scholarly journals Specific Measures of Executive Function Predict Cognitive Decline in Older Adults

2011 ◽  
Vol 18 (1) ◽  
pp. 118-127 ◽  
Author(s):  
Lindsay R. Clark ◽  
Dawn M. Schiehser ◽  
Gali H. Weissberger ◽  
David P. Salmon ◽  
Dean C. Delis ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Decline ◽  
Rating Scale ◽  
Prospective Longitudinal Study ◽  
Switching Condition ◽  
Interference Test ◽  
Design Fluency ◽  
Spatial Fluency ◽  
Prospective Longitudinal

AbstractDecline in executive function has been noted in the prodromal stage of Alzheimer's disease (AD) and may presage more global cognitive declines. In this prospective longitudinal study, five measures of executive function were used to predict subsequent global cognitive decline in initially nondemented older adults. Of 71 participants, 15 demonstrated significant decline over a 1-year period on the Dementia Rating Scale (Mattis, 1988) and the remaining participants remained stable. In the year before decline, the decline group performed significantly worse than the no-decline group on two measures of executive function: the Color-Word Interference Test (CWIT; inhibition/switching condition) and Verbal Fluency (VF; switching condition). In contrast, decliners and non-decliners performed similarly on measures of spatial fluency (Design Fluency switching condition), spatial planning (Tower Test), and number-letter switching (Trail Making Test switching condition). Furthermore, the CWIT inhibition-switching measure significantly improved the prediction of decline and no-decline group classification beyond that of learning and memory measures. These findings suggest that some executive function measures requiring inhibition and switching provide predictive utility of subsequent global cognitive decline independent of episodic memory and may further facilitate early detection of dementia. (JINS, 2012, 18, 118–127)

scholarly journals Physical Activity as a Predictor of Cognitive Decline in an Elderly Essential Tremor Cohort: A Prospective, Longitudinal Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Keith H. Radler ◽  
Silvia Chapman ◽  
Maria Anna Zdrodowska ◽  
Hollie N. Dowd ◽  
Xinhua Liu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Executive Function ◽  
Longitudinal Study ◽  
Cognitive Decline ◽  
Activity Level ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
Baseline Physical Activity ◽  
Lower Physical Activity ◽  
Over Time

Background: Essential tremor (ET), one of the most common neurological diseases, is associated with cognitive impairment. Surprisingly, predictors of cognitive decline in ET remain largely unidentified, as longitudinal studies are rare. In the general population, however, lower physical activity has been linked to cognitive decline.Objectives: To determine whether baseline physical activity level is a predictor of cognitive decline in ET.Methods: One hundred and twenty-seven ET cases (78.1 ± 9.5 years, range = 55–95), enrolled in a prospective, longitudinal study of cognition. At baseline, each completed the Physical Activity Scale for the Elderly (PASE), a validated, self-rated assessment of physical activity. Cases underwent an extensive battery of motor-free neuropsychological testing at baseline, 1.5 years, and 3 years, which incorporated assessments of cognitive subdomains. Generalized estimating equations (GEEs) were used to assess the predictive utility of baseline physical activity for cognitive change.Results: Mean follow-up was 2.9 ± 0.4 years (range = 1.3–3.5). In cross-sectional analyses using baseline data, lower physical activity was associated with lower overall cognitive function as well as lower cognitive scores in numerous cognitive domains (memory, language, executive function, visuospatial function and attention, all p < 0.05). In adjusted GEE models, lower baseline physical activity level significantly predicted overall cognitive decline over time (p=0.047), and declines in the subdomains of memory (p = 0.001) and executive function (p = 0.03).Conclusions: We identified reduced physical activity as a predictor of greater cognitive decline in ET. The identification of risk factors often assists clinicians in determining which patients are at higher risk of cognitive decline over time. Interventional studies, to determine whether increasing physical activity could modify the risk of developing cognitive decline in ET, may be warranted.

scholarly journals 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

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.

scholarly journals 44 Association between Falls and Cognitive Frailty among Community Dwelling Older Adults: A Cross Sectional Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Resshaya Roobini Murukesu ◽  
Devinder Kaur Ajit Singh ◽  
Noor Izyani Mokhtar ◽  
Janet Bong May Ing ◽  
Ponnusamy Subramaniam ◽  
...  
Keyword(s):  
Older Adults ◽  
Rating Scale ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cognitive Frailty ◽  
Prospective Longitudinal ◽  
Community Dwelling Older Adults

Abstract Introduction The presence of either frailty or cognitive impairment have been determined as precursors of falls among older adults. However, the association between falls and cognitive frailty has yet to be established. Objective To investigate the association between falls and cognitive frailty among community dwelling older adults. Methods A total of 246 Malaysian community dwelling older adults aged 60 years and above residing in the state of Selangor participated in this cross-sectional study. Sociodemographic details and clinical characteristics including the history of falls were obtained via interview. The presence of cognitive frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Data analysis was carried out via binary logistic regression. Results The prevalence of falls and cognitive frailty in this study were 21.2% and 21.9% respectively among community dwelling older adults (mean age 72.39±5.40). No significant relationship between falls and cognitive frailty [OR:1.187, 95% C.I: 0.493-2.856, p=0.702] was demonstrated. However, older women [OR:2.663, 95% C.I, 1.136-6.239, p=0.024] and the presence of multi-morbidities [OR: 1.431, 95% C.I, 1.026-1.997, p=0.035] were significantly associated with falls which corroborates with existing literature. Conclusion Cognitive frailty was not a significant risk factor of falls among community dwelling older adults in this study. Further research is required in prospective, longitudinal, population-based studies to confirm this result.

scholarly journals FINANCIAL EXPLOITATION OF OLDER ADULTS: PRELIMINARY RESULTS FROM A PROSPECTIVE LONGITUDINAL STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Scott R Beach ◽  
Sara J Czaja ◽  
Richard Schulz ◽  
David Loewenstein ◽  
Peter Lichtenberg
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Psychosocial Factors ◽  
Cognitive Abilities ◽  
Self Report ◽  
Prospective Longitudinal Study ◽  
Preliminary Results ◽  
Financial Exploitation ◽  
Advance Theory ◽  
Prospective Longitudinal

Abstract This paper presents study design and preliminary results from a new study funded by the National Institute on Aging that is examining financial exploitation (FE) among 720 White, African-American and Hispanic adults age 60+ (240 per group; 120 age 60-79; 120 age 80+). A conceptual model linking socio-demographics, physical health, social support / integration, cognitive function, financial skills / supports, and psychosocial factors to FE is being evaluated. Three assessments (baseline, 12; 24 mos.) include: a detailed cognitive battery, web-based banking simulation tasks, scam scenarios, and a standardized battery of self-report measures assessing socio-demographic and psychosocial variables. Preliminary baseline results from ~200 participants show support for the proposed model. Exposure to sales, remote purchasing behavior, and telemarketer receptivity (scam exposure); and scam vulnerability as measured by credibility ratings of “legitimate” and “fake” scam scenarios are positively associated with reports of both stranger-initiated and trusted other FE. Older adults with smaller social networks and less social support were more likely to report both exposure and vulnerability to scams. Higher general cognitive abilities, financial skills, and numeracy; and better performance on online banking tasks correlate with less scam exposure and vulnerability. Preliminary analyses of psychosocial factors also show that more depressed, impulsive, and trusting older adults report more exposure and scam vulnerability. The paper will present updated analyses of ~500 baseline participants. Understanding multiple pathways to FE is important to advance theory and for the development of interventions to minimize risk.

Sleep quality mediates the relationship between frailty and cognitive dysfunction in non-demented middle aged to older adults

2019 ◽  
Vol 31 (06) ◽  
pp. 779-788 ◽  
Author(s):  
Sonya Kaur ◽  
Nikhil Banerjee ◽  
Michelle Miranda ◽  
Mitchell Slugh ◽  
Ni Sun-Suslow ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Sleep Quality ◽  
Cognitive Decline ◽  
Processing Speed ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Delayed Recall ◽  
The Relationship

ABSTRACTObjectives:Frailty is associated with cognitive decline in older adults. However, the mechanisms explaining this relationship are poorly understood. We hypothesized that sleep quality may mediate the relationship between frailty and cognition.Participants:154 participants aged between 50-90 years (mean = 69.1 years, SD = 9.2 years) from the McKnight Brain Registry were included.Measurements:Participants underwent a full neuropsychological evaluation, frailty and subjective sleep quality assessments. Direct relationships between frailty and cognitive function were assessed using linear regression models. Statistical mediation of these relationships by sleep quality was assessed using nonparametric bootstrapping procedures.Results:Frailty severity predicted weaker executive function (B = −2.77, β = −0.30, 95% CI = −4.05 – −1.29) and processing speed (B = −1.57, β = −0.17, 95% CI = −3.10 – −0.16). Poor sleep quality predicted poorer executive function (B = −0.47, β = −0.21, 95% CI = −0.79 – −0.08), processing speed (B = −0.64, β = −0.28, 95% CI = −0.98 – −0.31), learning (B = −0.42, β = −0.19, 95% CI = −0.76 – −0.05) and delayed recall (B = −0.41, β = −0.16, 95% CI = −0.80 – −0.31). Poor sleep quality mediated the relationships between frailty severity and executive function (B = −0.66, β = −0.07, 95% CI = −1.48 – −0.39), learning (B = −0.85, β = −0.07, 95% CI = −1.85 – −0.12), delayed recall (B = −0.47, β = −0.08, 95% CI = −2.12 – −0.39) and processing speed (B = −0.90, β = −0.09, 95% CI = −1.85 – −0.20).Conclusions:Relationships between frailty severity and several cognitive outcomes were significantly mediated by poor sleep quality. Interventions to improve sleep quality may be promising avenues to prevent cognitive decline in frail older adults.

Accelerated sarcopenia and outcomes in older adults with cancer: The Health ABC Study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11526-11526
Author(s):  
Grant Richard Williams ◽  
Yanjun Chen ◽  
Kelly Kenzik ◽  
Andrew Michael McDonald ◽  
Shlomit S. Shachar ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
Cancer Diagnosis ◽  
Cox Regression ◽  
Community Dwelling ◽  
Mixed Effect ◽  
Prospective Longitudinal Study ◽  
Targeted Interventions ◽  
Prospective Longitudinal ◽  
Time Varying Covariates

11526 Background: Progressive loss of muscle mass and strength (sarcopenia) is a well-known phenomenon of aging; however, little is known about the contribution of a cancer diagnosis to sarcopenia and its subsequent impact on disability. Using a prospective cohort of older adults from pre- to post-cancer diagnosis and a similarly-followed non-cancer cohort, we examined the trajectory of sarcopenia measures and their association with overall survival (OS) and major disability among those with cancer. Methods: The Health, Aging, and Body Composition (Health ABC) Study is a prospective longitudinal study where 3,075 community-dwelling older adults (70-79y) underwent 6 annual assessments of body composition and were followed for development of sentinel events (cancer, disability, death). Appendicular lean mass (ALM [kg]) was a sum of DXA-based lean tissue of all extremities. Hand grip strength (HGS [kg]) was averaged from 2 trials per hand. Gait speed (GS) was evaluated over a 20m course. We used linear mixed effect models to compare the change in ALM, HGS, and GS between individuals who subsequently developed cancer and those who did not, adjusting for age, race, gender, enrollment site. Among patients with cancer, we used multivariable cox regression for time from cancer diagnosis to mortality and major disability (cane/walker, inability to walk 0.25 mile/climb 10 steps, assistance with activities of daily living) treating sarcopenia measures as time-varying covariates. Results: Mean age at enrollment was 75y; 52% female; 42% black; 515 new cancers (prostate: 23%, colorectal: 15%, lung: 13%, breast: 11%). Compared with non-cancer controls, we found significantly steeper declines in HGS ( p= 0.03) and GS ( p< 0.001), and a trend in ALM ( p= 0.07) prior to cancer diagnosis; and a significantly steeper decline in ALM ( p< 0.001), but no difference in HGS ( p= 0.6) or GS ( p= 0.4) after cancer diagnosis. Slow GS was associated with a 44% increase in mortality ( p= 0.02) and a 70% increase in disability ( p= 0.02), but not ALM or HGS. Conclusions: Accelerated loss in sarcopenia measures both prior to and after a cancer diagnosis, and association with disability and mortality in older adults with cancer, present opportunities for targeted interventions.

Efficacy and Tolerability of Aripiprazole Intramuscular as Maintenance Treatment in Patients with Paranoid Schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S280-S280
Author(s):  
B. Serván ◽  
A. Montes ◽  
M. Machín ◽  
P. Gómez ◽  
J. García-Albea ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Paranoid Schizophrenia ◽  
Tolerability Profile ◽  
Prospective Longitudinal Study ◽  
Therapeutic Adherence ◽  
Significant Difference ◽  
Previously Treated ◽  
Prospective Longitudinal

IntroductionPatients suffering from paranoid schizophrenia, require long-term anti-psychotic treatment, which provide, in addition to adequate efficacy both positive and negative symptoms, a good safety and tolerability profile that would ensure adequate adherence to prevent relapse.ObjectivesTo analyze the efficacy, tolerability and therapeutic adherence over a year after the introduction of aripiprazole depot in patients diagnosed with paranoid schizophrenia previously treated with other oral or depot anti-psychotics [1,2,3].MethodsOne-year prospective longitudinal study with a sample size of 23 patients diagnosed with schizophrenia in outpatient treatment. Study variables (baseline, 6 and 12 months): Brief Psychiatric Rating Scale (BPRS), clinical global impression (CGI), mean dose of aripiprazole depot, previous treatments, adherence, relapse rate, prolactin levels, sexual dysfunction, BMIs.ResultsTwenty-three patients (71% men, 29% women) diagnosed with paranoid schizophrenia were identified. Improvement was obtained in the different study variables with statistically significant difference (P ≤ 0.05).ConclusionsFollowing the introduction of aripiprazole depot in patients diagnosed with schizophrenia previously treated with other oral or depot anti-psychotics in our study, we conclude that maintaining therapeutic efficacy a better tolerability and safety profile, better therapeutic adherence and consequently lower relapse rate were achieved.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cognitive decline in Parkinson’s disease: A prospective longitudinal study

2009 ◽  
Vol 15 (3) ◽  
pp. 426-437 ◽  
Author(s):  
DINO MUSLIMOVIĆ ◽  
BART POST ◽  
JOHANNES D. SPEELMAN ◽  
ROB J. DE HAAN ◽  
BEN SCHMAND
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Decline ◽  
Disease Onset ◽  
Cognitive Change ◽  
Newly Diagnosed ◽  
Psychomotor Speed ◽  
Prospective Longitudinal Study ◽  
Normative Comparisons ◽  
Prospective Longitudinal

AbstractThis controlled prospective study examined the evolution and predictors of cognitive decline in Parkinson’s disease (PD). Consecutive patients diagnosed at baseline with PD (n = 89), established PD (EPD) patients (n = 52) with a mean disease duration of 6.5 years, and healthy control subjects (n = 64) underwent extensive neuropsychological assessment twice, approximately 3 years apart. A standardized regression-based method, normative data, and multivariate normative comparisons were used to assess the cognitive course of PD. Cognitive performance of newly diagnosed patients decreased significantly over time, particularly on measures of psychomotor speed and attention and to a lesser extent on tests of memory, visuospatial skills, and executive functions. About 50% of the patients showed cognitive decline and 9% developed dementia. Similar results were observed in EPD patients. None of the baseline features predicted cognitive change in newly diagnosed patients, whereas age at disease onset and axial impairment (postural and gait disorders) contributed to decline in established patients. We conclude that within few years after diagnosis, PD patients show faster rate of cognitive decline than matched healthy subjects, particularly in domains of attention and psychomotor speed. Selection bias probably led to underestimation of the true extent of cognitive decline in established patients. (JINS, 2009, 15, 426–437.)

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