A-09 Concussion History May Accelerate Cognitive Decline in Older Adults

Abstract Objective Concussion is a common occurrence among older adults, stemming largely from falls. Evidence suggests that history of moderate–severe traumatic brain injury (TBI) increases risk for cognitive decline and dementia; however, long-term outcomes associated with concussion remain unclear. This study aims to investigate longitudinal cognitive change among older adults with self-reported concussion history (CH). Method Older adults (n = 39) enrolled in an observational, longitudinal study by the Center for Neurodegeneration and Translational Neuroscience diagnosed with mild cognitive impairment or Alzheimer’s disease were studied, including 14 with CH. Participants completed baseline and one-year follow-up testing, including the Montreal Cognitive Assessment (MoCA). Repeated measures ANCOVA with age and education covariates assessed change in MoCA Total Scores from baseline to follow-up based on CH. Results Main effects for age, education, time, and CH were not significant; however, significant interaction for CH by time was revealed, F(1,34) = 4.46, p < .05 such that those with CH demonstrated significantly greater decline from baseline to follow-up than those without CH (p < .05). In the CH group, change over time was associated with an effect size of 1.20 (Cohen’s d) compared to an effect size of 0.22 in the non-CH group. Conclusions History of concussion may lead to accelerated rate of cognitive decline in those diagnosed with MCI and AD over a 1-year period, which is consistent with prior research in moderate–severe TBI. These results preliminarily support the notion that concussion may be associated with significantly worse cognitive outcomes among older adults. Confirmation of our findings in larger samples and prospective validation of the observation are warranted.

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Cognitive decline and alcohol consumption adjusting for functional status over a 3-year period in French speaking community living older adults

Journal of Public Health ◽

10.1093/pubmed/fdy126 ◽

2018 ◽

Vol 41 (2) ◽

pp. e177-e184 ◽

Cited By ~ 1

Author(s):

Helen-Maria Vasiliadis ◽

Marie-Christine Payette ◽

Djamal Berbiche ◽

Sébastien Grenier ◽

Carol Hudon

Keyword(s):

Older Adults ◽

Alcohol Consumption ◽

Cognitive Decline ◽

Functional Status ◽

Repeated Measures ◽

Service Use ◽

High Functioning ◽

French Speaking ◽

Changing Patterns

AbstractBackgroundThe effect of alcohol consumption on cognitive decline is not clear. We aimed to study the association between alcohol consumption and cognitive functioning controlling for functional heath status.MethodsA total of 1610 older adults with a score ≥26 on the Mini-Mental State Examination (MMSE) were followed to assess the change in scores at the 3-year follow-up. Information on alcohol consumption as well as socio-demographic, lifestyle, psychosocial and clinical factors, as well as health service use were assessed at baseline and 3-year follow-up interviews. Linear mixed models with repeated measures were used stratifying by functional status.ResultsClose to 73% reported consuming alcohol in the past 6 months, of which 11% were heavy drinkers (≥11 and ≥16 drinks for women and men). A significant decrease in MMSE scores was observed in low functioning non-drinkers (−1.48; 95% CI: −2.06, −0.89) and light to moderate drinkers (−0.99; 95% CI: −1.54, −0.44) and high functioning non-drinkers (−0.51; 95% CI: −0.91, −0.10).ConclusionsAlcohol consumption did not contribute to cognitive decline. Cognitive decline was greater in individuals reporting low functional status. Research should focus on the interaction between changing patterns of alcohol consumption and social participation in individuals with low and high functioning status.

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1137 Sleep Duration, Physical Activity And Cognitive Decline In Chinese Older Adults: Findings From The CHARLS

SLEEP ◽

10.1093/sleep/zsaa056.1131 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A433-A433

Author(s):

J Li ◽

A J Alfini ◽

F Yu ◽

J A Schrack ◽

V Cotter ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cognitive Decline ◽

Sleep Duration ◽

Community Dwelling ◽

Cognitive Outcomes ◽

Short Sleep Duration ◽

Short Sleep ◽

Long Sleep

Abstract Introduction Lack of physical activity and disturbed sleep have been linked to older adult’s poor cognitive outcomes; however, little is unknown how they interact to affect cognition long-term. The purpose of this study was to examine the association of baseline sleep duration and physical activity (PA) with change in cognition independently and interactively over four years. Methods The sample included 1126 community-dwelling older adults aged 60+ (mean age 67.1±5.9 years, 51% female) from the 2011 baseline and 2015 follow-up data of the China Health and Retirement Longitudinal Study (CHARLS). All variables were assessed through interviews. Sleep duration was measured with hours per 30-minute interval and categorized as very-short (<5h), short (5-6.5h), normal (7-8.5h), and long (≥9h). PA was calculated based on PA intensity, duration, and number of days. Cognition was a composite score of mental capacity, episodic memory, and visuospatial abilities. Data were analyzed using multiple regression (primary outcome: change in cognition; main independent variables: baseline sleep, PA, and sleep PA interaction). Results At baseline, 19% of participants had very-short sleep duration, 34.4% had short sleep, 39.2% had normal sleep, and 7.2% had long sleep. At follow-up, 57.5% of participants experienced cognitive decline (-3.5±2.5). After controlling for age, gender, education, region, body mass index, smoking, drinking, number of chronic conditions, pain, depression, and cognition at baseline, compared to participants reporting 7-8.5h sleep, those with ≥9h sleep had significantly greater decline in cognition [β=-1.4, 95% CI=2.4, -0.4], while those with <5h sleep [β=-0.5, 95% CI=-1.2, 0.2] and 5-6.5h sleep did not [β=-0.1, 95% CI=-0.7, 0.5]. PA was neither associated with cognitive decline, nor moderated the relationship between sleep duration and cognitive decline. Conclusion Long sleep might be a marker of cognitive decline in older adults. Prospective analysis, using objectively measured PA and sleep should be conducted to further examine these associations. Support National Institute of Nursing Research R00NR016484

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Associations Among Personality Traits, Stress Experiences, and Physical and Cognitive Outcomes in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.034 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 9-9

Author(s):

Eileen Graham ◽

David Almeida

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Personality Traits ◽

Perceived Stress ◽

Cognitive Change ◽

Cognitive Outcomes ◽

Key Factors ◽

Cognitive Health ◽

Novel Approach ◽

New Findings

Abstract Understanding between and within person variability in personality traits, and the processes of general and perceived stress are essential to understanding how to optimize cognitive health in older adults. It is well known that there is large variation in cognitive change: the pace and direction of change differs greatly across individuals. Personality traits and stress experiences are key factors that may account for some of these individual differences. The goal of our symposium is to present novel research in this area and discuss the implications for understanding personality, stress, and cognitive decline. First, Ferguson and colleagues will present a novel approach to assessing daily variability in personality. Their results demonstrate that daily personality assessments are able to capture within-person variability in personality, which could potentially help predict health trajectories in later adulthood. This is an important step in the study of change processes. Second, Luo and colleagues will present the factor structure of general and perceived stress, and show the predictive utility of these factors on physical and cognitive health outcomes. Third, Lawson and colleagues will discuss the extent to which personality is associated with cognitive function in a large sample of Mexican-origin adults. Fourth, Graham and colleagues will present results from a coordinated analysis that addressed associations among personality traits and cognitive decline both pre- and post- dementia diagnosis. Discussant David Almeida will contextualize these new findings and propose next steps.

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Latent Cognitive Class at Enrollment Predicts Future Cognitive Trajectories of Decline in a Community Sample of Older Adults

Journal of Alzheimer s Disease ◽

10.3233/jad-210484 ◽

2021 ◽

pp. 1-12

Author(s):

Andrea R. Zammit ◽

Jingyun Yang ◽

Aron S. Buchman ◽

Sue E. Leurgans ◽

Graciela Muniz-Terrera ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Latent Variable ◽

Community Sample ◽

Cognitive Change ◽

Cognitive Profiles ◽

Longitudinal Trajectories ◽

Variable Approach ◽

Latent Variable Methods

Background: Methods that can identify subgroups with different trajectories of cognitive decline are crucial for isolating the biologic mechanisms which underlie these groupings. Objective: This study grouped older adults based on their baseline cognitive profiles using a latent variable approach and tested the hypothesis that these groups would differ in their subsequent trajectories of cognitive change. Methods: In this study we applied time-varying effects models (TVEMs) to examine the longitudinal trajectories of cognitive decline across different subgroups of older adults in the Rush Memory and Aging Project. Results: A total of 1,662 individuals (mean age = 79.6 years, SD = 7.4, 75.4%female) participated in the study; these were categorized into five previously identified classes of older adults differing in their baseline cognitive profiles: Superior Cognition (n = 328, 19.7%), Average Cognition (n = 767, 46.1%), Mixed-Domains Impairment (n = 71, 4.3%), Memory-Specific Impairment (n = 274, 16.5%), and Frontal Impairment (n = 222, 13.4%). Differences in the trajectories of cognition for these five classes persisted during 8 years of follow-up. Compared with the Average Cognition class, The Mixed-Domains and Memory-Specific Impairment classes showed steeper rates of decline, while other classes showed moderate declines. Conclusion: Baseline cognitive classes of older adults derived through the use of latent variable methods were associated with distinct longitudinal trajectories of cognitive decline that did not converge during an average of 8 years of follow-up.

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High education accelerates cognitive decline in dementia: A brief report from the population-based NEDICES cohort

Dementia & Neuropsychologia ◽

10.1590/1980-57642016dn11-030012 ◽

2017 ◽

Vol 11 (3) ◽

pp. 297-300 ◽

Cited By ~ 4

Author(s):

Israel Contador ◽

Félix Bermejo-Pareja ◽

D. Lora Pablos ◽

Alberto Villarejo ◽

Julián Benito-León

Keyword(s):

Older Adults ◽

Cohort Study ◽

High Education ◽

Cognitive Decline ◽

Effect Size ◽

Educational Level ◽

Total Sample ◽

Population Based ◽

Low Educated

ABSTRACT High education has been associated with faster cognitive decline after diagnosis of Alzheimer's disease (AD), but it is unclear whether these findings extend to other dementia subtypes. OBJECTIVE: We investigated whether educational attainment influences the cognitive trajectories of older adults with different dementia subtypes. METHODS: All participants were selected from NEDICES, a prospective population-based cohort study of Spanish older adults. A total sample of 53 individuals with dementia completed the MMSE-37 at Times 1 and 2 (mean follow-up=2.8±0.5 years) to assess cognitive decline. RESULTS: At follow-up, MMSE-37 scores had decreased by 3.34±4.98 points in low-educated individuals with dementia versus 7.90±4.88 points in high-educated subjects (effect size (r)=0.32, p=0.02). CONCLUSION: Educational level influenced the cognitive trajectories of patients with dementia assessed by the MMSE-37.

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Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽

10.1024/0301-1526/a000023 ◽

2010 ◽

Vol 39 (2) ◽

pp. 169-174 ◽

Cited By ~ 7

Author(s):

Reich-Schupke ◽

Weyer ◽

Altmeyer ◽

Stücker

Keyword(s):

Scientific Evidence ◽

Daily Practice ◽

Severe Adverse Effect ◽

Safe Procedure ◽

Efficacy And Safety ◽

Foam Sclerotherapy ◽

History Of ◽

One Year ◽

Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

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Neuropsychological Effects of Cybercycling for Older Adults: One-Year Follow-Up

PsycEXTRA Dataset ◽

10.1037/e640972010-001 ◽

2010 ◽

Author(s):

Cay Anderson-Hanley ◽

Paul Arciero ◽

Joseph Nimon ◽

Vadim Yerkohin ◽

Veronica Hopkins ◽

...

Keyword(s):

Older Adults ◽

Neuropsychological Effects ◽

One Year

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Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

Psychological Medicine ◽

10.1017/s0033291720001026 ◽

2021 ◽

pp. 1-8

Author(s):

Bin Yu ◽

Andrew Steptoe ◽

Yongjie Chen ◽

Xiaohua Jia

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Cognitive Function ◽

Episodic Memory ◽

Cognitive Decline ◽

Social Isolation ◽

Mental Status ◽

Chinese Older Adults ◽

Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

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Impact of atrial fibrillation pattern on outcomes after left atrial appendage closure: lessons from the prospective LAARGE registry

Clinical Research in Cardiology ◽

10.1007/s00392-021-01874-3 ◽

2021 ◽

Author(s):

Shinwan Kany ◽

Johannes Brachmann ◽

Thorsten Lewalter ◽

Ibrahim Akin ◽

Horst Sievert ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial Appendage ◽

Systemic Embolism ◽

Long Term Outcomes ◽

Increased Risk ◽

History Of ◽

One Year ◽

The One

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract

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Effectiveness of a Modified Version of Airflow Therapy

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.4702.160 ◽

1982 ◽

Vol 47 (2) ◽

pp. 160-164

Author(s):

Glenn L. Falkowski ◽

Arthur M. Guilford ◽

Jack Sandler

Keyword(s):

Success Rate ◽

Scientific Literature ◽

Future Research ◽

Relative Importance ◽

Differential Effectiveness ◽

History Of ◽

One Year ◽

Main Components

Utilizing airflow therapy, Schwartz (1976) has claimed an 89% success rate with stutterers following treatment and an 83% success rate at one year follow-up. Such claims have yet to be documented in the scientific literature. The purposes of this study were: (a) to investigate the effectiveness of a modified version of airflow therapy; (b) to examine the relative importance of its two main components—passive airflow and elongation of the first vowel spoken. The speech of two adult male stutterers with a lengthy history of stuttering, was assessed with spontaneous speaking and reading tasks. Results indicated marked improvement in both subjects' speech on the reading task was maintained at follow-up 10 weeks later. For spontaneous speech, results were generally weaker and less durable. Effects of the two treatment components were cumulative and did not allow determination of any differential effectiveness between components. Implications of these findings were considered and directions for future research discussed.

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