged 60 years and over. A quantitative food frequency questionnaire with 106 items was used to investigate dietary intake. The Korean version of the MMSE-KC (Mini-Mental Status Examination-Korean version) was used to assess cognitive function. Two major dietary patterns were identified using K-means cluster analysis. The "MFDF" dietary pattern indicated high consumption of Multigrain rice, Fish, Dairy products, Fruits and fruit juices, while the "WNC" dietary pattern referred to higher intakes of White rice, Noodles, and Coffee. Means of the total MMSE-KC and orientation score of the participants in the MFDF dietary pattern were higher than those of the WNC dietary pattern. Compared with the WNC dietary pattern, the MFDF dietary pattern showed a lower risk of cognitive impairment after adjusting for covariates (OR 0.64, 95% CI 0.44-0.94). The MFDF dietary pattern, with high consumption of multigrain rice, fish, dairy products, and fruits may be related to better cognition among Korean older adults. PMID:26035243

  9. Cognitive Functioning and Driving Simulator Performance in Middle-aged and Older Adults with HIV

    PubMed Central

    Vance, David E.; Fazeli, Pariya L.; Ball, David A.; Slater, Larry Z.; Ross, Lesley A.

    2014-01-01

    Nearly half of people living with HIV experience cognitive deficits that may impact instrumental activities of daily living. As the number of people aging with HIV increases, concerns mount that disease-related cognitive deficits may be compounded by age-related deficits, which may further compromise everyday functions such as driving. In this cross-sectional pilot study, during a 2.5-hour visit, 26 middle-aged and older adults (40+ years) were administered demographic, health, psychosocial, and driving habits questionnaires; cognitive assessments; and driving simulator tests. Although CD4+T lymphocyte count and viral load were unrelated to driving performance, older age was related to poorer driving. Furthermore, poorer visual speed of processing performance (i.e., Useful Field of View) was related to poorer driving performance (e.g., average gross reaction time). Mixed findings were observed between driving performance and cognitive function on self-reported driving habits of participants. Implications for these findings on nursing practice and research are posited. PMID:24513104

  10. Racial bias in the assessment of cognitive functioning of older adults.

    PubMed

    Jones, R N

    2003-03-01

    This study was undertaken to determine if the difference in assessed cognition between Black/African-American and White older adults was due differential item functioning (DIF) and/or differences in the effect of background variables. Participants were 15257 adults aged 50 and older surveyed in the Study of Asset and Health Dynamics of the Oldest Old (AHEAD) and Health and Retirement Study (HRS). The cognitive measure was a modified telephone interview for cognitive status. The analytic strategy was a multiple group structural equation model grounded in item response theory. Results suggest that most (89%) of the group difference could be attributed to measurement or structural differences, the remainder being not significantly different from zero (p=0.193). Most items displayed racial DIF, accounting for most of the group difference. After controlling for DIF, the group difference that remained could be attributed to heterogeneity in the effect of background variables. For example, low education was more deleterious for Black/African-Americans, and high income conferred an advantage only for Whites. These findings underscore the importance of efforts to generate culture-fair measurement devices. However, culture-fair assessments may attenuate, but not eliminate, group differences in assessed cognition due to the incommensurate action of background variables PMID:12745387

  11. Dietary Patterns Derived by Cluster Analysis are Associated with Cognitive Function among Korean Older Adults

    PubMed Central

    Kim, Jihye; Yu, Areum; Choi, Bo Youl; Nam, Jung Hyun; Kim, Mi Kyung; Oh, Dong Hoon; Yang, Yoon Jung

    2015-01-01

    The objective of this study was to investigate major dietary patterns among older Korean adults through cluster analysis and to determine an association between dietary patterns and cognitive function. This is a cross-sectional study. The data from the Korean Multi-Rural Communities Cohort Study was used. Participants included 765 participants aged 60 years and over. A quantitative food frequency questionnaire with 106 items was used to investigate dietary intake. The Korean version of the MMSE-KC (Mini-Mental Status Examination–Korean version) was used to assess cognitive function. Two major dietary patterns were identified using K-means cluster analysis. The “MFDF” dietary pattern indicated high consumption of Multigrain rice, Fish, Dairy products, Fruits and fruit juices, while the “WNC” dietary pattern referred to higher intakes of White rice, Noodles, and Coffee. Means of the total MMSE-KC and orientation score of the participants in the MFDF dietary pattern were higher than those of the WNC dietary pattern. Compared with the WNC dietary pattern, the MFDF dietary pattern showed a lower risk of cognitive impairment after adjusting for covariates (OR 0.64, 95% CI 0.44–0.94). The MFDF dietary pattern, with high consumption of multigrain rice, fish, dairy products, and fruits may be related to better cognition among Korean older adults. PMID:26035243

  12. Testing Covariates of Type 2 Diabetes-Cognition Associations in Older Adults: Moderating or Mediating Effects?

    PubMed Central

    McFall, G. Peggy; Geall, Bonnie P.; Fischer, Ashley L.; Dolcos, Sanda; Dixon, Roger A.

    2010-01-01

    Objective The general goal of this study was to advance our understanding of Type 2 diabetes (T2D)-cognition relationships in older adults by linking and testing comprehensive sets of potential moderators, potential mediators, and multiple cognitive outcomes. Method We identified in the literature 13 health-related (but T2D-distal) potential covariates, representing four informal domains (i.e., biological vitality, personal affect, subjective health, lifestyle activities). Cross-sectional data from the Victoria Longitudinal Study (age range = 53-90 years; n = 41 T2D and n = 458 control participants) were used. We first examined whether any of the 13 potential covariates influenced T2D-cognition associations, as measured by a comprehensive neuropsychological battery (15 measures). Next, using standard regression-based moderator and mediator analyses, we systematically tested whether the identified covariates would significantly alter observed T2D-cognition relationships. Results Six potential covariates were found to be sensitive to T2D associations with performance on seven cognitive measures. Three factors (systolic blood pressure, gait-balance composite, subjective health) were significant mediators. Each mediated multiple cognitive outcomes, especially measures of neurocognitive speed, executive functioning, and episodic memory. Conclusions Our findings offer a relatively comprehensive perspective of T2D-related cognitive deficits, comorbidities, and modulating influences. The implications for future research reach across several fields of study and application. These include (a) neuropsychological research on neural and biological bases of T2D-related cognitive decline, (b) clinical research on intervention and treatment strategies, and (c) larger-scale longitudinal studies examining the potential multilateral and dynamic relationships among T2D status, related comorbidities, and cognitive outcomes. PMID:20804243

  13. Perceived Stress and Change in Cognitive Function Among Adults Aged 65 and Older

    PubMed Central

    Aggarwal, Neelum T.; Wilson, Robert S.; Beck, Todd L.; Rajan, Kumar B.; Mendes de Leon, Carlos F.; Evans, Denis A.; Everson-Rose, Susan A.

    2014-01-01

    Objective Exposure to acute and chronic stress can affect learning and memory but most evidence comes from animal studies or clinical observations. Almost no population-based studies have investigated the relation of stress to cognition or changes in cognition over time. We examined whether higher levels of perceived stress were associated with accelerated decline in cognitive function in older blacks and whites from a community-based population sample. Methods Participants included 6,207 black and white adults (65.7% black, 63.3% women) from the Chicago Health and Aging project. Two to five in-home assessments were completed over an average of 6.8 years of follow up, and included sociodemographics, health behaviors, psychosocial measures, cognitive function tests, and health history. Perceived stress was measured by a 6-item scale, and a composite measure of four tests of cognition was used to determine cognitive function at each assessment. Results Mixed effects regression models showed that increasing levels of perceived stress were related to lower initial cognitive scores (B=-0.0379, SE=0.0025, p<.001) and a faster rate of cognitive decline (stress × time interaction: B=-0.0015, SE=0.0004, p<.001). Results were similar after adjusting for demographic variables, smoking, systolic blood pressure, body mass index, chronic medical conditions, and psychosocial factors and did not vary by race, sex, age or education. Conclusion Increasing levels of stress are independently associated with accelerated declines in cognitive function in black and white adults aged 65 and above. PMID:24367123

  14. The influence of cognition on self-management of type 2 diabetes in older people.

    PubMed

    Tomlin, Ali; Sinclair, Alan

    2016-01-01

    Diabetes is a growing public health issue, increasing in prevalence, eroding quality of life, and burdening health care systems. The complications of diabetes can be avoided or delayed by maintaining good glycemic control, which is achievable through self-management and, where necessary, medication. Older people with diabetes are at increased risk for cognitive impairment. This review aims to bring together current research that has investigated both cognition and diabetes self-management together. The Cumulative Index to Nursing and Allied Health (Cinahl), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System (Medline), and Psychological Information (PsychInfo) databases were searched. Studies were included if they featured older people with type 2 diabetes and had looked for associations between at least one distinct measure of cognition and at least one distinct measure of diabetes self-management. English language publications from the year 2000 were included. Cognitive measures of executive function, memory, and low scores on tests of global cognitive functioning showed significant correlations with multiple areas of diabetes self-management, including diabetes-specific numeracy ability, diabetes knowledge, insulin adjustment skills, ability to learn to perform insulin injections, worse adherence to medications, decreased frequency of self-care activities, missed appointments, decreased frequency of diabetes monitoring, and increased inaccuracies in reporting blood glucose monitoring. The nature of the subjects studied was quite variable in terms of their disease duration, previous medical histories, associated medical comorbidities, and educational level attained prior to being diagnosed with diabetes. The majority of studies were of an associational nature and not findings confirmed by repeat testing or by the effects of an intervention, neither were the majority of studies designed to give a view or conclusion on the clinical

  15. The influence of cognition on self-management of type 2 diabetes in older people

    PubMed Central

    Tomlin, Ali; Sinclair, Alan

    2016-01-01

    Diabetes is a growing public health issue, increasing in prevalence, eroding quality of life, and burdening health care systems. The complications of diabetes can be avoided or delayed by maintaining good glycemic control, which is achievable through self-management and, where necessary, medication. Older people with diabetes are at increased risk for cognitive impairment. This review aims to bring together current research that has investigated both cognition and diabetes self-management together. The Cumulative Index to Nursing and Allied Health (Cinahl), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System (Medline), and Psychological Information (PsychInfo) databases were searched. Studies were included if they featured older people with type 2 diabetes and had looked for associations between at least one distinct measure of cognition and at least one distinct measure of diabetes self-management. English language publications from the year 2000 were included. Cognitive measures of executive function, memory, and low scores on tests of global cognitive functioning showed significant correlations with multiple areas of diabetes self-management, including diabetes-specific numeracy ability, diabetes knowledge, insulin adjustment skills, ability to learn to perform insulin injections, worse adherence to medications, decreased frequency of self-care activities, missed appointments, decreased frequency of diabetes monitoring, and increased inaccuracies in reporting blood glucose monitoring. The nature of the subjects studied was quite variable in terms of their disease duration, previous medical histories, associated medical comorbidities, and educational level attained prior to being diagnosed with diabetes. The majority of studies were of an associational nature and not findings confirmed by repeat testing or by the effects of an intervention, neither were the majority of studies designed to give a view or conclusion on the clinical

  16. A GROWTH CURVE MODEL OF LEARNING ACQUISITION AMONG COGNITIVELY NORMAL OLDER ADULTS

    PubMed Central

    Jones, Richard N.; Rosenberg, Adrienne L.; Morris, John N.; Allaire, Jason C.; McCoy, Karin J. M.; Marsiske, Michael; Kleinman, Ken P.; Rebok, George W.; Malloy, Paul F.

    2010-01-01

    The objective of this study was to model recall and learning on the Auditory Verbal Learning Test using latent growth curve techniques. Participants were older adults recruited for the ACTIVE cognitive intervention pilot. A series of nested models revealed that an approximately logarithmic growth curve model provided optimal fit to the data. Although recall and learning factors were statistically uncorrelated, a fitted multivariate model suggested that initial recall was significantly associated with demographic characteristics but unrelated to health factors and cognitive abilities. Individual differences in learning were related to race/ethnicity, speed of processing, verbal knowledge, and global cognitive function level. These results suggest that failing to recognize initial recall and learning as distinct constructs clouds the interpretation of supraspan memory tasks. PMID:16036723

  17. Dual-task and electrophysiological markers of executive cognitive processing in older adult gait and fall-risk

    PubMed Central

    Walshe, Elizabeth A.; Patterson, Matthew R.; Commins, Seán; Roche, Richard A. P.

    2015-01-01

    The role of cognition is becoming increasingly central to our understanding of the complexity of walking gait. In particular, higher-level executive functions are suggested to play a key role in gait and fall-risk, but the specific underlying neurocognitive processes remain unclear. Here, we report two experiments which investigated the cognitive and neural processes underlying older adult gait and falls. Experiment 1 employed a dual-task (DT) paradigm in young and older adults, to assess the relative effects of higher-level executive function tasks (n-Back, Serial Subtraction and visuo-spatial Clock task) in comparison to non-executive distracter tasks (motor response task and alphabet recitation) on gait. All DTs elicited changes in gait for both young and older adults, relative to baseline walking. Significantly greater DT costs were observed for the executive tasks in the older adult group. Experiment 2 compared normal walking gait, seated cognitive performances and concurrent event-related brain potentials (ERPs) in healthy young and older adults, to older adult fallers. No significant differences in cognitive performances were found between fallers and non-fallers. However, an initial late-positivity, considered a potential early P3a, was evident on the Stroop task for older non-fallers, which was notably absent in older fallers. We argue that executive control functions play a prominent role in walking and gait, but the use of neurocognitive processes as a predictor of fall-risk needs further investigation. PMID:25941481

  18. Different Context but Similar Cognitive Structures: Older Adults in Rural Bangladesh.

    PubMed

    Sternäng, Ola; Lövdén, Martin; Kabir, Zarina N; Hamadani, Jena D; Wahlin, Åke

    2016-06-01

    Most research in cognitive aging is based on literate participants from high-income and Western populations. The extent to which findings generalize to low-income and illiterate populations is unknown. The main aim was to examine the structure of between-person differences in cognitive functions among elderly from rural Bangladesh. We used data from the Poverty and Health in Aging (PHA) project in Bangladesh. The participants (n = 452) were in the age range 60-92 years. Structural equation modeling was used to estimate the fit of a five-factor model (episodic recall, episodic recognition, verbal fluency, semantic knowledge, processing speed) and to examine whether the model generalized across age, sex, and literacy. This study demonstrates that an established model of cognition is valid also among older persons from rural Bangladesh. The model demonstrated strong (or scalar) invariance for age, and partial strong invariance for sex and literacy. Semantic knowledge and processing speed showed weak (or metric) sex invariance, and semantic knowledge demonstrated also sensitivity to illiteracy. In general, women performed poorer on all abilities. The structure of individual cognitive differences established in Western populations also fits a population in rural Bangladesh well. This is an important prerequisite for comparisons of cognitive functioning (e.g., declarative memory) across cultures. It is also worth noting that absolute sex differences in cognitive performance among rural elderly in Bangladesh differ from those usually found in Western samples. PMID:26860478

  19. Fluid cognitive ability is a resource for successful emotion regulation in older and younger adults.

    PubMed

    Opitz, Philipp C; Lee, Ihno A; Gross, James J; Urry, Heather L

    2014-01-01

    The Selection, Optimization, and Compensation with Emotion Regulation (SOC-ER) framework suggests that (1) emotion regulation (ER) strategies require resources and that (2) higher levels of relevant resources may increase ER success. In the current experiment, we tested the specific hypothesis that individual differences in one internal class of resources, namely cognitive ability, would contribute to greater success using cognitive reappraisal (CR), a form of ER in which one reinterprets the meaning of emotion-eliciting situations. To test this hypothesis, 60 participants (30 younger and 30 older adults) completed standardized neuropsychological tests that assess fluid and crystallized cognitive ability, as well as a CR task in which participants reinterpreted the meaning of sad pictures in order to alter (increase or decrease) their emotions. In a control condition, they viewed the pictures without trying to change how they felt. Throughout the task, we indexed subjective emotional experience (self-reported ratings of emotional intensity), expressive behavior (corrugator muscle activity), and autonomic physiology (heart rate and electrodermal activity) as measures of emotional responding. Multilevel models were constructed to explain within-subjects variation in emotional responding as a function of ER contrasts comparing increase or decrease conditions with the view control condition and between-subjects variation as a function of cognitive ability and/or age group (older, younger). As predicted, higher fluid cognitive ability-indexed by perceptual reasoning, processing speed, and working memory-was associated with greater success using reappraisal to alter emotional responding. Reappraisal success did not vary as a function of crystallized cognitive ability or age group. Collectively, our results provide support for a key tenet of the SOC-ER framework that higher levels of relevant resources may confer greater success at emotion regulation. PMID:24987387

  20. Fluid cognitive ability is a resource for successful emotion regulation in older and younger adults

    PubMed Central

    Opitz, Philipp C.; Lee, Ihno A.; Gross, James J.; Urry, Heather L.

    2014-01-01

    The Selection, Optimization, and Compensation with Emotion Regulation (SOC-ER) framework suggests that (1) emotion regulation (ER) strategies require resources and that (2) higher levels of relevant resources may increase ER success. In the current experiment, we tested the specific hypothesis that individual differences in one internal class of resources, namely cognitive ability, would contribute to greater success using cognitive reappraisal (CR), a form of ER in which one reinterprets the meaning of emotion-eliciting situations. To test this hypothesis, 60 participants (30 younger and 30 older adults) completed standardized neuropsychological tests that assess fluid and crystallized cognitive ability, as well as a CR task in which participants reinterpreted the meaning of sad pictures in order to alter (increase or decrease) their emotions. In a control condition, they viewed the pictures without trying to change how they felt. Throughout the task, we indexed subjective emotional experience (self-reported ratings of emotional intensity), expressive behavior (corrugator muscle activity), and autonomic physiology (heart rate and electrodermal activity) as measures of emotional responding. Multilevel models were constructed to explain within-subjects variation in emotional responding as a function of ER contrasts comparing increase or decrease conditions with the view control condition and between-subjects variation as a function of cognitive ability and/or age group (older, younger). As predicted, higher fluid cognitive ability—indexed by perceptual reasoning, processing speed, and working memory—was associated with greater success using reappraisal to alter emotional responding. Reappraisal success did not vary as a function of crystallized cognitive ability or age group. Collectively, our results provide support for a key tenet of the SOC-ER framework that higher levels of relevant resources may confer greater success at emotion regulation. PMID:24987387

  1. Cognitive Decline Is Associated with Risk Aversion and Temporal Discounting in Older Adults without Dementia

    PubMed Central

    James, Bryan D.; Boyle, Patricia A.; Yu, Lei; Han, S. Duke; Bennett, David A.

    2015-01-01

    Risk aversion and temporal discounting are preferences that are strongly linked to sub-optimal financial and health decision making ability. Prior studies have shown they differ by age and cognitive ability, but it remains unclear whether differences are due to age-related cognitive decline or lower cognitive abilities over the life span. We tested the hypothesis that cognitive decline is associated with higher risk aversion and temporal discounting in 455 older persons without dementia from the Memory and Aging Project, a longitudinal cohort study of aging in Chicago. All underwent repeated annual cognitive evaluations using a detailed battery including 19 tests. Risk aversion was measured using standard behavioral economics questions: participants were asked to choose between a certain monetary payment versus a gamble in which they could gain more or nothing; potential gamble gains varied across questions. Temporal discounting: participants were asked to choose between an immediate, smaller payment and a delayed, larger one; two sets of questions addressed small and large stakes based on payment amount. Regression analyses were used to examine whether prior rate of cognitive decline predicted level of risk aversion and temporal discounting, controlling for age, sex, and education. Over an average of 5.5 (SD=2.9) years, cognition declined at an average of 0.016 units per year (SD=0.03). More rapid cognitive decline predicted higher levels of risk aversion (p=0.002) and temporal discounting (small stakes: p=0.01, high stakes: p=0.006). Further, associations between cognitive decline and risk aversion (p=0.015) and large stakes temporal discounting (p=0.026) persisted in analyses restricted to persons without any cognitive impairment (i.e., no dementia or mild cognitive impairment); the association of cognitive decline and small stakes temporal discounting was no longer statistically significant (p=0.078). These findings are consistent with the hypothesis that

  2. Cognitive decline is associated with risk aversion and temporal discounting in older adults without dementia.

    PubMed

    James, Bryan D; Boyle, Patricia A; Yu, Lei; Han, S Duke; Bennett, David A

    2015-01-01

    Risk aversion and temporal discounting are preferences that are strongly linked to sub-optimal financial and health decision making ability. Prior studies have shown they differ by age and cognitive ability, but it remains unclear whether differences are due to age-related cognitive decline or lower cognitive abilities over the life span. We tested the hypothesis that cognitive decline is associated with higher risk aversion and temporal discounting in 455 older persons without dementia from the Memory and Aging Project, a longitudinal cohort study of aging in Chicago. All underwent repeated annual cognitive evaluations using a detailed battery including 19 tests. Risk aversion was measured using standard behavioral economics questions: participants were asked to choose between a certain monetary payment versus a gamble in which they could gain more or nothing; potential gamble gains varied across questions. Temporal discounting: participants were asked to choose between an immediate, smaller payment and a delayed, larger one; two sets of questions addressed small and large stakes based on payment amount. Regression analyses were used to examine whether prior rate of cognitive decline predicted level of risk aversion and temporal discounting, controlling for age, sex, and education. Over an average of 5.5 (SD=2.9) years, cognition declined at an average of 0.016 units per year (SD=0.03). More rapid cognitive decline predicted higher levels of risk aversion (p=0.002) and temporal discounting (small stakes: p=0.01, high stakes: p=0.006). Further, associations between cognitive decline and risk aversion (p=0.015) and large stakes temporal discounting (p=0.026) persisted in analyses restricted to persons without any cognitive impairment (i.e., no dementia or mild cognitive impairment); the association of cognitive decline and small stakes temporal discounting was no longer statistically significant (p=0.078). These findings are consistent with the hypothesis that

  3. Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction

    PubMed Central

    Erekson, Elisabeth A.; Fried, Terri R.; Martin, Deanna K.; Rutherford, Thomas J.; Strohbehn, Kris; Bynum, Julie P.W.

    2015-01-01

    Introduction There is a growing body of evidence demonstrating frailty as an important predictor of surgical outcomes in older adults undergoing major surgeries. The age-related onset of many symptoms of female pelvic floor dysfunction (PFD) in women suggests that many women seeking treatment for PFD may also have a high prevalence of frailty, which could potentially impact the risks and benefits of surgical treatment options. Our primary objective was to determine the prevalence of frailty, cognitive impairment, and functional disability in older women seeking treatment for PFD. Methods We conducted a cross-sectional study with prospective recruitment between 9/2011 and 9/2012. Women, age 65 years and older, were recruited at the conclusion of their new patient consultation for PFD at a tertiary center. A comprehensive geriatric screening including frailty measurements (Fried Frailty Index), cognitive screening (Saint Louis University Mental Status Score), and functional status evaluation for activities of daily living (Katz ADL score) was conducted. Results Sixteen percent (n/N = 25/150) of women were categorized as frail according to the Fried Frailty Index Score. After adjusting for education level, 21.3% of women (n/N =32/150) screened positive for dementia and 46 (30.7%) reported functional difficulty or dependence in performing at least one Katz ADL. Sixty-nine women (46.0%) chose surgical options for treatment of their PFD at the conclusion of their new patient visit with their physician. Conclusion Frailty, cognitive impairment, and functional disability are common in older women seeking treatment for PFD. PMID:25516232

  4. Association of white matter hyperintensities and gray matter volume with cognition in older individuals without cognitive impairment.

    PubMed

    Arvanitakis, Zoe; Fleischman, Debra A; Arfanakis, Konstantinos; Leurgans, Sue E; Barnes, Lisa L; Bennett, David A

    2016-05-01

    Both presence of white matter hyperintensities (WMH) and smaller total gray matter volume on brain magnetic resonance imaging (MRI) are common findings in old age, and contribute to impaired cognition. We tested whether total WMH volume and gray matter volume had independent associations with cognition in community-dwelling individuals without dementia or mild cognitive impairment (MCI). We used data from participants of the Rush Memory and Aging Project. Brain MRI was available in 209 subjects without dementia or MCI (mean age 80; education = 15 years; 74 % women). WMH and gray matter were automatically segmented, and the total WMH and gray matter volumes were measured. Both MRI-derived measures were normalized by the intracranial volume. Cognitive data included composite measures of five different cognitive domains, based on 19 individual tests. Linear regression analyses, adjusted for age, sex, and education, were used to examine the relationship of logarithmically-transformed total WMH volume and of total gray matter volume to cognition. Larger total WMH volumes were associated with lower levels of perceptual speed (p < 0.001), but not with episodic memory, semantic memory, working memory, or visuospatial abilities (all p > 0.10). Smaller total gray matter volumes were associated with lower levels of perceptual speed (p = 0.013) and episodic memory (p = 0.001), but not with the other three cognitive domains (all p > 0.14). Larger total WMH volume was correlated with smaller total gray matter volume (p < 0.001). In a model with both MRI-derived measures included, the relation of WMH to perceptual speed remained significant (p < 0.001), while gray matter volumes were no longer related (p = 0.14). This study of older community-dwelling individuals without overt cognitive impairment suggests that the association of larger total WMH volume with lower perceptual speed is independent of total gray matter volume. These results help elucidate the

  5. Cardiovascular and Coordination Training Differentially Improve Cognitive Performance and Neural Processing in Older Adults

    PubMed Central

    Voelcker-Rehage, Claudia; Godde, Ben; Staudinger, Ursula M.

    2011-01-01

    Recent studies revealed a positive influence of physical activity on cognitive functioning in older adults. Studies that investigate the behavioral and neurophysiological effects of type and long term duration of physical training, however, are missing. We performed a 12-month longitudinal study to investigate the effects of cardiovascular and coordination training (control group: relaxation and stretching) on cognitive functions (executive control and perceptual speed) in older adults. We analyzed data of 44 participants aged 62–79 years. Participants were trained three times a week for 12 months. Their physical and cognitive performance was tested prior to training, and after 6 and 12 months. Changes in brain activation patterns were investigated using functional MRI. On the behavioral level, both experimental groups improved in executive functioning and perceptual speed but with differential effects on speed and accuracy. In line with the behavioral findings, neurophysiological results for executive control also revealed changes (increases and reductions) in brain activity for both interventions in frontal, parietal, and sensorimotor cortical areas. In contrast to the behavioral findings, neurophysiological changes were linear without indication of a plateau. In both intervention groups, prefrontal areas showed decreased activation after 6 and 12 months when performing an executive control task, as compared to the control group, indicating more efficient information processing. Furthermore, cardiovascular training was associated with an increased activation of the sensorimotor network, whereas coordination training was associated with increased activation in the visual–spatial network. Our data suggest that besides cardiovascular training also other types of physical activity improve cognition of older adults. The mechanisms, however, that underlie the performance changes seem to differ depending on the intervention. PMID:21441997

  6. OLFACTION AND THE 5-YEAR INCIDENCE OF COGNITIVE IMPAIRMENT IN AN EPIDEMIOLOGIC STUDY OF OLDER ADULTS

    PubMed Central

    Schubert, Carla R.; Carmichael, Lakeesha L.; Murphy, Claire; Klein, Barbara E.K.; Klein, Ronald; Cruickshanks, Karen J.

    2008-01-01

    Objectives To determine if odor identification ability is associated with the 5-year incidence of cognitive impairment in a large population of older adults with normal cognition at baseline and if olfactory impairment contributes to the prediction of cognitive decline in a population. Design Population-based longitudinal study. Setting Beaver Dam, WI. Participants 1920 participants in the Epidemiology of Hearing Loss Study (mean age = 66.9 years). Measurements Olfaction was measured by the San Diego Odor Identification Test (SDOIT). Incident cognitive impairment was defined as a Mini-Mental State Exam Score (MMSE) < 24 or reported diagnosis of dementia or Alzheimer’s disease (AD) at the follow-up among people with MMSE ≥ 24 and no diagnosis of dementia or AD at baseline. Results There was a significant association between olfactory impairment at baseline and the 5-year incidence of cognitive impairment (Odds Ratio (O.R.) = 6.62, 95% Confidence Interval (C.I.) = 4.36, 10.05). The association remained significant after adjusting for possible confounders (O.R. = 3.72, 95% C.I. = 2.31, 5.99). The Positive Predictive Value of the SDOIT was 15.9%, the Negative Predictive Value was 97.2% and the sensitivity and specificity were 55.1% and 84.4%, respectively, for the 5-year incidence of cognitive impairment. Conclusion Olfactory impairment at baseline was strongly associated with the 5-year incidence of cognitive impairment as measured by the MMSE. Odor identification testing may be useful in high risk settings, but not in the general population, to identify patients at risk for cognitive decline. PMID:18662205

  7. Association between Tooth Loss and Cognitive Function among 3063 Chinese Older Adults: A Community-Based Study

    PubMed Central

    Luo, Jianfeng; Wu, Bei; Zhao, Qianhua; Guo, Qihao; Meng, Haijiao; Yu, Lirong; Zheng, Li; Hong, Zhen; Ding, Ding

    2015-01-01

    Background Oral health has been found to be associated with cognitive function in basic research and epidemiology studies. Most of these studies had no comprehensive clinical diagnosis on cognitive function. This study firstly reported the association between tooth loss and cognitive function among Chinese older population. Methods The study included 3,063 community dwelling older adults aged 60 or above from the Shanghai Aging Study. Number of teeth missing was obtained from self-reporting questionnaire and confirmed by trained interviewers. Participants were diagnosed as “dementia”, “mild cognitive impairment (MCI)”, or “cognitive normal” by neurologists using DSM-IV and Petersen criteria. Multivariate logistic regression model was applied to examine the association between number of teeth missing and cognitive function. Results The study participants had an average of 10.2 teeth lost. Individuals with dementia lost 18.7 teeth on average, much higher than those with MCI (11.8) and cognitive normal (9.3) (p<0.001). After adjusted for sex, age, education year, living alone, body mass index, cigarette smoking, alcohol drinking, anxiety, depression, heart disease, hypertension, diabetes, and APOE-ε4, tooth loss of >16 were significantly associated with dementia with an OR of 1.56 (95%CI 1.12-2.18). Conclusion Having over 16 missing teeth was associated with severe cognitive impairment among Chinese older adults. Poor oral health might be considered as a related factor of neurodegenerative symptom among older Chinese population. PMID:25803052

  8. Interactive Cognitive-Motor Step Training Improves Cognitive Risk Factors of Falling in Older Adults – A Randomized Controlled Trial

    PubMed Central

    Schoene, Daniel; Valenzuela, Trinidad; Toson, Barbara; Delbaere, Kim; Severino, Connie; Garcia, Jaime; Davies, Thomas A.; Russell, Frances; Smith, Stuart T.; Lord, Stephen R.

    2015-01-01

    Purpose Interactive cognitive-motor training (ICMT) requires individuals to perform both gross motor movements and complex information processing. This study investigated the effectiveness of ICMT on cognitive functions associated with falls in older adults. Methods A single-blinded randomized controlled trial was conducted in community-dwelling older adults (N = 90, mean age 81.5±7) without major cognitive impairment. Participants in the intervention group (IG) played four stepping games that required them to divide attention, inhibit irrelevant stimuli, switch between tasks, rotate objects and make rapid decisions. The recommended minimum dose was three 20-minute sessions per week over a period of 16 weeks unsupervised at home. Participants in the control group (CG) received an evidence-based brochure on fall prevention. Measures of processing speed, attention/executive function (EF), visuo-spatial ability, concerns about falling and depression were assessed before and after the intervention. Results Eighty-one participants (90%) attended re-assessment. There were no improvements with respect to the Stroop Stepping Test (primary outcome) in the intervention group. Compared to the CG, the IG improved significantly in measures of processing speed, visuo-spatial ability and concern about falling. Significant interactions were observed for measures of EF and divided attention, indicating group differences varied for different levels of the covariate with larger improvements in IG participants with poorer baseline performance. The interaction for depression showed no change for the IG but an increase in the CG for those with low depressive symptoms at baseline. Additionally, low and high-adherer groups differed in their baseline performance and responded differently to the intervention. Compared to high adherers, low adherers improved more in processing speed and visual scanning while high-adherers improved more in tasks related to EF. Conclusions This study shows

  9. Partial maintenance of auditory-based cognitive training benefits in older adults

    PubMed Central

    Anderson, Samira; White-Schwoch, Travis; Choi, Hee Jae; Kraus, Nina

    2014-01-01

    The potential for short-term training to improve cognitive and sensory function in older adults has captured the public’s interest. Initial results have been promising. For example, eight weeks of auditory-based cognitive training decreases peak latencies and peak variability in neural responses to speech presented in a background of noise and instills gains in speed of processing, speech-in-noise recognition, and short-term memory in older adults. But while previous studies have demonstrated short-term plasticity in older adults, we must consider the long-term maintenance of training gains. To evaluate training maintenance, we invited participants from an earlier training study to return for follow-up testing six months after the completion of training. We found that improvements in response peak timing to speech in noise and speed of processing were maintained, but the participants did not maintain speech-in-noise recognition or memory gains. Future studies should consider factors that are important for training maintenance, including the nature of the training, compliance with the training schedule, and the need for booster sessions after the completion of primary training. PMID:25111032

  10. Internet mindfulness meditation for cognition and mood in older adults: a pilot study

    PubMed Central

    Wahbeh, Helané; Goodrich, Elena; Oken, Barry S.

    2016-01-01

    Background Older adults are at risk for greater chronic stress and cognitive decline. Mindfulness meditation training may help reduce stress and thus cognitive decline in older adults, but little research has explored this. Objective The primary aim was to evaluate the feasibility and acceptability of an internet mindfulness meditation intervention and an internet health and wellness education program for a sample of older adults (65–90 years old). The secondary aims were to collect preliminary pre-post data on mood and cognitive function. Design and Setting Baseline and endpoint assessments occurred in participants’ homes. Participants were randomized to the meditation or education program taught how to access and complete their allocated intervention at their home. Participants 16 participants completed the study (8 receiving each intervention), and five dropped out (76% completion rate). Mean age was 76.2, 88% Caucasian, 50% Female. Intervention Both the meditation and education interventions had a one-hour online session each week for six weeks with 30 minutes daily home practice. Primary Outcome Measures Feasibility and acceptability were measured through adherence and a Client Satisfaction Questionnaire. Mood and cognitive outcomes were evaluated before and after the interventions. Results Of 21 people enrolled, 16 participants completed the study with 8 in each arm (76% completion rate). There were no significant between-arm differences on important demographic and other characteristics. Acceptability was high for the interventions based on above average scores on the Client Satisfaction Questionnaire. The IMMI participants completed 4.25 ± 2.4 sessions (range 0–6), 604 ± 506 (range 0–1432) home practice minutes, and 21.3 ± 15.5 days of practice (range 0–46). The Education participants completed an average of 4.75 ± 1.8 sessions (range 2–6), 873 ± 395 (range 327–1524) home practice minutes and 25.6 days of practice (range 11–35

  11. Implementing Routine Cognitive Screening of Older Adults in Primary Care: Process and Impact on Physician Behavior

    PubMed Central

    Scanlan, James; Hummel, Jeffrey; Gibbs, Kathy; Lessig, Mary; Zuhr, Elizabeth

    2007-01-01

    Background Early detection of cognitive impairment is a goal of high-quality geriatric medical care, but new approaches are needed to reduce rates of missed cases. Objective To evaluate whether adding routine cognitive screening to primary care visits for older adults increases rates of dementia diagnosis, specialist referral, or prescribing of antidementia medications. Setting Four primary care clinics in a university-affiliated primary care network. Design A quality improvement screening project and quasiexperimental comparison of 2 intervention clinics and 2 control clinics. The Mini-Cog was administered by medical assistants to intervention clinic patients aged 65+ years. Rates of dementia diagnoses, referrals, and medication prescribing were tracked over time using computerized administrative data. Results Twenty-six medical assistants successfully screened 70% (n = 524) of all eligible patients who made at least 1 clinic visit during the intervention period; 18% screened positive. There were no complaints about workflow interruption. Relative to baseline rates and control clinics, Mini-Cog screening was associated with increased dementia diagnoses, specialist referrals, and prescribing of cognitive enhancing medications. Patients without previous dementia indicators who had a positive Mini-Cog were more likely than all other patients to receive a new dementia diagnosis, specialty referral, or cognitive enhancing medication. However, relevant physician action occurred in only 17% of screen-positive patients. Responses were most related to the lowest Mini-Cog score level (0/5) and advanced age. Conclusion Mini-Cog screening by office staff is feasible in primary care practice and has measurable effects on physician behavior. However, new physician action relevant to dementia was likely to occur only when impairment was severe, and additional efforts are needed to help primary care physicians follow up appropriately on information suggesting cognitive

  12. Adoption and Use of a Mobile Health Application in Older Adults for Cognitive Stimulation.

    PubMed

    Yasini, Mobin; Marchand, Guillaume

    2016-01-01

    Serious games could be used to improve cognitive functions in the elderly. We evaluated the adoption of a new tablet application dedicated to cognitive stimulation in the elderly. The Stim'Art application offers various serious games to work different cognitive functions (memory, attention, concentration, etc.). The usage of fifteen older adults was followed for six months. The type of the game, the number of launches for each game, the time spent on each game, the difficulty level, the success rate and perceived well-being of users have been studied and compared at the end of the first and the sixth months. The participants have played half an hour per day on average. The average time of playing per day in the sixth month was significantly higher than the average time of playing during the first month (p value < 7 * 10-4). The same result was found for the average number of game launches per day (p value < 7 * 10-4). However, older people seem not to launch more difficult levels in the last month. The success rate at sixth months was significantly higher than the success rate at the end of the first month (p value < 6.4 * 10-4). Generally, seniors have had an improvement in their wellbeing score judged by themselves. Our study showed that the mobile application receives a good admission from users. The results are promising and can pave the way for improving cognitive function in the elderly patients. The use of tablets and the constitution of serious games in close cooperation with health professionals and elderly patients (the end user), are likely to provide satisfactory results to improve healthcare provided for elderly patients suffering from cognitive disorders. PMID:27071867

  13. Aerobic exercise improves cognition for older adults with glucose intolerance, a risk factor for Alzheimer's disease.

    PubMed

    Baker, Laura D; Frank, Laura L; Foster-Schubert, Karen; Green, Pattie S; Wilkinson, Charles W; McTiernan, Anne; Cholerton, Brenna A; Plymate, Stephen R; Fishel, Mark A; Watson, G Stennis; Duncan, Glen E; Mehta, Pankaj D; Craft, Suzanne

    2010-01-01

    Impaired glucose regulation is a defining characteristic of type 2 diabetes mellitus (T2DM) pathology and has been linked to increased risk of cognitive impairment and dementia. Although the benefits of aerobic exercise for physical health are well-documented, exercise effects on cognition have not been examined for older adults with poor glucose regulation associated with prediabetes and early T2DM. Using a randomized controlled design, twenty-eight adults (57-83 y old) meeting 2-h tolerance test criteria for glucose intolerance completed 6 months of aerobic exercise or stretching, which served as the control. The primary cognitive outcomes included measures of executive function (Trails B, Task Switching, Stroop, Self-ordered Pointing Test, and Verbal Fluency). Other outcomes included memory performance (Story Recall, List Learning), measures of cardiorespiratory fitness obtained via maximal-graded exercise treadmill test, glucose disposal during hyperinsulinemic-euglycemic clamp, body fat, and fasting plasma levels of insulin, cortisol, brain-derived neurotrophic factor, insulin-like growth factor-1, amyloid-β (Aβ40 and Aβ42). Six months of aerobic exercise improved executive function (MANCOVA, p=0.04), cardiorespiratory fitness (MANOVA, p=0.03), and insulin sensitivity (p=0.05). Across all subjects, 6-month changes in cardiorespiratory fitness and insulin sensitivity were positively correlated (p=0.01). For Aβ42, plasma levels tended to decrease for the aerobic group relative to controls (p=0.07). The results of our study using rigorous controlled methodology suggest a cognition-enhancing effect of aerobic exercise for older glucose intolerant adults. Although replication in a larger sample is needed, our findings potentially have important therapeutic implications for a growing number of adults at increased risk of cognitive decline. PMID:20847403

  14. Functional Connectivity in Multiple Cortical Networks Is Associated with Performance Across Cognitive Domains in Older Adults

    PubMed Central

    Shaw, Emily E.; Schultz, Aaron P.; Sperling, Reisa A.

    2015-01-01

    Abstract Intrinsic functional connectivity MRI has become a widely used tool for measuring integrity in large-scale cortical networks. This study examined multiple cortical networks using Template-Based Rotation (TBR), a method that applies a priori network and nuisance component templates defined from an independent dataset to test datasets of interest. A priori templates were applied to a test dataset of 276 older adults (ages 65–90) from the Harvard Aging Brain Study to examine the relationship between multiple large-scale cortical networks and cognition. Factor scores derived from neuropsychological tests represented processing speed, executive function, and episodic memory. Resting-state BOLD data were acquired in two 6-min acquisitions on a 3-Tesla scanner and processed with TBR to extract individual-level metrics of network connectivity in multiple cortical networks. All results controlled for data quality metrics, including motion. Connectivity in multiple large-scale cortical networks was positively related to all cognitive domains, with a composite measure of general connectivity positively associated with general cognitive performance. Controlling for the correlations between networks, the frontoparietal control network (FPCN) and executive function demonstrated the only significant association, suggesting specificity in this relationship. Further analyses found that the FPCN mediated the relationships of the other networks with cognition, suggesting that this network may play a central role in understanding individual variation in cognition during aging. PMID:25827242

  15. Cognitive Interventions in Older Persons: Do They Change the Functioning of the Brain?

    PubMed Central

    van Os, Yindee; de Vugt, Marjolein E.; van Boxtel, Martin

    2015-01-01

    Background. Cognitive interventions for older persons that may diminish the burden of cognitive problems and could delay conversion to dementia are of great importance. The underlying mechanisms of such interventions might be psychological compensation and neuronal plasticity. This review provides an overview of the literature concerning the evidence that cognitive interventions cause brain activation changes, even in damaged neural systems. Method. A systematic search of the literature was conducted in several international databases, Medline, Embase, Cinahl, Cochrane, and Psychinfo. The methodological quality was assessed according to the guidelines of the Dutch Institute for Health Care Improvement (CBO). Results. Nineteen relevant articles were included with varied methodological quality. All studies were conducted in diverse populations from healthy elderly to patients with dementia and show changes in brain activation after intervention. Conclusions. The results thus far show that cognitive interventions cause changes in brain activation patterns. The exact interpretation of these neurobiological changes remains unclear. More study is needed to understand the extent to which cognitive interventions are effective to delay conversion to dementia. Future studies should more explicitly try to relate clinically significant improvement to changes in brain activation. Long-term follow-up data are necessary to evaluate the stability of the effects. PMID:26583107

  16. Functional Connectivity in Multiple Cortical Networks Is Associated with Performance Across Cognitive Domains in Older Adults.

    PubMed

    Shaw, Emily E; Schultz, Aaron P; Sperling, Reisa A; Hedden, Trey

    2015-10-01

    Intrinsic functional connectivity MRI has become a widely used tool for measuring integrity in large-scale cortical networks. This study examined multiple cortical networks using Template-Based Rotation (TBR), a method that applies a priori network and nuisance component templates defined from an independent dataset to test datasets of interest. A priori templates were applied to a test dataset of 276 older adults (ages 65-90) from the Harvard Aging Brain Study to examine the relationship between multiple large-scale cortical networks and cognition. Factor scores derived from neuropsychological tests represented processing speed, executive function, and episodic memory. Resting-state BOLD data were acquired in two 6-min acquisitions on a 3-Tesla scanner and processed with TBR to extract individual-level metrics of network connectivity in multiple cortical networks. All results controlled for data quality metrics, including motion. Connectivity in multiple large-scale cortical networks was positively related to all cognitive domains, with a composite measure of general connectivity positively associated with general cognitive performance. Controlling for the correlations between networks, the frontoparietal control network (FPCN) and executive function demonstrated the only significant association, suggesting specificity in this relationship. Further analyses found that the FPCN mediated the relationships of the other networks with cognition, suggesting that this network may play a central role in understanding individual variation in cognition during aging. PMID:25827242

  17. Brain structure and cognitive correlates of body mass index in healthy older adults

    PubMed Central

    Bolzenius, Jacob D.; Laidlaw, David H.; Cabeen, Ryan P.; Conturo, Thomas E.; McMichael, Amanda R.; Lane, Elizabeth M.; Heaps, Jodi M.; Salminen, Lauren E.; Baker, Laurie M.; Scott, Staci E.; Cooley, Sarah A.; Gunstad, John; Paul, Robert H.

    2014-01-01

    Obesity, commonly measured with body mass index (BMI), is associated with numerous deleterious health conditions including alterations in brain integrity related to advanced age. Prior research has suggested that white matter integrity observed using diffusion tensor imaging (DTI) is altered in relation to high BMI, but the integrity of specific white matter tracts remains poorly understood. Additionally, no studies have examined white matter tract integrity in conjunction with neuropsychological evaluation associated with BMI among older adults. The present study examined white matter tract integrity using DTI and cognitive performance associated with BMI in 62 healthy older adults (20 males, 42 females) aged 51 to 81. Results revealed that elevated BMI was associated with lower fractional anisotropy (FA) in the uncinate fasciculus, though there was no evidence of an age by BMI interaction relating to FA in this tract. No relationships were observed between BMI and other white matter tracts or cognition after controlling for demographic variables. Findings suggest that elevated BMI is associated with lower structural integrity in a brain region connecting frontal and temporal lobes and this alteration precedes cognitive dysfunction. Future studies should examine biological mechanisms that mediate the relationships between BMI and white matter tract integrity, as well as the evolution of these abnormalities utilizing longitudinal designs. PMID:25448431

  18. Problems meeting basic needs predict cognitive decline in community-dwelling Hispanic older adults.

    PubMed

    Sachs-Ericsson, Natalie; Corsentino, Elizabeth; Cougle, Jesse R

    2009-09-01

    Objectives. Indices of low socioeconomic status (SES) have been found to predict negative health outcomes. However, problems meeting basic needs (e.g., not having enough money for health care, adequate food, etc.) may be a more potent measure of negative health outcomes than other more typically assessed indices of SES, such as income. This article examined the association between problems meeting basic needs and cognitive decline in a sample of community-dwelling Hispanic older adults (N = 1,964). Method. The authors used a prospective design to study the influence of problems meeting basic needs on cognitive functioning. Analyses controlled for demographics, health problems, and depressive symptoms. Results. The authors found problems meeting basic needs to be a more potent predictor of cognitive decline than income. Discussion. Interventions focused on providing older adults with resources for meeting basic needs, such as adequate food and health care, may substantially reduce the subsequent level of stress and health problems in this population. PMID:19571183

  19. Brain structure and cognitive correlates of body mass index in healthy older adults.

    PubMed

    Bolzenius, Jacob D; Laidlaw, David H; Cabeen, Ryan P; Conturo, Thomas E; McMichael, Amanda R; Lane, Elizabeth M; Heaps, Jodi M; Salminen, Lauren E; Baker, Laurie M; Scott, Staci E; Cooley, Sarah A; Gunstad, John; Paul, Robert H

    2015-02-01

    Obesity, commonly measured with body mass index (BMI), is associated with numerous deleterious health conditions including alterations in brain integrity related to advanced age. Prior research has suggested that white matter integrity observed using diffusion tensor imaging (DTI) is altered in relation to high BMI, but the integrity of specific white matter tracts remains poorly understood. Additionally, no studies have examined white matter tract integrity in conjunction with neuropsychological evaluation associated with BMI among older adults. The present study examined white matter tract integrity using DTI and cognitive performance associated with BMI in 62 healthy older adults (20 males, 42 females) aged 51-81. Results revealed that elevated BMI was associated with lower fractional anisotropy (FA) in the uncinate fasciculus, though there was no evidence of an age by BMI interaction relating to FA in this tract. No relationships were observed between BMI and other white matter tracts or cognition after controlling for demographic variables. Findings suggest that elevated BMI is associated with lower structural integrity in a brain region connecting frontal and temporal lobes and this alteration precedes cognitive dysfunction. Future studies should examine biological mechanisms that mediate the relationships between BMI and white matter tract integrity, as well as the evolution of these abnormalities utilizing longitudinal designs. PMID:25448431

  20. Change in Cognitive Functioning in Depressed Older Adults Following Treatment with Sertraline or Nortriptyline

    PubMed Central

    Culang-Reinlieb, Michelle E.; Sneed, Joel R.; Keilp, John G.; Roose, Steven P.

    2012-01-01

    Objective To compare the impact of nortriptyline to sertraline on change in cognitive functioning in depressed older adults. Methods We used pre-post neuropsychological data collected as part of a 12-week medication trial comparing sertraline to nortriptyline in the treatment of older adults with non-psychotic, unipolar major depression to examine change in cognitive functioning. Neuropsychological assessments included mental status (Mini-Mental Status Exam), psychomotor speed (Purdue Pegboard), attention (Continuous Performance Test; Trail Making Test A), executive functioning (Stroop Color/Word Test; Trail Making Test B), and memory (Buschke Selective Reminding Test). Results Within treatment groups, patients treated with sertraline improved only on verbal learning. This change did not depend on responder status. Between treatment groups, patients treated with sertraline improved more in verbal learning compared to patients treated with nortriptyline. Looking at change in cognition as a function of medication condition and responder status revealed that sertraline responders improved more in verbal learning compared to nortriptyline responders but not more than sertraline non-responders or nortriptyline non-responders. Nortriptyline responders were the only treatment by responder status group to show no improvement in verbal learning from baseline to endpoint. Conclusions Unexpectedly, nortriptyline responders showed no improvement in verbal learning as compared to patients treated with sertraline or nortriptyline non-responders. However, given the small sample sizes and number of statistical tests (potential for type 1 error), replication is warranted. PMID:21919060

  1. Difficulty, effort and cardiovascular response to a working memory challenge: Older adults with and without mild cognitive impairment.

    PubMed

    Stewart, Christopher C; Wright, Rex A; Griffith, H Randall

    2016-06-01

    We presented cognitively healthy older adults and patients with mild cognitive impairment (MCI) three versions of a modified Sternberg memory task designed to range in difficulty from low to high. Among cognitively healthy older adults, blood pressure responses assessed during the work periods rose with difficulty. By contrast, among MCI patients, blood pressure responses assessed during the work periods were low irrespective of difficulty. Findings are discussed primarily in relation to a conceptual analysis concerned with ability determinants of effort (task engagement) and associated cardiovascular responses. They also are discussed in the context of other recent cardiovascular studies involving older adults and with regard to the potential for exaggerated cardiovascular responses to accelerate cognitive decline in advanced age. PMID:27109608

  2. Ability of older people with dementia or cognitive impairment to manage medicine regimens: a narrative review.

    PubMed

    Elliott, Rohan A; Goeman, Dianne; Beanland, Christine; Koch, Susan

    2015-01-01

    Impaired cognition has a significant impact on a person's ability to manage their medicines. The aim of this paper is to provide a narrative review of contemporary literature on medicines management by people with dementia or cognitive impairment living in the community, methods for assessing their capacity to safely manage medicines, and strategies for supporting independent medicines management. Studies and reviews addressing medicines management by people with dementia or cognitive impairment published between 2003 and 2013 were identified via searches of Medline and other databases. The literature indicates that as cognitive impairment progresses, the ability to plan, organise, and execute medicine management tasks is impaired, leading to increased risk of unintentional non-adherence, medication errors, preventable medication-related hospital admissions and dependence on family carers or community nursing services to assist with medicines management. Impaired functional capacity may not be detected by health professionals in routine clinical encounters. Assessment of patients' (or carers') ability to safely manage medicines is not undertaken routinely, and when it is there is variability in the methods used. Self-report and informant report may be helpful, but can be unreliable or prone to bias. Measures of cognitive function are useful, but may lack sensitivity and specificity. Direct observation, using a structured, standardised performance-based tool, may help to determine whether a person is able to manage their medicines and identify barriers to adherence such as inability to open medicine packaging. A range of strategies have been used to support independent medicines management in people with cognitive impairment, but there is little high-quality research underpinning these strategies. Further studies are needed to develop and evaluate approaches to facilitate safe medicines management by older people with cognitive impairment and their carers. PMID

  3. Moderate, Regular Alcohol Consumption is Associated with Higher Cognitive Function in Older Community-Dwelling Adults

    PubMed Central

    Reas, E.T.; Laughlin, G.A.; Kritz-Silverstein, D.; Barrett-Connor, E.; McEvoy, L.K.

    2016-01-01

    BACKGROUND Evidence suggests that moderate alcohol consumption may protect against cognitive decline and dementia. However, uncertainty remains over the patterns of drinking that are most beneficial. OBJECTIVE To examine associations between amount and frequency of alcohol consumption with multiple domains of cognitive function in a well-characterized cohort of older community-dwelling adults in southern California. DESIGN Observational, cross-sectional cohort study. SETTING A research visit between 1988–1992 in Rancho Bernardo, California. PARTICIPANTS 1624 participants of the Rancho Bernardo Study (mean age ± SD = 73.2 ± 9.3 years). Measurements Participants completed a neuropsychological test battery, self-administered questionnaires on alcohol consumption and lifestyle, and a clinical health evaluation. We classified participants according to average amount of alcohol intake into never, former, moderate, heavy and excessive drinkers, and according to frequency of alcohol intake, into non-drinkers, rare, infrequent, frequent and daily drinkers. We examined the association between alcohol intake and cognitive function, controlling for age, sex, education, exercise, smoking, waist-hip ratio, hypertension and self-assessed health. RESULTS Amount and frequency of alcohol intake were significantly associated with cognitive function, even after controlling for potentially related health and lifestyle variables. Global and executive function showed positive linear associations with amount and frequency of alcohol intake, whereas visual memory showed an inverted U-shaped association with alcohol intake, with better performance for moderate and infrequent drinkers than for non-drinkers, excessive drinkers or daily drinkers. CONCLUSIONS In several cognitive domains, moderate, regular alcohol intake was associated with better cognitive function relative to not drinking or drinking less frequently. This suggests that beneficial cognitive effects of alcohol intake may be

  4. Relationship between diet quality and cognition depends on socioeconomic position in healthy older adults.

    PubMed

    Parrott, Matthew D; Shatenstein, Bryna; Ferland, Guylaine; Payette, Hélène; Morais, José A; Belleville, Sylvie; Kergoat, Marie-Jeanne; Gaudreau, Pierrette; Greenwood, Carol E

    2013-11-01

    Both diet quality and socioeconomic position (SEP) have been linked to age-related cognitive changes, but there is little understanding of how the socioeconomic context of dietary intake may shape its cognitive impact. We examined whether equal adherence to "prudent" and "Western" dietary patterns, identified by principal components analysis, was associated with global cognitive function [Modified Mini-Mental State Examination (3MS)] in independently living older adults with different SEPs (aged 68-84 y; n = 1099). The interaction of dietary pattern adherence with household income, educational attainment, occupational prestige, and a composite indicator of SEP combining all 3 was examined in multiple-adjusted mixed models over 3 y of follow-up in participants of the NuAge study (Quebec Longitudinal Study on Nutrition and Successful Aging). Adherence to the prudent pattern (vegetables, fruits, fish, poultry, and lower-fat dairy products) was related to higher 3MS scores at recruitment only in the upper categories of income [parameter estimate (B): 0.56; 95% CI: 0.11, 1.01], education (B: 0.44; 95% CI: 0.080, 0.80), or composite SEP (B: 0.37; 95% CI: 0.045, 0.70). High prudent pattern adherence was associated with less cognitive decline only in those with low composite SEP (B: 0.25; 95% CI: 0.0094, 0.50). Conversely, adherence to the Western pattern (meats, potatoes, processed foods, and higher-fat dairy products) was associated with more cognitive decline (B: -0.23; 95% CI: -0.43, -0.032) only in those with low educational attainment. In summary, among individuals with equivalent diet quality, the magnitude and characteristics of the diet-cognition relationship depended on their socioeconomic circumstances. These results suggest that interventions promoting retention of cognitive function through improved diet quality would provide maximum benefit to those with relatively low SEP. PMID:23986363

  5. Effects of alcohol consumption on cognition and regional brain volumes among older adults.

    PubMed

    Downer, Brian; Jiang, Yang; Zanjani, Faika; Fardo, David

    2015-06-01

    This study utilized data from the Framingham Heart Study Offspring Cohort to examine the relationship between midlife and late-life alcohol consumption, cognitive functioning, and regional brain volumes among older adults without dementia or a history of abusing alcohol. The results from multiple linear regression models indicate that late life, but not midlife, alcohol consumption status is associated with episodic memory and hippocampal volume. Compared to late life abstainers, moderate consumers had larger hippocampal volume, and light consumers had higher episodic memory. The differences in episodic memory according to late life alcohol consumption status were no longer significant when hippocampal volume was included in the regression model. The findings from this study provide new evidence that hippocampal volume may contribute to the observed differences in episodic memory among older adults and late life alcohol consumption status. PMID:25202027

  6. Telehealth Cognitive Behavior Therapy for Co-Occurring Insomnia and Depression Symptoms in Older Adults

    PubMed Central

    Lichstein, Kenneth L.; Scogin, Forrest; Thomas, S. Justin; DiNapoli, Elizabeth A.; Dillon, Haley R.; McFadden, Anna

    2015-01-01

    Objective Telehealth has proven effective with a wide range of disorders, but there is a paucity of data on the use of telehealth using cognitive-behavior therapy (CBT) with late-life insomnia and depression. This pilot study was designed to examine the feasibility and effectiveness of using telehealth to treat older adults with comorbid insomnia and depression living in rural Alabama. Method Five patients received 10 sessions of CBT for insomnia and depression. Patients were engaged in treatment via Skype from their primary care physician’s office. Assessments were conducted at baseline, posttreatment, and 2-month follow-up. Results Patients exhibited clinically significant improvement in both insomnia (sleep diaries and Insomnia Severity Index) and depression (Hamilton Rating Scale for Depression) at posttreatment, and these gains were well maintained at 2-month follow-up. Conclusions These preliminary data suggest that telehealth may be an effective means of providing treatment to older adults, including underserved populations. PMID:24014056

  7. Effects of Alcohol Consumption on Cognition and Regional Brain Volumes Among Older Adults

    PubMed Central

    Downer, Brian; Jiang, Yang; Zanjani, Faika; Fardo, David

    2015-01-01

    This study utilized data from the Framingham Heart Study Offspring Cohort to examine the relationship between midlife and late-life alcohol consumption, cognitive functioning, and regional brain volumes among older adults without dementia or a history of abusing alcohol. The results from multiple linear regression models indicate that late life, but not midlife, alcohol consumption status is associated with episodic memory and hippocampal volume. Compared to late life abstainers, moderate consumers had larger hippocampal volume, and light consumers had higher episodic memory. The differences in episodic memory according to late life alcohol consumption status were no longer significant when hippocampal volume was included in the regression model. The findings from this study provide new evidence that hippocampal volume may contribute to the observed differences in episodic memory among older adults and late life alcohol consumption status. PMID:25202027

  8. Comparison of evidence-based interventions on outcomes of hospitalized, cognitively impaired older adults

    PubMed Central

    Naylor, Mary D; Hirschman, Karen B; Hanlon, Alexandra L; Bowles, Kathryn H; Bradway, Christine; McCauley, Kathleen M; Pauly, Mark V

    2014-01-01

    Aim This article reports the effects of three evidence-based interventions of varying intensity, each designed to improve outcomes of hospitalized cognitively impaired older adults. Patients & methods In this comparative effectiveness study, 202 older adults with cognitive impairment (assessed within 24 h of index hospitalization) were enrolled at one of three hospitals within an academic health system. Each hospital was randomly assigned one of the following interventions: Augmented Standard Care (ASC; lower dose: n = 65), Resource Nurse Care (RNC; medium dose: n = 71) or the Transitional Care Model (TCM; higher dose: n = 66). Since randomization at the patient level was not feasible due to potential contamination, generalized boosted modeling that estimated multigroup propensity score weights was used to balance baseline patient characteristics between groups. Analyses compared the three groups on time with first rehospitalization or death, the number and days of all-cause rehospitalizations per patient and functional status through 6-month postindex hospitalization. Results In total, 25% of the ASC group were rehospitalized or died by day 33 compared with day 58 for the RNC group versus day 83 for the TCM group. The largest differences between the three groups on time to rehospitalization or death were observed early in the Kaplan–Meier curve (at 30 days: ASC = 22% vs RNC = 19% vs TCM = 9%). The TCM group also demonstrated lower mean rehospitalization rates per patient compared with the RNC (p < 0.001) and ASC groups (p = 0.06) at 30 days. At 90-day postindex hospitalization, the TCM group continued to demonstrate lower mean rehospitalization rates per patient only when compared with the ASC group (p = 0.02). No significant group differences in functional status were observed. Conclusion Findings suggest that the TCM intervention, compared with interventions of lower intensity, has the potential to decrease costly resource use outcomes in the immediate

  9. Protocol for Fit Bodies, Fine Minds: a randomized controlled trial on the affect of exercise and cognitive training on cognitive functioning in older adults

    PubMed Central

    O'Dwyer, Siobhan T; Burton, Nicola W; Pachana, Nancy A; Brown, Wendy J

    2007-01-01

    Background Declines in cognitive functioning are a normal part of aging that can affect daily functioning and quality of life. This study will examine the impact of an exercise training program, and a combined exercise and cognitive training program, on the cognitive and physical functioning of older adults. Methods/Design Fit Bodies, Fine Minds is a randomized, controlled trial. Community-dwelling adults, aged between 65 and 75 years, are randomly allocated to one of three groups for 16 weeks. The exercise-only group do three 60-minute exercise sessions per week. The exercise and cognitive training group do two 60-minute exercise sessions and one 60-minute cognitive training session per week. A no-training control group is contacted every 4 weeks. Measures of cognitive functioning, physical fitness and psychological well-being are taken at baseline (0 weeks), post-test (16 weeks) and 6-month follop (40 weeks). Qualitative responses to the program are taken at post-test. Discussion With an increasingly aged population, interventions to improve the functioning and quality of life of older adults are particularly important. Exercise training, either alone or in combination with cognitive training, may be an effective means of optimizing cognitive functioning in older adults. This study will add to the growing evidence base on the effectiveness of these interventions. Trial Registration Australian Clinical Trials Register: ACTRN012607000151437 PMID:17915035

  10. Cognitive decline impairs financial and health literacy among community-based older persons without dementia

    PubMed Central

    Boyle, Patricia A.; Yu, Lei; Wilson, Robert S.; Segawa, Eisuke; Buchman, Aron S.; Bennett, David A.

    2013-01-01

    Literacy is an important determinant of health and well-being across the lifespan but is critical in aging, when many influential health and financial decisions are made. Prior studies suggest that older persons exhibit lower literacy than younger persons, particularly in the domains of financial and health literacy, but the reasons why remain unknown. The objectives of this study were to: a) examine pathways linking diverse resources (i.e., education, word knowledge, cognitive function, and decision making style) to health and financial literacy among older persons and determine the extent to which the relation of age with literacy represents a direct effect versus an indirect effect due to decrements in specific cognitive functions (i.e., executive functions and episodic memory), and b) test the hypothesis that declines in executive function and episodic memory are associated with lower literacy among older persons without dementia. 645 community-based older persons without dementia underwent detailed assessments of diverse resources, including education, word knowledge, cognitive function (i.e., executive function, episodic memory) and decision making style (i.e., risk aversion), and completed a measure of literacy that included items similar to those assessed in the Health and Retirement Study, such as numeracy, financial concepts such as compound inflation and knowledge of stocks and bonds, and important health concepts such as understanding of drug risk and Medicare Part D. Path analysis revealed a strong effect of age on literacy, with about half of the effect of age on literacy due to decrements in executive functions and episodic memory. In addition, executive function had an indirect effect on literacy via decision making style (i.e., risk aversion), and education and word knowledge had independent effects on literacy. Finally, among (n=447) persons with repeated cognitive assessments available for up to 14 years, regression analysis supported the

  11. Assessment of the effects of glutamic acid decarboxylase antibodies and trace elements on cognitive performance in older adults

    PubMed Central

    Alghadir, Ahmad H; Gabr, Sami A; Al-Eisa, Einas S

    2015-01-01

    Background Homeostatic imbalance of trace elements such as iron (Fe), copper (Cu), and zinc (Zn) demonstrated adverse effects on brain function among older adults. Objective The present study aimed to investigate the effects of trace elements and the presence of anti-glutamic acid decarboxylase antibodies (GADAs) in human cognitive abilities among healthy older adults. Methods A total of 100 healthy subjects (65 males, 35 females; age range; 64–96 years) were recruited for this study. Based on Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score, the participants were classified according to cognitive performance into normal (n=45), moderate (n=30), and severe (n=25). Cognitive functioning, leisure-time physical activity (LTPA), serum trace elements – Fe, Cu, Zn, Zn/Cu, and GADAs were assessed using LOTCA battery, pre-validated physical activity (PA) questionnaire, atomic absorption, and immunoassay techniques, respectively. Results Approximately 45% of the study population (n=45) had normal distribution of cognitive function and 55% of the study population (n=55) had abnormal cognitive function; they were classified into moderate (score 62–92) and severe (score 31–62). There was a significant reduction in the level of Zn and Zn/Cu ratio along with an increase in the level of Fe, Cu, and anti-GADAs in subjects of severe (P=0.01) and moderate (P=0.01) cognitive performance. LOTCA-cognitive scores correlated positively with sex, HbA1c, Fe, Cu, Zn, and Zn/Cu ratio, and negatively with age, PA, body mass index, and anti-GADAs. Significant inter-correlation was reported between serum trace element concentrations and anti-GADAs which suggest producing a cognitive decline via oxidative and neural damage mechanism. Conclusion This study found significant associations among trace elements, anti-GADAs, and cognitive function in older adults. The homeostatic balance of trace elements should be recommended among older adults for better cognitive

  12. Cognition and Indicators of Dietary Habits in Older Adults from Southern Brazil

    PubMed Central

    França, Vivian Francielle; Barbosa, Aline Rodrigues; D’Orsi, Eleonora

    2016-01-01

    Objective To assess the association between unhealthy dietary habits and cognition in older adults from Southern Brazil. Methods This cross-sectional study analyzed data from the second wave of a population- and household-based epidemiological survey (2013–2014) conducted in the city of Florianópolis. A total of 1,197 older adults (778 women) over 60 years old participated in the study. Cognition, the dependent variable, was measured by the Mini-Mental State Examination (MMSE). The independent variables were the following indicators of unhealthy dietary habits: low intake of fruits and vegetables (≤ 4 servings/day); fish (< 1 serving/week); and habitual fatty meat intake (yes/no). Adjustments were made for age, education level, income, smoking status, alcohol intake, leisure-time physical activity, depression symptoms, chronic diseases, and body mass index. Simple and multiple linear regression analyses were performed, considering sampling weights and stratification by gender. Results The mean MMSE scores for men and women were 25.15 ± 5.56 and 24.26 ± 5.68, respectively (p = 0.009). After adjustments, in women low fruit and vegetable intake (≤ 4 servings/day) was independently associated with the lowest MMSE scores. No associations were found in men. Additionally, women’s mean MMSE scores increased as their daily frequency of fruit and vegetable intake increased (p = 0.001). Conclusion Women with low fruit and vegetable intake according to the World Health Organization (WHO) have lower cognition scores. Regular intake of fruits, vegetables, and fish in exchange of fatty meats may be a viable public policy strategy to preserve cognition in aging. PMID:26894259

  13. Sleepiness and Cognitive Performance among Younger and Older Adolescents across a 28-Hour Forced Desynchrony Protocol

    PubMed Central

    Wu, Lora J.; Acebo, Christine; Seifer, Ronald; Carskadon, Mary A.

    2015-01-01

    , Carskadon MA. Sleepiness and cognitive performance among younger and older adolescents across a 28-hour forced desynchrony protocol. SLEEP 2015;38(12):1965–1972. PMID:26194564

  14. Cognitive Processing Speed in Older Adults: Relationship with White Matter Integrity

    PubMed Central

    Kerchner, Geoffrey A.; Racine, Caroline A.; Hale, Sandra; Wilheim, Reva; Laluz, Victor; Miller, Bruce L.; Kramer, Joel H.

    2012-01-01

    Cognitive processing slows with age. We sought to determine the importance of white matter integrity, assessed by diffusion tensor imaging (DTI), at influencing cognitive processing speed among normal older adults, assessed using a novel battery of computerized, non-verbal, choice reaction time tasks. We studied 131 cognitively normal adults aged 55–87 using a cross-sectional design. Each participant underwent our test battery, as well as MRI with DTI. We carried out cross-subject comparisons using tract-based spatial statistics. As expected, reaction time slowed significantly with age. In diffuse areas of frontal and parietal white matter, especially the anterior corpus callosum, fractional anisotropy values correlated negatively with reaction time. The genu and body of the corpus callosum, superior longitudinal fasciculus, and inferior fronto-occipital fasciculus were among the areas most involved. This relationship was not explained by gray or white matter atrophy or by white matter lesion volume. In a statistical mediation analysis, loss of white matter integrity mediated the relationship between age and cognitive processing speed. PMID:23185621

  15. The Relationship between Mean Corpuscular Volume and Cognitive Performance in Older Adults

    PubMed Central

    Gamaldo, Alyssa A.; Ferrucci, Luigi; Rifkind, Joseph; Longo, Dan L.; Zonderman, Alan B.

    2013-01-01

    OBJECTIVES To examine the relationship between erythrocyte mean corpuscular volume (MCV) and cognitive performance over time. DESIGN Longitudinal. SETTING Sample from the Baltimore Longitudinal Study of Aging (BLSA) PARTICIPANTS The sample consisted of 827 participants from the Baltimore Longitudinal Study of Aging (BLSA; M age = 67; range = 50 – 96). MEASUREMENTS MCV and several other blood indices were measured including hemoglobin, iron, ferritin, vitamin B12, folate, white blood cell count, albumin and erythrocyte sedimentation rate. Cognitive performance was examined using neuropsychological measures of visual memory, verbal memory, language, attention, executive function and global mental status. RESULTS High MCV levels were significantly associated with lower global mental status even after adjusting for potential confounders. High MCV levels were also significantly associated with accelerated rates of decline on tasks of global mental status, long delay memory, and attention even after adjusting for potential confounders. CONCLUSION Our findings confirm a previous observation that larger erythrocytes in older adults are associated with poorer cognitive function. The relationship between MCV and cognition does not appear to be explained by anemia and inflammation. Further research is needed to clarify the mechanisms behind this association. PMID:23301873

  16. Functional mobility in a divided attention task in older adults with cognitive impairment.

    PubMed

    Borges, Sheila de Melo; Radanovic, Márcia; Forlenza, Orestes Vicente

    2015-01-01

    Motor disorders may occur in mild cognitive impairment (MCI) and at early stages of Alzheimer's disease (AD), particularly under divided attention conditions. We examined functional mobility in 104 older adults (42 with MCI, 26 with mild AD, and 36 cognitively healthy) using the Timed Up and Go test (TUG) under 4 experimental conditions: TUG single task, TUG plus a cognitive task, TUG plus a manual task, and TUG plus a cognitive and a manual task. Statistically significant differences in mean time of execution were found in all four experimental conditions when comparing MCI and controls (p < .001), and when comparing MCI and AD patients (p < .05). Receiver-operating characteristic curve analyses showed that all four testing conditions could differentiate the three groups (area under the curve > .8, p < .001 for MCI vs. controls; area under the curve > .7, p < .001 for MCI vs. AD). The authors conclude that functional motor deficits occurring in MCI can be assessed by the TUG test, in single or dual task modality. PMID:25610990

  17. Handedness and Cognitive Function in Older Men and Women: A Comparison of Methods

    PubMed Central

    Siengthai, Boonclaire; Kritz-Silverstein, Donna; Barrett-Connor, Elizabeth

    2009-01-01

    Objective Previous studies of handedness and cognitive function rely on self-classification and yield inconsistent results. This study examines the associations of self-reported versus grip-strength-based handedness with cognitive function in healthy older men and women. Design Cross-sectional study. Setting 1988–91 follow-up clinic visit and 1991 mailed survey. Participants 684 men and 985 women aged 55–95 who were community dwelling. Measurements Cognitive function was assessed with 12 tests and grip strength was measured by hand-held dynamometer. Self-reported handedness was obtained with a mailed survey. Results By self-report, 92.1% of men and women were right-handed; 2.0% were left handed. By grip strength, in men, 64.3% were right-handed, 22.5% left-handed, and 13.2% ambidextrous. In women, 61.3% were right-handed, 17.3% left-handed, and 21.4% ambidextrous. No cognitive function differences were found by self-reported handedness in either sex (p’s>0.10). However, based on grip strength, left-handed women scored poorer than right-handed or ambidextrous women in immediate and delayed memory, attention, and verbal fluency (p’s<0.05). Using categorical definitions, left-handed or ambidextrous individuals based on grip strength were more likely to show poor cognitive function on 4 of 5 tests. Conclusion Grip strength is a useful alternative to self-reports for classifying handedness. Left-handedness by grip-strength, may be related to poorer cognitive function; this association may vary by gender. PMID:18953462

  18. The Longitudinal Association of Cumulative Lead Dose with Cognitive Function in Community-dwelling Older Adults

    PubMed Central

    Bandeen-Roche, Karen; Glass, Thomas A.; Bolla, Karen I.; Todd, Andrew C.; Schwartz, Brian S.

    2012-01-01

    Background To evaluate whether cumulative lead dose from environmental exposures is associated with cognitive function and decline, and whether persistent, reversible, or progressive effects are indicated. Methods We used longitudinal linear modeling to evaluate associations of tibia lead concentration with cognitive function and decline in socio-demographically diverse, community-dwelling adults, aged 50-70 years, randomly selected from neighborhoods in Baltimore. Six summary measures of cognitive function were created from standard tests in these domains: language, processing speed, eye-hand coordination, executive functioning, verbal memory and learning, and visual memory. Results The mean (SD) tibia lead level was 18.8 (11.6) μg/g. In models adjusting for demographic characteristics, socioeconomic status (SES), and race/ethnicity, higher tibia lead was associated with a progressive decline in eye-hand coordination in all subjects; stratified analysis substantiated this association only in African-Americans. In all subjects, tibia lead was associated with persistent effects with worse cognitive function in all six domains, but these associations weakened after increasing covariate control. In fully adjusted stratified analysis, persistent effects were present in whites in eye-hand coordination, executive functioning, and verbal memory and learning. Conclusions The study presents the strongest adult evidence to date in a diverse population of the impacts of cumulative lead dose on cognitive function independent of SES. As the study population was relatively young and the average total duration of follow-up short (< 30 months), the findings may represent the lower bound of what the impact of cumulative lead dose might be on the cognitive function of older Americans. PMID:19752734

  19. Cognitive Correlates of Functional Performance in Older Adults: Comparison of Self-Report, Direct Observation, and Performance-Based Measures

    PubMed Central

    Schmitter-Edgecombe, Maureen; Parsey, Carolyn; Cook, Diane J.

    2013-01-01

    Neuropsychologists are often asked to answer questions about the effects of cognitive deficits on everyday functioning. This study examined the relationship between and the cognitive correlates of self-report, performance-based, and direct observation measures commonly used as proxy measures for everyday functioning. Participants were 88 community-dwelling, cognitively healthy older adults (age 50–86 years). Participants completed standardized neuropsychological tests and questionnaires, and performed eight activities of daily living (e.g., water plants, fill a medication dispenser) while under direct observation in a campus apartment. All proxy measures of everyday function were sensitive to the effects of healthy cognitive aging. After controlling for age, cognitive predictors explained a unique amount of the variance for only the performance-based behavioral simulation measure (i.e., Revised Observed Tasks of Daily Living). The self-report instrumental activities of daily living (IADL) and the performance-based everyday problem-solving test (i.e., EPT) did not correlate with each other; however, both were unique predictors of the direct observation measure. These findings suggest that neuropsychologists must be cautious in making predictions about the quality of everyday activity completion in cognitively healthy older adults from specific cognitive functions. The findings further suggest that a self-report of IADLs and the performance-based EPT may be useful measures for assessing everyday functional status in cognitively healthy older adults. PMID:21729400

  20. The right insula contributes to memory awareness in cognitively diverse older adults.

    PubMed

    Cosentino, Stephanie; Brickman, Adam M; Griffith, Erica; Habeck, Christian; Cines, Sarah; Farrell, Meagan; Shaked, Danielle; Huey, Edward D; Briner, Tamara; Stern, Yaakov

    2015-08-01

    Unawareness of memory loss is a challenging characteristic of Alzheimer's disease (AD) and other age-related neurodegenerative conditions at their earliest stages, adversely affecting important outcomes such as patient decision making and safety. The basis of this metacognitive disturbance has been elusive; however it is almost certainly determined in part by compromise to brain regions critical for self-assessment. The subjectivity of traditional measurements of self-awareness in dementia has likely limited the rigor with which its neuroanatomic correlates can be established. Here we objectively measure memory awareness (metamemory) using a Feeling of Knowing (FOK) task in a group of cognitively diverse older adults, including 14 with mild AD and 20 cognitively healthy older adults. Performance on the metamemory task was examined in relation to the structural integrity of 14 bilateral neuroanatomic regions hypothesized to support self-awareness. Less accurate metamemory was associated only with reduced right insular volume (r=.41, p=.019). Implications of the current findings for models of metacognitive aging are discussed, with attention to the role of the insula in the conscious detection of errors. PMID:26049091

  1. The Acceptability and Usefulness of Cognitive Stimulation Therapy for Older Adults with Dementia: A Narrative Review

    PubMed Central

    Toh, Hui Moon; Ghazali, Shazli Ezzat

    2016-01-01

    Cognitive stimulation therapy (CST) is an evidence-based therapy for individuals with mild-to-moderate dementia. Past reviews have only synthesized outcomes obtained through quantitative study which does not fully represent the understanding on the acceptability and usefulness of CST. Therefore, the present review aims to integrate outcomes obtained from both quantitative and qualitative studies to provide a deeper understanding on the acceptability and usefulness of CST for older adults with dementia. Findings of literature were retrieved from searches of computerized databases in relation to CST for people with dementia. Literatures were selected according to selection criteria outlined. Results obtained in previous studies pertaining to the effects of CST were discussed in relation to variables such as cognitive function, quality of life, and family caregivers' wellbeing. The review also explores the use of CST in different cultural context, the perception on its effectiveness, and individualized CST (iCST). There is considerable evidence obtained through quantitative and qualitative studies on the usefulness and acceptability of CST for older adults with dementia. Recommendations for future research are provided to strengthen the evidence of CST's effectiveness. PMID:27478677

  2. Associative memory and underlying brain correlates in older adults with mild cognitive impairment.

    PubMed

    Chen, Pei-Ching; Chang, Yu-Ling

    2016-05-01

    This study investigated associative recognition memory by using unique features of the Chinese language and the underlying neuroanatomical correlates. The study participants were 22 Chinese speakers with mild cognitive impairment (MCI) and 25 cognitively normal (CN) Chinese speakers. The results revealed that the MCI group demonstrated impaired associative memory performance, despite exhibiting item memory performance comparable with that of the CN group, and that associative memory performance in older adults was associated with gray matter integrity in the medial temporal regions as well as executive function. An abnormal elevation was also observed in false-positive errors related to features unique to Chinese characters, namely orthographical errors, in addition to rearranged and semantic errors in the MCI group relative to the CN group, and the three error subtypes were differentially associated with gray matter integrity in the hippocampus or lateral prefrontal regions. Overall, these results demonstrate the value of evaluating associative memory in people with prodromal Alzheimer's disease (AD), and further elucidate the underlying neural substrates related to associative recognition memory in older adults. PMID:27033742

  3. Problems experienced by informal caregivers with older care recipients with and without cognitive impairment

    PubMed Central

    Van Bruggen, Sytske; Gussekloo, Jacobijn; Bode, Christina; Touwen, Dorothea P.; Engberts, Dick P.; Blom, Jeanet W.

    2016-01-01

    ABSTRACT The care of older persons can have negative impact on the caregiver. The objective of this population-based observational study is to identify problems experienced by informal caregivers, and the extent of related difficulties, in their care of older care-dependent recipients with and without cognitive impairment. Caregivers (n = 2,704) caring for a home-dwelling person aged ≥ 75 years responded to a questionnaire with 23 questions on problems and related difficulties by mail. Prevalence of self-reported problems and related difficulties was calculated. The impact of the problem was estimated by weighing the percentage of problems reported as being difficult against the prevalence of problems. The median number of problems was 12 (range 0–23), with 5 (range 0–23) reported as difficult. Informal caregivers experience a variety of problems, with the impossibility to engage in joint social activities having the highest impact. The impact of problems increased when the care recipient had a cognitive problem. PMID:27018745

  4. The right insula contributes to memory awareness in cognitively diverse older adults

    PubMed Central

    Cosentino, Stephanie; Brickman, Adam M.; Griffith, Erica; Habeck, Christian; Cines, Sarah; Farrell, Meagan; Shaked, Danielle; Huey, Edward D.; Briner, Tamara; Stern, Yaakov

    2015-01-01

    Unawareness of memory loss is a challenging characteristic of Alzheimer’s disease (AD) and other age-related neurodegenerative conditions at their earliest stages, adversely affecting important outcomes such as patient decision making and safety. The basis of this metacognitive disturbance has been elusive; however it is almost certainly determined in part by compromise to brain regions critical for self-assessment. The subjectivity of traditional measurements of self-awareness in dementia has likely limited the rigor with which its neuroanatomic correlates can be established. Here we objectively measure memory awareness (metamemory) using a Feeling of Knowing (FOK) task in a group of cognitively diverse older adults, including 14 with mild AD and 20 cognitively healthy older adults. Performance on the metamemory task was examined in relation to the structural integrity of 14 bilateral neuroanatomic regions hypothesized to support self-awareness. Less accurate metamemory was associated only with reduced right insular volume (r = .41, p = .019). Implications of the current findings for models of metacognitive aging are discussed, with attention to the role of the insula in the conscious detection of errors. PMID:26049091

  5. Problems experienced by informal caregivers with older care recipients with and without cognitive impairment.

    PubMed

    Van Bruggen, Sytske; Gussekloo, Jacobijn; Bode, Christina; Touwen, Dorothea P; Engberts, Dick P; Blom, Jeanet W

    2016-01-01

    The care of older persons can have negative impact on the caregiver. The objective of this population-based observational study is to identify problems experienced by informal caregivers, and the extent of related difficulties, in their care of older care-dependent recipients with and without cognitive impairment. Caregivers (n = 2,704) caring for a home-dwelling person aged ≥ 75 years responded to a questionnaire with 23 questions on problems and related difficulties by mail. Prevalence of self-reported problems and related difficulties was calculated. The impact of the problem was estimated by weighing the percentage of problems reported as being difficult against the prevalence of problems. The median number of problems was 12 (range 0-23), with 5 (range 0-23) reported as difficult. Informal caregivers experience a variety of problems, with the impossibility to engage in joint social activities having the highest impact. The impact of problems increased when the care recipient had a cognitive problem. PMID:27018745

  6. Evaluation of an intelligent wheelchair system for older adults with cognitive impairments

    PubMed Central

    2013-01-01

    Background Older adults are the most prevalent wheelchair users in Canada. Yet, cognitive impairments may prevent an older adult from being allowed to use a powered wheelchair due to safety and usability concerns. To address this issue, an add-on Intelligent Wheelchair System (IWS) was developed to help older adults with cognitive impairments drive a powered wheelchair safely and effectively. When attached to a powered wheelchair, the IWS adds a vision-based anti-collision feature that prevents the wheelchair from hitting obstacles and a navigation assistance feature that plays audio prompts to help users manoeuvre around obstacles. Methods A two stage evaluation was conducted to test the efficacy of the IWS. Stage One: Environment of Use – the IWS’s anti-collision and navigation features were evaluated against objects found in a long-term care facility. Six different collision scenarios (wall, walker, cane, no object, moving and stationary person) and three different navigation scenarios (object on left, object on right, and no object) were performed. Signal detection theory was used to categorize the response of the system in each scenario. Stage Two: User Trials – single-subject research design was used to evaluate the impact of the IWS on older adults with cognitive impairment. Participants were asked to drive a powered wheelchair through a structured obstacle course in two phases: 1) with the IWS and 2) without the IWS. Measurements of safety and usability were taken and compared between the two phases. Visual analysis and phase averages were used to analyze the single-subject data. Results Stage One: The IWS performed correctly for all environmental anti-collision and navigation scenarios. Stage Two: Two participants completed the trials. The IWS was able to limit the number of collisions that occurred with a powered wheelchair and lower the perceived workload for driving a powered wheelchair. However, the objective performance (time to complete course

  7. Height and cognitive function at older ages: is height a useful summary measure of early childhood experiences?

    PubMed

    Guven, Cahit; Lee, Wang Sheng

    2013-02-01

    Previous research using US data suggests that height, as a marker for early investments in health, is associated with better cognitive functioning in later life, but this association disappears once education is controlled for. Using an English cohort of men and women older than 50 years, we find that the association between height and cognitive outcomes remains significant after controlling for education suggesting that height affects cognitive functioning not simply via higher educational attainment. Furthermore, the significant association between height and cognitive function remains even after controls for early life indicators have been included. PMID:22231981

  8. Effects of a social cognitive theory-based hip fracture prevention web site for older adults.

    PubMed

    Nahm, Eun-Shim; Barker, Bausell; Resnick, Barbara; Covington, Barbara; Magaziner, Jay; Brennan, Patricia Flatley

    2010-01-01

    The purposes of this study were to develop a Social Cognitive Theory-based, structured Hip Fracture Prevention Web site for older adults and conduct a preliminary evaluation of its effectiveness. The Theory-based, structured Hip Fracture Prevention Web site is composed of learning modules and a moderated discussion board. A total of 245 older adults recruited from two Web sites and a newspaper advertisement were randomized into the Theory-based, structured Hip Fracture Prevention Web site and the conventional Web sites groups. Outcomes included (1) knowledge (hip fractures and osteoporosis), (2) self-efficacy and outcome expectations, and (3) calcium intake and exercise and were assessed at baseline, end of treatment (2 weeks), and follow-up (3 months). Both groups showed significant improvement in most outcomes. For calcium intake, only the Theory-based, structured Hip Fracture Prevention Web site group showed improvement. None of the group and time interactions were significant. The Theory-based, structured Hip Fracture Prevention Web site group, however, was more satisfied with the intervention. The discussion board usage was significantly correlated with outcome gains. Despite several limitations, the findings showed some preliminary effectiveness of Web-based health interventions for older adults and the use of a Theory-based, structured Hip Fracture Prevention Web site as a sustainable Web structure for online health behavior change interventions. PMID:20978408

  9. Auditory and cognitive factors underlying individual differences in aided speech-understanding among older adults

    PubMed Central

    Humes, Larry E.; Kidd, Gary R.; Lentz, Jennifer J.

    2013-01-01

    This study was designed to address individual differences in aided speech understanding among a relatively large group of older adults. The group of older adults consisted of 98 adults (50 female and 48 male) ranging in age from 60 to 86 (mean = 69.2). Hearing loss was typical for this age group and about 90% had not worn hearing aids. All subjects completed a battery of tests, including cognitive (6 measures), psychophysical (17 measures), and speech-understanding (9 measures), as well as the Speech, Spatial, and Qualities of Hearing (SSQ) self-report scale. Most of the speech-understanding measures made use of competing speech and the non-speech psychophysical measures were designed to tap phenomena thought to be relevant for the perception of speech in competing speech (e.g., stream segregation, modulation-detection interference). All measures of speech understanding were administered with spectral shaping applied to the speech stimuli to fully restore audibility through at least 4000 Hz. The measures used were demonstrated to be reliable in older adults and, when compared to a reference group of 28 young normal-hearing adults, age-group differences were observed on many of the measures. Principal-components factor analysis was applied successfully to reduce the number of independent and dependent (speech understanding) measures for a multiple-regression analysis. Doing so yielded one global cognitive-processing factor and five non-speech psychoacoustic factors (hearing loss, dichotic signal detection, multi-burst masking, stream segregation, and modulation detection) as potential predictors. To this set of six potential predictor variables were added subject age, Environmental Sound Identification (ESI), and performance on the text-recognition-threshold (TRT) task (a visual analog of interrupted speech recognition). These variables were used to successfully predict one global aided speech-understanding factor, accounting for about 60% of the variance. PMID

  10. Auditory and cognitive factors underlying individual differences in aided speech-understanding among older adults.

    PubMed

    Humes, Larry E; Kidd, Gary R; Lentz, Jennifer J

    2013-01-01

    This study was designed to address individual differences in aided speech understanding among a relatively large group of older adults. The group of older adults consisted of 98 adults (50 female and 48 male) ranging in age from 60 to 86 (mean = 69.2). Hearing loss was typical for this age group and about 90% had not worn hearing aids. All subjects completed a battery of tests, including cognitive (6 measures), psychophysical (17 measures), and speech-understanding (9 measures), as well as the Speech, Spatial, and Qualities of Hearing (SSQ) self-report scale. Most of the speech-understanding measures made use of competing speech and the non-speech psychophysical measures were designed to tap phenomena thought to be relevant for the perception of speech in competing speech (e.g., stream segregation, modulation-detection interference). All measures of speech understanding were administered with spectral shaping applied to the speech stimuli to fully restore audibility through at least 4000 Hz. The measures used were demonstrated to be reliable in older adults and, when compared to a reference group of 28 young normal-hearing adults, age-group differences were observed on many of the measures. Principal-components factor analysis was applied successfully to reduce the number of independent and dependent (speech understanding) measures for a multiple-regression analysis. Doing so yielded one global cognitive-processing factor and five non-speech psychoacoustic factors (hearing loss, dichotic signal detection, multi-burst masking, stream segregation, and modulation detection) as potential predictors. To this set of six potential predictor variables were added subject age, Environmental Sound Identification (ESI), and performance on the text-recognition-threshold (TRT) task (a visual analog of interrupted speech recognition). These variables were used to successfully predict one global aided speech-understanding factor, accounting for about 60% of the variance. PMID

  11. Gaming for health: a systematic review of the physical and cognitive effects of interactive computer games in older adults.

    PubMed

    Bleakley, Chris M; Charles, Darryl; Porter-Armstrong, Alison; McNeill, Michael D J; McDonough, Suzanne M; McCormack, Brendan

    2015-04-01

    This systematic review examined the physical and cognitive effects of physically based interactive computer games (ICGs) in older adults. Literature searching was carried out from January 2000 to June 2011. Eligible studies were trials involving older adults (>65 years) describing the effects of ICGs with a physical component (aerobic, strength, balance, flexibility) on physical or cognitive outcomes. Secondary outcomes included adverse effects, compliance, and enjoyment. Twelve trials met the inclusion criteria. ICG interventions varied in terms of software, game type, and nature of the computer interaction. Although there was preliminary evidence that ICG is a safe and effective exercise intervention for older adults, the dearth of high-quality evidence limits this finding. No major adverse effects were reported and two studies reported minor events. ICG could be improved further by tailoring interventions for older adults; in particular, they should aim to optimize participant safety, motivation, and enjoyment for this population. PMID:24652863

  12. Oily Fish Intake and Cognitive Performance in Community-Dwelling Older Adults: The Atahualpa Project.

    PubMed

    Del Brutto, Oscar H; Mera, Robertino M; Gillman, Jennifer; Zambrano, Mauricio; Ha, Jung-eun

    2016-02-01

    Due to their high content of omega-3 polyunsaturated fatty acids, oily fish consumption is likely associated with a better cognitive performance. However, information on this association is controversial, with some studies showing a positive effect while others showing no association. We aimed to assess the effects of oily fish consumption on cognitive performance in a population of frequent fish consumers living in rural coastal Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door survey and evaluated by the use of the Montreal Cognitive Assessment (MoCA). Oily fish servings per week were calculated in all participants. We estimated whether fish intake correlated with MoCA scores in generalized multivariate linear models adjusted for demographics, cardiovascular risk factors, edentulism and symptoms of depression. Out of 330 eligible persons, 307 (93%) were enrolled. Mean MoCA scores were 19 ± 4.8 points, and mean oily fish consumption was 8.6 ± 5.3 servings per week. In multivariate analyses, MoCA scores were related to fish servings (β 0.097, 95% CI 0.005-0.188, p = 0.038). Locally weighted scatterplot smoothing showed an inflection point in the total MoCA score curve at four fish servings per week. However, predictive margins of the MoCA score were similar across groups below and above this point, suggesting a direct linear relationship between oily fish intake and cognitive performance. Simple preventive measures, such as modifying dietary habits might be of value to reduce the rate of cognitive decline in community-dwelling older adults living in underserved populations. PMID:26187093

  13. The role of auditory and cognitive factors in understanding speech in noise by normal-hearing older listeners

    PubMed Central

    Schoof, Tim; Rosen, Stuart

    2014-01-01

    Normal-hearing older adults often experience increased difficulties understanding speech in noise. In addition, they benefit less from amplitude fluctuations in the masker. These difficulties may be attributed to an age-related auditory temporal processing deficit. However, a decline in cognitive processing likely also plays an important role. This study examined the relative contribution of declines in both auditory and cognitive processing to the speech in noise performance in older adults. Participants included older (60–72 years) and younger (19–29 years) adults with normal hearing. Speech reception thresholds (SRTs) were measured for sentences in steady-state speech-shaped noise (SS), 10-Hz sinusoidally amplitude-modulated speech-shaped noise (AM), and two-talker babble. In addition, auditory temporal processing abilities were assessed by measuring thresholds for gap, amplitude-modulation, and frequency-modulation detection. Measures of processing speed, attention, working memory, Text Reception Threshold (a visual analog of the SRT), and reading ability were also obtained. Of primary interest was the extent to which the various measures correlate with listeners' abilities to perceive speech in noise. SRTs were significantly worse for older adults in the presence of two-talker babble but not SS and AM noise. In addition, older adults showed some cognitive processing declines (working memory and processing speed) although no declines in auditory temporal processing. However, working memory and processing speed did not correlate significantly with SRTs in babble. Despite declines in cognitive processing, normal-hearing older adults do not necessarily have problems understanding speech in noise as SRTs in SS and AM noise did not differ significantly between the two groups. Moreover, while older adults had higher SRTs in two-talker babble, this could not be explained by age-related cognitive declines in working memory or processing speed. PMID:25429266

  14. The 2-Minute Step Test is Independently Associated with Cognitive Function in Older Adults with Heart Failure

    PubMed Central

    Alosco, Michael L.; Spitznagel, Mary Beth; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H.; Colbert, Lisa H.; Josephson, Richard; Waechter, Donna; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Background and Aims Cognitive impairment is common in persons with heart failure (HF), and measures like the 6-minute walk test (6MWT) are known to correspond to level of impairment. The 2-minute step test (2MST) has been suggested as a more practical alternative to the 6MWT, though no study has examined whether it is associated with cognitive impairment in persons with HF. This study examined whether the 2MST is associated with cognitive function in older adults with HF. Methods Older adults with HF (N = 145; 68.97±9.31 years) completed the 2MST and a neuropsychological test battery that assessed function in multiple cognitive domains. Results Consistent with past work, HF patients exhibited high rates of cognitive impairment. Hierarchical regression analyses adjusting for demographic and medical characteistics found that the 2MST accounted for unique variance in global cognitive function (ΔR2 = .09, p < .001), executive function (ΔR2 = .03, p < .05), and language (ΔR2 = .10, p < .001). A trend emerged for attention (ΔR2 = .02, p = .09), Follow-up tests indicated that better 2MST performance was significantly correlated with better global, attention, executive, and language test performance. Conclusion The current results indicate that the 2MST is associated with cognitive function in older adults with HF. Further work is needed to clarify underlying mechanisms for this association and the value of implementing the 2MST during routine visits. PMID:22182711

  15. Improved Blood Biomarkers but No Cognitive Effects from 16 Weeks of Multivitamin Supplementation in Healthy Older Adults

    PubMed Central

    Harris, Elizabeth; Macpherson, Helen; Pipingas, Andrew

    2015-01-01

    Supplementation with vitamins, minerals and phytonutrients may be beneficial for cognition, especially in older adults. The aim of this study was to assess the effects of multivitamin supplementation in older adults on cognitive function and associated blood biomarkers. In a randomised, double blind, placebo-controlled trial, healthy women (n = 68) and men (n = 48) aged 55–65 years were supplemented daily for 16 weeks with women’s and men’s formula multivitamin supplements. Assessments at baseline and post-supplementation included computerised cognitive tasks and blood biomarkers relevant to cognitive aging. No cognitive improvements were observed after supplementation with either formula; however, several significant improvements were observed in blood biomarkers including increased levels of vitamins B6 and B12 in women and men; reduced C-reactive protein in women; reduced homocysteine and marginally reduced oxidative stress in men; as well as improvements to the lipid profile in men. In healthy older people, multivitamin supplementation improved a number of blood biomarkers that are relevant to cognition, but these biomarker changes were not accompanied by improved cognitive function. PMID:25996285

  16. Improved blood biomarkers but no cognitive effects from 16 weeks of multivitamin supplementation in healthy older adults.

    PubMed

    Harris, Elizabeth; Macpherson, Helen; Pipingas, Andrew

    2015-05-01

    Supplementation with vitamins, minerals and phytonutrients may be beneficial for cognition, especially in older adults. The aim of this study was to assess the effects of multivitamin supplementation in older adults on cognitive function and associated blood biomarkers. In a randomised, double blind, placebo-controlled trial, healthy women (n = 68) and men (n = 48) aged 55-65 years were supplemented daily for 16 weeks with women's and men's formula multivitamin supplements. Assessments at baseline and post-supplementation included computerised cognitive tasks and blood biomarkers relevant to cognitive aging. No cognitive improvements were observed after supplementation with either formula; however, several significant improvements were observed in blood biomarkers including increased levels of vitamins B6 and B12 in women and men; reduced C-reactive protein in women; reduced homocysteine and marginally reduced oxidative stress in men; as well as improvements to the lipid profile in men. In healthy older people, multivitamin supplementation improved a number of blood biomarkers that are relevant to cognition, but these biomarker changes were not accompanied by improved cognitive function. PMID:25996285

  17. OLDER ADULT PSYCHIATRIC INPATIENTS WITH NON-COGNITIVE DISORDERS SHOULD BE SCREENED FOR VITAMIN B12 DEFICIENCY

    PubMed Central

    LACHNER, C.; MARTIN, C.; JOHN, D.; NEKKALAPU, S.; SASAN, A.; STEINLE, N.; REGENOLD, W.T.

    2016-01-01

    Objective Vitamin B12 (B12) deficiency is most prevalent among older adults. Practice guidelines recommend screening older adults with symptoms of cognitive disorder for B12 deficiency. However, guidelines for non-cognitive psychiatric disorders typically do not mention screening older adults for B12 deficiency. The purpose of this study was to determine whether routine screening of older adult psychiatric inpatients for B12 deficiency, regardless of cognitive symptoms, is clinically justified. Design We conducted a retrospective chart-review study of consecutive inpatient admissions. Setting Older Adult Acute Psychiatric Inpatient Unit at the University of Maryland Medical Center from 10/2007-4/2010. Participants Acute psychiatric inpatients aged ≥50 years who met inclusion criteria (N=374). Measurements Mean (SD) B12 levels and percentages of probable (<180pg/mL) and possible (180–350pg/mL) B12 deficiency as well as characteristics of patients with probable and possible B12 deficiency compared to patients with optimal B12 levels. Results Mean (SD) B12 levels and percentages of probable and possible B12 deficiency, respectively, for cognitive disorder patients [468 (284) pg/mL, 7.8 % (n=5) and 29.7% (n=19)] and for non-cognitive disorder patients [481(268) pg/mL, 4.8 %(n=15) and 33.2%(n=103)] were not significantly different (t=0.339, df=372, P=0.735; χ2=1.084, df=2, P=0.582, respectively). Conclusion Considering the potential benefits and low costs of screening and treatment, we conclude that it is justified to routinely screen older adult psychiatric inpatients for B12 deficiency whether or not cognitive disorder symptoms are present. PMID:24522476

  18. Role of Dietary Protein and Thiamine Intakes on Cognitive Function in Healthy Older People: A Systematic Review

    PubMed Central

    Koh, Freda; Charlton, Karen; Walton, Karen; McMahon, Anne-Therese

    2015-01-01

    The effectiveness of nutritional interventions to prevent and maintain cognitive functioning in older adults has been gaining interest due to global population ageing. A systematic literature review was conducted to obtain and appraise relevant studies on the effects of dietary protein or thiamine on cognitive function in healthy older adults. Studies that reported on the use of nutritional supplementations and/or populations with significant cognitive impairment were excluded. Seventeen eligible studies were included. Evidence supporting an association between higher protein and/or thiamine intakes and better cognitive function is weak. There was no evidence to support the role of specific protein food sources, such as types of meat, on cognitive function. Some cross-sectional and case-control studies reported better cognition in those with higher dietary thiamine intakes, but the data remains inconclusive. Adequate protein and thiamine intake is more likely associated with achieving a good overall nutritional status which affects cognitive function rather than single nutrients. A lack of experimental studies in this area prevents the translation of these dietary messages for optimal cognitive functioning and delaying the decline in cognition with advancing age. PMID:25849949

  19. Role of dietary protein and thiamine intakes on cognitive function in healthy older people: a systematic review.

    PubMed

    Koh, Freda; Charlton, Karen; Walton, Karen; McMahon, Anne-Therese

    2015-04-01

    The effectiveness of nutritional interventions to prevent and maintain cognitive functioning in older adults has been gaining interest due to global population ageing. A systematic literature review was conducted to obtain and appraise relevant studies on the effects of dietary protein or thiamine on cognitive function in healthy older adults. Studies that reported on the use of nutritional supplementations and/or populations with significant cognitive impairment were excluded. Seventeen eligible studies were included. Evidence supporting an association between higher protein and/or thiamine intakes and better cognitive function is weak. There was no evidence to support the role of specific protein food sources, such as types of meat, on cognitive function. Some cross-sectional and case-control studies reported better cognition in those with higher dietary thiamine intakes, but the data remains inconclusive. Adequate protein and thiamine intake is more likely associated with achieving a good overall nutritional status which affects cognitive function rather than single nutrients. A lack of experimental studies in this area prevents the translation of these dietary messages for optimal cognitive functioning and delaying the decline in cognition with advancing age. PMID:25849949

  20. Napping in older people 'at risk' of dementia: relationships with depression, cognition, medical burden and sleep quality.

    PubMed

    Cross, Nathan; Terpening, Zoe; Rogers, Naomi L; Duffy, Shantel L; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L

    2015-10-01

    Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those 'at risk' of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults 'at risk' of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults 'at risk' of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes. PMID:26096839

  1. Exercise-induced changes in basal ganglia volume and cognition in older adults.

    PubMed

    Niemann, C; Godde, B; Staudinger, U M; Voelcker-Rehage, C

    2014-12-01

    Physical activity has been demonstrated to diminish age-related brain volume shrinkage in several brain regions accompanied by a reduction of age-related decline in cognitive functions. Most studies investigated the impact of cardiovascular fitness or training. Other types of fitness or training are less well investigated. In addition, little is known about exercise effects on volume of the basal ganglia, which, however, are involved in motor activities and cognitive functioning. In the current study (1) we examined the relationships of individual cardiovascular and motor fitness levels with the volume of the basal ganglia (namely caudate, putamen, and globus pallidus) and selected cognitive functions (executive control, perceptual speed). (2) We investigated the effect of 12-month training interventions (cardiovascular and coordination training, control group stretching and relaxation) on the volume of the respective basal ganglia nuclei. Results revealed that motor fitness but not cardiovascular fitness was positively related with the volume of the putamen and the globus pallidus. Additionally, a moderating effect of the volume of the basal ganglia (as a whole, but also separately for putamen and globus pallidus) on the relationship between motor fitness and executive function was revealed. Coordination training increased caudate and globus pallidus volume. We provide evidence that coordinative exercise seems to be a favorable leisure activity for older adults that has the potential to improve volume of the basal ganglia. PMID:25255932

  2. [Evaluation of peruvian money test in screening of cognitive impairment among older adults].

    PubMed

    Oscanoa, Teodoro J; Cieza, Edwin; Parodi, José F; Paredes, Napoleón

    2016-03-01

    Objectives To evaluate the Peruvian adaptation of the money test (Eurotest) for identifying cognitive impairment among >60-year-old adults. Materials and methods This is a phase I study of diagnostic test, with a convenience sampling and calculation of the test´s sensitivity and specificity, based on a pretest prevalence of 50%. The criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) and Global Deterioration Scale (GDS) were used for the operational definition of patients with cognitive impairment. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cut-off value. Results The study evaluated 42 cases and 42 controls; there was no significant difference between age (77.88 ± 6.01 years vs. 6.49 76.14 ± years) and years of education (13.69 ± 3.70 years vs. 8.17 ± 4.71 years). The Peruvian version of the Eurotest has a sensitivity of 90.5% and specificity of 83.3% with cut-off value of 24. Conclusions The Peruvian adapted version of the Eurotest, called prueba de la moneda peruana could be useful in screening for cognitive impairment among older adults. PMID:27384624

  3. Exercise holds immediate benefits for affect and cognition in younger and older adults.

    PubMed

    Hogan, Candice L; Mata, Jutta; Carstensen, Laura L

    2013-06-01

    Physical activity is associated with improved affective experience and enhanced cognitive processing. Potential age differences in the degree of benefit, however, are poorly understood because most studies examine either younger or older adults. The present study examined age differences in cognitive performance and affective experience immediately following a single bout of moderate exercise. Participants (144 community members aged 19 to 93) were randomly assigned to one of two experimental conditions: (a) exercise (15 min of moderate intensity stationary cycling) or (b) control (15 min completing ratings of neutral IAPS images). Before and after the manipulation, participants completed tests of working memory and momentary affect experience was measured. Results suggest that exercise is associated with increased levels of high-arousal positive affect (HAP) and decreased levels of low-arousal positive affect (LAP) relative to control condition. Age moderated the effects of exercise on LAP, such that younger age was associated with a drop in reported LAP postexercise, whereas the effects of exercise on HAP were consistent across age. Exercise also led to faster RTs on a working memory task than the control condition across age. Self-reported negative affect was unchanged. Overall, findings suggest that exercise may hold important benefits for both affective experience and cognitive performance regardless of age. PMID:23795769

  4. Absence of amyloid β oligomers at the postsynapse and regulated synaptic Zn2+ in cognitively intact aged individuals with Alzheimer’s disease neuropathology

    PubMed Central

    2012-01-01

    Background Early cognitive impairment in Alzheimer Disease (AD) is thought to result from the dysfunctional effect of amyloid beta (Aβ) oligomers targeting the synapses. Some individuals, however, escape cognitive decline despite the presence of the neuropathologic features of AD (Aβ plaques and neurofibrillary tangles). We term this group Non-Demented with AD Neuropathology or NDAN. The present study illustrates one putative resistance mechanism involved in NDAN cases which may suggest targets for the effective treatment of AD. Results Here we describe the localization of Aβ oligomers at the postsynapse in hippocampi from AD cases. Notably, however, we also found that while present in soluble fractions, Aβ oligomers are absent from hippocampal postsynapses in NDAN cases. In addition, levels of phosphorylated (active) CREB, a transcription factor important for synaptic plasticity, are normal in NDAN individuals, suggesting that their synapses are functionally intact. Analysis of Zn2+ showed that levels were increased in both soluble fractions and synaptic vesicles in AD hippocampi, paralleled by a decrease of expression of the synaptic vesicle Zn2+ transporter, ZnT3. Conversely, in NDAN individuals, levels of Zn2+ in soluble fractions were significantly lower than in AD, whereas in synaptic vesicles the levels of Zn2+ were similar to AD, but accompanied by preserved expression of the ZnT3. Conclusions Taken together, these data illustrate that despite substantial AD neuropathology, Aβ oligomers, and increased synaptic vesicle Zn2+, susceptible brain tissue in these aged NDAN individuals features, as compared to symptomatic AD subjects, significantly lower total Zn2+ levels and no association of Aβ oligomers with the postsynapse, which collectively may promote the maintenance of intact cognitive function. PMID:22640423

  5. Effect of Baduanjin exercise on cognitive function in older adults with mild cognitive impairment: study protocol for a randomised controlled trial

    PubMed Central

    Zheng, Guohua; Huang, Maomao; Li, Shuzhen; Li, Moyi; Xia, Rui; Zhou, Wenji; Tao, Jing; Chen, Lidian

    2016-01-01

    Introduction Mild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and dementia characterised by a reduction in memory and/or other cognitive processes. An increasing number of studies have indicated that regular physical activity/exercise may have beneficial association with cognitive function of older adults with or without cognitive impairment. As a traditional Chinese Qigong exercise, Baduanjin may be even more beneficial in promoting cognitive ability in older adults with MCI, but the evidence is still insufficient. The main purpose of this study is to investigate the effect of Baduanjin exercise on neuropsychological outcomes of community-dwelling older adults with MCI, and to explore its mechanism of action from neuroimaging based on functional MRI (fMRI) and cerebrovascular function. Methods and analysis The design of this study is a randomised, controlled trial with three parallel groups in a 1:1:1 allocation ratio with allocation concealment and assessor blinding. A total of 135 participants will be enrolled and randomised to the 24-week Baduanjin exercise intervention, 24-week brisk walking intervention and 24-week usual physical activity control group. Global cognitive function and the specific domains of cognition (memory, processing speed, executive function, attention and verbal learning and memory) will be assessed at baseline and 9, 17, 25 and 37 weeks after randomisation, while the structure and function of brain regions related to cognitive function and haemodynamic variables of the brain will be measured by fMRI and transcranial Doppler, respectively, at baseline and 25 and 37 weeks after randomisation. Ethics and dissemination Ethics approval was given by the Medical Ethics Committee of the Second People's Hospital of Fujian Province (approval number 2014-KL045-02). The findings will be disseminated through peer-reviewed publications and at scientific conferences. Trial registration number

  6. Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial.

    PubMed

    Ballesteros, Soledad; Prieto, Antonio; Mayas, Julia; Toril, Pilar; Pita, Carmen; Ponce de León, Laura; Reales, José M; Waterworth, John

    2014-01-01

    Age-related cognitive and brain declines can result in functional deterioration in many cognitive domains, dependency, and dementia. A major goal of aging research is to investigate methods that help to maintain brain health, cognition, independent living and wellbeing in older adults. This randomized controlled study investigated the effects of 20 1-h non-action video game training sessions with games selected from a commercially available package (Lumosity) on a series of age-declined cognitive functions and subjective wellbeing. Two groups of healthy older adults participated in the study, the experimental group who received the training and the control group who attended three meetings with the research team along the study. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. All participants were assessed individually before and after the intervention, or a similar period of time, using neuropsychological tests and laboratory tasks to investigate possible transfer effects. The results showed significant improvements in the trained group, and no variation in the control group, in processing speed (choice reaction time), attention (reduction of distraction and increase of alertness), immediate and delayed visual recognition memory, as well as a trend to improve in Affection and Assertivity, two dimensions of the Wellbeing Scale. Visuospatial working memory (WM) and executive control (shifting strategy) did not improve. Overall, the current results support the idea that training healthy older adults with non-action video games will enhance some cognitive abilities but not others. PMID:25352805

  7. A Cross-Sectional Study of the Relationship of Physical Activity with Depression and Cognitive Deficit in Older Adults.

    PubMed

    Paulo T, R S; Tribess, Sheilla; Sasaki, Jeffer Eidi; Meneguci, Joilson; Martins, Cristiane A; Freitas, Ismael F; Romo-Perez, Vicente; Virtuoso, Jair S

    2016-04-01

    The aim of this study was to examine the association of physical activity with depression and cognition deficit, separately and combined, in Brazilian older adults. We analyzed data from 622 older adults. Physical activity was assessed using the International Physical Activity Questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale, while cognitive deficit was assessed using the Mini-Mental State Examination. Multinomial logistic regressions were used to assess associations of depression and cognitive deficit with sociodemographic, health, and behavioral variables. Prevalence of physical inactivity (< 150 min of moderate-to-vigorous physical activity/ week), depression, and cognitive deficit were 35.7%, 37.4%, and 16.7%. Physical inactivity was associated with depression (OR: 1.83, 95% CI: 1.14-2.94) and with depression and cognitive deficit combined (OR: 4.23, 95% CI: 2.01-8.91). Physically inactive participants were also more likely to present limitations in orientation and language functions. Physical inactivity was associated with depression and also with depression and cognitive deficit combined in older adults. PMID:26439455

  8. Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial

    PubMed Central

    Ballesteros, Soledad; Prieto, Antonio; Mayas, Julia; Toril, Pilar; Pita, Carmen; Ponce de León, Laura; Reales, José M.; Waterworth, John

    2014-01-01

    Age-related cognitive and brain declines can result in functional deterioration in many cognitive domains, dependency, and dementia. A major goal of aging research is to investigate methods that help to maintain brain health, cognition, independent living and wellbeing in older adults. This randomized controlled study investigated the effects of 20 1-h non-action video game training sessions with games selected from a commercially available package (Lumosity) on a series of age-declined cognitive functions and subjective wellbeing. Two groups of healthy older adults participated in the study, the experimental group who received the training and the control group who attended three meetings with the research team along the study. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. All participants were assessed individually before and after the intervention, or a similar period of time, using neuropsychological tests and laboratory tasks to investigate possible transfer effects. The results showed significant improvements in the trained group, and no variation in the control group, in processing speed (choice reaction time), attention (reduction of distraction and increase of alertness), immediate and delayed visual recognition memory, as well as a trend to improve in Affection and Assertivity, two dimensions of the Wellbeing Scale. Visuospatial working memory (WM) and executive control (shifting strategy) did not improve. Overall, the current results support the idea that training healthy older adults with non-action video games will enhance some cognitive abilities but not others. PMID:25352805

  9. Trait Neuroticism, Depression, and Cognitive Function in Older Primary Care Patients

    PubMed Central

    Boyle, Lisa L.; Lyness, Jeffrey M.; Duberstein, Paul R.; Karuza, Jurgis; King, Deborah A.; Messing, Susan; Tu, Xin

    2010-01-01

    Objective Prior studies on the association of trait neuroticism and cognitive function in older adults have yielded mixed findings. We tested hypotheses that neuroticism is associated with measures of cognition and that depression moderates these relationships. Design Cross-sectional observational study. Setting Primary care offices. Participants Primary care patients age ≥65 years. Measurements Trait neuroticism was assessed by the NEO-Five Factor Inventory. Major and minor depression (MDD, MinD) were determined by the Structured Clinical Interview for DSM-IV, and depressive symptom severity by the Hamilton Depression Rating Scale (Ham-D). Cognitive measures included the Mini-Mental State Examination (MMSE), Initiation-Perseveration subscale of the Mattis Dementia Rating Scale, and Trail-Making Tests A and B. Results In multiple regression analyses, neuroticism was associated with MMSE score independent of depression diagnosis (β = −0.04, χ2 = 14.2, df = 1, p = 0.0002, 95% CI = −0.07, −0.02) and Ham-D score (β = −0.04, χ2 = 8.97, df = 1, p = 0.003, 95% CI = −0.06, −0.01). Interactions between neuroticism and depression diagnosis (χ2 = 7.21, df = 2, p = 0.03) and Ham-D scores (χ2 = 0.55, df = 1, p = 0.46) failed to lend strong support to the moderation hypothesis. Conclusion Neuroticism is associated with lower MMSE scores. Findings do not confirm a moderating role for depression, but suggest that depression diagnosis may confer additional risk for poorer global cognitive function in patients with high neuroticism. Further study is necessary. PMID:20220585

  10. Contributions of cognitive function to straight- and curved-path walking in older adults

    PubMed Central

    Lowry, Kristin A.; Brach, Jennifer S.; Nebes, Robert D.; Studenski, Stephanie A.; VanSwearingen, Jessie M.

    2016-01-01

    Objective To determine whether the cognitive function contribution to straight- and curved-path walking differs for older adults. Design Cross-sectional observational study. Setting Ambulatory clinical research training center. Participants One hundred six people aged 65 years to 92 years, able to walk household distances independently with or without an assistive device, and who scored ≥ 24 on the Mini-Mental State Examination. Intervention Not applicable. Main Outcome Measurements Cognitive function was assessed using the Digit Symbol Substitution Test (DSST) as a measure of psychomotor speed, and Trail Making Tests A and B (Trails A, Trails B), and the Trail Making Test difference score (Trails B-A) as executive function measures of complex visual scanning and set-shifting. Gait speed recorded over an instrumented walkway was used as the measure of straight-path walking. Curved-path walking was assessed using the Figure-of-8 Walk Test (F8W) and recorded as the total time and number of steps for completion. Results Both DSST and Trails A independently contributed to usual gait speed (P < 0.001). Trails A performance contributed to F8W time (P < 0.001). Neither Trails B nor Trails B-A contributed to usual gait speed or time to complete the F8W. For the number of steps taken to complete the F8W, Trails A, Trails B, and Trails B-A (all P < 0.001) were independent contributors while DSST performance was not. Conclusion Curved-path walking, as measured by F8W test, involves different cognitive processes compared to straight-path walking. Cognitive flexibility and set-shifting processes uniquely contributed to how individuals navigated curved-paths. The measure of curved-path walking provides different and meaningful information about daily life walking ability than usual gait speed alone. PMID:22541307

  11. Traumatic brain injury and age at onset of cognitive impairment in older adults.

    PubMed

    Li, Wei; Risacher, Shannon L; McAllister, Thomas W; Saykin, Andrew J

    2016-07-01

    There is a deficiency of knowledge regarding how traumatic brain injury (TBI) is associated with age at onset (AAO) of cognitive impairment in older adults. Participants with a TBI history were identified from the Alzheimer's disease neuroimaging initiative (ADNI 1/GO/2) medical history database. Using an analysis of covariance (ANCOVA) model, the AAO was compared between those with and without TBI, and potential confounding factors were controlled. The AAO was also compared between those with mild TBI (mTBI) and moderate or severe TBI (sTBI). Lastly, the effects of mTBI were analyzed on the AAO of participants with clinical diagnoses of either mild cognitive impairment (MCI) or Alzheimer's disease (AD). The AAO for a TBI group was 68.2 ± 1.1 years [95 % confidence interval (CI) 66.2-70.3, n = 62], which was significantly earlier than the AAO for the non-TBI group of 70.9 ± 0.2 years (95 % CI 70.5-71.4, n = 1197) (p = 0.013). Participants with mTBI history showed an AAO of 68.5 ± 1.1 years (n = 56), which was significantly earlier than the AAO for the non-TBI group (p = 0.032). Participants with both MCI and mTBI showed an AAO of 66.5 ± 1.3 years (95 % CI 63.9-69.1, n = 45), compared to 70.6 ± 0.3 years for the non-TBI MCI group (95 % CI 70.1-71.1, n = 935) (p = 0.016). As a conclusion, a history of TBI may accelerate the AAO of cognitive impairment by two or more years. These results were consistent with reports of TBI as a significant risk factor for cognitive decline in older adults, and TBI is associated with an earlier AAO found in patients with MCI or AD. PMID:27007484

  12. Does Older Adults' Cognitive Function Disrupt the Malleability of Their Attitudes toward Outgroup Members?: An fMRI Investigation.

    PubMed

    Krendl, Anne C; Kensinger, Elizabeth A

    2016-01-01

    In the current study we examine how individual differences in older adults' global cognitive function impacts the extent to which their attitudes toward stigmatized individuals are malleable. Because prior research has elucidated the neural processes that are involved in evaluating stigmatized individuals who are responsible or not responsible for their condition, a cognitive neuroscience approach may be well-suited to answer this question. In the current study, 36 older and 17 young adults underwent functional magnetic resonance imaging while evaluating images of homeless people who were described as being responsible or not responsible for their condition. They also indicated how much pity they felt for each of the individuals in order to determine the extent to which their attitudes were malleable (e.g., more pity for not-responsible as compared to responsible individuals). Participants' cognitive function and baseline measure of their attitudes toward stigmatized individuals (including homeless individuals) were assessed. Results revealed that although older adults' attitudes were malleable, the extent to which this was true varied due to individual differences in their global cognitive function. Specifically, the difference in the magnitude of older adults' self-reported pity for not-responsible as compared to responsible homeless individuals was predicted by their global cognitive function. Moreover, the difference in pity that older adults expressed toward not-responsible as compared to responsible homeless individuals was related to activity in the left insula and the anterior cingulate cortex (regions implicated in empathy). These results suggest that attitude malleability is affected by individual differences in global cognitive function. PMID:27074046

  13. Does Older Adults’ Cognitive Function Disrupt the Malleability of Their Attitudes toward Outgroup Members?: An fMRI Investigation

    PubMed Central

    Krendl, Anne C.; Kensinger, Elizabeth A.

    2016-01-01

    In the current study we examine how individual differences in older adults’ global cognitive function impacts the extent to which their attitudes toward stigmatized individuals are malleable. Because prior research has elucidated the neural processes that are involved in evaluating stigmatized individuals who are responsible or not responsible for their condition, a cognitive neuroscience approach may be well-suited to answer this question. In the current study, 36 older and 17 young adults underwent functional magnetic resonance imaging while evaluating images of homeless people who were described as being responsible or not responsible for their condition. They also indicated how much pity they felt for each of the individuals in order to determine the extent to which their attitudes were malleable (e.g., more pity for not-responsible as compared to responsible individuals). Participants’ cognitive function and baseline measure of their attitudes toward stigmatized individuals (including homeless individuals) were assessed. Results revealed that although older adults’ attitudes were malleable, the extent to which this was true varied due to individual differences in their global cognitive function. Specifically, the difference in the magnitude of older adults’ self-reported pity for not-responsible as compared to responsible homeless individuals was predicted by their global cognitive function. Moreover, the difference in pity that older adults expressed toward not-responsible as compared to responsible homeless individuals was related to activity in the left insula and the anterior cingulate cortex (regions implicated in empathy). These results suggest that attitude malleability is affected by individual differences in global cognitive function. PMID:27074046

  14. Self-reported sleep duration mitigates the association between inflammation and cognitive functioning in hospitalized older men.

    PubMed

    Dzierzewski, Joseph M; Song, Yeonsu; Fung, Constance H; Rodriguez, Juan C; Jouldjian, Stella; Alessi, Cathy A; Breen, Elizabeth C; Irwin, Michael R; Martin, Jennifer L

    2015-01-01

    Examination of predictors of late-life cognitive functioning is particularly salient in at-risk older adults, such as those who have been recently hospitalized. Sleep and inflammation are independently related to late-life cognitive functioning. The potential role of sleep as a moderator of the relationship between inflammation and global cognitive functioning has not been adequately addressed. We examined the relationship between self-reported sleep duration, inflammatory markers, and general cognitive functioning in hospitalized older men. Older men (n = 135; Mean age = 72.9 ± 9.7 years) were recruited from inpatient rehabilitation units at a VA Medical Center to participate in a cross-sectional study of sleep. Participants completed the Mini-Mental State Examination and Pittsburgh Sleep Quality Index, and underwent an 8 a.m. blood draw to measure inflammatory markers [i.e., C-reactive protein (CRP), tumor necrosis factor alpha (TNFα), soluble intercellular adhesion molecule-1 (sICAM-1), and interleukin-6 (IL-6)]. Hierarchical regression analyses (controlling for age, education, race, depression, pain, health comorbidity, and BMI) revealed that higher levels of CRP and sICAM are associated with higher global cognitive functioning in older men with sleep duration ≥6 h (β = -0.19, β = -0.18, p's < 0.05, respectively), but not in those with short sleep durations (p's > 0.05). In elderly hospitalized men, sleep duration moderates the association between inflammation and cognitive functioning. These findings have implications for the clinical care of older men within medical settings. PMID:26257670

  15. Minimal functional brain differences between older adults with and without mild cognitive impairment during the stroop.

    PubMed

    Puente, Antonio Nicolas; Faraco, Carlos; Terry, Douglas P; Brown, Courtney; Miller, L Stephen

    2014-01-01

    This investigation compared the neural correlates of inhibition in normal older adults (OAs) and OAs with mild cognitive impairment (MCI). It was hypothesized the MCI group would require a greater amount of resources for inhibition, and therefore display greater functional activation in specific regions of interest (ROIs). Twenty-six OAs without and 17 with MCI completed the Stroop task during functional neuroimaging, and completed additional out-of-scanner neuropsychological measures. During inhibition, there were minimal functional Magnetic Resonance Imaging (fMRI) differences found between groups in a priori specified ROIs and with post-hoc multiple regression analyses. However, these minimal differences did not survive corrected thresholds. Robust differences were found with several tasks of a neuropsychological screening battery. The results of this study suggest only very minimal group differences in fMRI activation during inhibition which may not reliably identify MCI, and this condition may be best detected by traditional neuropsychological techniques. PMID:23984890

  16. Cross-Sectional and Longitudinal Associations of Different Sedentary Behaviors with Cognitive Performance in Older Adults

    PubMed Central

    Kesse-Guyot, Emmanuelle; Charreire, Hélène; Andreeva, Valentina A.; Touvier, Mathilde; Hercberg, Serge; Galan, Pilar; Oppert, Jean-Michel

    2012-01-01

    Background The deleterious health effects of sedentary behaviors, independent of physical activity, are increasingly being recognized. However, associations with cognitive performance are not known. Purpose To estimate the associations between different sedentary behaviors and cognitive performance in healthy older adults. Methods Computer use, time spent watching television (TV), time spent reading and habitual physical activity levels were self-reported twice (in 2001 and 2007) by participants in the SUpplémentation en Vitamines et MinérauX (SU.VI.MAX and SU.VI.MAX2) study. Cognitive performance was assessed at follow-up (in 2007–2009) via a battery of 6 neuropsychological tests used to derive verbal memory and executive functioning scores. Analyses (ANCOVA) were performed among 1425 men and 1154 women aged 65.6±4.5 at the time of the neuropsychological evaluation. We estimated mean differences with 95% confidence intervals (95%CI) in cognitive performance across categories of each type of sedentary behavior. Results In multivariable cross-sectional models, compared to non-users, participants using the computer for >1 h/day displayed better verbal memory (mean difference = 1.86; 95%CI: 0.95, 2.77) and executive functioning (mean difference = 2.15; 95%CI: 1.22, 3.08). A negative association was also observed between TV viewing and executive functioning. Additionally, participants who increased their computer use by more than 30 min between 2001 and 2007 showed better performance on both verbal memory (mean difference = 1.41; 95%CI: 0.55, 2.27) and executive functioning (mean difference = 1.41; 95%CI: 0.53, 2.28) compared to those who decreased their computer use during that period. Conclusion Specific sedentary behaviors are differentially associated with cognitive performance. In contrast to TV viewing, regular computer use may help maintain cognitive function during the aging process. Clinical Trial Registration clinicaltrial.gov (number NCT

  17. Risk and protective factors for cognitive impairment in persons aged 85 years and older

    PubMed Central

    Cha, Ruth H.; Mielke, Michelle M.; Geda, Yonas E.; Boeve, Bradley F.; Machulda, Mary M.; Knopman, David S.; Petersen, Ronald C.

    2015-01-01

    Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older. Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records. Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, 62% women), 121 developed MCI at a median 4.1 years of follow-up. Predictors of MCI were APOE ε4 allele (hazard ratio [HR] 1.89; p = 0.008), current depressive symptoms (HR 1.78; p = 0.02), midlife onset of hypertension (HR 2.43; p = 0.005), increasing number of vascular diseases (HR 1.13; p = 0.02), and chronic conditions from the Charlson Comorbidity Index (HR 1.08; p = 0.006). Models were adjusted for sex and education, with age as the time variable. The risk of MCI was reduced for participants who reported engagement in artistic (HR 0.27; p = 0.03), craft (HR 0.55; p = 0.02), and social (HR 0.45; p = 0.005) activities in both midlife and late life, and in the use of a computer in late life (HR 0.47; p = 0.008). Conclusions: Chronic disease burden increases risk of MCI, whereas certain lifestyle factors reduce risk in persons 85 years and older. This implies that preventive strategies for MCI may need to begin in midlife and should persist throughout late life. PMID:25854867

  18. An examination of an enhancing effect of music on attentional abilities in older persons with mild cognitive impairment.

    PubMed

    Lake, Jessica I; Goldstein, Felicia C

    2011-02-01

    While the effect of listening to music on cognitive abilities is highly debated, studies reporting an enhancing effect of music in elderly populations appear to be more consistent. In this study, the effects of listening to music on attention in groups of cognitively normal older adults and those with mild cognitive impairment were considered. Participants were exposed to both a music and silence condition, and after each condition performed Digit Span and Coding tasks which require attention for maximal performance. The hypothesis that listening to music, compared to a silence condition, enhances performance was not supported for either group. Various explanations for these findings are considered. PMID:21466100

  19. Empathic accuracy for happiness in the daily lives of older couples: Fluid cognitive performance predicts pattern accuracy among men.

    PubMed

    Hülür, Gizem; Hoppmann, Christiane A; Rauers, Antje; Schade, Hannah; Ram, Nilam; Gerstorf, Denis

    2016-08-01

    Correctly identifying other's emotional states is a central cognitive component of empathy. We examined the role of fluid cognitive performance for empathic accuracy for happiness in the daily lives of 86 older couples (mean relationship length = 45 years; mean age = 75 years) on up to 42 occasions over 7 consecutive days. Men performing better on the Digit Symbol test were more accurate in identifying ups and downs of their partner's happiness. A similar association was not found for women. We discuss the potential role of fluid cognitive performance and other individual, partner, and situation characteristics for empathic accuracy. (PsycINFO Database Record PMID:27362351

  20. Cognitive Behavioral Treatment for Older Adults with Generalized Anxiety Disorder: A Therapist Manual for Primary Care Settings

    ERIC Educational Resources Information Center

    Stanley, Melinda A.; Diefenbach, Gretchen J.; Hopko, Derek R.

    2004-01-01

    At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project…

  1. Pain reporting in older adults: the influence of cognitive impairment – results from the Cambridge City >75 Cohort study

    PubMed Central

    Docking, Rachael E; Fleming, Jane; Brayne, Carol; Zhao, Jun; Macfarlane, Gary J

    2014-01-01

    Objectives: Evidence suggests that while disabling back pain (BP), and rheumatic diseases associated with pain, continues to increase with age, the prevalence of non-disabling BP reaches a plateau, or even decreases, in the oldest old. This study aimed to determine whether this age-related pattern of non-disabling BP is a function of increasing cognitive impairment. Methods: Cross-sectional study of adults aged >77 years. Participants answered interviewer-administered questions on BP and cognitive function, assessed using the Mini-Mental State Examination, categorised into normal versus mild, moderate or severe impairment. The relationship between cognitive function and BP was examined using multinomial logistic regression, adjusted for age, sex and residence. Results: Of 1174 participants with BP data, 1126 (96%) completed cognitive assessments. The relationship between cognitive function and BP differed for disabling and non-disabling BP. Across categories of cognitive impairment, increasingly higher prevalence of disabling BP was reported, compared to those with normal cognition, although this was not statistically significant (odds ratio (OR) = 1.7; 95% confidence interval (CI) = 0.7–4.6). No association was found between cognitive function and non-disabling BP (OR = 0.8; 95% CI = 0.4–1.6). Conclusion: This study found no association between the reporting of BP and level of cognitive impairment, suggesting that increasing cognitive impairment is an inadequate explanation for age-related decline in self-reported non-disabling BP. Future research should determine the reasons for the decline in non-disabling pain in older adults, although, meanwhile, it is important to ensure that this group receive appropriate pain assessment and pain management. Key points Prevalence of non-disabling back pain decreases in the oldest old. Some have proposed that this may be a function of cognitive impairment in older age, and an increasing inability to adequately report pain

  2. How older adults use cognition in sentence-final word recognition.

    PubMed

    Cahana-Amitay, Dalia; Spiro, Avron; Sayers, Jesse T; Oveis, Abigail C; Higby, Eve; Ojo, Emmanuel A; Duncan, Susan; Goral, Mira; Hyun, Jungmoon; Albert, Martin L; Obler, Loraine K

    2016-07-01

    This study examined the effects of executive control and working memory on older adults' sentence-final word recognition. The question we addressed was the importance of executive functions to this process and how it is modulated by the predictability of the speech material. To this end, we tested 173 neurologically intact adult native English speakers aged 55-84 years. Participants were given a sentence-final word recognition test in which sentential context was manipulated and sentences were presented in different levels of babble, and multiple tests of executive functioning assessing inhibition, shifting, and efficient access to long-term memory, as well as working memory. Using a generalized linear mixed model, we found that better inhibition was associated with higher accuracy in word recognition, while increased age and greater hearing loss were associated with poorer performance. Findings are discussed in the framework of semantic control and are interpreted as supporting a theoretical view of executive control which emphasizes functional diversity among executive components. PMID:26569553

  3. Boredom-proneness, loneliness, social engagement and depression and their association with cognitive function in older people: a population study.

    PubMed

    Conroy, Ronan M; Golden, Jeannette; Jeffares, Isabelle; O'Neill, Desmond; McGee, Hannah

    2010-08-01

    In this study, we use data from a population survey of persons aged 65 and over living in the Irish Republic to examine the relationship of cognitive impairment, assessed using the Abbreviated Mental Test, with loneliness, boredom-proneness, social relations, and depression. Participants were randomly selected community-dwelling Irish people aged 65+ years. An Abbreviated Mental Test score of 8 or 9 out of 10 was classified as 'low normal', and a score of less than 8 as 'possible cognitive impairment'. We used clustering around latent variables analysis (CLV) to identify families of variables associated with reduced cognitive function. The overall prevalence of possible cognitive impairment was 14.7% (95% CI 12.4-17.3%). Low normal scores had a prevalence of 30.5% (95% CI 27.2-33.7%). CLV analysis identified three groups of predictors: 'Low social support' (widowed, living alone, low social support), 'personal cognitive reserve' (low social activity, no leisure exercise, never having married, loneliness and boredom-proneness), and 'sociodemographic cognitive reserve' (primary education, rural domicile). In multivariate analysis, both cognitive reserve clusters, but not social support, were independently associated with cognitive function. Loneliness and boredom-proneness are associated with reduced cognitive function in older age, and cluster with other factors associated with cognitive reserve. Both may have a common underlying mechanism in the failure to select and maintain attention on particular features of the social environment (loneliness) or the non-social environment (boredom-proneness). PMID:20677084

  4. Physical Exercise with Multicomponent Cognitive Intervention for Older Adults with Alzheimer's Disease: A 6-Month Randomized Controlled Trial

    PubMed Central

    Kim, Min-Ji; Han, Chang-Wan; Min, Kyoung-Youn; Cho, Chae-Yoon; Lee, Chae-Won; Ogawa, Yoshiko; Mori, Etsuro; Kohzuki, Masahiro

    2016-01-01

    Aims This study aimed to investigate the effect of 6-month physical exercise with a multicomponent cognitive program (MCP) on the cognitive function of older adults with moderate to severe Alzheimer's disease (AD). Methods We included 33 participants with AD in a 6-month randomized controlled trial. The intervention group participated in physical exercise and received a MCP. The control group received only the MCP. Before and after the intervention, cognitive outcomes were assessed using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Mini-Mental State Examination, and the Clock Drawing Test. Physical performance was evaluated by exercise time, the number of pedal rotation, total load, grip strength, and the Berg Balance Scale (BBS). Results In all cognitive measures, there were no significant improvements between the two groups after 6 months in the baseline value-adjusted primary analysis. However, the ADAS-cog score was significantly lower between the two groups in secondary analysis adjusted for baseline value, age, sex, and education years. All physical outcomes were significantly higher in the intervention group except for total load compared with baseline measurements. Conclusion This study indicates that it is possible to improve cognitive function in older adults with moderate to severe AD through 6-month physical exercise with a multicomponent cognitive intervention. PMID:27403134

  5. Risk factors related to cognitive functioning: a cross-national comparison of U.S. and Korean older adults.

    PubMed

    Lyu, Jiyoung; Lee, Chae Man; Dugan, Elizabeth

    2014-01-01

    The purpose of this study was to conduct a cross-national comparison of factors related to cognitive functioning in later life in a U.S. and Korean sample. The study sample was comprised of subjects from the HRS (N = 10,175) and the KLoSA (N = 3,550). Separate multivariate regression models were employed to examine the impact of socio-demographic, health, and health behaviors on cognitive functioning among older adults. Regression results showed that age, gender, education, wealth, self-rated health, ADL, IADL, stroke, and poor eyesight were significantly associated with cognitive functioning in both countries. However, depression, high blood pressure, diabetes, and drinking were significantly associated with cognition only among Americans, while marital status and poor hearing were significantly associated with cognition only among Koreans. In addition, gender-specific models suggested several socio-economic and health factors had significantly different effects by gender in both countries. Cross-national comparative research identified similar risk factors, suggesting robust associations. Unique factors related to cognitive functioning in U.S. and Korean older adults highlight the important role of societal influences on cognitive outcomes. PMID:25508851

  6. Risk factors related to cognitive functioning: a cross-national comparison of U.S. and Korean older adults.

    PubMed

    Lyu, Jiyoung; Lee, Chae Man; Dugan, Elizabeth

    2014-01-01

    The purpose of this study was to conduct a cross-national comparison of factors related to cognitive functioning in later life in a U.S. and Korean sample. The study sample was comprised of subjects from the HRS (N = 10,175) and the KLoSA (N = 3,550). Separate multivariate regression models were employed to examine the impact of socio-demographic, health, and health behaviors on cognitive functioning among older adults. Regression results showed that age, gender, education, wealth, self-rated health, ADL, IADL, stroke, and poor eyesight were significantly associated with cognitive functioning in both countries. However, depression, high blood pressure, diabetes, and drinking were significantly associated with cognition only among Americans, while marital status and poor hearing were significantly associated with cognition only among Koreans. In addition, gender-specific models suggested several socio-economic and health factors had significantly different effects by gender in both countries. Cross-national comparative research identified similar risk factors, suggesting robust associations. Unique factors related to cognitive functioning in U.S. and Korean older adults highlight the important role of societal influences on cognitive outcomes. PMID:25486720

  7. Cognitive reserve modulates ERPs associated with verbal working memory in healthy younger and older adults

    PubMed Central

    Speer, Megan E.; Soldan, Anja

    2014-01-01

    Although many epidemiological studies suggest the beneficial effects of higher cognitive reserve (CR) in reducing age-related cognitive decline and dementia risk, the neural basis of CR is poorly understood. To our knowledge, the current study represents the first electrophysiological investigation of the relationship between CR and neural reserve (i.e., neural efficiency and capacity). Specifically, we examined whether CR modulates event-related potentials (ERPs) associated with performance on a verbal recognition memory task with three set sizes (1, 4, or 7 letters) in healthy younger and older adults. Neural data showed that as task difficulty increased, the amplitude of the parietal P3b component during the probe phase decreased and its latency increased. Notably, the degree of these neural changes was negatively correlated with CR in both age groups, such that individuals with higher CR showed smaller changes in P3b amplitude and less slowing in P3b latency (i.e., smaller changes in the speed of neural processing) with increasing task difficulty, suggesting greater neural efficiency. These CR-related differences in neural efficiency may underlie reserve against neuropathology and age-related burden. PMID:25619663

  8. Effects of interactive physical-activity video-game training on physical and cognitive function in older adults.

    PubMed

    Maillot, Pauline; Perrot, Alexandra; Hartley, Alan

    2012-09-01

    The purpose of the present study was to assess the potential of exergame training based on physically simulated sport play as a mode of physical activity that could have cognitive benefits for older adults. If exergame play has the cognitive benefits of conventional physical activity and also has the intrinsic attractiveness of video games, then it might be a very effective way to induce desirable lifestyle changes in older adults. To examine this issue, the authors developed an active video game training program using a pretest-training-posttest design comparing an experimental group (24 × 1 hr of training) with a control group without treatment. Participants completed a battery of neuropsychological tests, assessing executive control, visuospatial functions, and processing speed, to measure the cognitive impact of the program. They were also given a battery of functional fitness tests to measure the physical impact of the program. The trainees improved significantly in measures of game performance. They also improved significantly more than the control participants in measures of physical function and cognitive measures of executive control and processing speed, but not on visuospatial measures. It was encouraging to observe that, engagement in physically simulated sport games yielded benefits to cognitive and physical skills that are directly involved in functional abilities older adults need in everyday living (e.g., Hultsch, Hertzog, Small, & Dixon, 1999). PMID:22122605

  9. Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be Preserved and Enhanced?

    PubMed

    Hertzog, Christopher; Kramer, Arthur F; Wilson, Robert S; Lindenberger, Ulman

    2008-10-01

    In this monograph, we ask whether various kinds of intellectual, physical, and social activities produce cognitive enrichment effects-that is, whether they improve cognitive performance at different points of the adult life span, with a particular emphasis on old age. We begin with a theoretical framework that emphasizes the potential of behavior to influence levels of cognitive functioning. According to this framework, the undeniable presence of age-related decline in cognition does not invalidate the view that behavior can enhance cognitive functioning. Instead, the course of normal aging shapes a zone of possible functioning, which reflects person-specific endowments and age-related constraints. Individuals influence whether they function in the higher or lower ranges of this zone by engaging in or refraining from beneficial intellectual, physical, and social activities. From this point of view, the potential for positive change, or plasticity, is maintained in adult cognition. It is an argument that is supported by newer research in neuroscience showing neural plasticity in various aspects of central nervous system functioning, neurochemistry, and architecture. This view of human potential contrasts with static conceptions of cognition in old age, according to which decline in abilities is fixed and individuals cannot slow its course. Furthermore, any understanding of cognition as it occurs in everyday life must make a distinction between basic cognitive mechanisms and skills (such as working-memory capacity) and the functional use of cognition to achieve goals in specific situations. In practice, knowledge and expertise are critical for effective functioning, and the available evidence suggests that older adults effectively employ specific knowledge and expertise and can gain new knowledge when it is required. We conclude that, on balance, the available evidence favors the hypothesis that maintaining an intellectually engaged and physically active lifestyle

  10. Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study.

    PubMed

    Takeuchi, Kenji; Izumi, Maya; Furuta, Michiko; Takeshita, Toru; Shibata, Yukie; Kageyama, Shinya; Ganaha, Seijun; Yamashita, Yoshihisa

    2015-01-01

    Early detection and subsequent reduction of modifiable risk factors for cognitive decline is important for extending healthy life expectancy in the currently aging society. Although a recent increase in studies on the state or number of the teeth and cognitive function, few studies have focused on the association between posterior teeth occlusion necessary to maintain chewing function and cognitive function among older adults. This study examined the association between posterior teeth occlusion and cognitive function in nursing home older residents. In this cross-sectional study, 279 residents aged ≥60 years from eight nursing homes in Aso City, Japan participated in cognitive function and dental status assessments and completed a comprehensive questionnaire survey in 2014. Cognitive function was measured using a Mini-Mental State Examination (MMSE). Posterior teeth occlusion was assessed using a total number of functional tooth units (total-FTUs), depending on the number and location of the remaining natural and artificial teeth on implant-supported, fixed, and removable prostheses. Linear regression models were used to assess univariate and multivariate associations between total-FTUs and MMSE scores. Models were sequentially adjusted for demographic characteristics, number of natural teeth, socioeconomic status, health behaviors, comorbidities, physical function, and nutritional status. Among the 200 residents included in our analysis, mean MMSE scores and total-FTUs were 11.0 ± 8.6 and 9.3 ± 4.6, respectively. Higher total-FTUs were significantly associated with higher MMSE scores after adjustment for demographics and teeth number (B = 0.48, 95% confidence interval [CI] = 0.22-0.74). The association remained significant even after adjustment for all covariates (B = 0.25, 95% CI = 0.01-0.49). The current findings demonstrated that loss of posterior teeth occlusion was independently associated with cognitive decline in nursing home older residents in Japan

  11. A cognitive training intervention improves modality-specific attention in a randomized controlled trial of healthy older adults

    PubMed Central

    Long, Ashley B.; Morgan, Ashley R.; Rawley-Payne, Melissa; Laurienti, Paul J.

    2009-01-01

    Age-related deficits in cognitive and sensory function can result in increased distraction from background sensory stimuli. This randomized controlled trial investigated the effects of a cognitive training intervention aimed at helping healthy older adults suppress irrelevant auditory and visual stimuli. Sixty-six participants received 8 weeks of either the modality-specific attention training program or an educational lecture control program. Participants who completed the intervention program had larger improvements in modality-specific selective attention following training than controls. These improvements also correlated with reductions in bimodal integration during selective attention. Further, the intervention group showed larger improvements than the control group in non-trained domains such as processing speed and dual-task completion, demonstrating the utility of modality-specific attention training for improving cognitive function in healthy older adults. PMID:19428142

  12. Effect of Exercise and Cognitive Activity on Self-Reported Sleep Quality in Community-Dwelling Older Adults with Cognitive Complaints: A Randomized Controlled Trial

    PubMed Central

    Pa, Judy; Goodson, William; Bloch, Andrew; King, Abby C.; Yaffe, Kristine; Barnes, Deborah E.

    2015-01-01

    Objectives To compare the effects of different types of physical and mental activity on self-reported sleep quality over 12 weeks in older adults with cognitive and sleep complaints. Design Randomized controlled trial. Setting General community. Participants Seventy-two inactive community-dwelling older adults with self-reported sleep and cognitive problems (mean age 73.3±6.1; 60% women). Intervention Random allocation to four arms using a two-by-two factorial design: aerobic+cognitive training, aerobic+educational DVD, stretching+cognitive training, and stretching+educational DVD arms (60 min/d, 3 d/wk for physical and mental activity for 12 weeks). Measurements Change in sleep quality using seven questions from the Sleep Disorders Questionnaire on the 2005–06 National Health and Nutrition Examination Survey (range 0–28, with higher scores reflecting worse sleep quality). Analyses used intention-to-treat methods. Results Sleep quality scores did not differ at baseline, but there was a significant difference between the study arms in change in sleep quality over time (p<.005). Mean sleep quality scores improved significantly more in the stretching+educational DVD arm (5.1 points) than in the stretching+cognitive training (1.2 points), aerobic+educational DVD (1.1 points), or aerobic+cognitive training (0.25 points) arm (all p<.05, corrected for multiple comparisons). Differences between arms were strongest for waking at night (p=.02) and taking sleep medications (p=.004). Conclusion Self-reported sleep quality improved significantly more with low-intensity physical and mental activities than with moderate- or high-intensity activities in older adults with self-reported cognitive and sleep difficulties. Future longer-term studies with objective sleep measures are needed to corroborate these results. PMID:25516028

  13. Short-term testosterone manipulations do not affect cognition or motor function but differentially modulate emotions in young and older male rhesus monkeys

    PubMed Central

    Kelly, Brian; Maguire-Herring, Vanessa; Rose, Christian M.; Gore, Heather E.; Ferrigno, Stephen; Novak, Melinda A.; Lacreuse, Agnès

    2014-01-01

    Human aging is characterized by declines in cognition and fine motor function as well as improved emotional regulation. In men, declining levels of testosterone (T) with age have been implicated in the development of these age-related changes. However, studies examining the effects of T replacement on cognition, emotion and fine motor function in older men have not provided consistent results. Rhesus monkeys (Macaca mulatta) are excellent models for human cognitive aging and may provide novel insights on this issue. We tested 10 aged intact male rhesus monkeys (mean age = 19, range 15–25) on a battery of cognitive, motor and emotional tasks at baseline and under low or high T experimental conditions. Their performance was compared to that of 6 young males previously tested in the same paradigm (Lacreuse et al., 2009; Lacreuse et al., 2010). Following a 4-week baseline testing period, monkeys were treated with a gonadotropin releasing hormone agonist (Depot Lupron, 200 µg/kg) to suppress endogenous T and were tested on the task battery under a 4-week high T condition (injection of Lupron + T enanthate, 20 mg/kg, n = 8) or 4-week low T condition (injection of Lupron + oil vehicle, n = 8) before crossing over to the opposite treatment. The cognitive tasks consisted of the Delayed Non-Matching-to-Sample (DNMS), the Delayed Response (DR), and the Delayed Recognition Span Test (spatial-DRST). The emotional tasks included an object Approach-Avoidance task and a task in which monkeys were played videos of unfamiliar conspecifics in different emotional context (Social Playbacks). The fine motor task was the Lifesaver task that required monkeys to remove a Lifesaver candy from rods of different complexity. T manipulations did not significantly affect visual recognition memory, working memory, reference memory or fine motor function at any age. In the Approach-Avoidance task, older monkeys, but not younger monkeys, spent more time in proximity of novel objects in the high

  14. Short-term testosterone manipulations do not affect cognition or motor function but differentially modulate emotions in young and older male rhesus monkeys.

    PubMed

    Kelly, Brian; Maguire-Herring, Vanessa; Rose, Christian M; Gore, Heather E; Ferrigno, Stephen; Novak, Melinda A; Lacreuse, Agnès

    2014-11-01

    Human aging is characterized by declines in cognition and fine motor function as well as improved emotional regulation. In men, declining levels of testosterone (T) with age have been implicated in the development of these age-related changes. However, studies examining the effects of T replacement on cognition, emotion and fine motor function in older men have not provided consistent results. Rhesus monkeys (Macaca mulatta) are excellent models for human cognitive aging and may provide novel insights on this issue. We tested 10 aged intact male rhesus monkeys (mean age=19, range 15-25) on a battery of cognitive, motor and emotional tasks at baseline and under low or high T experimental conditions. Their performance was compared to that of 6 young males previously tested in the same paradigm (Lacreuse et al., 2009; Lacreuse et al., 2010). Following a 4-week baseline testing period, monkeys were treated with a gonadotropin releasing hormone agonist (Depot Lupron, 200 μg/kg) to suppress endogenous T and were tested on the task battery under a 4-week high T condition (injection of Lupron+T enanthate, 20 mg/kg, n=8) or 4-week low T condition (injection of Lupron+oil vehicle, n=8) before crossing over to the opposite treatment. The cognitive tasks consisted of the Delayed Non-Matching-to-Sample (DNMS), the Delayed Response (DR), and the Delayed Recognition Span Test (spatial-DRST). The emotional tasks included an object Approach-Avoidance task and a task in which monkeys were played videos of unfamiliar conspecifics in different emotional context (Social Playbacks). The fine motor task was the Lifesaver task that required monkeys to remove a Lifesaver candy from rods of different complexity. T manipulations did not significantly affect visual recognition memory, working memory, reference memory or fine motor function at any age. In the Approach-Avoidance task, older monkeys, but not younger monkeys, spent more time in proximity of novel objects in the high T condition

  15. Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up

    PubMed Central

    Eggenberger, Patrick; Schumacher, Vera; Angst, Marius; Theill, Nathan; de Bruin, Eling D

    2015-01-01

    Background Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive–physical components would add training specific cognitive benefits compared to exclusively physical training. Methods Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Results Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive–physical programs were found in two dimensions of executive function. “Shifting attention” showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and “working memory” showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R2=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Conclusion Particular executive functions benefit from simultaneous cognitive–physical training compared to exclusively physical multicomponent training. Cognitive–physical training programs

  16. Assessing Specific Cognitive Deficits Associated with Dementia in Older Adults with Down Syndrome: Use and Validity of the Arizona Cognitive Test Battery (ACTB)

    PubMed Central

    Sinai, Amanda; Hassiotis, Angela; Rantell, Khadija; Strydom, Andre

    2016-01-01

    Background Down syndrome is associated with specific cognitive deficits. Alongside this, older adults with Down syndrome are a high risk group for dementia. The Arizona Cognitive Test Battery (ACTB), a cognitive assessment battery specifically developed for use with individuals with Down syndrome, has been proposed for use as outcome measures for clinical trials in this population. It has not been validated in older adults with Down syndrome. This study aims to assess the use and validity of the ACTB in older adults with Down syndrome. Methods Participants with Down syndrome aged 45 and over were assessed using the ACTB, standard tabletop tests and informant ratings. Results Assessment outcomes of 49 participants were analysed. Of these, 19 (39%) had a diagnosis of dementia or possible dementia. Most participants were able to attempt most of the tasks, although some tasks had high floor effects (including CANTAB Intra-Extra Dimensional shift stages completed and Modified Dots Task). Of the ACTB tasks, statistically significant differences were observed between the dementia and no dementia groups on CANTAB Simple Reaction Time median latency, NEPSY Visuomotor Precision—Car and Motorbike and CANTAB Paired Associates Learning stages completed. No significant differences were observed for CANTAB Intra-Extra Dimensional Shift, Modified Dots Task, Finger Sequencing, NEPSY Visuomotor precision—Train and Car and CANTAB Paired Associates Learning first trial memory score. Several of the tasks in the ACTB can be used in older adults with Down syndrome and have mild to moderate concurrent validity when compared to tabletop tests and informant ratings, although this varies on a test by test basis. Conclusions Overall, scores for a number of tests in the ACTB were similar when comparing dementia and no dementia groups of older adults with Down syndrome, suggesting that it would not be an appropriate outcome measure of cognitive function for clinical trials of dementia

  17. Five dimensions of wellness and predictors of cognitive health protection in community-dwelling older adults: a historical COLLAGE cohort study.

    PubMed

    Strout, Kelley A; Howard, Elizabeth P

    2015-03-01

    Wellness is associated with cognitive health protection; however, findings are limited because they only examine variable(s) within one dimension of wellness. This research examined the association between multiple dimensions of wellness and cognition among aging adults. The sample included 5,605 male and female community-dwelling adults 60 years and older. Four dimensions of wellness demonstrated a statistically significant higher mean difference in cognitively healthy older adults compared to cognitively impaired older adults, F(4, 5,595) = 47.57, p < .001. Emotional wellness demonstrated the strongest association with cognitive health, followed by physical and spiritual wellness, F(5, 5,372) = 50.35, p < .001. Future research is needed to examine the cognitive protective benefits of wellness using longitudinal, prospective designs that control for the potential temporal relationship between wellness and cognition. PMID:24972928

  18. Caregiving Networks in Later Life: Does Cognitive Status Make a Difference?

    ERIC Educational Resources Information Center

    Strain, Laurel A.; Blandford, Audrey A.

    2003-01-01

    This study examines the caregiving networks of older adults, with particular emphasis on differences according to cognitive status (n = 303). Individuals with cognitive impairment were significantly more likely than those who were cognitively intact to receive assistance with personal care, linking with the outside world, and mobility. The types…

  19. Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis.

    PubMed

    Lo, June C; Groeger, John A; Cheng, Grand H; Dijk, Derk-Jan; Chee, Michael W L

    2016-01-01

    Sleep is important for optimal cognitive functioning across the lifespan. Among older adults (≥55 years), self-reported short and long sleep durations have been repeatedly, albeit inconsistently, reported to elevate the risk for poor cognitive function. This meta-analytic review quantitatively summarizes the risk for poorer cognitive function among short and long sleepers in older adults. Eligible publications were searched online and manually. A total of 35 independent samples (N = 97,264) from 11 cross-sectional and seven prospective cohort studies were included. Pooled odds ratios (OR) with 95% confidence intervals (CI) were derived using random-effects models. Self-reported short and long sleep increased the odds for poor cognitive function by 1.40 (CI = 1.27-1.56) and 1.58 times (CI = 1.43-1.74), respectively. Effect sizes varied across studies and may have been moderated by both study type (cross-sectional and prospective) and cognitive domain assessed. For cross-sectional studies, extreme sleep durations were significantly associated with poorer multiple-domain performance, executive functions, verbal memory, and working memory capacity. Prospective cohort studies revealed the significant long-term impact of short and long sleep on multiple-domain performance only. These findings establish self-reported extreme sleep duration as a risk factor for cognitive aging. PMID:26847980

  20. A quasi-experimental study of a reminiscence program focused on autobiographical memory in institutionalized older adults with cognitive impairment.

    PubMed

    Lopes, Teresa Silveira; Afonso, Rosa Marina Lopes Brás Martins; Ribeiro, Óscar Manuel

    2016-01-01

    Working with past memories through reminiscence interventions has been practiced for several decades with successful outcomes on mental health in older adults. Few studies however have focused on autobiographical memory recall in older individuals with cognitive impairment. This study aims to analyze the impact of an individual reminiscence program in a group of older persons with cognitive decline living in nursing homes on the dimensions of cognition, autobiographical memory, mood, behavior and anxiety. A two-group pre-test and post-test design with single blinded assessment was conducted. Forty-one participants were randomized to an experimental group (n=20) and a control group (n=21). The first group attended five weekly individual reminiscence sessions. Changes in the outcome measures were examined for cognition (Montreal Cognitive Assessment; Autobiographical Memory Test), behavior (Alzheimer Disease Assessment Subscale Non-Cog) and emotional status (Cornell Scale for Depression in Dementia; Geriatric Depression Scale, and Geriatric Anxiety Inventory). Participants attending reminiscence sessions exhibited better outcomes compared to the control group in cognition, anxiety and depression (p<0.001), and presented a higher number of retrieved autobiographical events, specificity of evoked memories and positive valence of events (p<0.001), and also presented lower latency time for recalling events, and lower negative recalled events (p<0.01). This study supports the potential value of reminiscence therapy in improving the recall of autobiographical memory. Reminiscence therapy can be helpful to maintain or improve cognitive function, decrease anxiety and manage depressive symptoms and altered behavior, but further investigation is needed to clarify long-term effects. PMID:27347792

  1. The Effects of Acupressure Training on Sleep Quality and Cognitive Function of Older Adults: A 1-Year Randomized Controlled Trial.

    PubMed

    Zeng, Hui; Liu, Mengjiao; Wang, Ping; Kang, Jiaxun; Lu, Fenghua; Pan, Lu

    2016-10-01

    We explored the effects of acupressure training on older adults' sleep quality and cognitive function. Ninety older adults with impaired sleep quality were selected from screened volunteers and randomly divided into equal control and experimental groups; 82 completed the 1-year follow-up. Participants in the control group were given instructions on sleep health, while those in the experimental group received sleep health instructions plus individual and small group acupressure training sessions and support to practice the intervention on their own each day. All participants were assessed by trained assistants blind to study group allocation using Chinese versions of the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Mini-Mental State Examination, and four subscales from the revised Chinese version of the Wechsler Memory Scale, at baseline and at 3, 6, and 12 months. Repeated measures analysis of variance showed that acupressure training improved older adults' sleep quality and cognitive function, but the mediating effect of sleep on the relationship between acupressure training and cognitive function was not supported. Given the ease, simplicity, and safety of acupressure training observed with community-dwelling older adults in China, attempts should be made to replicate these preliminary positive findings with larger samples. © 2016 Wiley Periodicals, Inc. PMID:27327537

  2. Prospective Associations Between Leisure-Time Physical Activity and Cognitive Performance Among Older Adults Across an 11-Year Period

    PubMed Central

    Ku, Po-Wen; Stevinson, Clare; Chen, Li-Jung

    2012-01-01

    Background Few studies have explored the relations between naturally occurring changes in physical activity and cognitive performance in later life. This study examined prospective associations between changes in physical activity and cognitive performance in a population-based sample of Taiwanese older adults during an 11-year period. Methods Analyses were based on nationally representative data from the Taiwan Health and Living Status of the Elderly Survey collected in 1996, 1999, 2003, and 2007. Data from a fixed cohort of 1160 participants who were aged 67 years or older in 1996 and followed for 11 years were included. Cognitive performance (outcome) was assessed using 5 questions from the Short Portable Mental Status Questionnaire. Physical activity (exposure) was self-reported as number of sessions per week. The latent growth model was used to examine associations between changes in physical activity and cognitive performance after controlling for sociodemographic variables, lifestyle behaviors, and health status. Results With multivariate adjustment, higher initial levels of physical activity were significantly associated with better initial cognitive performance (standardized coefficient β = 0.17). A higher level of physical activity at baseline (1996) was significantly related to slower decline in cognitive performance, as compared with a lower level of activity (β = 0.22). The association between changes in physical activity and changes in cognitive performance was stronger (β = 0.36) than the previous 2 associations. The effect remained after excluding participants with cognitive decline before baseline. Conclusions Physical activity in later life is associated with slower age-related cognitive decline. PMID:22343329

  3. The Impact of Tai Chi on Cognitive Performance in Older Adults: A Systematic Review and Meta-Analysis

    PubMed Central

    Wayne, Peter M.; Walsh, Jacquelyn N.; Taylor-Piliae, Ruth E.; Wells, Rebecca E.; Papp, Kathryn V.; Donovan, Nancy J.; Yeh, Gloria Y.

    2013-01-01

    OBJECTIVES Summarize and critically evaluate research on the effects of Tai Chi on cognitive function in older adults. DESIGN Systematic review with meta-analysis. SETTING Community and residential care. PARTICIPANTS Individuals aged 60 and over (with the exception of one study) with and without cognitive impairment. MEASUREMENTS Cognitive ability using a variety of neuropsychological testing. RESULTS Twenty eligible studies with a total of 2,553 participants were identified that met inclusion criteria for the systematic review: 11 of the 20 eligible studies were randomized controlled trials (RCTs), 1 was a prospective non-randomized controlled study, 4 were prospective non-controlled observational studies, and 4 were cross-sectional studies. Overall quality of RCTs was modest, with 3 of 11 trials categorized as high risk of bias. Meta-analyses of outcomes related to executive function in RCTs of cognitively healthy adults indicated a large effect size when Tai Chi was compared to non-intervention controls (Hedge’s g=0.90; p=0.043) and moderate effect size when compared to exercise controls (Hedge’s g=0.51; p=0.003). Meta-analyses of outcomes related to global cognitive function in RCTs of cognitively impaired adults, ranging from mild cognitive impairment to dementia, showed smaller but statistically significant effects when Tai Chi was compared to both non-intervention controls (Hedge’s g=0.35; p=0.004) and other active interventions (Hedge’s g=0.30; p=0.002). Findings from non-randomized studies add further evidence that Tai Chi may positively impact these and other domains of cognitive function. CONCLUSION Tai Chi shows potential to enhance cognitive function in older adults, particularly in the realm of executive functioning and in those individuals without significant impairment. Larger and methodologically sound trials with longer follow-up periods are needed before more definitive conclusions can be drawn. PMID:24383523

  4. Effects of momentum-based dumbbell training on cognitive function in older adults with mild cognitive impairment: a pilot randomized controlled trial

    PubMed Central

    Lü, Jiaojiao; Sun, Mingyun; Liang, Leichao; Feng, Yi; Pan, Xiaoyu; Liu, Yu

    2016-01-01

    Purpose The purpose of this study was to explore the effects of an innovative momentum-based dumbbell-training intervention on cognitive function in older adults with mild cognitive impairment (MCI). Subjects and methods A total of 45 community-dwelling older adults with MCI were randomly assigned to either a dumbbell-training group (DTG; n=22) or a control group (CG; n=23). Participants in the DTG participated in exercise sessions three times weekly for 12 weeks. The primary outcome measures were cognitive function, including the Alzheimer’s Disease Assessment Scale (ADAS) – Cognitive subscale, Trail Making Test part B, Digit Span Test (DST) – forward, and DST – backward, with secondary outcome measures being Timed Up and Go, functional reach, and the Activities-Specific Balance Confidence Scale. Results In an intent-to-treat analysis, participants in the DTG had significantly improved ADAS – Cognitive subscale scores compared to those in the CG (5.02 points, P=0.012). There was a significant within-group change (improvement) in Trail Making Test part B (33.32 seconds, P<0.001) and DST – backward (0.41 points, P=0.025) scores. No change was observed for the DST – forward measure. Participants in the DTG also improved their functional mobility compared to those in the CG (Timed Up and Go, 0.81 seconds; P=0.043). Conclusion There is preliminary evidence showing the potential benefit of momentum-based dumbbell training for improving cognitive function in older adults with MCI. PMID:26766905

  5. Characterization of cognitive and motor performance during dual-tasking in healthy older adults and patients with Parkinson's disease.

    PubMed

    Wild, Lucia Bartmann; de Lima, Daiane Borba; Balardin, Joana Bisol; Rizzi, Luana; Giacobbo, Bruno Lima; Oliveira, Henrique Bianchi; de Lima Argimon, Irani Iracema; Peyré-Tartaruga, Leonardo Alexandre; Rieder, Carlos R M; Bromberg, Elke

    2013-02-01

    The primary purpose of this study was to investigate the effect of dual-tasking on cognitive performance and gait parameters in patients with idiopathic Parkinson's disease (PD) without dementia. The impact of cognitive task complexity on cognition and walking was also examined. Eighteen patients with PD (ages 53-88, 10 women; Hoehn and Yahr stage I-II) and 18 older adults (ages 61-84; 10 women) completed two neuropsychological measures of executive function/attention (the Stroop Test and Wisconsin Card Sorting Test). Cognitive performance and gait parameters related to functional mobility of stride were measured under single (cognitive task only) and dual-task (cognitive task during walking) conditions with different levels of difficulty and different types of stimuli. In addition, dual-task cognitive costs were calculated. Although cognitive performance showed no significant difference between controls and PD patients during single or dual-tasking conditions, only the patients had a decrease in cognitive performance during walking. Gait parameters of patients differed significantly from controls at single and dual-task conditions, indicating that patients gave priority to gait while cognitive performance suffered. Dual-task cognitive costs of patients increased with task complexity, reaching significantly higher values then controls in the arithmetic task, which was correlated with scores on executive function/attention (Stroop Color-Word Page). Baseline motor functioning and task executive/attentional load affect the performance of cognitive tasks of PD patients while walking. These findings provide insight into the functional strategies used by PD patients in the initial phases of the disease to manage dual-task interference. PMID:23052601

  6. Association between Sleep-Disordered Breathing and Neuropsychological Performance in Older Adults with Mild Cognitive Impairment.

    PubMed

    Terpening, Zoe; Lewis, Simon J G; Yee, Brendon J; Grunstein, Ron R; Hickie, Ian B; Naismith, Sharon L

    2015-01-01

    Sleep-disordered breathing in middle-age and older adults has been shown to be linked to a range of neuropsychological deficits, but the extent to which these relationships are evident in older people 'at risk' of developing dementia in unknown. In this study, we aimed to determine whether changes in sleep-disordered breathing and sleep fragmentation during nocturnal sleep were related to neuropsychological dysfunction in patients with mild cognitive impairment. Forty-six patients with MCI (mean age = 66.1 y, sd = 8.4) and 40 age-matched healthy controls (mean age = 63.5 y, sd = 8.9) underwent psychiatric, medical, and neuropsychological assessment, in addition to overnight polysomnography and self-report questionnaires. Measures of hypoxemia, sleep fragmentation, and sleep quality were derived including the apnoea-hypopnea index, oxygen desaturation index, percentage of total sleep time spent below 90% oxygen saturation, arousal index, sleep efficiency, and wake after sleep onset. Patients with MCI did not differ from healthy aging on any measure of sleep-disordered breathing or sleep fragmentation. In MCI, processing speed was negatively correlated with greater sleep time spent below 90% oxygen saturation and a higher apnoea-hypopnea index. In contrast, in the healthy aging, processing speed was negatively correlated with an increased oxygen desaturation index and the arousal index. Sleep-disordered breathing is evident in both healthy aging and MCI with associated decrements in processing speed. Future research is needed to determine the unique and synergistic effects of these differential associations, their potential to inform disease trajectory, and possible therapeutic interventions. PMID:25720400

  7. Would Older Adults with Mild Cognitive Impairment Adhere to and Benefit from a Structured Lifestyle Activity Intervention to Enhance Cognition?: A Cluster Randomized Controlled Trial

    PubMed Central

    Lam, Linda Chiu-wa; Chan, Wai Chi; Leung, Tony; Fung, Ada Wai-tung; Leung, Edward Man-fuk

    2015-01-01

    Background Epidemiologic evidence suggests that cognitive and physical activities are associated with better cognition in late life. The present study was conducted to examine the possible benefits of four structured lifestyle activity interventions and compare their effectiveness in optimizing cognition for older adults with mild cognitive impairment (MCI). Method and Findings This was a 12-month cluster randomized controlled trial. 555 community-dwelling Chinese older adults with MCI (295 with multiple-domain deficits (mdMCI), 260 with single-domain deficit (sdMCI)) were recruited. Participants were randomized into physical exercise (P), cognitive activity (C), integrated cognitive and physical exercise (CP), and social activity (S, active control) groups. Interventions comprised of one-hour structured activities three times per week. Primary outcome was Clinical Dementia Rating sum of boxes (CDR-SOB) scores. Secondary outcomes included Chinese versions of Alzheimer’s Disease Assessment Scale - Cognitive subscale (ADAS-Cog), delayed recall, Mini-Mental State Examination, Category Verbal Fluency Test (CVFT) and Disability Assessment for Dementia – Instrumental Activities of Daily Living (DAD-IADL). Percentage adherence to programs and factors affecting adherence were also examined. At 12th month, 423 (76.2%) completed final assessment. There was no change in CDR-SOB and DAD-IADL scores across time and intervention groups. Multilevel normal model and linear link function showed improvement in ADAS-Cog, delayed recall and CVFT with time (p<0.05). Post-hoc subgroup analyses showed that the CP group, compared with other intervention groups, had more significant improvements of ADAS-Cog, delayed recall and CVFT performance with sdMCI participants (p<0.05). Overall adherence rate was 73.3%. Improvements in ADAS-Cog and delayed recall scores were associated with adherence after controlling for age, education, and intervention groups (univariate analyses). Conclusions

  8. Structural neuroimaging correlates of cognitive status in older adults: A person-oriented approach.

    PubMed

    Malpas, Charles B

    2016-08-01

    Person-oriented approaches to clinical research aim to uncover subgroups of patients with different patterns of clinically relevant variables. Such approaches, however, are not yet widely employed in clinical neuroimaging research. This paper demonstrates an accessible approach to person-oriented research using model-based clustering in high-dimensional structural neuroimaging data. Cortical thickness measurements for 369 older adults (182 women, 187 men) were obtained from the Alzheimer's Disease Neuroimaging Initiative. Model-based cluster analysis was performed on these imaging variables and then validated using variables that were not used in the clustering process. Variable selection identified two specific regions that contributed to cluster formation: the left and right entorhinal cortices. Two subgroups were uncovered: a "typical" cluster with higher entorhinal thickness (M=3.59mm, 95% confidence interval=3.57, 3.62), and an "atypical" cluster with relatively lower thickness (M=2.84mm, 95% confidence interval=2.75, 2.92). Members of the atypical cluster also had lower hippocampal volumes, memory scores, and executive function scores, and were also more likely to be clinically classified as cognitively impaired. These findings demonstrate the utility of model-based clustering of structural neuroimaging data in studies of ageing. The role of the entorhinal cortices in cluster formation is consistent with the known pathological substrate of Alzheimer's disease. The entorhinal cortices are implicated in the early genesis of the disease and atrophy of these regions is strongly associated with the cognitive phenotype. Overall, this approach can be readily applied to future neuroimaging investigations. PMID:27056675

  9. Cognitive training with and without additional physical activity in healthy older adults: cognitive effects, neurobiological mechanisms, and prediction of training success

    PubMed Central

    Rahe, Julia; Becker, Jutta; Fink, Gereon R.; Kessler, Josef; Kukolja, Juraj; Rahn, Andreas; Rosen, Jan B.; Szabados, Florian; Wirth, Brunhilde; Kalbe, Elke

    2015-01-01

    Data is inconsistent concerning the question whether cognitive-physical training (CPT) yields stronger cognitive gains than cognitive training (CT). Effects of additional counseling, neurobiological mechanisms, and predictors have scarcely been studied. Healthy older adults were trained with CT (n = 20), CPT (n = 25), or CPT with counseling (CPT+C; n = 23). Cognition, physical fitness, BDNF, IGF-1, and VEGF were assessed at pre- and post-test. No interaction effects were found except for one effect showing that CPT+C led to stronger gains in verbal fluency than CPT (p = 0.03). However, this superiority could not be assigned to additional physical training gains. Low baseline cognitive performance and BDNF, not carrying apoE4, gains in physical fitness and the moderation of gains in physical fitness × gains in BDNF predicted training success. Although all types of interventions seem successful to enhance cognition, our data do not support the hypotheses that CPT shows superior CT gains compared to CT or that CPT+C adds merit to CPT. However, as CPT leads to additional gains in physical fitness which in turn is known to have positive impact on cognition in the long-term, CPT seems more beneficial. Training success can partly be predicted by neuropsychological, neurobiological, and genetic parameters. Unique Identifier: WHO ICTRP (http://www.who.int/ictrp); ID: DRKS00005194. PMID:26528177

  10. Life-Space and Cognitive Decline in a Community-Based Sample of African American and Caucasian Older Adults

    PubMed Central

    Crowe, Michael; Andel, Ross; Wadley, Virginia G.; Okonkwo, Ozioma C.; Sawyer, Patricia; Allman, Richard M.

    2010-01-01

    Background Life-space, a measure of movement through one’s environment, may be viewed as one aspect of environmental complexity for older adults. We examined the relationship between life-space and subsequent change in cognitive function. Methods Participants were 624 community-dwelling Medicare beneficiaries (49% African American) who completed in-home assessments at baseline and follow-up 4 years later. The Life-Space Assessment was used at baseline to measure extent, frequency, and independence of participants’ movement within and outside the home. Cognitive decline was measured with the Mini-Mental State Examination (MMSE). Results In a regression model adjusted for baseline MMSE, age, gender, race, residence (rural/urban), and education, greater life-space at baseline predicted reduced cognitive decline (β = −.177, p < .001). This association remained statistically significant in subsequent models that examined what proportion of the observed association was explained by baseline physical activity, physical function, vascular risk factors, comorbidity, and psychosocial factors. Physical function accounted for the largest proportion (37.3%) of the association between life-space and cognitive decline. There was no significant interaction between life-space and race, gender, or age in predicting cognitive decline. In a logistic regression analysis, participants in the highest quartile of life-space had 53% reduced odds of substantial cognitive decline (≥4 points on MMSE) compared to those in the lowest quartile. Conclusions These preliminary findings suggest that life-space may be a useful identifier of older adults at risk for cognitive decline. Future research should investigate the potential reciprocal relationship between life-space and cognitive function as well as the interrelationship between these factors and physical function. PMID:19038840

  11. Plasma c-peptide levels and rates of cognitive decline in older, community-dwelling women without diabetes

    PubMed Central

    Okereke, Olivia I.; Pollak, Michael N.; Hu, Frank B.; Hankinson, Susan E.; Selkoe, Dennis J.; Grodstein, Francine

    2008-01-01

    SUMMARY Background Both type 2 diabetes and hyperinsulinemia have been related to diminished cognition. To address independent effects of increasing mid-life insulin secretion on late-life cognition, we prospectively examined the relation of plasma c-peptide levels to cognitive decline in a large sample of older women without diabetes or stroke. Methods Plasma c-peptide levels were measured in 1,187 “young-old” women (mean age=64 years) without diabetes in the Nurses’ Health Study. Cognitive decline was assessed approximately 10 years later. Three repeated cognitive batteries were administered over an average of 4.4 years using telephone-based tests of general cognition, verbal memory, category fluency, and attention. Primary outcomes were general cognition (measured by the Telephone interview for Cognitive Status [TICS], as well as a global score averaging all tests) and a verbal memory score averaging 4 tests of word-list and paragraph recall. Linear mixed effects models were used to compute associations between c-peptide levels and rates of cognitive decline. Results Higher c-peptide levels were associated with faster decline in global cognition and verbal memory. Compared to those in the lowest c-peptide quartile, multivariable-adjusted mean differences (95% CI) in rates of decline for women in the highest quartile were −0.03 (−0.06, − 0.00) units/year for the global score, and −0.05 (−0.09, −0.02) units/year for verbal memory. Each one standard-deviation increase in c-peptide was associated with significantly faster decline on the TICS (p-trend=0.05), global score (p-trend=0.04) and verbal memory (p-trend=0.006). Conclusions Higher levels of insulin secretion in those without diabetes may be related to decline in general cognition and verbal memory. PMID:18261857

  12. To Switch or Not to Switch: Role of Cognitive Control in Working Memory Training in Older Adults.

    PubMed

    Basak, Chandramallika; O'Connell, Margaret A

    2016-01-01

    It is currently not known what are the best working memory training strategies to offset the age-related declines in fluid cognitive abilities. In this randomized clinical double-blind trial, older adults were randomly assigned to one of two types of working memory training - one group was trained on a predictable memory updating task (PT) and another group was trained on a novel, unpredictable memory updating task (UT). Unpredictable memory updating, compared to predictable, requires greater demands on cognitive control (Basak and Verhaeghen, 2011a). Therefore, the current study allowed us to evaluate the role of cognitive control in working memory training. All participants were assessed on a set of near and far transfer tasks at three different testing sessions - before training, immediately after the training, and 1.5 months after completing the training. Additionally, individual learning rates for a comparison working memory task (performed by both groups) and the trained task were computed. Training on unpredictable memory updating, compared to predictable, significantly enhanced performance on a measure of episodic memory, immediately after the training. Moreover, individuals with faster learning rates showed greater gains in this episodic memory task and another new working memory task; this effect was specific to UT. We propose that the unpredictable memory updating training, compared to predictable memory updating training, may a better strategy to improve selective cognitive abilities in older adults, and future studies could further investigate the role of cognitive control in working memory training. PMID:26973554

  13. Neuromarkers of the common angiotensinogen polymorphism in healthy older adults: A comprehensive assessment of white matter integrity and cognition.

    PubMed

    Salminen, Lauren E; Schofield, Peter R; Pierce, Kerrie D; Zhao, Yi; Luo, Xi; Wang, Youdan; Laidlaw, David H; Cabeen, Ryan P; Conturo, Thomas E; Tate, David F; Akbudak, Erbil; Lane, Elizabeth M; Heaps, Jodi M; Bolzenius, Jacob D; Baker, Laurie M; Cagle, Lee M; Paul, Robert H

    2016-01-01

    The common angiotensinogen (AGT) M268T polymorphism (rs699; historically referred to as M235T) has been identified as a significant risk factor for cerebrovascular pathologies, yet it is unclear if healthy older adults carrying the threonine amino acid variant have a greater risk for white matter damage in specific fiber tracts. Further, the impact of the threonine variant on cognitive function remains unknown. The present study utilized multiple indices of diffusion tensor imaging (DTI) and neuropsychological assessment to examine the integrity of specific white matter tracts and cognition between individuals with homozygous genotypes of M268T (MetMet n=27, ThrThr n=27). Differences in subcortical hyperintensity (SH) volume were also examined between groups. Results indicated that the threonine variant was associated with significantly reduced integrity in the superior longitudinal fasciculus (SLF) and the cingulate gyrus segment of the cingulum bundle (cingulum CG) compared to those with the methionine variant, and poorer cognitive performance on tests of attention/processing speed and language. Despite these associations, integrity of these tracts did not significantly mediate relationships between cognition and genetic status, and SH did not differ significantly between groups. Collectively our results suggest that the threonine variant of M268T is a significant risk factor for abnormalities in specific white matter tracts and cognitive domains in healthy older adults, independent of SH burden. PMID:26318936

  14. To Switch or Not to Switch: Role of Cognitive Control in Working Memory Training in Older Adults

    PubMed Central

    Basak, Chandramallika; O’Connell, Margaret A.

    2016-01-01

    It is currently not known what are the best working memory training strategies to offset the age-related declines in fluid cognitive abilities. In this randomized clinical double-blind trial, older adults were randomly assigned to one of two types of working memory training – one group was trained on a predictable memory updating task (PT) and another group was trained on a novel, unpredictable memory updating task (UT). Unpredictable memory updating, compared to predictable, requires greater demands on cognitive control (Basak and Verhaeghen, 2011a). Therefore, the current study allowed us to evaluate the role of cognitive control in working memory training. All participants were assessed on a set of near and far transfer tasks at three different testing sessions – before training, immediately after the training, and 1.5 months after completing the training. Additionally, individual learning rates for a comparison working memory task (performed by both groups) and the trained task were computed. Training on unpredictable memory updating, compared to predictable, significantly enhanced performance on a measure of episodic memory, immediately after the training. Moreover, individuals with faster learning rates showed greater gains in this episodic memory task and another new working memory task; this effect was specific to UT. We propose that the unpredictable memory updating training, compared to predictable memory updating training, may a better strategy to improve selective cognitive abilities in older adults, and future studies could further investigate the role of cognitive control in working memory training. PMID:26973554

  15. Frequency and Correlates of Advance Planning Among Cognitively Impaired Older Adults

    PubMed Central

    Lingler, Jennifer Hagerty; Hirschman, Karen B.; Garand, Linda; Dew, Mary Amanda; Becker, James T.; Schulz, Richard; DeKosky, Steven T.

    2009-01-01

    Objective To examine the prevalence and sociodemographic correlates of written advance planning among patients with or at risk for dementia-imposed decisional incapacity. Design Retrospective, cross-sectional. Setting University-based memory disorders clinic. Participants Persons with a consensus-based diagnosis of mild cognitive impairment (N = 112), probable or possible Alzheimer disease (AD; N = 549), and nondemented comparison subjects (N = 84). Intervention N/A. Measurements Semistructured interviews to assess durable power of attorney (DPOA) and living will (LW) status upon initial presentation for a dementia evaluation. Results Sixty-five percent of participants had a DPOA and 56% had a LW. Planning rates did not vary by diagnosis. European Americans (adjusted odds ratio = 4.75; 95% CI, 2.40-9.38), older adults (adjusted odds ratio = 1.05; 95% CI, 1.03-1.07) and college graduates (adjusted odds ratio = 2.06; 95% CI, 1.33-3.20) were most likely to have a DPOA. Findings were similar for LW rates. Conclusions Although a majority of persons with and at risk for the sustained and progressive decisional incapacity of AD are formally planning for the future, a substantial minority are not. PMID:18669942

  16. Mental State Inferences Abilities Contribution to Verbal Irony Comprehension in Older Adults with Mild Cognitive Impairment

    PubMed Central

    Gaudreau, G.; Monetta, L.; Macoir, J.; Poulin, S.; Laforce, R. Jr.; Hudon, C.

    2015-01-01

    Objective. The present study examined mentalizing capacities as well as the relative implication of mentalizing in the comprehension of ironic and sincere assertions among 30 older adults with mild cognitive impairment (MCI) and 30 healthy control (HC) subjects. Method. Subjects were administered a task evaluating mentalizing by means of short stories. A verbal irony comprehension task, in which participants had to identify ironic or sincere statements within short stories, was also administered; the design of the task allowed uniform implication of mentalizing across the conditions. Results. Findings indicated that participants with MCI have second-order mentalizing difficulties compared to HC subjects. Moreover, MCI participants were impaired compared to the HC group in identifying ironic or sincere stories, both requiring mental inference capacities. Conclusion. This study suggests that, in individuals with MCI, difficulties in the comprehension of ironic and sincere assertions are closely related to second-order mentalizing deficits. These findings support previous data suggesting a strong relationship between irony comprehension and mentalizing. PMID:26199459

  17. Cognitive behavioral treatment for older adults with generalized anxiety disorder. A therapist manual for primary care settings.

    PubMed

    Stanley, Melinda A; Diefenbach, Gretchen J; Hopko, Derek R

    2004-01-01

    At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project suggested the potential benefits of a new version of CBT for GAD among older patients in primary care. The manual developed and tested in this pilot project is presented here. Treatment components include motivation and education, relaxation skills, cognitive therapy, problem-solving-skills training, exposure exercises, and sleep-management-skills training. Procedures are designed to be administered flexibly to maximize attention to individual patient needs. Examples of session summaries, patient handouts, and homework forms are provided. PMID:14710708

  18. Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults

    PubMed Central

    Vanoh, Divya; Shahar, Suzana; Rosdinom, Razali; Din, Normah Che; Yahya, Hanis Mastura; Omar, Azahadi

    2016-01-01

    Background and aim Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS). Methodology A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. Results A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. Conclusion TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose. PMID:27274208

  19. Longitudinal Alterations to Brain Function, Structure, and Cognitive Performance in Healthy Older Adults: a fMRI-DTI study

    PubMed Central

    Hakun, Jonathan G.; Zhu, Zude; Brown, Christopher A.; Johnson, Nathan F.; Gold, Brian T.

    2015-01-01

    Cross-sectional research has shown that older adults tend to have different frontal cortex activation patterns, poorer brain structure, and lower task performance than younger adults. However, relationships between longitudinal changes in brain function, brain structure, and cognitive performance in older adults are less well understood. Here we present the results of a longitudinal, combined fMRI-DTI study in cognitive normal (CN) older adults. A two time-point study was conducted in which participants completed a task switching paradigm while fMRI data was collected and underwent the identical scanning protocol an average of 3.3 years later (SD = 2 months). We observed longitudinal fMRI activation increases in bilateral regions of lateral frontal cortex at time point 2. These fMRI activation increases were associated with longitudinal declines in WM microstructure in a portion of the corpus callosum connecting the increasingly recruited frontal regions. In addition, the fMRI activation increase in the left VLPFC was associated with longitudinal increases in response latencies. Taken together, our results suggest that local frontal activation increases in CN older adults may in part reflect a response to reduced inter-hemispheric signaling mechanisms. PMID:25862416

  20. Activity in older adults: cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults.

    PubMed

    Aartsen, Marja J; Smits, Carolien H M; van Tilburg, Theo; Knipscheer, Kees C P M; Deeg, Dorly J H

    2002-03-01

    The impact of three types of everyday activities (i.e., social, experiential, and developmental) on four cognitive functions (i.e., immediate recall, learning, fluid intelligence, and information-processing speed) and one global indicator of cognitive functioning (Mini-Mental State Exam score) over a period of 6 years was studied in a large 55--85 year-old population-based sample (N = 2,076). A cross-lagged regression model with latent variables was applied to each combination of 1 cognitive function and 1 type of activity, resulting in 15 (3 x 5) different models. None of the activities were found to enhance cognitive functioning 6 years later when controlling for age, gender, level of education, and health, as well as for unknown confounding variables. Conversely, one cognitive function (i.e., information-processing speed) appeared to affect developmental activity. It is suggested that no specific activity, but rather socioeconomic status to which activities are closely connected, contributes to maintenance of cognitive functions. PMID:11867663

  1. Components of Air Pollution and Cognitive Function in Middle-aged and Older Adults in Los Angeles

    PubMed Central

    Gatto, Nicole M.; Henderson, Victor W.; Hodis, Howard N.; St John, Jan A.; Lurmann, Fred; Chen, Jiu-Chiuan; Mack, Wendy J.

    2014-01-01

    While experiments in animals demonstrate neurotoxic effects of particulate matter (PM) and ozone (O3), epidemiologic evidence is sparse regarding the relationship between different constituencies of air pollution mixtures and cognitive function in adults. We examined cross-sectional associations between various ambient air pollutants [O3, PM2.5 and nitrogen dioxide (NO2)] and six measures of cognitive function and global cognition among healthy, cognitively intact individuals (n=1,496, mean age 60.5 years) residing in the Los Angeles Basin. Air pollution exposures were assigned to each residential address in 2000–06 using a geographic information system that included monitoring data. A neuropsychological battery was used to assess cognitive function; a principal components analysis defined six domain-specific functions and a measure of global cognitive function was created. Regression models estimated effects of air pollutants on cognitive function, adjusting for age, gender, race, education, income, study and mood. Increasing exposure to PM2.5 was associated with lower verbal learning (β = −0.32 per 10 ug/m3 PM2.5, 95% CI = −0.63, 0.00; p = 0.05). Ambient exposure to NO2 >20 ppb tended to be associated with lower logical memory. Compared to the lowest level of exposure to ambient O3, exposure above 49 ppb was associated with lower executive function. Including carotid artery intima-media thickness, a measure of subclinical atherosclerosis, in models as a possible mediator did not attenuate effect estimates. This study provides support for cross-sectional associations between increasing levels of ambient O3, PM2.5 and NO2 and measures of domain-specific cognitive abilities. PMID:24148924

  2. Pork and Chicken Meals Similarly Impact on Cognitive Function and Strength in Community-Living Older Adults: A Pilot Study.

    PubMed

    Charlton, Karen; Walton, Karen; Batterham, Marijka; Brock, Erin; Langford, Kelly; McMahon, Anne; Roodenrys, Steven; Koh, Freda; Host, Alison; Crowe, Ruth; Thornhill, Kayla

    2016-01-01

    A pilot quasi-experimental study investigated whether provision of pork, a rich source of thiamin, as the main protein source in meals four times/week for 12 weeks resulted in improved muscle mass, body strength, and cognitive function in community-living older adults compared to similar meals containing chicken. Retirement villages were randomized to receive pre-prepared frozen meals containing either pork or chicken. Dietary intake was assessed by three-day food records and cognitive domains assessed using validated tests. Hand grip strength was measured and lower extremity performance assessed by the sit-to-stand test, get-up-and-go test and six-minute walk test. Forty-eight volunteers participated (78.2 ± 6.2 y). In linear mixed models, controlling for baseline physical activity and dietary protein and energy intake, no differences were found between pork (n = 19) and chicken (n = 12) groups. The chicken group had improved Rey Auditory Verbal Learning test scores (verbal learning and memory) at six weeks (p < 0.001). Provision of four pork meals a week did not result in improvements in cognitive function, nor measures of strength or physical function, compared to those receiving chicken meals in healthy older adults. This suggests that merely changing the type of dietary protein provided by meat does not impact physical or cognitive function. PMID:27153252

  3. Targeting alertness to improve cognition in older adults: A preliminary report of benefits in executive function and skill acquisition.

    PubMed

    Van Vleet, Thomas M; DeGutis, Joseph M; Merzenich, Michael M; Simpson, Gregory V; Zomet, Ativ; Dabit, Sawsan

    2016-09-01

    Efficient self-regulation of alertness declines with age exacerbating normal declines in performance across multiple cognitive domains, including learning and skill acquisition. Previous cognitive intervention studies have shown that it is possible to enhance alertness in patients with acquired brain injury and marked attention impairments, and that this benefit generalizes to improvements in more global cognitive functions. In the current preliminary studies, we sought to test whether this approach, that targets both tonic (over a period of minutes) and phasic (moment-to-moment) alertness, can improve key executive functioning declines in older adults, and enhance the rate of skill acquisition. The results of both Experiments 1 and 2 demonstrate that, compared to active control (AC) training, alertness training significantly enhanced performance in several validated executive function measures. In Experiment 2, alertness training significantly improved skill acquisition compared to AC training in a well-characterized speed of processing (SOP) task, with the largest benefits shown in the most challenging SOP blocks. The results of the current study suggest that targeting intrinsic alertness through cognitive training provides a novel approach to improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments. PMID:27372902

  4. Phobic anxiety and cognitive performance over 4 years among community-dwelling older women in the Nurses’ Health Study

    PubMed Central

    Okereke, Olivia I.; Grodstein, Francine

    2012-01-01

    Objective To examine the relation of phobic anxiety to late-life cognitive trajectory. Design Prospective cohort. Setting Nurses’ Health Study – U.S. registered nurses. Participants 16,351 women among whom phobic anxiety symptoms were assessed in 1988 (mean age=63 years). Measurements Beginning a decade after phobic anxiety ascertainment (mean age=74 years), three assessments of general cognition, word and paragraph immediate and delayed recall, category fluency, and attention/working memory were administered over an average of 4.4 years; global cognitive and verbal memory composite scores were generated from the component tests. General linear models of response profiles were used to evaluate relations of phobic anxiety to initial cognitive performance and subsequent change. Results Higher phobic anxiety was associated with poorer initial performance: e.g., comparing women with the highest anxiety to those with no/minimal symptoms, the multivariate-adjusted mean difference (95% confidence interval) in scores was −0.10 (−0.13,−0.06) standard units for the global score summarizing all tests, and −0.08 (−0.11,−0.04) standard units for verbal memory (summarizing 4 word- and paragraph-recall tasks). Mean differences between extreme categories of phobic anxiety were equal to those for participants aged 1.5–2 years apart: i.e., cognitively equivalent to being about two years older. There were no relations of phobic anxiety to subsequent cognitive change. Conclusions Higher mid-life phobic anxiety was related to worse later-life overall cognition and verbal memory. Yet, profiles of poorer cognition with higher anxiety remained parallel over time, suggesting phobic anxiety may impose impact on cognition earlier in life, rather than ongoing impact in later-life. PMID:23567369

  5. Stroke symptoms with absence of recognized stroke are associated with cognitive impairment and depressive symptoms in older adults with diabetes

    PubMed Central

    Passler, Jesse S.; Clay, Olivio J.; Wadley, Virginia G.; Ovalle, Fernando; Crowe, Michael

    2016-01-01

    Self-reported stroke symptoms may represent unrecognized cerebrovascular events leading to poorer cognitive and mental health. We examined relationships between stroke symptoms, cognitive impairment, and depressive symptoms in a high-risk sample: 247 adults age ≥65 with diabetes. Stroke symptoms were assessed using the Questionnaire for Verifying Stroke-free Status, cognitive impairment was measured with the modified Telephone Interview for Cognitive Status, and depressive symptoms were measured using the 15-item Geriatric Depression Scale. In 206 participants without history of stroke/TIA, 27.7% reported stroke symptoms, with sudden loss of comprehension most frequently reported (11.7%). Having >1 vs. 0 stroke symptoms was associated with greater odds of cognitive impairment (OR=3.04, 95% CI, 1.15–8.05) and more depressive symptoms (b =2.60, p<.001) while controlling for age, race, gender, education, diabetes duration, diabetes severity, and cardiovascular comorbidities. Better recognition and treatment of cerebrovascular problems in older adults with diabetes may lead to improved cognition and mental health. PMID:26801916

  6. The Effect of a Six-Month Dancing Program on Motor-Cognitive Dual-Task Performance in Older Adults.

    PubMed

    Hamacher, Dennis; Hamacher, Daniel; Rehfeld, Kathrin; Hökelmann, Anita; Schega, Lutz

    2015-10-01

    Dancing is a complex sensorimotor activity involving physical and mental elements which have positive effects on cognitive functions and motor control. The present randomized controlled trial aims to analyze the effects of a dancing program on the performance on a motor-cognitive dual task. Data of 35 older adults, who were assigned to a dancing group or a health-related exercise group, are presented in the study. In pretest and posttest, we assessed cognitive performance and variability of minimum foot clearance, stride time, and stride length while walking. Regarding the cognitive performance and the stride-to-stride variability of minimum foot clearance, interaction effects have been found, indicating that dancing lowers gait variability to a higher extent than conventional health-related exercise. The data show that dancing improves minimum foot clearance variability and cognitive performance in a dual-task situation. Multi-task exercises (like dancing) might be a powerful tool to improve motor-cognitive dual-task performance. PMID:25642826

  7. Health and Quality of Life Perception in Older Adults: The Joint Role of Cognitive Efficiency and Functional Mobility.

    PubMed

    Forte, Roberta; Boreham, Colin A G; De Vito, Giuseppe; Pesce, Caterina

    2015-09-01

    Cognitive and mobility functions are involved in health-related quality of life (HRQoL). The present cross-sectional study aimed at investigating what facets of efficient cognition and functional mobility interactively contribute to mental and physical HRQoL. Fifty-six healthy older individuals (aged 65-75 years) were evaluated for mental and physical HRQoL, core cognitive executive functions (inhibition, working memory, and cognitive flexibility), and functional mobility (walking) under single and dual task conditions. Multiple regression analyses were run to verify which core executive functions predicted mental and physical HRQoL and whether the ability to perform complex (dual) walking tasks moderated such association. Inhibitory efficiency and the ability to perform physical-mental dual tasks interactively predicted mental HRQoL, whereas cognitive flexibility and the ability to perform physical dual tasks interactively predicted physical HRQoL. Different core executive functions seem relevant for mental and physical HRQoL. Executive function efficiency seems to translate into HRQoL perception when coupled with tangible experience of the ability to walk under dual task conditions that mirror everyday life demands. Implications of these results for supporting the perception of mental and physical quality of life at advanced age are discussed, suggesting the usefulness of multicomponent interventions and environments conducive to walking that jointly aid successful cognitive aging and functional mobility. PMID:26378556

  8. Curcumin and cognition: a randomised, placebo-controlled, double-blind study of community-dwelling older adults.

    PubMed

    Rainey-Smith, Stephanie R; Brown, Belinda M; Sohrabi, Hamid R; Shah, Tejal; Goozee, Kathryn G; Gupta, Veer B; Martins, Ralph N

    2016-06-01

    Curcumin therapy in animals has produced positive cognitive and behavioural outcomes; results of human trials, however, have been inconsistent. In this study, we report the results of a 12-month, randomised, placebo-controlled, double-blind study that investigated the ability of a curcumin formulation to prevent cognitive decline in a population of community-dwelling older adults. Individuals (n 96) ingested either placebo or 1500 mg/d BiocurcumaxTM for 12 months. A battery of clinical and cognitive measures was administered at baseline and at the 6-month and 12-month follow-up assessments. A significant time×treatment group interaction was observed for the Montreal Cognitive Assessment (repeated-measures analysis; time×treatment; F=3·85, P<0·05). Subsequent analysis revealed that this association was driven by a decline in function of the placebo group at 6 months that was not observed in the curcumin treatment group. No differences were observed between the groups for all other clinical and cognitive measures. Our findings suggest that further longitudinal assessment is required to investigate changes in cognitive outcome measures, ideally in conjunction with biological markers of neurodegeneration. PMID:27102361

  9. Stroke Symptoms With Absence of Recognized Stroke Are Associated With Cognitive Impairment and Depressive Symptoms in Older Adults With Diabetes.

    PubMed

    Passler, Jesse S; Clay, Olivio J; Wadley, Virginia G; Ovalle, Fernando; Crowe, Michael

    2016-05-01

    Self-reported stroke symptoms may represent unrecognized cerebrovascular events leading to poorer cognitive and mental health. We examined relationships between stroke symptoms, cognitive impairment, and depressive symptoms in a high-risk sample: 247 adults aged ≥65 with diabetes. Stroke symptoms were assessed using the Questionnaire for Verifying Stroke-free Status, cognitive impairment was measured with the modified Telephone Interview for Cognitive Status, and depressive symptoms were measured using the 15-item Geriatric Depression Scale. In 206 participants without history of stroke/transient ischemic attack, 27.7% reported stroke symptoms, with sudden loss of comprehension most frequently reported (11.7%). Having >1 versus 0 stroke symptoms was associated with greater odds of cognitive impairment (odds ratio = 3.04, 95% confidence interval 1.15-8.05) and more depressive symptoms (b= 2.60,P< .001) while controlling for age, race, gender, education, diabetes duration, diabetes severity, and cardiovascular comorbidities. Better recognition and treatment of cerebrovascular problems in older adults with diabetes may lead to improved cognition and mental health. PMID:26801916

  10. Health and Quality of Life Perception in Older Adults: The Joint Role of Cognitive Efficiency and Functional Mobility

    PubMed Central

    Forte, Roberta; Boreham, Colin A.G.; De Vito, Giuseppe; Pesce, Caterina

    2015-01-01

    Cognitive and mobility functions are involved in health-related quality of life (HRQoL). The present cross-sectional study aimed at investigating what facets of efficient cognition and functional mobility interactively contribute to mental and physical HRQoL. Fifty-six healthy older individuals (aged 65–75 years) were evaluated for mental and physical HRQoL, core cognitive executive functions (inhibition, working memory, and cognitive flexibility), and functional mobility (walking) under single and dual task conditions. Multiple regression analyses were run to verify which core executive functions predicted mental and physical HRQoL and whether the ability to perform complex (dual) walking tasks moderated such association. Inhibitory efficiency and the ability to perform physical-mental dual tasks interactively predicted mental HRQoL, whereas cognitive flexibility and the ability to perform physical dual tasks interactively predicted physical HRQoL. Different core executive functions seem relevant for mental and physical HRQoL. Executive function efficiency seems to translate into HRQoL perception when coupled with tangible experience of the ability to walk under dual task conditions that mirror everyday life demands. Implications of these results for supporting the perception of mental and physical quality of life at advanced age are discussed, suggesting the usefulness of multicomponent interventions and environments conducive to walking that jointly aid successful cognitive aging and functional mobility. PMID:26378556

  11. Cognitive and Physical Demands of Activities of Daily Living In Older Adults: Validation of Expert Panel Ratings

    PubMed Central

    Fong, Tamara G.; Gleason, Lauren J.; Wong, Bonnie; Habtemariam, Daniel; Jones, Richard N.; Schmitt, Eva M.; de Rooij, Sophia E.; Saczynski, Jane S.; Gross, Alden L.; Bean, Jonathan F.; Brown, Cynthia J.; Fick, Donna M.; Gruber-Baldini, Ann L.; O’Connor, Margaret; Tabloski, Patrica A.; Marcantonio, Edward R.; Inouye, Sharon K.

    2015-01-01

    Background Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living. Objectives To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults. Design Expert panel survey. Setting Web-based platform. Participants Eleven experts from eight academic medical centers and 300 community dwelling elderly adults age 70 and older scheduled for elective non-cardiac surgery from two academic medical centers. Methods Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study. Main Outcome Measurements Correlation between expert ratings and objective neuropsychological tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks. Results Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, while walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychological performance (r=0.13–0.23, p<.05) and largely physical activities correlated with physical performance (r=0.15–0.46, p<.05). Conclusions Quantifying the degree of cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, post-acute care needs, treatment plans, and caregiver education. PMID:25661463

  12. A Reanalysis of Cognitive-Functional Performance in Older Adults: Investigating the Interaction Between Normal Aging, Mild Cognitive Impairment, Mild Alzheimer's Disease Dementia, and Depression.

    PubMed

    de Paula, Jonas J; Bicalho, Maria A; Ávila, Rafaela T; Cintra, Marco T G; Diniz, Breno S; Romano-Silva, Marco A; Malloy-Diniz, Leandro F

    2015-01-01

    Depressive symptoms are associated with cognitive-functional impairment in normal aging older adults (NA). However, less is known about this effect on people with mild Cognitive Impairment (MCI) and mild Alzheimer's disease dementia (AD). We investigated this relationship along with the NA-MCI-AD continuum by reanalyzing a previously published dataset. Participants (N = 274) underwent comprehensive neuropsychological assessment including measures of Executive Function, Language/Semantic Memory, Episodic Memory, Visuospatial Abilities, Activities of Daily Living (ADL), and the Geriatric Depression Scale. MANOVA, logistic regression and chi-square tests were performed to assess the association between depression and cognitive-functional performance in each group. In the NA group, depressed participants had a lower performance compared to non-depressed participants in all cognitive and functional domains. However, the same pattern was not observed in the MCI group or in AD. The results suggest a progressive loss of association between depression and worse cognitive-functional performance along the NA-MCI-AD continuum. PMID:26858666

  13. A Reanalysis of Cognitive-Functional Performance in Older Adults: Investigating the Interaction Between Normal Aging, Mild Cognitive Impairment, Mild Alzheimer's Disease Dementia, and Depression

    PubMed Central

    de Paula, Jonas J.; Bicalho, Maria A.; Ávila, Rafaela T.; Cintra, Marco T. G.; Diniz, Breno S.; Romano-Silva, Marco A.; Malloy-Diniz, Leandro F.

    2016-01-01

    Depressive symptoms are associated with cognitive-functional impairment in normal aging older adults (NA). However, less is known about this effect on people with mild Cognitive Impairment (MCI) and mild Alzheimer's disease dementia (AD). We investigated this relationship along with the NA-MCI-AD continuum by reanalyzing a previously published dataset. Participants (N = 274) underwent comprehensive neuropsychological assessment including measures of Executive Function, Language/Semantic Memory, Episodic Memory, Visuospatial Abilities, Activities of Daily Living (ADL), and the Geriatric Depression Scale. MANOVA, logistic regression and chi-square tests were performed to assess the association between depression and cognitive-functional performance in each group. In the NA group, depressed participants had a lower performance compared to non-depressed participants in all cognitive and functional domains. However, the same pattern was not observed in the MCI group or in AD. The results suggest a progressive loss of association between depression and worse cognitive-functional performance along the NA-MCI-AD continuum. PMID:26858666

  14. Clinical validation of the WMS-IV-NL brief cognitive status exam (BCSE) in older adults with MCI or dementia.

    PubMed

    Bouman, Zita; Hendriks, Marc P H; Aldenkamp, Albert P; Kessels, Roy P C

    2014-07-31

    ABSTRACT Background: The Brief Cognitive Status Exam (BCSE) is a new, optional subtest of the Wechsler Memory Scale-IV (WMS-IV) developed for rapid detection of cognitive deficits. We examined the clinical validation of the Dutch version of the BCSE in older adults with mild cognitive impairment (MCI) or dementia, comparing it to the Mini-Mental State Examination (MMSE). Method: BCSE and MMSE were administered in 39 older adults with MCI, 51 with dementia and 96 matched healthy controls. Results: Our results show that the BCSE is a valid screening instrument, with psychometric properties similar to the widely used MMSE. High correlations were found between the BCSE and MMSE (r = 0.79, n = 183, p < 0.001). Furthermore, a BCSE cut-off score ≤ 42 revealed a sensitivity of 96% a specificity of 92%, a positive predictive value of 86% and a negative predictive value of 97%, whereas the MMSE cut-off score of ≤ 24 showed values of 84%, 96%, 91%, and 92%, respectively. Sensitivity, specificity, positive and negative predictive values to detect MCI compared to controls was 81%, 80%, 61%, and 92%, respectively, on the BCSE, with a cut-off score of ≤ 46, and 84%, 76%, 57%, and 92%, respectively, on the MMSE, with a cut-off score of ≤ 27. Conclusions: The Dutch version of the BCSE is a clinically valid screening instrument for the detection of cognitive impairment in patients with dementia. Nevertheless, for distinguishing older adults with MCI from healthy controls both the BCSE and MMSE have limitations. PMID:25079232

  15. The disruptive – and beneficial – effects of distraction on older adults’ cognitive performance

    PubMed Central

    Weeks, Jennifer C.; Hasher, Lynn

    2014-01-01

    Older adults’ decreased ability to inhibit irrelevant information makes them especially susceptible to the negative effects of simultaneously occurring distraction. For example, older adults are more likely than young adults to process distraction presented during a task, which can result in delayed response times, decreased reading comprehension, disrupted problem solving, and reduced memory for target information. However, there is also some evidence that the tendency to process distraction can actually facilitate older adults’ performance when the distraction is congruent with the target information. For example, congruent distraction can speed response times, increase reading comprehension, benefit problem solving, and reduce forgetting in older adults. We review data showing that incongruent distraction can harm older adults’ performance, as well as evidence suggesting that congruent distraction can play a supportive role for older adults by facilitating processing of target information. Potential applications of distraction processing are also discussed. PMID:24634662

  16. Brain White Matter Tract Integrity and Cognitive Abilities in Community-Dwelling Older People: The Lothian Birth Cohort, 1936

    PubMed Central

    2013-01-01

    Objective: The present study investigates associations between brain white matter tract integrity and cognitive abilities in community-dwelling older people (N = 655). We explored two potential confounds of white matter tract−cognition associations in later life: (a) whether the associations between tracts and specific cognitive abilities are accounted for by general cognitive ability (g); and (b) how the presence of atrophy and white matter lesions affect these associations. Method: Tract integrity was determined using quantitative diffusion magnetic resonance imaging tractography (tract-averaged fractional anisotropy [FA]). Using confirmatory factor analysis, we compared first-order and bifactor models to investigate whether specific tract-ability associations were accounted for by g. Results: Significant associations were found between g and FA in bilateral anterior thalamic radiations (r range: .16−.18, p < .01), uncinate (r range: .19−.26, p < .001), arcuate fasciculi (r range: .11−.12, p < .05), and the splenium of corpus callosum (r = .14, p < .01). After controlling for g within the bifactor model, some significant specific cognitive domain associations remained. Results also suggest that the primary effects of controlling for whole brain integrity were on g associations, not specific abilities. Conclusion: Results suggest that g accounts for most of, but not all, the tract−cognition associations in the current data. When controlling for age-related overall brain structural changes, only minor attenuations of the tract−cognition associations were found, and these were primarily with g. In totality, the results highlight the importance of controlling for g when investigating associations between specific cognitive abilities and neuropsychology variables. PMID:23937481

  17. Getting the Message out about Cognitive Health: A Cross-Cultural Comparison of Older Adults' Media Awareness and Communication Needs on How to Maintain a Healthy Brain

    ERIC Educational Resources Information Center

    Friedman, Daniela B.; Laditka, James N.; Hunter, Rebecca; Ivey, Susan L.; Wu, Bei; Laditka, Sarah B.; Tseng, Winston; Corwin, Sara J.; Liu, Rui; Mathews, Anna E.

    2009-01-01

    Purpose: Evidence suggests that physical activity and healthy diets may help to maintain cognitive function, reducing risks of developing Alzheimer's disease and vascular dementia. Using a cross-cultural focus, we describe older adults' awareness about cognitive health, and their ideas about how to inform and motivate others to engage in…

  18. Language, aging, and cognition: frontal aslant tract and superior longitudinal fasciculus contribute toward working memory performance in older adults.

    PubMed

    Rizio, Avery A; Diaz, Michele T

    2016-06-15

    Previous research has documented change in white matter tract integrity with increasing age. Both interhemispheric and intrahemispheric tracts that underlie language processing are susceptible to these age-related changes. The aim of the current study was to explore age and white matter integrity in language-related tracts as predictors of cognitive task performance in younger and older adults. To this end, we carried out principal component analyses of white matter tracts and confirmatory factor analysis of neuropsychological measures. We next carried out a series of regression analyses that used white matter components to predict scores on each of the neuropsychological components. For both younger and older adults, age was a significant predictor of processing speed and working memory. However, white matter integrity did not contribute independently toward these models. In older adults only, both age and a white matter component that included the bilateral frontal aslant tract and left superior longitudinal fasciculus were significant predictors of working memory. Taken together, these results extend our understanding of the contributions of language-related white matter structure to cognitive processing and highlight the effects of age-related differences in both frontal and dorsal tracts. PMID:27138951

  19. Set-Shifting Ability Is Associated with Gray Matter Volume in Older People with Mild Cognitive Impairment

    PubMed Central

    Tsutsumimoto, Kota; Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Suzuki, Takao

    2015-01-01

    Background/Aims An understanding of the association between gray matter volume and executive functioning could provide strategies to reduce dementia risk in older people with mild cognitive impairment (MCI). Methods In a cross-sectional analysis, we assessed executive functioning in 83 older people with MCI using three standard neuropsychological tests: set shifting (difference between Trail Making Test Parts B and A), working memory (difference between Digit Span forward and backward from the Wechsler Adult Intelligence Scale-IV), and selective attention/response inhibition (difference between the second and third conditions of the color- and picture-word Stroop test). Gray matter volume was computed from brain MRIs and SIENAX from FSL software. Results Gray matter volume was significantly associated with set-shifting performance after accounting for age, gender, body mass index, education, and global cognition (standardized β = −0.376, p = 0.001), but not with working memory or selective attention/response inhibition. Conclusion The executive function of set-shifting ability was correlated with gray matter volume in older people with MCI. PMID:26628898

  20. Improved Processing Speed: Online Computer-Based Cognitive Training in Older Adults

    ERIC Educational Resources Information Center

    Simpson, Tamara; Camfield, David; Pipingas, Andrew; Macpherson, Helen; Stough, Con

    2012-01-01

    In an increasingly aging population, a number of adults are concerned about declines in their cognitive abilities. Online computer-based cognitive training programs have been proposed as an accessible means by which the elderly may improve their cognitive abilities; yet, more research is needed in order to assess the efficacy of these programs. In…

  1. Longitudinal Associations between Physical and Cognitive Performance among Community-Dwelling Older Adults

    PubMed Central

    Tolea, Magdalena I.; Morris, John C.; Galvin, James E.

    2015-01-01

    To assess the directionality of the association between physical and cognitive decline in later life, we compared patterns of decline in performance across groups defined by baseline presence of cognitive and/or physical impairment [none (n = 217); physical only (n = 169); cognitive only (n = 158), or both (n = 220)] in a large sample of participants in a cognitive aging study at the Knight Alzheimer’s Disease Research Center at Washington University in St. Louis who were followed for up to 8 years (3,079 observations). Rates of decline reached 20% for physical performance and varied across cognitive tests (global, memory, speed, executive function, and visuospatial skills). We found that physical decline was better predicted by baseline cognitive impairment (slope = -1.22, p<0.001), with baseline physical impairment not contributing to further decline in physical performance (slope = -0.25, p = 0.294). In turn, baseline physical impairment was only marginally associated with rate of cognitive decline across various cognitive domains. The cognitive-functional association is likely to operate in the direction of cognitive impairment to physical decline although physical impairment may also play a role in cognitive decline/dementia. Interventions to prevent further functional decline and development of disability and complete dependence may benefit if targeted to individuals with cognitive impairment who are at increased risk. PMID:25875165

  2. Long-term moderate alcohol consumption does not exacerbate age-related cognitive decline in healthy, community-dwelling older adults

    PubMed Central

    Moussa, Malaak N.; Simpson, Sean L.; Mayhugh, Rhiannon E.; Grata, Michelle E.; Burdette, Jonathan H.; Porrino, Linda J.; Laurienti, Paul J.

    2015-01-01

    Recent census data has found that roughly 40% of adults 65 years and older not only consume alcohol but also drink more of it than previous generations. Older drinkers are more vulnerable than younger counterparts to the psychoactive effects of alcohol due to natural biological changes that occur with aging. This study was specifically designed to measure the effect of long-term moderate alcohol consumption on cognitive health in older adult drinkers. An extensive battery of validated tests commonly used in aging and substance use literature was used to measure performance in specific cognitive domains, including working memory and attention. An age (young, old) * alcohol consumption (light, moderate) factorial study design was used to evaluate the main effects of age and alcohol consumption on cognitive performance. The focus of the study was then limited to light and moderate older drinkers, and whether or not long-term moderate alcohol consumption exacerbated age-related cognitive decline. No evidence was found to support the idea that long-term moderate alcohol consumption in older adults exacerbates age-related cognitive decline. Findings were specific to healthy community dwelling social drinkers in older age and they should not be generalized to individuals with other consumption patterns, like heavy drinkers, binge drinkers or ex-drinkers. PMID:25601835

  3. Quantitative multi-modal MRI of the Hippocampus and cognitive ability in community-dwelling older subjects.

    PubMed

    Aribisala, Benjamin S; Royle, Natalie A; Maniega, Susana Muñoz; Valdés Hernández, Maria C; Murray, Catherine; Penke, Lars; Gow, Alan; Starr, John M; Bastin, Mark E; Deary, Ian J; Wardlaw, Joanna M

    2014-04-01

    Hippocampal structural integrity is commonly quantified using volumetric measurements derived from brain magnetic resonance imaging (MRI). Previously reported associations with cognitive decline have not been consistent. We investigate hippocampal integrity using quantitative MRI techniques and its association with cognitive abilities in older age. Participants from the Lothian Birth Cohort 1936 underwent brain MRI at mean age 73 years. Longitudinal relaxation time (T1), magnetization transfer ratio (MTR), fractional anisotropy (FA) and mean diffusivity (MD) were measured in the hippocampus. General factors of fluid-type intelligence (g), cognitive processing speed (speed) and memory were obtained at age 73 years, as well as childhood IQ test results at age 11 years. Amongst 565 older adults, multivariate linear regression showed that, after correcting for ICV, gender and age 11 IQ, larger left hippocampal volume was significantly associated with better memory ability (β = .11, p = .003), but not with speed or g. Using quantitative MRI and after correcting for multiple testing, higher T1 and MD were significantly associated with lower scores of g (β range = -.11 to -.14, p < .001), speed (β range = -.15 to -.20, p < .001) and memory (β range = -.10 to -.12, p < .001). Higher MTR and FA in the hippocampus were also significantly associated with higher scores of g (β range = .17 to .18, p < .0001) and speed (β range = .10 to .15, p < .0001), but not memory. Quantitative multi-modal MRI assessments were more sensitive at detecting cognition-hippocampal integrity associations than volumetric measurements, resulting in stronger associations between MRI biomarkers and age-related cognition changes. PMID:24561387

  4. Aerobic Exercise Improves Cognition for Older Adults with Glucose Intolerance, A Risk Factor for Alzheimer’s Disease

    PubMed Central

    Baker, Laura D.; Frank, Laura L.; Foster-Schubert, Karen; Green, Pattie S; Wilkinson, Charles W.; McTiernan, Anne; Cholerton, Brenna A.; Plymate, Stephen R.; Fishel, Mark A.; Watson, G. Stennis; Duncan, Glen E.; Mehta, Pankaj D.; Craft, Suzanne

    2011-01-01

    Impaired glucose regulation is a defining characteristic of type 2 diabetes mellitus (T2DM) pathology and has been linked to increased risk of cognitive impairment and dementia. Although the benefits of aerobic exercise for physical health are well-documented, exercise effects on cognition have not been examined for older adults with poor glucose regulation associated with prediabetes and early T2DM. Using a randomized controlled design, twenty-eight adults (57–83 y old) meeting 2-h tolerance test criteria for glucose intolerance completed 6 months of aerobic exercise or stretching, which served as the control. The primary cognitive outcomes included measures of executive function (Trails B, Task Switching, Stroop, Self-ordered Pointing Test, and Verbal Fluency). Other outcomes included memory performance (Story Recall, List Learning), measures of cardiorespiratory fitness obtained via maximal-graded exercise treadmill test, glucose disposal during hyperinsulinemic-euglycemic clamp, body fat, and fasting plasma levels of insulin, cortisol, brain-derived neurotrophic factor, insulin-like growth factor-1, amyloid-β (Aβ40 and Aβ42). Six months of aerobic exercise improved executive function (MANCOVA, p = 0.04), cardiorespiratory fitness (MANOVA, p = 0.03), and insulin sensitivity (p = 0.05). Across all subjects, 6-month changes in cardiorespiratory fitness and insulin sensitivity were positively correlated (p = 0.01). For Aβ42, plasma levels tended to decrease for the aerobic group relative to controls (p = 0.07). The results of our study using rigorous controlled methodology suggest a cognition-enhancing effect of aerobic exercise for older glucose intolerant adults. Although replication in a larger sample is needed, our findings potentially have important therapeutic implications for a growing number of adults at increased risk of cognitive decline. PMID:20847403

  5. Cognition and dual-task performance in older adults with Parkinson’s and Alzheimer’s disease

    PubMed Central

    Christofoletti, Gustavo; Andrade, Larissa Pires; Beinotti, Fernanda; Borges, Guilherme

    2014-01-01

    Background Patients with neurodegenerative diseases usually experience significant functional deficits. Older adults with Parkinson’s disease (PD) and Alzheimer’s disease (AD) may suffer from both motor and cognitive impairments, making them especially vulnerable to poor dual-task performance. Objective To analyze the dual-task cost of walking in subjects with PD and AD exposed to motor and cognitive distracters. Methods A cross-sectional study was conducted involving 126 older adults comprising three groups: PD (n=43), AD (n=38), and control (n=45). The subjects were evaluated using the Timed Up and Go (TUG) test administered with motor and cognitive distracters. Mixed-design analysis of variance (ANOVA) with cognition as a covariant factor was used to test the possible main effects of dual-task on motion. A 5% threshold for significance was set, with a 95% confidence interval (CI). The partial eta square (n2p) analysis was included to estimate the magnitude of effect. Results Examining the effects for dual-task, ANOVA revealed the main effect for group×task interactions (F=13.09; P=0.001; n2p =0.178), for task (F=8.186; P=0.001; n2p =0.063) but not for group (F=2.954; P=0.056; n2p =0.047). Cognition applied as a covariant factor indicated interference on dual-tasks (F=30.43; P=0.001; n2p =0.201). Conclusion The findings of this study suggest that dual-task interference is a particularly noticeable problem in PD and AD, affecting subjects’ ability to appropriately adapt to environmental challenges. PMID:25092996

  6. Recommended Measures for the Assessment of Cognitive and Physical Performance in Older Patients with Dementia: A Systematic Review

    PubMed Central

    Bossers, Willem J.R.; van der Woude, Lucas H.V.; Boersma, Froukje; Scherder, Erik J.A.; van Heuvelen, Marieke J.G.

    2012-01-01

    Aim/Goal To recommend a set of neuropsychological and physical exercise tests for researchers to assess cognition and physical fitness in clinical trials with older patients with dementia; to create consensus, decrease heterogeneity, and improve research quality. Methods A literature search (2005–2011) yielded 89 randomized controlled trials. To provide information on test recommendations the frequency of test use, effect size of the test outcome, study quality, and psychometric properties of tests were analyzed. Results Fifty-nine neuropsychological tests (cognitive domains: global cognition, executive functioning, memory, and attention) and 10 exercise tests (physical domains: endurance capacity, muscle strength, balance, and mobility) were found. Conclusion The Severe Impairment Battery, Mini Mental State Examination, and Alzheimer Disease Assessment Scale – cognitive subscale were recommended to measure global cognition. The Verbal Fluency Test Category/Letters, Clock Drawing Test, and Trail Making Test-B were recommended to measure executive functioning. No specific memory test could be recommended. The Digit Span Forward, Digit Span Backward, and Trail Making Test-A were recommended to measure attention. As physical exercise tests, the Timed Up and Go and Six Meter Walk for mobility, the Six Minute Walk Distance for endurance capacity, and the Tinetti Balance Scale were recommended. PMID:23341825

  7. Repetition-lag training to improve recollection memory in older people with amnestic mild cognitive impairment. A randomized controlled trial.

    PubMed

    Finn, Maurice; McDonald, Skye

    2015-01-01

    The results of a randomized controlled trial of repetition-lag training in older adults with amnestic mild cognitive impairment (aMCI) are reported. A modified repetition-lag training procedure with extended encoding time and strategy choice was used. The training required discriminating studied words from non-studied lures that were repeated at varying intervals during the test phase. Participants were assessed pre/post using untrained measures of cognition and self-report questionnaires. Primary outcome measures were recall of unrelated word pairs both immediately following presentation and following a delay. Secondary outcomes were a measure of attention, cognitive flexibility, and visual working memory. Participants were also asked to report on the frequency of cognitive failures and mood before and after training. Participants (N = 31) were randomized into either the treatment or a no-contact control group and attended the clinic twice per week over a four week period. Twenty-four participants completed the study (twelve in each group). Results indicated that the training group improved at recalling unrelated word pairs after a delay. There were no significant effects of training on other outcomes, self-reported cognitive failures or mood. The results are discussed along with suggestions for future research. PMID:24820545

  8. Abnormality in glutamine–glutamate cycle in the cerebrospinal fluid of cognitively intact elderly individuals with major depressive disorder: a 3-year follow-up study

    PubMed Central

    Hashimoto, K; Bruno, D; Nierenberg, J; Marmar, C R; Zetterberg, H; Blennow, K; Pomara, N

    2016-01-01

    Major depressive disorder (MDD), common in the elderly, is a risk factor for dementia. Abnormalities in glutamatergic neurotransmission via the N-methyl-d-aspartate receptor (NMDA-R) have a key role in the pathophysiology of depression. This study examined whether depression was associated with cerebrospinal fluid (CSF) levels of NMDA-R neurotransmission-associated amino acids in cognitively intact elderly individuals with MDD and age- and gender-matched healthy controls. CSF was obtained from 47 volunteers (MDD group, N=28; age- and gender-matched comparison group, N=19) at baseline and 3-year follow-up (MDD group, N=19; comparison group, N=17). CSF levels of glutamine, glutamate, glycine, l-serine and d-serine were measured by high-performance liquid chromatography. CSF levels of amino acids did not differ across MDD and comparison groups. However, the ratio of glutamine to glutamate was significantly higher at baseline in subjects with MDD than in controls. The ratio decreased in individuals with MDD over the 3-year follow-up, and this decrease correlated with a decrease in the severity of depression. No correlations between absolute amino-acid levels and clinical variables were observed, nor were correlations between amino acids and other biomarkers (for example, amyloid-β42, amyloid-β40, and total and phosphorylated tau protein) detected. These results suggest that abnormalities in the glutamine–glutamate cycle in the communication between glia and neurons may have a role in the pathophysiology of depression in the elderly. Furthermore, the glutamine/glutamate ratio in CSF may be a state biomarker for depression. PMID:26926880

  9. Physical Activity and Executive Control: Implications for Increased Cognitive Health during Older Adulthood

    ERIC Educational Resources Information Center

    Hillman, Charles H.; Belopolsky, Artem V.; Snook, Erin M.; Kramer, Arthur F.; McAuley, Edward

    2004-01-01

    Electrocortical and behavioral responses of low, moderate, and high physically active older adults where compared with a younger control group on neutral and incompatible conditions of a flankers task. Compared to younger adults, high and moderate active older adults exhibited increased event-related potentials component P3 amplitude for the…

  10. Mediterranean diet, healthy eating index 2005, and cognitive function in middle-aged and older Puerto Rican adults.

    PubMed

    Ye, Xingwang; Scott, Tammy; Gao, Xiang; Maras, Janice E; Bakun, Peter J; Tucker, Katherine L

    2013-02-01

    Adherence to a Mediterranean diet has recently been shown to protect against cognitive decline and dementia. It remains unclear, however, whether such protection extends to different ethnic groups and middle-aged individuals and how it might compare with adherence to the US Department of Agriculture's 2005 Dietary Guidelines for Americans (measured with Healthy Eating Index 2005 [HEI 2005]). This study examined associations between diet quality, as assessed by the Mediterranean diet and HEI 2005, and cognitive performance in a sample of 1,269 Puerto Rican adults aged 45 to 75 years and living in the Greater Boston area of Massachusetts. Dietary intake was assessed with a food frequency questionnaire specifically designed for and validated with this population. Adherence to the Mediterranean diet was assessed with a 0- to 9-point scale, and the HEI 2005 score was calculated with a maximum score of 100. Cognitive performance was measured with a battery of seven tests and the Mini Mental State Examination was used for global cognitive function. Greater adherence to the Mediterranean diet was associated with higher Mini Mental State Examination score (P trend=0.012) and lower likelihood (odds ratio=0.87 for each additional point; 95% CI 0.80 to 0.94; P<0.001) of cognitive impairment, after adjustment for confounders. Similarly, individuals with higher HEI 2005 score had higher Mini Mental State Examination score (P trend=0.011) and lower odds of cognitive impairment (odds ratio=0.86 for each 10 points; 95% CI 0.74 to 0.99; P=0.033). In conclusion, high adherence to either the Mediterranean diet or the diet recommended by the US Department of Agriculture 2005 Dietary Guidelines for Americans can protect cognitive function in middle-aged and older adults. PMID:23351632

  11. RBANS Memory Indices Are Related to Medial Temporal Lobe Volumetrics in Healthy Older Adults and Those with Mild Cognitive Impairment

    PubMed Central

    England, Heather B.; Gillis, M. Meredith; Hampstead, Benjamin M.

    2014-01-01

    The current study (i) determined whether NeuroQuant® volumetrics are reflective of differences in medial temporal lobe (MTL) volumes between healthy older adults and those with mild cognitive impairment (MCI) and (ii) examined the relationship between RBANS indices and MTL volumes. Forty-three healthy older adults and 57 MCI patients completed the RBANS and underwent structural MRI. Hippocampal and inferior lateral ventricle (ILV) volumes were obtained using NeuroQuant®. Results revealed significantly smaller hippocampal and larger ILV volumes in MCI patients. MTL volumes were significantly related to the RBANS Immediate and Delayed Memory and Language indices but not the Attention or Visuoconstruction indices; findings that demonstrate anatomical specificity. Following discriminant function analysis, we calculated a cutpoint that may prove clinically useful for integrating MTL volumes into the diagnosis of MCI. These findings demonstrate the potential clinical utility of NeuroQuant® and are the first to document the relationship between RBANS indices and MTL volumes. PMID:24709384

  12. RBANS memory indices are related to medial temporal lobe volumetrics in healthy older adults and those with mild cognitive impairment.

    PubMed

    England, Heather B; Gillis, M Meredith; Hampstead, Benjamin M

    2014-06-01

    The current study (i) determined whether NeuroQuant(®) volumetrics are reflective of differences in medial temporal lobe (MTL) volumes between healthy older adults and those with mild cognitive impairment (MCI) and (ii) examined the relationship between RBANS indices and MTL volumes. Forty-three healthy older adults and 57 MCI patients completed the RBANS and underwent structural MRI. Hippocampal and inferior lateral ventricle (ILV) volumes were obtained using NeuroQuant(®). Results revealed significantly smaller hippocampal and larger ILV volumes in MCI patients. MTL volumes were significantly related to the RBANS Immediate and Delayed Memory and Language indices but not the Attention or Visuoconstruction indices; findings that demonstrate anatomical specificity. Following discriminant function analysis, we calculated a cutpoint that may prove clinically useful for integrating MTL volumes into the diagnosis of MCI. These findings demonstrate the potential clinical utility of NeuroQuant(®) and are the first to document the relationship between RBANS indices and MTL volumes. PMID:24709384

  13. Physicians' attitudes about artificial feeding in older patients with severe cognitive impairment in Japan: a qualitative study

    PubMed Central

    Aita, Kaoruko; Takahashi, Miyako; Miyata, Hiroaki; Kai, Ichiro; Finucane, Thomas E

    2007-01-01

    Background The question of whether to withhold artificial nutrition and hydration (ANH) from severely cognitively impaired older adults has remained nearly unexplored in Japan, where provision of ANH is considered standard care. The objective of this study was to identify and analyze factors related to the decision to provide ANH through percutaneous endoscopic gastrostomy (PEG) in older Japanese adults with severe cognitive impairment. Methods Retrospective, in-depth interviews with thirty physicians experienced in the care of older, bed-ridden, non-communicative patients with severe cognitive impairment. Interview content included questions about factors influencing the decision to provide or withhold ANH, concerns and dilemmas concerning ANH and the choice of PEG feeding as an ANH method. The process of data collection and analysis followed the Grounded Theory approach. Results Data analysis identified five factors that influence Japanese physicians' decision to provide ANH through PEG tubes: (1) the national health insurance system that allows elderly patients to become long-term hospital in-patients; (2) legal barriers with regard to limiting treatment, including the risk of prosecution; (3) emotional barriers, especially abhorrence of death by 'starvation'; (4) cultural values that promote family-oriented end-of-life decision making; and (5) reimbursement-related factors involved in the choice of PEG. However, a small number of physicians did offer patients' families the option of withholding ANH. These physicians shared certain characteristics, such as a different perception of ANH and repeated communication with families concerning end-of-life care. These qualities were found to reduce some of the effects of the factors that favor provision of ANH. Conclusion The framework of Japan's medical-legal system unintentionally provides many physicians an incentive to routinely offer ANH for this patient group through PEG tubes. It seems apparent that end

  14. Apathy and cognitive and functional decline in community-dwelling older adults: Results from the Baltimore ECA longitudinal study

    PubMed Central

    Clarke, Diana E.; Ko, Jean Y.; Lyketsos, Constantine; Rebok, George W.; Eaton, William W.

    2010-01-01

    Background Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer’s disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and / or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults. Methods Data on 1,136 community-dwelling adults age 50 and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Chi-square, t-tests, logistic regression, and Generalized Estimating Equations were used to accomplish the study’s objectives. Results The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower MMSE scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR=2.74; 95%CI= 1.35, 5.57) function at 1 year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were 2-fold more likely to have functional decline. Incidence of apathy at 1- year follow up and 13- year follow-up was respectively, 22.6% and 29.4%. Conclusions These results underline the public health importance of apathy and the need for further population-based studies in this area. PMID:20478091

  15. Efficacy and Safety of MMFS-01, a Synapse Density Enhancer, for Treating Cognitive Impairment in Older Adults: A Randomized, Double-Blind, Placebo-Controlled Trial

    PubMed Central

    Liu, Guosong; Weinger, Jason G.; Lu, Zhong-Lin; Xue, Feng; Sadeghpour, Safa

    2015-01-01

    Background: Cognitive impairment is a major problem in elderly, affecting quality of life. Pre-clinical studies show that MMFS-01, a synapse density enhancer, is effective at reversing cognitive decline in aging rodents. Objective: Since brain atrophy during aging is strongly associated with both cognitive decline and sleep disorder, we evaluated the efficacy of MMFS-01 in its ability to reverse cognitive impairment and improve sleep. Methods: We conducted a randomized, double-blind, placebo-controlled, parallel-designed trial in older adult subjects (age 50–70) with cognitive impairment. Subjects were treated with MMFS-01 (n = 23) or placebo (n = 21) for 12 weeks and cognitive ability, sleep quality, and emotion were evaluated. Overall cognitive ability was determined by a composite score of tests in four major cognitive domains. Results: With MMFS-01 treatment, overall cognitive ability improved significantly relative to placebo (p = 0.003; Cohen’s d = 0.91). Cognitive fluctuation was also reduced. The study population had more severe executive function deficits than age-matched controls from normative data and MMFS-01 treatment nearly restored their impaired executive function, demonstrating that MMFS-01 may be clinically significant. Due to the strong placebo effects on sleep and anxiety, the effects of MMFS-01 on sleep and anxiety could not be determined. Conclusions: The current study demonstrates the potential of MMFS-01 for treating cognitive impairment in older adults. PMID:26519439

  16. A Battery of Tests for Assessing Cognitive Function in U.S. Chinese Older Adults—Findings From the PINE Study

    PubMed Central

    Chang, E-Shien

    2014-01-01

    Background. Existing methodological challenges in aging research has dampened our assessment of cognitive function among minority older adults. We aim to report the composite scores of five cognitive function tests among U.S. Chinese older adults, and examine the association between cognitive function and key sociodemographic characteristics. Methods. The Population Study of Chinese Elderly in Chicago Study enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults. We administered five cognitive function tests, including the Chinese Mini-Mental State Examination, the immediate and delayed recall of the East Boston Memory Test, the Digit Span Backwards assessment, and the Symbol Digit Modalities Test. We used Spearman correlation coefficients to examine the correlation between cognitive function and sociodemographic variables. Linear regression models were used to report the effect of sociodemographic and health variables including age, sex, education on cognitive function. Results. Our multivariate analysis suggested that performance in each domain of cognitive function was inversely associated with age and positively related to education. With respect to sex, after adjusted for age, education and all key variables presented in the model, being male was positively related to global cognitive score and working memory. Being married, having fewer children, having been in the United States for fewer years, having been in the community for fewer years, and better self-reported health were positively correlated with all cognitive function domains. Conclusions. This population-based study of U.S. Chinese older adults is among the first to examine a battery of five cognitive function tests, which in aggregate enables researchers to capture a wide range of cognitive performance. PMID:25324222

  17. Memory plasticity in older adults: Cognitive predictors of training response and maintenance following learning of number-consonant mnemonic.

    PubMed

    Sandberg, Petra; Rönnlund, Michael; Derwinger-Hallberg, Anna; Stigsdotter Neely, Anna

    2016-10-01

    The study investigated the relationship between cognitive factors and gains in number recall following training in a number-consonant mnemonic in a sample of 112 older adults (M = 70.9 years). The cognitive factors examined included baseline episodic memory, working memory, processing speed, and verbal knowledge. In addition, predictors of maintenance of gains to a follow-up assessment, eight months later, were examined. Whereas working memory was a prominent predictor of baseline recall, the magnitude of gains in recall from pre- to post-test assessments were predicted by baseline episodic memory, processing speed, and verbal knowledge. Verbal knowledge was the only significant predictor of maintenance. Collectively, the results indicate the need to consider multiple factors to account for individual differences in memory plasticity. The potential contribution of additional factors to individual differences in memory plasticity is discussed. PMID:26043066

  18. Cognitive Impairment and Outcomes in Older Adult Survivors of Acute Myocardial Infarction: Findings from the TRIUMPH Registry

    PubMed Central

    Gharacholou, S. Michael; Reid, Kimberly J.; Arnold, Suzanne V.; Spertus, John; Rich, Michael W.; Pellikka, Patricia A.; Singh, Mandeep; Holsinger, Tracey; Krumholz, Harlan M.; Peterson, Eric D.; Alexander, Karen P.

    2012-01-01

    Background Cognitive impairment without dementia (CIND) and acute myocardial infarction (AMI) are prevalent in older adults; however, the association of CIND with outcomes after AMI is unknown. Methods We used a multicenter registry to study 772 patients ≥65 years with AMI, enrolled between April 2005 and December 2008, who underwent cognitive function assessment with the Telephone Interview for Cognitive Status-modified (TICS-m) 1 month after AMI. Patients were categorized by cognitive status to describe characteristics and in-hospital treatment, including quality of life and survival 1 year after AMI. Results Mean age was 73.2±6.3 years; 58.5% were males and 78.2% were white. Normal cognitive function (TICS-m>22) was present in 44.4%; mild CIND (TICS-m 19–22) in 29.8% and moderate/severe CIND (TICS-m <19) in 25.8% of patients. Rates of hypertension (72.6%, 77.4%, 81.9%), cerebrovascular accidents (3.5%, 7.0%, 9.0%), and myocardial infarction (20.1%, 22.2%, 29.6%) were higher in those with lower TICS-m scores (p<0.05 for comparisons). AMI medications were similar by cognitive status; however, CIND was associated with lower cardiac catheterization rates (p=0.002) and cardiac rehabilitation referrals (p<0.001). Patients with moderate/severe CIND had higher risk-adjusted 1 year mortality that was non-statistically significant (adjusted HR 1.97; 95% CI 0.99 – 3.94; p=0.054; referent normal, TICS-m >22). Quality of life across cognitive status was similar at 1 year. Conclusions Most older patients surviving AMI have measurable CIND. CIND was associated with less invasive care, less referral and participation in cardiac rehabilitation, and worse risk-adjusted 1 year survival in those with moderate/severe CIND, making it an important condition to consider in optimizing AMI care. PMID:22093202

  19. Cognitive remediation therapy and cognitive behavioral therapy with an older adult with anorexia nervosa: A brief case report.

    PubMed

    Darcy, Alison M; Fitzpatrick, Kara K; Lock, James

    2016-06-01

    Cognitive remediation therapy represents a new approach to the treatment of anorexia nervosa (AN) emerging from research, suggesting that adults with chronic AN have specific neurocognitive inefficiencies. Specifically, adults with AN demonstrate an overly detailed cognitive processing bias (Roberts, Tchanturia, & Treasure, 2013) and difficulties shifting set quickly and efficiently (Roberts, Tchanturia, Stahl, Southgate, & Treasure, 2007). These characteristics manifest as rigid, rule-bound, and detail-focused cognitions, beliefs, and behaviors. Versions of these problems appear to persist after weight restoration (Tchanturia et al., 2004) and are observable in patient's healthy sisters (Roberts et al., 2013). Thus, central coherence difficulties and set-shifting problems have been proposed as endophenotypes and maintaining factors of AN (Roberts et al., 2013). (PsycINFO Database Record PMID:27267509

  20. Serum Vitamin D Concentrations and Cognitive Function in a Population-Based Study among Older Adults in South Germany.

    PubMed

    Nagel, Gabriele; Herbolsheimer, Florian; Riepe, Matthias; Nikolaus, Thorsten; Denkinger, Michael D; Peter, Richard; Weinmayr, Gudrun; Rothenbacher, Dietrich; Koenig, Wolfgang; Ludolph, Albert C; von Arnim, Christine A F

    2015-01-01

    Our objective was to investigate the associations of vitamin D serum levels with dementia and cognitive function in specific domains in community dwelling older adults. Between 2009 and 2010, we conducted a cross-sectional study in 1,373 individuals (56% men) aged 65+ years in the "Activity and Function in the Elderly in Ulm" (ActiFE) study. Dementia was defined as a Mini-Mental State Examination (MMSE) score ≤ 24. The 25-OHD serum level [ng/mL] was measured by an electrochemilumineszenz immunoassay (ECLIA). Logistic regression models were used to calculate odds ratios (OR)s for cognitive domains (cut-point: 10th percentile) by serum 25-OHD concentrations (both continuously and by cut-point of 20 ng/ml for vitamin D deficiency). Mean age of the study population was 75.6 (SD 6.6) years.We identified 75 participants (43% women) with dementia. 25-OHD concentrations were significantly lower in the participants with dementia compared to persons with a MMSE score >24. We also observed an association of continuous 25-OHD serum concentrations with prevalence of dementia (crude OR 1.05, 95% confidence interval (CI), 1.01-1.08, p-value 0.009) per 1 ng/mL decrease, after adjustment the OR was 1.03, 95% CI, 0.995-1.08 (p-value 0.09). Although vitamin D deficiency was tentatively associated with severity of dementia measured by MMSE (OR 1.35, 95% CI, 0.84-2.19), the association was not statistically significant. However, deficits in specific cognitive domains such as executive functions, wordlist encoding, and visual memory (encoding and recall) were significantly associated with low vitamin D concentration. Our results suggest an association between vitamin D deficiency and cognitive function in specific domains in community dwelling older adults. PMID:25649649

  1. Comparative Cognitive and Subjective Side Effects of Immediate Release Oxycodone in Healthy Middle Age and Older Adults

    PubMed Central

    Cherrier, M.; Amory, J.; Ersek, M.; Risler, L.; Shen, D.

    2009-01-01

    This study measured the objective and subjective neurocognitive effects of a single 10mg dose of immediate-release oxycodone in healthy, older (>65 years) and middle age (35 – 55 years) adults who were not suffering from chronic or significant daily pain. Seventy-one participants completed two separate study days and were blind to medication condition (placebo, 10 mg oxycodone). Plasma oxycodone concentration peaked between 60 and 90 min post dose (p<0.01) and pupil size, an indication of physiological effects of the medication peaked at approximately 90 to 120 min post dose (p<0.01). Significant declines in simple and sustained attention, working memory and verbal memory were observed at one hour post dose compared to baseline for both age groups with a trend toward return to baseline by five hours post dose. For almost all cognitive measures there were no medication by age interaction effects, which indicates that the two age groups exhibited a similar responses to the medication challenge. This study suggests that for healthy older adults who are not suffering from chronic pain, neurocognitive and pharmacodynamic changes in response to a 10 mg dose of immediate release oxycodone are similar to those observed for middle age adults. Perspective Study findings indicate that the metabolism, neurocognitive effects, and physical side effects of oral oxycodone are similar for healthy middle-age and older adults. Therefore, clinicians should not avoid prescribing oral opioids to older adults based on the belief that older adults are at higher risk for side effects than younger adults. PMID:19729346

  2. The impact of hearing loss on language performance in older adults with different stages of cognitive function

    PubMed Central

    Lodeiro-Fernández, Leire; Lorenzo-López, Laura; Maseda, Ana; Núñez-Naveira, Laura; Rodríguez-Villamil, José Luis; Millán-Calenti, José Carlos

    2015-01-01

    Purpose The possible relationship between audiometric hearing thresholds and cognitive performance on language tests was analyzed in a cross-sectional cohort of older adults aged ≥65 years (N=98) with different degrees of cognitive impairment. Materials and methods Participants were distributed into two groups according to Reisberg’s Global Deterioration Scale (GDS): a normal/predementia group (GDS scores 1–3) and a moderate/moderately severe dementia group (GDS scores 4 and 5). Hearing loss (pure-tone audiometry) and receptive and production-based language function (Verbal Fluency Test, Boston Naming Test, and Token Test) were assessed. Results Results showed that the dementia group achieved significantly lower scores than the predementia group in all language tests. A moderate negative correlation between hearing loss and verbal comprehension (r=−0.298; P<0.003) was observed in the predementia group (r=−0.363; P<0.007). However, no significant relationship between hearing loss and verbal fluency and naming scores was observed, regardless of cognitive impairment. Conclusion In the predementia group, reduced hearing level partially explains comprehension performance but not language production. In the dementia group, hearing loss cannot be considered as an explanatory factor of poor receptive and production-based language performance. These results are suggestive of cognitive rather than simply auditory problems to explain the language impairment in the elderly. PMID:25914528

  3. Estimating the Co-Development of Cognitive Decline and Physical Mobility Limitations in Older U.S. Adults.

    PubMed

    Bishop, Nicholas J; Eggum-Wilkens, Natalie D; Haas, Steven A; Kronenfeld, Jennie J

    2016-04-01

    This study examines the co-development of cognitive and physical function in older Americans using an age-heterogeneous sample drawn from the Health and Retirement Study (1998-2008). We used multiple-group parallel process latent growth models to estimate the association between trajectories of cognitive function as measured by immediate word recall scores, and limitations in physical function as measured as an index of functional mobility limitations. Nested model fit testing was used to assess model fit for the separate trajectories followed by estimation of an unconditional parallel process model. Controls for demographic characteristics, socioeconomic status, and chronic health conditions were added to the best-fitting parallel process model. Pattern mixture models were used to assess the sensitivity of the parameter estimates to the effect of selective attrition. Results indicated that favorable cognitive health and mobility at initial measurement were associated with faster decline in the alternate functional domain. The cross-process associations remained significant when we adjusted estimates for the influence of covariates and selective attrition. Demographic and socioeconomic characteristics were consistently associated with initial cognitive and physical health but had few relations with change in these measures. PMID:26936611

  4. Comorbid Visual and Cognitive Impairment: Relationship with Disability Status and Self-Rated Health Among Older Singaporeans

    PubMed Central

    Whitson, HE.; Malhotra, R.; Chan, A.; Matchar, DB.; Østbye, T.

    2012-01-01

    Our objective was to examine the prevalence and consequences of co-existing vision and cognitive impairments in an Asian population. Data were collected from 4508 community-dwelling Singaporeans aged 60 years and over. Cognition was assessed by the Short Portable Mental Status Questionnaire while vision, disability, and self-rated health (SRH) were determined by self-report. Vision impairment was present in 902 (18.5%) participants and cognitive impairment in 835 (13.6%), with 232 (3.5%) participants experiencing both impairments. Persons with the comorbidity experienced higher odds of disability than persons with either single impairment. The association of vision impairment with SRH was stronger among women (odds ratio [OR] 6.79, 95% confidence interval [CI] 4.64 to 9.92) than among men (OR 1.71, 95% CI 1.21 to 2.41). Concurrent cognitive and vision impairment is prevalent in older Singaporeans and associated with high rates of disability. Gender differences in vision-dependent roles may affect the patient-perceived impact of this comorbidity. PMID:22535554

  5. Serum Levels of ApoA1 and ApoA2 Are Associated with Cognitive Status in Older Men

    PubMed Central

    Ma, Cheng; Li, Jin; Bao, Zhijun; Ruan, Qingwei; Yu, Zhuowei

    2015-01-01

    Background. Advancing age, chronic inflammation, oxidative damage, and disorders of lipid metabolism are positively linked to the late-life cognitive impairment. Serum biomarkers may be associated with the cognitive status in older men. Methods. 440 old male subjects with different cognitive functions were recruited to investigate probable serum markers. Pearson Chi-Squared test, univariate analysis, and multivariate logistic regression analysis were performed to evaluate biomarkers which may be associated with cognitive status. Results. Levels of fundus atherosclerosis (AS) (P < 0.001), age (P < 0.001), serum biomarkers peroxidase (POD) (P = 0.026) and interleukin-6 (IL-6) (P = 0.001), serum levels of high-density lipoprotein cholesterol (HDL-C) (P < 0.001), apolipoprotein A2 (ApoA2) (P = 0.001), and ApoC2 (P = 0.005) showed significant differences. Compared to group 3, ApoA1 in group 1 (OR = 1.30, 95% CI 1.01–1.67) and group 2 (OR = 1.47, 95% CI 1.11–1.94) were higher, while ApoA2 were lower (group 1: OR = 0.43, 95% CI 0.18–1.02; group 2: OR = 0.21, 95% CI 0.08–0.54) after adjusting for control variables. Conclusion. The results demonstrated that age, AS levels, POD, IL-6, HDL-C, ApoA2, and ApoC2 were significantly related to cognitive status. Moreover, ApoA1 and ApoA2 were independently associated with cognitive impairment and late-life dementia. PMID:26682220

  6. Subjective Cognitive Decline in Older Adults: An Overview of Self-Report Measures Used Across 19 International Research Studies.

    PubMed

    Rabin, Laura A; Smart, Colette M; Crane, Paul K; Amariglio, Rebecca E; Berman, Lorin M; Boada, Mercé; Buckley, Rachel F; Chételat, Gaël; Dubois, Bruno; Ellis, Kathryn A; Gifford, Katherine A; Jefferson, Angela L; Jessen, Frank; Katz, Mindy J; Lipton, Richard B; Luck, Tobias; Maruff, Paul; Mielke, Michelle M; Molinuevo, José Luis; Naeem, Farnia; Perrotin, Audrey; Petersen, Ronald C; Rami, Lorena; Reisberg, Barry; Rentz, Dorene M; Riedel-Heller, Steffi G; Risacher, Shannon L; Rodriguez, Octavio; Sachdev, Perminder S; Saykin, Andrew J; Slavin, Melissa J; Snitz, Beth E; Sperling, Reisa A; Tandetnik, Caroline; van der Flier, Wiesje M; Wagner, Michael; Wolfsgruber, Steffen; Sikkes, Sietske A M

    2015-09-24

    Research increasingly suggests that subjective cognitive decline (SCD) in older adults, in the absence of objective cognitive dysfunction or depression, may be a harbinger of non-normative cognitive decline and eventual progression to dementia. Little is known, however, about the key features of self-report measures currently used to assess SCD. The Subjective Cognitive Decline Initiative (SCD-I) Working Group is an international consortium established to develop a conceptual framework and research criteria for SCD (Jessen et al., 2014, Alzheimers Dement 10, 844-852). In the current study we systematically compared cognitive self-report items used by 19 SCD-I Working Group studies, representing 8 countries and 5 languages. We identified 34 self-report measures comprising 640 cognitive self-report items. There was little overlap among measures- approximately 75% of measures were used by only one study. Wide variation existed in response options and item content. Items pertaining to the memory domain predominated, accounting for about 60% of items surveyed, followed by executive function and attention, with 16% and 11% of the items, respectively. Items relating to memory for the names of people and the placement of common objects were represented on the greatest percentage of measures (56% each). Working group members reported that instrument selection decisions were often based on practical considerations beyond the study of SCD specifically, such as availability and brevity of measures. Results document the heterogeneity of approaches across studies to the emerging construct of SCD. We offer preliminary recommendations for instrument selection and future research directions including identifying items and measure formats associated with important clinical outcomes. PMID:26402085

  7. Subjective Cognitive Decline in Older Adults: An Overview of Self-Report Measures Used Across 19 International Research Studies

    PubMed Central

    Rabin, Laura A.; Smart, Colette M.; Crane, Paul K.; Amariglio, Rebecca E.; Berman, Lorin M.; Boada, Mercè; Buckley, Rachel F.; Chételat, Gaël; Dubois, Bruno; Ellis, Kathryn A.; Gifford, Katherine A.; Jefferson, Angela L.; Jessen, Frank; Katz, Mindy J.; Lipton, Richard B.; Luck, Tobias; Maruff, Paul; Mielke, Michelle M.; Molinuevo, José Luis; Naeem, Farnia; Perrotin, Audrey; Petersen, Ronald C.; Rami, Lorena; Reisberg, Barry; Rentz, Dorene M.; Riedel-Heller, Steffi G.; Risacher, Shannon L.; Rodriguez, Octavio; Sachdev, Perminder S.; Saykin, Andrew J.; Slavin, Melissa J.; Snitz, Beth E.; Sperling, Reisa A.; Tandetnik, Caroline; van der Flier, Wiesje M.; Wagner, Michael; Wolfsgruber, Steffen; Sikkes, Sietske A.M.

    2015-01-01

    Research increasingly suggests that subjective cognitive decline (SCD) in older adults, in the absence of objective cognitive dysfunction or depression, may be a harbinger of non-normative cognitive decline and eventual progression to dementia. Little is known, however, about the key features of self-report measures currently used to assess SCD. The Subjective Cognitive Decline Initiative (SCD-I) Working Group is an international consortium established to develop a conceptual framework and research criteria for SCD (Jessen et al., 2014, Alzheimers Dement 10, 844–852). In the current study we systematically compared cognitive self-report items used by 19 SCD-I Working Group studies, representing 8 countries and 5 languages. We identified 34 self-report measures comprising 640 cognitive self-report items. There was little overlap among measures—approximately 75% of measures were used by only one study. Wide variation existed in response options and item content. Items pertaining to the memory domain predominated, accounting for about 60% of items surveyed, followed by executive function and attention, with 16% and 11% of the items, respectively. Items relating to memory for the names of people and the placement of common objects were represented on the greatest percentage of measures (56% each). Working group members reported that instrument selection decisions were often based on practical considerations beyond the study of SCD specifically, such as availability and brevity of measures. Results document the heterogeneity of approaches across studies to the emerging construct of SCD. We offer preliminary recommendations for instrument selection and future research directions including identifying items and measure formats associated with important clinical outcomes. PMID:26402085

  8. Cognitive ability, acquiescence, and the structure of personality in a sample of older adults.

    PubMed

    Lechner, Clemens M; Rammstedt, Beatrice

    2015-12-01

    Acquiescence, or the tendency to respond to descriptions of conceptually distinct personality attributes with agreement/affirmation, constitutes a major challenge in personality assessment. The aim of this study was to shed light on cognitive ability as a potential source of individual differences in acquiescent responding. We hypothesized that respondents with lower cognitive ability exhibit stronger acquiescent response tendencies than respondents with higher cognitive ability and that this leads to problems in establishing the Big Five structure by means of principal component analyses (exploratory factor analysis was not applicable to these data) in the former group. Further, we hypothesized that after controlling for acquiescence by using mean-corrected instead of raw item scores, the Big Five structure holds even among respondents with lower cognitive ability. Analyses in a sample of 1,071 German adults aged 56 to 75 years using the Digit Symbol Substitution Test as a measure of cognitive ability and the BFI-10, a 10-item abbreviated version of the Big Five Inventory, as a measure of personality, corroborated these hypotheses. These findings suggest that lower cognitive ability and age-related declines in cognitive functioning more specifically are associated with higher acquiescence, which in turn leads to problems in establishing the Big Five structure among individuals with lower cognitive ability that should be addressed by controlling for acquiescence. PMID:26011482

  9. Cognitive Findings of an Exploratory Trial of Docosahexaenoic Acid and Lutein in Older Women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Low levels of docosahexaenoic acid (DHA) and low intake of foods rich in lutein may negatively affect cognitive function. DHA and lutein are concentrated in the brain. The objective of this study was to determine effects of supplemental DHA (800 mg/d) and/or lutein (12 mg/d) on cognitive function in...

  10. Group Cognitive Therapy and Alprazolam in the Treatment of Depression in Older Adults.

    ERIC Educational Resources Information Center

    Beutler, Larry E.; And Others

    1987-01-01

    Explored relative and combined effectiveness of alprazolam and group cognitive therapy among 56 elderly adults experiencing major affective disorder. Results revealed that individuals assigned to group cognitive therapy showed consistent improvement in subjective state and sleep efficiency relative to non-group-therapy subjects. No differences…

  11. ACTIVE: A Cognitive Intervention Trial to Promote Independence in Older Adults

    PubMed Central

    Jobe, Jared B.; Smith, David M.; Ball, Karlene; Tennstedt, Sharon L.; Marsiske, Michael; Willis, Sherry L.; Rebok, George W.; Morris, John N.; Helmers, Karin F.; Leveck, Mary D.; Kleinman, Ken

    2010-01-01

    The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial is a randomized, controlled, single-masked trial designed to determine whether cognitive training interventions (memory, reasoning, and speed of information processing), which have previously been found to be successful at improving mental abilities under laboratory or small-scale field conditions, can affect cognitively based measures of daily functioning. Enrollment began during 1998; 2-year follow-up will be completed by January 2002. Primary outcomes focus on measures of cognitively demanding everyday functioning, including financial management, food preparation, medication use, and driving. Secondary outcomes include health-related quality of life, mobility, and health-service utilization. Trial participants (n = 2832) are aged 65 and over, and at entry into the trial, did not have significant cognitive, physical, or functional decline. Because of its size and the carefully developed rigor, ACTIVE may serve as a guide for future behavioral medicine trials of this nature. PMID:11514044

  12. Effects of vitamin B-12 supplementation on neurologic and cognitive function in older people: a randomized controlled trial12

    PubMed Central

    Dangour, Alan D; Allen, Elizabeth; Clarke, Robert; Elbourne, Diana; Fletcher, Astrid E; Letley, Louise; Richards, Marcus; Whyte, Ken; Uauy, Ricardo; Mills, Kerry

    2015-01-01

    Background: Moderate vitamin B-12 deficiency is relatively common in older people. However, there is little robust evidence on the effect of vitamin B-12 supplementation on neurologic and cognitive outcomes in later life. Objective: We investigated whether vitamin B-12 supplementation benefits neurologic and cognitive function in moderately vitamin B-12–deficient older people. Design: We conducted a double-blind, randomized, placebo-controlled trial in 7 general practices in South East England, United Kingdom. Study participants were aged ≥75 y and had moderate vitamin B-12 deficiency (serum vitamin B-12 concentrations: 107–210 pmol/L) in the absence of anemia and received 1 mg crystalline vitamin B-12 or a matching placebo as a daily oral tablet for 12 mo. Peripheral motor and sensory nerve conduction, central motor conduction, a clinical neurologic examination, and cognitive function were assessed before and after treatment. Results: A total of 201 participants were enrolled in the trial, and 191 subjects provided outcome data. Compared with baseline, allocation to vitamin B-12 was associated with a 177% increase in serum concentration of vitamin B-12 (641 compared with 231 pmol/L), a 331% increase in serum holotranscobalamin (240 compared with 56 pmol/L), and 17% lower serum homocysteine (14.2 compared with 17.1 μmol/L). In intention-to-treat analysis of covariance models, with adjustment for baseline neurologic function, there was no evidence of an effect of supplementation on the primary outcome of the posterior tibial compound muscle action potential amplitude at 12 mo (mean difference: −0.2 mV; 95% CI: –0.8, 0.3 mV). There was also no evidence of an effect on any secondary peripheral nerve or central motor function outcome, or on cognitive function or clinical examination. Conclusion: Results of the trial do not support the hypothesis that the correction of moderate vitamin B-12 deficiency, in the absence of anemia and of neurologic and cognitive

  13. Ten-Year Effects of the ACTIVE Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults

    PubMed Central

    Rebok, George W.; Ball, Karlene; Guey, Lin T.; Jones, Richard N.; Kim, Hae-Young; King, Jonathan W.; Marsiske, Michael; Morris, John N.; Tennstedt, Sharon L.; Unverzagt, Frederick W.; Willis, Sherry L.

    2013-01-01

    Objective To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years. Design, Setting, and Participants Ten-year follow-up of a randomized, controlled single-blind trial with 3 intervention groups and a no-contact control group. A volunteer sample of 2832 persons (mean baseline age, 73.6 years; 26% African American) living independently in 6 US cities. Interventions Ten-session training for memory, reasoning, or speed-of-processing.; 4-session booster training at 11 and at 35 months after training. Measurements Objectively measured cognitive abilities and self-reported and performance-based measures of everyday function. Results Participants in each intervention group reported less difficulty with instrumental activities of daily living (IADL) (memory: effect size, 0.48 [99% CI, 0.12-0.84]; reasoning: effect size, 0.38 [99% CI, 0.02-0.74]; speed-of-processing: effect size, 0.36 [99% CI, 0.01-0.72]). At mean age of 82 years, about 60% of trained participants compared to 50% of controls (p<.05) were at or above their baseline level of self-reported IADL function at 10 years. The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years (reasoning: effect size, 0.23 [99% CI, 0.09-0.38]; speed-of-processing: effect size, 0.66 [99% CI, 0.43-0.88]). Memory training effects were no longer maintained for memory performance. Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance (effect size, 0.21 [99% CI, 0.01-0.41]) and the speed-of-processing intervention for speed-of-processing performance (effect size, 0.62 [99% CI, 0.31-0.93]). Conclusions Each ACTIVE cognitive intervention resulted in less decline in self-reported IADL compared with the control group. Reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years. PMID:24417410

  14. Beverage Consumption Patterns and Micronutrient and Caloric Intake from Beverages in Older Adults with Mild Cognitive Impairment.

    PubMed

    Venci, Brittany; Hodac, Nicole; Lee, Seung-Yeon; Shidler, Marcelle; Krikorian, Robert

    2015-01-01

    The purpose of this study was to determine total water intake and patterns of beverage consumption, and its contribution to total daily micronutrients and calories in older adults with mild memory decline. A descriptive, cross-sectional study was used with 60 independent community-dwelling older adults (71.7 ± 5.4 years) with mild cognitive impairment, who were mostly female, well-educated, and white. Three-day food records were analyzed using the Nutrition Data Systems for Research. Descriptive statistics were conducted for a summary of demographics, the average intakes of beverages, and the contribution of beverages to total calorie and micronutrient intakes. Total daily water intake was 53.6 ± 26.7 fl oz and milk, plain water, and tea/coffee were beverages consumed most frequently. Beverage consumption contributed substantially to the intake of vitamin D (29.4%), calcium (26.4%), riboflavin (22.0%), magnesium (18.9%), and vitamin C (18.1%), but constituted only ∼12.5% of total energy. These findings suggest that nutrient-dense beverages play a fundamental role in overall micronutrient intake, despite comprising a small component of daily caloric intake. Incorporating adequate amounts of such beverages in meals and snacks may help older adults meet their nutrient recommendations. PMID:26571357

  15. Cognitive and neural plasticity in older adults' prospective memory following training with the Virtual Week computer game.

    PubMed

    Rose, Nathan S; Rendell, Peter G; Hering, Alexandra; Kliegel, Matthias; Bidelman, Gavin M; Craik, Fergus I M

    2015-01-01

    Prospective memory (PM) - the ability to remember and successfully execute our intentions and planned activities - is critical for functional independence and declines with age, yet few studies have attempted to train PM in older adults. We developed a PM training program using the Virtual Week computer game. Trained participants played the game in 12, 1-h sessions over 1 month. Measures of neuropsychological functions, lab-based PM, event-related potentials (ERPs) during performance on a lab-based PM task, instrumental activities of daily living, and real-world PM were assessed before and after training. Performance was compared to both no-contact and active (music training) control groups. PM on the Virtual Week game dramatically improved following training relative to controls, suggesting PM plasticity is preserved in older adults. Relative to control participants, training did not produce reliable transfer to laboratory-based tasks, but was associated with a reduction of an ERP component (sustained negativity over occipito-parietal cortex) associated with processing PM cues, indicative of more automatic PM retrieval. Most importantly, training produced far transfer to real-world outcomes including improvements in performance on real-world PM and activities of daily living. Real-world gains were not observed in either control group. Our findings demonstrate that short-term training with the Virtual Week game produces cognitive and neural plasticity that may result in real-world benefits to supporting functional independence in older adulthood. PMID:26578936

  16. Cognitive and neural plasticity in older adults’ prospective memory following training with the Virtual Week computer game

    PubMed Central

    Rose, Nathan S.; Rendell, Peter G.; Hering, Alexandra; Kliegel, Matthias; Bidelman, Gavin M.; Craik, Fergus I. M.

    2015-01-01

    Prospective memory (PM) – the ability to remember and successfully execute our intentions and planned activities – is critical for functional independence and declines with age, yet few studies have attempted to train PM in older adults. We developed a PM training program using the Virtual Week computer game. Trained participants played the game in 12, 1-h sessions over 1 month. Measures of neuropsychological functions, lab-based PM, event-related potentials (ERPs) during performance on a lab-based PM task, instrumental activities of daily living, and real-world PM were assessed before and after training. Performance was compared to both no-contact and active (music training) control groups. PM on the Virtual Week game dramatically improved following training relative to controls, suggesting PM plasticity is preserved in older adults. Relative to control participants, training did not produce reliable transfer to laboratory-based tasks, but was associated with a reduction of an ERP component (sustained negativity over occipito-parietal cortex) associated with processing PM cues, indicative of more automatic PM retrieval. Most importantly, training produced far transfer to real-world outcomes including improvements in performance on real-world PM and activities of daily living. Real-world gains were not observed in either control group. Our findings demonstrate that short-term training with the Virtual Week game produces cognitive and neural plasticity that may result in real-world benefits to supporting functional independence in older adulthood. PMID:26578936

  17. Impact of novelty and type of material on recognition in healthy older adults and persons with mild cognitive impairment.

    PubMed

    Belleville, Sylvie; Ménard, Marie-Claude; Lepage, Emilie

    2011-08-01

    The goal of this study was to assess the effect of novelty on correct recognition (hit minus false alarms) and on recollection and familiarity processes in normal aging and amnestic mild cognitive impairment (MCI). Recognition tasks compared well-known and novel stimuli in the verbal domain (words vs. pseudowords) and in the musical domain (well-known vs. novel melodies). Results indicated that novel materials associated with lower correct recognition and lower recollection, an effect that can be related to its lower amenability to elaborative encoding in comparison with well-known items. Results also indicated that normal aging impairs recognition of well-known items, whereas MCI impairs recognition of novel items only. Healthy older adults showed impaired recollection and familiarity relative to younger controls and individuals with MCI showed impaired recollection relative to healthy older adults. The recollection deficit in healthy older adults and persons with MCI and their impaired recognition of well-known items is compatible with the difficulty both groups have in encoding information in an elaborate manner. In turn, familiarity deficit could be related to impaired frontal functioning. Therefore, novelty of material has a differential impact on recognition in persons with age-related memory disorders. PMID:21703285

  18. Health Literacy, Cognitive Function, Proper Use, and Adherence to Inhaled Asthma Controller Medications Among Older Adults With Asthma

    PubMed Central

    Wolf, Michael S.; Smith, Samuel G.; Martynenko, Melissa; Vicencio, Daniel P.; Sano, Mary; Wisnivesky, Juan P.; Federman, Alex D.

    2015-01-01

    BACKGROUND: We sought to investigate the degree to which cognitive skills explain associations between health literacy and asthma-related medication use among older adults with asthma. METHODS: Patients aged ≥ 60 years receiving care at eight outpatient clinics (primary care, geriatrics, pulmonology, allergy, and immunology) in New York, New York, and Chicago, Illinois, were recruited to participate in structured, in-person interviews as part of the Asthma Beliefs and Literacy in the Elderly (ABLE) study (n = 425). Behaviors related to medication use were investigated, including adherence to prescribed regimens, metered-dose inhaler (MDI) technique, and dry powder inhaler (DPI) technique. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Cognitive function was assessed in terms of fluid (working memory, processing speed, executive function) and crystallized (verbal) ability. RESULTS: The mean age of participants was 68 years; 40% were Hispanic and 30% non-Hispanic black. More than one-third (38%) were adherent to their controller medication, 53% demonstrated proper DPI technique, and 38% demonstrated correct MDI technique. In multivariable analyses, limited literacy was associated with poorer adherence to controller medication (OR, 2.3; 95% CI, 1.29-4.08) and incorrect DPI (OR, 3.51; 95% CI, 1.81-6.83) and MDI (OR, 1.64; 95% CI, 1.01-2.65) techniques. Fluid and crystallized abilities were independently associated with medication behaviors. However, when fluid abilities were added to the model, literacy associations were reduced. CONCLUSIONS: Among older patients with asthma, interventions to promote proper medication use should simplify tasks and patient roles to overcome cognitive load and suboptimal performance in self-care. PMID:25275432

  19. Poorer Financial and Health Literacy Among Community-Dwelling Older Adults With Mild Cognitive Impairment

    PubMed Central

    Han, S. Duke; Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Bennett, David A.

    2015-01-01

    Objective Literacy is an important determinant of financial and health outcomes in old age, and cognitive decline has been linked with lower literacy. We tested the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and health literacy. Method Participants (n = 730) from the Rush Memory and Aging Project were given a clinical evaluation and an assessment of total, financial, and health literacy. Regression was used to examine whether MCI was associated with lower literacy. In secondary analyses, we investigated the association of particular cognitive systems with literacy. Results MCI was associated with lower total, financial, and health literacy. An interaction was observed such that higher education reduced the effect of MCI on total and financial literacy. Multiple cognitive systems were associated with literacy in participants with MCI, and semantic memory accounted for the most variance. Discussion Persons with MCI exhibit poorer financial and health literacy, and education mitigates this effect. PMID:25903976

  20. Vitamin E levels, cognitive impairment and dementia in older persons: the InCHIANTI study.

    PubMed

    Cherubini, Antonio; Martin, Antonio; Andres-Lacueva, Cristina; Di Iorio, Angelo; Lamponi, Marco; Mecocci, Patrizia; Bartali, Benedetta; Corsi, Annamaria; Senin, Umberto; Ferrucci, Luigi

    2005-07-01

    There is conflicting evidence that antioxidants contribute to maintaining cognitive function in elderly subjects. We investigated whether vitamin E plasma levels are related to the presence of dementia and cognitive impairment in a population-based cohort study conducted in Italy. A total of 1033 participants aged at least 65 years received clinical and neuropsychological examinations, donated blood for vitamin E analysis and had their diets assessed. Participants with plasma vitamin E levels in the bottom tertile had a significantly higher probability of being demented (OR 2.6, 95% CI 1.0-7.1) and also of suffering from cognitive impairment (OR 2.2, 95% CI 1.2-4.2) compared to those in the highest vitamin E tertile after adjustment for age, gender, education, lipid levels, energy intake, vitamin E intake, and smoking. This study supports the notion that higher vitamin E plasma levels might provide significant protection against cognitive impairment and dementia in elderly subjects. PMID:15748776

  1. Amyloid mediates the association of apolipoprotein E e4 allele to cognitive function in older people

    PubMed Central

    Bennett, D; Schneider, J; Wilson, R; Bienias, J; Berry-Kravis, E; Arnold, S

    2005-01-01

    Background: The neurobiological changes underlying the association of the apolipoprotein E (APOE) e4 allele with level of cognition are poorly understood. Objective: To test the hypothesis that amyloid load can account for (mediate) the association of the APOE e4 allele with level of cognition assessed proximate to death. Methods: There were 44 subjects with clinically diagnosed Alzheimer's disease and 50 without dementia, who had participated in the Religious Orders Study. They underwent determination of APOE allele status, had comprehensive cognitive testing in the last year of life, and brain autopsy at death. The percentage area of cortex occupied by amyloid beta and the density of tau positive neurofibrillary tangles were quantified from six brain regions and averaged to yield summary measures of amyloid load and neurofibrillary tangles. Multiple regression analyses were used to examine whether amyloid load could account for the effect of allele status on level of cognition, controlling for age, sex, and education. Results: Possession of at least one APOE e4 allele was associated with lower level of cognitive function proximate to death (p = 0.04). The effect of the e4 allele was reduced by nearly 60% and was no longer significant after controlling for the effect of amyloid load, whereas there was a robust inverse association between amyloid and cognition (p = 0.001). Because prior work had suggested that neurofibrillary tangles could account for the association of amyloid on cognition, we next examined whether amyloid could account for the effect of allele status on tangles. In a series of regression analyses, e4 was associated with density of tangles (p = 0.002), but the effect of the e4 allele was reduced by more than 50% and was no longer significant after controlling for the effect of amyloid load. Conclusion: These findings are consistent with a sequence of events whereby the e4 allele works through amyloid deposition and subsequent tangle formation to

  2. Cardiac Rehabilitation is Associated with Lasting Improvements in Cognitive Function in Older Adults with Heart Failure

    PubMed Central

    Alosco, Michael L.; Spitznagel, Mary Beth; Cohen, Ronald; Sweet, Lawrence H.; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Objective Heart failure (HF) is a known risk factor for cognitive impairment. Cardiac rehabilitation (CR) may attenuate poor neurocognitive outcomes in HF via improved physical fitness—a significant promoter of cognitive function. However, no study has examined the possible acute and lasting benefits of CR on cognitive function in persons with HF. Methods and Results 52 patients with HF completed a 12-week Phase II CR program. All participants were administered neuropsychological testing and completed a brief physical fitness assessment at baseline, completion of CR (i.e. 12-weeks), and 12-month follow-up. Repeated measures analyses showed a significant time effect for both attention/executive function and memory (p < 0.05). Attention/executive function performance increased from baseline to 12-weeks and these gains remained up to 12-months; memory was unchanged from baseline to 12-weeks, but then improved between the 12-week and 12-month time points. Physical fitness improved from baseline to 12-weeks and these benefits were maintained 12-months later. Changes in physical fitness and cognitive function over time did not reach a statistically significant association, though poorer physical fitness was associated with decreased cognitive performance at the baseline and 12-month time points. Conclusions CR is associated with both acute and lasting cognitive benefits in patients with HF. Prospective studies with extended follow-ups are needed to clarify the mechanisms that underpin cognitive improvements following CR (e.g., improved cerebral perfusion) and whether CR can ultimately reduce risk for cognitive decline and conditions like Alzheimer’s disease in HF. PMID:25181916

  3. Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study

    PubMed Central

    Mine, Masashi; Miyata, Kimie; Morikawa, Masayuki; Nishi, Tomo; Okamoto, Nozomi; Kawasaki, Ryo; Yamashita, Hidetoshi; Kurumatani, Norio; Ogata, Nahoko

    2016-01-01

    Abstract Both visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA) >0.2 logarithm of the minimum angle of resolution (logMAR) units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE) score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation). The mean BCVA of the better eye was −0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = −0.10, p < 0.0001). Subjects with mild visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5–3.8, p < 0.001) after adjusting for age, sex, and length of education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment. PMID:27610269

  4. Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study.

    PubMed

    Mine, Masashi; Miyata, Kimie; Morikawa, Masayuki; Nishi, Tomo; Okamoto, Nozomi; Kawasaki, Ryo; Yamashita, Hidetoshi; Kurumatani, Norio; Ogata, Nahoko

    2016-01-01

    Both visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA) >0.2 logarithm of the minimum angle of resolution (logMAR) units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE) score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation). The mean BCVA of the better eye was -0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = -0.10, p < 0.0001). Subjects with mild visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5-3.8, p < 0.001) after adjusting for age, sex, and length of education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment. PMID:27610269

  5. Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial

    PubMed Central

    Shaw, Fiona E; Bond, John; Richardson, David A; Dawson, Pamela; Steen, I Nicholas; McKeith, Ian G; Kenny, Rose Anne

    2003-01-01

    Objective To determine the effectiveness of multifactorial intervention after a fall in older patients with cognitive impairment and dementia attending the accident and emergency department. Design Randomised controlled trial. Participants 274 cognitively impaired older people (aged 65 or over) presenting to the accident and emergency department after a fall: 130 were randomised to assessment and intervention and 144 were randomised to assessment followed by conventional care (control group). Setting Two accident and emergency departments, Newcastle upon Tyne. Main outcome measures Primary outcome was number of participants who fell in year after intervention. Secondary outcomes were number of falls (corrected for diary returns), time to first fall, injury rates, fall related attendances at accident and emergency department, fall related hospital admissions, and mortality. Results Intention to treat analysis showed no significant difference between intervention and control groups in proportion of patients who fell during 1 year's follow up (74% (96/130) and 80% (115/144), relative risk ratio 0.92, 95% confidence interval 0.81 to 1.05). No significant differences were found between groups for secondary outcome measures. Conclusions Multifactorial intervention was not effective in preventing falls in older people with cognitive impairment and dementia presenting to the accident and emergency department after a fall. What is already known on this topicMultifactorial intervention prevents falls in cognitively normal older people living in the community and in those who present to the accident and emergency department after a fallFall prevention strategies have not been tested by controlled trials in patients with cognitive impairment and dementia who fallWhat this study addsNo benefit was shown from multifactorial assessment and intervention after a fall in patients with cognitive impairment and dementia presenting to the accident and emergency department

  6. Depression, Hippocampal Volume Changes, and Cognitive Decline in a Clinical Sample of Older Depressed Outpatients and Non-depressed Controls

    PubMed Central

    Sawyer, Kathryn; Corsentino, Elizabeth; Sachs-Ericsson, Natalie; Steffens, David C.

    2012-01-01

    Objective The aim of this study was to develop and test a model of depression, hippocampal changes, and cognitive decline. Method Participants were 248 community-dwelling, depressed patients and 147 healthy, non-depressed individuals 60 years and older. Participants received a structured interview assessing current depressive symptoms and past depressive episodes, completed cognitive testing with the MMSE, and underwent structural MRI of the brain. For up to ten years, assessment of depressive symptoms and MMSE administration was repeated at least annually, and MRI was repeated every two years. Results Regression analyses demonstrated that depression diagnosis at baseline predicted decrease in right (but not left) hippocampal volume over a four-year period. Analyses using structural equation modeling demonstrated that a decrease in left and right hippocampal volume predicted decrease in MMSE score over four years. Conclusion Results provide some evidence for relationships between depression and decrease in right hippocampal volume, and between hippocampal volume and MMSE score. This would be consistent with depression as a causal factor in subsequent cognitive decline. Plausible biological mechanisms include a glucocorticoid cascade or a facilitating effect of depression on amyloid-beta plaque formation. Future studies should examine the relationship between hippocampal volume and specialized memory measures, as well as between depression diagnosis and volume of other brain structures. PMID:22548411

  7. Feasibility and effectiveness of a walking program for community-dwelling older adults with mild cognitive impairment.

    PubMed

    van Uffelen, Jannique G Z; Chinapaw, Marijke J M; Hopman-Rock, Marijke; van Mechelen, Willem

    2009-10-01

    This study examined the feasibility and effect on aerobic fitness of a 1-yr, twice-weekly, group-based moderate-intensity walking program (MI-WP, n = 77) compared with a low-intensity activity program (LI-AP, n = 75) for community-dwelling older adults with mild cognitive impairment (MCI). Thirty participants did not start a program; median attendance in the other 122 participants was 71%. Small but significant associations were observed between attendance and memory in the MI-WP and general cognition in the LI-AP. Associations were no longer significant when both groups were analyzed together. Intensity, assessed using percentage of heart-rate reserve and the Borg scale, equaled intended intensity for both programs. Aerobic fitness improved significantly in participants in the MI-WP. In conclusion, cognition was not clearly associated with attendance in the 62 participants starting the MI-WP, and average attendance was good. The intensity was feasible for participants who continued the MI-WP. The findings support the proposal that regular moderate-intensity walking improves aerobic fitness in adults with MCI. PMID:19940321

  8. The association of physical activity, cognitive processes and automobile driving ability in older adults: A review of the literature.

    PubMed

    Miller, Sally M; Taylor-Piliae, Ruth E; Insel, Kathleen C

    2016-01-01

    As the number of older adults in the United States grows, the number of automobile drivers over the age of 65 will also increase. Several cognitive processes necessary for automobile driving are vulnerable to age-related decline. These include declines in executive function, working memory, attention, and speed of information processing. The benefits of physical activity on physical, psychological and particular cognitive processes are well-documented; however few studies have explored the relationship between physical activity and driving ability in older adults or examined if cognitive processes mediate (or moderate) the effect of physical activity on driving ability. The purpose of this paper is to review the existing literature regarding physical activity, cognition and automobile driving. Recommendations for further research and utility of the findings to nursing and the health care team are provided. PMID:27260109

  9. Cognitive and Functional Decline among Individuals 50 Years of Age or Older in Cambé, Paraná, Brazil: A Population-Based Study

    PubMed Central

    Cabrera, Marcos Aparecido Sarria; Bortoletto, Maira Aira Sayuri Sakay; de Souza, Regina Kazue Tanno; Prina, Douglas Manuel Carrapeiro; Vieira, Maria Cristina Umpierrez; Silva, Ana Maria Rigo

    2016-01-01

    Aims To identify the frequency of cognitive and functional decline (CFD) among adults 50 years of age and older by a population-based study. Methods Cognitive function was analyzed by the Mini-Mental State Examination, and the functional conditions were based on instrumental activities of daily living (IADL). Cases of CFD included individuals with cognitive decline and 2 or more compromised IADL. Results A total of 693 individuals were studied. The frequency of CFD was 16.3%. A low socioeconomic profile was associated with greater CFD independent of gender, age, education, and presence of depression (OR = 2.46; 95% CI: 1.53-3.97). Conclusions These data show a high frequency of CFD among adults 50 years and older. Individuals with less education and a lower socioeconomic level exhibited poorer cognitive and functional conditions. PMID:27350779

  10. Time Out-of-Home and Cognitive, Physical, and Emotional Wellbeing of Older Adults: A Longitudinal Mixed Effects Model

    PubMed Central

    Petersen, Johanna

    2015-01-01

    Background Time out-of-home has been linked with numerous health outcomes, including cognitive decline, poor physical ability and low emotional state. Comprehensive characterization of this important health metric would potentially enable objective monitoring of key health outcomes. The objective of this study is to determine the relationship between time out-of-home and cognitive status, physical ability and emotional state. Methods and Findings Participants included 85 independent older adults, age 65–96 years (M = 86.36; SD = 6.79) who lived alone, from the Intelligent Systems for Assessing Aging Changes (ISAAC) and the ORCATECH Life Laboratory cohorts. Factors hypothesized to affect time out-of-home were assessed on three different temporal levels: yearly (cognitive status, loneliness, clinical walking speed), weekly (pain and mood) or daily (time out-of-home, in-home walking speed, weather, and season). Subject characteristics including age, race, and gender were assessed at baseline. Total daily time out-of-home in hours was assessed objectively and unobtrusively for up to one year using an in-home activity sensor platform. A longitudinal tobit mixed effects regression model was used to relate daily time out-of-home to cognitive status, physical ability and emotional state. More hours spend outside the home was associated with better cognitive function as assessed using the Clinical Dementia Rating (CDR) Scale, where higher scores indicate lower cognitive function (βCDR = -1.69, p<0.001). More hours outside the home was also associated with superior physical ability (βPain = -0.123, p<0.001) and improved emotional state (βLonely = -0.046, p<0.001; βLow mood = -0.520, p<0.001). Weather, season, and weekday also affected the daily time out-of-home. Conclusions These results suggest that objective longitudinal monitoring of time out-of-home may enable unobtrusive assessment of cognitive, physical and emotional state. In addition, these results indicate

  11. Habitual sugar intake and cognitive function among middle-aged and older Puerto Ricans without diabetes

    PubMed Central

    Ye, Xingwang; Gao, Xiang; Scott, Tammy; Tucker, Katherine L.

    2016-01-01

    Intake of added sugars, mainly fructose and sucrose, has been associated with risk factors for cognitive impairment, such as obesity, the metabolic syndrome and type 2 diabetes. The objective of this analysis was to examine whether habitual intakes of total sugars, added sugars, sugar-sweetened beverages or sweetened solid foods are associated with cognitive function. The present study included 737 participants without diabetes, aged 45–75 years, from the Boston Puerto Rican Health Study, 2004–9. Cognitive function was measured with a battery of seven tests: Mini-Mental State Examination (MMSE), word list learning, digit span, clock drawing, figure copying, and Stroop and verbal fluency tests. Usual dietary intake was assessed with a validated FFQ. Greater intakes of total sugars, added sugars and sugar-sweetened beverages, but not of sugar-sweetened solid foods, were significantly associated with lower MMSE score, after adjusting for covariates. Adjusted OR for cognitive impairment (MMSE score <24) were 2·23 (95 % CI 1·24, 3·99) for total sugars and 2·28 (95 % CI 1·26, 4·14) for added sugars, comparing the highest with lowest intake quintiles. Greater intake of total sugars was also significantly associated with lower word list learning score. In conclusion, higher sugar intake appears to be associated with lower cognitive function, but longitudinal studies are needed to clarify the direction of causality. PMID:21736803

  12. Measurement Invariance of Cognitive Abilities Across Ethnicity, Gender, and Time Among Older Americans

    PubMed Central

    McArdle, John J.

    2015-01-01

    Objectives. The aim of this research was to test the invariance of the cognitive variables in the Health and Retirement Study/Asset Health Dynamics Among the Oldest Old studies (HRS/AHEAD) across ethnicity, gender, and time. Method. Analyses were conducted using a selected subsample of the HRS/AHEAD data set. The cognitive performance tests measuring episodic memory and mental status were used, and invariance of a two-factor structure was tested using confirmatory factor analyses and multilevel modeling for longitudinal data. Results. Results provided some support for “strict” factorial invariance of the episodic memory and mental status measures across ethnicity and gender. Further support of weak (“metric”) measurement invariance was found across time. Discussion. Results of the research further our understanding of invariance of the HRS/AHEAD cognitive ability measures. Further implications are discussed. PMID:24170715

  13. Neighborhood Context and Cognitive Decline in Older Mexican Americans: Results From the Hispanic Established Populations for Epidemiologic Studies of the Elderly

    PubMed Central

    Peek, M. Kristen

    2009-01-01

    In previous research on cognitive decline among older adults, investigators have not considered the potential impact of contextual variables, such as neighborhood-level conditions. In the present investigation, the authors examined the association between 2 neighborhood-context variables—socioeconomic status and percentage of Mexican-American residents—and individual-level cognitive function over a 5-year follow-up period (1993–1998). Data were obtained from the Hispanic Established Populations for Epidemiologic Studies of the Elderly, a longitudinal study of community-dwelling older Mexican Americans (n = 3,050) residing in the southwestern United States. Individual records were linked with 1990 US Census tract data, which provided information on neighborhood characteristics. Hierarchical linear growth-curve models and hierarchical logistic models were used to examine relations between individual- and neighborhood-level variables and the rate and incidence of cognitive decline. Results showed that baseline cognitive function and rates of cognitive decline varied significantly across US Census tracts. Respondents living in economically disadvantaged neighborhoods experienced significantly faster rates of cognitive decline than those in more advantaged neighborhoods. Odds of incident cognitive decline decreased as a function of neighborhood percentage of Mexican-American residents and increased with neighborhood economic disadvantage. The authors conclude that neighborhood context is associated with late-life cognitive function and that the effects are independent of individual-level risk factors. PMID:19270047

  14. A High Omega-3 Fatty Acid Multinutrient Supplement Benefits Cognition and Mobility in Older Women: A Randomized, Double-blind, Placebo-controlled Pilot Study

    PubMed Central

    Strike, Siobhán C.; Carlisle, Alison; Gibson, E. Leigh

    2016-01-01

    Background. Mobility is a key determinant of frailty in older persons, and a variety of dietary factors, such as the omega-3 fatty acid docosahexaenoic acid (DHA), are positively associated with decreased frailty and improved mobility and cognition in older persons. Methods. The effects of a multinutrient supplement on mobility and cognition were assessed in postmenopausal women (60–84 years). Participants received either Efalex Active 50+ (1g DHA, 160mg eicosapentaenoic acid, 240mg Ginkgo biloba, 60mg phosphatidylserine, 20mg d-α tocopherol, 1mg folic acid, and 20 µg vitamin B12 per day; N = 15) or placebo (N = 12) for 6 months. Mobility was assessed by VICON 9 motion capture camera system synchronized with Kistler force plates, cognitive performance by computerized cognitive function tests, and blood fatty acid levels by pin-prick analysis. Results. Significant effects of treatment were seen in two of the four cognitive tests, with shorter mean latencies in a motor screening task (p < .05) and more words remembered (p < .03), and one of the three primary mobility measures with improved habitual walking speed (p < .05). Compared with the placebo group, supplementation also resulted in significantly higher blood DHA levels (p < .02). Conclusions. In this pilot study, multinutrient supplementation improved cognition and mobility in able older females at clinically relevant levels, suggesting a potential role in reducing the decline to frailty. PMID:26265727

  15. Fasting Insulin Levels and Cognitive Decline in Older Women without Diabetes

    PubMed Central

    van Oijen, Marieke; Okereke, Olivia I.; Kang, Jae Hee; Pollak, Michael N.; Hu, Frank B.; Hankinson, Susan E.; Grodstein, Francine

    2008-01-01

    Background Type 2 diabetes has been associated with an increased risk of dementia. To assess possible independent effects of insulin, we investigated the relation of insulin levels to cognitive decline in nondiabetic women. Methods Fasting plasma insulin levels were measured in mid-life in 1,416 nondiabetic Nurses’ Health Study participants, who also completed cognitive testing that began 10 years later (current age: 70–75 years). Over 4 years, 3 assessments of general cognition, verbal memory, category fluency and attention were administered. Primary outcomes were the Telephone Interview for Cognitive Status (TICS) performance, the global score (average of all tests) and verbal memory (average of verbal recall tests). Linear mixed-effects models were used to calculate the association between insulin and cognitive decline. Results Higher insulin levels were associated with a faster decline on the TICS and verbal memory. For analysis, batch-specific quartiles of insulin levels were constructed. Compared to the lowest quartile, adjusted differences in the annual rates of decline (with 95% CI values in parentheses) for the second, third and fourth quartiles were: TICS, −0.06 (−0.16, 0.03), −0.14 (−0.24, −0.04), and −0.09 (−0.19, 0.01) points (p trend = 0.04); verbal memory, −0.01 (−0.04, 0.02), −0.05 (−0.08, −0.02), and −0.02 (−0.05, 0.01) units (p trend = 0.02). These associations remained after multivariable adjustment. Conclusions Our study provides evidence for a potential role of higher fasting insulin levels in cognitive decline, possibly independent of diabetes. PMID:18421217

  16. Intrinsic Brain Activity of Cognitively Normal Older Persons Resembles More That of Patients Both with and at Risk for Alzheimer's Disease Than That of Healthy Younger Persons

    PubMed Central

    Pasquini, Lorenzo; Tonch, Annika; Plant, Claudia; Zherdin, Andrew; Ortner, Marion; Kurz, Alexander; Förstl, Hans; Zimmer, Claus; Grimmer, Timo; Wohlschäger, Afra; Riedl, Valentin

    2014-01-01

    Abstract In Alzheimer's disease (AD), recent findings suggest that amyloid-β (Aβ)-pathology might start 20–30 years before first cognitive symptoms arise. To account for age as most relevant risk factor for sporadic AD, it has been hypothesized that lifespan intrinsic (i.e., ongoing) activity of hetero-modal brain areas with highest levels of functional connectivity triggers Aβ-pathology. This model induces the simple question whether in older persons without any cognitive symptoms intrinsic activity of hetero-modal areas is more similar to that of symptomatic patients with AD or to that of younger healthy persons. We hypothesize that due to advanced age and therefore potential impact of pre-clinical AD, intrinsic activity of older persons resembles more that of patients than that of younger controls. We tested this hypothesis in younger (ca. 25 years) and older healthy persons (ca. 70 years) and patients with mild cognitive impairment and AD-dementia (ca. 70 years) by the use of resting-state functional magnetic resonance imaging, distinct measures of intrinsic brain activity, and different hierarchical clustering approaches. Independently of applied methods and involved areas, healthy older persons' intrinsic brain activity was consistently more alike that of patients than that of younger controls. Our result provides evidence for larger similarity in intrinsic brain activity between healthy older persons and patients with or at-risk for AD than between older and younger ones, suggesting a significant proportion of pre-clinical AD cases in the group of cognitively normal older people. The observed link of aging and AD with intrinsic brain activity supports the view that lifespan intrinsic activity may contribute critically to the pathogenesis of AD. PMID:24689864

  17. Comprehensively Assessing Cognitive and Behavioral Risks for HIV Infection among Middle-Aged and Older Adults

    ERIC Educational Resources Information Center

    Paniagua, Freddy A.; O'Boyle, Michael

    2008-01-01

    A comprehensive survey of HIV/AIDS with middle-aged and older adults should include six domains (e.g., factual knowledge regarding the acquisition and transmission of HIV, traditionally-accepted behavioral risks for HIV infection). A sample of 23 women (54.8%) and 19 men (45.2%), ranging in age from 51 to 85 were surveye