Relative Trajectories of Gait and Cognitive Decline in Aging

2021 ◽  
Author(s):  
Oshadi Jayakody ◽  
Monique Breslin ◽  
Emmeline Ayers ◽  
Joe Verghese ◽  
Nir Barzilai ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Sex Education ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Cognitive Test ◽  
Language Functions ◽  
Cognitive Risk ◽  
Study Participants ◽  
Aging People ◽  
Jewish Descent

Abstract Background Gait and cognition decline with advancing age, and presage the onset of dementia. Yet, the relative trajectories of gait and cognitive decline in aging are poorly understood – particularly among those with the Motoric Cognitive Risk (MCR) syndrome. This study compared changes in simple and complex gait performance and cognition, as a function of age and MCR. Methods We examined gait and cognitive functions of 1,095 LonGenity study participants (mean age = 75.4±6.7 years) with up to 12 years of annual follow-up. Participants were of Ashkenazi Jewish descent, free of dementia, ambulatory, and had a 12.2 % MCR prevalence at baseline. Gait speed was measured at usual pace walking (single-task walking, STW-speed) and walking while talking (WWT-speed). Eleven neuropsychological test scores were examined separately, and as a global cognition composite. Linear mixed-effects models adjusted for baseline sex, education, parental longevity, cognitive impairment and global health were used to estimate changes in gait and cognition, as a function of age and MCR. Results STW-speed, WWT-speed, and cognitive tests performance declined in a non-linear (accelerating) fashion with age. STW-speed declined faster than WWT-speed and cognitive test scores. People with MCR showed faster rates of decline on figure copy and phonemic fluency. Conclusions Gait declines at a faster rate than cognition in aging. People with MCR are susceptible to faster decline in visuospatial, executive, and language functions. This study adds important knowledge of trajectories of gait and cognitive decline in aging, and identifies MCR as a risk factor for accelerated cognitive decline.

scholarly journals Digital Technology Differentiates Graphomotor and Information Processing Speed Patterns of Behavior

2021 ◽  
Vol 82 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Stacy L. Andersen ◽  
Benjamin Sweigart ◽  
Nancy W. Glynn ◽  
Mary K. Wojczynski ◽  
Bharat Thyagarajan ◽  
...  
Keyword(s):  
Information Processing ◽  
Physical Function ◽  
Digital Technology ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Apoe Genotype ◽  
Digital Data ◽  
Cognitive Test ◽  
Digit Symbol Substitution Test ◽  
Information Processing Speed

Background: Coupling digital technology with traditional neuropsychological test performance allows collection of high-precision metrics that can clarify and/or define underlying constructs related to brain and cognition. Objective: To identify graphomotor and information processing trajectories using a digitally administered version of the Digit Symbol Substitution Test (DSST). Methods: A subset of Long Life Family Study participants (n = 1,594) completed the DSST. Total time to draw each symbol was divided into ‘writing’ and non-writing or ‘thinking’ time. Bayesian clustering grouped participants by change in median time over intervals of eight consecutively drawn symbols across the 90 s test. Clusters were characterized based on sociodemographic characteristics, health and physical function data, APOE genotype, and neuropsychological test scores. Results: Clustering revealed four ‘thinking’ time trajectories, with two clusters showing significant changes within the test. Participants in these clusters obtained lower episodic memory scores but were similar in other health and functional characteristics. Clustering of ‘writing’ time also revealed four performance trajectories where one cluster of participants showed progressively slower writing time. These participants had weaker grip strength, slower gait speed, and greater perceived physical fatigability, but no differences in cognitive test scores. Conclusion: Digital data identified previously unrecognized patterns of ‘writing’ and ‘thinking’ time that cannot be detected without digital technology. These patterns of performance were differentially associated with measures of cognitive and physical function and may constitute specific neurocognitive biomarkers signaling the presence of subtle to mild dysfunction. Such information could inform the selection and timing of in-depth neuropsychological assessments and help target interventions.

scholarly journals Nutritional Status and Its Association with Cognitive Function among School Aged Children at Soddo Town and Soddo Zuriya District, Southern Ethiopia: Institution Based Comparative Study

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110281
Author(s):  
Tesfaye Honja Kabero ◽  
Tafese Bosha ◽  
Fentaw Wassie Feleke ◽  
Demewoz Haile Weldegebreal ◽  
Barbara Stoecker
Keyword(s):  
Cognitive Function ◽  
Nutritional Status ◽  
School Performance ◽  
School Children ◽  
Test Scores ◽  
Primary School Children ◽  
Cognitive Test ◽  
Southern Ethiopia ◽  
School Aged Children ◽  
Study Participants

About 1 billion stunted school-aged children are growing up with impaired mental development which can lead to low cognitive performance, reduced school achievement, and low productivity. But there is scarce evidence on cognitive function, school performance and their associated factors among school aged children. The main aim of this study was to assess cognitive function, school performance and determine their association with nutritional status among school children aged 7 to 10 years at Soddo Town and Soddo Zuriya Woreda, Wolaita Zone, Southern Ethiopia. Institutional comparative cross-sectional study was conducted on a total sample of 178 primary school children. The Raven’s Color Progressive Matrices (RCPM) and selected tests from Kaufman assessment battery for children second edition were used. Mid-year average students’ examination result was also used. Data were analyzed by using SPSS version 25, WHO Anthro plus, and independent sample t-test. Bivariate and multivariate linear regression analyses were also used. Mean (±SD) cognitive test scores of urban study participants was 18.7 ± 3.4 for RCPM which was higher ( P < .001) as compared to rural (16.5 ± 3.3). The urban mean cognitive test scores was also higher for both pattern reasoning and visual processing with ( P < .001) as compared to rural counterparts. School performance was higher ( P < .001) for urban. Maternal education ( P < .002) and wealth index ( P < .006) were positively predicted while stunting ( P < .001) negatively predicted cognitive function test scores and school performance. Cognitive function and school performance of study participants were associated with their nutritional status and rural participants had significantly lower mean scores as compared to urban counterparts. Further study should be done to community level.

scholarly journals Single Neuropsychological Test Scores Associated With Rate of Cognitive Decline in Early Alzheimer Disease

2014 ◽  
Vol 28 (6) ◽  
pp. 926-940 ◽  
Author(s):  
Mili Parikh ◽  
Linda S. Hynan ◽  
Myron F. Weiner ◽  
Laura Lacritz ◽  
Wendy Ringe ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Cognitive Decline ◽  
Test Scores ◽  
Neuropsychological Test

Associations between Visual Acuity and Cognitive Decline in Older Adulthood: A 9-Year Longitudinal Study

2021 ◽  
pp. 1-11
Author(s):  
Ashlyn Runk ◽  
Yichen Jia ◽  
Anran Liu ◽  
Chung-Chou H. Chang ◽  
Mary Ganguli ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Risk Factor ◽  
Cognitive Decline ◽  
Test Performance ◽  
Cognitive Abilities ◽  
Neuropsychological Test ◽  
Joint Modeling ◽  
Modifiable Risk Factor ◽  
Cognitive Test ◽  
Cognitive Test Performance

Abstract Objective: Emerging evidence suggests low vision may be a modifiable risk factor for cognitive decline. We examined effects of baseline visual acuity (VA) on level of, and change in, cognitive test performance over 9 years. Method: A population-based sample of 1,621 participants (average age 77 years) completed a comprehensive neuropsychological evaluation and VA testing at baseline and reassessed at nine subsequent annual visits. Linear regression modeled the association between baseline VA and concurrent cognitive test performance. Joint modeling of a longitudinal sub-model and a survival sub-model to adjust for attrition were used to examine associations between baseline VA and repeated cognitive test performance over time. Results: Better baseline VA was associated cross-sectionally with younger age, male sex, greater than high school education, and higher baseline neuropsychological test scores on both vision-dependent (B coefficient range −0.163 to −0.375, p = .006 to <.001) and vision-independent tests (−0.187 to −0.215, p = .003 to .002). In longitudinal modeling, better baseline VA was associated with slower decline in vision-dependent tests (B coefficient range −0.092 to 0.111, p = .005 to <.001) and vision-independent tests (−0.107 to 0.067, p = .007 to <.001). Conclusions: Higher VA is associated with higher concurrent cognitive abilities and slower rates of decline over 9 years in both vision-dependent and vision-independent tests of memory, language, and executive functioning. Findings are consistent with emerging literature supporting vision impairment in aging as a potentially modifiable risk factor for cognitive decline. Clinicians should encourage patient utilization of vision assessment and correction with the added aim of protecting cognition.

scholarly journals Predicting Progression & Cognitive Decline in Amyloid-Positive Patients with Alzheimer's Disease

2021 ◽  
Author(s):  
Hákon Valur Dansson ◽  
Lena Stempfle ◽  
Hildur Egilsdóttir ◽  
Alexander Schliep ◽  
Erik Portelius ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Disease Progression ◽  
Test Scores ◽  
Amyloid Β ◽  
Cognitive Test ◽  
Progression Rate ◽  
Specific Level ◽  
Clinical Variables

Abstract BackgroundIn Alzheimer’s disease (AD), amyloid- β (Aβ) peptides aggregate in the brain forming amyloid plaques, which are a key pathological hallmark of the disease. However, plaques may also be present in cognitively unimpaired elderly individuals. Therefore, it is of great value to explain the variance in disease progression among patients with Aβ pathology. MethodsA cohort of n= 2293 participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database was selected to study heterogeneity in disease progression for individuals with Aβ plaque pathology. The analysis used baseline clinical variables including demographics, genetic markers and neuropsychological data to predict how the cognitive ability and AD diagnosis of subjects progressed using statistical models and machine learning. Due to the limited prevalence of Aβ pathology, models fit only to Aβ-positive subjects were compared to models fit to an extended cohort including subjects without established Aβ pathology, adjusting for covariate differences between the cohorts. ResultsAβ pathology status was determined based the Aβ 42 /Aβ 40 ratio. The best predictive model of change in cognitive test scores for Aβ-positive subjects at the two-year follow-up achieved an R 2 score of 0.388 while the best model predicting adverse changes in diagnosis achieved a weighted F1 score of 0.791. Conforming to expectations, Aβ-positive subjects declined faster on average than those without Aβ pathology, but the specific level of Aβ plaques was not predictive of progression rate. For the four-year prediction task of cognitive score change, the best model achieved an R 2 score of 0.325 and it was found that fitting models to the extended cohort substantially improved performance. Moreover, using all clinical variables outperformed the best model based only on baseline cognitive test scores which achieved an R 2 score of 0.228. ConclusionOur analysis shows that levels of Aβ plaques are not strong predictors of the rate of cognitive decline in Aβ-positive subjects. Baseline assessments of cognitive function accounts for the majority of variance explained in the prediction of two-year decline but is insufficient for achieving optimal results in longer-term predictions. Predicting changes both in cognitive test scores and in diagnosis provides multiple perspectives of the progression of potential AD subjects.

scholarly journals Chronic kidney disease biomarkers, cognitive impairment and incident dementia in an older healthy cohort

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0005672021
Author(s):  
Anne M. Murray ◽  
Le Thi Phuong Thao ◽  
Joanne Ryan ◽  
Rory Wolfe ◽  
James B. Wetmore ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Cognitive Decline ◽  
Test Scores ◽  
Older Persons ◽  
Cognitive Test ◽  
Cognitive Tests ◽  
Incident Dementia ◽  
Increased Risk

Background: Chronic kidney disease is a risk factor for cognitive impairment (CI),but reports of individual associations of estimated glomerular filtration rate (eGFR) and albuminuria with CI and incident dementia in healthier older longitudinal populations are lacking. Our goal was to estimate these associations in a large cohort of older healthy persons. Methods: In a longitudinal cohort study of older persons without prior cardiovascular disease, we estimated the associations between baseline eGFR (in mL/min per 1.73 m2) and albuminuria, measured as urine albumin-to-creatinine ratio (UACR, in mg/mmol) and cognitive test scores, declines in cognitive test scores and incident dementia, using adjusted linear and linear mixed models. Cox proportional hazards regression models assessed the association between baseline kidney function and incident CI no dementia (CIND) or dementia at a median of 4.7 years. Results: At baseline, among 18,131 participants, median age was 74 years, eGFR 74 (IQR 63, 84), UACR 0.8 (IQR 0.5, 1.5; (7.1 (4.4- 13.3 mg/g and 56% were female. Baseline eGFR was not associated with performance on any cognitive tests in cross-sectional analysis, nor incident CIND or dementia over median follow-up of 4.7 years. However, baseline UACR ≥ 3 (≥ 26.6 mg/g) was significantly associated with lower baseline scores and larger declines on the Modified Mini Mental State Exam, verbal memory and processing speed tests, and with incident CIND [(hazard ratio, HR, 1.19; 95% confidence interval, CI,1.07 - 1.33)] and dementia (HR 1.32;1.06 - 1.66). Conclusion: Mild albuminuria was associated with worse baseline cognitive function, cognitive decline, and increased risk for incident CIND and dementia. Screening global cognitive tests for older persons with UACR ≥ 3 mg/mmol could identify those at elevated risk of cognitive decline and dementia.

scholarly journals Cognitive profile of mild behavioral impairment in Brain Health Registry participants

2021 ◽  
Author(s):  
Farzeen Kassam ◽  
Hung-Yu Chen ◽  
Rachel L Nosheny ◽  
Alexander McGirr ◽  
Tirzah Williams ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Test Performance ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Behavioral Assessment ◽  
Cognitive Test ◽  
Brain Health ◽  
Behavioral Impairment ◽  
Cognitive Test Performance ◽  
Health Registry

INTRODUCTION: Dementia assessment includes cognitive and behavioral testing with informant validation. Conventional testing is resource intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. We interrogated the relationship between informant-rated behavioral changes and neuropsychological test performance in older adults in the Brain Health Registry. METHODS: Participants completed online unsupervised cognitive tests, and informants completed the Mild Behavioral Impairment Checklist via a Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity. RESULTS: Mean age of the 499 participants was 67, 61% of which were female. MBI+ participants had lower working memory and executive function test scores. Lower cognitive test scores associated with greater MBI burden. DISCUSSION: Our findings support the feasibility of remote, informant-reported behavioral assessment and support its validity by demonstrating a relationship to cognitive test performance using online unsupervised assessments for dementia risk assessment.

Abstract 95: Nutrition and Cognitive Decline Over 21-years: Results from the Atherosclerosis Risk in Communities Study (ARIC)

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jennifer L Dearborn ◽  
Aozhou Wu ◽  
Lyn M Steffen ◽  
David S Knopman ◽  
Thomas H Mosley ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Test Scores ◽  
Population Based ◽  
Word Recall ◽  
Cognitive Test ◽  
Z Score ◽  
Balanced Diet ◽  
Diet Pattern

Background: A healthy diet may be protective against cognitive decline by mechanisms that involve improved vascular risk factors such as hypertension and dysglycemia, and reduced systemic inflammation. In this population-based study, we hypothesized that midlife diet pattern would be associated with cognitive decline over 21-years. Methods: This study included 13,603 participants in the ARIC population-based cohort recruited from four U.S. sites who were aged 45 to 64 at baseline (1987-89) when diet was measured. Participants recorded diet using a 66-item food frequency questionnaire. Two dietary patterns, called “Meat and Fried” and the “Balanced Diet”, were named after the most representative foods that emerged from constructs derived from a principal component analysis of 30 food groups. A higher diet pattern score represented greater adherence. Cognitive testing, including the digit symbol substitution, the word fluency and delayed word recall tests, were combined to a z-score at each visit (visits 2, 1990-92; 4, 1996-98 and 5, 2011-2013). Test scores for participants not attending subsequent visits were imputed using Multiple Imputation by Chained Equations to account for cohort attrition. Cognitive performance at visit 2 was compared by tertile (T) of each diet pattern. Using mixed effects models with a random slope and intercept , we determined the 21-year change in cognitive function by diet pattern tertile, adjusting for demographics and medical history. Results: At visit 2, adherence to the Meat and Fried pattern was associated with lower cognitive test scores (z-score T3: -0.172, SD 0.985; T1: 0.149, SD 0.981, p-trend <0.001). Adherence to the Balanced Diet was not associated with differences in cognitive performance (z-score T3: 0.013, SD 0.988; T1 -0.036, SD 1.001, p-trend 0.10). 21-year change in cognitive function did not differ by adherence to diet pattern with adjustments (difference of the change in z-score for Meat and Fried, T3 vs. T1: 0.02, [CI -0.05 to 0.08]; Balanced Diet T3 vs. T1: -0.03, [CI -0.09 to 0.02]). Conclusion: Although participants with a diet pattern high in meat and fried foods had lower cognition at time of first assessment, diet patterns at midlife did not carry independent associations with cognitive decline.

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