Interpreting cognitive decline in the face of cognitive reserve

2018 ◽  
Author(s):  
Ellen Bialystok ◽  
John A. E. Anderson ◽  
John G. Grundy
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Brain Structure ◽  
Cognitive Reserve ◽  
Cognitive Status ◽  
Cognitive Level ◽  
The Face

Evaluation of the cognitive level of older adults, including decisions about meeting clinical thresholds for dementia, is typically based on behavioral levels of performance. However, individuals with high cognitive reserve will outperform the levels typically associated with their brain structure, providing inaccurate assessments of their status. We define cognitive reserve as the relation between brain integrity and cognitive level, and use the case of bilingualism as a source of cognitive reserve to illustrate how information from only one can distort the interpretation of the individual’s cognitive status.

The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailty

2017 ◽  
Vol 29 (9) ◽  
pp. 1469-1474 ◽  
Author(s):  
Andreas Ihle ◽  
Élvio R. Gouveia ◽  
Bruna R. Gouveia ◽  
Duarte L. Freitas ◽  
Jefferson Jurema ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Old Age ◽  
Cognitive Reserve ◽  
Cognitive Activity ◽  
Leisure Activity ◽  
Cognitive Status ◽  
Cognitive Level ◽  
Physical Frailty

ABSTRACTBackground:It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults.Methods:We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity.Results:Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength.Conclusions:Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.

P2-421: Indicators of Cognitive Reserve Moderate the Adverse Relationship Between Poor Diet Quality and Cognitive Decline in Independent Older Adults: The Nuage Study

2016 ◽  
Vol 12 ◽  
pp. P806-P806
Author(s):  
Matthew D. Parrott ◽  
Alexandra J. Fiocco ◽  
Pierre-Hugues Carmichael ◽  
Nicole D. Anderson ◽  
Danielle Laurin ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Diet Quality ◽  
Cognitive Reserve ◽  
Poor Diet

scholarly journals Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults

2016 ◽  
Vol 21 (Suppl. 1) ◽  
pp. 21-28 ◽  
Author(s):  
Alessandro Castiglione ◽  
Alice Benatti ◽  
Carmelita Velardita ◽  
Diego Favaro ◽  
Elisa Padoan ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Decline ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Digit Span ◽  
Depression Scale ◽  
Cognitive Status ◽  
Long Term Memory ◽  
Auditory Rehabilitation

A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on short- and long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance.

scholarly journals IN-HOSPITAL NURSE CARE CONTINUITY: DOES IT MATTER?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S740-S740
Author(s):  
Orly Tonkikh ◽  
Anna Zisberg ◽  
Efrat Shadmi
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Interpersonal Relationship ◽  
Severity Of Illness ◽  
Cognitive Status ◽  
Cognitive Outcomes ◽  
Full Time ◽  
Hospital Nursing ◽  
Hospitalized Older Adults ◽  
Time Standard

Abstract In-hospital cognitive decline affects up to 40% of hospitalized older adults and is associated with post-hospitalization worsening of medical and functional status. Studies pointed to the substantial role of the interpersonal relationship between older adults with cognitive impairment and the nurses who care for them. We investigated the association between nursing interpersonal continuity and cognitive outcomes in a cohort of 646 older adults aged 70 or older admitted to internal units for non-disabling conditions. Cognitive decline was defined as at least one point decline in the Short Portable Mental Status Questionnaire from at admission to discharge assessments. Nursing interpersonal continuity was measured using continuity of care index (CoC). CoC assesses the extent of different nurses assigned to take care of each patient during the hospital stay (2 shifts per day) and ranges from 0 (none of the nurses is the same) to 0.4 (highest feasible score according to full time standard shift plan and length of stay (LOS)). Multivariate logistic regression showed that achieving 25% of the highest feasible in-hospital nursing CoC was associated with lower odds of cognitive decline (OR=0.67, 95% CI=0.47-0.97), controlling for age, sex, premorbid activities of daily living status, at admission cognitive status, comorbidities, severity of illness and LOS. This study shows that in-hospital nursing continuity is negatively associated with older adults’ cognitive decline, even in low-continuity levels. Future studies should investigate in-hospital continuity patterns and interventions maintaining continuity in larger and more heterogenic samples.

scholarly journals Health Trajectories in Swedish Centenarians

2020 ◽  
Vol 76 (1) ◽  
pp. 157-163
Author(s):  
Davide L Vetrano ◽  
Giulia Grande ◽  
Alessandra Marengoni ◽  
Amaia Calderón-Larrañaga ◽  
Debora Rizzuto
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Chronic Diseases ◽  
Care Delivery ◽  
Cognitive Status ◽  
National Study ◽  
Health Trajectories ◽  
Kungsholmen Project ◽  
Cognitively Intact

Abstract Background Longitudinal studies describing centenarians’ health trajectories are currently lacking. We compared health trajectories of older adults becoming centenarians and their shorter-living counterparts in terms of chronic diseases, disability, and cognitive decline. Methods We identified 3,573 individuals participating in the Kungsholmen Project and the Swedish National Study on Aging and Care in Kungsholmen who lived <100 years and 222 who survived to their 100th birthday. Trajectories of chronic diseases, disability (impaired activities of daily living), and cognitive status were obtained via linear mixed models over 13 years. Results Centenarians had fewer chronic diseases than noncentenarians. Before age 85, centenarians showed slower health changes. In centenarians, multimorbidity, disability, and cognitive impairment occurred 4 to 9 years later than in noncentenarians. After age 85, the speed of accumulation of chronic diseases, disabilities, and cognitive decline accelerated in centenarians. At age 100, 39% of the centenarians were cognitively intact and 55% had escaped disability. Only 5% were free of multimorbidity at age 100. When compared with their shorter lived counterparts, in terms of years spent in poor health, centenarians experienced more years with multimorbidity (9.4 vs 6.8 years; p < .001), disability (4.3 vs 3.1 years; p = .005), and cognitive impairment (6.3 vs 4.3 years; p < .001). Conclusions Older people who become centenarians present a delay in the onset of morbidity, but spend more years in this condition compared to their shorter lived peers. The observation of older adults’ health trajectories might help to forecast healthier aging, and plan future medical and social care delivery.

scholarly journals Transforming Aging: Increased Access to Care Minimizes Rural and Urban Differences in Cognitive Change

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 482-483
Author(s):  
Timothy Ly ◽  
Rebecca Allen ◽  
Barbara Jackson ◽  
Amy Albright ◽  
John Bell ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Cognitive Decline ◽  
Access To Care ◽  
Behavioral Health ◽  
Urban Areas ◽  
Cognitive Change ◽  
Cognitive Status ◽  
Cognitive Health ◽  
Rural And Urban

Abstract Rural-urban disparities in cognitive health outcomes, such as greater prevalence of cognitive decline among rural-dwelling older adults, have been linked to inequity in access to care. However, few studies have demonstrated whether longitudinal increased access to care may mitigate such disparities. This paper presents data from ongoing systematically collected behavioral health data on new and returning patients at an interdisciplinary geriatrics clinic at the University of Alabama Medical Center. The aim of this study was to determine baseline predictors of cognitive change across three annual visits (n = 42, mean age of 75.63 years (SD = 9.15)). Adjusting for baseline cognitive status, baseline subjective health literacy, and baseline depression and anxiety, results from a univariate ANCOVA showed that age at first visit (B = -.024, 95% CI [-.041, -.008], t(35) = -2.990, p = .005) and rural-urban status (B = .555, 95% CI [.123, .988], t(35) = 2.608, p = .013) predicted cognitive change at timepoint three (T3). Specifically, individuals from rural areas were less likely to experience cognitive decline and scored .555 points better than individuals from urban areas on cognitive screeners at T3 compared with baseline cognitive status. These results suggest that increased access to and utilization of care may ameliorate traditional disparate rates of cognitive decline between rural- and urban-dwelling older adults. Moreover, behavioral health screenings in primary geriatrics clinic care may help identify patient cognitive needs and facilitate integrated care through combined medical, pharmacological, and behavioral interventions to promote positive cognitive health outcomes.

scholarly journals Effects of Caregiver Interventions for Informal Caregivers of Older Adults With Cognitive Decline

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 647-647
Author(s):  
Machiko Tomita
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Classification Accuracy ◽  
Informal Caregivers ◽  
Cognitive Status ◽  
Process Data ◽  
Physical Strain ◽  
Caregiver Support ◽  
Baseline Factors ◽  
Process Factors

Abstract Objectives To identify baseline factors and process factors, which indicate changes that are associated with caregiving confidence improvement attributed to caregiver support. Methods An intervention study using 35 informal caregivers (ICG) of older adults (≥65 years old) with cognitive decline. Recipients of ICGs belonged to the Programs of All Inclusive Care for the Elderly (PACE). Interventions were occupational therapy (OT) support or education about illness and effective caregiving methods, which took place in ICGs’ homes. OT interventions included training to reduce physical strain, and improve time and task organizations, and providing assistive devices). Caregiver confidence was measured using a Visual Analog Scale. Data were divided into two groups: improved confidence and decreased/no-change confidence. Eleven baseline data of care recipients (CRs) and ICGs as well as five process data were analyzed using logistic regression. Results Baseline factors that differentiated the two groups were ICG’s age, caregiving confidence level, and CR’s cognitive status, of which classification accuracy was 94.3%. Only Zarit Buren Interview (ZBI) score was associated with caregiving confidence change, of which classification accuracy was 74.3%. Younger ICGs, lower cognition, and lower caregiving confidence among baseline factors, and improved ZBI among the process factors were associated with improved confidence. Discussion Although our interventions prevented 65.7% of caregivers form declining their caregiving confidence, improving caregiving confidence was difficult while CRs’ cognition continued to decline. However, this positive change was possible even CRs had moderate dementia, on average. Personal interventions may be necessary to improve caregiving confidence and reduce ICG’s burden.

scholarly journals Face Masks Protect From Infection but May Impair Social Cognition in Older Adults and People With Dementia

2021 ◽  
Vol 12 ◽  
Author(s):  
Matthias L. Schroeter ◽  
Jana Kynast ◽  
Arno Villringer ◽  
Simon Baron-Cohen
Keyword(s):  
Older Adults ◽  
Social Cognition ◽  
Cognitive Decline ◽  
Emotion Recognition ◽  
Mental States ◽  
High Impact ◽  
Compensatory Strategies ◽  
People With Dementia ◽  
Long Run ◽  
The Face

The coronavirus disease 2019 (COVID-19) pandemic will have a high impact on older adults and people with Alzheimer's disease and other dementias. Social cognition enables the understanding of another individual's feelings, intentions, desires and mental states, which is particularly important during the COVID-19 pandemic. To prevent further spread of the disease face masks have been recommended. Although justified for prevention of this potentially devastating disease, they partly cover the face and hamper emotion recognition and probably mindreading. As social cognition is already affected by aging and dementia, strategies must be developed to cope with these profound changes of communication. Face masking even could accelerate cognitive decline in the long run. Further studies are of uppermost importance to address face masks' impact on social cognition in aging and dementia, for instance by longitudinally investigating decline before and in the pandemic, and to design compensatory strategies. These issues are also relevant for face masking in general, such as in medical surroundings—beyond the COVID-19 pandemic.

Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

2018 ◽  
Vol 45 (3-4) ◽  
pp. 190-197 ◽  
Author(s):  
Andreas Ihle ◽  
Michel Oris ◽  
Julia Sauter ◽  
Ulrike Rimmele ◽  
Matthias Kliegel
Keyword(s):  
Older Adults ◽  
Social Capital ◽  
Cognitive Performance ◽  
Old Age ◽  
Psychological Stress ◽  
Processing Speed ◽  
Cognitive Reserve ◽  
Leisure Activities ◽  
Cognitive Level ◽  
Verbal Abilities

Aims: The present study set out to investigate the relation of psychological stress to cognitive performance and its interplay with key life course markers of cognitive reserve and social capital in a large sample of older adults. Methods: We assessed cognitive performance (verbal abilities and processing speed) and psychological stress in 2,812 older adults. The Participants reported information on education, occupation, leisure activities, family, and close friends. Results: Greater psychological stress was significantly related to lower performance in verbal abilities and processing speed. Moderation analyses suggested that the relations of psychological stress to cognitive performance were reduced in individuals with higher education, a higher cognitive level of the first profession practiced after education, a larger number of midlife leisure activities, a larger number of significant family members, and a larger number of close friends. Conclusion: Cognitive reserve and social capital accrued in early and midlife may reduce the detrimental influences of psychological stress on cognitive functioning in old age.

scholarly journals Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
R. Boyle ◽  
S. P. Knight ◽  
C. De Looze ◽  
D. Carey ◽  
S. Scarlett ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Function ◽  
Brain Structure ◽  
Cognitive Reserve ◽  
Cognitive Outcome ◽  
Verbal Intelligence ◽  
Cross Sectional ◽  
Healthy Older Adults ◽  
Occupational Complexity

Abstract Background Cognitive reserve is most commonly measured using socio-behavioural proxy variables. These variables are easy to collect, have a straightforward interpretation, and are widely associated with reduced risk of dementia and cognitive decline in epidemiological studies. However, the specific proxies vary across studies and have rarely been assessed in complete models of cognitive reserve (i.e. alongside both a measure of cognitive outcome and a measure of brain structure). Complete models can test independent associations between proxies and cognitive function in addition to the moderation effect of proxies on the brain-cognition relationship. Consequently, there is insufficient empirical evidence guiding the choice of proxy measures of cognitive reserve and poor comparability across studies. Method In a cross-sectional study, we assessed the validity of 5 common proxies (education, occupational complexity, verbal intelligence, leisure activities, and exercise) and all possible combinations of these proxies in 2 separate community-dwelling older adult cohorts: The Irish Longitudinal Study on Ageing (TILDA; N = 313, mean age = 68.9 years, range = 54–88) and the Cognitive Reserve/Reference Ability Neural Network Study (CR/RANN; N = 234, mean age = 64.49 years, range = 50–80). Fifteen models were created with 3 brain structure variables (grey matter volume, hippocampal volume, and mean cortical thickness) and 5 cognitive variables (verbal fluency, processing speed, executive function, episodic memory, and global cognition). Results No moderation effects were observed. There were robust positive associations with cognitive function, independent of brain structure, for 2 individual proxies (verbal intelligence and education) and 16 composites (i.e. combinations of proxies). Verbal intelligence was statistically significant in all models. Education was significant only in models with executive function as the cognitive outcome variable. Three robust composites were observed in more than two-thirds of brain-cognition models: the composites of (1) occupational complexity and verbal intelligence, (2) education and verbal intelligence, and (3) education, occupational complexity, and verbal intelligence. However, no composite had larger average effects nor was more robust than verbal intelligence alone. Conclusion These results support the use of verbal intelligence as a proxy measure of CR in cross-sectional studies of cognitively healthy older adults.

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