P3-234: ELEVATED SERUM DICKKOPF-1 IS ASSOCIATED WITH PROGRESSIVE COGNITIVE DECLINE IN COMMUNITY-DWELLING OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT AND MILD-TO-MODERATE ALZHEIMER'S DISEASE

BackgroundExperimental studies indicate that lithium may facilitate neurotrophic/protective responses in the brain. Epidemiological and imaging studies in bipolar disorder, in addition to a few trials in Alzheimer's disease support the clinical translation of these findings. Nonetheless, there is limited controlled data about potential use of lithium to treat or prevent dementia.AimsTo determine the benefits of lithium treatment in patients with amnestic mild cognitive impairment (MCI), a clinical condition associated with high risk for Alzheimer's disease.MethodA total of 61 community-dwelling, physically healthy, older adults with MCI were randomised to receive lithium or placebo (1:1) for 2 years (double-blind phase), and followed-up for an additional 24 months (single-blinded phase) (trial registration at clinicaltrials.gov: NCT01055392). Lithium carbonate was prescribed to yield subtherapeutic concentrations (0.25–0.5 mEq/L). Primary outcome variables were the cognitive (Alzheimer's Disease Assessment Scale – cognitive subscale) and functional (Clinical Dementia Rating – Sum of Boxes) parameters obtained at baseline and after 12 and 24 months. Secondary outcomes were neuropsychological test scores; cerebrospinal fluid (CSF) concentrations of Alzheimer's disease-related biomarkers determined at 0, 12 and 36 months; conversion rate from MCI to dementia (0–48 months).ResultsParticipants in the placebo group displayed cognitive and functional decline, whereas lithium-treated patients remained stable over 2 years. Lithium treatment was associated with better performance on memory and attention tests after 24 months, and with a significant increase in CSF amyloid-beta peptide (Aβ1−42) after 36 months.ConclusionsLong-term lithium attenuates cognitive and functional decline in amnestic MCI, and modifies Alzheimer's disease-related CSF biomarkers. The present data reinforces the disease-modifying properties of lithium in the MCI–Alzheimer's disease continuum.Declaration of interestNone.

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Physical activity perceptions, experiences, and beliefs of older adults with mild cognitive impairment or Alzheimer’s disease and their care partners

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2019-0730 ◽

2020 ◽

Vol 45 (11) ◽

pp. 1216-1224 ◽

Cited By ~ 1

Author(s):

Lauren E. Bechard ◽

Dorcas Beaton ◽

Katherine S. McGilton ◽

Maria Carmela Tartaglia ◽

Sandra E. Black

Keyword(s):

Physical Activity ◽

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Health Promotion ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Community Dwelling ◽

Cognitively Impaired ◽

Care Partners

Physical activity (PA) participation provides functional and social benefits for persons with mild cognitive impairment (MCI) and Alzheimer’s disease (AD), but PA participation in these populations is low. To support health promotion initiatives for cognitively impaired older adults, this study explored the perceptions, experiences, and beliefs of older adults with cognitive impairment and their caregivers concerning PA. Ten care dyads (community-dwelling adult aged ≥65 years diagnosed with MCI or mild-to-moderate AD and their care partner) participated in semi-structured interviews informed by the Theoretical Domains Framework about their PA perceptions, experiences, and beliefs. Interpretive phenomenological analysis of interview transcripts yielded 4 emergent themes: (1) PA as a meaningful activity, (2) experience versus evidence as motivating, (3) participation is possible despite dementia, and (4) care partners as enablers. Findings from this study address a research gap concerning the PA perceptions, experiences, and beliefs of cognitively impaired older adults and their care partners. Novelty Older adults with MCI/AD want to and are capable of engaging in PA. Care partners are critical supporters of PA participation in MCI/AD. Adapted health promotion strategies could enhance PA in MCI/AD.

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Retrospective metamemory monitoring of semantic memory in community-dwelling older adults with subjective cognitive decline and mild cognitive impairment

Neuropsychological Rehabilitation ◽

10.1080/09602011.2020.1831552 ◽

2020 ◽

pp. 1-35

Author(s):

Susan Y. Chi ◽

Elizabeth F. Chua ◽

Dustin W. Kieschnick ◽

Laura A. Rabin

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Semantic Memory ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Metamemory Monitoring ◽

Community Dwelling Older Adults

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p-tau/Aβ42 Ratio Associates with Cognitive Decline in Alzheimer’s disease, Mild Cognitive Impairment, and Cognitively Unimpaired Older Adults

10.1101/2020.10.13.20211375 ◽

2020 ◽

Author(s):

Ruchika Shaurya Prakash ◽

Michael R. McKenna ◽

Oyetunde Gbadeyan ◽

Rebecca Andridge ◽

Douglas W. Scharre ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Executive Functioning ◽

Episodic Memory ◽

Cognitive Decline ◽

Cognitive Functioning ◽

The Impact

AbstractINTRODUCTIONThe most well-studied biomarkers in AD are CSF amyloid beta-42 (Aβ42), tau, p-tau, and the ratio p-tau/Aβ42. The ratiometric measure of p-tau/Aβ42 shows the best diagnostic accuracy, and correlates reliably with metrics of cognition in unimpaired participants. However, no study has examined the impact of the CSF p-tau/Aβ42 ratio in predicting cognitive decline in both healthy and AD individuals in one sample. The goal of this study was to examine whether CSF-based p-tau/Aβ42 predicts changes in global cognitive functioning, episodic memory, and executive functioning over a two-year period in cognitively impaired older adults (CU), and in individuals with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD).METHODSThis study involves secondary analysis of data from 1215 older adults available in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Neuropsychological variables, collected at baseline, 6-month, 12-month, and 24-month follow-ups, included the Preclinical Alzheimer’s Cognitive Composite (PACC) to assess global cognitive functioning, ADNI-MEM to assess episodic memory functioning, and ADNI-EF to assess executive functioning. Linear mixed models were constructed to examine the effect of CSF p-tau/Aβ42, diagnostic group, and change over time (baseline, 6-month, 12-month, and 24-month) on cognitive scores.RESULTSCSF p-tau/Aβ42 ratios predicted worsening cognitive impairment, both on global cognition and episodic memory in individuals with MCI and AD, but not in CU older adults and predicted decline in executive functioning for all three diagnostic groups.DISCUSSIONOur study, including CU, MCI, and AD individuals, provides evidence for differential cognitive consequences of accumulated AD pathology based on diagnostic groups.

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The NIH Toolbox Cognition Battery App in healthy aging and cognitive decline due to Alzheimer’s Disease and Mild Cognitive Impairment

European Journal of Public Health ◽

10.1093/eurpub/ckaa040.032 ◽

2020 ◽

Vol 30 (Supplement_2) ◽

Author(s):

C Marques-Costa ◽

M S Pinho ◽

M R Simões ◽

G Prieto

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Language Processing ◽

Healthy Aging ◽

Older Individuals ◽

Average Life Expectancy

Abstract Introduction There has been a significant increase in average life expectancy. This increase brought more focus on aging with more health, autonomy and independence. Among current public health concerns, the detection of cognitive decline in older individuals stands out, namely in Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI). Accurate, brief, practical and automated measures are needed to assess cognitive function throughout the life-span. Since 2015, there is the NIH Toolbox Cognition Battery (NIHTB-CB) app that meets these requirements and assesses the neurocognitive subdomains of attention, episodic memory, executive function, language, processing speed, and working memory. The European Portuguese app, developed by our team, will be validated for the Portuguese older adults. Objectives The aim is presenting a literature review of the use of NIHTB-CB in healthy aging and cognitive decline in MCI and AD. Methodology Advanced search in the databases of Web of Science and Google Scholar for studies published between 2016-2019, including articles and meeting abstracts with the words: NIH Toolbox Cognition Battery, AD, MCI, Elder or Senior or Older. Results According to the studies reviewed, NIHTB-CB may be useful in memory clinics (e.g.Hackett et al, 2018; Mayeda et al. 2018); clinical trials (e.g.Buckley et al., 2017; Parsey, Bagger & Hanson, 2019); and healthy aging (e.g.Scott, Sorell, & Benitez, 2019). Preliminary results of the ARMADA study (Weintraub et al, 2019) with people with more than 85 years old became available showing that generally, NIHTB-CB is well accepted, also in MCI patients. No difficulties were found in the use of the iPad with older adults. Conclusion NIHTB-CB measures provide a valid assessment of neurocognitive domains that are important in healthy aging, MCI and AD. As the studies are still scarce, more research is needed.

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Mindfulness Awareness Practice (MAP) to Prevent Dementia in Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Trial and Implementation Outcomes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910205 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10205

Author(s):

Ted Kheng Siang Ng ◽

Lei Feng ◽

Johnson Fam ◽

Iris Rawtaer ◽

Alan Prem Kumar ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Outcome Measures ◽

Controlled Trial ◽

Community Dwelling ◽

Randomized Controlled ◽

Community Dwelling Older Adults

Background: With an aging population, developing non-pharmacological interventions (NPIs) to delay dementia has become critical. Apart from cognitive decline, dementia is associated with multiple pathophysiology, including increased oxidative stress, dysregulated gene expressions, cytokine, neurotrophin, and stress markers, telomere shortening, and deteriorations in brain connectivity. Although mindfulness practices have been proposed to ameliorate these biological changes, no empirical studies were conducted. We thus aimed to investigate the effects of mindfulness awareness practice (MAP) to prevent cognitive decline and improve peripheral biomarkers in community-dwelling older adults diagnosed with mild cognitive impairment (MCI). Methods/Design: This was a single-blinded and parallel-group randomized controlled trial with two arms (intervention and active control arms), conducted over nine months. A total of 60 consenting community-dwelling older adults diagnosed with MCI were planned to be randomized in a 1:1 ratio to either the MAP or the Health Education Program (HEP). Interventions were performed weekly for the initial 12 weeks, and monthly for the subsequent six months. Outcome measures were assessed at baseline, 3-month, and 9-month post-intervention by blinded assessors. Primary outcomes were neurocognitive tests, comprehensive peripheral biomarkers, and brain imaging scans. Secondary outcomes included basic health screening measures, affective symptoms, and measures of physical functions. Linear-mixed models were used to examine the effects of MAP on these outcome measures. Significance: This is the first randomized controlled trial to systematically investigate the effects of a mindfulness intervention in improving cognitive functions and various biomarkers in community-dwelling older adults diagnosed with MCI. Our findings have the potential to inform mindfulness intervention as a novel approach to delay dementia.

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P3-085: Life space and risk of Alzheimer's disease, mild cognitive impairment, and cognitive decline in older adults

Alzheimer s & Dementia ◽

10.1016/j.jalz.2010.05.1579 ◽

2010 ◽

Vol 6 ◽

pp. S474-S475

Author(s):

Bryan D. James ◽

Patricia A. Boyle ◽

Aron S. Buchman ◽

Lisa L. Barnes ◽

David A. Bennett

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Life Space

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Subjective Spatial Navigation Complaints - A Frequent Symptom Reported by Patients with Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer's Disease

Current Alzheimer Research ◽

10.2174/1567205014666171120145349 ◽

2018 ◽

Vol 15 (3) ◽

pp. 219-228 ◽

Cited By ~ 6

Author(s):

Jiri Cerman ◽

Ross Andel ◽

Jan Laczo ◽

Martin Vyhnalek ◽

Zuzana Nedelska ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Spatial Navigation ◽

Subjective Cognitive Decline ◽

Great Effort ◽

Frequent Symptom ◽

Normal Controls

Background: Great effort has been put into developing simple and feasible tools capable to detect Alzheimer's disease (AD) in its early clinical stage. Spatial navigation impairment occurs very early in AD and is detectable even in the stage of mild cognitive impairment (MCI). Objective: The aim was to describe the frequency of self-reported spatial navigation complaints in patients with subjective cognitive decline (SCD), amnestic and non-amnestic MCI (aMCI, naMCI) and AD dementia and to assess whether a simple questionnaire based on these complaints may be used to detect early AD. Method: In total 184 subjects: patients with aMCI (n=61), naMCI (n=27), SCD (n=63), dementia due to AD (n=20) and normal controls (n=13) were recruited. The subjects underwent neuropsychological examination and were administered a questionnaire addressing spatial navigation complaints. Responses to the 15 items questionnaire were scaled into four categories (no, minor, moderate and major complaints). Results: 55% of patients with aMCI, 64% with naMCI, 68% with SCD and 72% with AD complained about their spatial navigation. 38-61% of these complaints were moderate or major. Only 33% normal controls expressed complaints and none was ranked as moderate or major. The SCD, aMCI and AD dementia patients were more likely to express complaints than normal controls (p's<0.050) after adjusting for age, education, sex, depressive symptoms (OR for SCD=4.00, aMCI=3.90, AD dementia=7.02) or anxiety (OR for SCD=3.59, aMCI=3.64, AD dementia=6.41). Conclusion: Spatial navigation complaints are a frequent symptom not only in AD, but also in SCD and aMCI and can potentially be detected by a simple and inexpensive questionnaire.

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