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

2018 ◽  
Vol 41 (2) ◽  
pp. e177-e184 ◽  
Author(s):  
Helen-Maria Vasiliadis ◽  
Marie-Christine Payette ◽  
Djamal Berbiche ◽  
Sébastien Grenier ◽  
Carol Hudon

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.

2020 ◽  
Vol 35 (6) ◽  
pp. 799-799
Author(s):  
Bell S ◽  
Maietta J ◽  
Caldwell J ◽  
Hawley N ◽  
Ritter A ◽  
...  

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.


2019 ◽  
Vol 39 (9) ◽  
pp. 1046-1051
Author(s):  
Faika Zanjani ◽  
Ann L. Gruber-Baldini ◽  
Barbara Resnick ◽  
Denise Orwig ◽  
Marc Hochberg ◽  
...  

Background: We examined the relationship between alcohol consumption and hip fracture recovery. Methods: Repeated measures analysis was used to analyze Baltimore Hip Studies (BHS) seventh cohort 12-month prospective data of hip fracture patients. The analytical sample was limited to individuals with baseline and follow-up alcohol data, representing n = 278 sample size, 49% male, and mean age 81 years. Results: In the year prior to fracture, sample reporting indicated 45% nondrinking, 48% one to seven drinks per week, and 7% eight or more drinks per week alcohol levels. There were some changes in alcohol status during the study period ( p < .001); 42% remained nondrinkers and 47% remained alcohol consumers, but 8% stopped alcohol use, and 3% reported alcohol consumption after nondrinking at baseline. Alcohol was a predictor ( p < .05) of disability and physical function, not showing worse recovery for drinkers. Conclusion: Almost half of the sample consumed alcohol throughout the study period, with no clear indication of negative effects on hip fracture recovery.


2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia

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.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.


2019 ◽  
Vol 2 (9) ◽  
pp. e1910319 ◽  
Author(s):  
Manja Koch ◽  
Annette L. Fitzpatrick ◽  
Stephen R. Rapp ◽  
Richard L. Nahin ◽  
Jeff D. Williamson ◽  
...  

2019 ◽  
Vol 33 (3) ◽  
pp. 155-160 ◽  
Author(s):  
Odelia Elkana ◽  
Noy Tal ◽  
Noga Oren ◽  
Shani Soffer ◽  
Elissa L. Ash

Background: The Montreal Cognitive Assessment (MoCA) is widely used to evaluate cognitive decline in older individuals. Although, age and education-related norms have been published, the vast majority of diagnostic clinicians use the MoCA cutoff score to identify patients with cognitive impairment. Aim: To identify whether the MoCA cutoff is too stringent for cognitively normal older adults. Methods: Twenty-seven participants aged 68 to 83 (mean = 75.07, standard deviation [SD] = 4.62), with high education level (mean = 17.14 years, SD = 3.21) underwent cognitive assessment once a year for 5 consecutive years. The cognitive assessment included MoCA; Rey Auditory Verbal Learning Test; Rey Osterrieth Complex Figure test; Wechsler Adult Intelligence Scale Information and Digit Span Subtest; Trail Making Test; Verbal Fluency Test; and Beck Depression Inventory questionnaire. Repeated measures analysis of variance (ANOVA) was used to analyze all standardized scores as well as MoCA standardized and raw scores across all years. Results: Repeated-measures ANOVA for MoCA raw scores yielded significant decline across the years ( P < .05). From the second year and forward, the average MoCA total score was below the cutoff of 26/30. However, in substantial contrast, all other neuropsychological scores and the MoCA standardized scores were within the normal range and even above in all years. Conclusion: Our study demonstrates that the currently used MoCA cutoff is too high even for highly educated, cognitively normal older adults. Therefore, it is crucial to use the age- and education-related norms for the MoCA in order to avoid misdiagnosis of cognitive decline.


2019 ◽  
Vol 48 (6) ◽  
pp. 845-851 ◽  
Author(s):  
Flavia Barreto Garcez ◽  
Daniel Apolinario ◽  
Flavia Campora ◽  
Jose Antonio Esper Curiati ◽  
Wilson Jacob-Filho ◽  
...  

Abstract Objectives to investigate the association between delirium occurrence in acutely ill older adults and incident dementia after hospital discharge. Methods retrospective cohort study examining acutely ill older adults aged +60 years and consecutively admitted to the geriatric ward of a tertiary university hospital from 2010 to 2016. Inclusion criteria were absence of baseline cognitive decline on admission and documented clinical follow-up of +12 months after discharge. Admission data were collected from our local database, including results from a standardized comprehensive geriatric assessment completed for every patient. Pre-existing cognitive decline was identified based on clinical history, CDR and IQCODE-16. Delirium was diagnosed using short-CAM criteria, while post-discharge dementia after 12 months was identified based on medical records’ review. We used competing-risk proportional-hazard models to explore the association between delirium and post-discharge dementia. Results we included 309 patients. Mean age was 78 years, and 186 (60%) were women. Delirium was detected in 66 (21%) cases. After a median follow-up of 24 months, 21 (32%) patients who had experienced delirium progressed with dementia, while only 38 (16%) of those without delirium had the same outcome (P = 0.003). After adjusting for possible confounders, delirium was independently associated with post-discharge dementia with a sub-hazard ratio of 1.94 (95%CI = 1.10–3.44; P = 0.022). Conclusion one in three acutely ill older adults who experienced delirium in the hospital developed post-discharge dementia during follow-up. Further understanding of delirium as an independent and potentially preventable risk factor for cognitive decline emphasizes the importance of systematic initiatives to fight it.


2019 ◽  
Vol 71 (s1) ◽  
pp. S65-S73 ◽  
Author(s):  
Andrea L. Rosso ◽  
Andrea L. Metti ◽  
Kimberly Faulkner ◽  
Mark Redfern ◽  
Kristine Yaffe ◽  
...  

2014 ◽  
Vol 22 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Karen A. Croteau ◽  
Vijiayurani Suresh ◽  
Elanna Farnham

The purpose of this pilot study was to determine if using physical activity (PA) mentors has any additional impact on daily steps of older adults participating in the Maine in Motion (MIM) program in the primary care setting. Participants were randomly assigned to a MIM-only group (n= 14) or a MIM+ mentor group (n= 14). The MIM intervention lasted 6 months with follow-up at 12 months. Average age of participants was 64 ± 8.8 years and most participants had multiple chronic illnesses. At baseline, mean body mass index (BMI) was 32.2 ± 5.1 and average daily steps were 4,236 ± 2,266. Repeated-measures ANOVA revealed significant main effects for steps,F(2.324, 59.104) = 4.168,p= .015, but no main effects for group,F(1, 25) = 2.988,p= .096, or time-by-group interaction,F(2.324, 59.104) = 0.905,p= .151. All participants significantly increased daily steps over the course of the intervention, with MIM+ participants maintaining increases at follow-up. No significant findings were found for BMI.


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