scholarly journals Associations of Brain Pathology Cognitive and Physical Markers With Age in Cognitively Normal Individuals Aged 60–102 Years

2019 ◽  
Vol 75 (9) ◽  
pp. 1609-1617 ◽  
Author(s):  
Nienke Legdeur ◽  
Betty M Tijms ◽  
Elles Konijnenberg ◽  
Anouk den Braber ◽  
Mara ten Kate ◽  
...  
Keyword(s):  
Handgrip Strength ◽  
Hippocampal Volume ◽  
Digit Symbol Substitution Test ◽  
Brain Pathology ◽  
Amyloid Aggregation ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
Normal Individuals ◽  
Symbol Substitution ◽  
Physical Functions

Abstract The prevalence of brain pathologies increases with age and cognitive and physical functions worsen over the lifetime. It is unclear whether these processes show a similar increase with age. We studied the association of markers for brain pathology cognitive and physical functions with age in 288 cognitively normal individuals aged 60–102 years selected from the cross-sectional EMIF-AD PreclinAD and 90+ Study at the Amsterdam UMC. An abnormal score was consistent with a score below the 5th percentile in the 60- to 70-year-old individuals. Prevalence of abnormal scores was estimated using Generalized Estimating Equations (GEE) models. The prevalence of abnormal handgrip strength, the Digit Symbol Substitution Test, and hippocampal volume showed the fastest increase with age and abnormal MMSE score, muscle mass, and amyloid aggregation the lowest. The increase in prevalence of abnormal markers was partly dependent on sex, level of education, and amyloid aggregation. We did not find a consistent pattern in which markers of brain pathology cognitive and physical processes became abnormal with age.

scholarly journals Sequence of Alzheimer disease biomarker changes in cognitively normal adults

Neurology ◽  
2020 ◽  
Vol 95 (23) ◽  
pp. e3104-e3116
Author(s):  
Jingqin Luo ◽  
Folasade Agboola ◽  
Elizabeth Grant ◽  
Colin L. Masters ◽  
Marilyn S. Albert ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Change Point ◽  
Standardized Uptake Value ◽  
Brain Structures ◽  
Hippocampal Volume ◽  
Cognitive Outcomes ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
Preclinical Ad ◽  
Normal Individuals

ObjectiveTo determine the ordering of changes in Alzheimer disease (AD) biomarkers among cognitively normal individuals.MethodsCross-sectional data, including CSF analytes, molecular imaging of cerebral fibrillar β-amyloid (Aβ) with PET using the [11C] benzothiazole tracer Pittsburgh compound B (PiB), MRI-based brain structures, and clinical/cognitive outcomes harmonized from 8 studies, collectively involving 3,284 cognitively normal individuals 18 to 101 years of age, were analyzed. The age at which each marker exhibited an accelerated change (called the change point) was estimated and compared across the markers.ResultsAccelerated changes in CSF Aβ1-42 (Aβ42) occurred at 48.28 years of age and in Aβ42/Aβ40 ratio at 46.02 years, followed by PiB mean cortical standardized uptake value ratio (SUVR) with a change point at 54.47 years. CSF total tau (Tau) and tau phosphorylated at threonine 181 (Ptau) had a change point at ≈60 years, similar to those for MRI hippocampal volume and cortical thickness. The change point for a cognitive composite occurred at 62.41 years. The change points for CSF Aβ42 and Aβ42/Aβ40 ratio, albeit not significantly different from that for PiB SUVR, occurred significantly earlier than that for CSF Tau, Ptau, MRI markers, and the cognitive composite. Adjusted analyses confirmed that accelerated changes in CSF Tau, Ptau, MRI markers, and the cognitive composite occurred at ages not significantly different from each other.ConclusionsOur findings support the hypothesized early changes of amyloid in preclinical AD and suggest that changes in neuronal injury and neurodegeneration markers occur close in time to cognitive decline.

scholarly journals Alzheimer’s disease neuropathology in the hippocampus and brainstem of people with obstructive sleep apnea

SLEEP ◽  
2020 ◽  
Author(s):  
Jessica E Owen ◽  
Bryndis Benediktsdottir ◽  
Elizabeth Cook ◽  
Isleifur Olafsson ◽  
Thorarinn Gislason ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Memory Deficits ◽  
Hippocampal Volume ◽  
Plaque Burden ◽  
Cognitively Normal ◽  
Normal Individuals ◽  
Obstructive Sleep

Abstract Obstructive sleep apnea (OSA) involves intermittent cessations of breathing during sleep. People with OSA can experience memory deficits and have reduced hippocampal volume; these features are also characteristic of Alzheimer’s disease (AD), where they are accompanied by neurofibrillary tangles (NFTs) and amyloid beta (Aβ) plaques in the hippocampus and brainstem. We have recently shown reduced hippocampal volume to be related to OSA severity, and although OSA may be a risk factor for AD, the hippocampus and brainstems of clinically verified OSA cases have not yet been examined for NFTs and Aβ plaques. The present study used quantitative immunohistochemistry to investigate postmortem hippocampi of 34 people with OSA (18 females, 16 males; mean age 67 years) and brainstems of 24 people with OSA for the presence of NFTs and Aβ plaques. OSA severity was a significant predictor of Aβ plaque burden in the hippocampus after controlling for age, sex, body mass index (BMI), and continuous positive airway pressure (CPAP) use. OSA severity also predicted NFT burden in the hippocampus, but not after controlling for age. Although 71% of brainstems contained NFTs and 21% contained Aβ plaques, their burdens were not correlated with OSA severity. These results indicate that OSA accounts for some of the “cognitively normal” individuals who have been found to have substantial Aβ burdens, and are currently considered to be at a prodromal stage of AD.

scholarly journals Peripheral Insulin Resistance in Cognitively Normal Older Adults Relates to Poorer Performance on a Test for Speed of Processing

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 76-76
Author(s):  
Aaron Smith ◽  
Matthew Taylor ◽  
Jim Backes ◽  
Juleah Littrell ◽  
Caitlin Boeckman ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Older Adults ◽  
Digit Symbol Substitution Test ◽  
Digit Symbol ◽  
Speed Of Processing ◽  
Cognitively Normal ◽  
Peripheral Insulin Resistance ◽  
Digit Symbol Substitution ◽  
Symbol Substitution ◽  
The Relationship

Abstract Objectives Peripheral insulin resistance (IR) and impaired glucose metabolism increases the risk for cognitive decline. However, data looking at peripheral IR's relationship with cognition in cognitively normal adults is limited. This study aimed to assess the relationship between peripheral IR and tests of speed of processing (SOP) in cognitively normal older adults using a novel IR measure. Methods Baseline data from 56 cognitively normal older adults participating in a nutrition intervention study (Nutrition Interventions for Cognitive Enhancement study; NICE study) were analyzed. Fasting blood draws were attained, and peripheral IR was measured using Quest Diagnostics’ Cardio IQ Insulin Resistance Panel (Test Code: 36,509). A cognitive battery was conducted by a trained psychometrician. Z-Scores of the Digit Symbol Substitution Test, Stroop Color, Stroop Word, Stroop Interference, and Stroop Letter Number Sequencing and Crossing-Off tests were combined to give a global SOP score. We constructed ordinary least squares regression models to assess IR's relationships with individual SOP tests and global SOP, including age and education as covariates. Statistical analyses were performed using R (v. 3.6.2; R Foundation, Vienna, Austria). Statistical significance was set at P < 0.05. Results Participants were 77% female and had a mean age of 72.1 ± 4.9 years. Higher IR scores were related to poorer performance on the Digit Symbol Substitution Test (β = −0.26, P = 0.04). IR scores were not related to other individual cognitive tests: Stroop Color (β = −0.17, P = 0.20), Stroop Word (β = −0.19, P = 0.11), Stroop Interference (β = −0.14, P = 0.28), Stroop Letter Number Sequencing (β = 0.03, P = 0.83), Crossing-Off (β = −0.18, P = 0.15), or Global SOP (β = −0.20, P = 0.11). Conclusions There was a relationship between higher IR scores and poorer performance on the Digit Symbol Substitution Test. Although other SOP tests were not significantly correlated with IR scores, directionality of the relationships indicated trend for higher IR being related to lower SOP. Consequently, maintaining insulin sensitivity with healthy lifestyle choices may be important for healthy aging. Future analyses with a larger sample size will be more informative for understanding the relationship between IR and SOP. Funding Sources National Institute on Aging.

scholarly journals Real-World Functioning in Patients With Schizophrenia: Beyond Negative and Cognitive Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
María Paz García-Portilla ◽  
Leticia García-Álvarez ◽  
Leticia González-Blanco ◽  
Francesco Dal Santo ◽  
Teresa Bobes-Bascarán ◽  
...  
Keyword(s):  
Real World ◽  
Ad Hoc ◽  
Social Performance ◽  
Pearson Correlation ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Digit Symbol Substitution Test ◽  
Symptom Scale ◽  
Cross Sectional ◽  
Symbol Substitution

Introduction: Interest in the idea of recovery for certain patients with schizophrenia has been growing over the last decade. Improving symptomatology and functioning is crucial for achieving this. Our study aims to identify those factors that substantially contribute to real-world functioning in these patients.Methods: We carried out a cross-sectional study in stable outpatients with schizophrenia on maintenance antipsychotic monotherapy. Patients: We studied 144 outpatients with schizophrenia (DSM-IV-TR criteria) meeting the following criteria: (1) 18–65 years of age; (2) being clinically stable for at least the previous three months; (3) on maintenance antipsychotic monotherapy (prescriptions ≤ 10 mg olanzapine, ≤200 mg quetiapine, or ≤100 mg levomepromazine as hypnotics were also allowed); and (4) written informed consent. Assessment: We collected information on demographic and clinical variables by using an ad hoc questionnaire. For psychopathology, we employed the Spanish versions of the following psychometric instruments: the Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS-Sp), and the Calgary Depression Scale (CDS). In addition, cognitive domains were assessed using the Verbal Fluency Test (VFT), the Digit Symbol Substitution Test (DSST), and the Trail Making Test, parts A and B (TMT-A and TMT-B). Finally, we employed the Spanish versions of the University of California San Diego Performance-based Skills Assessment (Sp-UPSA) and the Personal and Social Performance (PSP) for assessing functional capacity and real-world functioning, respectively. Statistical analysis: A forward stepwise regression was conducted by entering those variables significantly associated with PSP total score into the univariate analyses (Student's t-test, ANOVA with Duncan's post-hoc test, or bivariate Pearson correlation).Results: A total of 144 patients; mean age 40 years, 64% males, mean length of illness 12.4 years, PSP total score 54.3. The final model was a significant predictor of real-world functioning [F(7, 131) = 36.371, p < 0.001] and explained 66.0% of the variance. Variables retained in the model: BNSS-Sp abulia, asociality, and blunted affect, PANSS general psychopathology, Sp-UPSA transportation, TMT-B, and heart rate.Conclusion: Our model will contribute to a more efficient and personalized daily clinical practice by assigning specific interventions to each patient based on specific impaired factors in order to improve functioning.

scholarly journals Cognitive and self-care changes in patients with heart failure in the Amazon Region

2020 ◽  
Vol 9 (6) ◽  
pp. e98963321
Author(s):  
Adriana de Oliveira Lameira Veríssimo ◽  
Juniel Pereira Honorato ◽  
Silvio Douglas Medeiros Costa ◽  
João Victor Moura Garcia ◽  
Isis Jaspe Reis da Silva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Public Health Problem ◽  
Clinical Aspects ◽  
Digit Symbol Substitution Test ◽  
Cognitive Changes ◽  
Cross Sectional ◽  
Significance Level ◽  
Symbol Substitution ◽  
The Individual

Heart failure is characterized as the lack of blood pumping capacity performed by the heart, which is considered a public health problem worldwide. Due to HF, the individual can develop clinical aspects that impact cognitive function and, consequently, self-care. Therefore, this study aimed to investigate cognitive changes and self-care in patients affected by HF and compare it with the cognitive and self-care changes of healthy participants. This is a quantitative, epidemiological, cross-sectional case-control study carried out at an institution in the city of Belém, Pará, Brazil. The following tests were used for data collection: Montreal Cognitive Assessment, Digit Symbol Substitution Test, European Heart Failure Self-care Behavior Scale (EHFScBS). Data were tabulated in Microsoft Excel 2010 and statistically treated by Epi Info version 3.5.2 with a 5% significance level and considering a 95% confidence interval in all analyzes. It was observed that patients with HF have slightly better self-care compared to patients without HF with scores obtained by EHFScBS equal to 29.7 ± 6.9 and 31.8 ± 8.2, respectively. Additionally, patients with HF showed impairments in the three cognitive domains, and women with HF demonstrated greater cognitive impairment compared to the other participants. The present study provides data to help build new approaches to interventions by the multidisciplinary team to promote better self-care and avoid cognitive impairments in patients with HF.

scholarly journals Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition: Analysis of the PURE and CAHHM Studies

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012765
Author(s):  
Romella Durrani ◽  
Matthias G. Friedrich ◽  
Karleen M. Schulze ◽  
Philip Awadalla ◽  
Kumar Balasubramanian ◽  
...  
Keyword(s):  
Physical Activity ◽  
Brain Injury ◽  
Cognitive Reserve ◽  
Assessment Tool ◽  
White Matter Hyperintensity ◽  
Digit Symbol Substitution Test ◽  
Brain Health ◽  
Cross Sectional ◽  
Symbol Substitution ◽  
Leisure Physical Activity

Objective:To determine whether cognitive reserve attenuates the association of vascular brain injury with cognition.Methods:Cross-sectional data were analyzed from two harmonized studies: the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and the Prospective Urban and Rural Epidemiology (PURE) study. Markers of cognitive reserve were education, involvement in social activities, marital status, height, and leisure physical activity, which were combined into a composite score. Vascular brain injury was defined asnon-lacunar brain infarcts or high white matter hyperintensity (WMH) burden on MRI. Cognition was assessed using the Montreal Cognitive Assessment Tool (MoCA) and the Digit Symbol Substitution Test (DSST).Results:There were 10,450 participants age 35-81. Mean age was 58.8 years (range 35 to 81) and 55.8% were female. Education, moderate leisure physical activity, being in a marital partnership, being taller, and participating in social groups were each independently associated with higher cognition, as was the composite cognitive reserve score. Vascular brain injury was associated with lower cognition (beta-0.35 [95% CI -0.53 to -0.17] for MoCA and beta -2.19 [95% CI-3.22 to -1.15] for DSST)-but the association was not modified by the composite cognitive reserve variable (interaction p=0.59 for MoCA and p=0.72 for DSST).Conclusions:Both vascular brain injury and markers of cognitive reserve are associated with cognition. However, the effects were independent such that the adverse effects of covert vascular brain injury were not attenuated by higher cognitive reserve. To improve cognitive brain health, interventions to both prevent cerebrovascular disease and promote positive lifestyles are needed.

scholarly journals Association Between Perceived Physical Activity and Cognitive Function in Older Adults

2018 ◽  
Vol 122 (1) ◽  
pp. 108-116 ◽  
Author(s):  
Paul D. Loprinzi ◽  
Emily Frith
Keyword(s):  
Physical Activity ◽  
Cognitive Function ◽  
Mortality Risk ◽  
Physical Activity Behavior ◽  
Digit Symbol Substitution Test ◽  
Positive Health ◽  
Cross Sectional ◽  
Symbol Substitution ◽  
Activity Behavior ◽  
Future Work

There is irrefutable evidence that regular participation in physical activity is favorably associated with numerous positive health outcomes, including cognitive function. Emerging work suggests that perceived physical activity, independent of actual physical activity behavior, is inversely associated with mortality risk. In this study, we evaluate whether perceived physical activity, independent of actual physical activity, is associated with cognitive function, a robust indicator of mortality risk. Data from the cross-sectional 1999–2002 National Health and Nutrition Examination Survey were employed ( N = 2352; 60+ years of age). Actual physical activity was assessed via a validated survey. Perceived physical activity was assessed using the following question: “Compared with others of the same age, would you say that you are: more active, less active, or about the same?” Cognitive function was assessed from the Digit Symbol Substitution Test. When examined in separate models, both actual and perceived physical activity were positively and statistically significantly associated with cognitive function. However, when considered in the same model, actual physical activity was no longer statistically significantly associated with cognitive function, but perceived physical activity was. Perceived physical activity, independent of actual physical activity, is independently associated with cognitive function. If these findings are replicated, future work should consider evaluating perceived physical activity when examining the effects of actual physical activity behavior on cognitive function.

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