scholarly journals A novel approach to assessing memory at the population level: vulnerability to semantic interference

2010 ◽  
Vol 22 (5) ◽  
pp. 785-794 ◽  
Author(s):  
Beth E. Snitz ◽  
David A. Loewenstein ◽  
Chung-Chou H. Chang ◽  
Ching-Wen Lee ◽  
Joni Vander Bilt ◽  
...  
Keyword(s):  
Reading Ability ◽  
Healthy Aging ◽  
Community Setting ◽  
Population Level ◽  
Female Gender ◽  
Semantic Interference ◽  
Clinical Dementia Rating ◽  
Everyday Functioning ◽  
Logistic Regression Models ◽  
Interference Test

ABSTRACTBackground: There is increasing interest in identifying novel cognitive paradigms to help detect preclinical dementia. Promising results have been found in clinical settings using the Semantic Interference Test (SIT), a modification of an existing episodic memory test (Fuld Object Memory Evaluation) that exploits vulnerability to semantic interference in Alzheimer's disease. It is not yet known how broadly this work will generalize to the community at large.Methods: Participants aged ≥65 years from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) were administered the SIT at study entry. Independent of neuropsychological assessment, participants were rated on the Clinical Dementia Rating (CDR) scale, based on reported loss of cognitively driven everyday functioning. In individuals free of dementia (CDR <1), the concurrent validity of the SIT was assessed by determining its association with CDR using multiple logistic regression models, with CDR 0 (no dementia) vs. 0.5 (possible dementia) as the outcome and the SIT test variables as predictors.Results: Poorer performance on all SIT variables but one was associated with higher CDR reflecting possible dementia (Odds Ratios 2.24–4.79). Younger age and female gender also conferred a performance advantage. Years of education and reading ability (a proxy for quality of education) evidenced a very weak association with SIT performance.Conclusions: The SIT shows promise as a valid, novel measure to identify early preclinical dementia in a community setting. It has potential utility for assessment of persons who may be illiterate or of low education. Finally, we provide normative SIT data stratified by age which may be utilized by clinicians or researchers in future investigations.

scholarly journals Disease and weight loss: a prospective study of middle-aged and older adults in Costa Rica and England

2015 ◽  
Vol 57 (4) ◽  
pp. 312 ◽  
Author(s):  
Laura Blue ◽  
Noreen Goldman ◽  
Luis Rosero-Bixby
Keyword(s):  
Weight Loss ◽  
Statistical Power ◽  
Healthy Aging ◽  
Disease Onset ◽  
Population Level ◽  
Population Based ◽  
Logistic Regression Models ◽  
Measured Weight ◽  
Aging Study ◽  
A Prospective Study

Objective. To determine whether disease predicts weight loss in population-based studies, as this may confound the relationship between weight and mortality. Materials and methods. We used longitudinal data from the Costa Rican Longevity and Healthy Aging Study (CRELES) and the English Longitudinal Study of Ageing (ELSA). We defined two overlapping outcomes of measured weight loss between waves: >1.0 point of body mass index (BMI) and >2.0 BMI points. Logistic regression models estimated the associations with disease, adjusting for age (range 52-79), sex, smoking, and initial BMI. Results. In ELSA, onset of diabetes, cancer, or lung disease is associated with loss >2.0 points (respectively, OR=2.25 [95%CI: 1.34-3.80]; OR=2.70 [95%CI: 1.49-4.89]; OR=1.82 [95%CI: 1.02-3.26]). In CRELES, disease-onset reports are not associated with weight loss at 5% significance, but statistical power to detect associations is poor. Conclusion. Although it is known that some diseases cause weight loss, at the population level these associations vary considerably across samples.

scholarly journals Cognitive test performance predicts change in functional status at the population level: The MYHAT Project

2010 ◽  
Vol 16 (5) ◽  
pp. 761-770 ◽  
Author(s):  
MARY GANGULI ◽  
JONI VANDER BILT ◽  
CHING-WEN LEE ◽  
BETH E. SNITZ ◽  
CHUNG-CHOU H. CHANG ◽  
...  
Keyword(s):  
Functional Status ◽  
Test Performance ◽  
Population Level ◽  
Population Based ◽  
Cognitive Test ◽  
Clinical Dementia Rating ◽  
Everyday Functioning ◽  
Neuropsychological Measures ◽  
Baseline Test ◽  
Cognitive Test Performance

AbstractIn the community at large, many older adults with minimal cognitive and functional impairment remain stable or improve over time, unlike patients in clinical research settings, who typically progress to dementia. Within a prospective population-based study, we identified neuropsychological tests predicting improvement or worsening over 1 year in cognitively driven everyday functioning as measured by Clinical Dementia Rating (CDR). Participants were 1682 adults aged 65+ and dementia-free at baseline. CDR change was modeled as a function of baseline test scores, adjusting for demographics. Among those with baseline CDR = 0.5, 29.8% improved to CDR = 0; they had significantly better baseline scores on most tests. In a stepwise multiple logistic regression model, tests which remained independently associated with subsequent CDR improvement were Category Fluency, a modified Token Test, and the sum of learning trials on Object Memory Evaluation. In contrast, only 7.1% with baseline CDR = 0 worsened to CDR = 0.5. They had significantly lower baseline scores on most tests. In multiple regression analyses, only the Mini-Mental State Examination, delayed memory for visual reproduction, and recall susceptible to proactive interference, were independently associated with CDR worsening. At the population level, changes in both directions are observable in functional status, with different neuropsychological measures predicting the direction of change. (JINS, 2010, 16, 761–770.)

scholarly journals Decreased Time on the Nondominant One-Leg Standing Test Associated with Repeated Falls in Older Residents with Healthy Aging, Mild Cognitive Impairment, and Dementia: The Wakuya Project

2021 ◽  
pp. 122-128
Author(s):  
Keiichi Kumai ◽  
Mika Kumai ◽  
Junko Takada ◽  
Jiro Oonuma ◽  
Kei Nakamura ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Motor Function ◽  
Healthy Aging ◽  
Community Setting ◽  
Cross Sectional Study ◽  
Clinical Dementia Rating ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Study Participants

<b><i>Introduction:</i></b> The aim of this study is to clarify the association between repeated falls and the dominant/nondominant side in the open-eyed one-leg standing (OLS) test among people who are healthy or have mild cognitive impairment (MCI) or dementia in a community setting. We recruited 180 participants from 39 areas in the town of Wakuya. <b><i>Methods:</i></b> This is a cross-sectional study. Participants were classified into 3 Clinical Dementia Rating (CDR) groups, i.e., CDR 0 (healthy, <i>n</i> = 71), CDR 0.5 (MCI, <i>n</i> = 85), and CDR 1+ (<i>n</i> = 23), and they were investigated for motor function (grip strength, 6-m normal gait speed, timed up and go test, and OLS test) and falls during the past year. <b><i>Results:</i></b> Subjects with a CDR of 0.5 had higher rates of single and repeated falls (13.0 and 23.4%, respectively) than the CDR 0 group (12.1 and 4.5%, respectively), as did those in CDR 1+ group (15.0 and 30.0%). For the CDR 0.5 group, the frequency of falls was negatively (biologically meaningful direction) correlated with the left OLS time. No significant correlations with falls were found for other motor function tests. Another analysis separating the CDR 0.5 group into 2 subgroups (repeated falls vs. no or a single fall) also showed that the left OLS time was lower in subjects with repeated falls. <b><i>Conclusion:</i></b> People with MCI who had fallen repeatedly in the year before the assessment had a significantly lower left OLS time compared to those who had not fallen or had had 1 fall with MCI. None of the other physical measures were associated with past repeat falls including OLS on the dominant right side. No such findings were noted in the CDR 0 and CDR 0+ groups.

scholarly journals Effects of age, gender, education and race on two tests of language ability in community-based older adults

2009 ◽  
Vol 21 (6) ◽  
pp. 1051-1062 ◽  
Author(s):  
Beth E. Snitz ◽  
Frederick W. Unverzagt ◽  
Chung-Chou H. Chang ◽  
Joni Vander Bilt ◽  
Sujuan Gao ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Cognitive Aging ◽  
Healthy Aging ◽  
Female Gender ◽  
Population Based ◽  
Language Ability ◽  
Clinical Dementia Rating ◽  
Language Tests ◽  
Gender Education

ABSTRACTBackground:Neuropsychological tests, including tests of language ability, are frequently used to differentiate normal from pathological cognitive aging. However, language can be particularly difficult to assess in a standardized manner in cross-cultural studies and in patients from different educational and cultural backgrounds. This study examined the effects of age, gender, education and race on performance of two language tests: the animal fluency task (AFT) and the Indiana University Token Test (IUTT). We report population-based normative data on these tests from two combined ethnically divergent, cognitively normal, representative population samples of older adults.Methods:Participants aged ≥65 years from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and from the Indianapolis Study of Health and Aging (ISHA) were selected based on (1) a Clinical Dementia Rating (CDR) score of 0; (2) non-missing baseline language test data; and (3) race self-reported as African-American or white. The combined sample (n = 1885) was 28.1% African-American. Multivariate ordinal logistic regression was used to model the effects of demographic characteristics on test scores.Results:On both language tests, better performance was significantly associated with higher education, younger age, and white race. On the IUTT, better performance was also associated with female gender. We found no significant interactions between age and sex, and between race and education.Conclusions:Age and education are more potent variables than are race and gender influencing performance on these language tests. Demographically stratified normative tables for these measures can be used to guide test interpretation and aid clinical diagnosis of impaired cognition.

Prospective Memory Development Across the Lifespan

2020 ◽  
Vol 25 (3) ◽  
pp. 162-173 ◽  
Author(s):  
Sascha Zuber ◽  
Matthias Kliegel
Keyword(s):  
Prospective Memory ◽  
Healthy Aging ◽  
Present Model ◽  
Current Knowledge ◽  
Well Being ◽  
The Elderly ◽  
Cognitive Factors ◽  
Everyday Functioning ◽  
Integrative Framework

Abstract. Prospective Memory (PM; i.e., the ability to remember to perform planned tasks) represents a key proxy of healthy aging, as it relates to older adults’ everyday functioning, autonomy, and personal well-being. The current review illustrates how PM performance develops across the lifespan and how multiple cognitive and non-cognitive factors influence this trajectory. Further, a new, integrative framework is presented, detailing how those processes interplay in retrieving and executing delayed intentions. Specifically, while most previous models have focused on memory processes, the present model focuses on the role of executive functioning in PM and its development across the lifespan. Finally, a practical outlook is presented, suggesting how the current knowledge can be applied in geriatrics and geropsychology to promote healthy aging by maintaining prospective abilities in the elderly.

Physician-related predictors of referral for multidisciplinary paediatric obesity management: a population-based study

2021 ◽  
Author(s):  
Nicole D Gehring ◽  
Maryam Kebbe ◽  
Sarah Rathwell ◽  
Arnaldo Perez ◽  
Chenhui Peng ◽  
...  
Keyword(s):  
Management Strategies ◽  
Family Physicians ◽  
Population Level ◽  
Population Based ◽  
Overweight And Obesity ◽  
Obesity Management ◽  
Logistic Regression Models ◽  
Physician Characteristics ◽  
Paediatric Obesity ◽  
Multivariable Regression

Abstract Background It is recommended that primary care-based physicians refer children with overweight and obesity to multidisciplinary paediatric obesity management, which can help to improve weight and health. Objective To determine predictors of referral to multidisciplinary paediatric obesity management. Methods This retrospective, population-level study included physicians who could refer 2–17 years old with a body mass index ≥85th percentile to one of three multidisciplinary paediatric obesity management clinics in Alberta, Canada. Physician demographic and procedural data were obtained from Practitioner Claims and Provider Registry maintained by Alberta Health from January 2014 to December 2017. Physician characteristics were compared based on whether they did or did not refer children for obesity management. Univariable and multivariable logistic regression models analysed associations between physician characteristics and referral making. Results Of the 3863 physicians (3468 family physicians, 395 paediatricians; 56% male; 49.3 ± 12.2 years old; 22.3 ± 12.6 years since graduation) practicing during the study period, 1358 (35.2%) referred at least one child for multidisciplinary paediatric obesity management. Multivariable regression revealed that female physicians (versus males) [odds ratio (OR): 1.68, 95% confidence interval (CI): 1.46–1.93; P &lt; 0.0001], paediatricians (versus family physicians) (OR: 4.89, 95% CI: 3.85–6.21; P &lt; 0.0001) and urban-based physicians (versus non-urban-based physicians) (OR: 2.17, 95% CI: 1.79–2.65; P &lt; 0.0001) were more likely to refer children for multidisciplinary paediatric obesity management. Conclusions Approximately one-third of family physicians and paediatricians referred children for multidisciplinary paediatric obesity management. Strategies are needed to improve referral practices for managing paediatric obesity, especially among male physicians, family physicians and non-urban-based physicians as they were less likely to refer children.

scholarly journals Declining Incident Dementia Rates Across Four Population-Based Birth Cohorts

2018 ◽  
Vol 74 (9) ◽  
pp. 1439-1445 ◽  
Author(s):  
Kevin J Sullivan ◽  
Hiroko H Dodge ◽  
Tiffany F Hughes ◽  
Chung-Chou H Chang ◽  
Xinmei Zhu ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Sex Education ◽  
Healthy Aging ◽  
Epidemiological Studies ◽  
Population Based ◽  
Incidence Rates ◽  
Birth Cohorts ◽  
Clinical Dementia Rating ◽  
Or Education ◽  
Incident Dementia

Abstract Background Incidence rates of dementia appear to be declining in high-income countries according to several large epidemiological studies. We aimed to describe declining incident dementia rates across successive birth cohorts in a U.S. population-based sample and to explore the influences of sex and education on these trends. Methods We pooled data from two community-sampled prospective cohort studies with similar study aims and contiguous sampling regions: the Monongahela Valley Independent Elders Survey (1987–2001) and the Monongahela-Youghiogheny Healthy Aging Team (2006–Ongoing). We identified four decade-long birth cohorts spanning birth years 1902–1941. In an analysis sample of 3,010 participants (61% women, mean baseline age = 75.7 years, mean follow-up = 7.1 years), we identified 257 cases of incident dementia indicated by a Clinical Dementia Rating of 1.0 or higher. We used Poisson regression to model incident dementia rates by birth cohort, age, sex, education, and interactions of Sex × Cohort and Sex × Education. We further examined whether cohort effects varied by education, testing a Cohort × Education interaction and stratifying the models by education. Results Compared to the earliest birth cohort (1902–1911), each subsequent cohort had a significantly lower incident dementia rate (1912–1921: incidence rate ratio [IRR] = 0.655, 95% confidence interval [95% CI] = 0.477–0.899; 1922–1931: IRR = 0.387, 95% CI = 0.265–0.564; 1932–1941: IRR = 0.233, 95% CI = 0.121–0.449). We observed no significant interactions of either sex or education with birth cohort. Conclusions A decline in incident dementia rates was observed across successive birth cohorts independent of sex, education, and age.

scholarly journals Effectiveness of live attenuated monovalent human rotavirus vaccination in rural Ecuador, 2008-2013

2018 ◽  
Author(s):  
Alicia N. M. Kraay ◽  
Edward L. Ionides ◽  
Gwenyth O. Lee ◽  
William F. Cevallos Trujillo ◽  
Joseph N.S. Eisenberg
Keyword(s):  
Indirect Effects ◽  
Cox Regression ◽  
Age Groups ◽  
Community Setting ◽  
Population Level ◽  
Population Based ◽  
Case Control ◽  
Rotavirus Infection ◽  
Human Rotavirus ◽  
Overall Effectiveness

AbstractBackgroundWhile live attenuated monovalent human rotavirus vaccine (Rotarix) efficacy has been characterized through randomized studies, its effectiveness, especially in non-clinical settings, is unclear. In this study, we estimate direct, indirect, and overall effectiveness of Rotarix vaccination.MethodsWe analyze 29 months of all-cause diarrhea surveillance from a child cohort (n=376) and ten years of serial population-based case-control lab-confirmed rotavirus data (n=2489) from rural Ecuador during which Rotarix vaccination was introduced. We estimate: 1) the direct effect of vaccination from a cohort of children born from 2008-2013 using Cox regression to compare time to first all-cause diarrhea case by vaccine status; and 2) the overall effect on all-cause diarrheal and symptomatic and asymptomatic rotavirus infection for all age groups, including indirect effects on adults, from the case-control data using weighted logistic regression.ResultsRotarix vaccination provided direct protection against all-cause diarrhea among children 0.5 - 2 years (All-cause diarrhea reduction for receipt of 2 doses of Rotarix=57.1%, 95% CI: 16.6, 77.9%). Overall effectiveness against rotavirus infection was strong (Exposure to 100% coverage of Rotarix vaccination was associated with an 85.5% reduction, 95% CI: 61.1-94.6%) compared to 0% coverage. Indirect effects were observed among older, vaccine-ineligible children and adults (84.5% reduction, 95% CI: 48.2-95.4%). Vaccine effectiveness was high against both symptomatic (48.3% reduction,95% CI: 0.03-73.1%) and asymptomatic infection (90.1% reduction, 95% CI: 56.9-97.7%).ConclusionsRotarix vaccination suppresses overall transmission. It is highly effective among children in a rural community setting and provides population-level benefits through indirect protection among adults.

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