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Sample records for cognitively intact older

  1. Management of Relocation in Cognitively Intact Older Adults.

    PubMed

    Hertz, Judith E; Koren, Mary Elaine; Rossetti, Jeanette; Tibbits, Kathryn

    2016-11-01

    Relocation, a major life transition that can affect health positively and negatively, is moving from one permanent home to another. Many older adults will relocate at some time during their life. Relocation is also a complex process that requires careful consideration and planning before the move (i.e., pre-location) and adjustment to the new home after the move (i.e., post-relocation). The current article is a summary of content based on a comprehensive evidence-based practice guideline focused on management of relocation in cognitively intact older adults. The guideline was designed to be used across diverse settings by nurses and other providers. Pre-relocation guidelines include assessment for the need for relocation, interventions prior to moving, and outcomes for evaluation of the pre-relocation process. For post-relocation, content focuses on assessment of risks for not adjusting after the move as well as intervention guidelines to promote adjustment and outcomes for evaluation. Implications include advocacy for older adults by using the guideline, disseminating it, and conducting future research. [Journal of Gerontological Nursing, 42(11), 14-23.].

  2. Pain intensity assessment: a comparison of selected pain intensity scales for use in cognitively intact and cognitively impaired African American older adults.

    PubMed

    Taylor, Laurie Jowers; Herr, Keela

    2003-06-01

    The purpose of this study was to determine the reliability and validity of selected pain intensity scales including the Faces Pain Scale (FPS), the Verbal Description Scale, the Numeric Rating Scale, and the Iowa Pain Thermometer to assess pain in cognitively impaired minority older adults. A descriptive correlational design was used, and a convenience sample of 57 volunteers age 58 and older residing in the South was recruited for this study. The sample consisted of 8 males and 49 females with a mean age of 76. Fifty-nine percent of the sample completed an 11th grade education or less, and 59% completed high school or college. Seventy-seven percent (n = 44) of the sample scored 24 or less on the mental status exam, indicating some degree of cognitive impairment. The remaining 23% (n = 13) were cognitively intact. All of the participants were able to use each of the scales to rate their pain. Concurrent validity of the scales was supported with Spearman rank correlation coefficients ranging from.74 to.83 in the cognitively impaired group and.81 to.96 in the cognitively intact group. Test-retest reliability at a 2-week interval was acceptable in the cognitively intact group (Spearman rank correlations ranged from.73 to.83) and to a lesser degree in the cognitively impaired group (correlations ranged from.52 to.79). When asked about scale preference, both the cognitively impaired and the intact group indicated a preference for the FPS. Findings from this study suggest that cognitive impairment did not inhibit older minority participants' ability to use a variety of pain intensity scales. Additionally, options should be provided that address individual needs of older adults considering specific cognitive level and disability, education, gender, ethnicity, and cultural influences concerning perceptions of the various pain intensity scales.

  3. 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.

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

    PubMed Central

    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

  5. 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…

  6. 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.

  7. 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

  8. Loneliness, loss, and social support among cognitively intact older people with cancer, living in nursing homes – a mixed-methods study

    PubMed Central

    Drageset, Jorunn; Eide, Geir Egil; Dysvik, Elin; Furnes, Bodil; Hauge, Solveig

    2015-01-01

    Background Loneliness is a significant psychosocial effect following a cancer diagnosis and may prevent people from engaging in social activities, thus creating difficulties in interpersonal relationships. This study investigated loneliness and social support among cognitively intact nursing home residents with cancer by using a quantitatively driven mixed-methods design with sequential supplementary qualitative components. Methods The quantitative component consisted of face-to-face interviews of 60 nursing home residents (≥65 years) using the one-item Loneliness Scale and the Social Provisions Scale. The supplementary psychosocial component consisted of qualitative research interviews about experiences related to loneliness with nine respondents. Results The quantitative results indicated that reassurance of worth was associated with loneliness. The experience of loneliness was identified by the following: loneliness that was dominated by a feeling of inner pain, feeling of loss, and feeling small. Loneliness was alleviated by the following: being engaged in activities, being in contact with other people, and occupying oneself. Conclusion Enhancing the lives of nursing home residents with cancer requires attending to the residents’ experience of loneliness and social relationships in a targeted and individualized manner. This might require screening all nursing home residents for early detection of loneliness. Revealing factors that may contribute to or reduce loneliness improves the ability to enhance people’s lives. PMID:26451093

  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.

  10. 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)

  11. 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.

  12. 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

  13. OLDER MALES, COGNITIVE FUNCTION, AND ALCOHOL CONSUMPTION

    PubMed Central

    McDougall, Graham J.; Becker, Heather; Areheart, Kristopher L.

    2008-01-01

    We investigated the question, how do older men who drink alcohol differ from those who do not drink on measures of cognitive function, memory, affect, and health? Of the nonprobability sample of male participants (N = 60), 35 (58%) of the males reported some degree of alcohol consumption. Eleven men had one or more drinks per day, 14 had one or more drinks per week, and 9 were occasional drinkers. The drinkers reported significantly less depression, had higher self-reported general health and vitality, and had higher cognitive performance, cognitive flexibility, and verbal memory, and greater knowledge of memory processes. PMID:16546934

  14. 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

  15. 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.

  16. 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

  17. 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

  18. Prospective memory on a novel clinical task in older adults with mild cognitive impairment and subjective cognitive decline

    PubMed Central

    Rabin, Laura A.; Chi, Susan Y.; Wang, Cuiling; Fogel, Joshua; Kann, Sarah J.; Aronov, Avner

    2014-01-01

    Despite the relevance of prospective memory to everyday functioning and the ability to live independently, prospective memory tasks are rarely incorporated into clinical evaluations of older adults. We investigated the validity and clinical utility of a recently developed measure, the Royal Prince Alfred Prospective Memory Test (RPA-ProMem), in a demographically diverse, non-demented, community-dwelling sample of 257 older adults (mean age = 80.78 years, 67.7% female) with amnestic mild cognitive impairment (aMCI, n = 18), non-amestic mild cognitive impairment (naMCI, n = 38), subjective cognitive decline (SCD, n = 83) despite intact performance on traditional episodic memory tests, and healthy controls (HC, n = 118). Those with aMCI and naMCI performed significantly worse than controls on the RPA-ProMem and its subtasks (time-based, event-based, short-term, long-term). Also, those with SCD scored significantly lower than controls on long-term, more naturalistic subtasks. Additional results supported the validity and inter-rater reliability of the RPA-ProMem and demonstrated a relation between test scores and informant reports of real-world functioning. The RPA-ProMem may help detect subtle cognitive changes manifested by individuals in the earliest stages of dementia, which may be difficult to capture with traditional episodic memory tests. Also, assessment of prospective memory can help guide the development of cognitive interventions for older adults at risk for dementia. PMID:24875614

  19. The Role of Cognitive Control in Older Adult Cognitive Reappraisal: Detached and Positive Reappraisal

    PubMed Central

    Liang, Ying; Huo, Meng; Kennison, Robert; Zhou, Renlai

    2017-01-01

    Older adults are more likely to regulate their emotions by engaging in cognitive reappraisal. However, depending on the type of cognitive reappraisal used, efforts to regulate emotions are sometimes met with success and other times with failure. It has been suggested the well-known age-related decline in cognitive control might be the culprit behind the poor use of detached reappraisal by older adults. However, this possibility has not been thoroughly investigated. In addition, studies have not examined what aspects of cognitive control– shifting, updating or inhibition–might be relevant to cognitive reappraisal. In the present study, 41 older participants were tested on cognitive control and abilities to use detached and positive reappraisal. Results showed detached reappraisal compared to positive relied more heavily on cognitive control, specifically mental set shifting. Results of this study have important implications for development of cognitive training interventions for older adults. PMID:28326024

  20. The Role of Cognitive Control in Older Adult Cognitive Reappraisal: Detached and Positive Reappraisal.

    PubMed

    Liang, Ying; Huo, Meng; Kennison, Robert; Zhou, Renlai

    2017-01-01

    Older adults are more likely to regulate their emotions by engaging in cognitive reappraisal. However, depending on the type of cognitive reappraisal used, efforts to regulate emotions are sometimes met with success and other times with failure. It has been suggested the well-known age-related decline in cognitive control might be the culprit behind the poor use of detached reappraisal by older adults. However, this possibility has not been thoroughly investigated. In addition, studies have not examined what aspects of cognitive control- shifting, updating or inhibition-might be relevant to cognitive reappraisal. In the present study, 41 older participants were tested on cognitive control and abilities to use detached and positive reappraisal. Results showed detached reappraisal compared to positive relied more heavily on cognitive control, specifically mental set shifting. Results of this study have important implications for development of cognitive training interventions for older adults.

  1. 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

  2. Cognitive Development and Career Retraining in Older Adults.

    ERIC Educational Resources Information Center

    Franz, John B.

    1983-01-01

    Reviews recent research on the cognitive development and functioning of older adults in relation to vocational retraining. Proposes that retraining programs designed to facilitate the career adaptability and success of older persons should attempt to increase their complexity and flexibility. (JAC)

  3. 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…

  4. 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…

  5. 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…

  6. 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.

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

    PubMed

    Mossello, Enrico; Simoni, David

    2016-06-22

    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.

  8. 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

  9. The effect of self-transcendence on depression in cognitively intact nursing home patients.

    PubMed

    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.

  10. Depressive symptoms and cognitive performance in older adults.

    PubMed

    Shimada, Hiroyuki; Park, Hyuntae; Makizako, Hyuma; Doi, Takehiko; Lee, Sangyoon; Suzuki, Takao

    2014-10-01

    Many longitudinal studies have found that older adults with depressive symptoms or depression have increased risk of cognitive impairment. We investigated the relationships between depressive symptoms or depression, cognitive function, serum brain-derived neurotrophic factor (BDNF), and volumetric MRI measurements in older adults. A total of 4352 individuals aged 65 years or older (mean age 72 years) participated in the study. We investigated medical history and geriatric depression scale-15 (GDS-15) items to determine depression and depressive symptoms. Cognitive tests included the mini-mental state examination (MMSE), story memory, word list memory, trail-making tests, and the symbol digit substitution task. Of the 4352 participants, 570 (13%) fulfilled the criteria for depressive symptoms (GDS-15: 6 + points) and 87 (2%) were diagnosed with depression. All cognitive tests showed significant differences between the 'no depressive symptoms', 'depressive symptoms', and 'depression' groups. The 'depressive symptoms' and 'depression' groups showed lower serum BDNF (p < 0.001) concentrations than the 'no depressive symptoms' group. The 'depressive symptoms' group exhibited greater atrophy of the right medial temporal lobe than did the 'no depressive symptoms' group (p = 0.023). These results suggest that memory, executive function, and processing speed examinations are useful to identify cognitive decline in older adults who have depressive symptoms and depression. Serum BDNF concentration and atrophy of the right medial temporal lobe may in part mediate the relationships between depressive symptoms and cognitive decline.

  11. Stress hormones, sleep deprivation and cognition in older adults.

    PubMed

    Maggio, Marcello; Colizzi, Elena; Fisichella, Alberto; Valenti, Giorgio; Ceresini, Graziano; Dall'Aglio, Elisabetta; Ruffini, Livia; Lauretani, Fulvio; Parrino, Liborio; Ceda, Gian Paolo

    2013-09-01

    Cognition can be deteriorated in older persons because of several potential mechanisms including the hormonal changes occurring with age. Stress events cause modification in hormonal balance with acute and chronic changes such as increase in cortisol and thyroid hormones, and simultaneous alterations in dehydroepiandrosterone sulphate, testosterone and insulin like growth factor-1 levels. The ability to cope with stress and regain previous healthy status, also called resiliency, is particularly impaired in older persons Thus, stressful conditions and hormonal dysregulation might concur to the onset of cognitive impairment in this population. In this review we address the relationship between stress hormones and cognitive function in older persons focusing on the role of one of the main stress factors, such as sleep deprivation (SD). We extracted and cross-checked data from 2000 to 2013 March and selected 112 full-text articles assessed for eligibility. In particular we considered 68 studies regarding the contribution of hormonal pathway to cognition in older adults, and 44 regarding hormones and SD both in rats and humans. We investigated how the activation of a stress-pattern response, like the one evoked from SD, can influence cognitive development and worsen cognitive status in the elderly. We will show the limited number of studies targeting the effects of SD and the consequent changes in stress hormones on cognitive function in this age group. We conclude that the current literature is not strong enough to give definitive answers on the role of stress hormonal pathway to the development of cognitive impairment in older individuals.

  12. Omega 3 fatty acids and cognitive health in older people.

    PubMed

    Dangour, Alan D; Andreeva, Valentina A; Sydenham, Emma; Uauy, Ricardo

    2012-06-01

    Oily fish and other sources of long-chain n-3 polyunsaturated fatty acids (n-3 LCPs) have been proposed as protective against dementia and age related cognitive impairment. The basic mechanisms underlying these proposed benefits have been postulated and experimental studies supporting the plausibility of the putative effects have been published. Observational epidemiological and case control studies also largely support a protective role of fish consumption on cognitive function with advancing age, albeit with important unexplained heterogeneity in findings. In this review we report the findings of the latest Cochrane review on the benefits of n-3 LCP supplementation on cognitive function among cognitively healthy older people and expand the review by including trials conducted with individuals with prevalent poor cognitive function or dementia. We identified seven relevant trials, four among cognitively healthy older people, and three among individuals with pre-existing cognitive decline or dementia, and overall conclude that there is no evidence to support the routine use of n-3 LCPs supplements for the prevention, or amelioration, of cognitive decline in later life. We identified several challenges in the design of intervention studies for the prevention of dementia and cognitive decline in older people that require careful consideration especially in recruitment and retention in long-term trials. Whether the lack of agreement in findings from mechanistic and observational data and from intervention studies reflects a real absence of benefit on cognitive function from n-3 LCP supplementation, or whether it reflects intrinsic limitations in the design of published studies remains open to question.

  13. Nutritional management of older adults with cognitive decline and dementia.

    PubMed

    Ogawa, Sumito

    2014-04-01

    Age-related cognitive decline is a main predictor of disability among elderly people, and with the continued expansion of the aging population and the increase in life expectancy, the prevalence of mild cognitive impairment and dementia represented by Alzheimer's disease (AD), which is a multifactorial neurodegenerative disorder of older adults, have increased. Recent epidemiological and observational studies suggest a relationship exists between lifestyle factors, including nutrition and diet, and cognitive function in aging adults. It is also suggested that malnutrition and nutrient deficiencies are associated with cognitive decline in patients with dementia. There are a variety of nutritional factors, including nutritional status and dietary patterns, that might be associated with cognitive function, and specific micronutrients and dietary components have been suggested to have an association with cognitive function as well. Based on these findings and evidence, evaluation of nutritional state, as well as nutritional intervention, might be able to play a role in the management and prevention of dementia.

  14. Visuomotor adaptability in older adults with mild cognitive decline.

    PubMed

    Schaffert, Jeffrey; Lee, Chi-Mei; Neill, Rebecca; Bo, Jin

    2017-02-01

    The current study examined the augmentation of error feedback on visuomotor adaptability in older adults with varying degrees of cognitive decline (assessed by the Montreal Cognitive Assessment; MoCA). Twenty-three participants performed a center-out computerized visuomotor adaptation task when the visual feedback of their hand movement error was presented in a regular (ratio=1:1) or enhanced (ratio=1:2) error feedback schedule. Results showed that older adults with lower scores on the MoCA had less adaptability than those with higher MoCA scores during the regular feedback schedule. However, participants demonstrated similar adaptability during the enhanced feedback schedule, regardless of their cognitive ability. Furthermore, individuals with lower MoCA scores showed larger after-effects in spatial control during the enhanced schedule compared to the regular schedule, whereas individuals with higher MoCA scores displayed the opposite pattern. Additional neuro-cognitive assessments revealed that spatial working memory and processing speed were positively related to motor adaptability during the regular scheduled but negatively related to adaptability during the enhanced schedule. We argue that individuals with mild cognitive decline employed different adaptation strategies when encountering enhanced visual feedback, suggesting older adults with mild cognitive impairment (MCI) may benefit from enhanced visual error feedback during sensorimotor adaptation.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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.

  20. Older Siblings' Contributions to Young Child's Cognitive Skills.

    PubMed

    Dai, Xianhua; Heckman, James J

    2013-09-01

    This work finds that older siblings as well as early parenting influence young children's cognitive skills directly or indirectly, for example, Mathematics, and English. Our findings challenge a pervasive view in the economical literatures that early parenting play a dominant role in explaining child development. In economics, early environmental conditions are important to demonstrate the evolution of adolescent and adult cognitive skills (Knudsen, Heckman, Cameron, and Shonkoff, 2006; Cunha and Heckman, 2007), and it establishes causal impacts of early parental inputs and other environmental factors on cognitive and non-cognitive skills (Heckman, Stixrud, and Urzua, 2006; Borghans, Duckworth, Heckman, and Weel, 2006; Cunha, Heckman, and Schennach, 2010). Early parenting as well as older siblings should explain a diverse array of academic and social outcomes, for example, Mathematics, English, maritage and pregnancy. In fact, older siblings' characteristics are as important, if not more important, than parenting for child development. Our analysis addresses the problems of measurement error, imperfect proxies, and reverse causality that plague conventional approach in psychology. We find that older brother contributes much more than older sister to child's mathematical achievement, while older sister contributes much more to child's english achievement. Our evidence is consistent with psychology literature, for example, Hetherington (1988), Jenkins (1992), Zukow-Goldring (1995), Marshall, Garcia-Coll, Marx, McCartney, Keffe, and Rub (1997), Maynard (2002), and Brody Ge, Kim, Murry, Simons, Gibbons, Gerrard, and Conger (2003) for siblings' direct contributions to child development, Bronfenbrenner (1997), East (1998), Whiteman and Buchanan (2002), and Brody, Ge, Kim, Murry, Simons, Gibbons, Gerrard, and Conger (2003) for siblings's indirect contributions, and Reiss, Neiderhiser, Hetherington, and Plomin (2000), Feinberg and Hetherington (2001), Kowal, Kramer, Krull

  1. Older Siblings’ Contributions to Young Child’s Cognitive Skills

    PubMed Central

    Dai, Xianhua; Heckman, James J.

    2014-01-01

    This work finds that older siblings as well as early parenting influence young children’s cognitive skills directly or indirectly, for example, Mathematics, and English. Our findings challenge a pervasive view in the economical literatures that early parenting play a dominant role in explaining child development. In economics, early environmental conditions are important to demonstrate the evolution of adolescent and adult cognitive skills (Knudsen, Heckman, Cameron, and Shonkoff, 2006; Cunha and Heckman, 2007), and it establishes causal impacts of early parental inputs and other environmental factors on cognitive and non-cognitive skills (Heckman, Stixrud, and Urzua, 2006; Borghans, Duckworth, Heckman, and Weel, 2006; Cunha, Heckman, and Schennach, 2010). Early parenting as well as older siblings should explain a diverse array of academic and social outcomes, for example, Mathematics, English, maritage and pregnancy. In fact, older siblings’ characteristics are as important, if not more important, than parenting for child development. Our analysis addresses the problems of measurement error, imperfect proxies, and reverse causality that plague conventional approach in psychology. We find that older brother contributes much more than older sister to child’s mathematical achievement, while older sister contributes much more to child’s english achievement. Our evidence is consistent with psychology literature, for example, Hetherington (1988), Jenkins (1992), Zukow-Goldring (1995), Marshall, Garcia-Coll, Marx, McCartney, Keffe, and Rub (1997), Maynard (2002), and Brody Ge, Kim, Murry, Simons, Gibbons, Gerrard, and Conger (2003) for siblings’ direct contributions to child development, Bronfenbrenner (1997), East (1998), Whiteman and Buchanan (2002), and Brody, Ge, Kim, Murry, Simons, Gibbons, Gerrard, and Conger (2003) for siblings’s indirect contributions, and Reiss, Neiderhiser, Hetherington, and Plomin (2000), Feinberg and Hetherington (2001), Kowal

  2. 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.

  3. Perceived discrimination and cognition in older African Americans.

    PubMed

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

    2012-09-01

    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. (JINS, 2012, 18, 1-10).

  4. 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.

  5. Association between osteocalcin and cognitive performance in healthy older adults

    PubMed Central

    Bradburn, Steven; McPhee, Jamie S; Bagley, Liam; Sipila, Sarianna; Stenroth, Lauri; Narici, Marco Vincenzo; Pääsuke, Mati; Gapeyeva, Helena; Osborne, Gabrielle; Sassano, Lorraine; Meskers, Carel G. M.; Maier, Andrea B.; Hogrel, Jean-Yves; Barnouin, Yoann; Butler-Browne, Gillian; Murgatroyd, Chris

    2016-01-01

    Introduction cognitive deterioration and reductions of bone health coincide with increasing age. We examine the relationship between bone composition and plasma markers of bone remodelling with measures of cognitive performance in healthy adults. Methods this cross-sectional study included 225 old (52% women, mean age: 74.4 ± 3.3 years) and 134 young (52% women, mean age: 23.4 ± 2.7 years) adult participants from the MyoAge project. Whole body bone mineral density was measured by dual-energy X-ray absorptiometry. Blood analyses included a panel of bone-related peptides (dickkopf-1, osteoprotegerin, osteocalcin (OC), osteopontin, sclerostin, parathyroid hormone and fibroblast growth factor 23), as well as serum calcium and 25-hydroxy vitamin D assays. A selection of cognitive domains (working memory capacity, episodic memory, executive functioning and global cognition) was assessed with a standardised neuropsychological test battery. Results adjusting for covariates and multiple testing revealed that plasma OC levels were positively associated with measures of executive functioning (β = 0.444, P < 0.001) and global cognition (β = 0.381, P = 0.001) in the older women. Discussion these correlative results demonstrate a positive association between OC, a factor known to regulate bone remodelling, with cognitive performance in older non-demented women. Further work should address possible mechanistic interpretations in humans. PMID:27515675

  6. 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.

  7. Cognitive reserve moderates relation between global cognition and functional status in older adults.

    PubMed

    Duda, Bryant; Puente, Antonio N; Miller, Lloyd Stephen

    2014-01-01

    The ability to perform instrumental activities of daily living (IADLs) is necessary for independent living. Research suggests that community-dwelling older adults are at risk for experiencing subtle decrements in the performance of IADLs. Neuropsychological tests have been used to account for differences in IADL status. Studies of the relationship between cognitive ability and functional status have produced variable results, however, and cognitive ability appears to be only a moderate predictor. Several studies of normal aging have revealed cognitive and functional benefits of higher cognitive reserve (CR) in healthy, nondemented older adults. The purposes of the present study were to: (a) examine the relationship between global cognitive ability and IADL performance among 53 community-dwelling older adults, and (b) determine whether formal education, as a proxy of CR, significantly moderates this relationship. Consistent with previous findings, global cognitive ability accounted for a considerable portion of variance in IADL performance [ΔR(2) = .54; ΔF(2, 53) = 67.96; p < .001]. Additionally, CR modestly but significantly attenuated this relationship [ΔR(2) = .044; ΔF(4, 53) = 5.98; p = .018; total R(2) = .65]. This finding suggests that community-dwelling older adults with lower levels of formal education may be at greater risk for functional decrements associated with age-related cognitive decline.

  8. Upregulation of cognitive control networks in older adults’ speech comprehension

    PubMed Central

    Erb, Julia; Obleser, Jonas

    2013-01-01

    Speech comprehension abilities decline with age and with age-related hearing loss, but it is unclear how this decline expresses in terms of central neural mechanisms. The current study examined neural speech processing in a group of older adults (aged 56–77, n = 16, with varying degrees of sensorineural hearing loss), and compared them to a cohort of young adults (aged 22–31, n = 30, self-reported normal hearing). In a functional MRI experiment, listeners heard and repeated back degraded sentences (4-band vocoded, where the temporal envelope of the acoustic signal is preserved, while the spectral information is substantially degraded). Behaviorally, older adults adapted to degraded speech at the same rate as young listeners, although their overall comprehension of degraded speech was lower. Neurally, both older and young adults relied on the left anterior insula for degraded more than clear speech perception. However, anterior insula engagement in older adults was dependent on hearing acuity. Young adults additionally employed the anterior cingulate cortex (ACC). Interestingly, this age group × degradation interaction was driven by a reduced dynamic range in older adults who displayed elevated levels of ACC activity for both degraded and clear speech, consistent with a persistent upregulation in cognitive control irrespective of task difficulty. For correct speech comprehension, older adults relied on the middle frontal gyrus in addition to a core speech comprehension network recruited by younger adults suggestive of a compensatory mechanism. Taken together, the results indicate that older adults increasingly recruit cognitive control networks, even under optimal listening conditions, at the expense of these systems’ dynamic range. PMID:24399939

  9. Memorial familiarity remains intact for pictures but not for words in patients with amnestic mild cognitive impairment.

    PubMed

    Embree, Lindsay M; Budson, Andrew E; Ally, Brandon A

    2012-07-01

    Understanding how memory breaks down in the earliest stages of Alzheimer's disease (AD) process has significant implications, both clinically and with respect to intervention development. Previous work has highlighted a robust picture superiority effect in patients with amnestic mild cognitive impairment (aMCI). However, it remains unclear as to how pictures improve memory compared to words in this patient population. In the current study, we utilized receiver operating characteristic (ROC) curves to obtain estimates of familiarity and recollection for pictures and words in patients with aMCI and healthy older controls. Analysis of accuracy shows that even when performance is matched between pictures and words in the healthy control group, patients with aMCI continue to show a significant picture superiority effect. The results of the ROC analysis showed that patients demonstrated significantly impaired recollection and familiarity for words compared controls. In contrast, patients with aMCI demonstrated impaired recollection, but intact familiarity for pictures, compared to controls. Based on previous work from our lab, we speculate that patients can utilize the rich conceptual information provided by pictures to enhance familiarity, and perceptual information may allow for post-retrieval monitoring or verification of the enhanced sense of familiarity. Alternatively, the combination of enhanced conceptual and perceptual fluency of the test item might drive a stronger or more robust sense of familiarity that can be accurately attributed to a studied item.

  10. Cognitive aging in older Black and White persons.

    PubMed

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

    2015-06-01

    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.

  11. 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.

  12. Cognitive Aging and the Hippocampus in Older Adults

    PubMed Central

    O’Shea, Andrew; Cohen, Ronald A.; Porges, Eric C.; Nissim, Nicole R.; Woods, Adam J.

    2016-01-01

    The hippocampus is one of the most well studied structures in the human brain. While age-related decline in hippocampal volume is well documented, most of our knowledge about hippocampal structure-function relationships was discovered in the context of neurological and neurodegenerative diseases. The relationship between cognitive aging and hippocampal structure in the absence of disease remains relatively understudied. Furthermore, the few studies that have investigated the role of the hippocampus in cognitive aging have produced contradictory results. To address these issues, we assessed 93 older adults from the general community (mean age = 71.9 ± 9.3 years) on the Montreal Cognitive Assessment (MoCA), a brief cognitive screening measure for dementia, and the NIH Toolbox-Cognitive Battery (NIHTB-CB), a computerized neurocognitive battery. High-resolution structural magnetic resonance imaging (MRI) was used to estimate hippocampal volume. Lower MoCA Total (p = 0.01) and NIHTB-CB Fluid Cognition (p < 0.001) scores were associated with decreased hippocampal volume, even while controlling for sex and years of education. Decreased hippocampal volume was significantly associated with decline in multiple NIHTB-CB subdomains, including episodic memory, working memory, processing speed and executive function. This study provides important insight into the multifaceted role of the hippocampus in cognitive aging. PMID:28008314

  13. Neuroprotective pathways: lifestyle activity, brain pathology, and cognition in cognitively normal older adults.

    PubMed

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

    2014-08-01

    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 the 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 [(11)C] labeled Pittsburgh-Compound-B positron emission tomography), cerebrovascular lesions (using magnetic resonance imaging-defined white matter lesion [WML]), and neural integrity within AD regions (using a multimodal neuroimaging 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 [(11)C] labeled Pittsburgh-Compound-B 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.

  14. 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

  15. 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.

  16. Coffee consumption and cognitive function among older adults.

    PubMed

    Johnson-Kozlow, Marilyn; Kritz-Silverstein, Donna; Barrett-Connor, Elizabeth; Morton, Deborah

    2002-11-01

    This study examined the association of caffeinated and decaffeinated coffee intake with cognitive function in a community-based sample of older adults in 1988-1992. Participants were 890 women with a mean age of 72.6 years and 638 men with a mean age of 73.3 years from the Rancho Bernardo Study. Cognitive function was assessed by 12 standardized tests, and lifetime consumption and current coffee consumption were obtained by questionnaire. After adjustment for confounders, higher lifetime coffee consumption in women was associated with better (p < or = 0.05) performance on six of 12 tests, with a trend (p < or = 0.10) on two other cognitive function tests; current caffeinated coffee intake was associated with better performance on two tests (p < 0.05), with a trend (p < 0.10) on one other test. Among women aged 80 or more years, lifetime coffee intake was nonsignificantly associated with better performance on 11 of the 12 tests. No relation was found between coffee intake and cognitive function among men or between decaffeinated coffee intake and cognitive function in either sex. Lifetime and current exposure to caffeine may be associated with better cognitive performance among women, especially among those aged 80 or more years.

  17. Social cognition in aggressive offenders: Impaired empathy, but intact theory of mind.

    PubMed

    Winter, Korina; Spengler, Stephanie; Bermpohl, Felix; Singer, Tania; Kanske, Philipp

    2017-04-06

    Aggressive, violent behaviour is a major burden and challenge for society. It has been linked to deficits in social understanding, but the evidence is inconsistent and the specifics of such deficits are unclear. Here, we investigated affective (empathy) and cognitive (Theory of Mind) routes to understanding other people in aggressive individuals. Twenty-nine men with a history of legally relevant aggressive behaviour (i.e. serious assault) and 32 control participants were tested using a social video task (EmpaToM) that differentiates empathy and Theory of Mind and completed questionnaires on aggression and alexithymia. Aggressive participants showed reduced empathic responses to emotional videos of others' suffering, which correlated with aggression severity. Theory of Mind performance, in contrast, was intact. A mediation analysis revealed that reduced empathy in aggressive men was mediated by alexithymia. These findings stress the importance of distinguishing between socio-affective and socio-cognitive deficits for understanding aggressive behaviour and thereby contribute to the development of more efficient treatments.

  18. Depressive symptoms and cognitive change in older Mexican Americans.

    PubMed

    Raji, Mukaila A; Reyes-Ortiz, Carlos A; Kuo, Yong-Fang; Markides, Kyriakos S; Ottenbacher, Kenneth J

    2007-09-01

    To examine the association between presence of clinically relevant depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D] score >or= 16) and subsequent cognitive function (Mini-Mental State Examination [MMSE]) over a 7-year period in older Mexican Americans, a prospective cohort study was performed. Five south-western states contributed data to the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Participants included 2812 noninstitutionalized Mexican Americans aged 65 and older followed from 1993-1994 until 2000-2001. Cognitive change was assessed using the MMSE at baseline and at 2, 5, and 7 years of follow-up. Independent variables were sociodemographics, CES-D >or= 16, medical conditions (hypertension, diabetes, coronary artery disease, and stroke), and activities of daily living (ADL) status. A general linear mixed model was used to estimate cognitive change. There was a cross-sectional association between CES-D >or= 16 and lower MMSE score (estimate = -0.48; standard error [SE] = 0.15; P < .01), independent of age, gender, education, marital status, time of interview, ADL limitations, vision impairment, and medical conditions. In the fully adjusted longitudinal model, subjects with clinically relevant depressive symptoms had a greater decline in MMSE score over 7 years than those without clinically relevant depressive symptoms (estimate = -0.17; SE = 0.05; P < .001), adjusting for sociodemographics, ADL and medical conditions. Each point increase in the CES-D score was associated with a decline of 0.010 point in MMSE score per year (SE = 0.002; P < 0.0001), adjusting for relevant confounders. Presence of clinically relevant depressive symptoms was associated with subsequent decline in cognitive function over 7 years in older Mexican Americans, independent of demographic and health factors.

  19. Cerebral Amyloid Angiopathy Pathology and Cognitive Domains in Older Persons

    PubMed Central

    Arvanitakis, Zoe; Leurgans, Sue E.; Wang, Zhenxin; Wilson, Robert S.; Bennett, David A.; Schneider, Julie A.

    2011-01-01

    Objective To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia. Methods Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time-of-death (mean age-at-death 86). Using amyloid-β immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all rs > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no-to-minimal (<0.5), mild-to-moderate (0.5-2.5) and moderate-to-very severe CAA (>2.5). Results CAA was very common (84.9%; 94 had no-to-minimal, 233 mild-to-moderate, and 76 moderate-to-very severe disease) and was related to AD pathology (rs = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate-to-very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild-to-moderate CAA with cognition were found. Dementia did not modify these findings. Interpretation CAA pathology is very common in older community-dwelling persons and is associated with AD pathology. Moderate-to-very severe CAA, but not mild-to-moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. PMID:21387377

  20. 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

  1. 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

    2013-09-05

    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

  2. Shoulder and elbow muscle activity during fully supported trajectory tracking in neurologically intact older people.

    PubMed

    Hughes, A M; Freeman, C T; Burridge, J H; Chappell, P H; Lewin, P L; Pickering, R M; Rogers, E

    2009-12-01

    An inability to perform tasks involving reaching is a common problem for stroke patients. Knowledge of normal muscle activation patterns during these tasks is essential to the identification of abnormal patterns in post-stroke hemiplegia. Findings will provide insight into changes in muscle activation patterns associated with recovery of upper limb function. In this study with neurologically intact participants the co-ordination of shoulder and elbow muscle activity during two dimensional reaching tasks is explored. Eight participants undertook nine tracking tasks in which trajectory (orientation and length), duration, speed and resistance to movement were varied. The participants' forearm was supported using a hinged arm-holder, which constrained their hand to move in a two dimensional plane. EMG signals were recorded from triceps, biceps, anterior deltoid, upper, middle and lower trapezius and pectoralis major. A wide variation in muscle activation patterns, in terms of timing and amplitude, was observed between participants performing the same task. EMG amplitude increased significantly with length, duration and resistance of the task for all muscles except anterior deltoid. Co-activation between biceps and triceps was significantly dependent on both task and trajectory orientation. Activation pattern of pectoralis major was dependent on trajectory. Neither trajectory orientation nor task condition affected the activation pattern of anterior deltoid. Normal ranges of timing of muscle activity during the tasks were identified.

  3. Far transfer in cognitive training of older adults

    PubMed Central

    Zelinski, Elizabeth M.

    2014-01-01

    Purpose This article reviews the literature on far transfer effects in training of older adults. Methods Adapting a taxonomy of transfer developed by Barnett and Ceci (2002), to rehabilitation or enhancement of existing cognitive skills; results of studies assessing transfer effects from training of memory, reasoning, UFOV, dual task performance, and complex training are classified. Results Comparisons of the transfer outcomes of both strategy training and extended practice approaches suggest that far transfer has been observed. Conclusions Outcomes for strategy studies training memory have had less success than extended practice studies in obtaining far transfer. Reasons for this are discussed, as are suggestions for improved assessment of transfer outcomes. PMID:19847070

  4. 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

  5. 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

  6. 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

  7. Comparison of semantic and episodic memory BOLD fMRI activation in predicting cognitive decline in older adults

    PubMed Central

    Hantke, Nathan; Nielson, Kristy A.; Woodard, John L.; Guidotti Breting, Leslie M.; Butts, Alissa; Seidenberg, Michael; Smith, J. Carson; Durgerian, Sally; Lancaster, Melissa; Matthews, Monica; Sugarman, Michael A.; Rao, Stephen M.

    2013-01-01

    Previous studies suggest that task-activated fMRI can predict future cognitive decline among healthy older adults. The present fMRI study examined the relative sensitivity of semantic memory (SM) versus episodic memory (EM) activation tasks for predicting cognitive decline. Seventy-eight cognitively intact elders underwent neuropsychological testing at entry and after an 18-month interval, with participants classified as cognitively “Stable” or “Declining” based on ≥1.0 SD decline in performance. Baseline fMRI scanning involved SM (famous name discrimination) and EM (name recognition) tasks. SM and EM fMRI activation, along with APOE ε4 status, served as predictors of cognitive outcome using a logistic regression analysis. Twenty-seven (34.6%) participants were classified as Declining and 51 (65.4%) as Stable. APOE ε4 status alone significantly predicted cognitive decline (R2 = .106; C index = .642). Addition of SM activation significantly improved prediction accuracy (R2 = .285; C index = .787), whereas the addition of EM did not (R2 = .212; C index = .711). In combination with APOE status, SM task activation predicts future cognitive decline better than EM activation. These results have implications for use of fMRI in prevention clinical trials involving the identification of persons at-risk for age-associated memory loss and Alzheimer’s disease. PMID:23199565

  8. 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

  9. Measures of sleep-wake patterns and risk of mild cognitive impairment or dementia in older women

    PubMed Central

    Diem, Susan J; Blackwell, Terri L; Stone, Katie L; Yaffe, Kristine; Tranah, Greg; Cauley, Jane A; Ancoli-Israel, Sonia; Redline, Susan; Spira, Adam P; Hillier, Teresa A; Ensrud, Kristine E

    2016-01-01

    Objective Sleep disturbances are common in older adults. Little is known about the sleep of cognitively-intact older adults and its relationship to subsequent cognitive impairment. The objective of this study was to examine the association between objective sleep-wake measures and risk of incident cognitive impairment. Design Prospective cohort study Setting Four U.S. sites Participants 1245 women (mean age 82.6 years) without dementia participating in the Study of Osteoporotic Fractures who completed actigraphy at baseline visit and comprehensive cognitive assessment at follow-up. Measurements Examine the association between sleep-wake patterns measured by actigraphy and risk of incident mild cognitive impairment (MCI) and dementia. Results A total of 473 (38%) women developed cognitive impairment during an average (SD) follow-up of 4.9 (0.6) years; 290 (23.3%) developed MCI and 183 (14.7%) developed dementia. After controlling for multiple potential confounders, women in the lowest quartile of average sleep efficiency (<74%) had a 1.5-fold higher odds of developing MCI or dementia compared to women in the highest quartile of sleep efficiency (>86% )(OR Q1 vs. Q4 1.53, 95% CI 1.07, 2.19; Wald χ2 [1, N=1223]=5.34 for p for trend=0.03). Longer average sleep latency, but not total sleep time, was also associated with higher odds of developing cognitive impairment. Greater variability in both sleep efficiency and total sleep time was associated with an increased odds of developing MCI or dementia. Conclusions Lower average sleep efficiency, longer average sleep latency, and greater variability in sleep efficiency and total sleep time are associated with increased odds of developing cognitive impairment. Further research is needed to explore the mechanisms underlying these associations. PMID:26964485

  10. Does cognitive self-consciousness link older adults' cognitive functioning to obsessive-compulsive symptoms?

    PubMed

    Prouvost, Caroline; Calamari, John E; Woodard, John L

    2016-10-01

    To elucidate how obsessional symptoms might develop or intensify in late-life, we tested a risk model. We posited that cognitive self-consciousness (CSC), a tendency to be aware of and monitor thinking, would increase reactivity to aging-related cognitive changes and mediate the relationship between cognitive functioning and obsessive-compulsive disorder (OCD) symptoms. Older adults (Mage = 76.7 years) completed the Dementia Rating Scale-2 (DRS-2), a CSC measure, and an OCD symptom measure up to four times over 18 months. A model that included DRS-2 age and education adjusted total score as the indicator of cognitive functioning fit the data well, and CSC score change mediated the relationship between initial cognitive functioning and changes in OCD symptoms. In tests of a model that included DRS-2 Initiation/Perseveration (I/P) and Conceptualization subscale scores, the model again fit the data well. Conceptualization scores, but not I/P scores, were related to later OCD symptoms, and change in CSC scores again mediated the relationship. Lower scores on initial cognitive functioning measures predicted increases in CSC scores over time, which in turn predicted increases in OCD symptoms over the 18 months of the study. Implications for understanding late-life obsessional problems are discussed.

  11. Physical Fitness in Older People Recently Diagnosed with Cognitive Impairment Compared to Older People Recently Discharged from Hospital

    PubMed Central

    Hesseberg, Karin; Bergland, Astrid; Rydwik, Elisabeth; Brovold, Therese

    2016-01-01

    Background/Aims There is evidence of an association between cognitive function and physical fitness. The aim of this study was to compare physical fitness in patients with cognitive impairment with a group of older people recently discharged from hospital. Methods A cross-sectional study with 98 patients recently diagnosed with cognitive impairment and 115 patients recently discharged from hospital. Associations between the study group variable and different components in the Senior fitness test were examined, controlling for demographic factors and comorbidity. Results The group recently diagnosed with cognitive impairment indicated poorer results on three of six physical fitness components (p < 0.05). Conclusion Older adults with cognitive impairment are in need of individually tailored physical activity programs to increase the level of physical fitness. PMID:27703472

  12. Goal-directed memory: the role of cognitive control in older adults' emotional memory.

    PubMed

    Mather, Mara; Knight, Marisa

    2005-12-01

    The present study revealed that older adults recruit cognitive control processes to strengthen positive and diminish negative information in memory. In Experiment 1, older adults engaged in more elaborative processing when retrieving positive memories than they did when retrieving negative memories. In Experiment 2, older adults who did well on tasks involving cognitive control were more likely than those doing poorly to favor positive pictures in memory. In Experiment 3, older adults who were distracted during memory encoding no longer favored positive over negative pictures in their later recall, revealing that older adults use cognitive resources to implement emotional goals during encoding. In contrast, younger adults showed no signs of using cognitive control to make their memories more positive, indicating that, for them, emotion regulation goals are not chronically activated.

  13. Meta-analysis of amyloid-cognition relations in cognitively normal older adults

    PubMed Central

    Oh, Hwamee; Younger, Alayna P.; Patel, Tanu A.

    2013-01-01

    Objective: We conducted a meta-analysis of relationships between amyloid burden and cognition in cognitively normal, older adult humans. Methods: Methods of assessing amyloid burden included were CSF or plasma assays, histopathology, and PET ligands. Cognitive domains examined were episodic memory, executive function, working memory, processing speed, visuospatial function, semantic memory, and global cognition. Sixty-four studies representing 7,140 subjects met selection criteria, with 3,495 subjects from 34 studies representing independent cohorts. Weighted effect sizes were obtained for each study. Primary analyses were conducted limiting to independent cohort studies using only the most common assessment method (Pittsburgh compound B). Exploratory analyses included all assessment methods. Results: Episodic memory (r = 0.12) had a significant relationship to amyloid burden. Executive function and global cognition did not have significant relationships to amyloid in the primary analysis of Pittsburgh compound B (r = 0.05 and r = 0.08, respectively), but did when including all assessment methods (r = 0.08 and r = 0.09, respectively). The domains of working memory, processing speed, visuospatial function, and semantic memory did not have significant relationships to amyloid. Differences in the method of amyloid assessment, study design (longitudinal vs cross-sectional), or inclusion of control variables (age, etc.) had little influence. Conclusions: Based on this meta-analytic survey of the literature, increased amyloid burden has small but nontrivial associations with specific domains of cognitive performance in individuals who are currently cognitively normal. These associations may be useful for identifying preclinical Alzheimer disease or developing clinical outcome measures. PMID:23547267

  14. Total MRI load of cerebral small vessel disease and cognitive ability in older people.

    PubMed

    Staals, Julie; Booth, Tom; Morris, Zoe; Bastin, Mark E; Gow, Alan J; Corley, Janie; Redmond, Paul; Starr, John M; Deary, Ian J; Wardlaw, Joanna M

    2015-10-01

    Cerebral small vessel disease (SVD) may cause cognitive dysfunction. We tested the association between the combined presence of magnetic resonance imaging (MRI) features of SVD and cognitive ability in older age. Cognitive testing and brain MRI were performed in 680 older participants. MRI presence of lacunes, white matter hyperintensities, microbleeds, and perivascular spaces were summed in a score of 0-4 representing all SVD features combined. We also applied latent variable modeling to test whether the 4 MRI features form a unitary SVD construct. The SVD score showed significant associations with general cognitive ability. Latent variable modeling indicated that the 4 MRI markers formed a unitary construct, which showed consistent associations with cognitive ability compared with the SVD score. Total MRI load of SVD is associated with lower general cognitive ability in older age. The total SVD score performed consistently with the more complex latent variable model, suggesting validity and potential utility in future research for determining total SVD load.

  15. The Association of Anxiety and Depressive Symptoms with Cognitive Performance in Community-Dwelling Older Adults

    PubMed Central

    Beaudreau, Sherry A.; O’Hara, Ruth

    2009-01-01

    We examined the association of anxiety, depressive symptoms, and their co-occurrence on cognitive processes in 102 community-dwelling older adults. Participants completed anxiety and depression questionnaires, and measures of episodic and semantic memory, word fluency, processing speed/shifting attention, and inhibition. Participants with only increased anxiety had poorer processing speed/shifting attention, and inhibition, but depressive symptoms alone were not associated with any cognitive deficits. Although co-existing anxiety and depressive symptoms was associated with deficits in 3 cognitive domains, reductions in inhibition were solely attributed to anxiety. Findings suggest an excess cognitive load on inhibitory ability in normal older adults reporting mild anxiety. PMID:19485667

  16. A Battery of Tests for Assessing Cognitive Function in Older Latino Persons

    PubMed Central

    Krueger, Kristin R.; Wilson, Robert S.; Bennett, David A.; Aggarwal, Neelum T.

    2009-01-01

    With the proportion of older Latinos in the United States rapidly growing, dementia is expected to be an increasing public health problem in this segment of the population. Yet relatively few cognitive test batteries have been developed for evaluating older Spanish speaking persons. We selected a battery of cognitive tests used in cognitive aging studies of English speakers, adapted it for Spanish speakers, and administered it to 66 older Latinos (mean age = 71.1, SD = 8.1). The results of a factor analysis supported grouping the tests into the same five functional domains identified for English speakers. Composite measures of performance in each domain were positively related to education and, with some exceptions, inversely related to age. The results suggest that this battery may be useful in epidemiologic research on cognition in older Latinos. PMID:19561439

  17. [Sleep in older adults: association between chronic insomnia and cognitive functioning].

    PubMed

    Haimov, Iris; Vadas, Limor

    2009-05-01

    Chronic insomnia and cognitive impairment are both common complaints among older adults. Even so, only a few studies have examined the effects of chronic insomnia on cognitive functioning among the elderly, and the results of these studies are contradictory. The authors therefore examined whether insomnia is associated with changes in cognitive functioning among elderly people. The study population comprised two groups: 64 older adult subjects without sleep disorders, and 48 older adult insomniacs. All subjects were living independently in the community and were in good clinical condition. The cognitive capacity of each subject was tested at the subject's home using the computerized "MindFit" test (CogniFit, Inc.). The results demonstrate that chronic insomnia in older adults is associated with impairment in cognitive functioning. Specifically, we found that older people suffering from late-life insomnia exhibit significantly reduced performance in memory span, allocating attention to a target, time estimation, working memory and integration of two dimensions. The present findings suggest that late-life insomnia may be one of the factors contributing to the decline in cognitive functioning seen among older people. Thus, it is particularly important for health care practitioners to screen for, evaluate and treat insomnia symptoms in the elderly. The findings of this study offer hope that treatment of insomnia in older adults can have beneficial effects in improving cognitive functioning in these patients. Therefore, attention to and effective treatment of chronic insomnia in older persons may not only improve the quality of their nighttime sleep, but conceivabLy, may also maintain cognitive function, thus improving their overall quality of life.

  18. The Older Adult Positivity Effect in Evaluations of Trustworthiness: Emotion Regulation or Cognitive Capacity?

    PubMed Central

    Zebrowitz, Leslie A.; Boshyan, Jasmine; Ward, Noreen; Gutchess, Angela; Hadjikhani, Nouchine

    2017-01-01

    An older adult positivity effect, i.e., the tendency for older adults to favor positive over negative stimulus information more than do younger adults, has been previously shown in attention, memory, and evaluations. This effect has been attributed to greater emotion regulation in older adults. In the case of attention and memory, this explanation has been supported by some evidence that the older adult positivity effect is most pronounced for negative stimuli, which would motivate emotion regulation, and that it is reduced by cognitive load, which would impede emotion regulation. We investigated whether greater older adult positivity in the case of evaluative responses to faces is also enhanced for negative stimuli and attenuated by cognitive load, as an emotion regulation explanation would predict. In two studies, younger and older adults rated trustworthiness of faces that varied in valence both under low and high cognitive load, with the latter manipulated by a distracting backwards counting task. In Study 1, face valence was manipulated by attractiveness (low /disfigured faces, medium, high/fashion models’ faces). In Study 2, face valence was manipulated by trustworthiness (low, medium, high). Both studies revealed a significant older adult positivity effect. However, contrary to an emotion regulation account, this effect was not stronger for more negative faces, and cognitive load increased rather than decreased the rated trustworthiness of negatively valenced faces. Although inconsistent with emotion regulation, the latter effect is consistent with theory and research arguing that more cognitive resources are required to process negative stimuli, because they are more cognitively elaborated than positive ones. The finding that increased age and increased cognitive load both enhanced the positivity of trustworthy ratings suggests that the older adult positivity effect in evaluative ratings of faces may reflect age-related declines in cognitive capacity

  19. The effect of cognitive testing and feedback on older adults' subjective age.

    PubMed

    Geraci, Lisa; De Forrest, Ross; Hughes, Matthew; Saenz, Gabriel; Tirso, Robert

    2017-03-10

    Subjective age, or how old a person feels, is an important measure of self-perception that is associated with consequential cognitive and health outcomes. Recent research suggests that subjective age is affected by certain situations, including cognitive testing contexts. The current study examined whether cognitive testing and positive performance feedback affect subjective age and subsequent cognitive performance. Older adults took a series of neuropsychological and cognitive tests and subjective age was measured at various time points. Participants also either received positive or no feedback on an initial cognitive task, an analogies task. Results showed that participants felt older over the course of the testing session, particularly after taking a working memory test, relative to baseline. Positive feedback did not significantly mitigate this subjective aging effect. Results suggest that subjective age is malleable and that it can be affected by standard cognitive and neuropsychological test conditions.

  20. Nicotinic Acetylcholine Receptor Density in Cognitively Intact Subjects at an Early Stage of Parkinson’s Disease

    PubMed Central

    Isaias, Ioannis Ugo; Spiegel, Jörg; Brumberg, Joachim; Cosgrove, Kelly P.; Marotta, Giorgio; Oishi, Naoya; Higuchi, Takahiro; Küsters, Sebastian; Schiller, Markus; Dillmann, Ulrich; van Dyck, Christopher H.; Buck, Andreas; Herrmann, Ken; Schloegl, Susanne; Volkmann, Jens; Lassmann, Michael; Fassbender, Klaus; Lorenz, Reinhard; Samnick, Samuel

    2014-01-01

    We investigated in vivo brain nicotinic acetylcholine receptor (nAChR) distribution in cognitively intact subjects with Parkinson’s disease (PD) at an early stage of the disease. Fourteen patients and 13 healthy subjects were imaged with single photon emission computed tomography and the radiotracer 5-[123I]iodo-3-[2(S)-2-azetidinylmethoxy]pyridine ([123I]5IA). Patients were selected according to several criteria, including short duration of motor signs (<7 years) and normal scores at an extensive neuropsychological evaluation. In PD patients, nAChR density was significantly higher in the putamen, the insular cortex and the supplementary motor area and lower in the caudate nucleus, the orbitofrontal cortex, and the middle temporal gyrus. Disease duration positively correlated with nAChR density in the putamen ipsilateral (ρ = 0.56, p < 0.05) but not contralateral (ρ = 0.49, p = 0.07) to the clinically most affected hemibody. We observed, for the first time in vivo, higher nAChR density in brain regions of the motor and limbic basal ganglia circuits of subjects with PD. Our findings support the notion of an up-regulated cholinergic activity at the striatal and possibly cortical level in cognitively intact PD patients at an early stage of disease. PMID:25177294

  1. 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…

  2. 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…

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. The relationship between Big-5 personality traits and cognitive ability in older adults - a review.

    PubMed

    Curtis, Rachel G; Windsor, Tim D; Soubelet, Andrea

    2015-01-01

    It is well established that fundamental aspects of cognition such as memory and speed of processing tend to decline with age; however, there is substantial between-individual variability in levels of cognitive performance in older adulthood and in rates of change in cognitive abilities over time. Recent years have seen an increasing number of studies concerned with examining personality characteristics as possible predictors of some of this variability in cognitive aging. The purpose of this article is to review the literature, and identify patterns of findings regarding the relationships between personality (focusing on the Big-5) and cognitive ability across nonclinical populations of older adults. Possible mechanisms underlying associations of personality characteristics with cognition are reviewed, and assessed in the context of the current literature. Some relatively consistent relationships are identified, including positive associations between openness and cognitive ability, and associations of conscientiousness with slower rates of cognitive decline. However, the relationships between several personality traits and cognitive abilities in older adults remain unclear. We suggest some approaches to research design and analysis that may help increase our understanding of how personality differences may contribute to cognitive aging.

  8. Cognitive effects of testosterone and finasteride administration in older hypogonadal men

    PubMed Central

    Borst, Stephen E; Yarrow, Joshua F; Fernandez, Carmen; Conover, Christine F; Ye, Fan; Meuleman, John R; Morrow, Matthew; Zou, Baiming; Shuster, Jonathan J

    2014-01-01

    Serum concentrations of neuroactive androgens decline in older men and, in some studies, low testosterone is associated with decreased cognitive function and incidence of depression. Existing studies evaluating the effect of testosterone administration on cognition in older men have been largely inconclusive, with some studies reporting minor to moderate cognitive benefit, while others indicate no cognitive effect. Our objective was to assess the cognitive effects of treating older hypogonadal men for 1 year with a supraphysiological dose of testosterone, either alone or in combination with finasteride (a type II 5α-reductase inhibitor), in order to determine whether testosterone produces cognitive benefit and whether suppressed dihydrotestosterone influences cognition. Sixty men aged ≥60 years with a serum testosterone concentration of ≤300 ng/dL or bioavailable testosterone ≤70 ng/dL and no evidence of cognitive impairment received testosterone-enanthate (125 mg/week) versus vehicle, paired with finasteride (5 mg/day) versus placebo using a 2×2 factorial design. Testosterone caused a small decrease in depressive symptoms as assessed by the Geriatric Depression Scale and a moderate increase in visuospatial memory as assessed by performance on a recall trial of the Rey-Osterrieth Complex Figure Test. Finasteride caused a small increase in performance on the Benton Judgment of Line Orientation test. In total, major improvements in cognition were not observed either with testosterone or finasteride. Further studies are warranted to determine if testosterone replacement may improve cognition in other domains. PMID:25143719

  9. Physical Performance Is Associated with Working Memory in Older People with Mild to Severe Cognitive Impairment

    PubMed Central

    Volkers, K. M.; Scherder, E. J. A.

    2014-01-01

    Background. Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. Methods. This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years). Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. Results. The full models explain 49–57% of the variance in working memory and 40–43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3–7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. Conclusions. Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482. PMID:24757674

  10. Cognitive effects of testosterone and finasteride administration in older hypogonadal men.

    PubMed

    Borst, Stephen E; Yarrow, Joshua F; Fernandez, Carmen; Conover, Christine F; Ye, Fan; Meuleman, John R; Morrow, Matthew; Zou, Baiming; Shuster, Jonathan J

    2014-01-01

    Serum concentrations of neuroactive androgens decline in older men and, in some studies, low testosterone is associated with decreased cognitive function and incidence of depression. Existing studies evaluating the effect of testosterone administration on cognition in older men have been largely inconclusive, with some studies reporting minor to moderate cognitive benefit, while others indicate no cognitive effect. Our objective was to assess the cognitive effects of treating older hypogonadal men for 1 year with a supraphysiological dose of testosterone, either alone or in combination with finasteride (a type II 5α-reductase inhibitor), in order to determine whether testosterone produces cognitive benefit and whether suppressed dihydrotestosterone influences cognition. Sixty men aged ≥ 60 years with a serum testosterone concentration of ≤ 300 ng/dL or bioavailable testosterone ≤ 70 ng/dL and no evidence of cognitive impairment received testosterone-enanthate (125 mg/week) versus vehicle, paired with finasteride (5 mg/day) versus placebo using a 2×2 factorial design. Testosterone caused a small decrease in depressive symptoms as assessed by the Geriatric Depression Scale and a moderate increase in visuospatial memory as assessed by performance on a recall trial of the Rey-Osterrieth Complex Figure Test. Finasteride caused a small increase in performance on the Benton Judgment of Line Orientation test. In total, major improvements in cognition were not observed either with testosterone or finasteride. Further studies are warranted to determine if testosterone replacement may improve cognition in other domains.

  11. Observing prioritization effects on cognition and gait: The effect of increased cognitive load on cognitively healthy older adults' dual-task performance.

    PubMed

    Maclean, Linda M; Brown, Laura J E; Khadra, H; Astell, Arlene J

    2017-03-01

    Previous studies exploring the effects of attention-prioritization on cognitively healthy older adults' gait and cognitive dual task (DT) performance have shown DT cost in gait outcomes but inconsistent effects on cognitive performance, which may reflect task difficulty (the cognitive load). This study aimed to identify whether changing the cognitive load during a walking and counting DT improved the challenge/sensitivity of the cognitive task to observe prioritization effects on concurrent gait and cognitive performance outcomes. Seventy-two cognitively healthy older adults (Mean=73years) walked 15m, counted backwards in 3s and 7s as single tasks (ST), and concurrently walked and counted backwards as DTs. Attention-prioritization was examined in Prioritizing Walking (PW) and Prioritizing Counting (PC) DT conditions. Dual-task performance costs (DTC) were calculated for number of correct cognitive responses (CCR) in the counting tasks, and step-time variability and velocity in the gait task. All DT conditions showed a benefit (DTB) for cognitive outcomes with trade-off cost to gait. In the Serial 3s task, the cognitive DTBs increased in PC over the PW condition (p<0.05), with a greater cost to walking velocity (p<0.05). DT effects were more pronounced in the Serial 7s with a lower cognitive DTB when PC than when PW, (p<0.05) with no trade-off increase in cost to gait outcomes (p<0.05). The findings suggest that increased cognitive load during a gait and cognitive DT produces more pronounced gait measures of attention-prioritization in cognitively healthy older adults. A cognitive load effect was also observed in the cognitive outcomes, with unexpected results.

  12. 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…

  13. 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...

  14. 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

  15. 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…

  16. Frailty and cognitive impairment: Unique challenges in the older emergency surgical patient

    PubMed Central

    Moug, SJ; Stechman, M; McCarthy, K; Pearce, L; Myint, PK; Hewitt, J

    2016-01-01

    Introduction Older patients (>65 years of age) admitted as general surgical emergencies increasingly require improved recognition of their specific needs relative to younger patients. Two such needs are frailty and cognitive impairment. These are evolving research areas that the emergency surgeon increasingly requires knowledge of to improve short- and long-term patient outcomes. Methods This paper reviews the evidence for frailty and cognitive impairment in the acute surgical setting by defining frailty and cognitive impairment, introducing methods of diagnosis, discussing the influence on prognosis and proposing strategies to improve older patient outcomes. Results Frailty is present in 25% of the older surgical population. Using frailty-scoring tools, frailty was associated with a significantly longer hospital stay and higher mortality at 30 and 90 days after admission to an acute surgical unit. Cognitive impairment is present in a high number of older acute surgical patients (approximately 70%), whilst acute onset cognitive impairment, termed delirium, is documented in 18%. However, patients with delirium had significantly longer hospital stays and higher in-hospital mortality than those with cognitive impairment. Conclusions Improved knowledge of frailty and delirium by the emergency surgeon allows the specialised needs of older surgical patients to be taken into account. Early recognition, and consideration of minimally invasive surgery or radiological intervention alongside potentially transferable successful elective interventions such as comprehensive geriatric assessment, may help to improve short- and long-term patient outcomes in this vulnerable population. PMID:26890834

  17. 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,…

  18. Spatial Cognition in Autism Spectrum Disorders: Superior, Impaired, or Just Intact?

    ERIC Educational Resources Information Center

    Edgin, Jamie O.; Pennington, Bruce F.

    2005-01-01

    The profile of spatial ability is of interest across autism spectrum disorders (ASD) because of reported spatial strengths in ASD and due to the recent association of Asperger's syndrome with Nonverbal Learning Disability. Spatial functions were examined in relation to two cognitive theories in autism: the central coherence and executive function…

  19. 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.

  20. Racial and ethnic differences in cognitive function among older adults in the USA

    PubMed Central

    Díaz-Venegas, Carlos; Downer, Brian; Langa, Kenneth M.; Wong, Rebeca

    2016-01-01

    Objective Examine differences in cognition between Hispanic, non-Hispanic black (NHB), and non-Hispanic white (NHW) older adults in the United States. Data/Methods The final sample includes 18 982 participants aged 51 or older who received a modified version of the Telephone Interview for Cognitive Status during the 2010 Health and Retirement Study follow-up. Ordinary least squares will be used to examine differences in overall cognition according to race/ethnicity. Results Hispanics and NHB had lower cognition than NHW for all age groups (51–59, 60–69, 70–79, 80+). Hispanics had higher cognition than NHB for all age groups but these differences were all within one point. The lower cognition among NHB compared to NHW remained significant after controlling for age, gender, and education, whereas the differences in cognition between Hispanics and NHW were no longer significant after controlling for these covariates. Cognitive scores increased with greater educational attainment for all race/ethnic groups, but Hispanics exhibited the least benefit. Discussion Our results highlight the role of education in race/ethnic differences in cognitive function during old age. Education seems beneficial for cognition in old age for all race/ethnic groups, but Hispanics appear to receive a lower benefit compared to other race/ethnic groups. Further research is needed on the racial and ethnic differences in the pathways of the benefits of educational attainment for late-life cognitive function. PMID:26766788

  1. Social-Economic Status and Cognitive Performance among Chinese Aged 50 Years and Older

    PubMed Central

    Wu, Fan; Guo, Yanfei; Zheng, Yang; Ma, Wenjun; Kowal, Paul; Chatterji, Somnath; Wang, Ling

    2016-01-01

    Background Numerous population-based studies have suggested that socio-economic status (SES) is associated with cognitive performance, but few nationally representative epidemiological studies on cognitive performance with a large sample of older adults are available in China. And many studies explore the factors associated with cognitive performance, mainly focusing on individual level and more rarely on multiple levels that include the individual and community. Methods This study uses SAGE-China Wave 1 data which consisted of 13,157 adults aged 50 years and older to explore socioeconomic inequalities in the cognitive performance from a multilevel perspective (individual and community levels). The overall cognition score was based on the seven separate components of the cognition tests, including the four verbal recall trials, the verbal fluency test, the forward digit span test and the backward digit span test. Factor analysis was applied to evaluate and generate a single overall score. A two-level hierarchical linear model was used to evaluate the association between SES at these two levels and the overall cognition score adjusted for age, sex and marital status. Results At individual level, years of education was significantly associated with overall cognition score for both urban and rural dwellers. At the community level, a positive association was obtained between median household income and median years of education and overall cognition score among urban participants. Conclusion A significant association between SES at both individual-level and community-level (only for urban area) and cognitive performance were found in this study of a national sample of 13,157 Chinese aged 50 years and older, even after adjusting for demographic characteristics. Identifying community-based SES variables that are associated with cognitive performance in the older population provides further evidence for the need to address community characteristics associated with

  2. 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.

  3. Allopregnanolone Levels are Reduced in Temporal Cortex in Patients with Alzheimer’s Disease Compared to Cognitively Intact Control Subjects

    PubMed Central

    Naylor, Jennifer C.; Kilts, Jason D.; Hulette, Christine M.; Steffens, David C.; Blazer, Dan G.; Ervin, John F.; Strauss, Jennifer L.; Allen, Trina B.; Massing, Mark W.; Payne, Victoria M.; Youssef, Nagy A.; Shampine, Lawrence J.; Marx, Christine E.

    2010-01-01

    Background The neurosteroid allopregnanolone has pronounced neuroprotective actions, increases myelination, and enhances neurogenesis. Evidence suggests that allopregnanolone dysregulation may play a role in the pathophysiology of Alzheimer’s disease (AD) and other neurodegenerative disorders. Our prior data demonstrate that allopregnanolone is reduced in prefrontal cortex in male patients with AD compared to male cognitively intact control subjects, and inversely correlated with neuropathological disease stage (Braak and Braak). We therefore determined if allopregnanolone levels are also reduced in AD patients compared to control subjects in temporal cortex, utilizing a larger set of samples from both male and female patients. In addition, we investigated if neurosteroids are altered in subjects who are APOE4 allele carriers. Methods Allopregnanolone, dehydroepiandrosterone (DHEA), and pregnenolone levels were determined in temporal cortex postmortem samples by gas chromatography/mass spectrometry, preceded by high performance liquid chromatography (40 subjects with AD/41 cognitively intact control subjects). Results Allopregnanolone levels are reduced in temporal cortex in patients with AD (median 2.68 ng/g, n= 40) compared to control subjects (median 5.64 ng/g, n=41), Mann-Whitney p=0.0002, and inversely correlated with Braak and Braak neuropathological disease stage (Spearman r= −0.38, p=0.0004). DHEA and pregnenolone are increased in patients with AD compared to control subjects. Patients carrying an APOE4 allele demonstrate reduced allopregnanolone levels in temporal cortex (Mann-Whitney p=0.04). Conclusions Neurosteroids are altered in temporal cortex in patients with AD and related to neuropathological disease stage. The APOE4 allele is associated with reduced allopregnanolone levels. Neurosteroids may be relevant to the neurobiology and therapeutics of AD. PMID:20488256

  4. 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.

  5. 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

  6. A cognitive intervention to enhance institutionalized older adults' social support networks and decrease loneliness.

    PubMed

    Winningham, R G; Pike, N L

    2007-11-01

    Nearly all older adults experience social losses, which can disrupt their social support networks and impair their quality of life. Events such as retirement, an inability to drive, death of a spouse and/or close life-long friends, or moving to an elder care facility may negatively affect the quality of older adults' social support networks. Low levels of perceived social support are associated with increased depression, impaired immune functioning and reduced life expectancy. Moreover, social interactions can be cognitively stimulating and may help older adults preserve their cognitive abilities. In the present study, institutionalized older adults were exposed to either a cognitive enhancement programme designed to enhance social networks or a control group. Measures of perceived social support and loneliness were administered before and after a 3-month, group-based intervention. There was a significant interaction between group and time. Those who did not participate in the intervention experienced a decrease in perceived social support and an increase in perceived loneliness. Participants in the intervention group stayed the same on the above measures. Helping older adults increase or maintain the quality of their social networks may lead to enhanced cognitive functioning, decreased depression and improved quality of life. Recommendations to help assisted living facilities, nursing homes, retirement communities and senior centres develop social and cognitive interventions are provided.

  7. The impact of sustained engagement on cognitive function in older adults: the Synapse Project.

    PubMed

    Park, Denise C; Lodi-Smith, Jennifer; Drew, Linda; Haber, Sara; Hebrank, Andrew; Bischof, Gérard N; Aamodt, Whitley

    2014-01-01

    In the research reported here, we tested the hypothesis that sustained engagement in learning new skills that activated working memory, episodic memory, and reasoning over a period of 3 months would enhance cognitive function in older adults. In three conditions with high cognitive demands, participants learned to quilt, learned digital photography, or engaged in both activities for an average of 16.51 hr a week for 3 months. Results at posttest indicated that episodic memory was enhanced in these productive-engagement conditions relative to receptive-engagement conditions, in which participants either engaged in nonintellectual activities with a social group or performed low-demand cognitive tasks with no social contact. The findings suggest that sustained engagement in cognitively demanding, novel activities enhances memory function in older adulthood, but, somewhat surprisingly, we found limited cognitive benefits of sustained engagement in social activities.

  8. 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.

  9. Identifying Mobility Types in Cognitively Heterogeneous Older Adults Based on GPS-Tracking: What Discriminates Best?

    PubMed

    Wettstein, Markus; Wahl, Hans-Werner; Shoval, Noam; Auslander, Gail; Oswald, Frank; Heinik, Jeremia

    2015-12-01

    Heterogeneity in older adults' mobility and its correlates have rarely been investigated based on objective mobility data and in samples including cognitively impaired individuals. We analyzed mobility profiles within a cognitively heterogeneous sample of N = 257 older adults from Israel and Germany based on GPS tracking technology. Participants were aged between 59 and 91 years (M = 72.9; SD = 6.4) and were either cognitively healthy (CH, n = 146), mildly cognitively impaired (MCI, n = 76), or diagnosed with an early-stage dementia of the Alzheimer's type (DAT, n = 35). Based on cluster analysis, we identified three mobility types ("Mobility restricted," "Outdoor oriented," "Walkers"), which could be predicted based on socio-demographic indicators, activity, health, and cognitive impairment status using discriminant analysis. Particularly demented individuals and persons with worse health exhibited restrictions in mobility. Our findings contribute to a better understanding of heterogeneity in mobility in old age.

  10. 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

  11. Changes in physical activity and cognitive decline in older adults living in the community.

    PubMed

    Lee, Yunhwan; Kim, Jinhee; Han, Eun Sook; Chae, Songi; Ryu, Mikyung; Ahn, Kwang Ho; Park, Eun Ju

    2015-01-01

    Accumulating evidence suggests that physical activity may be beneficial in preserving cognition in late life. This study examined the association between baseline and changes in physical activity and cognitive decline in community-dwelling older people. Data were from the Korean Longitudinal Study of Aging, with 2605 aged 65 years and older subjects interviewed in 2006 and followed up for 2 years. Cognitive decline was defined by calculating the Reliable Change Index using the Mini-Mental State Examination. Physical activity levels were categorized as sedentary, low, or high. Changes in physical activity were classified as inactive, decreaser, increaser, or active. Logistic regression analysis of baseline and changes in physical activity with cognitive decline was performed. Compared with the sedentary group at baseline, both the low and high activity groups were less likely to experience cognitive decline. The active (odds ratio [OR] = 0.40, 95 % confidence interval [CI] 0.23-0.68) and increaser (OR = 0.45, 95 % CI 0.27-0.74) group, compared with the inactive counterpart, demonstrated a significantly lower likelihood of cognitive decline. Older adults who remained active or increased activity over time had a reduced risk of cognitive decline. Engagement in physical activity in late life may have cognitive health benefits.

  12. The Impact of Desegregation on Cognition among Older African Americans.

    ERIC Educational Resources Information Center

    Whitfield, Keith E.; Wiggins, Sebrina A.

    2003-01-01

    Examined the influence of educational desegregation on cognitive performance. Data from African American adults who had attended desegregated (DS) versus segregated (SS) schools indicated that DS adults had significantly higher mean cognitive scores than SS adults. After controlling for age, gender, years of education, and years in desegregated…

  13. Cognitive basis about risk level classifications for the self-assessment of older drivers

    PubMed Central

    Choi, Seong Youl; Lee, Jae Shin

    2017-01-01

    [Purpose] This study analyzed the cognitive functions according to risk level for the Driver 65 Plus measure, and examined the cognitive basis of self-assessment for screening the driving risk of elderly drivers. [Subjects and Methods] A total of 46 older drivers with a driver’s license participated in this study. All participants were evaluated with Driver 65 Plus. They were classified into three groups of “safe,” “caution” and “stop,” and examined for cognitive functions with Trail Making Test and Montreal Cognitive Assessment-K. The cognitive test results of the three groups were compared. [Results] Trail Making Test-A, Trail Making Test-B, and Montreal Cognitive Assessment-K showed a significant difference between the three groups. The safe group showed significantly higher ability than the caution and stop groups in the three cognitive tests. In addition, cognitive functions of naming, attention, language, and delayed recall were significantly different between the three groups. [Conclusion] Self-assessment of older drivers is a useful tool for screening the cognitive aspects of driving risk. The cognitive functions, such as attention and recall, are the critical factors for screening the driving risk of elderly drivers. PMID:28356619

  14. 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

  15. Audiologic Management of Older Adults With Hearing Loss and Compromised Cognitive/Psychoacoustic Auditory Processing Capabilities

    PubMed Central

    Kricos, Patricia B.

    2006-01-01

    The number and proportion of older adults in the United States population is increasing, and more clinical audiologists will be called upon to deliver hearing care to the approximately 35% to 50% of them who experience hearing difficulties. In recent years, the characteristics and sources of receptive communication difficulties in older individuals have been investigated by hearing scientists, cognitive psychologists, and audiologists. It is becoming increasingly apparent that cognitive compromises and psychoacoustic auditory processing disorders associated with aging may contribute to communication difficulties in this population. This paper presents an overview of best practices, based on our current knowledge base, for clinical management of older individuals with limitations in cognitive or psychoacoustic auditory processing capabilities, or both, that accompany aging. PMID:16528428

  16. 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.

  17. Preventing Cognitive Decline in Older African Americans with Mild Cognitive Impairment: Design and Methods of a Randomized Clinical Trial

    PubMed Central

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

    2012-01-01

    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

  18. Youthful Processing Speed in Older Adults: Genetic, Biological, and Behavioral Predictors of Cognitive Processing Speed Trajectories in Aging

    PubMed Central

    Bott, Nicholas T.; Bettcher, Brianne M.; Yokoyama, Jennifer S.; Frazier, Darvis T.; Wynn, Matthew; Karydas, Anna; Yaffe, Kristine; Kramer, Joel H.

    2017-01-01

    Objective: To examine the impact of genetic, inflammatory, cardiovascular, lifestyle, and neuroanatomical factors on cognitive processing speed (CPS) change over time in functionally intact older adults. Methods: This observational study conducted over two time points, included 120 community dwelling cognitively normal older adults between the ages of 60 and 80 from the University of California San Francisco Memory and Aging Center. Participants were followed with composite measures of CPS, calculated based on norms for 20–30 year-olds. Variables of interest were AD risk genes (APOE, CR1), markers of inflammation (interleukin 6) and cardiovascular health (BMI, LDL, HDL, mean arterial pressure, fasting insulin), self-reported physical activity, and corpus callosum (CC) volumes. The sample was divided into three groups: 17 “resilient-agers” with fast and stable processing speed; 56 “average-agers” with average and stable processing speed; and 47 “sub-agers” with average baseline speed who were slower at follow-up. Results: Resilient-agers had larger baseline CC volumes than sub-agers (p < 0.05). Resilient-agers displayed lower levels of interleukin-6 (IL-6) and insulin (ps < 0.05) than sub-agers, and reported more physical activity than both average- and sub-agers (ps < 0.01). In a multinomial logistic regression, physical activity and IL-6 predicted average- and sub-ager groups. Resilient-agers displayed a higher frequency of APOE e4 and CR1 AA/AG alleles. Conclusion: Robust and stable CPS is associated with larger baseline CC volumes, lower levels of inflammation and insulin, and greater self-reported physical activity. These findings highlight the relevance of neuroanatomical, biological, and lifestyle factors in the identification and prediction of heterogeneous cognitive aging change over time. PMID:28344553

  19. Role of physical activity in reducing cognitive decline in older Mexican-American adults.

    PubMed

    Ottenbacher, Allison J; Snih, Soham Al; Bindawas, Saad M; Markides, Kyriakos S; Graham, James E; Samper-Ternent, Rafael; Raji, Mukaila; Ottenbacher, Kenneth J

    2014-09-01

    The effect of physical activity on cognitive function in older adults from minority and disadvantaged populations is not well understood. This study examined the longitudinal association between physical activity and cognition in older Mexican Americans. The study methodology included a prospective cohort with longitudinal analysis of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly. General linear mixed models were used to assess the associations and interactions between physical activity and cognitive function over 14 years. Community-based assessments were performed in participants' homes. Physical activity was recorded for 1,669 older Mexican Americans using the Physical Activity Scale for the Elderly. Cognition was measured using the Mini-Mental State Examination (MMSE) and separated into memory and nonmemory components. A statistically significant positive association was observed between levels of physical activity and cognitive function after adjusting for age, sex, marital status, education, and comorbid health conditions. There was a statistically significant difference in MMSE scores over time between participants in the third (β = 0.11, standard error (SE) = 0.05) and fourth (β = 0.10, SE = 0.2) quartiles of physical activity and those in the first. The protective effect of physical activity on cognitive decline was evident for the memory component of the MMSE but not the nonmemory component after adjusting for covariates. Greater physical activity at baseline was associated with less cognitive decline over 14 years in older Mexican Americans. The reduction in cognitive decline appeared to be related to the memory components of cognitive function.

  20. Effects of combined physical and cognitive training on fitness and neuropsychological outcomes in healthy older adults

    PubMed Central

    Desjardins-Crépeau, Laurence; Berryman, Nicolas; Fraser, Sarah A; Vu, Thien Tuong Minh; Kergoat, Marie-Jeanne; Li, Karen ZH; Bosquet, Laurent; Bherer, Louis

    2016-01-01

    Purpose Physical exercise and cognitive training have been shown to enhance cognition among older adults. However, few studies have looked at the potential synergetic effects of combining physical and cognitive training in a single study. Prior trials on combined training have led to interesting yet equivocal results. The aim of this study was to examine the effects of combined physical and cognitive interventions on physical fitness and neuropsychological performance in healthy older adults. Methods Seventy-six participants were randomly assigned to one of four training combinations using a 2×2 factorial design. The physical intervention was a mixed aerobic and resistance training program, and the cognitive intervention was a dual-task (DT) training program. Stretching and toning exercises and computer lessons were used as active control conditions. Physical and cognitive measures were collected pre- and postintervention. Results All groups showed equivalent improvements in measures of functional mobility. The aerobic–strength condition led to larger effect size in lower body strength, independently of cognitive training. All groups showed improved speed of processing and inhibition abilities, but only participants who took part in the DT training, independently of physical training, showed increased task-switching abilities. The level of functional mobility after intervention was significantly associated with task-switching abilities. Conclusion Combined training did not yield synergetic effects. However, DT training did lead to transfer effects on executive performance in neuropsychological tests. Both aerobic-resistance training and stretching-toning exercises can improve functional mobility in older adults. PMID:27698558

  1. 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

  2. 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

  3. Ten-Year Longitudinal Trajectories of Older Adults’ Basic and Everyday Cognitive Abilities

    PubMed Central

    Yam, Anna; Gross, Alden; Prindle, John; Marsiske, Michael

    2014-01-01

    Objective To examine the longitudinal trajectories of everyday cognition and longitudinal associations with basic (i.e., laboratory and experimentally measured) cognitive abilities, including verbal memory, inductive reasoning, visual processing speed, and vocabulary. Method Participants were healthy older adults drawn from the no-treatment control group (N = 698) of the ACTIVE randomized trial, and were assessed at baseline and 1, 2, 3, 5, and 10 years later. Analyses were conducted using latent growth models. Results Modeling revealed an overall inverted “U” shape (quadratic) trajectory across cognitive domains. Among basic cognitive predictors, level and slope in reasoning demonstrated the closest association to level and slope of everyday cognition, and accounted for most of the individual differences in linear gain in everyday cognition. Conclusions Everyday cognition is not buffered against decline, and is most closely related to inductive reasoning in healthy older adults. To establish the clinical utility of everyday cognitive measures, future research should examine these associations in samples with more cognitive impairment. PMID:24885451

  4. Neuromodulation as a cognitive enhancement strategy in healthy older adults: promises and pitfalls.

    PubMed

    Martins, Ana R S; Fregni, Felipe; Simis, Marcel; Almeida, Jorge

    2017-03-01

    Increases in life expectancy have been followed by an upsurge of age-associated cognitive decline. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have risen as promising approaches to prevent or delay such cognitive decline. However, consensus has not yet been reached about their efficacy in improving cognitive functioning in healthy older adults. Here we review the effects of TMS and tDCS on cognitive abilities in healthy older adults. Despite considerable variability in the targeted cognitive domains, design features and outcomes, the results generally show an enhancement or uniform benefit across studies. Most studies employed tDCS, suggesting that this technique is particularly well-suited for cognitive enhancement. Further work is required to determine the viability of these techniques as tools for long-term cognitive improvement. Importantly, the combination of TMS/tDCS with other cognitive enhancement strategies may be a promising strategy to alleviate the cognitive decline associated with the healthy aging process.

  5. Does caregiving stress affect cognitive function in older women?

    PubMed

    Lee, Sunmin; Kawachi, Ichiro; Grodstein, Francine

    2004-01-01

    Increasing numbers of women provide care to their ill spouses; however, no studies have examined possible effects of caregiving stress on cognitive function. We administered 6 tests of cognitive function to 13740 Nurses' Health Study participants aged 70-79 years. We collected information on caregiving and numerous potential confounding variables via biennial mailed questionnaires. After adjustment for potential confounders (age, education, mental health index, vitality index, use of antidepressants, and history of high blood pressure, diabetes, and heart disease), we found modest but significantly increased risks of low cognitive function on three of the cognitive tests among women who provided care to a disabled or ill spouse compared with women who did not provide any care. For example, on the TICS, a test of general cognition, the risk of a low score was 31% higher in women who provided care compared with women who did not (RR = 1.31, 95% CI 1.10, 1.56). We found a moderately increased risk of poor performance on several cognitive tests among women who provided care to their disabled or ill husbands.

  6. 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

  7. 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

  8. 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…

  9. 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.

  10. Periodic Limb Movements in Sleep are Associated with Greater Cognitive Decline in Older Men without Dementia

    PubMed Central

    Leng, Yue; Blackwell, Terri; Stone, Katie L.; Hoang, Tina D.; Redline, Susan; Yaffe, Kristine

    2016-01-01

    Study Objectives: To examine the association between periodic limb movements in sleep (PLMS) and change in selected aspects of cognition in community-dwelling older men. Methods: We studied 2,636 older men without dementia who underwent in-home polysomnography with measurement of the periodic limb movement index (PLMI) and periodic limb movement arousal index (PLMAI) using piezoelectric sensors. Random-effects models and logistic regression were used to examine the association between PLMI, PLMAI, and 3- to 4-y change in cognition. Results: After multivariable adjustment, men with a high PLMI had greater decline on the Trail Making Test – Part B (P trend = 0.02); those with a PLMI ≥ 30 were 48% more likely (odds ratio = 1.48, 95% confidence interval = 1.05–2.07) to experience the development of significant cognitive impairment (≥ 1 SD above mean change). Further adjustment for sleep efficiency, nocturnal hypoxemia, or dopaminergic medication use and analysis among men without Parkinson disease (n = 2,607) showed similar findings. No significant association was found for PLMAI or for Modified Mini-Mental State Examination scores. Conclusions: Among older men without dementia, higher PLMS frequency was associated with greater decline in cognition, particularly in executive function. Citation: Leng Y, Blackwell T, Stone KL, Hoang TD, Redline S, Yaffe K. Periodic limb movements in sleep are associated with greater cognitive decline in older men without dementia. SLEEP 2016;39(10):1807–1810. PMID:27568800

  11. Can training in a real-time strategy video game attenuate cognitive decline in older adults?

    PubMed

    Basak, Chandramallika; Boot, Walter R; Voss, Michelle W; Kramer, Arthur F

    2008-12-01

    Declines in various cognitive abilities, particularly executive control functions, are observed in older adults. An important goal of cognitive training is to slow or reverse these age-related declines. However, opinion is divided in the literature regarding whether cognitive training can engender transfer to a variety of cognitive skills in older adults. In the current study, the authors trained older adults in a real-time strategy video game for 23.5 hr in an effort to improve their executive functions. A battery of cognitive tasks, including tasks of executive control and visuospatial skills, were assessed before, during, and after video-game training. The trainees improved significantly in the measures of game performance. They also improved significantly more than the control participants in executive control functions, such as task switching, working memory, visual short-term memory, and reasoning. Individual differences in changes in game performance were correlated with improvements in task switching. The study has implications for the enhancement of executive control processes of older adults.

  12. 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

  13. Higher brain BDNF gene expression is associated with slower cognitive decline in older adults

    PubMed Central

    Yu, Lei; Boyle, Patricia A.; Schneider, Julie A.; De Jager, Philip L.; Bennett, David A.

    2016-01-01

    Objectives: We tested whether brain-derived neurotrophic factor (BDNF) gene expression levels are associated with cognitive decline in older adults. Methods: Five hundred thirty-five older participants underwent annual cognitive assessments and brain autopsy at death. BDNF gene expression was measured in the dorsolateral prefrontal cortex. Linear mixed models were used to examine whether BDNF expression was associated with cognitive decline adjusting for age, sex, and education. An interaction term was added to determine whether this association varied with clinical diagnosis proximate to death (no cognitive impairment, mild cognitive impairment, or dementia). Finally, we examined the extent to which the association of Alzheimer disease (AD) pathology with cognitive decline varied by BDNF expression. Results: Higher brain BDNF expression was associated with slower cognitive decline (p < 0.001); cognitive decline was about 50% slower with the 90th percentile BDNF expression vs 10th. This association was strongest in individuals with dementia. The level of BDNF expression was lower in individuals with pathologic AD (p = 0.006), but was not associated with macroscopic infarcts, Lewy body disease, or hippocampal sclerosis. BDNF expression remained associated with cognitive decline in a model adjusting for age, sex, education, and neuropathologies (p < 0.001). Furthermore, the effect of AD pathology on cognitive decline varied by BDNF expression such that the effect was strongest for high levels of AD pathology (p = 0.015); thus, in individuals with high AD pathology (90th percentile), cognitive decline was about 40% slower with the 90th percentile BDNF expression vs 10th. Conclusions: Higher brain BDNF expression is associated with slower cognitive decline and may also reduce the deleterious effects of AD pathology on cognitive decline. PMID:26819457

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

    PubMed

    Satterfield, Jason M; Crabb, Rebecca

    2010-02-01

    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.

  15. An Acute Bout of Exercise Improves the Cognitive Performance of Older Adults.

    PubMed

    Johnson, Liam; Addamo, Patricia K; Selva Raj, Isaac; Borkoles, Erika; Wyckelsma, Victoria; Cyarto, Elizabeth; Polman, Remco C

    2016-10-01

    There is evidence that an acute bout of exercise confers cognitive benefits, but it is largely unknown what the optimal mode and duration of exercise is and how cognitive performance changes over time after exercise. We compared the cognitive performance of 31 older adults using the Stroop test before, immediately after, and at 30 and 60 min after a 10 and 30 min aerobic or resistance exercise session. Heart rate and feelings of arousal were also measured before, during, and after exercise. We found that, independent of mode or duration of exercise, the participants improved in the Stroop Inhibition task immediately postexercise. We did not find that exercise influenced the performance of the Stroop Color or Stroop Word Interference tasks. Our findings suggest that an acute bout of exercise can improve cognitive performance and, in particular, the more complex executive functioning of older adults.

  16. 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.

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

    PubMed Central

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

    2016-01-01

    The physiologically active form of vitamin D, 1,25-dihydroxyvitamin D3, is a fat-soluble steroid hormone with a well established role in skeletal health. A growing body of evidence suggests that low vitamin D levels also play a role in the pathogenesis of a wide range of non-skeletal age-associated diseases such as cancer, heart disease, type 2 diabetes and stroke. Low serum 25-hydroxyvitamin D (25(OH)D) levels, a stable marker of vitamin D status, are also associated with increased odds of prevalent cognitive dysfunction, Alzheimer’s 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. So far the majority of human studies reporting associations between vitamin D and cognition or dementia have been cross-sectional or case-control designs that are unable 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 1.60, 95% CI 1.2-2.0) in elderly Italian adults who are severely deficient (<25 nmol/L) when compared them with those sufficient (>75 nmol/L). Similarly the odds of cognitive decline were 41% higher (odds ratio 1.41, 95% CI 0.9-2.2) when elderly US men in the lowest quartile (<50 nmol/L) were compared with those in the highest quartile (>74 nmol/L). To our knowledge no prospective studies have examined the association between 25(OH)D levels and incident dementia or neuroimaging abnormalities. The possible therapeutic benefits of

  18. Association between tooth loss and cognitive decline: A 13-year longitudinal study of Chinese older adults

    PubMed Central

    Li, Juan; Xu, Hanzhang; Pan, Wei; Wu, Bei

    2017-01-01

    Objectives To examine the association between the number of teeth remaining and cognitive decline among Chinese older adults over a 13-year period. Design A large national longitudinal survey of Chinese older adults Setting The Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998–2011). Participants A total of 8,153 eligible participants aged 60+ interviewed in up to six waves. Measurements Cognitive function and teeth number were measured at each interview. Cognitive function was measured by the Mini-Mental Status Examination (MMSE). Number of natural teeth was self-reported. Individuals with severe cognitive impairment were excluded. Covariates included demographic characteristics, adult socioeconomic status characteristics, childhood socioeconomic status, health conditions, and health behaviors. Linear mixed models were applied in the analysis. Results The mean teeth number at baseline was 17.5(SD = 0.1), and the mean of baseline cognitive function was 27.3(SD = 0.0). Cognitive function declined over time (β = -0.19, P < .001) after controlling covariates. But, regardless of time, more teeth were associated with better cognitive function (β = 0.01, P < .001). The interaction of teeth number and time was significant (β = 0.01, P < .001), suggesting that the participants who had more teeth showed a slower pace of cognitive decline over time than those with fewer teeth after controlling for other covariates. Conclusion This study showed that tooth loss was associated with cognitive decline among Chinese older adults. Further studies are needed to examine the linkages between cognitive decline and oral health status using clinical examination data. PMID:28158261

  19. Frontal-posterior coherence and cognitive function in older adults.

    PubMed

    Fleck, Jessica I; Kuti, Julia; Brown, Jessica; Mahon, Jessica R; Gayda-Chelder, Christine

    2016-12-01

    The reliable measurement of brain health and cognitive function is essential in mitigating the negative effects associated with cognitive decline through early and accurate diagnosis of change. The present research explored the relationship between EEG coherence for electrodes within frontal and posterior regions, as well as coherence between frontal and posterior electrodes and performance on standard neuropsychological measures of memory and executive function. EEG coherence for eyes-closed resting-state EEG activity was calculated for delta, theta, alpha, beta, and gamma frequency bands. Participants (N=66; mean age=67.15years) had their resting-state EEGs recorded and completed a neuropsychological battery that assessed memory and executive function, two cognitive domains that are significantly affected during aging. A positive relationship was observed between coherence within the frontal region and performance on measures of memory and executive function for delta and beta frequency bands. In addition, an inverse relationship was observed for coherence between frontal and posterior electrode pairs, particularly within the theta frequency band, and performance on Digit Span Sequencing, a measure of working memory. The present research supports a more substantial link between EEG coherence, rather than spectral power, and cognitive function. Continued study in this area may enable EEG to be applied broadly as a diagnostic measure of cognitive ability.

  20. 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

  1. 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

  2. Are Older Adults Less Embodied? A Review of Age Effects through the Lens of Embodied Cognition

    PubMed Central

    Costello, Matthew C.; Bloesch, Emily K.

    2017-01-01

    Embodied cognition is a theoretical framework which posits that cognitive function is intimately intertwined with the body and physical actions. Although the field of psychology is increasingly accepting embodied cognition as a viable theory, it has rarely been employed in the gerontological literature. However, embodied cognition would appear to have explanatory power for aging research given that older adults typically manifest concurrent physical and mental changes, and that research has indicated a correlative relationship between such changes. The current paper reviews age-related changes in sensory processing, mental representation, and the action-perception relationship, exploring how each can be understood through the lens of embodied cognition. Compared to younger adults, older adults exhibit across all three domains an increased tendency to favor visual processing over bodily factors, leading to the conclusion that older adults are less embodied than young adults. We explore the significance of this finding in light of existing theoretical models of aging and argue that embodied cognition can benefit gerontological research by identifying further factors that can explain the cause of age-related declines. PMID:28289397

  3. Screening of Cognitive Function and Hearing Impairment in Older Adults: A Preliminary Study

    PubMed Central

    Wong, Lena Lar Nar; Yu, Joannie Ka Yin; Chan, Shaina Shing; Tong, Michael Chi Fai

    2014-01-01

    Background. Previous research has found that hearing loss is associated with poorer cognitive function. The question is that when a hearing impairment is being compensated for by appropriately fitted monaural hearing aids, special precautions are still needed when screening cognitive function in older adults. Objective. This research examined cognitive function in elderly hearing aid users who used monaural hearing aids and whether the presence of a hearing impairment should be accounted for when screening cognitive function in these individuals. Methods. Auditory thresholds, sentence reception thresholds, and self-reported outcomes with hearing aids were measured in 34 older hearing aid users to ensure hearing aids were appropriately fitted. Mini-Mental State Examination (MMSE) results obtained in these participants were then compared to normative data obtained in a general older population exhibiting similar demographic characteristics. Stepwise multiple regression analyses were used to examine the effects of demographic and auditory variables on MMSE scores. Conclusions. Results showed that, even with appropriately fitted hearing aids, cognitive decline was significant. Besides the factors commonly measured in the literature, we believed that auditory deprivation was not being fully compensated for by hearing aids. Most importantly, screening of cognitive function should take into account the effects of hearing impairment, even when hearing devices have been appropriately fitted. PMID:25140321

  4. Mobility and Upright Posture Are Associated with Different Aspects of Cognition in Older Adults

    PubMed Central

    Cohen, Rajal G.; Vasavada, Anita N.; Wiest, Michelle M.; Schmitter-Edgecombe, Maureen

    2016-01-01

    Objectives: Aging is associated with cognitive decline, including visuomotor and memory concerns, and with motor system changes, including gait slowing and stooped posture. We investigated the associations of visuomotor performance and episodic memory with motor system characteristics in healthy older adults. Methods: Neurologically healthy older adults (N = 160, aged 50–89) completed a battery of cognitive and motor tasks. Cognitive variables were grouped by principal components analysis (PCA) into two components: visuomotor performance and verbal episodic memory. Our primary predictor variables were two aspects of motor function: timed-up-and-go (TUG) speed and neck angle. Additional predictor variables included demographic factors (age, sex and education) and indicators of physical fitness (body mass index/BMI and grip strength). All seven predictor variables were entered stepwise into a multiple regression model for each cognitive component. Results: Poor visuomotor performance was best predicted by a combination of advanced age, high BMI and slow TUG, whereas poor verbal memory performance was best predicted by a combination of advanced age, male sex, low education and acute neck angle. Conclusions: Upright posture and mobility were associated with different cognitive processes, suggesting different underlying neural mechanisms. These results provide the first evidence for a link between postural alignment and cognitive functioning in healthy older adults. Possible causal relationships are discussed. PMID:27877123

  5. Older patients undergoing dialysis treatment: cognitive functioning, depressive mood and health-related quality of life.

    PubMed

    Tyrrell, J; Paturel, L; Cadec, B; Capezzali, E; Poussin, G

    2005-07-01

    An increasing number of older patients receive dialysis treatment to compensate for deficient kidneys due to end-stage renal disease (ESRD). Ethical questions arise about the benefits of dialysis when a patient appears unwilling or unable to comply with this treatment procedure. Such attitudes and behaviour may be due to psychological factors, but these are not routinely assessed. The purpose of this study was to evaluate levels of cognitive impairment, depressive mood and self-reported quality of life in older dialysis patients (>70 years). A total of 51 outpatients receiving dialysis were assessed by psychologists, using a depression scale (MADRS), two cognitive tests (MMSE and BEC 96), and a quality of life questionnaire (NHP). Sixty percent of the patients were depressed, and between 30-47% had cognitive impairment. Almost half of the depressed patients were also cognitively impaired. The scores for self-reported quality of life varied widely within the sample. Cognitive impairment and depressive mood are often overlooked and underestimated in this population. Regular assessments of depressive mood, cognitive ability and quality of life are recommended, given the prevalence of problems in these domains for older dialysis patients. The information obtained should assist staff as they reflect on individual cases where the benefits of continuing treatment are being examined.

  6. Senior Dance Experience, Cognitive Performance, and Brain Volume in Older Women

    PubMed Central

    Niemann, Claudia; Godde, Ben

    2016-01-01

    Physical activity is positively related to cognitive functioning and brain volume in older adults. Interestingly, different types of physical activity vary in their effects on cognition and on the brain. For example, dancing has become an interesting topic in aging research, as it is a popular leisure activity among older adults, involving cardiovascular and motor fitness dimensions that can be positively related to cognition. However, studies on brain structure are missing. In this study, we tested the association of long-term senior dance experience with cognitive performance and gray matter brain volume in older women aged 65 to 82 years. We compared nonprofessional senior dancers (n = 28) with nonsedentary control group participants without any dancing experience (n = 29), who were similar in age, education, IQ score, lifestyle and health factors, and fitness level. Differences neither in the four tested cognitive domains (executive control, perceptual speed, episodic memory, and long-term memory) nor in brain volume (VBM whole-brain analysis, region-of-interest analysis of the hippocampus) were observed. Results indicate that moderate dancing activity (1-2 times per week, on average) has no additional effects on gray matter volume and cognitive functioning when a certain lifestyle or physical activity and fitness level are reached. PMID:27738528

  7. Senior Dance Experience, Cognitive Performance, and Brain Volume in Older Women.

    PubMed

    Niemann, Claudia; Godde, Ben; Voelcker-Rehage, Claudia

    2016-01-01

    Physical activity is positively related to cognitive functioning and brain volume in older adults. Interestingly, different types of physical activity vary in their effects on cognition and on the brain. For example, dancing has become an interesting topic in aging research, as it is a popular leisure activity among older adults, involving cardiovascular and motor fitness dimensions that can be positively related to cognition. However, studies on brain structure are missing. In this study, we tested the association of long-term senior dance experience with cognitive performance and gray matter brain volume in older women aged 65 to 82 years. We compared nonprofessional senior dancers (n = 28) with nonsedentary control group participants without any dancing experience (n = 29), who were similar in age, education, IQ score, lifestyle and health factors, and fitness level. Differences neither in the four tested cognitive domains (executive control, perceptual speed, episodic memory, and long-term memory) nor in brain volume (VBM whole-brain analysis, region-of-interest analysis of the hippocampus) were observed. Results indicate that moderate dancing activity (1-2 times per week, on average) has no additional effects on gray matter volume and cognitive functioning when a certain lifestyle or physical activity and fitness level are reached.

  8. 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

  9. Lifestyle Engagement Affects Cognitive Status Differences and Trajectories on Executive Functions in Older Adults

    PubMed Central

    de Frias, Cindy M.; Dixon, Roger A.

    2014-01-01

    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

  10. Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review.

    PubMed

    Mowszowski, L; Lampit, A; Walton, C C; Naismith, S L

    2016-09-01

    Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges' g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.

  11. 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…

  12. Association between Dietary Sodium Intake and Cognitive Function in Older Adults

    PubMed Central

    Rush, Toni M; Kritz-Silverstein, Donna; Laughlin, Gail A; Fung, Teresa T; Barrett-Connor, Elizabeth L; McEvoy, Linda K

    2016-01-01

    OBJECTIVES To examine the association of dietary sodium intake with cognitive function in community-dwelling older adults. DESIGN Cross-sectional study SETTING Southern California community PARTICIPANTS White men (n=373) and women (n=552), aged 50–96 years from the Rancho Bernardo Study, a longitudinal study of cardiovascular disease risk factors and healthy aging. MEASUREMENTS During the 1992–1996 research clinic visit, a food frequency questionnaire was used to determine daily sodium intake; cognitive function was assessed with Trails Making Test, part B (Trails B), Mini-Mental State Exam (MMSE), and Verbal Fluency Test (VFT); and medical, clinical and demographic information was obtained. Linear regression was used to assess the association between calorie-adjusted sodium intake and cognitive test scores with adjustment for demographic, behavioral and health measures. Logistic regression examined the odds of having cognitive impairment by sodium intake. RESULTS Lower sodium intake was associated with poorer performance on Trails B (p=0.008) and MMSE (p=0.003) after controlling for age, sex, and education. Associations did not differ by sex, but there was a significant interaction by age for the Trails B: older (≥80 years), but not younger, adults showed worse performance with lower sodium intake (p=0.03). Associations remained significant after additional adjustment for smoking, alcohol intake, exercise, body weight, cardiovascular risk factors, kidney function, diuretic medication use, and diet quality. Lower daily sodium intake was associated with increased odds of cognitive impairment on the MMSE (score < 26; OR per SD decrease = 1.12, 95% CI 1.08, 1.16). CONCLUSION Lower sodium intake was associated with worse cognitive function in older community-dwelling adults. For the maintenance of cognitive health, older adults may be advised to avoid very low sodium diets. PMID:28244567

  13. 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

  14. 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…

  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. 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.…

  17. Older Adults' Strategic Behavior: Effects of Individual versus Collaborative Cognitive Training

    ERIC Educational Resources Information Center

    Saczynski, Jane; Margrett, Jennifer; Willis, Sherry

    2004-01-01

    Changes in strategic behavior were examined in older married couples participating in a cognitive intervention study. Participants were randomly assigned to: Questionnaire Control, Individual Training, or Collaborative Training. Trained participants completed inductive reasoning training sessions at home individually or as a couple. Participants…

  18. Older Adults Strategic Behavior: Effects of Individual Versus Collaborative Cognitive Training

    ERIC Educational Resources Information Center

    Saczynski, Jane; Margrett, Jennifer; Willis, Sherry

    2004-01-01

    Changes in strategic behavior were examined in older married couples participating in a cognitive intervention study. Participants were randomly assigned to: Questionnaire Control, Individual Training, or Collaborative Training. Trained participants completed inductive reasoning training sessions at home individually or as a couple. Participants…

  19. Feasibility and Acceptability of Smartphone Assessment in Older Adults with Cognitive and Emotional Difficulties

    PubMed Central

    Ramsey, Alex T.; Wetherell, Julie Loebach; Depp, Colin; Dixon, David; Lenze, Eric

    2016-01-01

    Objectives Ecological momentary assessment (EMA) has several advantages in clinical research yet little is known about the feasibility of collecting EMA data with mobile technologies in older adults, particularly those with emotional or cognitive difficulties. The aim of this feasibility study was to assess perceived acceptability, adherence rates, and reasons for non-adherence to smartphone-based EMA. Method At two sites, participants (n=103) aged 65 years or older with a DSM-IV-defined anxiety or depressive disorder and cognitive concerns responded three times daily to smartphone-based EMA questions assessing clinical outcomes for two 10-day periods. Quantitative and qualitative measures assessed acceptability, adherence, and reasons for non-adherence following both 10-day EMA periods. Results Participants were moderately satisfied with and comfortable using smartphone-based EMA. Overall, 76% of participants completed surveys on ≥10 of the 20 assessment days, and 70% of participants completed at least 30% of the total surveys. Reasons for non-adherence included technical (malfunction), logistical (competing demands), physiological (hearing difficulties), and cognitive (forgetting) issues. Discussion Smartphone-based EMA is feasible in older adults with cognitive and emotional difficulties. EMA tools should be responsive to the needs and preferences of participants to ensure adequate acceptability and adherence in this population. Our findings can inform the design, development, and implementation of mobile technologies in older adults in research and clinical contexts. PMID:27683018

  20. Dietary strawberry improves cognition in older adults: a randomized, double-blind, placebo-controlled study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Older adults experience a variety of functional changes that decrease their quality of life with age-related cognitive decline and reduced mobility being of particular concern. Pre-clinical research indicates that berry fruit offer a promising dietary approach to preserving nervous system function, ...

  1. 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.…

  2. 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,…

  3. 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…

  4. 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…

  5. 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…

  6. Digital Technology and Caregiver Training for Older Persons: Cognitive and Affective Perspectives

    ERIC Educational Resources Information Center

    Zheng, Robert; Hicken, Bret L.; Hill, Robert D.; Luptak, Marilyn; Daniel, Candice M.; Grant, Marren; Rupper, Randall

    2016-01-01

    This research project included two studies that investigated (a) differences between technology use in tech-knowledgeable and less tech-knowledgeable older persons, (b) cognitive and affective variables and their association with the application of technology, and (c) the implications of these variables on the design of remote-delivered caregiver…

  7. 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

  8. 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

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

    PubMed

    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.

  10. Considerations of informed consent and decision-making competence in older adults with cognitive impairment.

    PubMed

    Mayo, Ann M; Wallhagen, Margaret I

    2009-04-01

    Including older adults with cognitive impairment in research studies is necessary to ensure that interventions designed to improve care are effective for all older adults. However, issues related to capacity to consent raise many difficult questions that nurse researchers must address. Protecting vulnerable participants while simultaneously maintaining autonomy and moving important research forward can be challenging. Assessing the decision-making abilities of understanding, appreciation, reasoning, and expressing a choice is an important aspect of determining decision-making capacity. Yet although this is the prominent rational method for judging decision-making competence, it does not take into consideration the importance of culture, values, and emotions. This article focuses on the assessment of decision-making capacity to consent, recommendations for obtaining informed consent in older adults with cognitive impairment, the use of surrogate decision makers, strategies to maximize research participation, and directions for future research.

  11. Evaluation of a Digital Companion for Older Adults with Mild Cognitive Impairment

    PubMed Central

    Demiris, George; Thompson, Hilaire J.; Lazar, Amanda; Lin, Shih-Yin

    2016-01-01

    Study Objective: The purpose of this study was to examine the feasibility of a digital companion system used by older adults with mild cognitive impairment (MCI). We utilized a commercially available system that is comprehensive in its functionalities (including conversation ability, use of pictures and other media, and reminders) to explore the system’s impact on older adults ‘ social interactions, anxiety, depressive symptoms, and acceptance of the system. Study Design: We conducted a three-month mixed methods evaluation study of the digital companion. Results: Ten female community-dwelling older adults (average age 78.3 years) participated in the study. Overall, participants utilized the tool regularly and appreciated its presence and their interactions. Participants scored higher at the end of the study in cognition and social support scales, and lower in presence of depressive symptoms. Conclusion: Findings indicate the feasibility of a digital companion for people with MCI and inform the need for additional research. PMID:28269845

  12. 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

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

    PubMed

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

    2013-06-01

    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 an auditory-cognitive system has emerged, recognizing the need to consider the processing of complex sounds in the context of dynamic neural circuits. Here, we used structural equation modeling to evaluate the interacting contributions of peripheral hearing, central processing, cognitive ability, and life experiences to understanding speech in noise. We recruited 120 older adults (ages 55-79) 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.

  14. 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.

  15. The association between aerobic fitness and cognitive function in older men mediated by frontal lateralization.

    PubMed

    Hyodo, Kazuki; Dan, Ippeita; Kyutoku, Yasushi; Suwabe, Kazuya; Byun, Kyeongho; Ochi, Genta; Kato, Morimasa; Soya, Hideaki

    2016-01-15

    Previous studies have shown that higher aerobic fitness is related to higher cognitive function and higher task-related prefrontal activation in older adults. However, a holistic picture of these factors has yet to be presented. As a typical age-related change of brain activation, less lateralized activity in the prefrontal cortex during cognitive tasks has been observed in various neuroimaging studies. Thus, this study aimed to reveal the relationship between aerobic fitness, cognitive function, and frontal lateralization. Sixty male older adults each performed a submaximal incremental exercise test to determine their oxygen intake (V·O2) at ventilatory threshold (VT) in order to index their aerobic fitness. They performed a color-word Stroop task while prefrontal activation was monitored using functional near infrared spectroscopy. As an index of cognitive function, Stroop interference time was analyzed. Partial correlation analyses revealed significant correlations among higher VT, shorter Stroop interference time and greater left-lateralized dorsolateral prefrontal cortex (DLPFC) activation when adjusting for education. Moreover, mediation analyses showed that left-lateralized DLPFC activation significantly mediated the association between VT and Stroop interference time. These results suggest that higher aerobic fitness is associated with cognitive function via lateralized frontal activation in older adults.

  16. 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.

  17. Acute effects of aerobic exercise on cognitive function in older adults.

    PubMed

    Kamijo, Keita; Hayashi, Yoichi; Sakai, Tomoaki; Yahiro, Tatsuhisa; Tanaka, Kiyoji; Nishihira, Yoshiaki

    2009-05-01

    The present study investigated the effects of acute aerobic exercise on cognitive brain functions of older adults. Twenty-four males (12 older and 12 younger adults) performed a modified flanker task during a baseline session (no exercise) and after light and moderate cycling exercise in counterbalanced order on different days while measures of task performance and the P3 component of an event-related brain potential were collected. The results indicated that, for both age groups, reaction time following moderate exercise was shorter relative to the other sessions, and P3 latencies following both light and moderate exercise were shorter compared with the baseline session. In contrast, P3 amplitude increased only following moderate exercise in younger adults. These findings suggest that light and moderate exercises improve cognitive function across the adult lifespan, although the mechanisms underlying the effects of observed acute aerobic exercise on cognitive function may be age dependent.

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

    PubMed Central

    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

  19. Predicting Cognitive Function from Clinical Measures of Physical Function and Health Status in Older Adults

    PubMed Central

    Bolandzadeh, Niousha; Kording, Konrad; Salowitz, Nicole; Davis, Jennifer C.; Hsu, Liang; Chan, Alison; Sharma, Devika; Blohm, Gunnar; Liu-Ambrose, Teresa

    2015-01-01

    Introduction Current research suggests that the neuropathology of dementia—including brain changes leading to memory impairment and cognitive decline—is evident years before the onset of this disease. Older adults with cognitive decline have reduced functional independence and quality of life, and are at greater risk for developing dementia. Therefore, identifying biomarkers that can be easily assessed within the clinical setting and predict cognitive decline is important. Early recognition of cognitive decline could promote timely implementation of preventive strategies. Methods We included 89 community-dwelling adults aged 70 years and older in our study, and collected 32 measures of physical function, health status and cognitive function at baseline. We utilized an L1–L2 regularized regression model (elastic net) to identify which of the 32 baseline measures were strongly predictive of cognitive function after one year. We built three linear regression models: 1) based on baseline cognitive function, 2) based on variables consistently selected in every cross-validation loop, and 3) a full model based on all the 32 variables. Each of these models was carefully tested with nested cross-validation. Results Our model with the six variables consistently selected in every cross-validation loop had a mean squared prediction error of 7.47. This number was smaller than that of the full model (115.33) and the model with baseline cognitive function (7.98). Our model explained 47% of the variance in cognitive function after one year. Discussion We built a parsimonious model based on a selected set of six physical function and health status measures strongly predictive of cognitive function after one year. In addition to reducing the complexity of the model without changing the model significantly, our model with the top variables improved the mean prediction error and R-squared. These six physical function and health status measures can be easily implemented in a

  20. Regular Latin Dancing and Health Education may Improve Cognition of Late Middle-Aged and Older Latinos.

    PubMed

    Marquez, David X; Wilson, Robert; Aguiñaga, Susan; Vásquez, Priscilla; Fogg, Louis; Yang, Zhi; Wilbur, JoEllen; Hughes, Susan; Spanbauer, Charles

    2017-01-17

    Disparities exist between Latinos and non-Latino whites in cognitive function. Dance is culturally appropriate and challenges individuals physically and cognitively, yet the impact of regular dancing on cognitive function in older Latinos has not been examined. A two-group pilot trial was employed among inactive, older Latinos. Participants (N = 57) participated in the BAILAMOS(©) dance program or a health education program. Cognitive test scores were converted to z-scores and measures of global cognition and specific domains (executive function, episodic memory, working memory) were derived. Results revealed a group x time interaction for episodic memory (p<0.05), such that the dance group showed greater improvement in episodic memory than the health education group. A main effect for time for global cognition (p<0.05) was also demonstrated, with participants in both groups improving. Structured Latin dance programs can positively influence episodic memory; and participation in structured programs may improve overall cognition among older Latinos.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. Cognitive training research on fluid intelligence in old age: what can older adults achieve by themselves?

    PubMed

    Baltes, P B; Sowarka, D; Kliegl, R

    1989-06-01

    Cognitive research on the plasticity of fluid intelligence has demonstrated that older adults benefit markedly from guided practice in cognitive skills and problem-solving strategies. We examined to what degree older adults are capable by themselves of achieving similar practice gains, focusing on the fluid ability of figural relations. A sample of 72 healthy older adults was assigned randomly to three conditions: control, tutor-guided training, self-guided training. Training time and training materials were held constant for the two training conditions. Posttraining performances were analyzed using a transfer of training paradigm in terms of three indicators: correct responses, accuracy, and level of item difficulty. The training programs were effective and produced a significant but narrow band of within-ability transfer. However, there was no difference between the two training groups. Older adults were shown to be capable of producing gains by themselves that were comparable to those obtained following tutor-guided training in the nature of test-relevant cognitive skills.

  6. 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

  7. Pain and Cognitive Function Among Older Adults Living in the Community

    PubMed Central

    van der Leeuw, Guusje; Eggermont, Laura H. P.; Shi, Ling; Milberg, William P.; Gross, Alden L.; Hausdorff, Jeffrey M.; Bean, Jonathan F.

    2016-01-01

    Background. Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. Methods. We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. Results. Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. Conclusions. Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults. PMID:26433218

  8. 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…

  9. Early post-surgical cognitive dysfunction is a risk factor for mortality among hip fracture hospitalized older persons.

    PubMed

    Ruggiero, C; Bonamassa, L; Pelini, L; Prioletta, I; Cianferotti, L; Metozzi, A; Benvenuti, E; Brandi, G; Guazzini, A; Santoro, G C; Mecocci, P; Black, D; Brandi, M L

    2017-02-01

    This study investigates the relationship between cognitive dysfunction or delirium detected in the early post-surgical phase and the 1-year mortality among 514 hip fracture hospitalized older persons. Patients with early cognitive dysfunction or delirium experienced a 2-fold increased mortality risk. Early post-operative cognitive dysfunction and delirium are negative prognostic factors for mortality.

  10. Comparison of Cognitive Change after Working Memory Training and Logic and Planning Training in Healthy Older Adults

    PubMed Central

    Goghari, Vina M.; Lawlor-Savage, Linette

    2017-01-01

    Recent attention has focused on the benefits of cognitive training in healthy adults. Many commercial cognitive training programs are available given the attraction of not only bettering one’s cognitive capacity, but also potentially preventing age-related declines, which is of particular interest to older adults. The issue of whether cognitive training can improve performance within cognitive domains not trained (i.e., far transfer) is controversial, with meta-analyses of cognitive training both supporting and falsifying this claim. More support is present for the near transfer (i.e., transfer in cognitive domain trained) of cognitive training; however, not in all studies. To date, no studies have compared working memory training to training higher-level processes themselves, namely logic and planning. We studied 97 healthy older adults above the age of 65. Healthy older adults completed either an 8-week web-based cognitive training program on working memory or logic and planning. An additional no-training control group completed two assessments 8-weeks apart. Participants were assessed on cognitive measures of near and far transfer, including working memory, planning, reasoning, processing speed, verbal fluency, cognitive flexibility, and creativity. Participants improved on the trained tasks from the first day to last day of training. Bayesian analyses demonstrated no near or far transfer effects after cognitive training. These results support the conclusion that performance-adaptive computerized cognitive training may not enhance cognition in healthy older adults. Our lack of findings could be due to a variety of reasons, including studying a cohort of healthy older adults that were performing near their cognitive ceiling, employing a training protocol that was not sufficient to produce a change, or that no true findings exist. Research suggests numerous study factors that can moderate the results. In addition, the role of psychological variables, such as

  11. Comparison of Cognitive Change after Working Memory Training and Logic and Planning Training in Healthy Older Adults.

    PubMed

    Goghari, Vina M; Lawlor-Savage, Linette

    2017-01-01

    Recent attention has focused on the benefits of cognitive training in healthy adults. Many commercial cognitive training programs are available given the attraction of not only bettering one's cognitive capacity, but also potentially preventing age-related declines, which is of particular interest to older adults. The issue of whether cognitive training can improve performance within cognitive domains not trained (i.e., far transfer) is controversial, with meta-analyses of cognitive training both supporting and falsifying this claim. More support is present for the near transfer (i.e., transfer in cognitive domain trained) of cognitive training; however, not in all studies. To date, no studies have compared working memory training to training higher-level processes themselves, namely logic and planning. We studied 97 healthy older adults above the age of 65. Healthy older adults completed either an 8-week web-based cognitive training program on working memory or logic and planning. An additional no-training control group completed two assessments 8-weeks apart. Participants were assessed on cognitive measures of near and far transfer, including working memory, planning, reasoning, processing speed, verbal fluency, cognitive flexibility, and creativity. Participants improved on the trained tasks from the first day to last day of training. Bayesian analyses demonstrated no near or far transfer effects after cognitive training. These results support the conclusion that performance-adaptive computerized cognitive training may not enhance cognition in healthy older adults. Our lack of findings could be due to a variety of reasons, including studying a cohort of healthy older adults that were performing near their cognitive ceiling, employing a training protocol that was not sufficient to produce a change, or that no true findings exist. Research suggests numerous study factors that can moderate the results. In addition, the role of psychological variables, such as

  12. Association of Objectively Measured Physical Activity with Cognitive Function in Older Adults - The REGARDS Study

    PubMed Central

    Zhu, Wenfei; Howard, Virginia J.; Wadley, Virginia G.; Hutto, Brent; Blair, Steven N.; Vena, John E.; Colabianchi, Natalie; Rhodes, David; Hooker, Steven P.

    2015-01-01

    Objectives To examine the relationship between objectively measured physical activity (PA) and cognitive function in white and black older adults. Design Cross-sectional. Setting REasons for Geographic and Racial Differences in Stroke (REGARDS) study Participants Older adults who provided valid data from accelerometer and cognitive function tests (N=7,098). Measurements Actical™ accelerometers provided estimates of PA variables for 4–7 consecutive days. PA count cut-points of 50 counts per minute (cpm) and 1065 cpm were applied to differentiate between being sedentary and light PA, and light and moderate-to-vigorous PA, respectively. Prevalence of cognitive impairment was defined by the Six-Item Screener (scored <4 out of 6). Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall), were conducted to assess memory and executive function. Results Of 7,098 participants (70.1 ± 8.5 yr, 54.2% women, 31.5% black), 359 (5.1%) exhibited impaired cognition within ±12 months of PA measurement. The average proportion of time spent in moderate-to-vigorous PA (MVPA%) was 1.4 ± 1.9%. Participants in the highest quartile of MVPA% (approximately 258.3 min/wk of MVPA) were less likely to be cognitively impaired than those in the lowest quartile (OR [95%C.I.] = 0.65 [0.43–0.97]). MVPA% was also significantly associated with z-scores of executive function and memory (P<0.001). Similar analyses of proportion of time spent in light PA (LPA%) and sedentary time (ST%) showed no significant associations with cognitive function. Conclusion Higher levels of objectively measured MVPA%, rather than LPA% or ST%, were associated with lower prevalence of cognitive impairment and better performance in memory and executive function in aging people. The amount of MVPA associated with lower prevalence of cognitive impairment is consistent with meeting PA guidelines. PMID:26691697

  13. 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.

  14. Modular Brain Network Organization Predicts Response to Cognitive Training in Older Adults

    PubMed Central

    Gallen, Courtney L.; Baniqued, Pauline L.; Chapman, Sandra B.; Aslan, Sina; Keebler, Molly; Didehbani, Nyaz; D’Esposito, Mark

    2016-01-01

    Cognitive training interventions are a promising approach to mitigate cognitive deficits common in aging and, ultimately, to improve functioning in older adults. Baseline neural factors, such as properties of brain networks, may predict training outcomes and can be used to improve the effectiveness of interventions. Here, we investigated the relationship between baseline brain network modularity, a measure of the segregation of brain sub-networks, and training-related gains in cognition in older adults. We found that older adults with more segregated brain sub-networks (i.e., more modular networks) at baseline exhibited greater training improvements in the ability to synthesize complex information. Further, the relationship between modularity and training-related gains was more pronounced in sub-networks mediating “associative” functions compared with those involved in sensory-motor processing. These results suggest that assessments of brain networks can be used as a biomarker to guide the implementation of cognitive interventions and improve outcomes across individuals. More broadly, these findings also suggest that properties of brain networks may capture individual differences in learning and neuroplasticity. Trail Registration: ClinicalTrials.gov, NCT#00977418 PMID:28006029

  15. A pilot study of cognitive training with and without transcranial direct current stimulation to improve cognition in older persons with HIV-related cognitive impairment

    PubMed Central

    Ownby, Raymond L; Acevedo, Amarilis

    2016-01-01

    Background In spite of treatment advances, HIV infection is associated with cognitive deficits. This is even more important as many persons with HIV infection age and experience age-related cognitive impairments. Both computer-based cognitive training and transcranial direct current stimulation (tDCS) have shown promise as interventions to improve cognitive function. In this study, we investigate the acceptability and efficacy of cognitive training with and without tDCS in older persons with HIV. Patients and methods In this single-blind randomized study, participants were 14 individuals of whom 11 completed study procedures (mean age =51.5 years; nine men and two women) with HIV-related mild neurocognitive disorder. Participants completed a battery of neuropsychological and self-report measures and then six 20-minute cognitive training sessions while receiving either active or sham anodal tDCS over the left dorsolateral prefrontal cortex. After training, participants completed the same measures. Success of the blind and participant reactions were assessed during a final interview. Assessments were completed by an assessor blind to treatment assignment. Pre- and post-training changes were evaluated via analysis of covariance yielding estimates of effect size. Results All participants believed that they had been assigned to active treatment; nine of the 11 believed that the intervention had improved their cognitive functioning. Both participants who felt the intervention was ineffective were assigned to the sham condition. None of the planned tested interactions of time with treatment was significant, but 12 of 13 favored tDCS (P=0.08). All participants indicated that they would participate in similar studies in the future. Conclusion Results show that both cognitive training via computer game playing and tDCS were well accepted by older persons with HIV infection. Results are suggestive that tDCS may improve cognitive function in persons with HIV infection. Further

  16. Exploring the contribution of spatial navigation to cognitive functioning in older adults.

    PubMed

    Laczó, Jan; Andel, Ross; Nedelska, Zuzana; Vyhnalek, Martin; Vlcek, Kamil; Crutch, Sebastian; Harrison, John; Hort, Jakub

    2017-03-01

    Spatial navigation (SN) impairment is present early in Alzheimer's disease (AD). We tested whether SN performance, self-centered (egocentric) and world-centered (allocentric), was distinguishable from performance on established cognitive functions-verbal and nonverbal memory, executive and visuospatial function, attention/working memory, and language function. 108 older adults (53 cognitively normal [CN] and 55 with amnestic mild cognitive impairment [aMCI]) underwent neuropsychological examination and real-space navigation testing. Subset (n = 63) had automated hippocampal volumetry. In a factor analysis, allocentric and egocentric navigation tasks loaded highly onto the same factor with low loadings on other factors comprising other cognitive functions. In linear regression, performance on other cognitive functions was not, or was only marginally, associated with spatial navigation performance in CN or aMCI groups. After adjustment for age, gender, and education, right hippocampal volume explained 26% of the variance in allocentric navigation in aMCI group. In conclusion, spatial navigation, a known cognitive marker of early AD, may be distinguished from other cognitive functions. Therefore, its assessment along with other major cognitive functions may be highly beneficial in terms of obtaining a comprehensive neuropsychological profile.

  17. Frontal Gamma-Aminobutyric Acid Concentrations Are Associated With Cognitive Performance in Older Adults

    PubMed Central

    Porges, Eric C.; Woods, Adam J.; Edden, Richard A.E.; Puts, Nicolaas A.J.; Harris, Ashley D.; Chen, Huaihou; Garcia, Amanda M.; Seider, Talia R.; Lamb, Damon G.; Williamson, John B.; Cohen, Ronald A.

    2017-01-01

    BACKGROUND Gamma-aminobutyric acid (GABA), the brain’s principal inhibitory neurotransmitter, has been associated with perceptual and attentional functioning. Recent application of magnetic resonance spectroscopy (MRS) provides in vivo evidence for decreasing GABA concentrations during adulthood. It is unclear, however, how age-related decrements in cerebral GABA concentrations contribute to cognitive decline, or whether previously reported declines in cerebral GABA concentrations persist during healthy aging. We hypothesized that participants with higher GABA concentrations in the frontal cortex would exhibit superior cognitive function and that previously reported age-related decreases in cortical GABA concentrations continue into old age. METHODS We measured GABA concentrations in frontal and posterior midline cerebral regions using a Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) 1H-MRS approach in 94 older adults without history or clinical evidence of mild cognitive impairment or dementia (mean age, 73 years). We administered the Montreal Cognitive Assessment to assess cognitive functioning. RESULTS Greater frontal GABA concentrations were associated with superior cognitive performance. This relation remained significant after controlling for age, years of education, and brain atrophy. GABA concentrations in both frontal and posterior regions decreased as a function of age. CONCLUSIONS These novel findings from a large, healthy, older population indicate that cognitive function is sensitive to cerebral GABA concentrations in the frontal cortex, and GABA concentration in frontal and posterior regions continue to decline in later age. These effects suggest that proton MRS may provide a clinically useful method for the assessment of normal and abnormal age-related cognitive changes and the associated physiological contributors. PMID:28217759

  18. Amyloid Deposition and Cognition in Older Adults: The Effects of Premorbid Intellect

    PubMed Central

    Duff, Kevin; Foster, Norman L.; Dennett, Kathryn; Hammers, Dustin B.; Zollinger, Lauren V.; Christian, Paul E.; Butterfield, Regan I.; Beardmore, Britney E.; Wang, Angela Y.; Morton, Kathryn A.; Hoffman, John M.

    2013-01-01

    Although amyloid deposition remains a marker of the development of Alzheimer's disease, results linking amyloid and cognition have been equivocal. Twenty-five community-dwelling non-demented older adults were examined with 18F-flutemetamol, an amyloid imaging agent, and a cognitive battery, including an estimate of premorbid intellect and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). In the first model, 18F-flutemetamol uptake significantly correlated with the Delayed Memory Index of the RBANS (r = −.51, p = .02) and premorbid intellect (r = .43, p = .03). In the second model, the relationship between 18F-flutemetamol and cognition was notably stronger when controlling for premorbid intellect (e.g., three of the five RBANS Indexes and its Total score significantly correlated with 18F-flutemetamol, r's = −.41 to −.58). Associations were found between amyloid-binding 18F-flutemetamol and cognitive functioning in non-demented older adults. These associations were greatest with delayed memory and stronger when premorbid intellect was considered, suggesting that cognitive reserve partly compensates for the symptomatic expression of amyloid pathology in community-dwelling elderly. PMID:23817438

  19. 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

  20. Cognitive function in middle-aged and older adults participating in synchronized swimming-exercise

    PubMed Central

    Maeshima, Etsuko; Okumura, Yuka; Tatsumi, Juri; Tomokane, Sayaka; Ikeshima, Akiko

    2017-01-01

    [Purpose] The purpose of the present study was to examine cognitive function in middle-aged and older adults regularly engaging in synchronized swimming-exercise. [Subjects and Methods] Twenty-three female synchronized swimmers ranging in age from 49 to 85 years were recruited for the present study. The duration of synchronized swimming experience ranged from 1 to 39 years. The control group consisted of 36 age- and gender-matched community-dwelling middle-aged and older adults (age range: 49 to 77 years). Cognitive function was evaluated using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) and compared between the synchronized swimmers and control participants. [Results] No significant differences in mean total MoCA-J scores were observed between the synchronized swimmers and control participants (23.2 ± 3.1 and 22.2 ± 3.6, respectively). Twenty-nine subjects in the control group and 17 in the synchronized swimming group scored below 26 on the MoCA-J, indicative of mild cognitive impairment. Significant differences in delayed recall—but not in visuospatial/executive function, naming, attention, language, abstraction, or orientation—were also observed between the two groups. [Conclusion] The results of the present study suggest that synchronized swimming has beneficial effects on cognitive function, particularly with regard to recent memory. PMID:28210062

  1. Amyloid deposition and cognition in older adults: the effects of premorbid intellect.

    PubMed

    Duff, Kevin; Foster, Norman L; Dennett, Kathryn; Hammers, Dustin B; Zollinger, Lauren V; Christian, Paul E; Butterfield, Regan I; Beardmore, Britney E; Wang, Angela Y; Morton, Kathryn A; Hoffman, John M

    2013-11-01

    Although amyloid deposition remains a marker of the development of Alzheimer's disease, results linking amyloid and cognition have been equivocal. Twenty-five community-dwelling non-demented older adults were examined with (18)F-flutemetamol, an amyloid imaging agent, and a cognitive battery, including an estimate of premorbid intellect and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). In the first model, (18)F-flutemetamol uptake significantly correlated with the Delayed Memory Index of the RBANS (r = -.51, p = .02) and premorbid intellect (r = .43, p = .03). In the second model, the relationship between (18)F-flutemetamol and cognition was notably stronger when controlling for premorbid intellect (e.g., three of the five RBANS Indexes and its Total score significantly correlated with (18)F-flutemetamol, r's = -.41 to -.58). Associations were found between amyloid-binding (18)F-flutemetamol and cognitive functioning in non-demented older adults. These associations were greatest with delayed memory and stronger when premorbid intellect was considered, suggesting that cognitive reserve partly compensates for the symptomatic expression of amyloid pathology in community-dwelling elderly.

  2. Evaluation of a brief survey instrument for assessing subtle differences in cognitive function among older adults

    PubMed Central

    Kotwal, Ashwin A.; Schumm, L Philip; Kern, David W.; McClintock, Martha K.; Waite, Linda J.; Shega, Joseph W.; Huisingh-Scheetz, Megan J.; Dale, William

    2016-01-01

    Most measures of cognitive function used in large-scale surveys of older adults have limited ability to detect subtle differences across cognitive domains, and standard clinical instruments are impractical to administer in general surveys. The Montreal Cognitive Assessment (MoCA) can address this need, but has limitations in a survey context. Therefore, we developed a survey-adaptation of the MoCA, called the MoCA-SA, and describe its psychometric properties in a large national survey. Using a pretest sample of older adults (n=120), we reduced MoCA administration time by 26%, developed a model to accurately estimate full MoCA scores from the MoCA-SA, and tested the model in an independent clinical sample (n=93). The validated 18-item MoCA-SA was then administered to community-dwelling adults aged 62–91 as part of the National Social life Health and Aging Project (NSHAP) Wave 2 sample (n=3,196). In NSHAP Wave 2, the MoCA-SA had good internal reliability (Cronbach α=0.76). Using item-response models, survey-adapted items captured a broad range of cognitive abilities and functioned similarly across gender, education, and ethnic groups. Results demonstrate that the MoCA-SA can be administered reliably in a survey setting while preserving sensitivity to a broad range of cognitive abilities and similar performance across demographic subgroups. PMID:25390883

  3. Correlation between functional mobility and cognitive performance in older adults with cognitive impairment.

    PubMed

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

    2016-12-09

    Association between cognitive impairment and gait performance occurs in mild cognitive impairment (MCI) and Alzheimer's disease (AD), particularly under "divided attention" conditions, leading to a greater risk of falls. We studied 36 controls, 42 MCI, and 26 mild AD patients, using the Timed Up-and-Go test (TUG) under four conditions: TUG single - TUG1; TUG cognitive - TUG2; TUG manual -TUG3; TUG cognitive and manual - TUG4. Cognition was assessed using the MMSE, SKT, Exit25, and TMT (A and B). We found significant correlations between cognitive scores and TUG2 [r values (MMSE: -0.383, TMT-A: 0.430, TMT-B: 0.386, Exit25: 0.455, SKT: 0.563)] and TUG4 [(MMSE: -0.398, TMT-A: 0.384, TMT-B: 0.352,Exit25: 0.466, SKT: 0.525)] in the AD group, and between all TUG modalities and SKT in MCI and AD. Our results revealed that functional mobility impairment in cognitive dual tasks correlated to cognitive decline in AD patients and to attention and memory impairment in MCI.

  4. The effects of cognitive speed of processing training among older adults with psychometrically- defined mild cognitive impairment.

    PubMed

    Valdes, Elise G; O'Connor, Melissa L; Edwards, Jerri D

    2012-11-01

    Despite the growing interest in cognitive training programs as a potential non-pharmacological approach to slowing cognitive decline in mild cognitive impairment (MCI), there has been little research on the differential effectiveness of training among subtypes of MCI (i.e., amnestic, single non-amnestic, and multi-domain). The current study examined the longitudinal effects of cognitive speed of processing training (SOPT) among older adults with psychometricallydefined MCI from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. Mixed model ANOVAs examined the effectiveness of SOPT in participants with MCI relative to controls and also compared training effectiveness in MCI subgroups to appropriate controls. A mixed effects model compared SOPT training effects longitudinally across five years relative to controls. A second mixed effects model compared the durability of training gains between the MCI subtypes across 5 years. All subtypes of MCI showed immediate improvement post-training relative to controls, with the single non-amnestic subtype showing the most benefit. Additionally, all subtypes showed similar trajectories across five years. There were no significant changes in performance across time, indicating initial training gains were maintained. These results provide support for the effectiveness and potential durability of SOPT among persons with MCI regardless of subtype. Future research should investigate if SOPT transfers to improvements in the everyday functioning of those with MCI.

  5. 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

  6. In-home cognitive training with older married couples: individual versus collaborative learning.

    PubMed

    Margrett, Jennifer A; Willis, Sherry L

    2006-06-01

    Research has demonstrated that older adults' cognitive performance can be enhanced via formal intervention, as well as more informal intervention including collaboration or working with a partner. The current study investigated the effects of an inductive reasoning training program adapted for in-home use among older adults assigned to individual training (n = 30), collaborative training (n = 34), or a no-treatment control group (n = 34). The training consisted of 10 sessions, and all participants completed a pretest followed by a post-test 6 weeks later. Findings suggest that older adults could effectively "train themselves" without the guidance of a formal instructor. The results, however, did not indicate immediate added benefit in reasoning performance for collaborative versus individual training using the current reasoning program.

  7. 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

  8. Antidepressant Medication Augmented With Cognitive-Behavioral Therapy for Generalized Anxiety Disorder in Older Adults

    PubMed Central

    Wetherell, Julie Loebach; Petkus, Andrew J.; White, Kamila S.; Nguyen, Hoang; Kornblith, Sander; Andreescu, Carmen; Zisook, Sidney; Lenze, Eric J.

    2014-01-01

    Objective Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. Method Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions:16 weeks of escitalopram (10–20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. Results Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. Conclusions This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy. PMID:23680817

  9. Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.

    PubMed

    Wetherell, Julie Loebach; Petkus, Andrew J; White, Kamila S; Nguyen, Hoang; Kornblith, Sander; Andreescu, Carmen; Zisook, Sidney; Lenze, Eric J

    2013-07-01

    OBJECTIVE Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. METHOD Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10-20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. RESULTS Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. CONCLUSIONS This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy.

  10. 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

  11. Improved cognitive-cerebral function in older adults with chromium supplementation.

    PubMed

    Krikorian, Robert; Eliassen, James C; Boespflug, Erin L; Nash, Tiffany A; Shidler, Marcelle D

    2010-06-01

    Insulin resistance is implicated in the pathophysiological changes associated with Alzheimer's disease, and pharmaceutical treatments that overcome insulin resistance improve memory function in subjects with mild cognitive impairment (MCI) and early Alzheimer's disease. Chromium (Cr) supplementation improves glucose disposal in patients with insulin resistance and diabetes. We sought to assess whether supplementation with Cr might improve memory and neural function in older adults with cognitive decline. In a placebo-controlled, double-blind trial, we randomly assigned 26 older adults to receive either chromium picolinate (CrPic) or placebo for 12 weeks. Memory and depression were assessed prior to treatment initiation and during the final week of treatment. We also performed functional magnetic resonance imaging (fMRI) scans on a subset of subjects. Although learning rate and retention were not enhanced by CrPic supplementation, we observed reduced semantic interference on learning, recall, and recognition memory tasks. In addition, fMRI indicated comparatively increased activation for the CrPic subjects in right thalamic, right temporal, right posterior parietal, and bifrontal regions. These findings suggest that supplementation with CrPic can enhance cognitive inhibitory control and cerebral function in older adults at risk for neurodegeneration.

  12. Cognitive resources related to speech recognition with a competing talker in young and older listeners.

    PubMed

    Meister, H; Schreitmüller, S; Grugel, L; Ortmann, M; Beutner, D; Walger, M; Meister, I G

    2013-03-01

    Speech recognition in a multi-talker situation poses high demands on attentional and other central resources. This study examines the relationship between age, cognition and speech recognition in tasks that require selective or divided attention in a multi-talker setting. Two groups of normal-hearing adults (one younger and one older group) were asked to repeat utterances from either one or two concurrent speakers. Cognitive abilities were then inspected by neuropsychological tests. Speech recognition scores approached its ceiling and did not significantly differ between age groups for tasks that demanded selective attention. However, when divided attention was required, performance in older listeners was reduced as compared to the younger group. When selective attention was required, speech recognition was strongly related to working memory skills, as determined by a regression model. In comparison, speech recognition for tests requiring divided attention could be more strongly determined by neuropsychological probes of fluid intelligence. The findings of this study indicate that - apart from hearing impairment - cognitive aspects account for the typical difficulties of older listeners in a multi-speaker setting. Our results are discussed in the context of evidence showing that frontal lobe functions in terms of working memory and fluid intelligence generally decline with age.

  13. Cognitive reserve and neuropsychological functioning in older HIV-infected people.

    PubMed

    Milanini, Benedetta; Ciccarelli, Nicoletta; Fabbiani, Massimiliano; Limiti, Silio; Grima, Pierfrancesco; Rossetti, Barbara; Visconti, Elena; Tamburrini, Enrica; Cauda, Roberto; Di Giambenedetto, Simona

    2016-10-01

    Progress in treatments has led to HIV+ patients getting older. Age and HIV are risk factors for neurocognitive impairment (NCI). We explored the role of cognitive reserve (CR) on cognition in a group of virologically suppressed older HIV+ people. We performed a multicenter study, consecutively enrolling asymptomatic HIV+ subjects ≥60 years old during routine outpatient visits. A comprehensive neuropsychological battery was administered. Raw test scores were adjusted based on Italian normative data and transformed into z-scores; NCI was defined according to Frascati criteria. All participants underwent the Brief Intelligence Test (TIB) and the Cognitive Reserve Index (CRI) questionnaire as proxies for CR. Relationships between TIB, CRI, and NCI were investigated by logistic or linear regression analyses. Sixty patients (85 % males, median age 66, median education 12, 10 % HCV co-infected, 25 % with past acquired immunodeficiency syndrome (AIDS)-defining events, median CD4 cells count 581 cells/μL, median nadir CD4 cells count 109 cells/μL) were enrolled. Twenty-four patients (40 %) showed Asymptomatic Neurocognitive Impairment. At logistic regression analysis, only CRI (OR 0.94; 95 % CI 0.91-0.97; P = 0.001) and TIB (OR 0.80; 95 % CI 0.71-0.90; P < 0.001) were associated with a lower risk of NCI. Higher CRI and TIB were significantly correlated with a better performance (composite z-score) both globally and at individual cognitive domains. Our findings highlight the role of CR over clinical variables in maintaining cognitive integrity in a virologically suppressed older HIV-infected population. A lifestyle characterized by experiences of mental stimulation may help to cope aging and HIV-related neurodegeneration.

  14. Left ventricular dysfunction: a clue to cognitive impairment in older patients with heart failure

    PubMed Central

    Zuccala, G.; Cattel, C.; Manes-Gravina, E.; Di, N; Cocchi, A.; Bernabei, R.

    1997-01-01

    OBJECTIVES—Cognitive impairment has been reported in middle aged patients with end stage heart failure. This cross sectional study assessed the prevalence and determinants of cognitive dysfunction in older patients with mild to moderate heart failure.
METHODS—57 consecutive patients (mean age 76.7 years) with chronic heart failure underwent physical examination, blood chemistry, urinalysis, chest radiography ECG, Doppler echocardiography, and the mini mental state examination (MMSE), mental deterioration battery, depression scale of the Center for Epidemiological Studies (CES-D), Katz activities of daily living, and instrumental activities of daily living 24 hours before hospital discharge.
RESULTS—MMSE scores <24 were found in 53% of participants. The MMSE score was associated with left ventricular ejection fraction according to a non-linear correlation, so that cognitive performance was significantly lower in subjects with left ventricular ejection fraction ⩽30%. The same pattern of correlation was evidenced between left ventricular ejection fraction and both the attention sub-item of MMSE and the Raven test score. In a multivariate linear regression model, after adjusting for age, sex, and a series of clinical data and objective tests, both age (β=−0.30; P=0.038) and the natural log of left ventricular ejection fraction (β=0.58; P=0.001) were associated with the MMSE score.
CONCLUSION—Cognitive impairment in older patients with chronic heart failure is common, and independently associated with lower left ventricular ejection fraction. Given the overwhelming incidence and prevalence of heart failure in older populations, early detection of cognitive impairment in these subjects with prompt, intensive treatment of left ventricular systolic dysfunction may prevent or delay a remarkable proportion of dementia in advanced age.

 PMID:9343133

  15. Exposure to Particulate Air Pollution and Cognitive Decline in Older Women

    PubMed Central

    Weuve, Jennifer; Puett, Robin C.; Schwartz, Joel; Yanosky, Jeff D.; Laden, Francine; Grodstein, Francine

    2013-01-01

    Background Chronic exposure to particulate air pollution may accelerate cognitive decline in older adults, although data on this association are limited. Our objective was to examine long-term exposure to particulate matter (PM) air pollution, both coarse ([PM 2.5–10 μm in diameter [PM2.5-10]) and fine (PM <2.5 μm in diameter [PM2.5]), in relation to cognitive decline. Methods The study population comprised the Nurses’ Health Study Cognitive Cohort, which included 19 409 US women aged 70 to 81 years. We used geographic information system–based spatiotemporal smoothing models to estimate recent (1 month) and long-term (7–14 years) exposures to PM2.5-10, and PM2.5 preceding base-line cognitive testing (1995–2001) of participants residing in the contiguous United States. We used generalized estimating equation regression to estimate differences in the rate of cognitive decline across levels of PM2.5-10 and PM2.5 exposures. The main outcome measure was cognition, via validated telephone assessments, administered 3 times at approximately 2-year intervals, including tests of general cognition, verbal memory, category fluency, working memory, and attention. Results Higher levels of long-term exposure to both PM2.5-10 and PM2.5 were associated with significantly faster cognitive decline. Two-year decline on a global score was 0.020 (95% CI, −0.032 to −0.008) standard units worse per 10 μg/m3 increment in PM2.5-10 exposure and 0.018 (95% CI, −0.035 to −0.002) units worse per 10 μg/m3 increment in PM2.5 exposure. These differences in cognitive trajectory were similar to those between women in our cohort who were approximately 2 years apart in age, indicating that the effect of a 10-μg/m3 increment in long-term PM exposure is cognitively equivalent to aging by approximately 2 years. Conclusion Long-term exposure to PM2.5-10 and PM2.5 at levels typically experienced by many individuals in the United States is associated with significantly worse cognitive

  16. 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

  17. 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

  18. 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

  19. 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

    2015-05-29

    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.

  20. 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

  1. 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

  2. Comparing Individual Differences in Inconsistency and Plasticity as Predictors of Cognitive Function in Older Adults

    PubMed Central

    Grand, Jacob H.G.; Stawski, Robert S.; MacDonald, Stuart W.S.

    2016-01-01

    Introduction Recent theorizing differentiates key constraints on cognition, including one’s current range of processing efficiency (i.e., flexibility or inconsistency) as well as the capacity to expand flexibility over time (i.e., plasticity). The present study uses intensive assessment of response time data to examine the interplay between markers of intraindividual variability (inconsistency) and gains across biweekly retest sessions (plasticity) in relation to age-related cognitive function. Method Participants included 304 adults (aged 64 to 92 years: M=74.02, SD=5.95) from Project MIND, a longitudinal burst design study assessing performance across micro and macro intervals (response latency trials, weekly bursts, annual retests). For two reaction time measures (choice RT and one-back choice RT), baseline measures of response time (RT) inconsistency (intraindividual standard deviation (ISD) across-trials at the first testing session) and plasticity (within-person performance gains in average RT across the 5 biweekly burst sessions) were computed, and then employed in linear mixed models as predictors of individual differences in cognitive function and longitudinal (6 year) rates of cognitive change. Results Independent of chronological age and years of education, higher RT inconsistency was associated uniformly with poorer cognitive function at baseline and with increased cognitive decline for measures of episodic memory and crystallized verbal ability. In contrast, predictive associations for plasticity were more modest for baseline cognitive function and were absent for 6-year cognitive change. Conclusions These findings underscore the potential utility of response times for articulating inconsistency and plasticity as dynamic predictors of cognitive function in older adults. PMID:26898536

  3. Rate of Cognitive Decline Before and After the Onset of Functional Limitations in Older Persons

    PubMed Central

    Rajan, Kumar B.; Hebert, Liesi E.; Scherr, Paul A.; Mendes de Leon, Carlos F.; Evans, Denis A.

    2015-01-01

    Background: Loss in physical function is indicative of deterioration in physiological health that may also be associated with deterioration in neurological health. The objective of this study was to examine whether the onset of functional limitations and their severity is associated with increases in cognitive decline among older adults. Methods: The study sample consists of 3825 (65% African Americans and 53% females) participants over the age of 65 with no functional limitations. Cognitive function was assessed using a standardized global cognitive score, and functional limitations using a summary measure of 8 Rosow-Breslau and Nagi limitations (ROS-B/Nagi). Cognitive decline before and after the onset of limitations were analyzed using a linear piecewise change point model. Results: During follow-up, 2682 (70%) participants reported limitations in ROS-B/Nagi measure. The rate of cognitive decline was 0.053-units per year before any limitations, and increased to 0.069-units per year after one or more limitations in ROS-B/Nagi measure. This was about 30% (95% Confidence Interval [CI]: 18 – 42%) increase in the rate of cognitive decline comparing before and after the onset of limitations in ROS-B/Nagi measure. Also, higher number of limitations in ROS-B/Nagi measure at the time of onset was associated with faster cognitive decline. Conclusions: The rate of cognitive decline was significantly higher following functional limitations. This study suggests that self-reported measures of functional limitations may serve as an important marker of cognitive decline. PMID:25934994

  4. 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

  5. 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

  6. Self-Reported Sleep Quality Predicts Poor Cognitive Performance in Healthy Older Adults

    PubMed Central

    Buysse, Daniel J.; Halligan, Edythe M.; Houck, Patricia R.; Monk, Timothy H.

    2009-01-01

    This study examined the relation between sleep quality and cognitive performance in older adults, controlling for common medical comorbidities. Participants were community volunteers who, while not selected on the basis of their sleep, did report substantial variability in sleep quality. Good and poor sleepers differed on tests of working memory, attentional set shifting, and abstract problem solving but not on processing speed, inhibitory function, or episodic memory. Poor sleep was also associated with increased depressive symptomatology but only for functional symptoms (e.g., decreased concentration) and not for mood (e.g., sadness). The relationships between sleep quality and cognition were not explained by confound factors such as cerebrovascular disease, depression, or medication usage. Sleep problems may contribute to performance variability between elderly individuals but only in certain cognitive domains. PMID:19204069

  7. Blood Pressure and Cognition Among Older Adults: A Meta-Analysis

    PubMed Central

    Gifford, Katherine A.; Badaracco, Maria; Liu, Dandan; Tripodis, Yorghos; Gentile, Amanda; Lu, Zengqi; Palmisano, Joseph; Jefferson, Angela L.

    2013-01-01

    Hypertension has adverse effects on cognition, can alter cerebral vasculature integrity, and is associated with the pathogenesis of dementia. Using meta-analysis, we correlated blood pressure to multiple cognitive domains among older adults free of clinical stroke and dementia. We identified 230 studies indexed in PubMed and PsycINFO relating blood pressure and cognition. After applying exclusion criteria, we selected n = 12 articles with n = 4,076 participants (age range 43–91 years). Meta-analysis yielded an association between blood pressure and episodic memory (r = −.18, p < .001) and between blood pressure and global cognition (r = −.07, p < .001). When limiting analyses to studies adjusting for vascular covariates (n = 8, n = 2,141), blood pressure was modestly related to global cognition (r = −.11, p < .001), attention (r = .14, p = .002), and episodic memory (r = −.20, p < .001) with a trend for language (r = −.22, p = .07). Findings underscore the need to manage blood pressure as a key prevention method in minimizing abnormal cognitive aging prior to the onset of clinical dementia. PMID:23838685

  8. Cognitive and Brain Reserve and the Risk of Postoperative Delirium in Older Patients

    PubMed Central

    Saczynski, Jane S.; Inouye, Sharon K.; Kosar, Cyrus; Tommet, Doug; Marcantonio, Edward R.; Fong, Tamara; Hshieh, Tammy; Vasunilashorn, Sarinnapha; Metzger, Eran D.; Schmitt, Eva; Alsop, David C.; Jones, Richard N.

    2015-01-01

    Background Cognitive and brain reserve theories suggest that aspects of neural architecture or cognitive processes modify the impact of neuropathological processes on cognitive outcomes. While frequently studied in the context of dementia, reserve in delirium is relatively understudied. Methods We examined the association of three markers of brain reserve (head circumference, MRI-derived brain volume, and leisure time physical activity) and five markers of cognitive reserve (education, vocabulary, cognitive activities, cognitive demand of lifetime occupation, and interpersonal demand of lifetime occupation) and the risk of postoperative delirium in a prospective observational study of 566 older adults free of dementia undergoing scheduled surgery. Findings Twenty four percent of patients (135/566) developed delirium during the postoperative hospitalization period. Of the reserve markers examined, only the Wechsler Test of Adult Reading (WTAR) was significantly associated with the risk of delirium. A one-half standard deviation better performance on the WTAR was associated with a 38% reduction in delirium risk (P = 0·01); adjusted relative risk of 0·62, 95% confidence interval 0·45–0·85. Interpretation In this relatively large and well-designed study, most markers of reserve fail to predict delirium risk. The exception to this is the WTAR. Our findings suggest that the reserve markers that are important for delirium may be different from those considered to be important for dementia. PMID:25642414

  9. 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.

  10. Blood pressure and cognition among older adults: a meta-analysis.

    PubMed

    Gifford, Katherine A; Badaracco, Maria; Liu, Dandan; Tripodis, Yorghos; Gentile, Amanda; Lu, Zengqi; Palmisano, Joseph; Jefferson, Angela L

    2013-11-01

    Hypertension has adverse effects on cognition, can alter cerebral vasculature integrity, and is associated with the pathogenesis of dementia. Using meta-analysis, we correlated blood pressure to multiple cognitive domains among older adults free of clinical stroke and dementia. We identified 230 studies indexed in PubMed and PsycINFO relating blood pressure and cognition. After applying exclusion criteria, we selected n = 12 articles with n = 4,076 participants (age range 43-91 years). Meta-analysis yielded an association between blood pressure and episodic memory (r = -.18, p < .001) and between blood pressure and global cognition (r = -.07, p < .001). When limiting analyses to studies adjusting for vascular covariates (n = 8, n = 2,141), blood pressure was modestly related to global cognition (r = -.11, p < .001), attention (r = .14, p = .002), and episodic memory (r = -.20, p < .001) with a trend for language (r = -.22, p = .07). Findings underscore the need to manage blood pressure as a key prevention method in minimizing abnormal cognitive aging prior to the onset of clinical dementia.

  11. 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

  12. The more the better? A meta-analysis on effects of combined cognitive and physical intervention on cognition in healthy older adults.

    PubMed

    Zhu, Xinyi; Yin, Shufei; Lang, Minjia; He, Rongqiao; Li, Juan

    2016-11-01

    Both cognitive intervention and physical exercise benefit cognitive function in older adults. It has been suggested that combined cognitive and physical intervention may induce larger effects than cognitive or physical intervention alone, but existing literature has shown mixed results. This meta-analysis aimed at assessing the efficacy of combined intervention on cognition by comparing combined intervention to control group, cognitive intervention and physical exercise. Eligible studies were controlled trials examining the effects of combined intervention on cognition in older adults without known cognitive impairment. Twenty interventional studies comprising 2667 participants were included. Results showed that the overall effect size for combined intervention versus control group was 0.29 (random effects model, p=0.001). Compared to physical exercise, combined intervention produced greater effects on overall effect size (0.22, p<0.01), while no significant difference was found between combined intervention and cognitive intervention. Effects of combined intervention were moderated by age of participants, intervention frequency and setting. The findings suggest that combined intervention demonstrates advantages over control group and physical exercise, while evidence is still lacking for superiority when compared combined intervention to cognitive intervention. More well-designed studies with long follow-ups are needed to clarify the potential unique efficacy of combined intervention for older adults.

  13. Association of Dynapenia, Sarcopenia, and Cognitive Impairment Among Community-Dwelling Older Taiwanese.

    PubMed

    Huang, Chung-Yu; Hwang, An-Chun; Liu, Li-Kuo; Lee, Wei-Ju; Chen, Liang-Yu; Peng, Li-Ning; Lin, Ming-Hsien; Chen, Liang-Kung

    2016-02-01

    A decline in physical and/or cognitive function is a common feature of aging, and frailty has been shown to be associated with cognitive impairment and dementia. This study aimed to evaluate the association between dynapenia, sarcopenia, and cognitive impairment among community-dwelling older people in Taiwan. Data from the I-Lan Longitudinal Aging Study (ILAS) were retrieved for study. Global cognitive function was assessed by Mini-Mental State Examination (MMSE), whereas the Chinese Version Verbal Learning Test, Boston Naming Test, Verbal Fluency Test, Taylor Complex Figure Test, Digits Backward Test, and Clock Drawing Test were used to assess different domains of cognitive function. Association between sarcopenia and global cognitive function as well as all different dimensions of cognitive function were evaluated. Data from 731 elderly participants (mean age 73.4 ± 5.4 years, 53.8% males) were used for study analysis. The overall prevalence of sarcopenia was 6.8%, which was significantly higher in men (9.3% versus 4.1%, p < 0.05). The mean MMSE score was 23.4 ± 4.4 for all participants, and 10.3% of the study participants were cognitively impaired. Sarcopenia was not significantly associated with global cognitive function (odds ratio [OR] = 1.55, p = 0.317), but global cognitive impairment was significantly associated with low physical performance (OR = 2.31, p = 0.003) and low muscle strength (OR = 2.59, p = 0.011). Nonetheless, sarcopenia was significantly associated with impairment in the verbal fluency test (OR = 3.96, p = 0.006) after adjustment for potential confounders. Dynapenia was significantly associated with cognitive impairment in multiple dimensions and global cognitive function, but sarcopenia was only associated with an impaired verbal fluency test. Reduced muscle strength and/or physical performance related to non-muscle etiology were strongly associated with cognitive impairment. More longitudinal

  14. 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

  15. Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems.

    PubMed

    Narazaki, Kenji; Matsuo, Eri; Honda, Takanori; Nofuji, Yu; Yonemoto, Koji; Kumagai, Shuzo

    2014-09-01

    Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score ≥24) were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%). Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p < 0.001). These associations were preserved after additional adjustment for years of formal education, body mass index, and other confounding factors (p < 0.001). The present study first demonstrated the associations between multiple aspects of physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community-based preventive care of

  16. Enhancing Cognitive Functioning in Healthly Older Adults: a Systematic Review of the Clinical Significance of Commercially Available Computerized Cognitive Training in Preventing Cognitive Decline.

    PubMed

    Shah, Tejal M; Weinborn, Michael; Verdile, Giuseppe; Sohrabi, Hamid R; Martins, Ralph N

    2017-03-01

    Successfully assisting older adults to maintain or improve cognitive function, particularly when they are dealing with neurodegenerative disorders such as Alzheimer's disease (AD), remains a major challenge. Cognitive training may stimulate neuroplasticity thereby increasing cognitive and brain reserve. Commercial brain training programs are computerized, readily-available, easy-to-administer and adaptive but often lack supportive data and their clinical validation literature has not been previously reviewed. Therefore, in this review, we report the characteristics of commercially available brain training programs, critically assess the number and quality of studies evaluating the empirical evidence of these programs for promoting brain health in healthy older adults, and discuss underlying causal mechanisms. We searched PubMed, Google Scholar and each program's website for relevant studies reporting the effects of computerized cognitive training on cognitively healthy older adults. The evidence for each program was assessed via the number and quality (PEDro score) of studies, including Randomized Control Trials (RCTs). Programs with clinical studies were subsequently classified as possessing Level I, II or III evidence. Out of 18 identified programs, 7 programs were investigated in 26 studies including follow-ups. Two programs were identified as possessing Level I evidence, three programs demonstrated Level II evidence and an additional two programs demonstrated Level III evidence. Overall, studies showed generally high methodological quality (average PEDro score = 7.05). Although caution must be taken regarding any potential bias due to selective reporting, current evidence supports that at least some commercially available computerized brain training products can assist in promoting healthy brain aging.

  17. 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

  18. Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study

    PubMed Central

    Blackwell, Terri; Yaffe, Kristine; Laffan, Alison; Ancoli-Israel, Sonia; Redline, Susan; Ensrud, Kristine E.; Song, Yeonsu; Stone, Katie L.

    2014-01-01

    Study Objectives: To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline. Design: A population-based longitudinal study. Setting: Six centers in the United States. Participants: Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y. Interventions: None. Measurements and Results: Objectively measured sleep predictors from wrist actigraphy: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase). Conclusions: Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline. Citation: Blackwell T; Yaffe K; Laffan A; Ancoli-Israel S; Redline S; Ensrud KE; Song Y; Stone KL. Associations of objectively and

  19. Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

    PubMed Central

    Mandelblatt, Jeanne S.; Clapp, Jonathan D.; Luta, Gheorghe; Faul, Leigh Anne; Tallarico, Michelle D.; McClendon, Trina D.; Whitley, Jessica A.; Cai, Ling; Ahles, Tim A.; Stern, Robert A.; Jacobsen, Paul B.; Small, Brent J.; Pitcher, Brandelyn N.; Dura‐Fernandis, Estrella; Muss, Hyman B.; Hurria, Arti; Cohen, Harvey J.; Isaacs, Claudine

    2016-01-01

    BACKGROUND The number of survivors of breast cancer aged ≥65 years (“older”) is growing, but to the authors' knowledge, little is known regarding the cognitive outcomes of these individuals. METHODS A cohort of cognitively intact older survivors with nonmetastatic, invasive breast cancer was recruited from 78 sites from 2004 through 2011; approximately 83.7% of the survivors (1280 survivors) completed baseline assessments. Follow‐up data were collected at 6 months and annually for up to 7 years (median, 4.1 years). Cognitive function was self‐reported using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ‐C30); scores ranged from 0 to 100, with a higher score indicating better function. Group‐based trajectory modeling determined trajectories; women were assigned to a trajectory group based on the highest predicted probability of membership. Multinomial logistic regression evaluated the association between receipt of chemotherapy (with or without hormonal treatment) and trajectory group. RESULTS Survivors were aged 65 to 91 years; approximately 41% received chemotherapy. There were 3 cognitive trajectories: “maintained high” (42.3% of survivors); “phase shift” (50.1% of survivors), with scores slightly below but parallel to maintained high; and “accelerated decline” (7.6% of survivors), with the lowest baseline scores and greatest decline (from 71.7 [standard deviation, 19.8] to 58.3 [standard deviation, 21.9]). The adjusted odds of being in the accelerated decline group (vs the maintained high group) were 2.1 times higher (95% confidence interval, 1.3‐3.5) for survivors who received chemotherapy (with or without hormonal therapy) versus those treated with hormonal therapy alone. Greater comorbidity and frailty also were found to be associated with accelerated decline. CONCLUSIONS Trajectory group analysis demonstrated that the majority of older survivors maintained good long

  20. 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

  1. 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

  2. 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

  3. 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

  4. Prediction of Cognitive Decline in Healthy Older Adults using fMRI

    PubMed Central

    Woodard, John L.; Seidenberg, Michael; Nielson, Kristy A.; Smith, J. Carson; Antuono, Piero; Durgerian, Sally; Guidotti, Leslie; Zhang, Qi; Butts, Alissa; Hantke, Nathan; Lancaster, Melissa; Rao, Stephen M.

    2010-01-01

    Few studies have examined the extent to which structural and functional MRI, alone and in combination with genetic biomarkers, can predict future cognitive decline in asymptomatic elders. This prospective study evaluated individual and combined contributions of demographic information, genetic risk, hippocampal volume, and fMRI activation for predicting cognitive decline after an 18-month retest interval. Standardized neuropsychological testing, an fMRI scans semantic memory task (famous name discrimination), and structural MRI (sMRI) were performed on 78 healthy elders (73% female; mean age = 73 years, range = 65 to 88 years). Positive family history of dementia and presence of one or both apolipoprotein E (APOE) ε4 alleles occurred in 51.3% and 33.3% of the sample, respectively. Hippocampal volumes were traced from sMRI scans. At follow-up, all participants underwent a repeat neuropsychological examination. At 18 months, 27 participants (34.6%) declined by at least 1 SD on one of three neuropsychological measures. Using logistic regression, demographic variables (age, years of education, gender) and family history of dementia did not predict future cognitive decline. Greater fMRI activity, absence of an APOE ε4 allele, and larger hippocampal volume were associated with reduced likelihood of cognitive decline. The most effective combination of predictors involved fMRI brain activity and APOE ε4 status. Brain activity measured from task-activated fMRI, in combination with APOE ε4 status, was successful in identifying cognitively intact individuals at greatest risk for developing cognitive decline over a relatively brief time period. These results have implications for enriching prevention clinical trials designed to slow AD progression. PMID:20634590

  5. 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 * 1010(-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.

  6. 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.

  7. Evidence for Narrow Transfer after Short-Term Cognitive Training in Older Adults.

    PubMed

    Souders, Dustin J; Boot, Walter R; Blocker, Kenneth; Vitale, Thomas; Roque, Nelson A; Charness, Neil

    2017-01-01

    The degree to which "brain training" can improve general cognition, resulting in improved performance on tasks dissimilar from the trained tasks (transfer of training), is a controversial topic. Here, we tested the degree to which cognitive training, in the form of gamified training activities that have demonstrated some degree of success in the past, might result in broad transfer. Sixty older adults were randomly assigned to a gamified cognitive training intervention or to an active control condition that involved playing word and number puzzle games. Participants were provided with tablet computers and asked to engage in their assigned training for 30 45-min training sessions over the course of 1 month. Although intervention adherence was acceptable, little evidence for transfer was observed except for the performance of one task that most resembled the gamified cognitive training: There was a trend for greater improvement on a version of the corsi block tapping task for the cognitive training group relative to the control group. This task was very similar to one of the training games. Results suggest that participants were learning specific skills and strategies from game training that influenced their performance on a similar task. However, even this near-transfer effect was weak. Although the results were not positive with respect to broad transfer of training, longer duration studies with larger samples and the addition of a retention period are necessary before the benefit of this specific intervention can be ruled out.

  8. Evaluation of a Self-Administered Computerized Cognitive Battery in an Older Population

    PubMed Central

    Koyama, Alain K.; Hagan, Kaitlin A.; Okereke, Olivia I.; Weisskopf, Marc G.; Rosner, Bernard; Grodstein, Francine

    2015-01-01

    Objective To assess the utility of the Cogstate self-administered computerized neuropsychological battery in a large population of older men. Methods We invited 7,167 men (mean age: 75 years) from the Health Professionals Follow-up Study, a prospective cohort of male health professionals. We considered individual Cogstate scores and composite scores measuring psychomotor speed and attention, learning and working memory, and overall cognition. Multivariate linear regression was used to assess the association between risk factors measured 4 and 28 years prior to cognitive testing and each outcome. Results The 1,866 men who agreed to complete Cogstate testing were similar to the 5,301 non-responders. Many expected risk factors were associated with Cogstate scores in multivariate-adjusted models. Increasing age was significantly associated with worse performance on all outcomes (p < 0.001). For risk factors measured four years prior to testing and overall cognition, a history of hypertension was significantly associated with worse performance (mean difference=−0.08 standard units [95% CI −0.16, 0.00]) and higher nut consumption was significantly associated with better performance (>2 servings/week vs. <1 serving/month: 0.15 [0.03, 0.27]). Conclusions The self-administered Cogstate battery showed significant associations with several risk factors known to be associated with cognitive function. Future studies of cognitive aging may benefit from the numerous advantages of self-administered computerized testing. PMID:26501919

  9. Daily mood and out-of-home mobility in older adults: does cognitive impairment matter?

    PubMed

    Kaspar, Roman; Oswald, Frank; Wahl, Hans-Werner; Voss, Elke; Wettstein, Markus

    2015-02-01

    This study explores the relationship between out-of-home behavior and daily mood of community-dwelling older adults with different levels of cognitive impairment across four consecutive weeks. The sample included 16 persons with early stage Alzheimer's disease (AD), 30 persons with mild cognitive impairment (MCI), and 95 cognitively healthy persons (CH). Using a multi-method approach, GPS tracking and daily-diary data were combined on a day-to-day basis. AD and MCI adults showed lower mood than the CH group. Whereas stronger positive links between mood and out-of-home behavior were found for AD compared to the total sample on an aggregate level, predicting daily mood by person (i.e., cognition) and occasion-specific characteristics (i.e., mobility and weekday), using multilevel regression analysis revealed no corresponding effect. In conclusion, cognitive status in old age appears to impact on mobility and mood as such, rather than on the mood and out-of-home behavior connection.

  10. 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

  11. Evidence for Narrow Transfer after Short-Term Cognitive Training in Older Adults

    PubMed Central

    Souders, Dustin J.; Boot, Walter R.; Blocker, Kenneth; Vitale, Thomas; Roque, Nelson A.; Charness, Neil

    2017-01-01

    The degree to which “brain training” can improve general cognition, resulting in improved performance on tasks dissimilar from the trained tasks (transfer of training), is a controversial topic. Here, we tested the degree to which cognitive training, in the form of gamified training activities that have demonstrated some degree of success in the past, might result in broad transfer. Sixty older adults were randomly assigned to a gamified cognitive training intervention or to an active control condition that involved playing word and number puzzle games. Participants were provided with tablet computers and asked to engage in their assigned training for 30 45-min training sessions over the course of 1 month. Although intervention adherence was acceptable, little evidence for transfer was observed except for the performance of one task that most resembled the gamified cognitive training: There was a trend for greater improvement on a version of the corsi block tapping task for the cognitive training group relative to the control group. This task was very similar to one of the training games. Results suggest that participants were learning specific skills and strategies from game training that influenced their performance on a similar task. However, even this near-transfer effect was weak. Although the results were not positive with respect to broad transfer of training, longer duration studies with larger samples and the addition of a retention period are necessary before the benefit of this specific intervention can be ruled out. PMID:28293188

  12. Assessment of physical activity in older people with and without cognitive impairment.

    PubMed

    Hauer, Klaus; Lord, Stephen R; Lindemann, Ulrich; Lamb, Sarah E; Aminian, Kamiar; Schwenk, Michael

    2011-10-01

    The purpose of this study was to validate a new interview-administered physical activity questionnaire (Assessment of Physical Activity in Frail Older People; APAFOP) in older people with and without cognitive impairment. The authors assessed feasibility, validity, and test-retest reliability in 168 people (n = 78 with, n = 88 without cognitive impairment). Concurrent validity was assessed against an inertia-based motion sensor and an established questionnaire. Sensitivity to change was tested in an ongoing study in patients with mild to moderate dementia (n = 81). Assessment of physical activity by the APAFOP and the motion sensor correlated well in the total sample (TS; p = .705), as well as in the subsamples with cognitive impairment (CI; p = .585) and without CI (p = .787). Excellent feasibility with an acceptance rate of 100%, test-retest reliability (intraclass correlation coefficients ranging from .973 (TS) to .975 (CI) to .966 (no CI), and sensitivity to change (effect sizes: 0.35-1.47) were found in both subsamples.

  13. The practical management of cognitive impairment and psychosis in the older Parkinson's disease patient.

    PubMed

    Hindle, John V

    2013-04-01

    Parkinson's disease (PD) has been described as an age-related disease. Ageing significantly increases the risk of psychosis and dementia. Older patients often have a complex mixture of delirium, psychosis, dementia, gait and balance problems and other comorbidities which can cause significant management problems. There are concerns about the safety and tolerability of the treatments for psychosis and dementia. Delirium is common in older Parkinson's patients and must be assessed and managed carefully. The aetiology of psychosis in Parkinson's is complex and often associated with the development of cognitive impairment. Initial adjustments of Parkinson's drugs should be considered if symptoms are intrusive. Where drug therapy is required, evidence suggests that quetiapine may be a safe initial option. There is no contraindication to the use of clozapine in older patients, with the required blood monitoring. Dementia is almost inevitable with very advanced disease and increasing age, and is associated with a marked cholinergic deficit in the brain. Cholinesterase inhibitors may be more effective in PD than in Alzheimer's disease and appear relatively safe with appropriate monitoring of the pulse. There is much less evidence for the use of memantine. There is no current evidence for the use of specific non-pharmacological therapies in the management of psychosis or dementia in PD. Due to the associated gait and balance problems, older Parkinson's patients benefit from comprehensive multi-disciplinary assessment.

  14. Cognitive therapy for depression: a comparison of individual psychotherapy and bibliotherapy for depressed older adults.

    PubMed

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

    2004-03-01

    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 (Bums, 1980) for bibliotherapy. Posttreatment comparisons with the delayed-treatment control indicated that both treatments were superior to a delayed-treatment control. Individual psychotherapy was superior to bibliotherapy at posttreatment on self-reported depression, but there were no differences on clinician-rated depression. Further, bibliotherapy participants continued to improve after posttreatment. and there were no differences between treatments at 3-month follow-up. Results suggest that bibliotherapy and that individual psychotherapy are both viable treatment options for depression in older adults.

  15. Effects of major depression on the cognitive function of younger and older subjects.

    PubMed

    Tarbuck, A F; Paykel, E S

    1995-03-01

    The effects of age and depression on cognitive function were investigated in two groups of in-patient major depressives aged under and over 60 years who were tested when depressed and after recovery. The majority of the tests showed impaired performance during depression with improvement after recovery, and also differences between the two age-groups in both the depressed and recovered phases. However, the older subjects were not more severely affected by depression than the younger subjects. The pattern of impairment associated with depression was different to that associated with older age: depression affected performance on more 'complex tasks', whereas age was associated particularly with slowing on timed tests. This study did not suggest that the impairment from baseline due to the depression is greater in the elderly than in younger subjects.

  16. Modifying Cognitive-Behavioral Therapy for a Depressed Older Adult With Partial Sight: A Case Report.

    PubMed

    Utoyo, Dharmayati Bambang

    2015-01-01

    Depression is a common mental health problem in older adults, especially among those suffering from visual impairment. A clinical case of an Indonesian older adult with retinal detachment (75% blindness) suffering from Major Depressive Disorder, based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria, was reported. Her principal motivation to seek help was her depressive symptoms, as well as her husband's discomfort with her change. A modified standardized cognitive-behavioral therapy was delivered in eight sessions, and a clinically significant reduction of depressive symptoms was observed at the middle of the treatment (Session 5); symptoms were further reduced at follow-up. This case report showed that conventional evidence-based psychological treatment can be modified to handle mental health problems in people with visual impairments.

  17. 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.

  18. Patient-rated versus proxy-rated cognitive and functional measures in older adults

    PubMed Central

    Howland, Molly; Allan, Kevin C; Carlton, Caitlin E; Tatsuoka, Curtis; Smyth, Kathleen A; Sajatovic, Martha

    2017-01-01

    Objectives Patients with cognitive impairment may have difficulty reporting their functional and cognitive abilities, which are important clinical outcomes. Health care proxies may be able to corroborate patient self-reports. Several studies reported discrepancy between patient and proxy ratings, though the literature is sparse on changes over time of these ratings. Our goals in this 12-month study were to compare patient and proxy reports on functioning, cognition, and everyday executive function, and to further elucidate correlates of patient–proxy discrepancy. Methods This was a prospective cohort study of individuals older than 70 years who ranged from having no cognitive impairment to having moderate dementia who had a proxy available to complete instruments at baseline (N=76). Measurements included Alzheimer’s Disease Cooperative Study–Activities of Daily Living Inventory (ADCS-ADLI), Neuro-QOL Executive Function, PROMIS Applied Cognition (PROMIS-Cog), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale. Results Patient- and proxy-rated ADCS-ADLI were correlated at baseline and at 1-year follow-up. Patient and proxy ratings were discrepant on Neuro-QOL Executive Function and PROMIS-Cog. Greater patient–proxy discrepancy on PROMIS-Cog was associated with younger age and less depression, and greater patient–proxy discrepancy on Neuro-QOL Executive Function was associated with less depression and worse cognitive impairment. Patient–proxy discrepancy increased over time for everyday executive function. Changes in proxy-rated but not patient-rated ADCS-ADLI correlated with MMSE changes. Conclusion Patients and proxies generally agree in reporting on activities of daily living. Patient and proxy reports differ in their respective evaluation of cognitive functioning and everyday executive function. Ratings from both sources may be preferred for these two domains, though studies using gold standard measures are necessary. It is important

  19. Vascular Health and Cognitive Function in Older Adults with Cardiovascular Disease.

    PubMed

    Forman, Daniel E; Cohen, Ronald A; Hoth, Karin F; Haley, Andreana P; Poppas, Athena; Moser, David J; Gunstad, John; Paul, Robert H; Jefferson, Angela L; Tate, David F; Ono, Makoto; Wake, Nicole; Gerhard-Herman, Marie

    2008-02-01

    BACKGROUND: We hypothesized that changes in vascular flow dynamics resulting from age and cardiovascular disease (CVD) would correlate to neurocognitive capacities, even in adults screened to exclude dementia and neurological disease. We studied endothelial-dependent as well as endothelial-independent brachial responses in older adults with CVD to study the associations of vascular responses with cognition. Comprehensive neurocognitive testing was used to discern which specific cognitive domain(s) correlated to the vascular responses. METHODS: Eighty-eight independent, community-dwelling older adults (70.02+7.67 years) with mild to severe CVD were recruited. Enrollees were thoroughly screened to exclude neurological disease and dementia. Flow-mediated (endothelial-dependent) and nitroglycerin-mediated (endothelial-independent) brachial artery responses were assessed using 2-d ultrasound. Cognitive functioning was assessed using comprehensive neuropsychological testing. Linear regression analyses were used to evaluate the relationships between the endothelial-dependent and endothelial-independent vascular flow dynamics and specific domains of neurocognitive function. RESULTS: Endothelial-dependent and endothelial-independent brachial artery responses both correlated with neurocognitive testing indices. The strongest independent relationship was between endothelial function and measures of attention-executive functioning. CONCLUSIONS: Endothelial-dependent and endothelial-independent vascular responsiveness correlate with neurocognitive performance among older CVD patients, particularly in the attention-executive domain. While further study is needed to substantiate causal relationships, our data demonstrate that brachial responses serve as important markers of risk for common neurocognitive changes. Learning and behavior-modifying therapeutic strategies that compensate for such common, insidious neurocognitive limitations will likely improve caregiving efficacy.

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

    PubMed

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

    2013-09-01

    Literacy is an important determinant of health and well-being across the life span 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. Six-hundred and forty-five 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 used 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

  1. 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

  2. Two-year follow-up of bibliotherapy and individual cognitive therapy for depressed older adults.

    PubMed

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

    2006-05-01

    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 on the Hamilton Rating Scale for Depression (HRSD) and the Geriatric Depression Scale (GDS). Results indicated that treatment gains from baseline to the 2-year follow-up period were maintained on the HRSD and GDS, and there was not a significant decline from posttreatment to follow-up. There were no significant differences between the treatments on the GDS or HRSD at the 2-year follow-up; however, bibliotherapy participants had significantly more recurrences of depression during the follow-up period.

  3. Cognitive Change Checklist (3CL): Psychometric Characteristicsin Community Dwelling Older Adults

    PubMed Central

    Schinka, John A.; Robinson, Diane C.; Mills, Whitney L.; Brown, Lisa M.

    2012-01-01

    Objective To extend the psychometric study of the Cognitive Change Checklist (3CL) by examining the reliability, factor structure, and external correlates of 3CL informant and self-report ratings in community dwelling adults. We also conducted ROC analyses examining rating scores from this normative sample with those of clinical samples. Design Scale reliability and validity study. Setting Community sites. Participants Six hundred and seventy-nine older adults. Results The pattern of scale relationships within and across versions, and the failure to find associations with age and education, were consistent with findings in clinic samples reported previously. Factor analysis replicated the four-factor structure of the informant ratings. All informant version scales significantly discriminated amnestic Mild Cognitive Impairment (MCI) cases and patients with mild dementia from normals. Conclusion These findings provide support for the use of the checklist as a clinical tool to facilitate identification of cases of MCI and early dementia. PMID:23032479

  4. 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

  5. Behavioral and neuroimaging evidence for impaired executive function in "cognitively normal" older HIV-infected adults.

    PubMed

    Jiang, Xiong; Barasky, Rebecca; Olsen, Halli; Riesenhuber, Maximilian; Magnus, Manya

    2016-01-01

    The increased prevalence of HIV among adults >50 years underscores the importance of improving our understanding of mechanisms causing HIV-associated neurocognitive disorders (HAND). Identifying novel and noninvasive diagnostic predictors of HAND prior to clinical manifestation is critical to ultimately identifying means of preventing progression to symptomatic HAND. Here, using a task-switching paradigm, in which subjects were cued (unpredictably) to perform a face-gender or a word-semantic task on superimposed face and word images, we examined the behavioral and neural profile of impaired cognitive control in older HIV + adults (N = 14, 9 HIV+). Functional magnetic resonance imaging (fMRI) and behavioral data were acquired while subjects were performing the face-gender or word-semantic task. We found that, despite comparable performance in standard neuropsychology tests that are designed to probe executive deficits, HIV-infected participants were significantly slower than uninfected controls in adapting to change in task demand, and the behavioral impairments can be quantitatively related to difference in fMRI signal at the dorsal anterior cingulate cortex (ACC). Due to the limited sample size of this hypothesis-generating study, we should take caution with these findings and future studies with a large and better matched sample size are needed. However, these rather novel findings in this study have a few important implications: first, the prevalence of cognitive impairments in HIV+ older adults might be even higher than previously proposed; second, ACC (in particularly its dorsal region) might be one of the key regions underlying cognitive impairments (in particularly executive functions) in HIV; and third, it might be beneficial to adopt paradigms developed and validated in cognitive neuroscience to study HAND, as these techniques might be more sensitive to some aspects of HIV-associated neurocognitive impairments than standard neuropsychology tests.

  6. 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

  7. Can cognitive enhancers reduce the risk of falls in older people with Mild Cognitive Impairment? A protocol for a randomised controlled double blind trial

    PubMed Central

    2009-01-01

    Background Older adults with cognitive problems have a higher risk of falls, at least twice that of cognitively normal older adults. The consequences of falls in this population are very serious: fallers with cognitive problems suffer more injuries due to falls and are approximately five times more likely to be admitted to institutional care. Although the mechanisms of increased fall risk in cognitively impaired people are not completely understood, it is known that impaired cognitive abilities can reduce attentional resource allocation while walking. Since cognitive enhancers, such as cholinesterase inhibitors, improve attention and executive function, we hypothesise that cognitive enhancers may reduce fall risk in elderly people in the early stages of cognitive decline by improving their gait and balance performance due to an enhancement in attention and executive function. Method/Design Double blinded randomized controlled trial with 6 months follow-up in 140 older individuals with Mild Cognitive Impairment (MCI). Participants will be randomized to the intervention group, receiving donepezil, and to the control group, receiving placebo. A block randomization by four and stratification based on fall history will be performed. Primary outcomes are improvements in gait velocity and reduction in gait variability. Secondary outcomes are changes in the balance confidence, balance sway, attention, executive function, and number of falls. Discussion By characterizing and understanding the effects of cognitive enhancers on fall risk in older adults with cognitive impairments, we will be able to pave the way for a new approach to fall prevention in this population. This RCT study will provide, for the first time, information regarding the effect of a medication designed to augment cognitive functioning have on the risk of falls in older adults with Mild Cognitive Impairment. We expect a significant reduction in the risk of falls in this vulnerable population as a function

  8. 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.

  9. Social disorder, APOE-E4 genotype, and change in cognitive function among older adults living in Chicago.

    PubMed

    Boardman, Jason D; Barnes, Lisa L; Wilson, Robert S; Evans, Denis A; Mendes de Leon, Carlos F

    2012-05-01

    The goal of this paper is to describe the simultaneous influence of social and genetic risk factors on declines in cognitive functioning among older American adults. We use detailed information about the social characteristics of older adults' neighborhoods from the Chicago Health and Aging Project (n = 1655; ages 65+) in conjunction with information about respondent's APOE genotype to predict changes in cognitive function over time. Results indicate that the presence of the ε4 allele is associated with a significantly lower cognitive function score at baseline and greater declines in cognitive function compared to those without this risk allele. Importantly, we also show significant variation in the effect of the ε4 allele across neighborhoods and our results indicate that this genotype is more strongly associated with cognitive function for residents of neighborhoods with the lowest levels of social disorder. Our findings support the non-causal social push gene-environment interaction model.

  10. Cognitive performance in older adults is inversely associated with fish consumption but not erythrocyte membrane n-3 fatty acids.

    PubMed

    Danthiir, Vanessa; Hosking, Diane; Burns, Nicholas R; Wilson, Carlene; Nettelbeck, Ted; Calvaresi, Eva; Clifton, Peter; Wittert, Gary A

    2014-03-01

    Higher n-3 (ω-3) polyunsaturated fatty acids (PUFAs) and fish intake may help maintain cognitive function in older age. However, evidence is inconsistent; few studies have examined the relation in cognitively healthy individuals across numerous cognitive domains, and none to our knowledge have considered lifetime fish intake. We examined associations between multiple domains of cognition and erythrocyte membrane n-3 PUFA proportions and historical and contemporary fish intake in 390 normal older adults, analyzing baseline data from the Older People, Omega-3, and Cognitive Health trial. We measured n-3 PUFA in erythrocyte membranes, and we assessed historical and contemporary fish intake by food-frequency questionnaires. We assessed cognitive performance on reasoning, working memory, short-term memory, retrieval fluency, perceptual speed, simple/choice reaction time, speed of memory-scanning, reasoning speed, inhibition, and psychomotor speed. Cognitive outcomes for each construct were factor scores from confirmatory factor analysis. Multiple linear regression models controlled for a number of potential confounding factors, including age, education, sex, apolipoprotein E-ε 4 allele, physical activity, smoking, alcohol intake, socioeconomic variables, and other health-related variables. Higher erythrocyte membrane eicosapaentonoic acid proportions predicted slower perceptual and reasoning speed in females, which was attenuated once current fish intake was controlled. No other associations were present between n-3 PUFA proportions and cognitive performance. Higher current fish consumption predicted worse performance on several cognitive speed constructs. Greater fish consumption in childhood predicted slower perceptual speed and simple/choice reaction time. We found no evidence to support the hypothesis that higher proportions of long-chain n-3 fatty acids or fish intake benefits cognitive performance in normal older adults.

  11. Video Feedback Intervention to Enhance the Safety of Older Drivers With Cognitive Impairment

    PubMed Central

    Davis, Jennifer D.; Bixby, Kimberly

    2017-01-01

    OBJECTIVE. To demonstrate that g-force technology can be used to help older adults with cognitive impairment improve their driving safety as part of an in-car video feedback intervention. METHOD. Unsafe driving events triggered g-forces leading to capture of video clips. The program included 3 mo of monitoring without intervention, 3 mo of intervention (weekly written progress reports, a DVD of unsafe driving events, and weekly telephone contacts), and 3 mo of postintervention monitoring. RESULTS. Mean total unsafe driving events per 1,000 miles were reduced from baseline by 38% for 9 of 12 participants during the intervention and by 55% for 7 participants during postintervention monitoring. Mean total unsafe driving severity scores per 1,000 miles were reduced from baseline by 43% during the intervention and by 56% during postintervention monitoring. CONCLUSION. Preliminary results suggest that driving safety among older drivers with cognitive impairment can be improved using a behavior modification approach aimed at problem behaviors detected in their natural driving environment. PMID:28218593

  12. 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

  13. 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

  14. Strategic Variations in Fitts’ Task: Comparison of Healthy Older Adults and Cognitively Impaired Patients

    PubMed Central

    Poletti, Céline; Sleimen-Malkoun, Rita; Decker, Leslie Marion; Retornaz, Frédérique; Lemaire, Patrick; Temprado, Jean-Jacques

    2017-01-01

    The present study aimed at investigating how healthy older adults (HOA) and cognitively impaired patients (CIP) differ in a discrete Fitts’ aiming task. Four levels of task difficulty were used, resulting from the simultaneous manipulation of the size of the target and its distance from home position. We found that movement times (MTs) followed Fitts’ law in both HOA and CIP, with the latter being significantly slower and more affected by increased task difficulty. Moreover, correlation analyses suggest that lower information processing speed (IPS) and deficits in executive functions (EFs) are associated with decline of sensorimotor performance in Fitts’ task. Analyses of strategic variations showed that HOA and CIP differed in strategy repertoire (which strategies they used), strategy distribution (i.e., how often they used each available strategy), and strategy execution (i.e., how quick they were with each available strategy). These findings further our understanding of how strategic variations used in a sensorimotor task are affected by cognitive impairment in older adults. PMID:28163682

  15. Hippocampal morphology and cognitive functions in community-dwelling older people: the Lothian Birth Cohort 1936.

    PubMed

    Valdés Hernández, Maria Del Carmen; Cox, Simon R; Kim, Jaeil; Royle, Natalie A; Muñoz Maniega, Susana; Gow, Alan J; Anblagan, Devasuda; Bastin, Mark E; Park, Jinah; Starr, John M; Wardlaw, Joanna M; Deary, Ian J

    2017-04-01

    Structural measures of the hippocampus have been linked to a variety of memory processes and also to broader cognitive abilities. Gross volumetry has been widely used, yet the hippocampus has a complex formation, comprising distinct subfields which may be differentially sensitive to the deleterious effects of age, and to different aspects of cognitive performance. However, a comprehensive analysis of multidomain cognitive associations with hippocampal deformations among a large group of cognitively normal older adults is currently lacking. In 654 participants of the Lothian Birth Cohort 1936 (mean age = 72.5, SD = 0.71 years), we examined associations between the morphology of the hippocampus and a variety of memory tests (spatial span, letter-number sequencing, verbal recall, and digit backwards), as well as broader cognitive domains (latent measures of speed, fluid intelligence, and memory). Following correction for age, sex, and vascular risk factors, analysis of memory subtests revealed that only right hippocampal associations in relation to spatial memory survived type 1 error correction in subiculum and in CA1 at the head (β = 0.201, p = 5.843 × 10(-4), outward), and in the ventral tail section of CA1 (β = -0.272, p = 1.347 × 10(-5), inward). With respect to latent measures of cognitive domains, only deformations associated with processing speed survived type 1 error correction in bilateral subiculum (βabsolute ≤ 0.247, p < 1.369 × 10(-4), outward), bilaterally in the ventral tail section of CA1 (βabsolute ≤ 0.242, p < 3.451 × 10(-6), inward), and a cluster at the left anterior-to-dorsal region of the head (β = 0.199, p = 5.220 × 10(-6), outward). Overall, our results indicate that a complex pattern of both inward and outward hippocampal deformations are associated with better processing speed and spatial memory in older age, suggesting that complex shape-based hippocampal analyses may provide valuable information beyond

  16. 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

  17. Attentional bias in older adults: effects of generalized anxiety disorder and cognitive behavior therapy.

    PubMed

    Mohlman, Jan; Price, Rebecca B; Vietri, Jeff

    2013-08-01

    Attentional biases are known to play a contributing, and perhaps even causal role in the etiology of anxiety and other negative affective states. The prevalence of anxiety disorders in the older cohort is growing, and there are both theoretical and empirical reasons to suspect that age-related factors could moderate attentional bias effects in the context of late-life anxiety. The current study included one of the most widely-used measures of attentional bias, the dot-probe task (Mathews & MacLeod, 1985). Participants were older adults who were either nonanxious or diagnosed with generalized anxiety disorder. The patient subsample also completed cognitive behavior therapy (CBT) or an equivalent wait list condition, after which the dot probe was administered a second time. Results showed that clinical anxiety had no particular importance for the deployment of attention, casting doubt on the universality of biased attention in older anxiety patients. Although there were no maladaptive biases detected toward either threat or depression words at pretreatment, there was nevertheless a marginally significant differential reduction in bias toward threat words following CBT. This reduction did not occur among those in the wait list condition. Implications are discussed.

  18. Relocation at older age: results from the Cognitive Function and Ageing Study

    PubMed Central

    Wu, Yu-Tzu; Prina, A. Matthew; Barnes, Linda E.; Matthews, Fiona E.; Brayne, Carol

    2015-01-01

    Background Community environment might play an important role in supporting ageing in place. This paper aims to explore relocation at older age and its associations with individual and community level factors. Methods The postcodes of the 2424 people in the year-10 interview of the Cognitive Function and Ageing Study (CFAS) in England were mapped onto Enumeration Districts and linked to their corresponding Townsend deprivation score and the 2011 rural/urban categories. Multilevel logistic regression was conducted to examine the influence of the baseline individual (age, gender, education and social class) and community (rural/urban categories and area deprivation) level factors on relocation over 10 years. Results One-third of people moved residence after the age of 65 years and over. Older age, low education, low social class and living in rural areas at baseline were associated with higher probability of moving later in life. The likelihood of relocation in later life increased from least to most deprived areas (odds ratio: 2.0, 95% confidence interval: 1.4, 2.8). Conclusions Urban/rural contexts and area deprivation are associated with relocation at older age and indicate that community environment may be relevant to ageing in place. PMID:25922369

  19. 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.

  20. The heritability of level and rate-of-change in cognitive functioning in Danish twins aged 70 years and older.

    PubMed

    McGue, Matt; Christensen, Kaare

    2002-01-01

    To investigate heritable influences on overall level and rate-of-change in cognitive ability, biometric growth models were fit to cognitive data from nearly 1000 Danish twins age 70 years and older. Twins are participants in the ongoing Longitudinal Study of Aging Danish Twins, a cohort-sequential study of twins assessed every 2 years for up to four waves. Cognitive ability was assessed by five brief cognitive tasks: a fluency measure, forward and backward digit span, and immediate and delayed list recall. Model-fitting results indicated that although the overall level of cognitive functioning was highly heritable (h(2) = .76, 95% confidence interval of .68 to .82), the rate of linear change was not (h(2) = .06, 95% confidence interval of .00 to .57). These findings suggest that the search for specific genes might reasonably focus on average level of cognitive performance, whereas specific environmental influences might account for cognitive change.

  1. 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

  2. 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.

  3. Kidney function and cognitive health in older adults: the Cardiovascular Health Study.

    PubMed

    Darsie, Brendan; Shlipak, Michael G; Sarnak, Mark J; Katz, Ronit; Fitzpatrick, Annette L; Odden, Michelle C

    2014-07-01

    Recent evidence has demonstrated the importance of kidney function in healthy aging. We examined the association between kidney function and change in cognitive function in 3,907 participants in the Cardiovascular Health Study who were recruited from 4 US communities and studied from 1992 to 1999. Kidney function was measured by cystatin C-based estimated glomerular filtration rate (eGFRcys). Cognitive function was assessed using the Modified Mini-Mental State Examination and the Digit Symbol Substitution Test, which were administered up to 7 times during annual visits. There was an association between eGFRcys and change in cognitive function after adjustment for confounders; persons with an eGFRcys of less than 60 mL/minute/1.73 m(2) had a 0.64 (95% confidence interval: 0.51, 0.77) points/year faster decline in Modified Mini-Mental State Examination score and a 0.42 (95% confidence interval: 0.28, 0.56) points/year faster decline in Digit Symbol Substitution Test score compared with persons with an eGFRcys of 90 or more mL/minute/1.73 m(2). Additional adjustment for intermediate cardiovascular events modestly affected these associations. Participants with an eGFRcys of less than 60 mL/minute/1.73 m(2) had fewer cognitive impairment-free life-years on average compared with those with eGFRcys of 90 or more mL/minute/1.73 m(2), independent of confounders and mediating cardiovascular events (mean difference = -0.44, 95% confidence interval: -0.62, -0.26). Older adults with lower kidney function are at higher risk of worsening cognitive function.

  4. 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

  5. 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

  6. Cognitive Impairment, Oral Self-care Function and Dental Caries Severity in Community-dwelling Older Adults

    PubMed Central

    Chen, Xi; Clark, Jennifer JJ; Chen, Hong; Naorungroj, Supawadee

    2013-01-01

    Objective To investigate whether oral self-care function mediates the associations between cognitive impairment and caries severity in community-dwelling older adults. Background Cognitive impairment significantly affects activities of daily living and compromises oral health, systemic health and quality of life in older adults. However, the associations among cognitive impairment, oral self-care capacity and caries severity remain unclear. This increases difficulty in developing effective interventions for cognitively impaired patients. Materials and methods Medical, dental, cognitive and functional assessments were abstracted from the dental records of 600 community-dwelling elderly. 230 participants were selected using propensity score matching and categorised into normal, cognitive impairment but no dementia (CIND) and dementia groups based on their cognitive status and a diagnosis of dementia. Multivariable regressions were developed to examine the mediating effect of oral self-care function on the association between cognitive status and number of caries or retained roots. Results Cognitive impairment, oral self-care function and dental caries severity were intercorrelated. Multivariable analysis showed that without adjusting for oral self-care capacity, cognition was significantly associated with the number of caries or retained roots (p = 0.003). However, the association was not significant when oral self-care capacity was adjusted (p = 0.125). In contrast, individuals with impaired oral self-care capacity had a greater risk of having a caries or retained root (RR = 1.67, 95% CI 1.15, 2.44). Conclusion Oral care capacity mediates the association between cognition and dental caries severity in community-dwelling older adults. PMID:23758583

  7. Development and Feasibility of a Virtual Reality Task for the Cognitive Assessment of Older Adults: The ECO-VR.

    PubMed

    Oliveira, Camila R; Lopes Filho, Brandel José P; Sugarman, Michael A; Esteves, Cristiane S; Lima, Margarida Maria B M P; Moret-Tatay, Carmen; Irigaray, Tatiana Q; Argimon, Irani Iracema L

    2016-12-13

    Cognitive assessment with virtual reality (VR) may have superior ecological validity for older adults compared to traditional pencil-and-paper cognitive assessment. However, few studies have reported the development of VR tasks. The aim of this study was to present the development, feasibility, content validity, and preliminary evidence of construct validity of an ecological task of cognitive assessment for older adults in VR (ECO-VR). The tasks were prepared based on theoretical and clinical backgrounds. We had 29 non-expert judges identify virtual visual stimuli and three-dimensional scenarios, and five expert judges assisted with content analysis and developing instructions. Finally, six older persons participated in three pilot studies and thirty older persons participated in the preliminary study to identify construct validity evidence. Data were analyzed by descriptive statistics and partial correlation. Target stimuli and three-dimensional scenarios were judged adequate and the content analysis demonstrated that ECO-VR evaluates temporo-spatial orientation, memory, language and executive functioning. We made significant changes to the instructions after the pilot studies to increase comprehensibility and reduce the completion time. The total score of ECO-VR was positively correlated mainly with performance in executive function (r = .172, p < .05) and memory tests (r = .488, p ≤ .01). The ECO-VR demonstrated feasibility for cognitive assessment in older adults, as well as content and construct validity evidences.

  8. 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.

  9. Correlations between aerobic capacity, pulmonary and cognitive functioning in the older women.

    PubMed

    Kara, B; Pinar, L; Uğur, F; Oğuz, M

    2005-04-01

    Regular aerobic exercise improves aerobic capacity and increases brain blood flow and oxygenation. Exercise also stimulates the reticular activating system and leads to a centrally excited state thereby makes the brain active and alert. In the present study, an aerobic exercise program consisting of submaximal level calisthenic exercises was devised for relatively healthy women between 60 and 80 years old, attending a solidarity center for the aged for daily activities. The effects of exercise on aerobic fitness, and the correlations between aerobic capacities, pulmonary functions and cognition were evaluated. Following a general health examination, 45 female volunteers fulfilling the international criteria of exercising standards for the aged were included in the program. The rhythmic and entertaining calisthenic exercises were performed by the older women for four months, three days a week, 40 or 50 minutes a day. Tests for aerobic capacities, pulmonary functions, and some neuropsychologic performances were carried out during the sedentary period and after the exercise program. The results revealed significant improvements in aerobic capacity, pulmonary functions, and some of the cognitive functions after the 4-month exercise program. We found strong relationships between aerobic capacities and cognitive functioning. Overall, the subjects expressed their happiness and well being on every occasion, during and after the exercise program.

  10. 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.

  11. Music intervention on cognitive dysfunction in healthy older adults: a systematic review and meta-analysis.

    PubMed

    Xu, Bing; Sui, Yi; Zhu, Chunyan; Yang, Xiaomei; Zhou, Jin; Li, Li; Ren, Li; Wang, Xu

    2017-03-08

    The background of this study is to determine whether there is an association between music intervention and cognitive dysfunction therapy in healthy older adults, and if so, whether music intervention can be used as first-line non-pharmacological treatment. The method used in this study is to conduct a systematic review and meta-analysis of clinical trials that examined the effects of music intervention on patient-relevant and disease-specific outcomes. A comprehensive literature was performed on PubMed, EMbase and the Cochrane Library from inception to September 2016. A total of 10 studies (14 analyses, 966 subjects) were included; all of them had an acceptable quality based on the PEDro scale score and CASP scale score. Compared with control group, the standardized mean difference was 0.03 (-0.18 to 0.24) for cognitive function as primary outcome by random effect model; secondary outcomes were included disruptive behavior, depressive score, anxiety and quality of life. No evidence of publication bias could be found in funnel plots, Begg's test and Egger's test. Subgroup analyses showed that intervention method, comparator, trial design, trial period and outcome measure instruments made little difference in outcomes. Meta-regression might not identify cause of heterogeneity. This study is registered with PROSPERO, number CRD442016036264. There was positive evidence to support the use of music intervention on treatment of cognitive function.

  12. Social support, physical functioning, and cognitive functioning among older African American adults.

    PubMed

    Ayotte, Brian J; Allaire, Jason C; Whitfield, Keith E

    2013-01-01

    Social support and functional ability are related to a number of outcomes in later life among African Americans, including cognitive performance. This study examined how providing and receiving social support was related to fluid and crystallized cognitive abilities among aging African American adults after accounting for functional limitations, age, education, sex, income, and self-reported health. Data from 602 African American adults (M = 69.08, SD = 9.74; 25% male) were analyzed using latent variable modeling. Fluid ability was a second-order factor indicated by measures that assessed verbal memory, working memory, perceptual speed, and inductive reasoning. Crystallized ability was a first-order factor indicated by three measures that assessed vocabulary (Shipley Verbal Meaning Test and parts A and B of the ETS Vocabulary Test). Results indicated that the receipt of social support was negatively related to both fluid and crystallized abilities, while the provision of support was positively related to fluid and crystallized ability. Follow-up tests found that the receipt of support was more strongly related to fluid ability than crystallized ability. There was no significant difference regarding the relationship of provision of support with fluid ability compared to crystallized ability. Results discuss the importance of considering the social context of older adults when examining cognitive ability.

  13. The Associations among Insulin Resistance, Hyperglycemia, Physical Performance, Diabetes Mellitus, and Cognitive Function in Relatively Healthy Older Adults with Subtle Cognitive Dysfunction

    PubMed Central

    Umegaki, Hiroyuki; Makino, Taeko; Uemura, Kazuki; Shimada, Hiroyuki; Hayashi, Takahiro; Cheng, Xian Wu; Kuzuya, Masafumi

    2017-01-01

    Insulin resistance (IR), diabetes mellitus (DM), sarcopenia, and cognitive dysfunction are thought to be mutually associated. We conducted a comprehensive assessment of the relationships among IR, gait speed, hyperglycemia, and DM by cross-sectionally analyzing the baseline data of an interventional study for cognitive preservation with physical exercise (the TOyota Preventional Intervention for Cognitive decline and Sarcopenia [TOPICS]). The participants (n = 444) were relatively healthy older individuals who had mild cognitive impairment without dementia, and 61 of the participants had DM. Slow gait speed and hyperglycemia were associated with cognitive dysfunction, mainly in the executive function domain, whereas IR was associated with memory impairment. The participants with DM had lower general cognition and executive function. Executive dysfunction in the DM participants seemed to be partly explained by hyperglycemia and/or slow gait speed. Our findings confirmed that IR, DM, sarcopenia, and cognitive dysfunction are mutually associated in complex ways. Understanding the mechanisms underlying these associations will lead to effective strategies to prevent and treat cognitive dysfunction in older individuals. PMID:28386227

  14. The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: a systematic review and meta-analysis.

    PubMed

    Kelly, Michelle E; Loughrey, David; Lawlor, Brian A; Robertson, Ian H; Walsh, Cathal; Brennan, Sabina

    2014-05-01

    This systematic review and meta-analysis investigates the impact of cognitive training and general mental stimulation on the cognitive and everyday functioning of older adults without known cognitive impairment. We examine transfer and maintenance of intervention effects, and the impact of training in group versus individual settings. Thirty-one randomised controlled trials were included, with 1806 participants in cognitive training groups and 386 in general mental stimulation groups. Meta-analysis results revealed that compared to active controls, cognitive training improved performance on measures of executive function (working memory, p=0.04; processing speed, p<0.0001) and composite measures of cognitive function (p=0.001). Compared to no intervention, cognitive training improved performance on measures of memory (face-name recall, p=0.02; immediate recall, p=0.02; paired associates, p=0.001) and subjective cognitive function (p=0.01). The impact of cognitive training on everyday functioning is largely under investigated. More research is required to determine if general mental stimulation can benefit cognitive and everyday functioning. Transfer and maintenance of intervention effects are most commonly reported when training is adaptive, with at least ten intervention sessions and a long-term follow-up. Memory and subjective cognitive performance might be improved by training in group versus individual settings.

  15. Rehabilitation Interventions for Older Individuals with Cognitive Impairment Post Hip Fracture: A Systematic Review

    PubMed Central

    Resnick, Barbara; Beaupre, Lauren; McGilton, Katherine S; Galik, Elizabeth; Liu, Wen; Neuman, Mark D.; Gruber-Baldini, Ann L.; Orwig, Denise; Magaziner, Jay

    2015-01-01

    Purpose Currently, most rehabilitation services for individuals who sustain a hip fracture are not designed to meet the complex needs of those who also have cognitive impairment. The goal of this review was to identify current best practices for rehabilitation in long term care settings and approaches to optimize outcomes among individuals with dementia and other cognitive impairments post hip fracture. Procedures The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (the PRISMA Statement) was used to guide the review. Five electronic databases, including Pubmed, EMBASE, CINAHL (EBSCO), Medline (EBSCO) and PsycINFO (EBSCO), were searched for intervention studies published in English language journals. Studies were eligible if they focused on rehabilitation interventions post hip fracture among older individuals (≥ 65 years) with cognitive impairment who were living in or transferred to long-term care or post-acute/rehabilitation settings post hip fracture. Studies were excluded if they did not enroll individuals with cognitive impairment, the study was descriptive without any intervention content, or the intervention components were only medication, surgical approach or medical treatment. Main Findings A total of 4,478 records were identified, 1915 of which were duplicative, 2,563 were relevant based on title and after careful review seven studies were included. Two included studies were randomized controlled trials, one was a single group pre- and post-test, one a descriptive comparison between those with and without cognitive impairment, one a case controlled matched trial, one a nonequivalent groups trial, and one a case report. The interventions varied between manipulating the type and amount of exercise or testing multifactorial issues including environmental interventions and the use of an interdisciplinary team to address psychosocial factors, medication management, use of assistive devices, and specific preferences or concerns of the

  16. An eye movement analysis of web usability: Differences between older adults with and without mild cognitive impairment.

    PubMed

    Haesner, Marten; Chandra, Johan; Steinert, Anika; Steinhagen-Thiessen, Elisabeth

    2017-02-02

    Older adults are exposed to computer-based applications daily. However, most websites and applications are not specifically developed for older adults. Studies have shown that older adults with mild cognitive impairment (MCI) behave differently from older adults without MCI in website usage. Eye tracking is a valuable tool to assess users' eye movement behavior in relation to website usability. Understanding the differences in web navigational behavior between older adults with and without MCI would be helpful for developing websites for this target group. This article presents eye tracking data from several tasks while using a cognitive training application. Overall results revealed that older adults with MCI required significantly longer to complete the tasks (U = 116.0, p < 0.05) and were significantly less successful in completing the tasks than those without MCI (U = 101.5, p < 0.05). However, there were no significant differences in eye movement patterns for any of the individual tasks, except one that required participants to use several pathways in order to successfully complete it. These findings demonstrate that eye tracking is an effective method for accessing users' eye movement patterns and the usability of a platform. However, the method was not successful in differentiating eye movement behavior between older adults with and without MCI.

  17. Sleep Duration and Subsequent Cortical Thinning in Cognitively Normal Older Adults

    PubMed Central

    Spira, Adam P.; Gonzalez, Christopher E.; Venkatraman, Vijay K.; Wu, Mark N.; Pacheco, Jennifer; Simonsick, Eleanor M.; Ferrucci, Luigi; Resnick, Susan M.

    2016-01-01

    Study Objectives: To determine the association between self-reported sleep duration and cortical thinning among older adults. Methods: We studied 122 cognitively normal participants in the Baltimore Longitudinal Study of Aging with a mean age = 66.6 y (range, 51–84) at baseline sleep assessment and 69.5 y (range, 56–86) at initial magnetic resonance imaging (MRI) scan. Participants reported average sleep duration and completed a mean of 7.6 1.5-T MRI scans (range, 3–11), with mean follow-up from initial scan of 8.0 y (range, 2.0–11.8). Results: In analyses adjusted for age, sex, education, race, and interval between sleep assessment and initial MRI scan, participants reporting > 7 h sleep at baseline had thinner cortex in the inferior occipital gyrus and sulcus of the left hemisphere at initial MRI scan than those reporting 7 h (cluster P < 0.05). In adjusted longitudinal analyses, compared to those reporting 7 h of sleep, participants reporting < 7 h exhibited higher rates of subsequent thinning in the superior temporal sulcus and gyrus, inferior and middle frontal gyrus, and superior frontal sulcus of the left hemisphere, and in the superior frontal gyrus of the right hemisphere; those reporting > 7 h of sleep had higher rates of thinning in the superior frontal and middle frontal gyrus of the left hemisphere (cluster P < 0.05 for all). In sensitivity analyses, adjustment for apolipoprotein E (APOE) e4 genotype reduced or eliminated some effects but revealed others. When reports of < 7 h of sleep were compared to reports of 7 or 8 h combined, there were no significant associations with cortical thinning. Conclusions: Among cognitively normal older adults, sleep durations of < 7 h and > 7 h may increase the rate of subsequent frontotemporal gray matter atrophy. Additional studies, including those that use objective sleep measures and investigate mechanisms linking sleep duration to gray matter loss, are needed. Citation: Spira AP, Gonzalez CE, Venkatraman

  18. 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

  19. Verbal Prompting To Improve Everyday Cognition in MCI and Unimpaired Older Adults

    PubMed Central

    Thomas, Kelsey R.; Marsiske, Michael

    2014-01-01

    Objective This study investigated the effect of verbal prompting on elders’ 10-year longitudinal change in everyday cognition. Differential effects of prompting associated with impaired cognitive status were also examined. Method At baseline, 2,802 participants (mean age=73.6 years, mean education=13.5 years) from the ACTIVE clinical trial were classified as unimpaired, having amnestic mild cognitive impairment (MCI) or non-amnestic MCI based on psychometric algorithm. Participants were given the Observed Tasks of Daily Living (OTDL; a behavioral measure with tasks involving medication management/finances/telephone use) at baseline and at 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said “I don’t know” or did not respond to an item, they received a standardized verbal prompt. At each occasion, Unprompted (sum of items correct without prompting) and Prompted (sum of items correct including both prompted and unprompted) scores were derived for each participant. Multi-level modeling, adjusting for demographics/health/training group, was used to determine the trajectories of OTDL performance. Results In general, persons with MCI performed at lower levels than those who were unimpaired (amnesticcognition over 10 years for both unimpaired and mildly-impaired older adults. PMID:24219613

  20. Subsyndromal depression and anxiety in older adults: health related, functional, cognitive and diagnostic implications.

    PubMed

    Kasckow, J W; Karp, J F; Whyte, E; Butters, M; Brown, C; Begley, A; Bensasi, S; Reynolds, C F

    2013-05-01

    Subsyndromal depression in later life is common in primary care. Comorbid anxiety disorders could exacerbate the negative effect of subsyndromal depression on functioning, health-related quality of life, comorbidity and/or cognition. We examined anxiety disorders co-existing with subsyndromal depression in participants ≥ age 50 in an NIH trial of Problem Solving Therapy for Primary Care for indicated prevention of major depression. There were 247 participants, with Centers for Epidemiologic Studies - Depression scores ≥ 11. Participants could have multiple psychiatric diagnoses: 22% of the sample had no DSM IV diagnosis; 39% of the sample had only 1 DSM IV diagnosis; 28% had 2 diagnoses; 6% had 3 DSM IV diagnoses; 4% had 4 DSM IV diagnoses; and 1% had 5 diagnoses. Furthermore, 34% of participants had a current comorbid DSM IV diagnosis of a syndromal anxiety disorder. We hypothesized that those with subsyndromal depression, alone relative to those with co-existing anxiety disorders, would report better health-related quality of life, less disability, less medical comorbidity and less cognitive impairment. However, there were no differences in quality of life based on the SF 12 nor in disability based on Late Life Function and Disability Instrument scores. There were no differences in medical comorbidity based on the Cumulative Illness Scale-Geriatrics scale scores nor in cognitive function based on the Executive Interview (EXIT), Hopkins Verbal Learning Test-Revised and Mini-Mental Status Exam. Our findings suggest that about one third of participants 50 years and older with subsyndromal depression have comorbid anxiety disorders; however, this does not appear to be associated with worse quality of life, functioning, disability, cognitive function or medical comorbidity.

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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

  6. Cognitive stimulation for Portuguese older adults with cognitive impairment: a randomized controlled trial of efficacy, comparative duration, feasibility, and experiential relevance.

    PubMed

    Alves, Jorge; Alves-Costa, Filipa; Magalhães, Rosana; Gonçalves, Oscar F; Sampaio, Adriana

    2014-09-01

    Although some studies point to cognitive stimulation as a beneficial therapy for older adults with cognitive impairments, this area of research and practice is still lacking dissemination and is underrepresented in many countries. Moreover, the comparative effects of different intervention durations remain to be established and, besides cognitive effects, pragmatic parameters, such as cost-effectiveness and experiential relevance to participants, are seldom explored. In this work, we present a randomized controlled wait-list trial evaluating 2 different intervention durations (standard = 17 vs brief = 11 sessions) of a cognitive stimulation program developed for older adults with cognitive impairments with or without dementia. 20 participants were randomly assigned to the standard duration intervention program (17 sessions, 1.5 months) or to a wait-list group. At postintervention of the standard intervention group, the wait-list group crossed over to receive the brief intervention program (11 sessions, 1 month). Changes in neuropsychological, functionality, quality of life, and caregiver outcomes were evaluated. Experience during intervention and costs and feasibility were also evaluated. The current cognitive stimulation programs (ie, standard and brief) showed high values of experiential relevance for both intervention durations. High adherence, completion rates, and reasonable costs were found for both formats. Further studies are needed to definitively establish the potential efficacy, optimal duration, cost-effectiveness, and experiential relevance for participants of cognitive intervention approaches.

  7. 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

  8. Cognitive Impairment, Alzheimer's Disease, and Other Dementias in the Lives of Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults and Their Caregivers.

    PubMed

    Fredriksen-Goldsen, Karen I; Jen, Sarah; Bryan, Amanda E B; Goldsen, Jayn

    2016-10-01

    Cognitive impairment, Alzheimer's disease, and other dementias are important health concerns for older adults. As a marginalized and growing segment of the older adult population, lesbian, gay, bisexual, and transgender (LGBT) older adults face distinct risk factors related to cognitive impairment and dementias, including social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. We examine cognitive impairment and dementias among LGBT older adults, describe their unique risk factors, and outline key competencies for health care and human service providers to ensure culturally relevant care for LGBT older adults experiencing cognitive impairment, Alzheimer's disease, or other dementias, as well as their caregivers, families, and communities. Implications include developing an awareness of the context of LGBT older adults' lives and relationships, the importance of early detection and support, and the development of policies and practices that promote community-level advocacy and education.

  9. The ERP Effects of Combined Cognitive Training on Intention-Based and Stimulus-Based Actions in Older Chinese Adults

    PubMed Central

    Niu, Ya-Nan; Zhu, Xinyi; Li, Juan; Fu, Jiang-Ning

    2016-01-01

    Age-related decreases in action are caused by neuromuscular weakness and cognitive decline. Although physical interventions have been reported to have beneficial effects on cognitive function in older adults, whether cognitive training improves action-related function remains unclear. In this study, we investigated the effects of combined cognitive training on intention-based and stimulus-based actions in older adults using event-related potentials (ERPs). A total of 26 healthy older adults (16 in the training group and 10 in the control group) participated in the study. The training group received 16 sessions of cognitive training, including eight sessions of executive function training and eight sessions of memory strategy training. Before and after training, both groups of participants underwent cognitive assessments and ERP recordings during both the acquisition and test phases with a motor cognitive paradigm. During the acquisition phase, subjects were asked to press one of two keys, either using a self-selected (intention-based) method or based on the preceding stimulus (stimulus-based). During the test phase, subjects were asked to respond to the pre-cues with either congruent or incongruent tasks. Using ERP indices—including readiness potential, P3 and contingent negative variation to identify motor preparation, stimulus processing and interference effect, respectively—we revealed the effects of training on both intention-based and stimulus-based actions. The correlations were also computed between the improved cognitive performance and the ERP amplitudes. It was shown that the improved executive function might extend substantial benefits to both actions, whereas associative memory may be specifically related to the bidirectional action-effect association of intention-based action, although the training effect of memory was absent during the insufficient training hours. In sum, the present study provided empirical evidence demonstrating that action

  10. The ERP Effects of Combined Cognitive Training on Intention-Based and Stimulus-Based Actions in Older Chinese Adults.

    PubMed

    Niu, Ya-Nan; Zhu, Xinyi; Li, Juan; Fu, Jiang-Ning

    2016-01-01

    Age-related decreases in action are caused by neuromuscular weakness and cognitive decline. Although physical interventions have been reported to have beneficial effects on cognitive function in older adults, whether cognitive training improves action-related function remains unclear. In this study, we investigated the effects of combined cognitive training on intention-based and stimulus-based actions in older adults using event-related potentials (ERPs). A total of 26 healthy older adults (16 in the training group and 10 in the control group) participated in the study. The training group received 16 sessions of cognitive training, including eight sessions of executive function training and eight sessions of memory strategy training. Before and after training, both groups of participants underwent cognitive assessments and ERP recordings during both the acquisition and test phases with a motor cognitive paradigm. During the acquisition phase, subjects were asked to press one of two keys, either using a self-selected (intention-based) method or based on the preceding stimulus (stimulus-based). During the test phase, subjects were asked to respond to the pre-cues with either congruent or incongruent tasks. Using ERP indices-including readiness potential, P3 and contingent negative variation to identify motor preparation, stimulus processing and interference effect, respectively-we revealed the effects of training on both intention-based and stimulus-based actions. The correlations were also computed between the improved cognitive performance and the ERP amplitudes. It was shown that the improved executive function might extend substantial benefits to both actions, whereas associative memory may be specifically related to the bidirectional action-effect association of intention-based action, although the training effect of memory was absent during the insufficient training hours. In sum, the present study provided empirical evidence demonstrating that action could

  11. The adverse effects of reduced cerebral perfusion on cognition and brain structure in older adults with cardiovascular disease

    PubMed Central

    Alosco, Michael L; Gunstad, John; Jerskey, Beth A; Xu, Xiaomeng; Clark, Uraina S; Hassenstab, Jason; Cote, Denise M; Walsh, Edward G; Labbe, Donald R; Hoge, Richard; Cohen, Ronald A; Sweet, Lawrence H

    2013-01-01

    Background It is well established that aging and vascular processes interact to disrupt cerebral hemodynamics in older adults. However, the independent effects of cerebral perfusion on neurocognitive function among older adults remain poorly understood. We examined the associations among cerebral perfusion, cognitive function, and brain structure in older adults with varying degrees of vascular disease using perfusion magnetic resonance imaging (MRI) arterial spin labeling (ASL). Materials and methods 52 older adults underwent neuroimaging and were administered the Mini Mental State Examination (MMSE), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and measures of attention/executive function. ASL and T1-weighted MRI were used to quantify total brain perfusion, total brain volume (TBV), and cortical thickness. Results Regression analyses showed reduced total brain perfusion was associated with poorer performance on the MMSE, RBANS total index, immediate and delayed memory composites, and Trail Making Test B. Reduced frontal lobe perfusion was associated with worse executive and memory function. A similar pattern emerged between temporal lobe perfusion and immediate memory. Regression analyses revealed that decreased total brain perfusion was associated with smaller TBV and mean cortical thickness. Regional effects of reduced total cerebral perfusion were found on temporal and parietal lobe volumes and frontal and temporal cortical thickness. Discussion Reduced cerebral perfusion is independently associated with poorer cognition, smaller TBV, and reduced cortical thickness in older adults. Conclusion Prospective studies are needed to clarify patterns of cognitive decline and brain atrophy associated with cerebral hypoperfusion. PMID:24363966

  12. 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…

  13. Comparison of older adults’ visual perceptual skills, cognitive function, and fall efficacy according to fall risk in the elderly

    PubMed Central

    Lee, HyeJin; Park, BoRa; Yang, YeongAe

    2016-01-01

    [Purpose] This research aims to identify the relationships among visual perceptual skills, cognitive functioning, and fall efficacy of older adults based on whether they are at risk for falls. [Subjects and Methods] Subjects included 116 older adults over 65 years of age who use D Seniors Welfare Center and Y Senior Citizen Center in Busan Metropolitan City. All research subjects were classified based on balance maintenance ability evaluation and whether or not they had experienced falls more than once. Those with scores below the cut-off standard were selected as a group of older adults at risk for falls. An MVPT-3 test was used to assess visual perceptual skill, MMSE-KC, and MoCA-K tests to assess cognitive function, and the FES-K falls efficacy test to classify subjects as either at risk for falls or not. [Results] After comparing scores for visual perceptual skills, cognitive functioning, and fall efficacy, subjects at risk for falls showed significantly lower scores than did those not at risk. [Conclusion] The study found that there are significant differences in balance ability, visual perceptual skill, cognitive functioning, and fall efficacy between older adults at risk for falls and those not at risk. PMID:27942139

  14. 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

  15. Long-term cognitive outcome after transcallosal resection of hypothalamic hamartoma in older adolescents and adults with gelastic seizures.

    PubMed

    Anderson, Jacqueline F I; Rosenfeld, Jeffrey V

    2010-05-01

    Hypothalamic hamartomas (HHs) are typically associated with pharmacologically intractable gelastic seizures, which often develop into complex partial and/or generalized tonic-clonic seizures. The transcallosal, anterior interforniceal (TAIF) approach to HH resection has been shown to be safe and to result in good seizure frequency reduction. We documented postsurgical cognitive functioning and examined whether using the TAIF approach with older adolescents and adults affected long-term cognitive outcome. Six older adolescents and adults, who had undergone resection of an HH using the TAIF approach, underwent comprehensive neuropsychological assessment at least 2 years postoperatively. Four of these individuals also had neuropsychological evaluation preoperatively. All participants who were assessed pre- and postoperatively demonstrated long-term improvement in perceptual/visuospatial function after surgery. Three of the four participants also demonstrated lasting reduction in memory function postoperatively. The TAIF approach to HH resection is associated with a high risk of long-term memory impairment in older adolescents and adults.

  16. 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.

  17. 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

  18. Cardiovascular disease biomarkers on cognitive function in older adults: Joint effects of cardiovascular disease biomarkers and cognitive function on mortality risk.

    PubMed

    Loprinzi, Paul D; Crush, Elizabeth; Joyner, Chelsea

    2017-01-01

    Previous research demonstrates an inverse association between age and cardiovascular disease (CVD) biomarkers with cognitive function; however, little is known about the combined associations of CVD risk factors and cognitive function with all-cause mortality in an older adult population, which was the purpose of this study. Data from the 1999-2002 NHANES were used (N=2,097; 60+yrs), with mortality follow-up through 2011. Evaluated individual biomarkers included mean arterial pressure (MAP), high-sensitivity C-reactive protein (CRP), HDL-C, total cholesterol (TC), A1C, and measured body mass index (BMI). Cognitive function was assessed using the Digit Symbol Substitution Test (DSST). Further, 4 groups were created based on CVD risk and cognitive function. Group 1: high cognitive function and low CVD risk; Group 2: high cognitive function and high CVD risk; Group 3: low cognitive function and low CVD risk; Group 4: low cognitive function and high CVD risk. An inverse relationship was observed where those with more CVD risk factors had a lower (worse) cognitive function score. Compared to those in Group 1, only those in Group 3 and 4 had an increase mortality risk.

  19. Non-Exercise Estimated Cardiorespiratory Fitness: Associations with Brain Structure, Cognition, and Memory Complaints in Older Adults

    PubMed Central

    McAuley, Edward; Szabo, Amanda N.; Mailey, Emily L.; Erickson, Kirk I.; Voss, Michelle; White, Siobhan M.; Wójcicki, Thomas R.; Gothe, Neha; Olson, Erin A.; Mullen, Sean P.; Kramer, Arthur F.

    2011-01-01

    There is increasing evidence that cardiorespiratory fitness (CRF) is associated with brain structure and function, and improvements in CRF through exercise training have been associated with neural and cognitive functioning in older adults. The objectives of this study were to validate the use of a non-exercise estimate of CRF, and to examine its association with cognitive function, brain structure and subjective memory complaints. Low active, older adults (N = 86; M age= 65.14) completed a physician-supervised maximal exercise test, a 1-mile timed walk, several measures of cognitive function, and a 3 Tesla structural MRI. Fitness was also calculated from an equation derived by (Jurca et al., 2005) based on age, sex, body mass index, resting heart rate, and self-reported physical activity level. Analyses indicated that all three measures of CRF were significantly correlated with one another. In addition, measures of cognitive function, hippocampus volume, and memory complaints were significantly correlated with each measure of fitness. These findings have implications for using a low-risk, low-cost, non-exercise estimate of CRF in determining fitness associations with brain structure and cognitive function in older adults. As such, this measure may have utility for larger population based studies. Further validation is required, as is determination of whether such relationships hold over the course of exercise interventions. PMID:21808657

  20. 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).

  1. Assessing Error Awareness as a Mediator of the Relationship between Subjective Concerns and Cognitive Performance in Older Adults

    PubMed Central

    Buckley, Rachel F.; Laming, Gemma; Chen, Li Peng Evelyn; Crole, Alice; Hester, Robert

    2016-01-01

    Objectives Subjective concerns of cognitive decline (SCD) often manifest in older adults who exhibit objectively normal cognitive functioning. This subjective-objective discrepancy is counter-intuitive when mounting evidence suggests that subjective concerns relate to future clinical progression to Alzheimer’s disease, and so possess the potential to be a sensitive early behavioural marker of disease. In the current study, we aimed to determine whether individual variability in conscious awareness of errors in daily life might mediate this subjective-objective relationship. Methods 67 cognitively-normal older adults underwent cognitive, SCD and mood tests, and an error awareness task. Results Poorer error awareness was not found to mediate a relationship between SCD and objective performance. Furthermore, non-clinical levels of depressive symptomatology were a primary driving factor of SCD and error awareness, and significantly mediated a relationship between the two. Discussion We were unable to show that poorer error awareness mediates SCD and cognitive performance in older adults. Our study does suggest, however, that underlying depressive symptoms influence both poorer error awareness and greater SCD severity. Error awareness is thus not recommended as a proxy for SCD, as reduced levels of error awareness do not seem to be reflected by greater SCD. PMID:27832173

  2. Music listening for maintaining attention of older adults with cognitive impairments.

    PubMed

    Gregory, Dianne

    2002-01-01

    Twelve older adults with cognitive impairments who were participants in weekly community-based group music therapy sessions, 6 older adults in an Alzheimer's caregivers' group, and 6 college student volunteers listened to a 3.5 minute prepared audiotape of instrumental excerpts of patriotic selections. The tape consisted of 7 excerpts ranging from 18 s to 34 s in duration. Each music excerpt was followed by a 7-9 s period of silence, a "wait" excerpt. Listeners were instructed to move a Continuous Response Digital Interface (CRDI) to the name of the music excerpt depicted on the CRDI overlay when they heard a music excerpt. Likewise, they were instructed to move the dial to the word "WAIT" when there was no music. They were also instructed to maintain the dial position for the duration of each music or silence excerpt. Statistical analysis indicated no significant differences between the caregivers' and the college students' group means for total dial changes, correct and incorrect recognitions, correct and incorrect responses to silence excerpts, and reaction times. The mean scores of these 2 groups were combined and compared with the mean scores of the group of elderly adults with cognitive impairments. The mean total dial changes were significantly lower for the listeners with cognitive impairments, resulting in significant differences in all of the other response categories except incorrect recognitions. In addition, their mean absence of response to silence excerpts was significantly higher than their mean absence of responding to music excerpts. Their mean reaction time was significantly slower than the comparison group's reaction time. To evaluate training effects, 10 of the original 12 music therapy participants repeated the listening task with assistance from the therapist (treatment) immediately following the first listening (baseline). A week later the order was reversed for the 2 listening trials. Statistical and graphic analysis of responses between

  3. Potential Benefits of Exergaming for Cognition and Dual-Task Function in Older Adults: A Systematic Review.

    PubMed

    Ogawa, Elisa F; You, Tongjian; Leveille, Suzanne G

    2016-04-01

    This paper provides a systematic review of current research findings using exergaming as a treatment for improving cognition and dual-task function in older adults. A literature search was conducted to collect exergaming intervention studies that were either randomized controlled or uncontrolled studies. Of the seven identified studies (five randomized controlled studies and two uncontrolled studies), three studies focused on cognitive function alone, two studies focused on dual-task function alone, and two studies measured both cognitive function and dual-task function. Current evidence supports that exergaming improves cognitive function and dual-task function, which potentially leads to fall prevention. However, it is unclear whether exergaming, which involves both cognitive input and physical exercise, has additional benefits compared with traditional physical exercise alone. Further studies should include traditional exercise as a control group to identify these potential, additional benefits.

  4. 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

  5. Hippocampal volumes among older Indian adults: Comparison with Alzheimer's disease and mild cognitive impairment

    PubMed Central

    Dhikav, Vikas; Duraisamy, Sharmila; Anand, Kuljeet Singh; Garga, Umesh Chandra

    2016-01-01

    Background: Hippocampal volume data from India have recently been reported in younger adults. Data in older adults are unknown. The present paper describes hippocampal volume from India among older adults and compares the same with patients having Alzheimer's disease (AD) and mild cognitive impairment (MCI). Materials and Methods: A total of 32 cognitively normal subjects, 20 patients with AD, and 13 patients with MCI were enrolled. Patients were evaluated for the diagnosis of AD/MCI using the National Institute of Neurological and Communicative Disorders and Stroke and the Related Disorders Association criteria and the Clinical Dementia Rating (CDR) Scale (score = 0.5), respectively. Hippocampal volume was measured using magnetic resonance imaging (MRI) machine by manual segmentation (Megnatom Symphony 1.5T scanner) three-dimensional (3D) sequences. Results: Age and duration of illness in the MCI group were 70.6 ± 8.6 years and 1.9 ± 0.9 years, respectively. In the AD group, age and duration of illness were 72 ± 8.1 years and 3.1 ± 2.2 years, respectively. In cognitively normal subjects, the age range was 45-88 years (66.9 ± 10.32) years. Mean mini–mental status examination (MMSE) score of healthy subjects was 28.28 ± 1.33. In the MCI group, MMSE was 27.05 ± 1.79. In the AD group, MMSE was 13.32 ± 5.6. In the healthy group, the hippocampal volume was 2.73 ± 0.53 cm3 on the left side and 2.77 ± 0.6 cm3 on the right side. Likewise, in MCI, the volume on the left side was 2.35 ± 0.42 cm3 and the volume on the right side was 2.36 ± 0.38 cm3. Similarly, in the AD group, the volume on the right side was 1.64 ± 0.55 cm3 and on the left side it was 1.59 ± 0.55 cm3. Post hoc analysis using Tukey's honestly significant difference (HSD) showed, using analysis of variance (ANOVA) that there was a statistically significant difference between healthy and AD (P ≤ 0.01), and between healthy and MCI (P ≤ 0.01) subjects. There was a correlation between MMSE

  6. 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

  7. Ventral striatal volume is associated with cognitive decline in older people: a population based MR-study.

    PubMed

    de Jong, L W; Wang, Y; White, L R; Yu, B; van Buchem, M A; Launer, L J

    2012-02-01

    Striatal degeneration may contribute to cognitive impairment in older people. Here, we examine the relation of degeneration of the striatum and substructures to cognitive decline and dementia in subjects with a wide range of cognitive function. Data are from the prospective community-based Honolulu Asia Aging Study of Japanese American men born 1900-1919. Brain magnetic resonance imaging (MRI) (1.5 T) was acquired on a stratified subsample (n = 477) that included four groups defined by cognitive status relative to the scan date: subjects without dementia (n = 347), subjects identified as demented 2-3 years before brain scanning (n = 30), at the time of scanning (n = 58), and 3-5 years after scanning (n = 42). Volumes of the striatum, including the accumbens, putamen, and caudate nucleus were automatically estimated from T1 MR images. Global cognitive function was measured with the cognitive ability screening instrument (CASI), at four examinations spanning an 8-year interval. Trajectories of cognitive decline were estimated for each quartile of striatal volume using mixed models, controlling for demographic variables, measures of cerebro-vascular damage, global brain atrophy, and hippocampal volume. Diagnosis of dementia before, during, and after brain scanning was associated with smaller volumes of n. accumbens and putamen, but not with caudate nucleus volume. Subjects in the lowest quartile of n. accumbens volume, both in the total sample and in the subjects not diagnosed with dementia during the study, had a significantly (p < 0.0001) steeper decline in cognitive performance compared with those in the highest quartile. In conclusion, volumes of the n. accumbens and putamen are closely associated with the occurrence of dementia and n. accumbens volume predicts cognitive decline in older people. These associations were found independent of the magnitude of other pivotal markers of cognitive decline, i.e. cerebro-vascular damage and hippocampal volume. The present

  8. Gender-Specific Incidence and Predictors of Cognitive Impairment among Older Koreans: Findings from a 6-Year Prospective Cohort Study

    PubMed Central

    Lyu, Jiyoung

    2016-01-01

    Objective This study investigated gender-specific incidence and predictors of cognitive impairment among community-dwelling older adults in South Korea. Methods Using data from the 2006 and 2012 Korean Longitudinal Study of Ageing (KLoSA), 925 females and 834 males aged 65 and over without cognitive impairment at 2006 were analyzed separately. Cognitive impairment was measured based on the Korean version of the Mini-Mental State Exam (K-MMSE) normative score. Generalized Estimating Equations (GEE) was conducted to examine the predictors of cognitive impairment at 6-year follow up. Results Incidence of cognitive impairment at 2012 was significantly higher for women (30.5%) than men (26.1%). GEE result showed that depression was significantly associated with cognitive impairment for both genders (female: OR=2.26, 95% CI=1.63–3.12; male: OR=3.26, 95% CI=2.19–4.83). Having IADL limitations (OR=1.15, 95% CI=1.03–1.28), high blood pressure (OR=1.72, 95% CI=1.27–2.34), poor hearing (OR=1.94, 95% CI=1.29–2.92), regular exercise (OR=0.67, 95% CI=0.45–0.99), and normal weight (OR=1.39, 95% CI=1.03–1.86) were significant predictors of cognitive impairment only among women. In contrast, age (OR=1.04, 95% CI=1.01–1.07) and ADL limitations (OR=1.48, 95% CI=1.21–1.82) were significant predictors of cognitive impairment at follow-up only among men. Conclusion Findings of this study show gender-specific predictors of cognitive impairment among older Koreans. This study can provide information for clinicians and policy makers to develop different intervention strategies considering gender differences in the progress of cognitive impairment. PMID:27757124

  9. Effects of Degree of Urbanization and Lifetime Longest-Held Occupation on Cognitive Impairment Prevalence in an Older Spanish Population.

    PubMed

    Lorenzo-López, Laura; Millán-Calenti, José C; López-López, Rocío; Diego-Diez, Clara; Laffon, Blanca; Pásaro, Eduardo; Valdiglesias, Vanessa; Maseda, Ana

    2017-01-01

    Our aim was to estimate the prevalence of cognitive impairment in rural and urban elderly populations and to examine the relationship between lifetime occupation and general cognitive performance. A cross-sectional study was carried out covering a representative sample (n = 749) of adults aged ≥65 years. Two categories were created to define the degree of urbanization using a criterion of geographical contiguity in combination with a minimum population threshold: densely populated (urban) areas and intermediate-thinly populated (rural) areas. Occupational histories were ranked by skill level requirements according to the Spanish National Classification of Occupations. Prevalence estimates of cognitive impairment were measured with the Mini-Mental State Examination. Results show that rural residence was not significantly associated with higher risk of cognitive impairment. A protective effect of cognitive demands at work against age-related cognitive decline was observed. However, this effect was not independent of confounder factors, such as age and education. A low overall prevalence of cognitive impairment was observed (6.5%), compared with previous estimates, possibly due to the sample selection in senior centers. Occupation during active life is not an isolated protective factor against cognitive impairment, and it is closely related to educational level. In future geriatric programs, description of both factors should be taken into consideration in screening older adults at increased risk of cognitive impairment and dementia.

  10. Effects of Degree of Urbanization and Lifetime Longest-Held Occupation on Cognitive Impairment Prevalence in an Older Spanish Population

    PubMed Central

    Lorenzo-López, Laura; Millán-Calenti, José C.; López-López, Rocío; Diego-Diez, Clara; Laffon, Blanca; Pásaro, Eduardo; Valdiglesias, Vanessa; Maseda, Ana

    2017-01-01

    Our aim was to estimate the prevalence of cognitive impairment in rural and urban elderly populations and to examine the relationship between lifetime occupation and general cognitive performance. A cross-sectional study was carried out covering a representative sample (n = 749) of adults aged ≥65 years. Two categories were created to define the degree of urbanization using a criterion of geographical contiguity in combination with a minimum population threshold: densely populated (urban) areas and intermediate-thinly populated (rural) areas. Occupational histories were ranked by skill level requirements according to the Spanish National Classification of Occupations. Prevalence estimates of cognitive impairment were measured with the Mini-Mental State Examination. Results show that rural residence was not significantly associated with higher risk of cognitive impairment. A protective effect of cognitive demands at work against age-related cognitive decline was observed. However, this effect was not independent of confounder factors, such as age and education. A low overall prevalence of cognitive impairment was observed (6.5%), compared with previous estimates, possibly due to the sample selection in senior centers. Occupation during active life is not an isolated protective factor against cognitive impairment, and it is closely related to educational level. In future geriatric programs, description of both factors should be taken into consideration in screening older adults at increased risk of cognitive impairment and dementia. PMID:28243214

  11. 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…

  12. Individual differences in cognitive functioning predict effectiveness of a heads-up lane departure warning for younger and older drivers.

    PubMed

    Aksan, Nazan; Sager, Lauren; Hacker, Sarah; Lester, Benjamin; Dawson, Jeffrey; Rizzo, Matthew; Ebe, Kazutoshi; Foley, James

    2017-02-01

    The effectiveness of an idealized lane departure warning (LDW) was evaluated in an interactive fixed base driving simulator. Thirty-eight older (mean age=77years) and 40 younger drivers (mean age=35years) took four different drives/routes similar in road culture composition and hazards encountered with and without LDW. The four drives were administered over visits separated approximately by two weeks to examine changes in long-term effectiveness of LDW. Performance metrics were number of LDW activations and average correction time to each LDW. LDW reduced correction time to re-center the vehicle by 1.34s on average (95% CI=1.12-1.57s) but did not reduce the number of times the drivers drifted enough in their lanes to activate the system (LDW activations). The magnitude of reductions in average correction RT was similar for older and younger drivers and did not change with repeated exposures across visits. The contribution of individual differences in basic visual and motor function, as well as cognitive function to safety gains from LDW was also examined. Cognitive speed of processing predicted lane keeping performance for older and younger drivers. Differences in memory, visuospatial construction, and executive function tended to predict performance differences among older but not younger drivers. Cognitive functioning did not predict changes in the magnitude of safety benefits from LDW over time. Implications are discussed with respect to real-world safety systems.

  13. 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.

  14. 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

  15. Plasma Tau Levels in Cognitively Normal Middle-Aged and Older Adults

    PubMed Central

    Chiu, Ming-Jang; Fan, Ling-Yun; Chen, Ta-Fu; Chen, Ya-Fang; Chieh, Jen-Jei; Horng, Herng-Er

    2017-01-01

    Using an ultra-sensitive technique, an immunomagnetic reduction assay, the plasma tau level can be measured to a limit of quantification of pg/ml. In total 126 cognitively normal middle-aged and older adults (45–95 years old) were recruited. The plasma tau levels were significantly higher in the older group (aged 65–95 years) 18.14 ± 7.33 pg/ml than those in the middle-aged group (aged 45–64 years) 14.35 ± 6.49 pg/ml when controlled gender and ApoEε4 carrier status (F = 3.102, P = 0.029). The ApoEε4 carriers had higher plasma tau levels than the non-carriers when controlled age and gender (F = 6.149, P = 0.001). Men had higher plasma tau levels than their women counterparts when controlled ApoEε4 carrier status and gender (F = 6.149, P = 0.001). The plasma tau levels were found to be positively associated with their ages (r = 0.359, P < 0.001). Regression analysis showed that age explained approximately 13% of the variance in the plasma tau levels, and explained more than 10% of the variance in the volumes of the hippocampus and white matter hypodensity (R2 change 0.123~0.167, all P < 0.001), and explained less than 10% of the variance in the volume of the amygdala, and central part of the corpus callosum (R2 change 0.085~0.097, all P = 0.001). However, the plasma tau levels do not further explain any residual variance in the volume of brain structures. In conclusion, the effect of age on the plasma tau levels should always be considered in clinical applications of this surrogate biomarker to middle-aged and elderly subjects. PMID:28321189

  16. Plasma Tau Levels in Cognitively Normal Middle-Aged and Older Adults.

    PubMed

    Chiu, Ming-Jang; Fan, Ling-Yun; Chen, Ta-Fu; Chen, Ya-Fang; Chieh, Jen-Jei; Horng, Herng-Er

    2017-01-01

    Using an ultra-sensitive technique, an immunomagnetic reduction assay, the plasma tau level can be measured to a limit of quantification of pg/ml. In total 126 cognitively normal middle-aged and older adults (45-95 years old) were recruited. The plasma tau levels were significantly higher in the older group (aged 65-95 years) 18.14 ± 7.33 pg/ml than those in the middle-aged group (aged 45-64 years) 14.35 ± 6.49 pg/ml when controlled gender and ApoEε4 carrier status (F = 3.102, P = 0.029). The ApoEε4 carriers had higher plasma tau levels than the non-carriers when controlled age and gender (F = 6.149, P = 0.001). Men had higher plasma tau levels than their women counterparts when controlled ApoEε4 carrier status and gender (F = 6.149, P = 0.001). The plasma tau levels were found to be positively associated with their ages (r = 0.359, P < 0.001). Regression analysis showed that age explained approximately 13% of the variance in the plasma tau levels, and explained more than 10% of the variance in the volumes of the hippocampus and white matter hypodensity (R(2) change 0.123~0.167, all P < 0.001), and explained less than 10% of the variance in the volume of the amygdala, and central part of the corpus callosum (R(2) change 0.085~0.097, all P = 0.001). However, the plasma tau levels do not further explain any residual variance in the volume of brain structures. In conclusion, the effect of age on the plasma tau levels should always be considered in clinical applications of this surrogate biomarker to middle-aged and elderly subjects.

  17. 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.

  18. Cognitive Behavioral Therapy for Insomnia in Older Veterans Using Nonclinician Sleep Coaches: Randomized Controlled Trial

    PubMed Central

    Alessi, Cathy; Martin, Jennifer L.; Fiorentino, Lavinia; Fung, Constance H.; Dzierzewski, Joseph M.; Rodriguez Tapia, Juan C.; Song, Yeonsu; Josephson, Karen; Jouldjian, Stella; Mitchell, Michael N.

    2017-01-01

    OBJECTIVES To test a new cognitive behavioral therapy for insomnia (CBT-I) program designed for use by nonclinicians. DESIGN Randomized controlled trial. SETTING Department of Veterans Affairs healthcare system. PARTICIPANTS Community-dwelling veterans aged 60 and older who met diagnostic criteria for insomnia of 3 months duration or longer (N = 159). INTERVENTION Nonclinician “sleep coaches” delivered a five-session manual-based CBT-I program including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy (individually or in small groups), with weekly telephone behavioral sleep medicine supervision. Controls received five sessions of general sleep education. MEASUREMENTS Primary outcomes, including self-reported (7-day sleep diary) sleep onset latency (SOL-D), wake after sleep onset (WASO-D), total wake time (TWT-D), and sleep efficiency (SE-D); Pittsburgh Sleep Quality Index (PSQI); and objective sleep efficiency (7-day wrist actigraphy, SE-A) were measured at baseline, at the posttreatment assessment, and at 6- and 12-month follow-up. Additional measures included the Insomnia Severity Index (ISI), depressive symptoms (Patient Health Questionnaire-9 (PHQ-9)), and quality of life (Medical Outcomes Study 12-item Short-form Survey version 2 (SF-12v2)). RESULTS Intervention subjects had greater improvement than controls between the baseline and posttreatment assessments, the baseline and 6-month assessments, and the baseline and 12-month assessments in SOL-D (−23.4, −15.8, and −17.3 minutes, respectively), TWT-D (−68.4, −37.0, and −30.9 minutes, respectively), SE-D (10.5%, 6.7%, and 5.4%, respectively), PSQI (−3.4, −2.4, and −2.1 in total score, respectively), and ISI (−4.5, −3.9, and −2.8 in total score, respectively) (all P < .05). There were no significant differences in SE-A, PHQ-9, or SF-12v2. CONCLUSION Manual-based CBT-I delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia

  19. The association between subjective memory complaint and objective cognitive function in older people with previous major depression

    PubMed Central

    Begum, Aysha; Liu, Shen-Ing; Chang, Ching-Jui; Chiu, Wei-Che; Chen, Chin-Hsin; Tang, Hwang-Shen; Yang, Chia-Li; Lin, Ying-Chin; Stewart, Robert

    2017-01-01

    The goal of this study is to investigate associations between subjective memory complaint and objective cognitive performance in older people with previous major depression–a high-risk sample for cognitive impairment and later dementia. A cross-sectional study was carried out in people aged 60 or over with previous major depression but not fulfilling current major depression criteria according to DSM-IV-TR. People with dementia or Mini-Mental State Examination score less than 17 were excluded. Subjective memory complaint was defined on the basis of a score ≧4 on the subscale of Geriatric Mental State schedule, a maximum score of 8. Older people aged equal or over 60 without any psychiatric diagnosis were enrolled as healthy controls. Cognitive function was evaluated using a series of cognitive tests assessing verbal memory, attention/speed, visuospatial function, verbal fluency, and cognitive flexibility in all participants. One hundred and thirteen older people with previous major depression and forty-six healthy controls were enrolled. Subjective memory complaint was present in more than half of the participants with depression history (55.8%). Among those with major depression history, subjective memory complaint was associated with lower total immediate recall and delayed verbal recall scores after adjustment. The associations between subjective memory complaint and worse memory performance were stronger in participants with lower depressive symptoms (Hamilton Depression Rating Scale score<7). The results suggest subjective memory complaint may be a valid appraisal of memory performance in older people with previous major depression and consideration should be given to more proactive assessment and follow-up in these clinical samples. PMID:28267772

  20. Unique and interactive effect of anxiety and depressive symptoms on cognitive and brain function in young and older adults

    PubMed Central

    Dotson, Vonetta M.; Szymkowicz, Sarah M.; Kirton, Joshua W.; McLaren, Molly E.; Green, Mackenzie L.; Rohani, Jessica Y.

    2014-01-01

    Objective Depression and anxiety and are associated with cognitive deficits and brain changes, especially in older adults. Despite the frequent co-occurrence of these conditions, cognitive neuroscience studies examining comorbid depression and anxiety are limited. The goal of the present study was to examine the unique and combined effect of depressive and anxiety symptoms on cognitive and brain functioning in young and older adults. Methods Seventy-one healthy, community-dwelling adults between the ages of 18 and 81 were administered a neuropsychological battery and completed the Center for Epidemiologic Studies Depression Scale (CES-D) and the trait form of the State-Trait Anxiety Inventory (STAI-T). A subset of 25 participants also underwent functional magnetic resonance imaging (fMRI) scanning while completing the n-back working memory task. Results Total depressive symptoms, depressed mood symptoms, and somatic symptoms were associated with deficits in speed, working memory and executive functions, especially in older adults. Symptoms of lack of well-being were not associated with any neuropsychological test. Anxiety was associated with better attention and working memory. Moreover, anxiety modified the relationship between depressive symptoms and executive functioning in older adults, as elevated depressive symptoms were associated with worse performance at low levels of anxiety, but not at higher anxiety levels. Similarly, analysis of fMRI data showed that total depressive symptoms and depressed mood symptoms were associated with decreased activity in the superior frontal gyrus at low anxiety levels, but not at high anxiety levels. Conclusion Results confirm previous reports that subthreshold depression and anxiety impact cognitive and brain functioning and suggest that the interaction of depression and anxiety results in distinct cognitive and brain changes. Findings highlight the importance of assessing and controlling for symptoms of depression and

  1. Can an old dog learn (and want to experience) new tricks? Cognitive training increases openness to experience in older adults

    PubMed Central

    Jackson, Joshua J.; Hill, Patrick L.; Payne, Brennan R.; Roberts, Brent W.; Stine-Morrow, Elizabeth A. L.

    2012-01-01

    The present study investigated whether an intervention aimed to increase cognitive ability in older adults also changes the personality trait of openness to experience. Older adults completed a 16-week program in inductive reasoning training supplemented by weekly crossword and Sudoku puzzles. Changes in openness to experience were modeled across four assessments over 30 weeks using latent growth curve models. Results indicate that participants in the intervention condition increased in the trait of openness compared to a waitlist control group. The study is one of the first to demonstrate that personality traits can change through non-psychopharmocological interventions. PMID:22251379

  2. Can an old dog learn (and want to experience) new tricks? Cognitive training increases openness to experience in older adults.

    PubMed

    Jackson, Joshua J; Hill, Patrick L; Payne, Brennan R; Roberts, Brent W; Stine-Morrow, Elizabeth A L

    2012-06-01

    The present study investigated whether an intervention aimed to increase cognitive ability in older adults also changes the personality trait of openness to experience. Older adults completed a 16-week program in inductive reasoning training supplemented by weekly crossword and Sudoku puzzles. Changes in openness to experience were modeled across four assessments over 30 weeks using latent growth curve models. Results indicate that participants in the intervention condition increased in the trait of openness compared with a waitlist control group. The study is one of the first to demonstrate that personality traits can change through nonpsychopharmocological interventions.

  3. Differential item functioning due to cognitive status does not impact depressive symptom measures in four heterogeneous samples of older adults

    PubMed Central

    Fieo, Robert; Mukherjee, Shubhabrata; Dmitrieva, Natalia O.; Fyffe, Denise C.; Gross, Alden L.; Sanders, Elizabeth R.; Romero, Heather R.; Potter, Guy G.; Manly, Jennifer J.; Mungas, Dan M.; Gibbons, Laura E.

    2016-01-01

    Objective The objective of this study is to determine whether differential item functioning (DIF) due to cognitive status impacted three depressive symptoms measures commonly used with older adults. Methods Differential item functioning in depressive symptoms was assessed among participants (N = 3558) taking part in four longitudinal studies of cognitive aging, using the Geriatric Depression Scale, the Montgomery–Åsberg Depression Rating Scale, and the Center for Epidemiologic Studies Depression Scale. Participants were grouped by cognitive status using a general cognitive performance score derived from each study’s neuropsychological battery and linked to a national average using a population-based survey representative of the US population. The Clinical Dementia Rating score was used as an alternate grouping variable in three of the studies. Results Although statistically significant DIF based on cognitive status was found for some depressive symptom items (e.g., items related to memory complaints, appetite loss, lack of energy, and mood), the effect of item bias on the total score for each scale was negligible. Conclusions The depressive symptoms scales in these four studies measured depression in the same way, regardless of cognitive status. This may reduce concerns about using these depression measures in cognitive aging research, as relationships between depression and cognitive decline are unlikely to have been due to item bias, at least in the ways that were measured in the datasets we considered. PMID:25475426

  4. Non-Pharmacologic Interventions for Older Adults with Subjective Cognitive Decline: Systematic Review, Meta-Analysis, and Preliminary Recommendations.

    PubMed

    Smart, Colette M; Karr, Justin E; Areshenkoff, Corson N; Rabin, Laura A; Hudon, Carol; Gates, Nicola; Ali, Jordan I; Arenaza-Urquijo, Eider M; Buckley, Rachel F; Chetelat, Gael; Hampel, Harald; Jessen, Frank; Marchant, Natalie L; Sikkes, Sietske A M; Tales, Andrea; van der Flier, Wiesje M; Wesselman, Linda

    2017-03-07

    In subjective cognitive decline (SCD), older adults present with concerns about self-perceived cognitive decline but are found to have clinically normal function. However, a significant proportion of those adults are subsequently found to develop mild cognitive impairment, Alzheimer's dementia or other neurocognitive disorder. In other cases, SCD may be associated with mood, personality, and physical health concerns. Regardless of etiology, adults with SCD may benefit from interventions that could enhance current function or slow incipient cognitive decline. The objective of this systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, is to examine the benefits of non-pharmacologic intervention (NPI) in persons with SCD. Inclusion criteria were studies of adults aged 55 + with SCD defined using published criteria, receiving NPI or any control condition, with cognitive, behavioural, or psychological outcomes in controlled trails. Published empirical studies were obtained through a standardized search of CINAHL Complete, Cochrane Central Register of Controlled Trials, MEDLINE with Full Text, PsycINFO, and PsycARTICLES, supplemented by a manual retrieval of relevant articles. Study quality and bias was determined using PEDro. Nine studies were included in the review and meta-analysis. A wide range of study quality was observed. Overall, a small effect size was found on cognitive outcomes, greater for cognitive versus other intervention types. The available evidence suggests that NPI may benefit current cognitive function in persons with SCD. Recommendations are provided to improve future trials of NPI in SCD.

  5. Homocysteine is not associated with global motor or cognitive measures in nondemented older Parkinson's disease patients.

    PubMed

    Camicioli, Richard M; Bouchard, Thomas P; Somerville, Martin J

    2009-01-30

    Levodopa (L-dopa) treatment of Parkinson's disease (PD) is associated with elevated homocysteine (Hcy). To examine the relationship between Hcy, methylenetetrahydrofolate reductase polymorphisms (MTHFR: 677C/T; 1298A/C), and B-vitamins in older PD patients and whether Hcy or MTHFR polymorphisms were associated with clinical measures. MTHFR polymorphisms, B-vitamin intake, and blood concentrations of Hcy, vitamin B12 and folate, and creatinine were determined and compared between groups (PD and controls). The relationship of Hcy to clinical measures was examined in PD. Among 51 patients [30M/21F, mean age (SD): 71.5 (4.7)] and 50 controls [29M/21F, 71.5 (4.8)], Hcy was higher in PD [13.6 (3.8); controls: 10.5 (2.5), P < 0.0005]. Hcy was associated with B-vitamin intake [F = 21.7, P < 0.0005], folate level (R = 0.31, P = 0.035), and the interaction of intake with MTHFR 677T (F = 5.2, P = 0.007), but not MTHFR 1298C genotype. Hcy did not correlate with global measures of cognition, mood, or parkinsonism in PD or with dyskinesias, fluctuations, or freezing. Higher vitamin B12 levels were associated with lower dyskinesia risk. Hcy was influenced by PD, MTHFR 677 genotype, and vitamin use, but not by the MTHFR 1298 genotype. There was no clear association with motor or cognitive measures, but dyskinesias were less likely with higher B12.

  6. Changes in Neural Activity Underlying Working Memory after Computerized Cognitive Training in Older Adults

    PubMed Central

    Tusch, Erich S.; Alperin, Brittany R.; Ryan, Eliza; Holcomb, Phillip J.; Mohammed, Abdul H.; Daffner, Kirk R.

    2016-01-01

    Computerized cognitive training (CCT) may counter the impact of aging on cognition, but both the efficacy and neurocognitive mechanisms underlying CCT remain controversial. In this study, 35 older individuals were randomly assigned to Cogmed adaptive working memory (WM) CCT or an active control CCT, featuring five weeks of five ∼40 min sessions per week. Before and after the 5-week intervention, event-related potentials were measured while subjects completed a visual n-back task with three levels of demand (0-back, 1-back, 2-back). The anterior P3a served as an index of directing attention and the posterior P3b as an index of categorization/WM updating. We hypothesized that adaptive CCT would be associated with decreased P3 amplitude at low WM demand and increased P3 amplitude at high WM demand. The adaptive CCT group exhibited a training-related increase in the amplitude of the anterior P3a and posterior P3b in response to target stimuli across n-back tasks, while subjects in the active control CCT group demonstrated a post-training decrease in the anterior P3a. Performance did not differ between groups or sessions. Larger overall P3 amplitudes were strongly associated with better task performance. Increased post-CCT P3 amplitude correlated with improved task performance; this relationship was especially robust at high task load. Our findings suggest that adaptive WM training was associated with increased orienting of attention, as indexed by the P3a, and the enhancement of categorization/WM updating processes, as indexed by the P3b. Increased P3 amplitude was linked to improved performance; however. there was no direct association between adaptive training and improved performance. PMID:27877122

  7. What are the top-circulating magazines in the United States telling older adults about cognitive health?

    PubMed

    Mathews, Anna E; Laditka, Sarah B; Laditka, James N; Friedman, Daniela B

    2009-01-01

    There is growing evidence that healthy behaviors may promote cognitive health. The behaviors include physical activity, heart-healthy diets, and social engagement. Popular print media helps disseminate health information. This study examines the content focused on cognitive health in 5 top-circulating magazines marketed to older people in the United States. All pages (29,881 pages) of each magazine published in 2006 and 2007 were searched. There were 84 articles on cognitive health. Few were by health or science writers. Of the 58 articles on prevention, the contents focused primarily on diet and multiple behaviors, with less on physical activity or social engagement. Less than 20% provided resources to help readers obtain further information. Articles focused on physical activity, with information directing readers to credible resources, and by writers with health or science backgrounds, could enhance the quality of cognitive health communication in popular media.

  8. Mindfulness-Based Stress Reduction for older adults with worry symptoms and co-occurring cognitive dysfunction

    PubMed Central

    Lenze, Eric J.; Hickman, Steven; Hershey, Tamara; Wendleton, Leah; Ly, Khanh; Dixon, David; Doré, Peter; Wetherell, Julie Loebach

    2014-01-01

    Background Mindfulness-Based Stress Reduction (MBSR) has the potential to reduce worry and improve cognitive functioning. Objectives In this treatment development project, we examined MBSR in older adults with worry symptoms and co-occurring cognitive dysfunction. We examined (1) acceptability of MBSR, (2) whether MBSR needs to be lengthened providing more repetition, (3) MBSR's benefits for worry reduction and cognitive improvements, and (4) continued use of MBSR techniques during follow-up. Method Two sites (St. Louis and San Diego) enrolled individuals aged 65+ with significant anxiety-related distress plus subjective cognitive dysfunction, into traditional 8-session MBSR groups and 12-session groups that had the same content but more repetition of topics and techniques. We examined measures of mindfulness, worry, and a neuropsychological battery focused on memory and executive function before and after the MBSR program, and we followed up participants for 6 months after the completion of MBSR regarding their continued use of its techniques. Results Participants (N=34) showed improvements in worry severity, increases in mindfulness, and improvements in memory as measured by paragraph learning and recall after a delay, all with a large effect size. Most participants continued to use MBSR techniques for six months post-instruction and found them helpful in stressful situations. There was no evidence that the extended 12-week MBSR produced superior cognitive or clinical outcomes, greater satisfaction, or greater continuation of MBSR techniques than 8-week MBSR. Conclusions These preliminary findings are promising for the further testing and use of MBSR in older adults suffering from clinical worry symptoms and co-occurring cognitive dysfunction. These are common problems in a broad range of older adults, many of whom have anxiety and mood disorders; therefore, stress reduction intervention for them may have great public health value. PMID:24677282

  9. Sex Matters: Hippocampal Volume Predicts Individual Differences in Associative Memory in Cognitively Normal Older Women but Not Men.

    PubMed

    Zheng, Zhiwei; Li, Rui; Xiao, Fengqiu; He, Rongqiao; Zhang, Shouzi; Li, Juan

    2017-01-01

    The hippocampus plays a prominent role in associative memory by supporting relational binding and recollection processes. Structural atrophy in the hippocampus is likely to induce associative memory deficits in older adults. Previous studies have primarily focused on average age-related differences in hippocampal structure and memory performance. To date, however, it remains unclear whether individual differences in hippocampal morphometry underlie differential associative memory performance, and whether there are sex differences in the structural correlates of associative memory in healthy older adults. Here, we used voxel-based morphometry (VBM) to examine the extent to which gray matter volume (GMV) of the hippocampus predicts associative memory performance in cognitively normal older adults. Seventy-one participants completed a cued recall paired-associative learning test (PALT), which consists of novel associations and semantically related associations, and underwent magnetic resonance imaging (MRI). We observed worse associative memory performance and larger variability for novel associations than for semantically related associations. The VBM results revealed that higher scores on associative memory for novel associations were related to greater hippocampal GMV across all older adults. When considering men and women separately, the correlation between hippocampal GMV and associative memory performance for novel associations reached significance only in older women. These findings suggest that hippocampal structural volumes may predict individual differences in novel associative memory in older women but not men.

  10. Sex Matters: Hippocampal Volume Predicts Individual Differences in Associative Memory in Cognitively Normal Older Women but Not Men

    PubMed Central

    Zheng, Zhiwei; Li, Rui; Xiao, Fengqiu; He, Rongqiao; Zhang, Shouzi; Li, Juan

    2017-01-01

    The hippocampus plays a prominent role in associative memory by supporting relational binding and recollection processes. Structural atrophy in the hippocampus is likely to induce associative memory deficits in older adults. Previous studies have primarily focused on average age-related differences in hippocampal structure and memory performance. To date, however, it remains unclear whether individual differences in hippocampal morphometry underlie differential associative memory performance, and whether there are sex differences in the structural correlates of associative memory in healthy older adults. Here, we used voxel-based morphometry (VBM) to examine the extent to which gray matter volume (GMV) of the hippocampus predicts associative memory performance in cognitively normal older adults. Seventy-one participants completed a cued recall paired-associative learning test (PALT), which consists of novel associations and semantically related associations, and underwent magnetic resonance imaging (MRI). We observed worse associative memory performance and larger variability for novel associations than for semantically related associations. The VBM results revealed that higher scores on associative memory for novel associations were related to greater hippocampal GMV across all older adults. When considering men and women separately, the correlation between hippocampal GMV and associative memory performance for novel associations reached significance only in older women. These findings suggest that hippocampal structural volumes may predict individual differences in novel associative memory in older women but not men. PMID:28321185

  11. Relationship of cognitive strategy use to prospective memory performance in a diverse sample of nondemented older adults with varying degrees of cognitive complaints and impairment.

    PubMed

    Aronov, Avner; Rabin, Laura A; Fogel, Joshua; Chi, Susan Y; Kann, Sarah J; Abdelhak, Nachama; Zimmerman, Molly E

    2015-01-01

    Although older adults typically have better performance on prospective memory (PM) tasks carried out in naturalistic settings, a paucity of research directly assesses older adults' use of compensatory strategies on such tasks. The current study investigates external memory strategy use during performance of a clinical PM test that features both short-term (in laboratory) and long-term (out of laboratory) subtasks (i.e., the Royal Prince Alfred Prospective Memory Test - RPA-ProMem. Nondemented, community-dwelling older adults (n = 214; mean age = 80.5; 68.2% female; 39.7% non-white) with mild cognitive impairment, subjective cognitive decline, and healthy controls completed the RPA-ProMem while external strategy use was permitted and recorded. Overall, participants utilized external strategies 41% of the time on the RPA-ProMem. Increased utilization of external memory strategies was significantly associated with better PM performance. Additionally, better performance on executive functioning tasks was associated with increased use of external memory strategies. Results are discussed in relation to how memory strategy use can be enhanced to improve everyday memory ability in older adults at risk for dementia.

  12. Relationship of cognitive strategy use to prospective memory performance in a diverse sample of nondemented older adults with varying degrees of cognitive complaints and impairment

    PubMed Central

    Aronov, Avner; Rabin, Laura A.; Fogel, Joshua; Chi, Susan Y.; Kann, Sarah J.; Abdelhak, Nachama; Zimmerman, Molly E.

    2015-01-01

    Although older adults typically have better performance on prospective memory (PM) tasks carried out in naturalistic settings, a paucity of research directly assesses older adults’ use of compensatory strategies on such tasks. The current study investigates external memory strategy use during performance of a clinical PM test that features both short-term (in laboratory) and long-term (out of laboratory) subtasks (i.e., the Royal Prince Alfred Prospective Memory Test – RPA-ProMem. Nondemented, community-dwelling older adults (n = 214; mean age = 80.5; 68.2% female; 39.7% non-white) with mild cognitive impairment, subjective cognitive decline, and healthy controls completed the RPA-ProMem while external strategy use was permitted and recorded. Overall, participants utilized external strategies 41% of the time on the RPA-ProMem. Increased utilization of external memory strategies was significantly associated with better PM performance. Additionally, better performance on executive functioning tasks was associated with increased use of external memory strategies. Results are discussed in relation to how memory strategy use can be enhanced to improve everyday memory ability in older adults at risk for dementia. PMID:25471537

  13. 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

  14. 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

  15. The relationship between cognitive reserve and functional ability is mediated by executive functioning in older adults.

    PubMed

    Puente, Antonio Nicolas; Lindbergh, Cutter A; Miller, L Stephen

    2015-01-01

    It has been noted in the literature that cognitive reserve (CR) predicts future functional ability (FA), but the association between CR and current FA is rather limited. This investigation aimed to explicate this relationship, and hypothesized it would be mediated by executive functioning (EF). To best understand the relationship between CR and FA, we recruited and tested independent community-dwelling older adults (OAs). Bivariate correlations and hierarchical regressions were completed to determine the association between CR and FA. Both individual CR measures and a composite CR score were used. Mediation analyses were completed to examine our hypothesis that EF would mediate the CR and FA relationship. All measures of CR were positively related to and predictive of FA. Although the highest zero-order correlation across the independent CR proxies was between income and FA (r = .417), education accounted for the greatest amount of variance in FA, 8.3% after controlling for age and Mini-Mental State Examination performance. Furthermore, the CR composite had a higher correlation (r = .447) and accounted for more variance than any of the independent proxies. Complete mediation was found between a CR composite and FA via an internally consistent D-KEFS composite score (Cronbach's α = .795). This suggests that as CR increases so does EF, which in turn improves FA. Thus, future investigations could determine the effect on FA in OAs by improving EF.

  16. Effect of exercise on cognitive performance in community-dwelling older adults: review of intervention trials and recommendations for public health practice and research.

    PubMed

    Snowden, Mark; Steinman, Lesley; Mochan, Kara; Grodstein, Francine; Prohaska, Thomas R; Thurman, David J; Brown, David R; Laditka, James N; Soares, Jesus; Zweiback, Damita J; Little, Deborah; Anderson, Lynda A

    2011-04-01

    There is evidence from observational studies that increasing physical activity may reduce the risk of cognitive decline in older adults. Exercise intervention trials have found conflicting results. A systematic review of physical activity and exercise intervention trials on cognition in older adults was conducted. Six scientific databases and reference lists of previous reviews were searched. Thirty studies were eligible for inclusion. Articles were grouped into intervention-outcome pairings. Interventions were grouped as cardiorespiratory, strength, and multicomponent exercises. Cognitive outcomes were general cognition, executive function, memory, reaction time, attention, cognitive processing, visuospatial, and language. An eight-member multidisciplinary panel rated the quality and effectiveness of each pairing. Although there were some positive studies, the panel did not find sufficient evidence that physical activity or exercise improved cognition in older adults. Future research should report exercise adherence, use longer study durations, and determine the clinical relevance of measures used.

  17. Modulation on brain gray matter activity and white matter integrity by APOE ε4 risk gene in cognitively intact elderly: A multimodal neuroimaging study.

    PubMed

    Cai, Suping; Jiang, Yuanyuan; Wang, Yubo; Wu, Xiaoming; Ren, Junchan; Lee, Min Seob; Lee, Sunghoon; Huang, Liyu

    2017-03-30

    Apolipoprotein E (APOE) ε4 allele is the genetic risk factor with the most established evidence for sporadic Alzheimer's disease. Previous neuroimaging studies have demonstrated insufficiently consistent functional and structural changes among healthy APOE ε4 carriers when compared to non-carriers. Here, in a cognitively intact elderly group (a total of 110: 45 APOE ε4 carriers, 65 non-carriers), we aimed to investigate the potential role of APOE ε4 in the modulation of grey matter activity, white matter integrity, and brain morphology before the development of clinically significant symptoms and signs, by methods of: amplitude of low frequency fluctuations and regional homogeneity analysis based on resting state fMRI, and fiber tractography approach based on diffusion tensor imaging. Our results revealed that compared to non-carriers, APOE ε4 carriers showed: (1) an inconsistent pattern of activity change in the default mode network, including increased gray matter activity in anterior cingulate cortex and medial prefrontal cortex and decreased activity in precuneus; (2) lower mean diffusivity (MD) in fibers of corona radiata and corpus callosum, and lower axial diffusivity in genu of corpus callosum; and (3) significant positive correlation between the MD value of the right superior corona radiate and gross white matter volume; significant negative correlation between the MD value of the right superior corona radiate and Mini-Mental State Examination (MMSE) score. Our results suggested that APOE ε4 gene can modulate gray matter activity and white matter integrity in cognitive and memory related regions, even before any clinical or neuropsychic symtoms or signs of imminent disease.

  18. Racial Differences in Suicidality in an Older Urban Population

    ERIC Educational Resources Information Center

    Cohen, Carl I.; Colemon, Yolonda; Yaffee, Robert; Casimir, Georges J.

    2008-01-01

    Purpose: This study used epidemiological data of older African Americans and Caucasians living in an urban community to compare those factors associated with active or passive suicidal ideation in each racial group. Design and Methods: Using 1990 census data for Brooklyn, New York, we attempted to interview all cognitively intact adults aged 55 or…

  19. 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.

  20. Educational attainment, MRI changes and cognitive function in older postmenopausal women from the Women’s Health Initiative Memory Study

    PubMed Central

    Rapp, Stephen R.; Espeland, Mark A.; Manson, JoAnn E.; Resnick, Susan M.; Bryan, Nick R.; Smoller, Sylvia; Coker, Laura H.; Phillips, Lawrence S.; Stefanick, Marcia L.; Sarto, Gloria E.

    2015-01-01

    The relationship between neuropathology and clinically manifested functional and cognitive deficits is complex. Clinical observations of individuals with greater neuropathology who function better than some individuals with less neuropathology are common and puzzling. Educational attainment, a proxy for ‘cognitive reserve’, may help to explain this apparent contradiction. The objective of this study is to determine if educational attainment is correlated with cognitive decline, brain lesion volume and total brain atrophy. One thousand three hundred ninety of the 7,479 community-dwelling women 65 years of age and older enrolled in the Women’s Health Initiative Memory Study, two parallel randomized, placebo-controlled clinical trials comparing unopposed and opposed post-menopausal hormone therapy with placebo, were studied. Study participants received annual assessments of global cognitive function with the Modified Mini Mental State exam. One thousand sixty-three participants also received a supplemental neurocognitive battery and neuroimaging studies. Magnetic resonance imaging was used to calculate total ischemic lesion and brain volumes. Incident cases of probable dementia and mild cognitive impairment were centrally adjudicated. After adjustment for total lesion and total brain volumes (atrophy), higher educational attainment predicted better cognitive performance (p<0.001). Following conversion to dementia/MCI, higher education predicted steeper declines in cognitive function (p<0.001). Thus, higher educational attainment was associated with a delay in diagnosis of dementia/MCI in the face of a growing neuropathological load. PMID:24552037

  1. Educational attainment, MRI changes, and cognitive function in older postmenopausal women from the Women's Health Initiative Memory Study.

    PubMed

    Rapp, Stephen R; Espeland, Mark A; Manson, Joann E; Resnick, Susan M; Bryan, Nick R; Smoller, Sylvia; Coker, Laura H; Phillips, Lawrence S; Stefanick, Marcia L; Sarto, Gloria E

    2013-01-01

    The relationship between neuropathology and clinically manifested functional and cognitive deficits is complex. Clinical observations of individuals with greater neuropathology who function better than some individuals with less neuropathology are common and puzzling. Educational attainment, a proxy for "cognitive reserve," may help to explain this apparent contradiction. The objective of this study is to determine if educational attainment is correlated with cognitive decline, brain lesion volume, and total brain atrophy. One thousand three hundred ninety of the 7,479 community-dwelling women 65 years of age and older enrolled in the Women's Health Initiative Memory Study, two parallel randomized, placebo-controlled clinical trials comparing unopposed and opposed postmenopausal hormone therapy with placebo, were studied. Study participants received annual assessments of global cognitive function with the Modified Mini Mental State exam. One thousand sixty-three participants also received supplemental neurocognitive battery and neuroimaging studies. Magnetic resonance imaging was used to calculate total ischemic lesion and brain volumes. Incident cases of probable dementia and mild cognitive impairment were centrally adjudicated. After adjustment for total lesion and total brain volumes (atrophy), higher educational attainment predicted better cognitive performance (p < 0.001). Following conversion to dementia/MCI, higher education predicted steeper declines in cognitive function (p < 0.001). Thus, higher educational attainment was associated with a delay in diagnosis of dementia/MCI in the face of a growing neuropathological load.

  2. Trajectories of peripheral interleukin-6, structure of the hippocampus, and cognitive impairment over 14 years in older adults

    PubMed Central

    Metti, Andrea L.; Aizenstein, Howard; Yaffe, Kristine; Boudreau, Robert M.; Newman, Anne; Launer, Lenore; Gianaros, Peter J.; Lopez, Oscar L.; Saxton, Judith; Ives, Diane G.; Kritchevsky, Stephen; Vallejo, Abbe N.; Rosano, Caterina

    2015-01-01

    We aimed to investigate if trajectory components (baseline level, slope and variability) of peripheral IL-6 over time were related to cognitive impairment and smaller hippocampal volume, and if hippocampal volume explained the associations between IL-6 and cognitive impairment. Multivariable regression models were used to test the association between IL-6 trajectory components with change in neuroimaging measures of the hippocampus, and with cognitive impairment among 135 older adults (70–79 years at baseline) from the Healthy Brain Project over 14 years. IL-6 variability was positively associated with cognitive impairment (OR = 5.86, 95% CI:1.24, 27.61) and with greater decrease per year of gray matter volume of the hippocampus (β=−0.008, SE=0.004, p=0.03). After adjustment for hippocampal volume, the odds ratio of cognitive impairment decreased for each unit of IL-6 variability, and confidence intervals widened (OR=4.36, 95% CI: 0.67, 28.29). Neither baseline levels nor slopes of IL-6 were related to cognitive impairment or hippocampal volume. We believe this has potential clinical and public health implications by suggesting adults with stable levels of peripheral IL-6 may be better targets for intervention studies for slowing or preventing cognitive decline. PMID:26279115

  3. Perceptions of a cognitive rehabilitation group by older people living with cognitive impairment and their caregivers: A qualitative interview study.

    PubMed

    Moebs, Isabelle; Gee, Susan; Miyahara, Motohide; Paton, Helen; Croucher, Matthew

    2015-10-08

    Cognitive rehabilitation has been developed to improve quality of life, activities of daily living and mood for people with cognitive impairment, but the voice of people with cognitive impairment has been underrepresented. This study aimed to understand the experience of people living with cognitive impairment, as well as their caregivers who took part in a cognitive rehabilitation intervention programme. Twelve individuals with cognitive impairment and 15 caregivers participated in individual qualitative interviews. The interview data were analysed in three steps: 1) familiarisation of the transcripts; 2) identification of themes; 3) re-interpretation, refinement and integration of themes with methodological auditors. Both participants living with cognitive impairment and caregivers valued the comfortable environment with friendly, caring and supportive group leaders who taught practical tips and strategies. The participants living with cognitive impairment enjoyed socialising with like others. Caregivers benefited from learning about memory problems and sharing their challenges with other caregivers. The participants living with cognitive impairment emphasised the benefits of relational and practical aspects, whereas the caregivers valued the informational and emotional support. In conclusion, both participants living with cognitive impairment and caregivers found the cognitive rehabilitation group useful.

  4. Longitudinal alterations to brain function, structure, and cognitive performance in healthy older adults: A fMRI-DTI study.

    PubMed

    Hakun, Jonathan G; Zhu, Zude; Brown, Christopher A; Johnson, Nathan F; Gold, Brian T

    2015-05-01

    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.

  5. The association of health literacy with physical activity and nutritional behavior in older adults, and its social cognitive mediators.

    PubMed

    Geboers, Bas; de Winter, Andrea F; Luten, Karla A; Jansen, Carel J M; Reijneveld, Sijmen A

    2014-01-01

    Inadequate health literacy is a common problem among older adults and is associated with poor health outcomes. Insight into the association between health literacy and health behaviors may support interventions to mitigate the effects of inadequate health literacy. The authors assessed the association of health literacy with physical activity and nutritional behavior in community-dwelling older adults. The authors also assessed whether the associations between health literacy and health behaviors are mediated by social cognitive factors. Data from a study among community-dwelling older adults (55 years and older) in a relatively deprived area in The Netherlands were used (baseline n=643, response: 43%). The authors obtained data on health literacy, physical activity, fruit and vegetable consumption, and potential social cognitive mediators (attitude, self-efficacy, and risk perception). After adjustment for confounders, inadequate health literacy was marginally significantly associated with poor compliance with guidelines for physical activity (OR=1.52, p=.053) but not with poor compliance with guidelines for fruit and vegetable consumption (OR=1.20, p=.46). Self-efficacy explained 32% of the association between health literacy and compliance with physical activity guidelines. Further research may focus on self-efficacy as a target for interventions to mitigate the negative effects of inadequate health literacy.

  6. 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

  7. 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

  8. Deterministic learning and attempted suicide among older depressed individuals: Cognitive assessment using the Wisconsin Card Sorting Task

    PubMed Central

    McGirr, Alexander; Dombrovski, Alexandre Y.; Butters, Meryl A.; Clark, Luke; Szanto, Katalin

    2011-01-01

    Background Late-life suicide is an under-investigated public health problem. Among the putative vulnerabilities for this complex multifactorial behaviour are deficits in cognitive control, an ability to integrate and prioritize multiple cognitive processes in order to flexibly adapt behaviour and meet situational demands. We investigated cognitive control during rule learning in a complex and changing environment in older individuals with suicide attempts of varying lethality. Method Ninety-three participants over the age of 60 (30 healthy controls, 29 depressed never suicidal, 20 low-lethality suicide attempters, 14 high-lethality suicide attempters) underwent structured clinical and cognitive assessments. Participants then completed the Wisconsin Card Sorting Test (WCST), a well-studied task of cognitive control during rule learning. Results High-lethality attempters demonstrated a pattern of deficits involving poor conceptual reasoning, perseverative errors and total errors. Compared to low-lethality attempters and healthy controls, high-lethality attempters demonstrated poor conceptual reasoning, as well as increased rates of perseverative errors and total errors. Compared to non-suicidal depressed participants, high-lethality attempters also made more conceptual errors. Conclusion High-lethality suicide attempts among older people are associated with impaired cognitive control during rule learning as detected by the WCST. Our data suggest that impairment in cognitive control during rule learning may represent a vulnerability distinct from the impulsive diathesis, typically manifesting in young, low-lethality attempters. This vulnerability may contribute to the high incidence of serious or, often, fatal suicidal acts in old age. PMID:22024486

  9. Impact of Type 2 Diabetes and Postmenopausal Hormone Therapy on Incidence of Cognitive Impairment in Older Women

    PubMed Central

    Brinton, Roberta Diaz; Hugenschmidt, Christina; Manson, JoAnn E.; Craft, Suzanne; Yaffe, Kristine; Weitlauf, Julie; Vaughan, Leslie; Johnson, Karen C.; Padula, Claudia B.; Jackson, Rebecca D.; Resnick, Susan M.

    2015-01-01

    OBJECTIVE In older women, higher levels of estrogen may exacerbate the increased risk for cognitive impairment conveyed by diabetes. We examined whether the effect of postmenopausal hormone therapy (HT) on cognitive impairment incidence differs depending on type 2 diabetes. RESEARCH DESIGN AND METHODS The Women’s Health Initiative (WHI) randomized clinical trials assigned women to HT (0.625 mg/day conjugated equine estrogens with or without [i.e., unopposed] 2.5 mg/day medroxyprogesterone acetate) or matching placebo for an average of 4.7–5.9 years. A total of 7,233 women, aged 65–80 years, were classified according to type 2 diabetes status and followed for probable dementia and cognitive impairment (mild cognitive impairment or dementia). RESULTS Through a maximum of 18 years of follow-up, women with diabetes had increased risk of probable dementia (hazard ratio [HR] 1.54 [95% CI 1.16–2.06]) and cognitive impairment (HR 1.83 [1.50–2.23]). The combination of diabetes and random assignment to HT increased their risk of dementia (HR 2.12 [1.47–3.06]) and cognitive impairment (HR 2.20 [1.70–2.87]) compared with women without these conditions, interaction P = 0.09 and P = 0.08. These interactions appeared to be limited to women assigned to unopposed conjugated equine estrogens. CONCLUSIONS These analyses provide additional support to a prior report that higher levels of estrogen may exacerbate risks that type 2 diabetes poses for cognitive function in older women. The role estrogen plays in suppressing non–glucose-based energy sources in the brain may explain this interaction. PMID:26486190

  10. Diabetes reduces the cognitive function with the decrease of the visual perception and visual motor integration in male older adults.

    PubMed

    Yun, Hyo-Soon; Kim, Eunhwi; Suh, Soon-Rim; Kim, Mi-Han; Kim, Hong

    2013-01-01

    This study investigated the influence of diabetes on cognitive decline between the diabetes and non- diabetes patients and identified the associations between diabetes and cognitive function, visual perception (VP), and visual motor integration (VMI). Sixty elderly men (67.10± 1.65 yr) with and without diabetes (n= 30 in each group) who were surveyed by interview and questionnaire in South Korea were enrolled in this study. The score of Mini-Mental State Examination of Korean version (MMSE-KC), Motor-free Visual Perception Test-Vertical Format (MVPT-V), and Visual-Motor Integration 3rd Revision (VMI-3R) were assessed in all of the participants to evaluate cognitive function, VP, and VMI in each. The score of MMSE-KC in the diabetic group was significantly lower than that of the non-diabetes group (P< 0.01). Participants in the diabetes group also had lower MVPT-V and VMI-3R scores than those in the non-diabetes group (P< 0.01, respectively). Especially, the scores of figure-ground and visual memory among the subcategories of MVPT-V were significantly lower in the diabetes group than in the non-diabetes group (P< 0.01). These findings indicate that the decline in cognitive function in individuals with diabetes may be greater than that in non-diabetics. In addition, the cognitive decline in older adults with diabetes might be associated with the decrease of VP and VMI. In conclusion, we propose that VP and VMI will be helpful to monitor the change of cognitive function in older adults with diabetes as part of the routine management of diabetes-induced cognitive declines.

  11. 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.

  12. Comorbid visual and cognitive impairment: relationship with disability status and self-rated health among older Singaporeans.

    PubMed

    Whitson, Heather E; Malhotra, Rahul; Chan, Angelique; Matchar, David B; Østbye, Truls

    2014-05-01

    The objective of this study was to examine the prevalence and consequences of coexisting vision and cognitive impairments in an Asian population. Data were collected from 4508 community-dwelling Singaporeans aged 60 years and older. Cognition was assessed by the Short Portable Mental Status Questionnaire whereas 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] = 4.64-9.92) than among men (OR = 1.71, 95% CI = 1.21-2.41). Concurrent cognitive and vision impairment is prevalent in older Singaporeans and is associated with high rates of disability. Gender differences in vision-dependent roles may affect the patient-perceived impact of this comorbidity.

  13. Successful cognitive aging and health-related quality of life in younger and older adults infected with HIV.

    PubMed

    Moore, Raeanne C; Fazeli, Pariya L; Jeste, Dilip V; Moore, David J; Grant, Igor; Woods, Steven Paul

    2014-06-01

    Neurocognitive impairments commonly occur and adversely impact everyday functioning in older adults infected with HIV, but little is known about successful cognitive aging (SCA) and its health-related quality of life (HRQoL) correlates. Seventy younger (≤40 years) and 107 older (≥50 years) HIV+ adults, as well as age-matched seronegative comparison groups of younger (N = 48) and older (N = 77) subjects completed a comprehensive battery of neuropsychological, psychiatric, medical, and HRQoL assessments. SCA was operationalized as the absence of both performance-based neurocognitive deficits and self-reported symptoms (SCA-ANDS) as determined by published normative standards. A stair-step decline in SCA-ANDS was observed in accordance with increasing age and HIV serostatus, with the lowest rates of SCA-ANDS found in the older HIV+ group (19 %). In both younger and older HIV+ adults, SCA-ANDS was strongly related to better mental HRQoL. HIV infection has additive adverse effects on SCA, which may play a unique role in mental well-being among HIV-infected persons across the lifespan.

  14. Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study

    PubMed Central

    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

  15. Screening for cognitive impairment among older people in black and minority ethnic groups.

    PubMed

    Parker, Chris; Philp, Ian

    2004-09-01

    There is a well-documented tendency for cognitive tests to underestimate the abilities of older people in black and minority ethnic groups. This gives rise to a substantially higher risk of mistaken diagnosis of dementia. Reasons include differences in extent or focus of formal education, lack of familiarity with English, lack of literacy in own first language, and culture-specific factors related to individual test items. Attempts to improve the accuracy of screening for these groups have included adaptation of existing tests, including adjustment of cut-points, translation and replacement of culture-specific items. So-called 'culture-free' tests have also been developed, which are less dependent on language, literacy and other skills developed during formal education. Cultural modifications and evidence of cross-cultural performance are summarized here for traditional tests (Mini-Mental State Examination, Short Portable Mental Status Questionnaire, Short Orientation-Memory-Concentration Test, Abbreviated Mental Test Score, Clifton Assessment Procedures for the Elderly), and for culture-free tests (Clock Drawing Test, Mini-Cog, 7-minute screening battery, Time and Change Test). The evidence on unadapted traditional tests shows that short ones perform at least as well as longer ones, and are more consistent across cultural and educational groups. Cut-point adjustments have not been universally found successful in improving accuracy, and do not address issues of acceptability. Translated and/or culturally adapted versions exist for a number of tests: it is important to establish cut-points appropriate to the target populations. There are promising results on culture-free tests, which are seen as less threatening and require little language interpretation, but they require further evaluation.

  16. 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

    2015-09-10

    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.

  17. 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.

  18. 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

  19. Incidence and risk factors for postoperative cognitive dysfunction in older adults undergoing major noncardiac surgery: A prospective study

    PubMed Central

    Shoair, Osama A.; Grasso II, Mario P.; Lahaye, Laura A.; Daniel, Ronsard; Biddle, Chuck J.; Slattum, Patricia W.

    2015-01-01

    Background & Aims: Postoperative cognitive dysfunction (POCD) is a decline in cognitive function that occurs after surgery. The purpose of this study was to estimate the incidence and identify potential risk factors of POCD in older adults undergoing major noncardiac surgery. Materials and Methods: A total of 69 patients aged 65 years or older undergoing major noncardiac surgery were enrolled. Patients’ cognitive function was assessed before and 3 months after surgery using a computerized neurocognitive battery. A nonsurgical control group of 54 older adults was recruited to adjust for learning effects from repeated administration of neurocognitive tests. Data about potential risk factors for POCD were collected before, during, and after surgery, including patient, medication, and surgery factors. The incidence of POCD was calculated using the Z-score method. A multivariable logistic regression model was used to identify risk factors for POCD. Results: POCD was present in eleven patients (15.9%, 95% confidence interval [CI] = 7.3-24.6) 3 months after major noncardiac surgery. Carrying the apolipoprotein E4 (APOE4) genotype (odds ratio [OR] = 4.74, 95% CI = 1.09-22.19), using one or more highly anticholinergic or sedative-hypnotic drugs at home prior to surgery (OR = 5.64, 95% CI = 1.35-30.22), and receiving sevoflurane for anesthesia (OR = 6.43, 95% CI = 1.49-34.66) were associated with the development of POCD. Conclusions: POCD was observed in 15.9% of older adults after major noncardiac surgery. Risk factors for POCD in these patients were carrying the APOE4 genotype, using one or more highly anticholinergic or sedative-hypnotic drugs prior to surgery, and receiving sevoflurane for anesthesia. PMID:25788770

  20. 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.

  1. 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

  2. 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

  3. 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…

  4. 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…

  5. 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

  6. 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

  7. Daytime somnolence as an early sign of cognitive decline in a community-based study of older people

    PubMed Central

    Tsapanou, Angeliki; Gu, Yian; O’Shea, Deirdre; Eich, Teal; Tang, Ming-Xin; Schupf, Nicole; Manly, Jennifer; Zimmerman, Molly; Scarmeas, Nikolaos; Stern, Yaakov

    2017-01-01

    Objective This study aimed to examine the association between self-reported sleep problems and cognitive decline in community-dwelling older people. We hypothesized that daytime somnolence predicts subsequent cognitive decline. Methods This is a longitudinal study in a 3.2-year follow-up, with 18-month intervals. The setting is the Washington Heights-Inwood Community Aging Project. There were 1098 participants, who were over 65 years old and recruited from the community. Sleep problems were estimated using five sleep categories derived from the RAND Medical Outcome Study Sleep Scale: sleep disturbance, snoring, awaken short of breath/with a headache, sleep adequacy, and daytime somnolence. Four distinct cognitive composite scores were calculated: memory, language, speed of processing, and executive functioning. We used generalized estimating equations analyses with cognitive scores as the outcome, and time, sleep categories and their interactions as the main predictors. Models were initially unadjusted and then adjusted for age, gender, education, ethnicity, depression, and apolipoprotein E-ε4 genotype. Results Increased daytime somnolence (including feeling drowsy/sleepy, having trouble staying awake, and taking naps during the day) was linked to slower speed of processing both cross-sectionally (B = −0.143, p = 0.047) and longitudinally (B = −0.003, p = 0.027). After excluding the demented participants at baseline, the results remained significant (B = −0.003, p = 0.021). Conclusions Our findings suggest that daytime somnolence may be an early sign of cognitive decline in the older population. Copyright # 2015 John Wiley & Sons, Ltd. PMID:26081795

  8. Aging, Subjective Experience, and Cognitive Control: Dramatic False Remembering by Older Adults

    ERIC Educational Resources Information Center

    Jacoby, Larry L.; Bishara, Anthony J.; Hessels, Sandra; Toth, Jeffrey P.

    2005-01-01

    Recent research suggests that older adults are more susceptible to interference effects than are young adults; however, that research has failed to equate differences in original learning. In 4 experiments, the authors show that older adults are more susceptible to interference effects produced by a misleading prime. Even when original learning…

  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. Disruptions in Brain Networks of Older Fallers Are Associated with Subsequent Cognitive Decline: A 12-Month Prospective Exploratory Study

    PubMed Central

    Hsu, Chun Liang; Voss, Michelle W.; Handy, Todd C.; Davis, Jennifer C.; Nagamatsu, Lindsay S.; Chan, Alison; Bolandzadeh, Niousha; Liu-Ambrose, Teresa

    2014-01-01

    Cognitive impairment and impaired mobility are major public health concerns. There is growing recognition that impaired mobility is an early biomarker of cognitive impairment and dementia. The neural basis for this association is currently unclear. We propose disrupted functional connectivity as a potential mechanism. In this 12-month prospective exploratory study, we compared functional connectivity of four brain networks– the default mode network (DMN), fronto-executive network (FEN), fronto-parietal network (FPN), and the primary motor sensory network (SMN) – between community-dwelling older adults with ≥ two falls in the last 12 months and their non-falling counterparts (≤ one fall in the last 12 months). Functional connectivity was examined both at rest and during a simple motor tapping task. Compared with non-fallers, fallers showed more connectivity between the DMN and FPN during right finger tapping (p = 0.04), and significantly less functional connectivity between the SMN and FPN during rest (p≤0.05). Less connectivity between the SMN and FPN during rest was significantly associated with greater decline in both cognitive function and mobility over the12-month period (r = −0.32 and 0.33 respectively; p≤0.04). Thus, a recent history of multiple falls among older adults without a diagnosis of dementia may indicate sub-clinical changes in brain function and increased risk for subsequent decline. PMID:24699668

  11. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults

    PubMed Central

    Tao, Jing; Chen, Xiangli; Egorova, Natalia; Liu, Jiao; Xue, Xiehua; Wang, Qin; Zheng, Guohua; Li, Moyi; Hong, Wenjun; Sun, Sharon; Chen, Lidian; Kong, Jian

    2017-01-01

    Cognitive impairment is one of the most common problem saffecting older adults. In this study, we investigated whether Tai Chi Chuan and Baduanjin practice can modulate mental control functionand the resting state functional connectivity (rsFC) of the cognitive control network in older adults. Participants in the two exercise groups practiced either Tai Chi Chuan or Baduanjin for 12 weeks, and those in the control group received basic health education. Memory tests and fMRI scans were conducted at baseline and at the end of the study. Seed-based (bilateral dorsolateral prefrontal cortex, DLPFC) rsFC analysis was performed. We found that compared to the controls, 1) both Tai Chi Chuan and Baduanjin groups demonstrated significant improvements in mental control function; 2) the Tai Chi Chuan group showed a significant decrease in rsFC between the DLPFC and the left superior frontal gyrus (SFG) and anterior cingulate cortex; and 3) the Baduanjin group showed a significant decrease in rsFC between the DLPFC and the left putamen and insula. Mental control improvement was negatively associated with rsFC DLPFC-putamen changes across all subjects. These findings demonstrate the potential of Tai Chi Chuan and Baduanjin exercises in preventing cognitive decline. PMID:28169310

  12. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults.

    PubMed

    Tao, Jing; Chen, Xiangli; Egorova, Natalia; Liu, Jiao; Xue, Xiehua; Wang, Qin; Zheng, Guohua; Li, Moyi; Hong, Wenjun; Sun, Sharon; Chen, Lidian; Kong, Jian

    2017-02-07

    Cognitive impairment is one of the most common problem saffecting older adults. In this study, we investigated whether Tai Chi Chuan and Baduanjin practice can modulate mental control functionand the resting state functional connectivity (rsFC) of the cognitive control network in older adults. Participants in the two exercise groups practiced either Tai Chi Chuan or Baduanjin for 12 weeks, and those in the control group received basic health education. Memory tests and fMRI scans were conducted at baseline and at the end of the study. Seed-based (bilateral dorsolateral prefrontal cortex, DLPFC) rsFC analysis was performed. We found that compared to the controls, 1) both Tai Chi Chuan and Baduanjin groups demonstrated significant improvements in mental control function; 2) the Tai Chi Chuan group showed a significant decrease in rsFC between the DLPFC and the left superior frontal gyrus (SFG) and anterior cingulate cortex; and 3) the Baduanjin group showed a significant decrease in rsFC between the DLPFC and the left putamen and insula. Mental control improvement was negatively associated with rsFC DLPFC-putamen changes across all subjects. These findings demonstrate the potential of Tai Chi Chuan and Baduanjin exercises in preventing cognitive decline.

  13. Long-Term High-Effort Endurance Exercise in Older Adults: Diminishing Returns for Cognitive and Brain Aging.

    PubMed

    Young, Jeremy C; Dowell, Nicholas G; Watt, Peter W; Tabet, Naji; Rusted, Jennifer M

    2016-10-01

    While there is evidence that age-related changes in cognitive performance and brain structure can be offset by increased exercise, little is known about the impact long-term high-effort endurance exercise has on these functions. In a cross-sectional design with 12-month follow-up, we recruited older adults engaging in high-effort endurance exercise over at least 20 years, and compared their cognitive performance and brain structure with a nonsedentary control group similar in age, sex, education, IQ, and lifestyle factors. Our findings showed no differences on measures of speed of processing, executive function, incidental memory, episodic memory, working memory, or visual search for older adults participating in long-term high-effort endurance exercise, when compared without confounds to nonsedentary peers. On tasks that engaged significant attentional control, subtle differences emerged. On indices of brain structure, long-term exercisers displayed higher white matter axial diffusivity than their age-matched peers, but this did not correlate with indices of cognitive performance.

  14. Older Adults Make Less Advantageous Decisions than Younger Adults: Cognitive and Psychological Correlates

    PubMed Central

    Fein, George; McGillivray, Shannon; Finn, Peter

    2007-01-01

    This study tested the hypotheses that older adults make less advantageous decisions than younger adults on the Iowa gambling task (IGT). Less advantageous decisions, as measured by the IGT, are characterized by choices that favor larger versus smaller immediate rewards, even though such choices may result in long-term negative consequences. The IGT, and measures of neuropsychological function, personality, and psychopathology were administered to 164 healthy adults 18–85 years of age. Older adults performed less advantageously on the IGT compared with younger adults. Additionally, a greater number of older adult’s IGT performances were classified as ‘impaired’ when compared to younger adults. Less advantageous decisions were associated with obsessive symptoms in older adults and with antisocial symptoms in younger adults. Performance on the IGT was positively associated with auditory working memory and psychomotor function in young adults, and in immediate memory in older adults. PMID:17445297

  15. Does Combined Physical and Cognitive Training Improve Dual-Task Balance and Gait Outcomes in Sedentary Older Adults?

    PubMed Central

    Fraser, Sarah A.; Li, Karen Z.-H.; Berryman, Nicolas; Desjardins-Crépeau, Laurence; Lussier, Maxime; Vadaga, Kiran; Lehr, Lora; Minh Vu, Thien Tuong; Bosquet, Laurent; Bherer, Louis

    2017-01-01

    Everyday activities like walking and talking can put an older adult at risk for a fall if they have difficulty dividing their attention between motor and cognitive tasks. Training studies have demonstrated that both cognitive and physical training regimens can improve motor and cognitive task performance. Few studies have examined the benefits of combined training (cognitive and physical) and whether or not this type of combined training would transfer to walking or balancing dual-tasks. This study examines the dual-task benefits of combined training in a sample of sedentary older adults. Seventy-two older adults (≥60 years) were randomly assigned to one of four training groups: Aerobic + Cognitive training (CT), Aerobic + Computer lessons (CL), Stretch + CT and Stretch + CL. It was expected that the Aerobic + CT group would demonstrate the largest benefits and that the active placebo control (Stretch + CL) would show the least benefits after training. Walking and standing balance were paired with an auditory n-back with two levels of difficulty (0- and 1-back). Dual-task walking and balance were assessed with: walk speed (m/s), cognitive accuracy (% correct) and several mediolateral sway measures for pre- to post-test improvements. All groups demonstrated improvements in walk speed from pre- (M = 1.33 m/s) to post-test (M = 1.42 m/s, p < 0.001) and in accuracy from pre- (M = 97.57%) to post-test (M = 98.57%, p = 0.005).They also increased their walk speed in the more difficult 1-back (M = 1.38 m/s) in comparison to the 0-back (M = 1.36 m/s, p < 0.001) but reduced their accuracy in the 1-back (M = 96.39%) in comparison to the 0-back (M = 99.92%, p < 0.001). Three out of the five mediolateral sway variables (Peak, SD, RMS) demonstrated significant reductions in sway from pre to post test (p-values < 0.05). With the exception of a group difference between Aerobic + CT and Stretch + CT in accuracy, there were no significant group differences after training. Results

  16. 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

  17. 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.

  18. 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

  19. Reconciling conceptualizations of relationships and person-centred care for older people with cognitive impairment in acute care settings.

    PubMed

    Rushton, Carole; Edvardsson, David

    2017-02-10

    Relationships are central to enacting person-centred care of the older person with cognitive impairment. A fuller understanding of relationships and the role they play facilitating wellness and preserving personhood is critical if we are to unleash the productive potential of nursing research and person-centred care. In this article, we target the acute care setting because much of the work about relationships and older people with cognitive impairment has tended to focus on relationships in long-term care. The acute care setting is characterized by archetypal constraints which differentiate it from long-term care, in terms of acuity and haste, task-orientated work patterns and influence from "the rule of medicine," all of which can privilege particular types of relating. In this article, we drew on existing conceptualizations of relationships from theory and practice by tapping in to the intellectual resources provided by nurse researchers, the philosophy of Martin Buber and ANT scholars. This involved recounting two examples of dyadic and networked relationships which were re-interpreted using two complementary theoretical approaches to provide deeper and more comprehensive conceptualizations of these relationships. By re-presenting key tenets from the work of key scholars on the topic relationships, we hope to hasten socialization of these ideas into nursing into the acute care setting. First, by enabling nurses to reflect on how they might work toward cultivating relationships that are more salutogenic and consistent with the preservation of personhood. Second, by stimulating two distinct but related lines of research enquiry which focus on dyadic and networked relationships with the older person with cognitive impairment in the acute care setting. We also hope to reconcile the schism that has emerged in the literature between preferred approaches to care of the older person with cognitive impairment, that is person-centred care versus relationship-centred care

  20. 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

  1. [Effects of physical activity and physical training on the psychological status of older persons with and without cognitive impairment].

    PubMed

    Gogulla, S; Lemke, N; Hauer, K

    2012-06-01

    Fear of falling and depression in the elderly and among cognitively impaired people lead to restrictions in quality of life. Being more active is associated with improved mental health as documented in cross-sectional and longitudinal studies. This is especially true for depression. Such epidemiologic evidence is lacking in fear of falling. This review summarizes current evidence from epidemiological and randomized controlled trials (RCTs) and gives an outlook for future research perspectives. The majority of studies included in this review document a significant reduction of depression and fear of falling in older persons by physical training with less evidence in persons with cognitive impairment. With respect to intensity, duration, and amount of exercise, evidence-based recommendations were limited by the small number of high-quality comparative RCTs. High-intensity strength or endurance training was the most effective for reducing depression, while participation in Tai-Chi or multifactorial training programs was most effective to reduce fear of falling.

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Influence of age and cognitive performance on resting-state brain networks of older adults in a population-based cohort.

    PubMed

    Jockwitz, Christiane; Caspers, Svenja; Lux, Silke; Eickhoff, Simon B; Jütten, Kerstin; Lenzen, Stefan; Moebus, Susanne; Pundt, Noreen; Reid, Andrew; Hoffstaedter, Felix; Jöckel, Karl-Heinz; Erbel, Raimund; Cichon, Sven; Nöthen, Markus M; Shah, N Jon; Zilles, Karl; Amunts, Katrin

    2017-04-01

    Aging leads to global changes in brain structure and cognitive performance, with reorganization of functional brain networks. Importantly, these age-related changes show higher inter-individual variability in older subjects. To particularly address this variability is a challenge for studies on lifetime trajectories from early to late adulthood. The present study therefore had a dedicated focus on late adulthood to characterize the functional connectivity in resting-state networks (RSFC) in relation to age and cognitive performance in 711 older adults (55-85 years) from the 1000BRAINS project. The executive, left and right frontoparietal resting-state (RS) networks showed age-related increases in RSFC. However, older adults did not show changes in RSFC in the default mode network (DMN). Furthermore, lower performance in working memory (WM) was associated with higher RSFC in the left frontoparietal RS network. The results suggest age-related compensatory increases in RSFC which might help to maintain cognitive performance. Nevertheless, the negative correlation between RSFC and WM performance hints at limited cognitive reserve capacity in lower performing older adults. Consequently, the current results provide evidence for a functional reorganization of the brain until late adulthood that might additionally explain parts of the variability of cognitive abilities in older adults.

  8. Factors associated with changing cognitive function in older adults: implications for nursing rehabilitation.

    PubMed

    Myers, Jamie S

    2008-01-01

    This article reviews the significant effects of aging on cognitive function. As people age, brain tissue volume decreases, white matter hyperintensities increase, and associated deficits are seen in working memory, attention, and executive function. Comorbidities include hypertension, diabetes, and cardiovascular risk factors. Another factor that affects cognitive function is the presence of apolipoprotein E-4, which is negatively correlated with cognitive function. In addition, decreased serum levels of endogenous sex hormones are related to changes in cognitive function, but hormone replacement therapy may be detrimental. Improved cognition has been associated with moderate alcohol intake, regular exercise, and exposure to novel stimuli. This article also examines research evaluating brain-plasticity-based training and rehabilitation to reverse losses in sensory, cognitive, and motor processing. Rehabilitation nursing strategies for dealing with the decline of cognitive function include educating patients and developing a program about lifestyle changes that will enhance cognitive stimulation; minimizing risks for and effects of hypertension, diabetes, and cardiovascular disease; recognizing and accommodating sensory deficits; and maintaining awareness of current research outcomes to guide evidence-based practice.

  9. 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

  10. Fish intake is associated with slower cognitive decline in Chinese older adults.

    PubMed

    Qin, Bo; Plassman, Brenda L; Edwards, Lloyd J; Popkin, Barry M; Adair, Linda S; Mendez, Michelle A

    2014-10-01

    Modifiable lifestyle changes, including dietary changes, could translate into a great reduction in the global burden of cognitive impairment and dementia. Few studies evaluated the benefits of fish intake for delaying cognitive decline, and no studies were conducted in a Chinese population, which may differ with respect to types, amounts, and correlates of fish consumption compared with Western populations. We hypothesized that higher consumption of fish would predict slower decline in cognitive function, independent of a wide range of potential confounders. This prospective cohort study comprised 1566 community-dwelling adults aged ≥ 55 y who completed a cognitive screening test at ≥2 waves of the China Health and Nutrition Survey in 1997, 2000, or 2004, with a mean follow-up of 5.3 y [age at entry (mean ± SD): 63 ± 6 y]. Diet was measured by 3-d 24-h recalls at baseline. Outcomes included repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), composite cognitive Z-scores (standardized units), and standardized verbal memory scores (standardized units). Multivariable-adjusted linear mixed-effects models were used to evaluate the relation of fish intake with changes in cognitive scores. Age was found to significantly modify the association between fish consumption and cognitive change (P = 0.007). Among adults aged ≥ 65 y, compared with individuals who consumed <1 serving/wk (i.e., 100 g) fish, the mean annual rate of global cognitive decline was reduced by 0.35 point (95% CI: 0.13, 0.58) among those consuming ≥ 1 serving/wk, equivalent to the disparity associated with 1.6 y of age. Fish consumption was also associated with a slower decline in composite and verbal memory scores. No associations were observed among adults aged 55-64 y. Our findings suggest a potential role of fish consumption as a modifiable dietary factor to reduce the rate of cognitive decline in later life.

  11. Adverse Vascular Risk is Related to Cognitive Decline in Older Adults

    PubMed Central

    Jefferson, Angela L.; Hohman, Timothy J.; Liu, Dandan; Haj-Hassan, Shereen; Gifford, Katherine A.; Benson, Elleena M.; Skinner, Jeannine S.; Lu, Zengqi; Sparling, Jamie; Sumner, Emily C.; Bell, Susan; Ruberg, Frederick L.

    2014-01-01

    Background Cardiovascular disease (CVD) and related risk factors are associated with Alzheimer’s disease (AD). This association is less well-defined in normal cognition (NC) or prodromal AD (mild cognitive impairment (MCI)). Objective Cross-sectionally and longitudinally relate a vascular risk index to cognitive outcomes among elders free of clinical dementia. Methods 3117 MCI (74±8 years, 56% female) and 6603 NC participants (72±8 years, 68% female) were drawn from the National Alzheimer’s Coordinating Center. A composite measure of vascular risk was defined using the Framingham Stroke Risk Profile (FSRP) score (i.e., age, systolic blood pressure, anti-hypertensive medication, diabetes, cigarette smoking, CVD history, atrial fibrillation). Ordinary linear regressions and generalized linear mixed models related baseline FSRP to cross-sectional and longitudinal cognitive outcomes, separately for NC and MCI, adjusting for age, sex, race, education, and follow-up time (in longitudinal models). Results In NC participants, increasing FSRP was related to worse baseline global cognition, information processing speed, and sequencing abilities (p-values<0.0001) and a worse longitudinal trajectory on all cognitive measures (p-values<0.0001). In MCI, increasing FSRP correlated with worse longitudinal delayed memory (p=0.004). In secondary models using an age-excluded FSRP score, associations persisted in NC participants for global cognition, naming, information processing speed, and sequencing abilities. Conclusions An adverse vascular risk profile is associated with worse cognitive trajectory, especially global cognition, naming, and information processing speed, among NC elders. Future studies are needed to understand how effective management of CVD and related risk factors can modify cognitive decline to identify the ideal timeframe for primary prevention implementation. PMID:25471188

  12. Validation of the Spanish Version of the Face Name Associative Memory Exam (S-FNAME) in Cognitively Normal Older Individuals

    PubMed Central

    Alegret, Montserrat; Valero, Sergi; Ortega, Gemma; Espinosa, Ana; Sanabria, Angela; Hernández, Isabel; Rodríguez, Octavio; Rosende-Roca, Maitee; Mauleón, Ana; Vargas, Liliana; Martín, Elvira; Ruíz, Agustín; Tárraga, Lluís; Amariglio, Rebecca E.; Rentz, Dorene M.; Boada, Mercè

    2015-01-01

    The Face Name Associative Memory Exam (FNAME) is a paired associative memory test that has demonstrated sensitivity to amyloid burden in cognitively normal individuals, a biomarker of preclinical Alzheimer's disease. Normative data adjusted for age were reported in American healthy individuals older than 57. We aimed to report the psychometric characteristics of a Spanish version of FNAME (S-FNAME) when administered to Spanish-speaking people. We sought to investigate convergent validity of S-FNAME with another memory measure and to identify which demographic characteristics might be associated with performance on S-FNAME. We administered the S-FNAME to 110 literate, cognitively normal, Spanish individuals older than 49 years from the Memory Clinic Fundació ACE. Construct validity of S-FNAME showed 2 components: face–name and face–occupation. A significant correlation between S-FNAME and Word List from the WMS-III supported convergent validity. The S-FNAME was also associated with age and gender. Thus, we provide normative data for age and gender. PMID:26289054

  13. Association of Functional Impairments and Co-Morbid Conditions with Driving Performance among Cognitively Normal Older Adults

    PubMed Central

    Barco, Peggy P.; Babulal, Ganesh M.; Stout, Sarah H.; Johnson, Anne M.; Xiong, Chengjie; Morris, John C.; Roe, Catherine M.

    2016-01-01

    Objectives To examine the relationship between key functional impairments, co-morbid conditions and driving performance in a sample of cognitively normal older adults. Design Prospective observational study Setting The Knight Alzheimer’s Disease Research Center, Washington University at St. Louis Participants Individuals with normal cognition, 64.9 to 88.2 years old (N = 129), with a valid driver’s license, who were currently driving at least once per week, and who had participated in longitudinal studies at the Knight Alzheimer’s Disease Research Center Measurements Static visual acuity, contrast sensitivity, physical frailty measures, motor skills, total medical conditions, and the modified Washington University Road Test. Results When controlling for age, race, gender, APOE, and education the total number of medical conditions was unassociated with both road test scores (pass vs. marginal + fail) and the total driver error count. There were marginal associations of our measure of physical frailty (p = 0.06) and contrast sensitivity score (p = 0.06) with total driving error count. Conclusion Future research that focuses on older adults and driving should consider adopting measures of physical frailty and contrast sensitivity, especially in samples that may have a propensity for disease impacting visual and/or physical function (e.g. osteoarthritis, Parkinson’s, eye disorders, advanced age >80 years, etc.). PMID:28005921

  14. Effects of rumenic acid rich conjugated linoleic acid supplementation on cognitive function and handgrip performance in older men and women.

    PubMed

    Jenkins, Nathaniel D M; Housh, Terry J; Miramonti, Amelia A; McKay, Brianna D; Yeo, Noelle M; Smith, Cory M; Hill, Ethan C; Cochrane, Kristen C; Cramer, Joel T

    2016-11-01

    The purpose of this study was to investigate the effects of 8weeks at 6g per day of RAR CLA versus placebo on cognitive function and handgrip performance in older men and women. Sixty-five (43 women, 22 men) participants (mean±SD; age=72.4±5.9yrs; BMI=26.6±4.2kg·m(-2)) were randomly assigned to a RAR CLA (n=30: 10 men, 20 women) or placebo (PLA; high oleic sunflower oil; n=35: 12 men, 23 women) group in double-blind fashion and consumed 6g·d(-1) of their allocated supplement for 8weeks. Before (Visit 1) and after supplementation (Visit 2), subjects completed the Serial Sevens Subtraction Test (S7), Trail Making Test Part A (TMA) and Part B (TMB), and Rey's Auditory Verbal Learning Test (RAVLT) to measure cognitive function. The RAVLT included 5, 15-item auditory word recalls (R1-5), an interference word recall (RB), a 6th word recall (R6), and a 15-item visual word recognition trial (RR). For handgrip performance, subjects completed maximal voluntary isometric handgrip strength (MVIC) testing before (MVICPRE) and after (MVICPOST) a handgrip fatigue test at 50% MVICPRE. Hand joint discomfort was measured during MVICPRE, MVICPOST, and the handgrip fatigue test. There were no treatment differences (p>0.05) for handgrip strength, handgrip fatigue, or cognitive function as measured by the Trail Making Test and Serial Seven's Subtraction Test in men or women. However, RAR CLA supplementation improved cognitive function as indicated by the RAVLT R5 in men. A qualitative examination of the mean change scores suggested that, compared to PLA, RAR CLA supplementation was associated with a small improvement in joint discomfort in both men and women. Longer-term studies are needed to more fully understand the potential impact of RAR CLA on cognitive function and hand joint discomfort in older adults, particularly in those with lower cognitive function.

  15. Relationships among cognitive deficits and component skills of reading in younger and older students with developmental dyslexia.

    PubMed

    Park, Heeyoung; Lombardino, Linda J

    2013-09-01

    Processing speed deficits along with phonological awareness deficits have been identified as risk factors for dyslexia. This study was designed to examine the behavioral profiles of two groups, a younger (6-8 years) and an older (10-15 years) group of dyslexic children for the purposes of (1) evaluating the degree to which phonological awareness and processing speed deficits occur in the two developmental cohorts; (2) determining the strength of relationships between the groups' respective mean scores on cognitive tasks of phonological awareness and processing speed and their scores on component skills of reading; and (3) evaluating the degree to which phonological awareness and processing speed serve as concurrent predictors of component reading skills for each group. The mean scaled scores for both groups were similar on all but one processing speed task. The older group was significantly more depressed on a visual matching test of attention, scanning, and speed. Correlations between reading skills and the cognitive constructs were very similar for both age-groups. Neither of the two phonological awareness tasks correlated with either of the two processing speed tasks or with any of the three measures of reading. One of the two processing speed measures served as a concurrent predictor of word- and text-level reading in the younger, however, only the rapid naming measure functioned as a concurrent predictor of word reading in the older group. Conversely, phonological processing measures did not serve as concurrent predictors for word-level or text-level reading in either of the groups. Descriptive analyses of individual subjects' deficits in the domains of phonological awareness and processing speed revealed that (1) both linguistic and nonlinguistic processing speed deficits in the younger dyslexic children occurred at higher rates than deficits in phonological awareness and (2) cognitive deficits within and across these two domains were greater in the older

  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.

  18. Exercise and cognition in older adults: is there a role for resistance training programmes?

    PubMed

    Liu-Ambrose, T; Donaldson, M G

    2009-01-01

    In recent years, there has been a strong interest in physical activity as a primary behavioural prevention strategy against cognitive decline. A number of large prospective cohort studies have highlighted the protective role of regular physical activity in lowering the risk of cognitive impairment and dementia. Most prospective intervention studies of exercise and cognition to date have focused on aerobic-based exercise training. These studies highlight that aerobic-based exercise training enhances both brain structure and function. However, it has been suggested that other types of exercise training, such as resistance training, may also benefit cognition. The purpose of this brief review is to examine the evidence regarding resistance training and cognitive benefits. Three recent randomised exercise trials involving resistance training among seniors provide evidence that resistance training may have cognitive benefits. Resistance training may prevent cognitive decline among seniors via mechanisms involving insulin-like growth factor I and homocysteine. A side benefit of resistance training, albeit a very important one, is its established role in reducing morbidity among seniors. Resistance training specifically moderates the development of sarcopenia. The multifactorial deleterious sequelae of sarcopenia include increased falls and fracture risk as well as physical disability. Thus, clinicians should consider encouraging their clients to undertake both aerobic-based exercise training and resistance training not only for "physical health" but also because of the almost certain benefits for "brain health".

  19. Do Economic Recessions During Early and Mid-Adulthood Influence Cognitive Function in Older Age?

    PubMed Central

    Leist, Anja K.; Hessel, Philipp; Avendano, Mauricio

    2014-01-01

    Background Fluctuations in the national economy shape labour market opportunities and outcomes, which in turn may influence the accumulation of cognitive reserve. This study examines whether economic recessions experienced in early and mid-adulthood are associated with later-life cognitive function. Method Data came from 12,020 respondents in 11 countries participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). Cognitive assessments in 2004/5 and 2006/7 were linked to complete work histories retrospectively collected in 2008/9, and to historical annual data on fluctuations in Gross Domestic Product (GDP) per capita for each country. Controlling for confounders, we assessed whether recessions experienced at ages 25-34, 35-44 and 45-49 were associated with cognitive function at ages 50-74. Results Among men, each additional recession at ages 45-49 was associated with worse cognitive function at ages 50-74 (b = -0.06, Confidence Interval [CI] -0.11, -0.01). Among women, each additional recession at ages 25-44 was associated with worse cognitive function at ages 50-74 (b25-34 = -0.03, CI -0.04, -0.01; b35-44= -0.02, CI -0.04, -0.00). Among men, recessions at ages 45-49 influenced risk of being laid-off, whereas among women, recessions at ages 25-44 led to working part-time and higher likelihood of downward occupational mobility, which were all predictors of worse later-life cognitive function. Conclusions Recessions at ages 45-49 among men and 25-44 among women are associated with later-life cognitive function, possibly via more unfavourable labour market trajectories. If replicated in future studies, findings may indicate that policies that ameliorate the impact of recessions on labour market outcomes may promote later-life cognitive function. PMID:24258197

  20. Effect of cognitive status on self-regulatory driving behavior in older adults: an assessment of naturalistic driving using in-car video recordings.

    PubMed

    Festa, Elena K; Ott, Brian R; Manning, Kevin J; Davis, Jennifer D; Heindel, William C

    2013-03-01

    Previous findings that older drivers engage in strategic self-regulatory behaviors to minimize perceived safety risks are primarily based on survey reports rather than actual behavior. This study analyzed in-car video recording of naturalistic driving of 18 patients with Alzheimer disease (AD) and 20 age-matched controls in order to (1) characterize self-regulatory behaviors engaged by older drivers and (2) assess how behaviors change with cognitive impairment. Only participants who were rated "safe" on a prior standardized road test were selected for this study. Both groups drove primarily in environments that minimized the demands on driving skill and that incurred the least risk for involvement in major crashes. Patients with AD displayed further restrictions of driving behavior beyond those of healthy elderly individuals, suggesting additional regulation on the basis of cognitive status. These data provide critical empirical support for findings from previous survey studies indicating an overall reduction in driving mobility among older drivers with cognitive impairment.

  1. Prevalences of dementia and cognitive impairment among older people in sub-Saharan Africa: a systematic review

    PubMed Central

    Powell, John; Thorogood, Margaret

    2013-01-01

    Abstract Objective To perform a systematic review of the literature on the prevalence of cognitive impairment and dementia in sub-Saharan Africa. Methods Five electronic databases were searched for relevant abstracts and to identify papers eligible for full-text review. A study was included if two authors agreed that it had a cohort, case–control or cross-sectional design and reported population-level data; was limited to black African adults older than 50 years or described as “elderly” or “old”; reported data for individuals residing in sub-Saharan Africa; and reported at least one measure of cognitive impairment or clinical outcomes relevant to cognitive decline. References of papers included in our study were searched to identify additional candidate publications. Disagreements about inclusion were adjudicated during discussions involving all authors. Data were extracted independently by two authors, using a form developed by the authors and tested on a sample of papers. Findings A total of 2320 unique papers was found; the full text of 87 was reviewed. Nineteen papers featuring 11 cross-sectional studies were included; all were published during 1995–2011. Studies occurred in Benin, Botswana, the Central African Republic, the Congo and Nigeria and enrolled approximately 10 500 participants. The prevalence of dementia ranged from 0%, in Nigeria, to 10.1% (95% confidence interval, CI: 8.6–11.8), also in Nigeria. The prevalence of cognitive impairment ranged from 6.3%, in Nigeria, to 25% (95% CI: 21.2–29.0), in the Central African Republic. Conclusion Prevalences of dementia and cognitive impairment in sub-Saharan Africa varied widely, with few published studies revealed by the literature search. PMID:24115801

  2. Genetic variants influencing biomarkers of nutrition are not associated with cognitive capability in middle-aged and older adults.

    PubMed

    Alfred, Tamuno; Ben-Shlomo, Yoav; Cooper, Rachel; Hardy, Rebecca; Deary, Ian J; Elliott, Jane; Harris, Sarah E; Hyppönen, Elina; Kivimaki, Mika; Kumari, Meena; Maddock, Jane; Power, Chris; Starr, John M; Kuh, Diana; Day, Ian N M

    2013-05-01

    Several investigations have observed positive associations between good nutritional status, as indicated by micronutrients, and cognitive measures; however, these associations may not be causal. Genetic polymorphisms that affect nutritional biomarkers may be useful for providing evidence for associations between micronutrients and cognitive measures. As part of the Healthy Ageing across the Life Course (HALCyon) program, men and women aged between 44 and 90 y from 6 UK cohorts were genotyped for polymorphisms associated with circulating concentrations of iron [rs4820268 transmembrane protease, serine 6 (TMPRSS6) and rs1800562 hemochromatosis (HFE)], vitamin B-12 [(rs492602 fucosyltransferase 2 (FUT2)], vitamin D ([rs2282679 group-specific component (GC)] and β-carotene ([rs6564851 beta-carotene 15,15'-monooxygenase 1 (BCMO1)]. Meta-analysis was used to pool within-study effects of the associations between these polymorphisms and the following measures of cognitive capability: word recall, phonemic fluency, semantic fluency, and search speed. Among the several statistical tests conducted, we found little evidence for associations. We found the minor allele of rs1800562 was associated with poorer word recall scores [pooled β on Z-score for carriers vs. noncarriers: -0.05 (95% CI: -0.09, -0.004); P = 0.03, n = 14,105] and poorer word recall scores for the vitamin D-raising allele of rs2282679 [pooled β per T allele: -0.03 (95% CI: -0.05, -0.003); P = 0.03, n = 16,527]. However, there was no evidence for other associations. Our findings provide little evidence to support associations between these genotypes and cognitive capability in older adults. Further investigations are required to elucidate whether the previous positive associations from observational studies between circulating measures of these micronutrients and cognitive performance are due to confounding and reverse causality.

  3. Excessive daytime sleepiness and fatigue may indicate accelerated brain aging in cognitively normal late middle-aged and older adults.

    PubMed

    Carvalho, Diego Z; St Louis, Erik K; Boeve, Bradley F; Mielke, Michelle M; Przybelski, Scott A; Knopman, David S; Machulda, Mary M; Roberts, Rosebud O; Geda, Yonas E; Petersen, Ronald C; Jack, Clifford R; Vemuri, Prashanthi

    2017-04-01

    Excessive daytime sleepiness (EDS) and fatigue increases with age. The aim of this study was to investigate the association between EDS and fatigue with cortical thickness and hippocampal volume in cognitively normal, late middle-aged and older adults. We performed a cross-sectional observational study of 1374 cognitively-normal subjects aged 50 years and older who had a structural MRI. Regional cortical thickness and hippocampal volume were measured. Multiple linear regression models were fit to explore associations between EDS and fatigue and structural MRI measures in different brain regions, adjusting for multiple covariates. EDS was defined as Epworth Sleepiness Scale ≥10. Fatigue severity was assessed with the Beck Depression Inventory-2. 208 participants had EDS, 27 had significant fatigue, and 11 had both. Participants with EDS or fatigue had significantly lower cognitive scores, more disturbed sleep, and medical comorbidities. The presence of EDS was associated with both global and regional atrophy, whereas fatigue was more associated with frontal and temporal changes. Cortical thinning predicted by EDS and fatigue was maximal in the temporal region with average reduction of 34.2 μm (95% CI, -54.1, -14.3; P = 0.001) and 90.2 μm (95% CI, -142.1, -38.2; P = 0.001), respectively. Fatigue was also associated with hippocampal volume reduction of -374.2 mm(3) (95% CI, -670.8, -77.7; P = 0.013). Temporal cortical thinning predicted by presence of EDS and fatigue was equivalent to more than 3.5 and 9 additional years of aging, respectively. EDS and fatigue were associated with cortical thickness reduction primarily in regions with increased age-susceptibility, which may indicate accelerated brain aging.

  4. 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

  5. The effect of