scholarly journals Cognitive decline associated with anticholinergics, benzodiazepines, and Z-drugs: findings from The Irish Longitudinal Study on Ageing (TILDA)

2020 ◽  
Author(s):  
Frank Moriarty ◽  
George M Savva ◽  
Carlota M Grossi ◽  
Kathleen Bennett ◽  
Chris Fox ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Medication Use ◽  
Community Dwelling ◽  
Word Recall ◽  
Middle Aged ◽  
Anticholinergic Medications ◽  
Pharmacy Claims ◽  
Burden Scale

Aim To estimate the association between patterns of anticholinergic, benzodiazepine, and Z-drug medication use and change in cognitive function in middle-aged and older adults. Method This prospective cohort study used data from the first three waves of The Irish Longitudinal Study on Ageing (TILDA), including community-dwelling adults aged ≥50 years followed for up to four years (n=7,027). Cognitive function was assessed using the Mini Mental State Examination, animal naming test, and word recall tests. Regular medication use was self-reported at baseline and follow-up interviews at two and four years. Pharmacy dispensing claims for a subset (n=2,905) allowed assessment of medication use between interviews and cumulative dosage. Medication use at consecutive waves of TILDA was analysed in relation to change in cognitive function between waves. Results Strongly anticholinergic medications (Anticholinergic Cognitive Burden scale 3), benzodiazepines, and Z-drugs were reported by 7.3%, 5.8% and 5.1% of participants respectively at any time during the study. Adjusting for potential confounders, new anticholinergic use between interviews was associated with change in recall score (-1.09, 95% confidence interval -1.64, -0.53) over 2 years compared to non-use, but not with MMSE (0.07; 95%CI -0.21, 0.34) or animal naming (-0.70; -1.43, 0.03). The pharmacy claims analysis was consistent with this finding. Other hypothesised associations were not supported. Discussion Except for new use of anticholinergic medications, no other findings supported a risk of cognitive decline over 2-year periods in this middle-aged and older cohort. Patients and prescribers should weigh this potential risk against potential benefits of commencing anticholinergic medications.

scholarly journals Environmental Factors Affecting Cognitive Function among Community-Dwelling Older Adults: A Longitudinal Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8528
Author(s):  
Atsushi Motohiro ◽  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Keiichi Onoda ◽  
Tomoko Ito ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Environmental Factors ◽  
Cognitive Decline ◽  
Rural Areas ◽  
Estimating Equation ◽  
Community Dwelling ◽  
Residential Density ◽  
Rural Older Adults

Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect on older adults living in rural areas. This longitudinal study aimed to investigate the role of neighborhood environmental factors in cognitive decline among rural older adults. The data of 485 older adults aged ≥60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were determined using geographic information system. We applied a generalized estimating equation with odds ratios (OR) and 95% confidence intervals (CIs) of cognitive decline in the quartiles of neighborhood environmental factors. A total of 56 (11.6%) participants demonstrated a decrease in cognitive function at follow up. Elevation (adjusted OR 2.58, 95% CI (1.39, 4.77) for Q4 vs. Q1) and hilliness (adjusted OR 1.93, 95% CI (1.03, 3.63) for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. The second quartiles of residential density showed significantly lower likelihoods of cognitive decline compared with the first quartiles (adjusted OR 0.36, 95% CI (0.19, 0.71) for Q2 vs. Q1). Thus, an elevated hilly environment and residential density predicted cognitive decline among rural older adults.

scholarly journals Interaction between cognitive leisure activity and long-chain polyunsaturated fatty acid intake on global cognitive decline in a Japanese longitudinal cohort study: National Institute for Longevity Sciences-Longitudinal Study of Aging

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chika Horikawa ◽  
Rei Otsuka ◽  
Yukiko Nishita ◽  
Chikako Tange ◽  
Yuki Kato ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Significant Interaction ◽  
Leisure Activities ◽  
Leisure Activity ◽  
Community Dwelling ◽  
Chain Polyunsaturated Fatty Acid ◽  
Art Appreciation ◽  
Long Chain

Abstract Background There is a growing interest in the significance of adopting a variety of lifestyle habits for maintaining cognitive function among older adults. A lifestyle that is easy to modify, simple, and less burdensome for older people is ideal. We investigated the longitudinal association between global cognitive decline and cognitive leisure activities (CLAs) combined with long-chain polyunsaturated fatty acids (LCPUFAs) intake. Methods The National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) enrolled community-dwelling middle-aged and older men and women who were randomly selected from Obu-City and Higashiura Town, Aichi, Japan. Baseline data (2006–2008), including CLAs and dietary intake, were obtained from 517 participants (aged 60–84 years) with normal cognition. Global cognitive decline, defined as the Mini-Mental State Examination (MMSE) score ≤ 27, was assessed at baseline and four years later. Interaction between CLAs and LCPUFAs on cognitive decline was investigated using a multiple logistic analysis with adjustment for confounders. CLA engagement and LCPUFA intake were divided into high and low groups according to the frequency at which each participant engaged in the activity and the median intake level according to sex, respectively. Results A significant interaction was detected for the combination of CLA engagement and LCPUFA intake. Logistic regression coefficients revealed significant interactions when participants engaged in more than five CLA varieties. One of the CLAs, art appreciation, produced a significant main effect against cognitive decline and a significant interaction in combination with LCPUFA intake. The major LCPUFAs—docosahexaenoic acid and arachidonic acid—also exhibited a significant interaction. The combination of high LCPUFA intake and high art appreciation frequency yielded a lower adjusted odds ratio for cognitive decline than the combination of low LCPUFA and low art appreciation [0.25 (95 % confidence intervals, 0.11–0.56)]. Conclusions Preserving cognitive function might be associated with a combination of varied and high-frequency engagement in CLAs combined with high LCPUFA intake.

scholarly journals Exploring the bidirectional associations between loneliness and cognitive functioning over 10 years: the English longitudinal study of ageing

2019 ◽  
Vol 48 (6) ◽  
pp. 1937-1948 ◽  
Author(s):  
Jiamin Yin ◽  
Camille Lassale ◽  
Andrew Steptoe ◽  
Dorina Cadar
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Fluency ◽  
Word Recall ◽  
Reverse Causality ◽  
Linear Slope ◽  
Rate Of Decline ◽  
English Longitudinal Study

Abstract Background As the population ages, cognitive decline and dementia have become major health concerns in the UK. Loneliness has been linked to cognitive decline, but the reverse causality of this association remains unclear. This study aims to examine whether there is a bidirectional relationship between loneliness and cognitive function in older English adults (age 50 years and over) over a 10-year follow-up. Methods Data came from a nationally representative sample of 5885 participants in the English Longitudinal Study of Ageing (ELSA), free of stroke or dementia and followed every 2 years up to wave 7 (2014–15). At each wave, cognitive function was measured with word recall and verbal fluency tests, and loneliness was measured with the abridged version of the revised UCLA Loneliness Scale. Bivariate dual change score models were used to assess the multivariate associations between loneliness and cognitive function, used interchangeably as exposures and outcomes. Results Greater loneliness at baseline was associated with poorer memory [β intercept = −0.03, standard error (SE) = 0.01, P  =  0.016] and verbal fluency (β intercept = −0.01, SE  =  001, P =  0.027) at baseline, and with a stronger linear rate of decline in both memory (β linear slope = −0.07, SE  =  001, P  ≤ 0.001) and verbal fluency (β linear slope = −0.09, SE  =  0.03, P =  0.003) over a 10-year follow-up period, although the performance on verbal fluency did not change substantially on average over this period. We also found that higher baseline memory, but not verbal fluency, predicted a slower change in loneliness (β linear slope = −0.01, SE  =  001, P =  0.004) and that a linear decline in memory was associated with an acceleration in loneliness (β quadratic slope = −0.02, SE  =  001, P  ≤ 0.001) during follow-up. Conclusions Higher loneliness is associated with poorer cognitive function at baseline and contributes to a worsening in memory and verbal fluency over a decade. These factors seem, however, to be partially intertwined, since baseline memory and its rate of decline also contribute to an increase in loneliness over time.

scholarly journals Association between anemia and cognitive decline among Chinese middle-aged and elderly: evidence from the China health and retirement longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tingting Qin ◽  
Mingming Yan ◽  
Zhen Fu ◽  
Yating Song ◽  
Wanrong Lu ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Cognitive Functions ◽  
Hemoglobin Concentration ◽  
Cognitive Test ◽  
Middle Aged ◽  
Cross Sectional ◽  
Global Cognitive Function

Abstract Background Our objective was to characterize the relationship of anemia and hemoglobin concentrations with cross-sectional cognitive functions and changes in cognitive functions over 2 years in a large sample of Chinese middle aged and elderly. Methods Ten thousand nine hundred eighteen adults aged 45 years or older participating in the China Health and Retirement Longitudinal Study (CHARLS) were used for cross-sectional analyses and 9324 were used for longitudinal analysis. Cognitive functions were assessed by memory recall (episodic memory), mental status (TICS), and global cognitive function at baseline survey (Visit 1) and first follow-up survey (Visit 2). The lower the cognitive test score, the worse the cognitive function. Anemia was defined as hemoglobin concentrations lower than 13 g/dl for men and lower than 12 g/dl for women. Adjusted multivariate regression analyses were used to explore the relationships of different cognitive domains with anemia and hemoglobin concentration. Results Overall, the prevalence of anemia was 12.86% and the mean hemoglobin concentration was 14.37 ± 2.20 g/dl. After adjusting for socio-demographic and health-related covariates, the cross-sectional association between anemia and global cognitive function [β (95%CI) = − 0.49(− 0.69~ − 0.29)], episodic memory [β (95%CI) = − 0.14(− 0.23~ − 0.05)], and TICS [β (95%CI) = − 0.23(− 0.38~ − 0.08)] were significant and did not differ by gender. The hemoglobin concentration was also associated with global cognitive function among the whole sample (P < 0.05 for all). The longitudinal analyses showed global cognitive function and episodic memory were associated with anemia independent of covariates (P < 0.05 for all). Sensitivity analyses further provided significant results showing the association between anemia and cognition decline (P < 0.05). Conclusion There was a cross-sectional and longitudinal association between anemia and accelerated decline in cognitive functions in Chinese middle-aged and elderly. This suggests that anemia and low hemoglobin concentrations are independent risk factors of cognitive decline.

scholarly journals Reading activity prevents long-term decline in cognitive function in older people: evidence from a 14-year longitudinal study

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Yu-Hung Chang ◽  
I-Chien Wu ◽  
Chao A. Hsiung
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Older People ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Education Levels ◽  
Reading Activity ◽  
Reduced Risk

ABSTRACT Objective: This study examined the effect of daily life reading activity on the risk of cognitive decline and whether the effect differs regarding education levels. Design: A longitudinal study with 6-, 10-, and 14-year follow-up. Setting: Face-to-face interviews with structured questionnaires at home. Participants: A representative sample of 1,962 Taiwanese community-dwelling older persons aged 64 and above, followed up in four waves of surveys over 14 years. Measurements: Baseline reading frequencies were measured based on a scale of leisure activity. The Short Portable Mental Status Questionnaire was used to measure cognitive performance. We performed logistic regression to assess associations between baseline reading and later cognitive decline. Interaction terms between reading and education were to compare the reading effects on cognitive decline at different education levels. Results: After adjusting for covariates, those with higher reading frequencies (≥1 time a week) were less likely to have cognitive decline at 6-year (adjusted odds ratio [AOR]: 0.54; 95% confidence interval [CI]: 0.34–0.86), 10-year (AOR: 0.58, 95% CI: 0.37–0.92), and 14-year (AOR: 0.54, 95% CI: 0.34–0.86); in a 14-year follow-up, a reduced risk of cognitive decline was observed among older people with higher reading frequencies versus lower ones at all educational levels. Conclusions: Reading was protective of cognitive function in later life. Frequent reading activities were associated with a reduced risk of cognitive decline for older adults at all levels of education in the long term.

scholarly journals Predictors of Changes in Cognitive Function in Older Korean Adults: The 2006–2018 Korean Longitudinal Study of Aging

2021 ◽  
Vol 18 (12) ◽  
pp. 6345
Author(s):  
Minjeong Kang ◽  
Inhwan Lee ◽  
Haeryun Hong ◽  
Jeonghyeon Kim ◽  
Hyunsik Kang
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Severe Cognitive Impairment ◽  
Korean Adults ◽  
Age Related ◽  
Normal Cognition

Cognitive decline with normal aging varies widely among individuals. This study aimed to investigate predictors of longitudinal changes in cognitive function in community-dwelling Korean adults aged 65 years and older. Data from 727 older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) survey from 2006 (baseline) until 2018 (seventh wave) were used. Cognitive performance was assessed with the Korean Mini-Mental State Examination. The participants were retrospectively classified into normal cognition, mild cognitive impairment, and moderate/severe cognitive impairment. Education, income, religion, living area, alcohol intake, smoking, physical activity, handgrip strength, functional dependency, depression, comorbidity, medications, fall experience, and unintentional weight loss were included as covariates. A linear mixed regression analysis showed that a steeper decline in cognitive function over time was significantly associated with parameters of poor socio-economic status, health conditions, and unhealthy behaviors. Individuals with mild cognitive impairment or moderate/severe cognitive impairment were likely to have steeper cognitive declines compared with individuals with normal cognition. The current findings of the study showed that age-related cognitive decline was multifactorial in older Korean adults.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

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.

The Long Arm of Childhood in China: Early-Life Conditions and Cognitive Function Among Middle-Aged and Older Adults

2017 ◽  
Vol 30 (8) ◽  
pp. 1319-1344 ◽  
Author(s):  
Zhenmei Zhang ◽  
Jinyu Liu ◽  
Lydia Li ◽  
Hongwei Xu
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Memory Performance ◽  
Word Recall ◽  
Middle Aged ◽  
Urban Residence ◽  
Childhood Conditions ◽  
Early Life Conditions ◽  
Childhood Socioeconomic Status ◽  
With Memory

Objective: This study examined the association between childhood conditions and cognitive function among middle-aged and older adults in China. Method: We analyzed data from the 2011 China Health and Retirement Longitudinal Study ( N = 11,868). Cognitive function was measured by word recall, a test of episodic memory. We examined the association between childhood conditions and cognitive function among the middle-aged (45-59 years) and the older (60 years and older) adults separately, using multilevel linear regressions. Results: Indicators of childhood socioeconomic status (SES) and nutrition were significantly associated with memory performance among the middle-aged and the older adults in China. Adulthood SES, education in particular, accounted for some but not all the associations. The protective effect of childhood urban residence was stronger for middle-aged women than for middle-aged men. Discussion: Childhood conditions are significantly associated with mid- to late-life cognitive function in China. The strengths of the associations may vary by gender and cohort.

Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Nutrition Survey

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.

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