Engagement in social activities and progression from mild to severe cognitive impairment: the MYHAT study

ABSTRACTBackground: It is of considerable public health importance to prevent or delay the progression of mild cognitive impairment (MCI) to more severely impaired cognitive states. This study examines the risk of progression from mild to severe cognitive impairment in relation to engagement in social activities while mildly impaired and the concurrence of subsequent change in engagement with MCI progression.Methods: Participants were 816 older adults with cognitively defined MCI (mean age 78.0 (standard deviation or SD = 7.4) years) from the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) Study – a prospective cohort study of MCI in the community. Over three years of follow-up, 78 individuals progressed from MCI to severe cognitive impairment, while 738 did not progress. Risk of progression was estimated using discrete time survival analyses. The main predictors were standardized composite measures of the variety and frequency of engagement in social activities.Results: Lower risk of progression from mild to severe cognitive impairment was associated with both a greater level of frequency of engagement in social activities while mildly impaired (OR = 0.72, 95% CI: 0.55–0.93, p = 0.01) and also with a slower rate of decline in the variety of activities over time (OR = 0.01, 95% CI: <0.001–0.38, p = 0.02).Conclusions: Greater engagement in social activities may potentially be beneficial for preventing or delaying further cognitive decline among older adults with MCI. Alternatively, lesser engagement in social activities may be a marker of impending cognitive decline in MCI.

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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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The Brief Odor Detection Test (B-ODT) for Very Early Diagnosis of Cognitive Decline: A Preliminary Study

Brain Impairment ◽

10.1017/brimp.2017.7 ◽

2017 ◽

Vol 18 (2) ◽

pp. 197-210

Author(s):

Dimitra Savvoulidou ◽

Efthymia Totikidou ◽

Chariklia Varvesiotou ◽

Magda Iakovidou ◽

Ourania Sfakianaki ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Adult Population ◽

Detection Threshold ◽

Community Dwelling ◽

Odor Detection ◽

Olfactory Impairment ◽

Older Adult Population ◽

Community Dwelling Older Adults

Olfactory impairment in older adults is associated with cognitive decline. This study describes the development of a Brief Odor Detection Test (B-ODT), and its pilot administration in community-dwelling older adults. The study aimed at examining whether the test could differentiate older adults with very mild cognitive impairment from their cognitively healthy counterparts. The sample consisted of 34 older adults (22 women), aged from 65 to 87 years. Participants were divided into two groups according to their general cognitive functioning. Odor detection was measured via vanillin solutions at the following concentrations: 150 mg/L, 30 mg/L, 15 mg/L, 3 mg/L, and .03 mg/L. The first condition of the test involved a scale administration of vanillin solutions. The second condition examined the change in air odour and it required vanillin solution of 30 mg/L and a metric ruler of 30 cm. The examiner had to place the solution at a specific distance point from each nostril. Odour identification sensitivity was secondarily measured. The results showed statistically significant differences in odour detection threshold between the two groups. In the unirhinal testing, left nostril differences of the two groups were definite. Hence, the B-ODT seems a promising instrument for very early cognitive impairment screening in older adult population.

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Fear of Falling and Cognitive Decline in Healthy Aging Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.849 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 265-265

Author(s):

Rebecca Kraut ◽

Roee Holtzer

Keyword(s):

Older Adults ◽

Executive Functions ◽

Cognitive Decline ◽

Healthy Aging ◽

Fear Of Falling ◽

Composite Score ◽

Cognitive Measures ◽

Delayed Recall ◽

Memory And Attention ◽

Aging Adults

Abstract Fear of Falling (FOF) is common and associated with poor mobility in aging but whether persistence of FOF endorsement influences cognitive decline has not been reported. Here we determined the effect of FOF, measured dichotomously and after accounting for persistence, on decline in global cognitive function (GCF), memory, and attention/executive functions. Older adults with persistent FOF (n=81; mean age=77.63±6.67 yrs; %female=74.1), transient FOF (n=60; mean age=76.93±6.01 yrs; %female=61.7), and no FOF (n=286; mean age=75.77±6.42 yrs; %female=49.3) were included. FOF was assessed through yes/no responses to “do you have a fear of falling?” at baseline. GCF was assessed using RBANS; memory was assessed using a composite score comprising the immediate and delayed recall index scores from RBANS; attention/executive functions were assessed via a composite score comprising TMT A & B, letter and category fluency tasks, and digit symbol modalities. Cognitive measures were administered annually for up to six years. Linear mixed effects models revealed that persistent FOF was associated with a worse decline in GCF compared to both transient FOF (estimate=0.78, p=.022) and no FOF (estimate=0.75, p=.004). Persistent FOF was also associated with a worse decline in memory compared to those with transient FOF (estimate=0.08, p=.004) and those with no FOF (estimate=0.06, p=.006). Associations between FOF status and decline in attention/executive functions were not significant. These findings demonstrate that persistent FOF is a risk factor for cognitive decline in community-residing older adults.

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P4-376: Behavioral performance as a predictor of cognitive decline: Detecting the transition from healthy aging to mild cognitive impairment

Alzheimer s & Dementia ◽

10.1016/j.jalz.2013.08.276 ◽

2012 ◽

Vol 8 (4S_Part_21) ◽

pp. S791-S791 ◽

Cited By ~ 1

Author(s):

Stuart Zola ◽

Cecelia Manzanares ◽

Paul Clopton ◽

James Lah ◽

Allan Levey

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Healthy Aging ◽

Behavioral Performance

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102315 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2315 ◽

Cited By ~ 3

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.

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Risk of progression from subjective cognitive decline to mild cognitive impairment: The role of study setting

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.12.003 ◽

2018 ◽

Vol 14 (6) ◽

pp. 734-742 ◽

Cited By ~ 43

Author(s):

Beth E. Snitz ◽

Tianxiu Wang ◽

Yona Keich Cloonan ◽

Erin Jacobsen ◽

Chung-Chou H. Chang ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Subjective Cognitive Decline ◽

Risk Of Progression ◽

Study Setting

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Is the Discrimination of Subjective Cognitive Decline from Cognitively Healthy Adulthood and Mild Cognitive Impairment Possible? A Pilot Study Utilizing the R4Alz Battery

Journal of Alzheimer s Disease ◽

10.3233/jad-200562 ◽

2020 ◽

Vol 77 (2) ◽

pp. 715-732

Author(s):

Eleni Poptsi ◽

Despina Moraitou ◽

Emmanouil Tsardoulias ◽

Andreas L. Symeonidisd ◽

Magda Tsolaki

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Control ◽

Cognitive Decline ◽

Neurocognitive Disorders ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Working Memory Updating

Background: The early diagnosis of neurocognitive disorders before the symptoms’ onset is the ultimate goal of the scientific community. REMEDES for Alzheimer (R4Alz) is a battery, designed for assessing cognitive control abilities in people with minor and major neurocognitive disorders. Objective: To investigate whether the R4Alz battery’s tasks differentiate subjective cognitive decline (SCD) from cognitively healthy adults (CHA) and mild cognitive impairment (MCI). Methods: The R4Alz battery was administered to 175 Greek adults, categorized in five groups a) healthy young adults (HYA; n = 42), b) healthy middle-aged adults (HMaA; n = 33), c) healthy older adults (HOA; n = 14), d) community-dwelling older adults with SCD (n = 34), and e) people with MCI (n = 52). Results: Between the seven R4Alz subtasks, four showcased the best results for differentiating HOA from SCD: the working memory updating (WMCUT-S3), the inhibition and switching subtask (ICT/RST-S1&S2), the failure sets (FS) of the ICT/RST-S1&S2, and the cognitive flexibility subtask (ICT/RST-S3). The total score of the four R4Alz subtasks (R4AlzTot4) leads to an excellent discrimination among SCD and healthy adulthood, and to fare discrimination among SCD and MCI. Conclusion: The R4Alz battery is a novel approach regarding the neuropsychological assessment of people with SCD, since it can very well assist toward discriminating SCD from HOA. The R4Alz is able to measure decline of specific cognitive control abilities - namely of working memory updating, and complex executive functions - which seem to be the neuropsychological substrate of cognitive complaints in community dwelling adults of advancing age.

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SAT-LB115 Metformin-Use Is Associated With Slowed Cognitive Decline and Reduced Incident Dementia in Older Adults With Type 2 Diabetes Mellitus: The Sydney Memory and Ageing Study

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2055 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Katherine Samaras ◽

Steve Makkar ◽

John D Crawford ◽

Nicole A Kochan ◽

Wei Wen ◽

...

Keyword(s):

Older Adults ◽

Heart Disease ◽

Executive Function ◽

Older People ◽

Cognitive Decline ◽

Community Dwelling ◽

Incident Dementia ◽

Ageing Study ◽

Global Cognition ◽

Rate Of Decline

Abstract Background Metformin use in diabetes has been associated with both increased and decreased dementia rates in observational studies of people with diabetes. Objective: To examine changes in global cognition and specific cognitive domains over 6 years in older adults with diabetes treated with metformin, compared to other glucose lowering medications, and to people without diabetes. Methods Data were examined from the Sydney Memory and Ageing Study, a prospective observational study of 6 years duration of 1037 non-demented community-dwelling elderly aged 70-90 at baseline, derived from a compulsory electoral roll. Neuropsychological testing was performed every 2 years with domain measures of memory, executive function, language, visuospatial function, attention and processing speed and a composite of global cognition. Data were analysed by linear mixed modelling, including age, sex, education, body mass index, heart disease, diabetes, hypertension, stroke, smoking and apolipoprotein E ε4 carriage as covariates. Results: At baseline, 123 participants had diabetes (DM) with 67 receiving metformin (DM+MF) who were similar in demographics to those not receiving metformin (DM-noMF) and those without diabetes (no-DM). Participants with diabetes had higher BMI, lower HDL- and LDL-cholesterol and more prevalent heart disease, hypertension and smoking, compared to no-DM. Over 6-years, DM+MF participants had significantly slower rates of decline in global cognition and executive function, compared to DM-noMF, adjusted for covariates. The rate of decline for each cognitive domain was similar between DM+MF and controls. No impact was found in analyses examining interactions with sex, ApoEε4 carriage or hyperlipidemia. No difference was found in the rate of decline in brain volumes between the groups over 2 years. Incident dementia was significantly higher in DM-noMF, compared to DM+MF (adjusted OR 5.29 [95% CI 1.17-23.88], p,0.05), whereas risk of incident dementia was similar between DM+MF and participants without diabetes. Conclusions: In older people with diabetes receiving metformin, rates of cognitive decline and dementia were similar to that found in people without diabetes and significantly less than that found in people with diabetes not receiving metformin. Large randomized studies in people with and without diabetes are required to determine whether these associations can be attributed to metformin alone or if other factors explain these observations. Future studies will clarify if this cheap and safe medication can be repurposed for prevention of cognitive decline in older people.

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