537 Insomnia Symptoms and Subsequent Cognitive Performance in Older Adults: Are Depressive Symptoms and Vascular Disease Mediators?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A212-A212
Author(s):  
Afsara Zaheed ◽  
Adam Spira ◽  
Ronald Chervin ◽  
Laura Zahodne
Keyword(s):  
Executive Function ◽  
Depressive Symptoms ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Vascular Diseases ◽  
Cognitive Domains ◽  
Falling Asleep ◽  
Function Language ◽  
Insomnia Symptoms

Abstract Introduction Alzheimer’s disease and related dementias (ADRD) are growing public health concerns, and poor sleep may represent a modifiable risk factor. However, there is limited research on insomnia as a predictor of subsequent performance in different cognitive domains and mechanisms that might underlie domain-specific associations. The current study examined: (1) which insomnia symptoms predicted performance across five cognitive domains 14 years later, and (2) whether depressive symptoms and/or vascular diseases mediated these associations. Methods Participants included 2,496 adults aged 51+ in the Health and Retirement Study. Insomnia symptoms in 2002 (i.e., “baseline”) were quantified by four self-reported items on frequency of trouble falling asleep, nighttime awakenings, early awakenings, and feeling rested upon awakening. Cognition was assessed in 2016 as part of the Harmonized Cognitive Assessment Protocol and operationalized with five factor scores corresponding to episodic memory, executive function, language, visuoconstruction, and processing speed. Multiple regressions examined associations between baseline insomnia symptoms and subsequent cognitive performance, controlling for sociodemographics and baseline global cognitive performance. Mediation models tested whether associations were explained by self-reported depressive symptoms and/or vascular diseases (i.e., hypertension, heart disease, diabetes, and/or stroke) in 2014, controlling for baseline values. Results Only trouble falling asleep in 2002 was associated with cognition in 2016. Specifically, more frequent trouble falling asleep predicted poorer episodic memory, executive function, language and processing speed performance, but not visuoconstruction. These associations were mediated by depressive symptoms and vascular diseases in 2014 for all domains except episodic memory; only depressive symptoms mediated the association involving memory. After accounting for these mediators, direct effects of trouble falling asleep remained for episodic memory, executive function and language, but not processing speed. Conclusion Difficulty with sleep initiation may be more consequential for later-life cognition than other insomnia symptoms. Depressive symptoms and vascular diseases may partially drive these associations. We speculate that sleep-onset insomnia could mean less total sleep, immune dysfunction, or endocrine effects that worsen mood, vascular health, and cognition. Remaining associations indicate that additional research is needed to characterize other mechanisms through which sleep initiation problems could contribute to later impairments in frontal and temporal cognitive systems, which are implicated early in ADRD. Support (if any):

scholarly journals The Effect of Midlife Cardiovascular Risk Factors on Cognitive Function Nearly Half a Decade Later

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 894-894
Author(s):  
Teresa Warren ◽  
Shandell Pahlen ◽  
Hong Xian ◽  
Jennifer De Anda ◽  
William Kremen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Executive Function ◽  
Cardiovascular Risk ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cardiovascular Risk Factors ◽  
Processing Speed ◽  
Cardiovascular Health ◽  
Semantic Fluency ◽  
Cognitive Domains

Abstract Several cardiovascular risk factors (CVRFs) have been associated with poor cognitive function. However, few studies have examined these factors longitudinally during midlife. We hypothesized that more midlife CVRFs would predict worse cognitive function approximately six years later. Participants were 886 men who participated in waves 2 and 3 of the Vietnam Era Twin Study of Aging. The American Heart Association’s “Life’s Simple 7” index was used to measure CVRFs. CVRFs were assessed at mean age 61 (range 55-66) and included smoking, physical activity, diet, body mass index, cholesterol, glucose, and blood pressure. Each factor was coded on a 3-point scale (0-2), ranging from poor to ideal status. These scores were then used to create a composite CVRF index (0-14). We examined several cognitive domains assessed at mean age 67 (range 61-73): abstract reasoning, episodic memory, processing speed, executive function, working memory, general verbal fluency, and semantic fluency. Analyses were adjusted for ethnicity, and education, and mean age 61. In the generalized estimating equation models, there were significant main effects indicating that the CVRF index at mean age 61 significantly predicted cognitive function at mean age 67 in episodic memory, 95% CI [.01, .08], p = .01, processing speed, 95% CI [.02, .09], p = .01, and executive function, 95% CI [.00, .06] ], p = .03. The CVRF index did not predict cognitive function in the other cognitive domains. These results suggest that poor cardiovascular health in late midlife may exacerbate cognitive decline.

scholarly journals Impaired Cognitive Performance in Patients With Mild Autonomous Cortisol Secretion

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A84-A85
Author(s):  
Catherine D Zhang ◽  
Sumitabh Singh ◽  
Malavika Suresh ◽  
Andreas Ladefoged Ebbehøj ◽  
Nikki H Stricker ◽  
...  
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Neuropsychiatric Symptoms ◽  
Cortisol Secretion ◽  
Autonomous Cortisol Secretion ◽  
The Impact ◽  
Age And Sex

Abstract Background: Cognitive deficits in memory, language, and executive function have been described in Cushing’s syndrome, but the impact of mild cortisol secretion on cognition is unclear. Rather than overt hypercortisolism, mild autonomous cortisol secretion (MACS) is typically associated with abnormal circadian cortisol production. Aim: To characterize the effect of MACS on cognitive performance. Methods: We conducted a cross-sectional analysis as part of an ongoing cohort study in patients with MACS compared to age and sex-matched referent subjects without cortisol excess. MACS was defined as serum cortisol concentration >1.8 mcg/dL after the 1 mg overnight dexamethasone suppression test (DST), in the absence of signs and symptoms of overt Cushing syndrome. We used the National Institute of Health Toolbox Cognition Battery to assess cognitive performance. A series of seven IPad-based tests were administered to evaluate five key domains: 1) executive function, 2) episodic memory, 3) working memory, 4) language, and 5) processing speed. Performance was reported using fully corrected T-scores for age, sex, education, and race with a normative mean of 50 and a standard deviation of 10. T-scores were generated for the individual components as well as three summary measures: 1) fluid cognition (includes executive function, episodic memory, working memory, and processing speed), 2) crystallized cognition (includes language), and 3) total cognition (composite of fluid and crystalized cognition). Results: A total of 23 patients with MACS and 23 age and sex-matched referent subjects without cortisol excess were enrolled. The median age of diagnosis was 63 years (range, 51–81), and 26 (56%) were women. In the MACS cohort, median cortisol following 1 mg DST was 2.6 ug/dL (range, 1.9–13.0) with median ACTH of 8.5 pg/mL (range, 5.0–38.0) and median DHEA-S of 37 mcg/dL (range, 5.0- 141.0). On cognitive assessment, patients with MACS had lower total cognition (T-scores 50 vs. 54, p=0.05) and fluid cognition (T-scores 48 vs. 53, p=0.01) composite scores compared to referent subjects without cortisol excess. In particular, patients with MACS performed worse on tests of executive function (Dimensional Change Card Sort: T-scores 55 vs. 63, p= 0.02 and Flanker Inhibitory Control and Attention: T-scores 45 vs. 52, p=0.01). There were no significant differences observed in the remaining individual domains of language, processing speed, working memory, and episodic memory, or crystallized cognition. Conclusions: MACS is associated with impaired total cognition, and in particular, executive function and fluid cognition. These findings suggest that patients with MACS are susceptible to cortisol-mediated changes in the brain. Additional studies should examine the contribution of neuropsychiatric symptoms on cognition in MACS, and possible improvement following treatment for cortisol excess.

scholarly journals Obesity Measures in Relation to Cognition in the Northern Manhattan Study

2020 ◽  
Vol 78 (4) ◽  
pp. 1653-1660
Author(s):  
Hannah Gardener ◽  
Michelle Caunca ◽  
Chuanhui Dong ◽  
Ying Kuen Cheung ◽  
Tatjana Rundek ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Standard Deviation ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Later Life ◽  
Initial Assessment ◽  
Cognitive Domains ◽  
The Relationship ◽  
Over Time

Background: Mid-life obesity is associated with cognitive impairment, though the relationship for late-life obesity is equivocal, and may depend on the anthropometric measure. Objective: We examined the relationship between adiposity and cognition across age categories, cognitive domains, and by measures of obesity in a multi-ethnic population-based cohort. Methods: The study included 1,179 Northern Manhattan Study participants with obesity measures at baseline (44% overweight, 30% obese), an initial neuropsychological assessment conducted within 7 years (mean age = 70), and a second cognitive assessment conducted on average 6 years later. Z-scores were derived for cognitive domains (episodic and semantic memory, executive function, processing speed) and averaged to calculate global cognition. Body mass index (BMI) and waist:hip ratio (WHR) were examined in relation to cognitive performance and change over time, stratified by age, using linear regression models adjusting for vascular risk factors. Results: Among those age<65 years at baseline, greater WHR was associated with worse global cognitive performance at initial assessment and directly associated with decline in performance between assessments. The association with initial performance was strongest for non-Hispanic Whites (beta = –0.155/standard deviation, p = 0.04), followed by non-Hispanic Black/African Americans (beta = –0.079/standard deviation, p = 0.07), and Hispanics (beta = –0.055/standard deviation, p = 0.03). The associations were most apparent for the domains of processing speed and executive function. There was no association for BMI among those <65 years. Among those age ≥65, there was no association for BMI or WHR with cognitive performance at initial assessment nor decline over time. Conclusion: Our results support the detrimental effect of mid-life rather than later life obesity, particularly abdominal adiposity, on cognitive impairment and decline.

scholarly journals Slow Wave Sleep and EEG Delta Spectral Power are Associated with Cognitive Function in Parkinson’s Disease

2020 ◽  
pp. 1-12
Author(s):  
Kimberly H. Wood ◽  
Adeel A. Memon ◽  
Raima A. Memon ◽  
Allen Joop ◽  
Jennifer Pilkington ◽  
...  
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Cognitive Performance ◽  
Slow Wave ◽  
Effect Size ◽  
Processing Speed ◽  
Slow Wave Sleep ◽  
Spectral Power ◽  
Z Scores ◽  
Domain Scores

Background: Cognitive and sleep dysfunction are common non-motor symptoms in Parkinson’s disease (PD). Objective: Determine the relationship between slow wave sleep (SWS) and cognitive performance in PD. Methods: Thirty-two PD participants were evaluated with polysomnography and a comprehensive level II neurocognitive battery, as defined by the Movement Disorders Society Task Force for diagnosis of PD-mild cognitive impairment. Raw scores for each test were transformed into z-scores using normative data. Z-scores were averaged to obtain domain scores, and domain scores were averaged to determine the Composite Cognitive Score (CCS), the primary outcome. Participants were grouped by percent of SWS into High SWS and Low SWS groups and compared on CCS and other outcomes using 2-sided t-tests or Mann-Whitney U. Correlations of cognitive outcomes with sleep architecture and EEG spectral power were performed. Results: Participants in the High SWS group demonstrated better global cognitive function (CCS) (p = 0.01, effect size: r = 0.45). In exploratory analyses, the High SWS group showed better performance in domains of executive function (effect size: Cohen’s d = 1.05), language (d = 0.95), and processing speed (d = 1.12). Percentage of SWS was correlated with global cognition and executive function, language, and processing speed. Frontal EEG delta power during N3 was correlated with the CCS and executive function. Cognition was not correlated with subjective sleep quality. Conclusion: Increased SWS and higher delta spectral power are associated with better cognitive performance in PD. This demonstrates the significant relationship between sleep and cognitive function and suggests that interventions to improve sleep might improve cognition in individuals with PD.

scholarly journals Association of AKAP6 and MIR2113 with cognitive performance in a population based sample of older adults

2016 ◽  
Author(s):  
Shea J. Andrews ◽  
Debjani Das ◽  
Kaarin J. Anstey ◽  
Simon Easteal
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Cognitive Change ◽  
European Ancestry ◽  
Substantial Contribution ◽  
Perceptual Speed ◽  
Cognitive Domains

AbstractGenetic factors make a substantial contribution to inter-individual variability in cognitive function. A recent meta-analysis of genome-wide association studies identified two loci, AKAP6 and MIR2113 that are associated with general cognitive function. Here, we extend this previous research by investigating the association of MIR2113 and AKAP6 with baseline and longitudinal nonlinear change across a broad spectrum of cognitive domains in community-based cohort of 1,570 older adults without dementia. Two SNPs, MIR211-rs10457441 and AKAP6-rs17522122 were genotyped in 1,570 non-demented older Australians of European ancestry, who were examined up to 4 times over 12 years. Linear mixed effects models were used to examine the association between AKAP6 and MIR2113 with cognitive performance in episodic memory, working memory, vocabulary, perceptual speed and reaction time at baseline and with linear and quadratic rates of change. AKAP6-rs17522122*T was associated with worse baseline performance in episodic memory, working memory, vocabulary and perceptual speed, but it was not associated with cognitive change in any domain. MIR2113-rs10457441*T was associated with accelerated decline in episodic memory. No other associations with baseline cognitive performance or with linear or quadratic rate or cognitive changes was observed for this SNP. These results confirm the previous finding that, AKAP6 is associated with performance across multiple cognitive domains at baseline but not with cognitive decline, while MIR2113 primarily affects the rate at which memory declines over time.

Cognitive performance and the course of depressive symptoms over 7 years of follow-up: the SMART-MR study

2014 ◽  
Vol 45 (8) ◽  
pp. 1741-1750 ◽  
Author(s):  
M. Kooistra ◽  
N. P. A. Zuithoff ◽  
A. M. Grool ◽  
M. Zinsmeester ◽  
G. J. Biessels ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Performance ◽  
Estimating Equation ◽  
Multiple Time ◽  
Information Processing Speed ◽  
Cognitive Domains ◽  
Interaction Terms ◽  
Multiple Time Points ◽  
Mr Study

BackgroundDepressive symptoms and cognitive impairment often co-occur, but their interactive relationship is complex and the direction of causation is still a topic of research. We examined the influence of cognitive performance on the course of depressive symptoms during 7 years of follow-up in patients with vascular disease.MethodWithin the SMART-MR study, 736 patients (mean age 62 ± 10 years) had neuropsychological assessment on four cognitive domains at baseline [memory (MEM), working memory (WMEM), executive functioning (EXEC), and information processing speed (SPEED)]. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9) at baseline and every 6 months during 7 years of follow-up. Generalized Estimating Equation (GEE) models were used to assess the association between cognitive performance with depressive symptoms at multiple time points during follow-up. Interaction terms between the respective cognitive domains and time was included to examine if the course of depressive symptoms differed according to baseline cognitive performance.ResultsThe GEE analyses showed no significant interactions between the respective cognitive domains and time indicating no different course of depressive symptoms according to baseline cognitive performance. Lower MEM, EXEC or SPEED, but not WMEM performance, was significantly associated with more depressive symptoms during follow-up per z score decrease: MEM [B = 0.70, 95% confidence interval (CI) 0.35–1.05]; EXEC (B = 0.88, 95% CI 0.41–1.36), and SPEED (B = 0.57, 95% CI 0.21–0.92).ConclusionsPoorer cognitive performance on the domains MEM, EXEC and SPEED, but not WMEM, was associated with higher levels of depressive symptoms over 7 years of follow-up, but not with a different course of depressive symptoms over time.

scholarly journals Relationship between depressive symptoms and cognitive status in acute ischemic stroke

Psihologija ◽  
2009 ◽  
Vol 42 (4) ◽  
pp. 479-489
Author(s):  
Vojislava Bugarski ◽  
Marija Semnic ◽  
Petar Slankamenac
Keyword(s):  
Ischemic Stroke ◽  
Depressive Symptoms ◽  
Acute Ischemic Stroke ◽  
Neuropsychological Testing ◽  
Cognitive Status ◽  
Two Dimensions ◽  
Stroke Patients ◽  
Cognitive Domains ◽  
Immediate Recall ◽  
Function Language

Depressive symptoms and cognitive impairment frequently occur already in the acute phase of ischemic stroke. The aim of the study was to determine whether there was an association between depressive symptoms and different domains of the cognitive status in acute ischemic stroke patients and to identify cognitive domains that significantly correlated with the presence of depressive symptoms. The study comprised 40 acute ischemic stroke patients (26 men and 14 women) aged 45-78 years, with 8-16 years of education. The presence of depressive symptoms was assessed using the self-reported Beck's Depression Inventory (BDI), whereas the cognitive status was evaluated using a comprehensive neuropsychological testing battery measuring performance in different cognitive domains. The following domains were evaluated: executive function, language, immediate recall, delayed recall, attention, divergent reasoning, and visual-constructive performance in two dimensions. The multiple regression analysis was applied. The results showed a significant association between the presence of depressive symptoms and different cognitive domains. The domain of language was found to be a significant partial predictor of depression, with poorer performance in this domain correlating with a higher prevalence of depressive symptoms.

scholarly journals Association of glial and neuronal degeneration markers with Alzheimer‘s disease cerebrospinal fluid profile and cognitive functions

2020 ◽  
Author(s):  
Unnur D. Teitsdottir ◽  
Maria K. Jonsdottir ◽  
Sigrun H. Lund ◽  
Taher Darreh-Shori ◽  
Jon Snaedal ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Episodic Memory ◽  
Processing Speed ◽  
Cognitive Functions ◽  
Neuronal Degeneration ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cognitive Domains ◽  
Verbal Episodic Memory

Abstract Background Neuroinflammation has gained increasing attention as a potential contributing factor in the onset and progression of Alzheimer‘s disease (AD). The objective of this study was to examine the association of selected cerebrospinal fluid (CSF) inflammatory and neuronal degeneration markers with signature CSF AD profile and cognitive functions among subjects at the symptomatic pre- and early dementia stages.Methods In this cross-sectional study, 52 subjects were selected from an Icelandic memory clinic cohort. Subjects were classified as having CSF AD (n=28, age=67, 33% female, Mini-mental state examination [MMSE]=28) or non-AD (n=24, age=70, 39% female, MMSE=27) profile based on the ratio between CSF total-tau (T-tau) and amyloid-β 1‐42 (Aβ 42 ) values (cut-off point chosen as 0.52). Novel CSF biomarkers included Neurofilament light (NFL), YKL-40, S100 calcium-binding protein B (S100B) and Glial fibrillary acidic protein (GFAP), measured with enzyme-linked immunosorbent assay (ELISA). Subjects underwent a neuropsychological assessment for evaluation of different cognitive domains including verbal episodic memory, non-verbal memory, language, processing speed and executive functions.Results Accuracy for distinguishing between the two CSF profiles was calculated for each CSF marker and cognitive domain. Verbal episodic memory performed the best overall (Area under curve [AUC]=0.80), with AUCs for CSF markers ranging from 0.61 to 0.64. For estimation of the relationships between CSF markers and cognitive domains (adjusted for age and education), Pearson‘s correlation and ridge regression analyses were performed. The ratio between NFL and YKL-40 levels correlated higher with verbal episodic memory score (r=-0.51, p <0.001) compared to single protein levels (NFL: r=-0.26, p =0.06; YKL-40: r=0.18, p =0.20). The correlation was also higher among those with CSF AD profile (r=-0.67, p <0.001) compared to those without (r=-0.46, p =0.03). GFAP levels showed weak correlation with executive functions scores (r=-0.37, p =0.007). Among those with a CSF AD profile, both S100B (r=-0.45, p =0.02) and GFAP (0.68, p <0.001) levels correlated with processing speed scores.ConclusionsThe novel CSF markers NFL, YKL-40 and GFAP show potential as markers for cognitive decline among individuals with core AD pathology at the symptomatic pre- and early stages of dementia.

scholarly journals A Longitudinal 5-Year Follow-Up Study of Cognitive Function After First Episode Major Depressive Disorder: Exploring State, Scar and Trait Effects

2020 ◽  
Vol 11 ◽  
Author(s):  
Eivind Haga Ronold ◽  
Marit Therese Schmid ◽  
Ketil Joachim Oedegaard ◽  
Åsa Hammar
Keyword(s):  
Executive Function ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Cognitive Deficits ◽  
Processing Speed ◽  
First Episode ◽  
Follow Up Study ◽  
History Of ◽  
Initial Episode

Major depression (MDD) is associated with cognitive deficits in processing speed and executive function (EF) following first episode (FE). It is unclear whether deficits are state or trait related. Studies following FE MDD over longer periods are lacking, making it uncertain how cognition and symptoms develop after the initial episode. The present study assessed cognitive function and symptoms 5 years following FE MDD. In addition, the study explored relationships between MDD symptoms, rumination, and cognitive deficits with regards to the trait, state, and scar perspective. Twenty-three participants with previous FE MDD, and 20 matched control participants were compared on Delis-Kaplan Executive Function System measures of processing speed and EF, in a 5-year longitudinal follow-up study. Correlations between current symptoms- and history of MDD, rumination, cognition were investigated. Findings indicated that cognitive deficits persisted with no clear signs of exacerbation after initial episode. Inhibition appeared independent of current and previous symptoms of depression. Processing speed was related to depressive- symptoms and rumination. In conclusion, results indicated persisting, stable deficits in both EFs and processing speed. Findings further suggest that depressive symptoms could be related to deficits in processing speed, indicating state effects. There was limited support for worsening of cognition after initial episode. Some aspects of EF like Inhibition could show persistent deficits independent of depressive symptoms indicating trait effects.

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