Education Differentially Buffers Cognitive Performance in Black and White Older Adults

Abstract Objectives Given that black American older adults are more likely to have lower educational attainment and perform worse on cognitive tests than white Americans, we examined whether increased education would confer greater cognitive advantage to black Americans on measures of global and specific domains of cognitive function. Methods The sample included 522 community-dwelling older adults from a larger study. An analysis of covariance was conducted with race and education as between-participant factors and global cognition as the dependent variable. A multivariate analysis of covariance was conducted with five cognitive domains (immediate memory, visuospatial/constructional ability, language, attention, and delayed memory) as the dependent variables. Results Significant main effects indicated that black Americans, F(1,516) = 29.18, p < .001, and individuals with less education, F(1,516) = 44.93, p < .001, evidenced lower cognitive functioning, controlling for age and overall health status, and the interaction term reached statistical significance, F(1,516) = 7.95, p = .005. The impact of education on global cognitive function for black participants was more than twice as large (Cohen’s d = 1.30) than for white participants (Cohen’s d = .52). There was a significant race × education interaction for the cognitive domain of attention (p < .001) and a composite measure of non-memory domains (i.e., language, visuospatial/constructional, and attention; p < .001). Discussion Our findings suggest that educational attainment is particularly important for black Americans with respect to global cognitive function, attention, and non-memory domains.

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Accelerated Epigenetic Age in Normal Cognitive Aging of Korean Community-Dwelling Older Adults

Biological Research For Nursing ◽

10.1177/1099800420983896 ◽

2021 ◽

pp. 109980042098389

Author(s):

Jongmin Park ◽

Chang Won Won ◽

Leorey N. Saligan ◽

Youn-Jung Kim ◽

Yoonju Kim ◽

...

Keyword(s):

Older Adults ◽

Dna Methylation ◽

Cognitive Function ◽

Cognitive Aging ◽

Community Dwelling ◽

Test Results ◽

Cohen’S D ◽

Epigenetic Age ◽

Epigenetic Age Acceleration ◽

Community Dwelling Older Adults

Background: Epigenetic age acceleration has been studied as a promising biomarker of age-related conditions, including cognitive aging. This pilot study aims to explore potential cognitive aging-related biomarkers by investigating the relationship of epigenetic age acceleration and cognitive function and by examining the epigenetic age acceleration differences between successful cognitive aging (SCA) and normal cognitive aging (NCA) among Korean community-dwelling older adults (CDOAs). Methods: We used data and blood samples of Korean CDOAs from the Korean Frailty and Aging Cohort Study. The participants were classified into two groups, SCA (above the 50th percentile in all domains of cognitive function) and NCA. The genome-wide DNA methylation profiling array using Illumina Infinium MethylationEPIC BeadChip was used to calculate the following: the DNA methylation age, universal epigenetic age acceleration, intrinsic epigenetic age acceleration (IEAA), and extrinsic epigenetic age acceleration (EEAA). We also used Pearson correlation analysis and independent t-tests to analyze the data. Results: Universal age acceleration correlated with the Frontal Assessment Battery test results ( r = −0.42, p = 0.025); the EEAA correlated with the Word List Recognition test results ( r = −0.41, p = 0.027). There was a significant difference between SCA and NCA groups in IEAA ( p = 0.041, Cohen’s d = 0.82) and EEAA ( p = 0.042, Cohen’s d = 0.78). Conclusions: Epigenetic age acceleration can be used as a biomarker for early detection of cognitive decline in Korean community-dwelling older adults. Large longitudinal studies are warranted.

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Association of Gait With Global and Domain-specific Cognitive Function Among Community-dwelling Older Adults: A Cross-sectional Study

10.21203/rs.3.rs-439336/v1 ◽

2021 ◽

Author(s):

WEN HAO ◽

Wenjing Zhao ◽

Takashi Kimura ◽

Shigekazu Ukawa ◽

Ken Kadoya ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cross Sectional Study ◽

Community Dwelling ◽

Initial Contact ◽

Sectional Study ◽

Cross Sectional ◽

Domain Specific ◽

Global Cognitive Function ◽

Gait Parameters

Abstract Background: Gait is associated with cognitive function and is a trait marker of dementia; however, research on gait and cognitive function usually concentrates on several individual gait parameters. This study used wearable sensors to measure gait parameters in different aspects and comprehensively explored the association of gait with global cognitive function and domain-specific cognitive function.Methods: The data of this cross-sectional study were obtained from 236 community-dwelling Japanese older adults (125 men and 111 women) aged 70–81 years. Gait was measured by asking participants to walk a 6-meter course and back using the Physilog® sensors (GaiUp®, Switzerland). Global cognitive function and cognitive domains were evaluated by face-to-face interviews using the Japanese version of the Montreal Cognitive Assessment. Twenty gait parameters were summarized as independent gait factors using factor analysis. A generalized linear model and linear regression model were used to explore the relationship of gait with global cognitive function and domain-specific cognitive function adjusted for several confounding factors.Results: Factor analysis yielded four gait factors: general cycle, initial contact, propulsion, and mid-swing. Among them, general cycle factor was significantly associated with global cognitive function (β=-0.565, [-0.967, -0.163]), executive function (P=0.012), and memory (P=0.045); initial contact was associated with executive function (P=0.019).Conclusion: Better gait was related to better cognitive function, especially the general cycle, which was correlated with both global and domain-specific cognitive function. The predictive value should be examined in future cohort studies.

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Renal dysfunction is associated with decline of cognitive function in community-dwelling older adults: Korean frailty and aging cohort study

BMC Geriatrics ◽

10.1186/s12877-020-01862-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ji Yoon Kong ◽

Jin Sug Kim ◽

Min Hye Kang ◽

Hyeon Seok Hwang ◽

Chang Won Won ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Cognitive Impairment ◽

Cognitive Function ◽

Renal Dysfunction ◽

Elderly Population ◽

Word List ◽

Community Dwelling ◽

Global Cognitive Function ◽

The Mean

Abstract Background Cognitive decline is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly population. We conducted this study to clarify the relationship between renal dysfunction and decline of cognitive function in community-dwelling elderly population. Methods A cross-sectional analysis was performed using data from the Korean Frailty and Aging Cohort Study, a nationwide cohort study. Total 2847 (1333 men, 1514 women) eligible participants were enrolled for this study. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Global cognitive function was assessed with the Mini-mental State Examination-Korean version. Other domains of cognitive function were tested with the Consortium to Establish a Registry for Alzheimer’s disease and the Frontal Assessment Battery. Results The mean age of all participants was 76.0 ± 3.9 years and eGFR (all in mL/min/1.73 m2) was 77.5 ± 14.3. And the mean eGFR was 91.7 ± 3.2 in quartile 1, 84.9 ± 1.8 in quartile 2, 76.1 ± 3.7 in quartile 3, and 57.2 ± 10.8 in quartile 4. In baseline characteristics, participants with lower eGFR tend to have lower cognitive function scores than participant with higher eGFR. In linear regression analysis, eGFR was correlated with the word list memory (β = 0.53, P = 0.005), word list recall (β = 0.86, P < 0.001), and word list recognition (β = 0.43, P = 0.030) after adjustment of confounding variables. Moreover, after multivariate adjustment the association with cognitive impairment in quartile 2 was stronger (adjusted OR: 1.535, 95% CI: 1.111–2.120, P = 0.009), and the ORs of cognitive impairment were 1.501 (95% CI: 1.084–2.079, P = 0.014) in quartile 3 and 1.423 (95% CI: 1.022–1.983, P = 0.037) in quartile 4. Conclusion In older adults, the immediate, recent memory, and recognition domains were significantly related to renal function. Also, the mild renal dysfunction was independently associated with impairment of global cognitive function. These results suggest that the early stages of renal dysfunction could be an effective target to prevent worsening of cognitive impairment. Therefore, regular monitoring and early detection of mild renal dysfunction in elderly population might be needed.

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Free-living standing activity as assessed by seismic accelerometers and cognitive function in community-dwelling older adults: The MIND trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glab106 ◽

2021 ◽

Author(s):

Shannon Halloway ◽

Klodian Dhana ◽

Pankaja Desai ◽

Puja Agarwal ◽

Thomas Holland ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cognitive Function ◽

Daily Life ◽

Vigorous Physical Activity ◽

Community Dwelling ◽

Perceptual Speed ◽

Free Living ◽

Activity Intensity ◽

The Impact

Abstract Background Few older adults are able to achieve recommended levels of moderate-vigorous physical activity despite known cognitive benefits. Alternatively, less intense activities such as standing can be easily integrated into daily life. No existing study has examined the impact of free-living standing activity during daily life as measured by a device on cognition in older adults. Our purpose was to examine the association between free-living standing activity and cognitive function in cognitively healthy older adults. Methods Participants were 98 adult participants aged 65 years or older from the ongoing MIND trial (NCT02817074) without diagnoses or symptoms of mild cognitive impairment or dementia. Linear regression analyses tested cross-sectional associations between standing activity (duration and intensity from the MoveMonitor+ accelerometer/gyroscope) and cognition (4 cognitive domains constructed from 12 cognitive performance tests). Results Participants were on average 69.7 years old (SD = 3.7), 69.4% women, and 73.5% had a college degree or higher. Higher mean intensity of standing activity was significantly associated with higher levels of perceptual speed when adjusting for age, gender, and education level. Each log unit increase in standing activity intensity was associated with 0.72 units higher of perceptual speed (p=.023). When we additionally adjusted for cognitive activities and moderate-vigorous physical activity, and then also for body mass index, depressive symptoms, prescription medication use, and device wear time, the positive association remained. Conclusions These findings should be further explored in longitudinal analyses and interventions for cognition that incorporate small changes to free-living activity in addition to promoting moderate-vigorous physical activity.

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Simplified olfactory reminiscence to help maintain the mental health in community-dwelling older adults

Ageing and Society ◽

10.1017/s0144686x21000076 ◽

2021 ◽

pp. 1-14

Author(s):

Hideaki Hanaoka ◽

Toshiaki Muraki ◽

Fumiko Kaneko ◽

Shingo Yamane ◽

Hitoshi Okamura

Keyword(s):

Mental Health ◽

Older Adults ◽

Cognitive Function ◽

Intervention Group ◽

Community Dwelling ◽

Analysis Of Covariance ◽

Cognitive Test ◽

Control Group ◽

Significant Difference ◽

Community Dwelling Older Adults

Abstract The purpose of this study was to examine the effects of simplified reminiscence practice using olfactory stimuli on depression and cognitive function in community-dwelling older adults in Japan. Accordingly, 61 individuals were randomly divided into two groups. In the intervention group, 12 sessions of reminiscence were performed using olfactory cards. In the control group, reminiscence sessions were similarly performed, but with language cards. The Geriatric Depression Scale-15 (GDS-15) was used to measure mental health status and the Five Cognitive Test was used to measure cognitive function at baseline and after completion of the intervention. The final sample included 27 participants in the intervention group and 23 participants in the control group. Basic characteristics of the participants at baseline were compared and a significant difference was observed between the two groups in age (p = 0.029). Repeated-measures analysis of covariance with age as the covariate revealed a significant interaction between time and group on the GDS-15 (p = 0.04). Furthermore, a before and after comparison using a paired t-test showed a significant difference only in the intervention group (p = 0.01). The results of this study suggest that simplified reminiscence practice using olfactory cards could serve as an intervention to help maintain the mental health of community-dwelling older adults.

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Association of Mild Anemia and Executive Cognitive Function Impairment in High Functioning Community-Dwelling Older Women.

Blood ◽

10.1182/blood.v106.11.3552.3552 ◽

2005 ◽

Vol 106 (11) ◽

pp. 3552-3552

Author(s):

Paulo H.M. Chaves ◽

Linda P. Fried ◽

Michelle Carlson

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Older Women ◽

The Elderly ◽

Forced Expiratory Volume ◽

Community Dwelling ◽

Cross Sectional ◽

High Functioning ◽

Mild Anemia ◽

The Impact

Abstract Background: Anemia in the elderly is common and may be associated with atypical clinical presentations. Although the impact of severe anemia on cognition has been studied in patients with cancer, less is known about the association of mild anemia on cognitive function in the elderly. Executive cognitive functioning (ECF) refers to the execution of complex activities that involve a set of higher-order cognitive abilities primarily dependent on the frontal lobes. ECF plays a major role in the maintenance of the functional status of older adults. Knowledge about potentially modifiable risk factors for ECF impairment in older adults is limited. The goal of this study was to test the hypothesis that mild anemia is associated with ECF impairment in high functioning, community-dwelling older women. Methods: Cross-sectional analysis of baseline data from the Women’s Health and Aging Study (WHAS) II, 1994–1996, Baltimore, MD. WHAS II is a population-based study of 436 cognitively intact (Mini-Mental State Exam >24) and highly physically functioning women aged 70–80 years. The analytic sample included 364 subjects with Hb >10 g/dL and the following ECF test components: Trail Making Tests part B (TMTB) - primary outcome - and part A (TMTA), and the difference TMTB-TMTA. Multivariate polytomous logistic regression models were used to model the relationship between performance (based on tertiles) on each ECF test as a function of Hb, while controlling for age, education, cardiovascular disease, and a number of other potential confounders, such as hypertension, diabetes, depressive symptoms, calculated creatinine clearance, forced expiratory volume in the first second, thyroid stimulating hormone, total cholesterol levels, body mass index, walking speed, and prevalent mobility difficulty. Results: Subjects with mild anemia (Hb 10–12 g/dL) performed worst in all ECF tests; i.e., the percentage of subjects in the best performance tertile for each test was lowest for those with Hb within 10–12 g/dL. Estimates from multivariate models revealed that, as compared to those with Hb≥12 g/dL, those with Hb within 10–12 g/dL were substantially less likely to be in the best performance tertile of the TMTB [odds ratio (OR).23, 95% confidence interval (CI):.06–.86; p=.029], TMTA (OR.27, 95%CI:.07–.98; p=.047), and TMTB-TMTA (OR.30, 95%CI:.10–.89; p=.031), even after comprehensive adjustment. Conclusion: In this cross-sectional study, mild anemia was an independent risk factor for prevalent ECF impairment in high functioning community-dwelling older women. This raises the hypothesis that correction of mild anemia could potentially provide an opportunity for prevention of cognitive and functional decline in older adults. To test this hypothesis, prospective observational studies and clinical trials are warranted.

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No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622318820849 ◽

2019 ◽

Vol 10 ◽

pp. 204062231882084 ◽

Cited By ~ 1

Author(s):

Ruth Peters

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Adult Population ◽

Community Dwelling ◽

Channel Blockers ◽

80 And Over ◽

Aged 80 And Over ◽

Increased Risk ◽

Older Adult Population ◽

The Impact

Background: Hypertension is prevalent in older adults. Hypertension has also been associated with an increased risk of cognitive decline. However, evidence relating to the impact of antihypertensive use is mixed. Calcium-channel blockers (CCB) have been suggested as the most beneficial class of antihypertensive for protection of cognition in older adults, however, to date, there have been no cohort studies designed to examine this. Methods: Community-dwelling treated hypertensive adults aged 80 and over were recruited from general practice sites and followed for 1 year. Cognitive function was assessed at baseline and 12 months using the modified Mini-Mental State Exam (3MS). Regression was used to examine the association between 12-month exposure to antihypertensive class and change in cognitive function. Results: A total of 292 participants completed the study. Mean change in 3MS score was a rise of 0.53 [standard deviation (SD) 4.7] 3MS points in those taking CCBs ( n = 135) compared with a drop of 0.09 (SD 5.1) in those without ( n = 157) p = 0.28. There was no relationship between CCBs or between any antihypertensive class and change in cognitive function over 1 year. Additional analyses using a clinically meaningful fall of 5 or more 3MS points showed similar results. Conclusion: In a hypertensive community-dwelling older adult population treated with antihypertensives, there was no evidence that CCBs were protective of cognitive function over a 12-month exposure. If a protective effect is present, it may be small or require a longer treatment period. Larger longer studies are required for confirmation.

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SOCIAL COHESION AFFECTS THE ASSOCIATION BETWEEN FRAILTY AND DISABILITY IN COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.2876 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S782-S782

Author(s):

Boqin Xie

Keyword(s):

Older Adults ◽

Social Cohesion ◽

Functional Disability ◽

Community Dwelling ◽

Analysis Of Covariance ◽

Health Study ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

The Impact ◽

Community Dwelling Older Adults

Abstract The relationships between physical frailty and perceived neighborhood social cohesion (PNSC) and functional disability among community-dwelling older adults are poorly understood. This study aims to (1) examine the associations of frailty and PNSC with disability; and (2) evaluate low PNSC as a risk factor in the association between frailty and disability. A sample of 1645 older adults using multi-stage sampling method in Shanghai were randomly selected in this cross-sectional study. Frailty operationalized as Cardiovascular Health Study criteria (OR=2.4, 95%CI 1.16-4.96 for pre-frailty; OR=7.28, 95%CI 3.37-15.73 for frailty) and PNSC measured as Neighborhood Cohesion Scale (OR=1.81, 95%CI 1.23-2.67) were independently associated with basic and instrumental activities of daily living disability. A significant interaction of frailty and PNSC on disability (F (2, 66)=4.31, P=.014) was found, using a two-way analysis of covariance (ANCOVA). Compared to robust individuals with high PNSC, pre-frailty with high PNSC was not significantly associated with disability while pre-frailty with low PNSC was associated with approximate 4-fold increased prevalence of disability (OR=3.87, 95%CI 1.46-10.24, p=.006). Frailty with high PNSC was associated with higher likelihood of disability (OR=6.47, 95%CI 2.35-17.87) and frail individuals with low PNSC stood out with 10-fold increased prevalence of disability (OR=9.94, 95%CI 3.50-28.26). All analyses were controlled for demographical and clinical covariates. Our results suggest high level of social cohesion serves as a buffer against the impact of physical frailty on functional disability. These findings notably imply to the development of interventions for older frail adults from the neighborhood perspective.

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The Feasibility and Effectiveness of a Community-Based Intervention to Reduce Sedentary Behavior in Older Adults

Journal of Applied Gerontology ◽

10.1177/0733464820987919 ◽

2021 ◽

pp. 073346482098791

Author(s):

Kevin M. Crombie ◽

Brianna N. Leitzelar ◽

Neda E. Almassi ◽

Jane E. Mahoney ◽

Kelli F. Koltyn

Keyword(s):

Older Adults ◽

Sedentary Behavior ◽

Physical Function ◽

Sedentary Time ◽

Controlled Trial ◽

Community Dwelling ◽

Control Group ◽

Post Intervention ◽

Cohen’S D ◽

Cohen's D

The purpose of this study was to examine the effectiveness and feasibility of translating a 4-week “Stand Up and Move More” (SUMM) intervention by state aging units to older adults ( N = 56, M age = 74 years). A randomized controlled trial assessed sedentary behavior, physical function, and health-related quality of life (HRQoL) before and after the intervention. Participants included healthy community-dwelling, sedentary (sit > 6 hr/day) and aged ≥ 55 years adults. For the primary outcome, the SUMM group ( n = 31) significantly ( p < .05) reduced total sedentary time post-intervention by 68 min/day on average (Cohen’s d = −0.56) compared with no change in the wait-list control group ( n = 25, Cohen’s d = 0.12). HRQoL and function also improved ( p < .05) in the SUMM group post-intervention. Workshop facilitators indicated the intervention was easy to implement, and participants expressed high satisfaction. The SUMM intervention reduced sedentary time, improved physical function and HRQoL, and was feasible to implement in community settings.

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Do Communication Patterns Affect the Association between Cognitive Impairment and Hearing Loss among Older Adults in Vietnam?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041603 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1603

Author(s):

Tran Dai Tri Han ◽

Keiko Nakamura ◽

Kaoruko Seino ◽

Vo Nu Hong Duc ◽

Thang Van Vo

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Cognitive Impairment ◽

Cognitive Function ◽

Vision Loss ◽

Community Dwelling ◽

Cross Sectional ◽

Ordinal Logistic Regression Analysis ◽

Communication Devices ◽

Community Dwelling Older Adults

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.

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