Hypertensive Retinopathy Is Associated With Worse Cognitive Function in Women: The SWAN Study

Abstract Based on the 2018 American Academy of Neurology guideline, the prevalence of mild cognitive impairment (CI) increases from 6.7% at 60-64 years to 25.2% at 80-84 years. There is interest to identify potential biomarkers in the retina for CI and dementia. The aims of this analysis was to test whether hypertensive retinopathy (HR) was associated with cognitive function using data from the Study of Women’s Health Across the Nation (SWAN), Michigan cohort. SWAN, launched in 1996/97, is a longitudinal study of women traversing midlife and into late adulthood. Starting in 2000, cognitive function tests were administered: East Boston Memory Test immediate (EBMTi) and 10-minute delay (EBMTd) for verbal episodic memory; digit span backwards (DSB) for working memory; and symbol digits modalities test (SDMT) for perception speed, motor speed, and visual scanning. Z-scores were calculated for EBMTi, EBMTd, DSB and SDMT and averaged at follow-up visit 15 (2015/16). Eye exams were performed on 255 women (66 + 2.6 years) at follow-up visit 16 (2016/17). HR was based on presence/absence of arteriovenous nicking. Logistic regression showed a statistically significant association of lower average cognitive Z-score with HR (p-value 0.03, beta=-0.21 [95% confidence interval: -0.40 to -0.02]) adjusting for measured hypertension or anti-hypertensive drugs, years of measured hypertension, race, education, and age. Preliminary results indicate that HR is associated with lower cognitive test scores in women in their 60s-70s. This association between a simple ophthalmic exam finding of systemic hypertension, i.e., arteriovenous nicking, and lower cognitive function is consistent with a cerebrovascular mechanism of CI.

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Cognitive Function in Adults with Enduring Anorexia Nervosa

Nutrients ◽

10.3390/nu13030859 ◽

2021 ◽

Vol 13 (3) ◽

pp. 859

Author(s):

Maria Seidel ◽

Helen Brooker ◽

Kamilla Lauenborg ◽

Keith Wesnes ◽

Magnus Sjögren

Keyword(s):

Anorexia Nervosa ◽

Cognitive Function ◽

Episodic Memory ◽

Reaction Times ◽

Assessment System ◽

Cognitive Test ◽

Attention Tasks ◽

Inclusion Study ◽

Prospective Longitudinal

Anorexia Nervosa (AN) is a severe and often enduring disorder characterized by restriction of food intake, low body weight, fear of weight gain, and distorted body image. Investigations on cognition performance in AN patients have yielded conflicting results. Using an established and sensitive computerized cognitive test battery, we aimed to assess core aspects of cognitive function, including attention span, information processing, reasoning, working and episodic memory, in AN patients and controls. Patients were recruited from the Danish Prospective Longitudinal all-comer inclusion study in Eating Disorders (PROLED). Included were 26 individuals with AN and 36 healthy volunteers (HV). All were tested with CogTrack (an online cognitive assessment system) at baseline, and AN patients were tested again at a follow-up time point after weight increase (n = 13). At baseline, AN patients showed faster reaction times in the attention tasks, as well as increased accuracy in grammatical reasoning compared to HV. There were no differences in cognitive function between AN patients and HV in the other cognitive domains measured (sustained attention, working and episodic memory, speed of retrieval, and speed of grammatical reasoning). No differences were visible in the AN sample between baseline and follow-up. Performance did not correlate with any clinical variables in the AN sample. These findings supplement results from other studies suggesting increased concentration and reasoning accuracy in patients suffering from AN, who showed increased performance in cognitive tasks despite their illness.

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Serum sodium in relation to various domains of cognitive function in the elderly US population

BMC Geriatrics ◽

10.1186/s12877-021-02260-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sohyae Lee ◽

Jin-young Min ◽

Beom Kim ◽

Sang-Won Ha ◽

Jeohng Ho Han ◽

...

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Serum Sodium ◽

Verbal Memory ◽

The Elderly ◽

Cognitive Change ◽

Cognitive Test ◽

P Value ◽

Digit Symbol Substitution Test ◽

Cross Sectional

Abstract Background Recent evidence suggests that sodium imbalances may be associated with cognitive impairment; however, the association between specific domains of cognition remains unclear. This study examines the association between serum sodium levels and immediate and delayed verbal memory as measured by the CERAD Word Learning Test (CERAD WLT), executive function as measured by the Animal Fluency test (AFT), and sustained attention, working memory, and processing speed as measured by the Digit Symbol Substitution test (DSST) in the elderly population of the US aged 60 and older who participated in the 2011–2014 National Health and Nutrition Examination Surveys (n = 2,541). Methods Cognitive function tests were performed by trained interviewers and sodium levels were measured using indirect ion selective electrode methodology. Results After adjusting for all covariates, quintiles of CERAD WLT scores showed significant positive associations with log-transformed sodium levels (Immediate recall (IR) β = 4.25 (SE = 1.83, p-value 0.027); Delayed recall (DR) β = 6.54 (SE = 1.82, p-value 0.001)). Compared to normal sodium levels, hyponatremia was significantly associated with lower CERAD WLT-IR (β = -0.34, SE = 0.15, p-value 0.035) and CERAD WLT-DR scores (β -0.48, SE = 0.10, p-value < 0.001) and showed borderline significance with AFT scores (β = = -0.38, SE = 0.19, p-value 0.052). Hypernatremia did not show any significant relationships with cognitive test scores, compared to normal sodium levels. Conclusions Our cross-sectional study showed that lower sodium levels were associated with cognitive change, especially regarding memory and executive function.

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Serum Sodium in Relation to Various Domains of Cognitive Function in the Elderly US Population

10.21203/rs.3.rs-71448/v1 ◽

2020 ◽

Author(s):

Sohyae Lee ◽

Jin-young Min ◽

Beom Kim ◽

Sang-Won Ha ◽

Jeohng Ho Han ◽

...

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Serum Sodium ◽

Verbal Memory ◽

The Elderly ◽

Cognitive Change ◽

Cognitive Test ◽

P Value ◽

Digit Symbol Substitution Test ◽

Cross Sectional

Abstract Background:Recent evidence suggests that sodium imbalances may be associated with cognitive impairment; however, the association between specific domains of cognition remains unclear. This study examines the association between serum sodium levels and immediate and delayed verbal memory as measured by the CERAD Word Learning Test (CERAD WLT), executive function as measured by the Animal Fluency test (AFT), and sustained attention, working memory, and processing speed as measured by the Digit Symbol Substitution test (DSST) in the elderly population of the US aged 60 and older who participated in the 2011–2014 National Health and Nutrition Examination Surveys (n=2,700). Methods:Cognitive function tests were performed by trained interviewers and sodium levels were measured using indirect ion selective electrode methodology. Results:After adjusting for all covariates, CERAD WLT scores showed significant positive associations with sodium levels (Immediate recall (IR) β = 0.11 (SE = 0.04, p-value 0.018); Delayed recall (DR) β = 0.07 (SE = 0.03, p-value 0.009)). Compared to individuals with normal sodium levels, individuals with hyponatremia were significantly associated with lower CERAD WLT-DR (β = -0.71, SE = 0.23, p-value 0.005) and AFT scores (β = -1.58, SE = 0.68, p-value 0.027), and showed a borderline significant relationship with lower CERAD WLT-DR scores (β = -1.11, SE = 0.56, p-value 0.057). Individuals with hypernatremia did not show any significant relationships with cognitive test scores, compared to those with normal sodium levels. Conclusions:Our cross-sectional study showed that lower sodium levels were associated with cognitive change, especially regarding memory and executive function.

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Hypertensive retinopathy in a neonate

BMJ Case Reports ◽

10.1136/bcr-2020-235720 ◽

2020 ◽

Vol 13 (10) ◽

pp. e235720

Author(s):

Prakhar Goyal ◽

Komal Agarwal

Keyword(s):

Pigment Epithelium ◽

Retinal Pigment ◽

Female Child ◽

Visual Development ◽

Fundus Photography ◽

Systemic Hypertension ◽

Hypertensive Retinopathy ◽

Long Term Effects ◽

Hard Exudates

A 23-day-old female child diagnosed as having systemic hypertensive emergency was referred for retinal screening. The fundus examination showed bilateral intraretinal haemorrhages and hard exudates especially at the macula. Venous looping was noted. The ocular features were suggestive of hypertensive retinopathy. Control of systemic hypertension was advised and was managed conservatively with close follow-up. Widefield fundus photography was done at presentation and follow-up to document the change in retinopathy with control of hypertension.The haemorrhages and exudates resolved on follow-up but significant retinal pigment epithelium changes with beaten bronze appearance were noted at the area of previous oedema. Presence of hypertensive retinopathy in a neonate is rare and has long-term effects on visual development. This report describes the course of hypertensive retinopathy in a neonate.

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Donepezil for Irradiated Brain Tumor Survivors: A Phase III Randomized Placebo-Controlled Clinical Trial

Journal of Clinical Oncology ◽

10.1200/jco.2014.58.4508 ◽

2015 ◽

Vol 33 (15) ◽

pp. 1653-1659 ◽

Cited By ~ 124

Author(s):

Stephen R. Rapp ◽

L. Doug Case ◽

Ann Peiffer ◽

Michelle M. Naughton ◽

Michael D. Chan ◽

...

Keyword(s):

Brain Tumor ◽

Cognitive Function ◽

Adult Brain ◽

Composite Score ◽

Phase Iii ◽

Cognitive Test ◽

Controlled Clinical Trial ◽

Motor Speed ◽

Whole Brain Irradiation ◽

Brain Irradiation

Purpose Neurotoxic effects of brain irradiation include cognitive impairment in 50% to 90% of patients. Prior studies have suggested that donepezil, a neurotransmitter modulator, may improve cognitive function. Patients and Methods A total of 198 adult brain tumor survivors ≥ 6 months after partial- or whole-brain irradiation were randomly assigned to receive a single daily dose (5 mg for 6 weeks, 10 mg for 18 weeks) of donepezil or placebo. A cognitive test battery assessing memory, attention, language, visuomotor, verbal fluency, and executive functions was administered before random assignment and at 12 and 24 weeks. A cognitive composite score (primary outcome) and individual cognitive domains were evaluated. Results Of this mostly middle-age, married, non-Hispanic white sample, 66% had primary brain tumors, 27% had brain metastases, and 8% underwent prophylactic cranial irradiation. After 24 weeks of treatment, the composite scores did not differ significantly between groups (P = .48); however, significant differences favoring donepezil were observed for memory (recognition, P = .027; discrimination, P = .007) and motor speed and dexterity (P = .016). Significant interactions between pretreatment cognitive function and treatment were found for cognitive composite (P = .01), immediate recall (P = .05), delayed recall (P = .004), attention (P = .01), visuomotor skills (P = .02), and motor speed and dexterity (P < .001), with the benefits of donepezil greater for those who were more cognitively impaired before study treatment. Conclusion Treatment with donepezil did not significantly improve the overall composite score, but it did result in modest improvements in several cognitive functions, especially among patients with greater pretreatment impairments.

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Blood pressure variability is related to faster cognitive decline in ischemic stroke patients: PICASSO subanalysis

Scientific Reports ◽

10.1038/s41598-021-83945-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yerim Kim ◽

Jae-Sung Lim ◽

Mi Sun Oh ◽

Kyung-Ho Yu ◽

Ji Sung Lee ◽

...

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Cognitive Function ◽

Cognitive Decline ◽

Repeated Measures ◽

Blood Pressure Variability ◽

Cognitive Test ◽

Multiple Variables ◽

Over Time

AbstractBlood pressure variability (BPV) is associated with higher cardiovascular morbidity risks; however, its association with cognitive decline remains unclear. We investigated whether higher BPV is associated with faster declines in cognitive function in ischemic stroke (IS) patients. Cognitive function was evaluated between April 2010 and August 2015 using the Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment in 1,240 Korean PICASSO participants. Patients for whom baseline and follow-up cognitive test results and at least five valid BP readings were available were included. A restricted maximum likelihood–based Mixed Model for Repeated Measures was used to compare changes in cognitive function over time. Among a total of 746 participants (64.6 ± 10.8 years; 35.9% female). Baseline mean-MMSE score was 24.9 ± 4.7. The median number of BP readings was 11. During a mean follow-up of 2.6 years, mean baseline and last follow-up MMSE scores were 25.4 ± 4.8 vs. 27.8 ± 4.4 (the lowest BPV group) and 23.9 ± 5.2 vs. 23.2 ± 5.9 (the highest BPV group). After adjusting for multiple variables, higher BPV was independently associated with faster cognitive decline over time. However, no significant intergroup difference in cognitive changes associated with mean systolic BP was observed. Further research is needed to elucidate how BPV might affect cognitive function.

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Increase in Right Temporal Cortex Thickness Is Related to Decline of Overall Cognitive Function in Patients With Hypertension

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.758787 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wei Li ◽

Ling Yue ◽

Shifu Xiao

Keyword(s):

Cognitive Function ◽

Total Protein ◽

Digit Span ◽

Linear Regression Analysis ◽

Density Lipoprotein ◽

Wood Block ◽

Temporal Pole ◽

The Right ◽

Normal Controls

Background: Hypertension is associated with poorer cognitive functions, but the mechanisms are unclear.Objective: This research aims to explore the cognitive status of elderly patients with hypertension and the possible mechanisms of hypertension affecting cognitive function.Methods: Data were obtained from the China Longitudinal Aging Study (CLAS), and a total of 128 residents, aged 60 years and above, were recruited in this study. Based on whether they had hypertension, these 128 people were divided into the hypertension (n = 64) and non-hypertension groups (n = 64). The Beijing version of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess the overall cognitive function of the subjects, while digit span, language fluency, Wechsler mapping, and Wechsler wood block were used to assess their domain-specific cognitive function (both at baseline and follow-up stages). At the same time, we also examined baseline blood biochemical indicators (such as total protein, fasting plasma glucose (FPG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, and triglyceride) and baseline MRI data of hippocampus and amygdala volume and temporal polar cortex thickness.Results: The total protein and thickness of temporal polar cortex in patients with hypertension were significantly higher than those in normal controls, but the scores on MMSE, MoCA, digit span, Wechsler mapping and Wechsler wood block at baseline were significantly lower than those in normal controls (p < 0.05). By linear regression analysis and correlation analysis (age and education were controlled), we found that baseline Wechsler mapping scores were negatively correlated with total protein (B = −0.243, t = −3,735, p < 0.001, 95% confidence interval (CI): −0.371 to −0.114); and both the follow-up MMSE score (B = 2.657, t = 2.002, p = 0.049, 95% CI: 0.009~5.306) and the change score of MMSE (r = −0.025, p = 0.047) were related to the thickness of the right temporal pole cortex. Then, by linear regression analysis (mediating model), we found that hypertension may influence follow-up MMSE scores by influencing the cortical thickness of the right temporal pole (B = 1.727, p = 0.022, 95% CI: 0.261–3.193).Conclusions: Elderly patients with hypertension exhibit poorer overall cognitive function and executive function, and the mechanism may be related to the effect of hypertension on the cortical thickness of the right temporal pole.

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Benefit of Musical Training for Speech Perception and Cognition Later in Life

Journal of Speech Language and Hearing Research ◽

10.1044/2021_jslhr-20-00588 ◽

2021 ◽

pp. 1-12

Author(s):

Natascha Merten ◽

Mary E. Fischer ◽

Lauren K. Dillard ◽

Barbara E. K. Klein ◽

Ted S. Tweed ◽

...

Keyword(s):

Hearing Loss ◽

Cognitive Impairment ◽

Speech Perception ◽

Cognitive Function ◽

Musical Training ◽

Cognitive Test ◽

Health Differences ◽

Study Participants ◽

Over Time

Purpose The aim of this study was to determine the long-term associations of musical training with speech perception in adverse conditions and cognition in a longitudinal cohort study of middle-age to older adults. Method This study is based on Epidemiology of Hearing Loss Study participants. We asked participants at baseline (1993–1995) about their musical training. Speech perception (word recognition in competing message; Northwestern University Auditory Test Number 6), cognitive function (cognitive test battery), and impairment (self-report or surrogate report of Alzheimer's disease or dementia, and/or a Mini-Mental State Examination score ≤ 24) were assessed up to 5 times over the 20-year follow-up. We included 2,938 Epidemiology of Hearing Loss Study participants who had musical training data and at least one follow-up of speech perception and/or cognitive assessment. We used linear mixed-effects models to determine associations between musicianship and decline in speech perception and cognitive function over time and Cox regression models to evaluate associations of musical training with 20-year cumulative incidence of speech perception and cognitive impairment. Models were adjusted for age, sex, and occupation and repeated with additional adjustment for health-related confounders and education. Results Musicians showed less speech perception decline over time with stronger effects in women (0.16% difference, 95% confidence interval [CI] [0.05, 0.26]). Among men, musicians had, on average, better speech perception than nonmusicians (3.41% difference, 95% CI [0.62, 6.20]) and were less likely to develop a cognitive impairment than nonmusicians (hazard ratio = 0.58, 95% CI [0.37, 0.91]). Conclusions Musicians showed an advantage in speech perception abilities and cognition later in life and less decline over time with different magnitudes of effect sizes in men and women. Associations remained with further adjustment, indicating that some degree of the advantage of musical training is independent of socioeconomic or health differences. If confirmed, these findings could have implications for developing speech perception intervention and prevention strategies. Supplemental Material https://doi.org/10.23641/asha.14825454

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PHYSICAL FUNCTION AND LONGITUDINAL CHANGES IN COGNITIVE FUNCTION

Innovation in Aging ◽

10.1093/geroni/igz038.3005 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S815-S815

Author(s):

Jinjiao Wang ◽

Dexia Kong ◽

XinQi Dong

Keyword(s):

Cognitive Function ◽

Physical Function ◽

Mini Mental State Examination ◽

Digit Span ◽

Chinese Adults ◽

Older Chinese ◽

Older Chinese Adults ◽

The Relationship ◽

State Examination

Abstract Among 2,038 older Chinese adults in the U.S., we examined the relationship between physical function (Short Performance Physical Battery [SPPB], [instrumental] activities of daily living [ADL/IADL] limitations) at baseline (2011-2013) and changes in cognitive function in the two-year follow-up (2013-2015). Cognitive function was measured by the East Boston Memory Test (EBMT), the Digit Span Backwards assessment (DSB), the Symbol Digit Modalities Test (SDMT), and the Mini-Mental State Examination (MMSE). During the two-year follow-up, 41.8%-50.88% of the participants decreased in cognitive function and 32.88%-44.8% increased. In linear regression that adjusted for baseline cognitive function, education, age, and other covariates, baseline SPPB and ADL/IADL limitations were significantly associated with changes in cognitive function in the two-year follow-up (SPPB: βEBMT=0.0149, p<0.05; βDSB=0.0253, p>0.05; βSDMT=0.2742, p<0.01; βMMSE=0.1070, p<0.001; ADL/IADL limitations: βEBMT= -0.0401, p<0.0001; βDSB= -0.0410, p<0.05; βSDMT= -0.3027, p<0.01; βMMSE= -0.2566, p<0.0001). This suggests that better physical function predicts positive changes in cognitive function.

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The effect of treatment for soil-transmitted helminthiasis on cognitive function in children

Paediatrica Indonesiana ◽

10.14238/pi52.2.2012.99-105 ◽

2012 ◽

Vol 52 (2) ◽

pp. 99 ◽

Cited By ~ 1

Author(s):

Dewi Sari ◽

Muhammad Ali ◽

Syahril Pasaribu

Keyword(s):

Cognitive Function ◽

Digit Span ◽

P Value ◽

Open Label ◽

Intelligence Scale ◽

School Aged Children ◽

Group I ◽

Before And After ◽

Effect Of Treatment ◽

Student’S T

Background Soil-transmitted helminth (STH) infections affectone-third of the world's population. School-aged children arereported to have the highest prevalence and intensity of disease,resulting in impaired cognitive function, malnutrition andmorbidity.Objective To examine differences in cognitive function in STHinfectedchildren before and after treatment.Methods We conducted a randomized, open-label, controlled trialfrom November 2 008 - March 2009 in Aek Na bar a, Lab uh an BatuDistrict, North Sumatera Province. Subjects were primary schoolagedchildren with STH infection. Before intervention, data onage, sex, nutritional status, STH infection status and cognitivefunction were collected. Subjects were divided into two groupsby simple randomization. Group I received 400 mg albendazoleand group II received a placebo. Three months after intervention,cognitive function of subjects in both groups was reassessed. Datawas analysed by Student's t test, with P value of less than 0.05considered to be statistically significant.Results Cognitive tests with the Wechsler Intelligence Scale forChildren (WISC) were performed in 120 children infected withSTH. Sixty children received 400 mg albendazole and 60 childrenreceived placebo. Seven children were excluded and one droppedout from this study. Three months after the intervention, wereevaluated cognitive function and found significant differencesin the categories of digit span (P=0.024) and total IQ score(P=0.027) between the two groups.Conclusions Treatment of STH infection with albendazoleimproved cognitive function of children in comprehension, codingand digit span testing. Performance and full IQ scores were alsoimproved after treatment. [Paediatr lndones. 2012;52:99-105].

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