Differential associations of modifiable and non‐modifiable dementia risk factors with memory decline and hippocampal volume loss in Aβ‐ and Aβ+ cognitively normal older adults

Abstract Background We investigated the association between trajectories of verbal episodic memory and burden of cardiovascular risk factors in middle-aged and older community-dwellers. Methods We analysed data from 4372 participants aged 50–64 and 3005 persons aged 65–79 years old from the English Longitudinal Study of Ageing who were repeatedly evaluated every 2 years and had six interviews of a 10-year follow-up. We measured the following baseline risk factors: diabetes, hypertension, smoking, physical inactivity and obesity to derive a cardiovascular risk factor score (CVRFs). Adjusted linear mixed effect regression models were estimated to determine the association between number of CVFRs and six repeated measurements of verbal memory scores, separately for middle-aged and older adults. Results CVRFs was not significantly associated with memory at baseline. CVFRs was significantly associated with memory decline in middle-aged (50-64y), but not in older (65-79y) participants. This association followed a dose-response pattern with increasing number of CVFRs being associated with greater cognitive decline. Comparisons between none versus some CVRFs yielded significant differences (p < 0.05). Conclusions Our findings confirm that the effect of cumulative CVRFs on subsequent cognitive deterioration is age-dependent. CVRFs are associated with cognitive decline in people aged 50–64 years, but not in those aged ≥65 years. Although modest, the memory decline associated with accumulation of cardiovascular risk factors in midlife may increase the risk of late-life dementia.

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Association of sex differences in dementia risk factors with sex differences in memory decline in a population-based cohort spanning 20–76 years

Scientific Reports ◽

10.1038/s41598-021-86397-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kaarin J. Anstey ◽

Ruth Peters ◽

Moyra E. Mortby ◽

Kim M. Kiely ◽

Ranmalee Eramudugolla ◽

...

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Older Women ◽

Late Life ◽

Population Based ◽

Modifiable Risk Factors ◽

Vascular Risk ◽

Memory Decline ◽

Dementia Risk ◽

With Memory

AbstractSex differences in late-life memory decline may be explained by sex differences in dementia risk factors. Episodic memory and dementia risk factors were assessed in young, middle-aged and older adults over 12 years in a population-based sample (N = 7485). For men in midlife and old age, physical, cognitive and social activities were associated with less memory decline, and financial hardship was associated with more. APOE e4 and vascular risk factors were associated with memory decline for women in midlife. Depression, cognitive and physical activity were associated with memory change in older women. Incident midlife hypertension (β = − 0.48, 95% CI − 0.87, − 0.09, p = 0.02) was associated with greater memory decline in women and incident late-life stroke accounted for greater memory decline in men (β = − 0.56, 95% CI − 1.12, − 0.01), p = 0.05). Women have fewer modifiable risk factors than men. Stroke and hypertension explained sex differences in memory decline for men and women respectively.

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Faculty Opinions recommendation of Effects of chronic stress on memory decline in cognitively normal and mildly impaired older adults.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1884957.2477064 ◽

2010 ◽

Author(s):

Johannes Siegrist

Keyword(s):

Older Adults ◽

Chronic Stress ◽

Memory Decline ◽

Cognitively Normal

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Association of anticholinergic medications and AD biomarkers with incidence of MCI among cognitively normal older adults

Neurology ◽

10.1212/wnl.0000000000010643 ◽

2020 ◽

Vol 95 (16) ◽

pp. e2295-e2304 ◽

Cited By ~ 1

Author(s):

Alexandra J. Weigand ◽

Mark W. Bondi ◽

Kelsey R. Thomas ◽

Noll L. Campbell ◽

Douglas R. Galasko ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Mixed Effects ◽

Mixed Effects Models ◽

Linear Mixed Effects Models ◽

Cognitively Normal ◽

Linear Mixed Effects ◽

Anticholinergic Medications ◽

Increased Risk ◽

Risk Of Progression

ObjectiveTo determine the cognitive consequences of anticholinergic medications (aCH) in cognitively normal older adults as well as interactive effects of genetic and CSF Alzheimer disease (AD) risk factors.MethodsA total of 688 cognitively normal participants from the Alzheimer's Disease Neuroimaging Initiative were evaluated (mean age 73.5 years, 49.6% female). Cox regression examined risk of progression to mild cognitive impairment (MCI) over a 10-year period and linear mixed effects models examined 3-year rates of decline in memory, executive function, and language as a function of aCH. Interactions with APOE ε4 genotype and CSF biomarker evidence of AD pathology were also assessed.ResultsaCH+ participants had increased risk of progression to MCI (hazard ratio [HR] 1.47, p = 0.02), and there was a significant aCH × AD risk interaction such that aCH+/ε4+ individuals showed greater than 2-fold increased risk (HR 2.69, p < 0.001) for incident MCI relative to aCH−/ε4−), while aCH+/CSF+) individuals demonstrated greater than 4-fold (HR 4.89, p < 0.001) increased risk relative to aCH−/CSF−. Linear mixed effects models revealed that aCH predicted a steeper slope of decline in memory (t = −2.35, p = 0.02) and language (t = −2.35, p = 0.02), with effects exacerbated in individuals with AD risk factors.ConclusionsaCH increased risk of incident MCI and cognitive decline, and effects were significantly enhanced among individuals with genetic risk factors and CSF-based AD pathophysiologic markers. Findings underscore the adverse impact of aCH medications on cognition and the need for deprescribing trials, particularly among individuals with elevated risk for AD.

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Cognitive worry in cognitively normal older adults is associated with decreased memory binding, hippocampal volume and parahippocampal thickness

Alzheimer s & Dementia ◽

10.1002/alz.045748 ◽

2020 ◽

Vol 16 (S6) ◽

Author(s):

Hana Markova ◽

Adela Fendrych Mazancova ◽

Katerina Cechova ◽

Tomas Nikolai ◽

Veronika Matuskova ◽

...

Keyword(s):

Older Adults ◽

Hippocampal Volume ◽

Cognitively Normal ◽

Memory Binding

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P1-193: Anticholinergic medication use in older adults is associated with memory and hippocampal volume

Alzheimer s & Dementia ◽

10.1016/j.jalz.2015.06.392 ◽

2015 ◽

Vol 11 (7S_Part_9) ◽

pp. P422-P422

Author(s):

Shannon L. Risacher ◽

Sungeun Kim ◽

Kwangsik Nho ◽

Li Shen ◽

Paul K. Crane ◽

...

Keyword(s):

Older Adults ◽

Medication Use ◽

Hippocampal Volume ◽

Anticholinergic Medication ◽

With Memory

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Association of Coronary Artery Bypass Grafting vs Percutaneous Coronary Intervention With Memory Decline in Older Adults Undergoing Coronary Revascularization

JAMA ◽

10.1001/jama.2021.5150 ◽

2021 ◽

Vol 325 (19) ◽

pp. 1955

Author(s):

Elizabeth L. Whitlock ◽

L. Grisell Diaz-Ramirez ◽

Alexander K. Smith ◽

W. John Boscardin ◽

Kenneth E. Covinsky ◽

...

Keyword(s):

Older Adults ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Coronary Revascularization ◽

Artery Bypass ◽

Coronary Intervention ◽

Bypass Grafting ◽

Memory Decline ◽

Percutaneous Coronary ◽

With Memory

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Feasibility and Preliminary Efficacy of the Lifestyle, Exercise and Diet (LEAD) Study: A Cluster Randomized Controlled Trial of a Combined Exercise and Diet Intervention in Older Adults with Vascular Risk Factors and Early Dementia Risk

10.21203/rs.3.rs-635502/v1 ◽

2021 ◽

Author(s):

Noah Koblinsky ◽

Nicole Anderson ◽

Fatim Ajwani ◽

Matthew Parrott ◽

Deirdre Dawson ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Health Education ◽

Healthy Eating ◽

Vascular Risk ◽

Brain Health ◽

Dietary Counselling ◽

Dementia Risk ◽

Early Dementia ◽

Cluster Randomized

Abstract Background: Healthy diet and exercise are associated with reduced risk of dementia in older adults. Evidence for the impact of clinical trials on brain health is less consistent, especially with dietary interventions which often rely on varying intervention approaches. Our objective was to evaluate the feasibility and preliminary efficacy of a 6-month intervention combining exercise with a novel dietary counselling approach among older adults with vascular risk factors (VRFs) and early dementia risk. Methods: Participants with VRF’s and SCD or early MCI were cluster randomized into the intervention (exercise + Baycrest Brain-healthy Eating Approach (EX+DIET)) or control group (exercise + brain health education (EX+ED)). Both groups participated in 1-hour of supervised exercise per week and were prescribed additional exercise at home. EX+DIET involved 1-hour per week of group-based dietary counselling comprising didactic education focused on brain healthy eating recommendations, goal setting and strategy training. Whereas, EX+ED involved 1-hour per week of group-based brain health education. The primary outcome was change in hippocampal volume from baseline to 6 months. Secondary outcomes included fitness, diet, cognition, and blood biomarkers. Recruitment challenges and early discontinuation of the trial due to COVID-19 necessitated a revised focus on feasibility and preliminary efficacy. Results: Of 190 older adults contacted, 14 (7%) were eligible and randomized, constituting 21% of our recruitment target. All participants completed the intervention and attended 90% of exercise and diet/education sessions on average. All 6-month follow-up assessments pre-COVID-19 were completed but disruptions to testing during the pandemic resulted in incomplete data collection. No serious adverse events occurred and all participants expressed positive feedback about the intervention. Mean improvements in peak oxygen consumption were observed in both EX+DIET (d = .98) and EX+ED (d =1.15) groups. Substantial improvements in diet and HbA1c were observed in the EX+DIET group compared to EX+ED (d = 1.75 and 1.07, respectively). Conclusions: High adherence and retention rates were observed among LEAD participants and preliminary findings illustrate improvements in cardiorespiratory fitness and diet quality. These results indicate that a larger trial is feasible if difficulties surrounding recruitment can be mitigated. Trial Registration: ClinicalTrials.gov identifier: NCT03056508

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