scholarly journals Association between surgery with anesthesia and cognitive decline in older adults: Analysis using shared parameter models for informative dropout

2020 ◽  
pp. 1-7
Author(s):  
Katrina L. Devick ◽  
Juraj Sprung ◽  
Michelle Mielke ◽  
Ronald C. Petersen ◽  
Phillip J. Schulte
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Missing At Random ◽  
Recent Analysis ◽  
Informative Dropout ◽  
Study Population ◽  
Data Missing ◽  
Clinic Study

Abstract Objectives/Goals: The association between surgery with general anesthesia (exposure) and cognition (outcome) among older adults has been studied with mixed conclusions. We revisited a recent analysis to provide missing data education and discuss implications of biostatistical methodology for informative dropout following dementia diagnosis. Methods/study population: We used data from the Mayo Clinic Study of Aging, a longitudinal study of prevalence, incidence, and risk factors for mild cognitive impairment (MCI) and dementia. We fit linear mixed effects models (LMMs) to assess the association between anesthesia exposure and subsequent trajectories of cognitive z-scores assuming data missing at random, hypothesizing that exposure is associated with greater decline in cognitive function. Additionally, we used shared parameter models for informative dropout assuming data missing not at random. Results: A total of 1948 non-demented participants were included. Median age was 79 years, 49% were female, and 16% had MCI at enrollment. Among median follow-up of 4 study visits over 6.6 years, 172 subjects developed dementia, 270 died, and 594 participants underwent anesthesia. In LMMs, exposure to anesthesia was associated with decline in cognitive function over time (change in annual cognitive z-score slope = −0.063, 95% CI: (−0.080, −0.046), p < 0.001). Accounting for informative dropout using shared parameter models, exposure was associated with greater cognitive decline (change in annual slope = −0.081, 95% CI: (−0.137, −0.026), p = 0.004). Discussion: We revisited prior work by our group with a focus on informative dropout. Although the conclusions are similar, we demonstrated the potential impact of novel biostatistics methodology in longitudinal clinical research.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals The association between injurious falls and older adults’ cognitive function: the role of depressive mood and physical performance

2021 ◽  
Author(s):  
Caterina Trevisan ◽  
Enrico Ripamonti ◽  
Giulia Grande ◽  
Federico Triolo ◽  
Stina Ek ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Physical Performance ◽  
Walking Speed ◽  
Depressive Mood ◽  
Time Interval ◽  
Injurious Falls

Abstract Background The impact of falls on cognitive function is unclear. We explored whether injurious falls are associated with cognitive decline in older adults, and evaluated the role of changes in psychological and physical health as mediators of such association. Methods This prospective study involved 2,267 community-dwelling participants in the Swedish National study on Aging and Care in Kungsholmen (≥60 years). Data on injurious falls (i.e., falls requiring medical attention) during each 3-year time interval of follow-up were obtained from national registers. Assessment of cognitive function (Mini-Mental State Examination[MMSE]), depressive mood (Montgomery-Åsberg Depression Rating Scale), and physical performance (walking speed) were carried out every 3 or 6 years over a 12-year follow-up. The association between falls and cognition was estimated through linear mixed effects models, and the mediating role of changes in depressive mood and physical performance was tested using mediation analysis. Results After adjusting for potential confounders, individuals who experienced injurious falls had a greater annual decline in MMSE in the subsequent time interval (β=-1.49, 95%CI:-1.84;-1.13), than those who did not. The association increased with the occurrence of ≥2 falls (β=-2.13, 95%CI:-2.70;-1.56). Worsening of walking speed and depressive mood explained around 26% and 8%, respectively, of the association between falls and cognitive decline. Conclusions Injurious falls are associated with greater cognitive decline, and this association is partly mediated by worsening of physical performance and, in a lesser extent, of depressive mood. These findings suggest that physical deficits and low mood are potential therapeutic targets for mitigating the association between falls and cognitive decline.

scholarly journals Plasma MCP-1 and changes on cognitive function in community-dwelling older adults

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Juan Luis Sanchez-Sanchez ◽  
Kelly V. Giudici ◽  
Sophie Guyonnet ◽  
Julien Delrieu ◽  
Yan Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Continuous Variable ◽  
Community Dwelling ◽  
Clinical Dementia Rating ◽  
Delayed Recall ◽  
Domain Specific

Abstract Background Monocyte Chemoattractant Protein-1 (MCP-1), a glial-derived chemokine, mediates neuroinflammation and may regulate memory outcomes among older adults. We aimed to explore the associations of plasma MCP-1 levels (alone and in combination with β-amyloid deposition—Aβ42/40) with overall and domain-specific cognitive evolution among older adults. Methods Secondary analyses including 1097 subjects (mean age = 75.3 years ± 4.4; 63.8% women) from the Multidomain Alzheimer Preventive Trial (MAPT). MCP-1 (higher is worse) and Aβ42/40 (lower is worse) were measured in plasma collected at year 1. MCP-1 in continuous and as a dichotomy (values in the highest quartile (MCP-1+)) were used, as well as a dichotomy of Aβ42/40. Outcomes were measured annually over 4 years and included the following: cognitive composite z-score (CCS), the Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) sum of boxes (overall cognitive function); composite executive function z-score, composite attention z-score, Free and Cued Selective Reminding Test (FCSRT - memory). Results Plasma MCP-1 as a continuous variable was associated with the worsening of episodic memory over 4 years of follow-up, specifically in measures of free and cued delayed recall. MCP-1+ was associated with worse evolution in the CCS (4-year between-group difference: β = −0.14, 95%CI = −0.26, −0.02) and the CDR sum of boxes (2-year: β = 0.19, 95%CI = 0.06, 0.32). In domain-specific analyses, MCP-1+ was associated with declines in the FCSRT delayed recall sub-domains. In the presence of low Aβ42/40, MCP-1+ was not associated with greater declines in cognitive functions. The interaction with continuous biomarker values Aβ42/40× MCP-1 × time was significant in models with CDR sum of boxes and FCSRT DTR as dependent variables. Conclusions Baseline plasma MCP-1 levels were associated with longitudinal declines in overall cognitive and episodic memory performance in older adults over a 4-year follow-up. How plasma MCP-1 interacts with Aβ42/40 to determine cognitive decline at different stages of cognitive decline/dementia should be clarified by further research. The MCP-1 association on cognitive decline was strongest in those with amyloid plaques, as measured by blood plasma Aβ42/40.

scholarly journals Short daytime napping reduces the risk of cognitive decline in community-dwelling older adults: a 5-year longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kaori Kitamura ◽  
Yumi Watanabe ◽  
Kazutoshi Nakamura ◽  
Chikako Takano ◽  
Naomi Hayashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Beneficial Effects ◽  
Daytime Nap ◽  
Study Participants

Abstract Background Beneficial effects of napping on cognition have been suggested in cross-sectional studies. This study aimed to clarify longitudinal associations between cognitive decline and sleep characteristics, particularly daytime napping, over a 5-year period in older adults. Methods Study participants were 389 community-dwelling individuals aged ≥65 years living in Ojiya City, Niigata, Japan. Baseline and follow-up examinations were conducted in 2011–2013 and 2016–2018, respectively. Trained nurses visited and interviewed participants to collect the following information at baseline and follow-up: demographic characteristics, disease history, lifestyle habits including bedtime, sleeping hours, and daytime nap duration, and cognitive function. The assessment of cognitive function was performed using the revised Hasegawa’s dementia scale (HDS-R), with cognitive decline defined as a change in the HDS-R of ≤ − 3 over 5 years. Odds ratios (ORs) for cognitive decline were calculated using multiple logistic regression analysis. Results Mean age of participants was 74.6 years (SD 6.4), and the cumulative incidence of cognitive decline was 106/389 (27.3%). The adjusted OR for 1–29 min daytime napping was significantly lower compared to that for no napping (OR = 0.47, 95%CI: 0.23–0.96). Earlier bedtime was associated with cognitive decline (adjusted P for trend = 0.0480). Conclusion Short daytime napping (< 30 min) reduces the risk of cognitive decline over 5 years for community-dwelling older people. A future study will be necessary to confirm the effect of short napping on the reduction of risk for clinically diagnosed dementia.

Association of pulmonary function with cognitive decline in older adults: a nationwide longitudinal study in China

2021 ◽  
Author(s):  
Xianwen Shang ◽  
David Scott ◽  
Roseanne Kimberley Chan ◽  
Lei Zhang ◽  
Mingguang He
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Pulmonary Function ◽  
Cognitive Decline ◽  
Multiple Time ◽  
Inverse Association ◽  
Immediate Memory ◽  
Never Smokers

Abstract This study aimed to examine whether pulmonary function and cognition are independently associated at multiple time points. We included 8264 participants (49.9% women) aged 50-94 years at baseline from the China Health and Retirement Longitudinal Study in our analysis. Participants were enrolled in 2011 and followed up in 2013 and 2015. Cognitive function was assessed through a face-to-face interview in each survey. Pulmonary function was assessed via peak expiratory flow. Pulmonary function and cognitive function decreased significantly with age in both genders. Individuals in quintile 5 of pulmonary function had a relative increase in immediate memory (β (95% CI): 0.19 (0.09, 0.30)) and delayed memory (0.16 (0.04, 0.28)) during follow-up compared with those in quintile 1. In the repeated-measures analysis, each standard deviation increment of pulmonary function was associated with a 0.44 (95% CI: 0.34, 0.53), 0.12 (0.09, 0.15), 0.12 (0.08, 0.16), 0.08 (0.06, 0.11), and 0.10 (0.07, 0.14) higher increase in global cognitive score, immediate memory, delayed memory, orientation and subtraction calculation, respectively. The inverse association between pulmonary function and cognitive decline during follow-up was more evident in women (P for interaction=0.0333), low educated individuals (P for interaction=0.0002), or never smokers (P for interaction=0.0412). In conclusion, higher baseline pulmonary function was independently associated with a lower rate of cognitive decline in older adults. The positive association between pulmonary function and cognition was stronger in women, lower educated individuals, or never smokers.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2020 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study (CHARLS) and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals Plasma MCP-1 and Changes on Cognitive Function in Community-Dwelling Older Adults

2021 ◽  
Author(s):  
Juan Luis Sanchez-Sanchez ◽  
Kelly V Giudici ◽  
Sophie Guyonnet ◽  
Delrieu Julien ◽  
Li Yan ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Z Score ◽  
Clinical Dementia Rating ◽  
Delayed Recall ◽  
Domain Specific

Abstract BackgroundMonocyte Chemoattractant Protein-1 (MCP-1), a glial-derived chemokine, mediates neuroinflammation and may regulate memory outcomes among older adults. We aimed to explore the associations of plasma MCP-1 levels (alone and in combination with β-amyloid deposition - Aβ42/40) with overall and domain-specific cognitive evolution among older adults.MethodsSecondary analyses including 1,097 subjects (mean age=75.3 years ± 4.4; 63.8% women) from the Multidomain Alzheimer Preventive Trial (MAPT). MCP-1 (higher is worse) and Aβ42/40 (lower is worse) were measured in plasma collected at year 1. MCP-1 in continuous and as a dichotomy (values in the highest quartile (MCP-1+)) were used, as well as a dichotomy of Aβ42/40. Outcomes were measured annually over 4 years and included: cognitive composite z-score (CCS), the Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) sum of boxes (overall cognitive function); composite executive function z-score, composite attention z-score, Free and Cued Selective Reminding Test (FCSRT - memory). ResultsPlasma MCP-1 as a continuous variable was associated with the worsening of episodic memory over 4-years of follow up, specifically in measures of free and cued delayed recall. MCP-1+ was associated with worse evolution in the CCS (4-year between-group difference: β=-0.14, 95%CI=-0.26, -0.02) and the CDR sum of boxes (2-year: β=0.19, 95%CI=0.06, 0.32). In domain-specific analyses, MCP-1+ was associated with declines in the FCSRT delayed recall sub-domains. In the presence of low Aβ42/40, MCP-1+ was not associated with greater declines in cognitive functions. The interaction with continuous biomarkers values Aβ42/40 x MCP-1 x time was significant in models with CDR sum of boxes and FCSRT DTR as dependent variables.ConclusionsBaseline plasma MCP-1 levels were associated with longitudinal declines in overall cognitive and episodic memory performance in older adults over a 4-year follow-up. Whether plasma MCP-1 interacts with Aβ42/40 to determine cognitive decline should be clarified by further research. The MCP-1 effect on cognitive decline was strongest in those with amyloid plaques, as measured by blood plasma Aβ42/40.

scholarly journals Cognitive decline and alcohol consumption adjusting for functional status over a 3-year period in French speaking community living older adults

2018 ◽  
Vol 41 (2) ◽  
pp. e177-e184 ◽  
Author(s):  
Helen-Maria Vasiliadis ◽  
Marie-Christine Payette ◽  
Djamal Berbiche ◽  
Sébastien Grenier ◽  
Carol Hudon
Keyword(s):  
Older Adults ◽  
Alcohol Consumption ◽  
Cognitive Decline ◽  
Functional Status ◽  
Repeated Measures ◽  
Service Use ◽  
High Functioning ◽  
French Speaking ◽  
Changing Patterns

AbstractBackgroundThe effect of alcohol consumption on cognitive decline is not clear. We aimed to study the association between alcohol consumption and cognitive functioning controlling for functional heath status.MethodsA total of 1610 older adults with a score ≥26 on the Mini-Mental State Examination (MMSE) were followed to assess the change in scores at the 3-year follow-up. Information on alcohol consumption as well as socio-demographic, lifestyle, psychosocial and clinical factors, as well as health service use were assessed at baseline and 3-year follow-up interviews. Linear mixed models with repeated measures were used stratifying by functional status.ResultsClose to 73% reported consuming alcohol in the past 6 months, of which 11% were heavy drinkers (≥11 and ≥16 drinks for women and men). A significant decrease in MMSE scores was observed in low functioning non-drinkers (−1.48; 95% CI: −2.06, −0.89) and light to moderate drinkers (−0.99; 95% CI: −1.54, −0.44) and high functioning non-drinkers (−0.51; 95% CI: −0.91, −0.10).ConclusionsAlcohol consumption did not contribute to cognitive decline. Cognitive decline was greater in individuals reporting low functional status. Research should focus on the interaction between changing patterns of alcohol consumption and social participation in individuals with low and high functioning status.

scholarly journals Effects of Participation in Social Activities on Cognitive Function Among Middle-Aged and Older Adults in Korea

2018 ◽  
Vol 15 (10) ◽  
pp. 2315 ◽  
Author(s):  
Jongnam Hwang ◽  
Sangmin Park ◽  
Sujin Kim
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Social Connectedness ◽  
Social Activity ◽  
Later Life ◽  
Well Being ◽  
Social Activities ◽  
The Social ◽  
Gender Groups

Cognitive function is a critical health issue in later life, the decline of which disrupts well-being and daily life function. Cognitive decline in older ages can also be understood in the context of the social environment such as social connectedness and engagement in personal life. This study aimed to examine: (1) whether participation in social activities contributes to preventing cognitive decline, and (2) what type of social activities are beneficial to maintaining cognitive function. Data from the Korean Longitudinal Study of Aging (KLOSA) 2006–2014, a longitudinal survey of the household-dwelling population aged 45 and older in Korea were used. The results revealed that Mini-Mental State Examination (MMSE) scores decreased with increasing age, at a rate of approximately 0.18 units across all age-gender groups, and the decrease was steeper for adults aged 65 and over. Participation in social gatherings was likely to delay the decline in cognitive function after the age of 65. In a gender-stratified model, social activity may not have an impact on the decline of cognitive function for men, whereas participation in social gatherings was negatively related to the decline of MMSE scores in women. This study suggests the need for a gender-stratified policy for preventing the decline of cognitive function while promoting engagement in social activities in Korean older adults.

Effect of the Fungus Isaria japonica from the Silkworm on Cognitive Function in Older Adults with Mild Cognitive Decline: A Pilot Study

2021 ◽  
Vol 19 (4) ◽  
pp. 383-387
Author(s):  
Daisuke Furushima ◽  
Yuri Takashima ◽  
Toshiji Miyagawa ◽  
Hiroshi Fujita ◽  
Yuzuki Nomura ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Blood Test ◽  
Mmse Score ◽  
Protective Role ◽  
In Vivo Studies ◽  
Serious Adverse Events ◽  
Silkworm Pupae

Several in vivo studies report that the fungus Isaria japonica grown on silkworm pupae, classified as a Cordycipitaceae, plays a role in preventing memory deficits and may have a protective role against cognitive impairment. The present study investigated the cognitive effects and safety of I. japonica in older adults with mild cognitive decline. Intervention trial was conducted in subjects over 60 years of age with mild cognitive decline (Mini-Mental State Examination [MMSE] score: 20-27). The subjects consumed the I. japonica supplements twice per day for 12 weeks. The outcome measures included the MMSE score and blood test values before and after the intervention. A total of 25 subjects (aged 64-94 years) were eligible for the study. After the intervention, the MMSE score (mean ± standard deviation) significantly increased from 25.5 ± 1.6 to 27.1 ± 2.4 (P < 0.0001). The blood test revealed no change in any of the hematological and biochemical parameters evaluated. Also, no serious adverse events were reported. Despite several limitations in the study design, the findings of the present study suggest that the fungus I. japonica is safe to consume and it may improve cognitive function in older adults with mild cognitive decline.

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