Cognitive predictors for five-year conversion to dementia in community-dwelling Chinese older adults

ABSTRACTBackground: This study evaluates which cognitive measure is best for predicting incident dementia in a population-based random sample of Chinese older adults without dementia over a five-year period.Methods: A total of 787 community-dwelling Chinese older adults without dementia in Hong Kong were assessed at baseline (T0), at two years (T1), and at five years (T2).Results: The annual conversion rate to dementia was 1.6% and 6.3% for baseline normal participants and baseline mild cognitive impairment (MCI) participants, respectively. The Cantonese version of Mini-mental State Examination (CMMSE) scores declined significantly over time. In participants who progressed to dementia, Category Verbal Fluency Test (CVFT) scores dropped significantly from T0 to T1. A 1-SD drop of either CMMSE or CVFT in two years predicted dementia at five years with 91.5% sensitivity and 62.0% specificity. A stable CMMSE and CVFT at two years predicted a 91% chance of not progressing to clinical dementia at five years.Conclusion: In this community sample of Chinese older adults, a decline in cognitive screening tests in short term (two years) offered useful information in predicting dementia conversion over a longer period.

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Association between Skin Conditions and Depressive Disorders in Community-Dwelling Older Adults

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2013.13167 ◽

2014 ◽

Vol 18 (4) ◽

pp. 256-264 ◽

Cited By ~ 2

Author(s):

Samantha Gontijo Guerra ◽

Michel Préville ◽

Helen-Maria Vasiliadis ◽

Djamal Berbiche

Keyword(s):

Older Adults ◽

Older Adult ◽

Depressive Disorders ◽

Adult Population ◽

Community Sample ◽

The Elderly ◽

Population Based ◽

Community Dwelling ◽

Cross Sectional ◽

Skin Conditions

Background: Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations. Objective: To test this association in a representative sample of an older-adult population. Methods: Data came from the Survey on the Health of the Elderly (Enquête sur la Santé des Aînés [ESA]), a longitudinal survey conducted in Quebec among 2,811 older adults. Cross-lagged panel models were used to simultaneously examine cross-sectional and longitudinal relationships between the presence of skin conditions and depressive disorders. Results: The prevalence of skin conditions was 13%, and the prevalence of depressive disorders among participants presenting with skin conditions was 11%. Our results indicated significant cross-sectional correlation ( ζ = 0.20) between skin conditions and depressive disorders, but no longitudinal association was observed. Conclusion: Our results reinforce the hypothesis that skin conditions and depressive disorders are concurrently associated in older adults. However, no evidence of the predictive effect of skin problems on depression (and vice versa) was found in our community sample. Despite the deleterious effect of the coexistence of these problems in older adults, studies are lacking. This article highlights the importance of this issue and emphasizes the need for further research on this topic.

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Pre-Dementia Stages and Incident Dementia in the NuAge Study

Journal of Alzheimer s Disease ◽

10.3233/jad-201571 ◽

2021 ◽

Vol 80 (4) ◽

pp. 1465-1470

Author(s):

Olivier Beauchet ◽

Harmehr Sekhon ◽

Cyrille P. Launay ◽

Pierrette Gaudreau ◽

José A. Morais ◽

...

Keyword(s):

Older Adults ◽

Successful Aging ◽

Population Based ◽

Community Dwelling ◽

Cognitive Risk ◽

Incident Dementia ◽

Annual Visit ◽

Observational Cohort ◽

Community Dwelling Older Adults

Background: Motoric cognitive risk syndrome (MCR) and mild cognitive impairment (MCI) are two pre-dementia stages with an overlap, which may influence the risk for dementia. Objective: The study aims to examine the association of MCR, MCI, and their combination with incident dementia in Quebec community-dwelling older adults. Methods: 1,063 older adults (i.e., ≥65) were selected from a population-based observational cohort study known as the “Nutrition as a determinant of successful aging: The Quebec longitudinal study” (NuAge). Participants were separated into four groups at the baseline assessment: those without MCR and MCI (i.e., cognitively healthy individual; CHI), those with MCR alone, those with MCI alone, and those with MCR plus MCI. Incident dementia was recorded at each annual visit during a 3-year follow-up. Results: The prevalence of CHI was 87.2%, MCR 3.0%, MCI 8.8%, and MCR plus MCI 0.9%. The overall incidence of dementia was 2.4% and was significantly associated with MCR alone (Odd Ratio (OR) = 5.00 with 95% Confidence interval (CI) = [1.01;24.59] and p = 0.049), MCI alone (OR = 6.04 with 95% CI = [2.36;15.47] and p≤0.001), and the combination of MCR and MCI (OR = 25.75 with 95% CI = [5.32;124.66] and p≤0.001). Conclusion: Combining MCR and MCI increased the risk for incident dementia. These results also demonstrated that this combination is a better predictor of dementia than MCI or MCR alone.

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Performance-based instrument to assess functional capacity in community-dwelling older adults

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn13-040004 ◽

2019 ◽

Vol 13 (4) ◽

pp. 386-393

Author(s):

Ana Cláudia Becattini-Oliveira ◽

Leonardo Cardoso Portela Câmara ◽

Douglas de Farias Dutra ◽

Antonia de Azevedo Falcão Sigrist ◽

Helenice Charchat-Fichman

Keyword(s):

Older Adults ◽

Functional Capacity ◽

Independent Living ◽

Community Dwelling ◽

Screening Tests ◽

Cognitive Screening ◽

Clock Drawing Test ◽

Neuropsychological Functions ◽

Figure Test ◽

Community Dwelling Older Adults

ABSTRACT Functional capacity (FC) is a mediator between neuropsychological functions and real-world functioning, but there is a lack of evidence of its correlation in community-dwelling older adults. Objective: The study aim was to determine the FC level of community-dwelling older adults using the UCSD Performance-based Skills Assessment (UPSA) and to evaluate correlation with cognitive screening tests. Methods: Senior center participants were selected according to inclusion criteria: Portuguese fluency, age ≥60 years and self-reported independent living. The subject exclusion criteria were: dementia or other DSM-5 diagnoses, suicidal ideation or intent, non-completion of assessment battery, enrollment in another psychosocial intervention or pharmacotherapy study. FC level was determined by the UPSA, brief UPSA (UPSA-B) and Instrumental Activities of Daily Living scale (IADL’s). The Mini-Mental State Examination (MMSE), Memory of Figure Test (MFT), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT) were used for cognitive assessment. A total of 35 subjects that had a mean age of 72 years, were predominantly females(88.6%) and had mean education level of 11.25 years were evaluated. Results: Mean UPSA and UPSA-B scores were 78.5 and 70, respectively. A statistically significant correlation was observed between the UPSA and IADL, MMSE and VFT. Conclusion: The UPSA serves as a screening assessment of FC in community-dwelling older adults, showing a positive correlation with cognitive screening tests.

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N-Terminal Prosomatostatin and Risk of Vascular Dementia

Cerebrovascular Diseases ◽

10.1159/000479940 ◽

2017 ◽

Vol 44 (5-6) ◽

pp. 259-265 ◽

Cited By ~ 3

Author(s):

Hannes Holm ◽

Katarina Nägga ◽

Erik D. Nilsson ◽

Fabrizio Ricci ◽

Eduardo Cinosi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Vascular Dementia ◽

Cox Regression ◽

Population Based ◽

Community Dwelling ◽

Incident Dementia ◽

Increased Risk ◽

Study Participants

Background: Increased somatostatin plasma concentration has been found in patients with vascular dementia. However, it is unknown whether or not somatostatin levels may predict dementia development in the general population. To this end, we sought to assess the association of circulating N-terminal prosomatostatin (NT-proSST) with incident dementia among community-dwelling older adults. Methods: In the prospective population-based Malmö Preventive Project, 5,347 study participants (mean age: 69 ± 6years; 70% men) provided plasma for the determination of NT-proSST concentration. Of these, 373 participants (7%) were diagnosed with dementia (120 Alzheimer's disease, 83 vascular, 102 mixed, and 68 other aetiology) during a follow-up period of 4.6 ± 1.3 years. The association of NT-proSST with the risk of dementia and its subtypes was studied using multivariable-adjusted Cox regression models controlling for age, gender, body mass index, systolic blood pressure, antihypertensive treatment, smoking, diabetes, lipid levels and prevalent stroke. Results: Higher levels of NT-proSST were significantly associated with an increased risk of vascular dementia (hazard ratio [HR] per 1 SD: 1.29; 95% CI 1.05-1.59; p = 0.016), whereas no association was observed with Alzheimer's disease (HR per 1 SD: 0.99; 95% CI 0.81-1.20; p = 0.91), all-cause dementia (HR per 1 SD: 1.04; 95% CI 0.94-1.16; p = 0.44), and mixed dementia (HR per 1 SD: 0.98; 95% CI 0.79-1.21; p = 0.84). Levels of NT-proSST above 563 pmol/L (highest quartile) conferred distinctly increased risk of vascular dementia (HR 1.66; 95% CI 1.05-2.63; p = 0.029) compared with lower values. Conclusions: Higher levels of circulating N-terminal-prosomatostatin are associated with increased incidence of vascular dementia. Our findings might be of importance for the understanding of dementia development in older adults.

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The prevalence of suicide attempts among community-dwelling US Chinese older adults – findings from the PINE study

Ethnicity and Inequalities in Health and Social Care ◽

10.1108/eihsc-10-2013-0030 ◽

2014 ◽

Vol 7 (1) ◽

pp. 23-35 ◽

Cited By ~ 4

Author(s):

XinQi Dong ◽

Ruijia Chen ◽

E-Shien Chang ◽

Melissa A. Simon

Keyword(s):

Older Adults ◽

Epidemiological Study ◽

Suicidal Behavior ◽

Suicide Attempts ◽

Population Based ◽

Intervention Strategies ◽

Community Dwelling ◽

Prevention And Intervention ◽

Content Type ◽

Chinese Older Adults

Purpose – The purpose of this paper is to examine the prevalence of suicide attempts and explore the suicide methods among community-dwelling Chinese older adults. Design/methodology/approach – Data were drawn from the Population Study of Chinese Elderly in Chicago (PINE) study, a population-based epidemiological study of Chinese older adults aged 60 years and above in the greater Chicago area. Guided by the community-based participatory research (CBPR) approach, the study enrolled 3,159 community-dwelling Chinese older adults from 2011 to 2013. Findings – The lifetime prevalence of suicide attempts is 791 per 100,000 and the past 12-month prevalence of suicide attempts is 285 per 100,000. Medication overdose is the most common suicide method both in the group of lifetime suicide attempts and 12-month suicide attempts. Lower income is positively correlated with lifetime suicide attempts and 12-month suicide attempts. Living with fewer household members is positively correlated with lifetime suicide attempts but not with 12-month suicide attempts. Research limitations/implications – The findings emphasize the needs for improved understanding of suicidal behavior among minority older adults and to develop culturally and linguistically sensitive prevention and intervention strategies. Practical implications – Community stakeholders should improve the accessibility and availability of culturally sensitive mental health services and extend timely and effective suicide interventions in the Chinese community. Originality/value – This study represents the first and largest population-based epidemiological study to investigate the suicide attempts and methods among US Chinese older adults. In addition, the implementation of the CBPR approach allows us to minimize the cultural barriers associated with suicide investigation. The study emphasizes the need for improved understanding on suicidal behavior among minority older adults to inform culturally and linguistically sensitive prevention and intervention strategies.

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Depressive Symptoms Predict Incident Dementia in a Community Sample of Older Adults: Results From the Einstein Aging Study

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988718824036 ◽

2019 ◽

Vol 32 (2) ◽

pp. 97-103 ◽

Cited By ~ 10

Author(s):

Ali Ezzati ◽

Mindy J. Katz ◽

Carol A. Derby ◽

Molly E. Zimmerman ◽

Richard B. Lipton

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Community Sample ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Incident Dementia ◽

Increased Risk ◽

Aging Study

Background: There is increasing evidence that depressive symptoms are associated with increased risk of cognitive impairment and dementia in older adults. In current study, we aimed to investigate the effect of depressive symptoms on incident Alzheimer disease and all-cause dementia in a community sample of older adults. Methods: Participants were 1219 older adults from the Einstein Aging Study, a longitudinal cohort study of community-dwelling older adults in Bronx County, New York. The Geriatric Depression Scale (GDS, 15-item) was used as a measure of depressive symptoms. The primary outcome was incident dementia diagnosed using the Diagnostic and Statistical Manual, Fourth Edition, criteria. Cox proportional hazard models were used to estimate the risk of incident dementia as a function of GDS score for the whole population and also for 2 different time intervals, <3 years and ≥3 years after baseline assessment. Results: Among participants, 132 individuals developed dementia over an average 4.5 years (standard deviation [SD] = 3.5) of follow-up. Participants had an average age of 78.3 (SD = 5.4) at baseline, and 62% were women. Among all participants, after controlling for demographic variables and medical comorbidities, a 1-point increase in GDS was associated with higher incidence of dementia (hazard ratio [HR] = 1.11, P = .007). After up to 3 years of follow-up, depressive symptoms were not significantly associated with dementia incidence (HR = 1.09; P = .070). However, after more than 3 years, GDS score was a significant predictor of incident dementia (HR = 1.13, P = .028). Conclusions: Our results suggest that depressive symptoms are associated with an increased risk of incident dementia in older adults.

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Sex disparities in cardiovascular health metrics among rural-dwelling older adults in China: a population-based study

BMC Geriatrics ◽

10.1186/s12877-021-02116-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaolei Han ◽

Ziying Jiang ◽

Yuanjing Li ◽

Yongxiang Wang ◽

Yajun Liang ◽

...

Keyword(s):

Older Adults ◽

Rural Communities ◽

Cardiovascular Health ◽

Rural China ◽

Descriptive Analysis ◽

Population Based ◽

Baseline Survey ◽

Chinese Older Adults ◽

Face To Face ◽

Sex Disparities

Abstract Background Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated sex disparities in CVH metrics and their management among rural-dwelling older adults in China. Methods This community-based study included 5026 participants (age ≥ 65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. In March–September 2018, data were collected through face-to-face interviews, clinical examinations, and laboratory tests. We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association’s recommendations. We performed descriptive analysis separately for men and women. Results Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global (9.7% vs. 7.8%) and behavioral (18.3% vs. 9.5%) CVH metrics (p < 0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% vs. 3.5%, p < 0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend< 0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p < 0.05). Conclusions The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct sex differences, alongside poor management of major biological risk factors. Trial registration ChiCTR1800017758 (Aug 13, 2018).

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Dual Decline in Gait and Cognition Is Associated With Future Dementia: Evidence for a Phenotype

Innovation in Aging ◽

10.1093/geroni/igaa057.846 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 264-264

Author(s):

Manuel Montero Odasso ◽

Mark Speechley ◽

Richard Camicioli ◽

Nellie Kamkar ◽

Qu Tian ◽

...

Keyword(s):

Older Adults ◽

Gait Speed ◽

Regression Models ◽

Community Dwelling ◽

Hierarchical Regression ◽

Chi Square ◽

Cox Models ◽

Incident Dementia ◽

Risk Of Progression ◽

Community Dwelling Older Adults

Abstract BACKGROUND: The concurrent decline in gait speed and cognition are associated with future dementia. However, the clinical profile of those who present with dual-decline has not yet been described. We aimed to describe the phenotype and risk for incident dementia of individuals who present a dual-decline in comparison with non dual-decliners. METHODS: Prospective cohort of community-dwelling older adults free of dementia at baseline. We evaluated participants’ gait speed, cognition, medical status, functionality, incidence of adverse events, and dementia biannually over 7 years. Gait speed was assessed with a 6-meter electronic-walkway, and global cognition was assessed using the MoCA test. We compared characteristics between dual-decliners and non dual-decliners using t-test, Chi-square, and hierarchical regression models. We estimated incident dementia using Cox models. RESULTS: Among 144 participants (mean age 74.23 ± 6.72 years, 54% women), 17% progressed to dementia. Dual-decliners had a three-fold risk (HR: 3.12, 95%CI:1.23-7.93, p=0.017) of progression to dementia compared with non dual-decliners. Dual-decliners were significantly older with a higher prevalence of hypertension and dyslipidemia (p=0.002). Hierarchical regression models show that age and sex alone explained 3% of the variation in the dual-decliners group, while adding hypertension and dyslipidemia increased the explained variation to 8% and 10 %, respectively. The risk of becoming a dual-decliner was 4-fold if hypertension was present. CONCLUSION: Older adults with concurrent decline in gait speed and cognition represent a group at the highest risk of progression to dementia. These dual-decliners have a distinct phenotype with a higher prevalence of hypertension, a potentially treatable condition.

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Association Between Informant-Reported Sleep Disturbance and Incident Dementia: An Analysis of the National Alzheimer’s Coordinating Center Uniform Data Set

Journal of Applied Gerontology ◽

10.1177/0733464820967202 ◽

2020 ◽

pp. 073346482096720

Author(s):

Woojung Lee ◽

Shelly L. Gray ◽

Douglas Barthold ◽

Donovan T. Maust ◽

Zachary A. Marcum

Keyword(s):

Older Adults ◽

Sleep Disturbance ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Cognitive Screening ◽

Cognitive Level ◽

Data Set ◽

Cox Proportional Hazards Models ◽

Incident Dementia ◽

Normal Cognition

Informants’ reports can be useful in screening patients for future risk of dementia. We aimed to determine whether informant-reported sleep disturbance is associated with incident dementia, whether this association varies by baseline cognitive level and whether the severity of informant-reported sleep disturbance is associated with incident dementia among those with sleep disturbance. A longitudinal retrospective cohort study was conducted using the uniform data set collected by the National Alzheimer’s Coordinating Center. Older adults without dementia at baseline living with informants were included in analysis. Cox proportional hazards models showed that participants with an informant-reported sleep disturbance were more likely to develop dementia, although this association may be specific for older adults with normal cognition. In addition, older adults with more severe sleep disturbance had a higher risk of incident dementia than those with mild sleep disturbance. Informant-reported information on sleep quality may be useful for prompting cognitive screening.

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Exploring the Association between Multimorbidity and Cognitive Impairment in Older Adults Living in the Community: A Review of the Literature

Home Health Care Management & Practice ◽

10.1177/10848223211030468 ◽

2021 ◽

pp. 108482232110304

Author(s):

Grace F. Wittenberg ◽

Michelle A. McKay ◽

Melissa O’Connor

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Assessment Tool ◽

Adult Population ◽

Home Health ◽

Adverse Outcomes ◽

Community Dwelling ◽

Cognitive Screening ◽

Review Of The Literature ◽

Increased Risk

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.

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