Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults

2017 ◽  
Vol 30 (2) ◽  
pp. 221-232 ◽  
Author(s):  
Moyra E. Mortby ◽  
Zahinoor Ismail ◽  
Kaarin J. Anstey

ABSTRACTBackground:A dearth of population-based epidemiological research examines neuropsychiatric symptom (NPS) in sub-clinical populations across the spectrum from normal aging to mild cognitive impairment (MCI). The construct of mild behavioral impairment (MBI) describes the emergence of sustained and impactful NPS in advance of or in combination with MCI. This is the first epidemiological study to operationalize the recently published diagnostic criteria for MBI and determine prevalence estimates across the spectrum from cognitively normal to MCI.Methods:MBI was assessed in 1,377 older (age range 72–79 years; 52% male; MCI ;= 133; cognitively normal, but-at-risk = 397; cognitively healthy = 847). MBI was assessed in accordance with the ISTAART-AA diagnostic criteria for MBI using the neuropsychiatric inventory.Results:34.1% of participants met the criteria for MBI. High prevalence of MBI across the cognitive spectrum was reported (48.9% vs. 43.1% vs. 27.6%). Irrespective of level of cognitive impairment, impulse dyscontrol (33.8% vs. 28.7% vs. 17.2%) and decreased motivation (32.3% vs. 26.2% vs. 16.3%) were the most frequently met MBI domains. MBI was more prevalent in men (χ2 = 4.98, p = 0.026), especially the domains of decreased motivation and impulse dyscontrol.Conclusions:This study presents the first population-based prevalence estimates for MBI using the recently published ISTAART-AA diagnostic criteria. Findings indicate relatively high prevalence of MBI in pre-dementia clinical states and amongst cognitively healthy older adults. Findings were gender-specific, with MBI affecting more men than women. Knowing the estimates of these symptoms in the population is essential for understanding and differentiating the very early development of clinical disorders.

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.


Author(s):  
Liselotte De Wit ◽  
Vitoria Piai ◽  
Pilar Thangwaritorn ◽  
Brynn Johnson ◽  
Deirdre O’Shea ◽  
...  

AbstractThe literature on repetition priming in Alzheimer’s disease (AD) is inconsistent, with some findings supporting spared priming while others do not. Several factors may explain these inconsistencies, including AD severity (e.g., dementia vs. Mild Cognitive Impairment; MCI) and priming paradigm-related characteristics. This systematic review and meta-analysis provides a quantitative summary of repetition priming in AD. We examined the between-group standard mean difference comparing repetition priming in AD dementia or amnestic MCI (aMCI; presumably due to AD) to controls. Thirty-two studies were selected, including 590 individuals with AD dementia, 267 individuals with amnestic MCI, and 703 controls. Our results indicated that both individuals with aMCI and AD dementia perform worse on repetition priming tasks than cognitively older adults. Paradigm-related moderators suggested that the effect size between studies comparing the combined aMCI or AD dementia group to cognitively healthy older adults was the highest for paradigms that required participants to produce, rather than identify, primes during the test phase. Our results further suggested that priming in AD is impaired for both conceptual and perceptual priming tasks. Lastly, while our results suggested that priming in AD is impaired for priming tasks that require deep processing, we were unable to draw firm conclusions about whether priming is less impaired in aMCI or AD dementia for paradigms that require shallow processing.


2021 ◽  
pp. 1-11
Author(s):  
Kylie R. Kadey ◽  
John L. Woodard ◽  
Allison C. Moll ◽  
Kristy A. Nielson ◽  
J. Carson Smith ◽  
...  

Background: Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. Objective: The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. Methods: The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer’s Coordinating Center (NACC) database. Results: After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p <  0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96–1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96–1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78–1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53–0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57–0.94). Conclusion: A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.


2020 ◽  
pp. 1-10
Author(s):  
Christopher Gonzalez ◽  
Nicole S. Tommasi ◽  
Danielle Briggs ◽  
Michael J. Properzi ◽  
Rebecca E. Amariglio ◽  
...  

Background: Financial capacity is often one of the first instrumental activities of daily living to be affected in cognitively normal (CN) older adults who later progress to amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. Objective: The objective of this study was to investigate the association between financial capacity and regional cerebral tau. Methods: Cross-sectional financial capacity was assessed using the Financial Capacity Instrument –Short Form (FCI-SF) in 410 CN, 199 MCI, and 61 AD dementia participants who underwent flortaucipir tau positron emission tomography from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Linear regression models with backward elimination were used with FCI-SF total score as the dependent variable and regional tau and tau-amyloid interaction as predictors of interest in separate analyses. Education, age sex, Rey Auditory Verbal Learning Test Total Learning, and Trail Making Test B were used as covariates. Results: Significant associations were found between FCI-SF and tau regions (entorhinal: p <  0.001; inferior temporal: p <  0.001; dorsolateral prefrontal: p = 0.01; posterior cingulate: p = 0.03; precuneus: p <  0.001; and supramarginal gyrus: p = 0.005) across all participants. For the tau-amyloid interaction, significant associations were found in four regions (amyloid and dorsolateral prefrontal tau interaction: p = 0.005; amyloid and posterior cingulate tau interaction: p = 0.005; amyloid and precuneus tau interaction: p <  0.001; and amyloid and supramarginal tau interaction: p = 0.002). Conclusion: Greater regional tau burden was modestly associated with financial capacity impairment in early-stage AD. Extending this work with longitudinal analyses will further illustrate the utility of such assessments in detecting clinically meaningful decline, which may aid clinical trials of early-stage AD.


Author(s):  
Alexandre Chauvin ◽  
Shari Baum ◽  
Natalie A. Phillips

Purpose Speech perception in noise becomes difficult with age but can be facilitated by audiovisual (AV) speech cues and sentence context in healthy older adults. However, individuals with Alzheimer's disease (AD) may present with deficits in AV integration, potentially limiting the extent to which they can benefit from AV cues. This study investigated the benefit of these cues in individuals with mild cognitive impairment (MCI), individuals with AD, and healthy older adult controls. Method This study compared auditory-only and AV speech perception of sentences presented in noise. These sentences had one of two levels of context: high (e.g., “Stir your coffee with a spoon”) and low (e.g., “Bob didn't think about the spoon”). Fourteen older controls ( M age = 72.71 years, SD = 9.39), 13 individuals with MCI ( M age = 79.92 years, SD = 5.52), and nine individuals with probable Alzheimer's-type dementia ( M age = 79.38 years, SD = 3.40) completed the speech perception task and were asked to repeat the terminal word of each sentence. Results All three groups benefited (i.e., identified more terminal words) from AV and sentence context. Individuals with MCI showed a smaller AV benefit compared to controls in low-context conditions, suggesting difficulties with AV integration. Individuals with AD showed a smaller benefit in high-context conditions compared to controls, indicating difficulties with AV integration and context use in AD. Conclusions Individuals with MCI and individuals with AD do benefit from AV speech and semantic context during speech perception in noise (albeit to a lower extent than healthy older adults). This suggests that engaging in face-to-face communication and providing ample context will likely foster more effective communication between patients and caregivers, professionals, and loved ones.


Author(s):  
Anne-S. Helvik

AbstractThe population of older adults (≥60 years) is currently growing. Thus, in the years to come it is expected that a high proportion of patients hospitalized will be in the older age range. In western countries, the proportion of older inpatients is about 40% in the medical and surgical hospitals units. Older people with illness is vulnerable to both physical and cognitive impairments as well as depression. Therefore, a health-promoting perspective and approach are highly warranted in clinical nursing care of older adults in medical hospitals. This chapter focuses on health promotion related to depressive symptoms, impairment in activities of daily living, and cognitive impairment in older hospitalized adults.


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