The association between falls and autonomy in older adults is mediated by self-efficacy

Abstract Objective Falling has various physical and psychological consequences in older adults. We aimed at replicating previous findings that reported autonomy is associated with a history of falls and that this association is moderated by self-efficacy. We further assumed that cognitive function would moderate this relationship. Method We analyzed data from the German Ageing Survey (“Deutscher Alterssurvey,” DEAS, year 2017, n = 6626), a longitudinal cohort-based survey of individuals living in private households aged 40 and over in Germany. Results Linear regression confirmed that perceived autonomy was negatively associated with a history of falls. With higher self-efficacy, the association between falls and autonomy was less substantial. Further, we extend previous findings in that self-efficacy also mediated the effect of falls on perceived autonomy. Against our assumptions, cognition as measured with the digit-symbol substitution test predicted perceived autonomy but did not moderator this association. Discussion We conclude that interventions facilitating self-efficacy might ameliorate negative effects of falling on autonomy of older adults.

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Peripheral Insulin Resistance in Cognitively Normal Older Adults Relates to Poorer Performance on a Test for Speed of Processing

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_076 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 76-76

Author(s):

Aaron Smith ◽

Matthew Taylor ◽

Jim Backes ◽

Juleah Littrell ◽

Caitlin Boeckman ◽

...

Keyword(s):

Insulin Resistance ◽

Older Adults ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Speed Of Processing ◽

Cognitively Normal ◽

Peripheral Insulin Resistance ◽

Digit Symbol Substitution ◽

Symbol Substitution ◽

The Relationship

Abstract Objectives Peripheral insulin resistance (IR) and impaired glucose metabolism increases the risk for cognitive decline. However, data looking at peripheral IR's relationship with cognition in cognitively normal adults is limited. This study aimed to assess the relationship between peripheral IR and tests of speed of processing (SOP) in cognitively normal older adults using a novel IR measure. Methods Baseline data from 56 cognitively normal older adults participating in a nutrition intervention study (Nutrition Interventions for Cognitive Enhancement study; NICE study) were analyzed. Fasting blood draws were attained, and peripheral IR was measured using Quest Diagnostics’ Cardio IQ Insulin Resistance Panel (Test Code: 36,509). A cognitive battery was conducted by a trained psychometrician. Z-Scores of the Digit Symbol Substitution Test, Stroop Color, Stroop Word, Stroop Interference, and Stroop Letter Number Sequencing and Crossing-Off tests were combined to give a global SOP score. We constructed ordinary least squares regression models to assess IR's relationships with individual SOP tests and global SOP, including age and education as covariates. Statistical analyses were performed using R (v. 3.6.2; R Foundation, Vienna, Austria). Statistical significance was set at P < 0.05. Results Participants were 77% female and had a mean age of 72.1 ± 4.9 years. Higher IR scores were related to poorer performance on the Digit Symbol Substitution Test (β = −0.26, P = 0.04). IR scores were not related to other individual cognitive tests: Stroop Color (β = −0.17, P = 0.20), Stroop Word (β = −0.19, P = 0.11), Stroop Interference (β = −0.14, P = 0.28), Stroop Letter Number Sequencing (β = 0.03, P = 0.83), Crossing-Off (β = −0.18, P = 0.15), or Global SOP (β = −0.20, P = 0.11). Conclusions There was a relationship between higher IR scores and poorer performance on the Digit Symbol Substitution Test. Although other SOP tests were not significantly correlated with IR scores, directionality of the relationships indicated trend for higher IR being related to lower SOP. Consequently, maintaining insulin sensitivity with healthy lifestyle choices may be important for healthy aging. Future analyses with a larger sample size will be more informative for understanding the relationship between IR and SOP. Funding Sources National Institute on Aging.

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Association Between Lower Digit Symbol Substitution Test Score and Slower Gait and Greater Risk of Mortality and of Developing Incident Disability in Well-Functioning Older Adults

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2008.01856.x ◽

2008 ◽

Vol 56 (9) ◽

pp. 1618-1625 ◽

Cited By ~ 145

Author(s):

Caterina Rosano ◽

Anne B. Newman ◽

Ronit Katz ◽

Calvin H. Hirsch ◽

Lewis H. Kuller

Keyword(s):

Older Adults ◽

Test Score ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Digit Symbol Substitution ◽

Risk Of Mortality ◽

Symbol Substitution

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Digit symbol substitution test score and hyperhomocysteinemia in older adults

Medicine ◽

10.1097/md.0000000000004535 ◽

2016 ◽

Vol 95 (35) ◽

pp. e4535 ◽

Cited By ~ 2

Author(s):

Wen-Chuin Hsu ◽

Yi-Chuan Chu ◽

Hon-Chung Fung ◽

Yau-Yau Wai ◽

Jiun-Jie Wang ◽

...

Keyword(s):

Older Adults ◽

Test Score ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Digit Symbol Substitution ◽

Symbol Substitution

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Association Between Diet And Cognitive Performance In Adults Aged 60 And Over: NHANES, 2011–2014

Innovation in Aging ◽

10.1093/geroni/igab046.2636 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 710-710

Author(s):

Md Towfiqul Alam ◽

Elizabeth Vasquez ◽

Sandra Echeverria

Keyword(s):

Older Adults ◽

Cognitive Performance ◽

Word List ◽

Healthy Eating Index ◽

Future Research ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Dietary Recommendations ◽

Digit Symbol Substitution ◽

Symbol Substitution

Abstract There is limited evidence examining associations between diet and cognitive performance (CP) in older adults. We used the 2011-2014 National Health and Nutrition Examination Survey to determine if meeting dietary recommendations was associated with CP in adults 60+ years of age. Diet was based on the healthy eating index (HEI) 2015 and categorized into quintiles (higher quintiles indicating healthier diet). CP was based on word list learning, animal naming, and digit symbol substitution test, with scores above 25th percentile indicating adequate performance. Multivariate logistic regression modeling was conducted and adjusted for potential cofounders. A total of 3,068 participants completed the CP tests. A slightly higher percentage of participants were female (54.0%), predominantly White (80.5%) and the largest percentage (54.7%) was 60 to 69 years of age. The mean HEI-2015 score (0-100) was 54.89 (SE = 0.56). High CP scores increased with healthier dietary quintiles. However, results were only significant (p for trend <0.05) for digit symbol substitution test when comparing those in the highest quintile (82.53%) to those in the lowest (70.23%). Compared with participants in the lowest quintile of HEI-2015, participants in the highest quintile had a two-fold increased odds of better digit symbol substitution test scores, after adjusting for confounders (Odds Ratio [OR]: 1.96, 95% Confidence Interval [CI]: 1.28-3.01). Results showed that meeting healthy diet recommendations is associated with improved digit symbol substitution test, a marker of attention, processing speed and executive function. Future research should consider the role of diet in older adults to improve cognitive performance.

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Digit Symbol Substitution test and future clinical and subclinical disorders of cognition, mobility and mood in older adults

Age and Ageing ◽

10.1093/ageing/afw116 ◽

2016 ◽

Vol 45 (5) ◽

pp. 687-694 ◽

Cited By ~ 22

Author(s):

Caterina Rosano ◽

Subashan Perera ◽

Marco Inzitari ◽

Anne B. Newman ◽

William T. Longstreth ◽

...

Keyword(s):

Older Adults ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Digit Symbol Substitution ◽

Symbol Substitution

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Painting by Lesions: Functional Networks Affected by White Matter Lesions Are Associated with Poorer Cognition

Innovation in Aging ◽

10.1093/geroni/igaa057.1586 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 490-491

Author(s):

Rachel Crockett ◽

Chun Liang Hsu ◽

Roger Tam ◽

Todd Handy ◽

Teresa Liu-Ambrose

Keyword(s):

Older Adults ◽

White Matter ◽

Clinical Sample ◽

White Matter Lesions ◽

Functional Networks ◽

Digit Symbol Substitution Test ◽

Symbol Substitution ◽

Trail Making ◽

Global Cognition ◽

Visual Network

Abstract Cerebrovascular disease (CvD) is the second most common cause of dementia. Its associated pathology, such as white matter lesions (WML), is associated with reduced cognition. Due to the high variability, the relevance of WML location remains unknown. We hypothesised that although the location of WMLs may appear sporadic, they may actually lie within common functional networks. We used novel imaging methods to map the location of WMLs in a clinical sample with the functional connectivity associated with the same location in the human connectome. This identified the functional networks containing the largest WML load (>50%) in older adults with CvD. We then analyzed the association between level of disruption to these networks and measures of global cognition and executive functions. Included in this study were 164 older adults (>55 years old) with CvD. Cognition was assessed using the: 1) Montreal Cognitive Assessment (MoCA); 2) Stroop Colour Word Test; 3) Trail Making Tests; and 4) Digit Symbol Substitution Test. Our results found that the visual network and ventral attention network (VAN) surpassed the 50% overlap threshold with 85% and 66% overlap respectively. Additionally, after controlling for multiple comparisons and age, the level of disruption to the VAN was significantly associated with poorer global cognition, as measured by the MoCA (p=.001). These novel findings identify the functional networks most affected by the presence of WMLs in older adults with CvD and suggest that the disruption to the VAN caused by WML load may underlie the deficits seen in cognition in this population.

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Discriminant Validity of the WAIS-R Digit Symbol Substitution Test in Subjective Cognitive Decline, Mild Cognitive Impairment (Amnestic Subtype) and Alzheimer’s Disease Dementia (ADD) in Greece

Brain Sciences ◽

10.3390/brainsci11070881 ◽

2021 ◽

Vol 11 (7) ◽

pp. 881

Author(s):

Marianna Tsatali ◽

Eleni Poptsi ◽

Despina Moraitou ◽

Christina Agogiatou ◽

Evaggelia Bakoglidou ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Subjective Cognitive Decline ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Digit Symbol Substitution ◽

Symbol Substitution ◽

Alzheimer’S Disease Dementia

Objective: The aim of the current study was to estimate the discriminant potential and validity of the Digit Symbol Substitution Test (DSST) of the WAIS-R in the Greek elderly population meeting criteria for subjective cognitive decline (SCD), mild cognitive impairment (aMCI; amnestic subtype), or Alzheimer’s disease dementia (ADD). Method: Four hundred eighty-eight community-dwelling older adults, visitors of the Day Center of Alzheimer Hellas, participated in the study. Two hundred forty-three of them met the criteria for ADD, one hundred eighty-two for aMCI and sixty-three for SCD. Results: Path analysis indicated that the DSST score is affected by age group, educational level, and diagnostic category, but is not affected by gender. The ROC curve analysis showed that the DSST sum score could perfectly differentiate SCD from ADD patients, whereas test’s discriminant potential between aMCI and dementia ADD’s subtype was satisfactory. However, DSST was unable to separate the SCD from the aMCI group. Conclusion: It appears that the DSST is unable to separate the SCD from aMCI population. Therefore, the test in question may be insensitive to incipient cognitive decline. On the contrary, the discriminant potential of the DSST as regards SCD and ADD is excellent, while discrimination between aMCI and ADD is good.

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