scholarly journals Self-reported health behaviors and longitudinal cognitive performance: Results from the Wisconsin Registry for Alzheimer’s Prevention

2019 ◽  
Author(s):  
Kimberly D. Mueller ◽  
Rebecca L. Koscik ◽  
Derek Norton ◽  
Martha C. Morris ◽  
Erin M. Jonaitis ◽  
...  

AbstractBackgroundStudies have suggested associations between self-reported engagement in health behaviors and reduced risk of cognitive decline. Most studies explore these relationships using one health behavior, often cross-sectionally or with dementia as the outcome. In this study, we explored whether several individual self-reported health behaviors were associated with cognitive decline when considered simultaneously, using data from the Wisconsin Registry for Alzheimer’s Prevention (WRAP), an Alzheimer’s disease risk-enriched cohort who were non-demented and in late midlife at baseline.MethodWe analyzed longitudinal cognitive data from 828 participants in WRAP, with a mean age at baseline cognitive assessment of 57 (range = 36-78, sd = 6.8) and an average of 6.3 years (standard deviation = 1.9, range = 2-10) of follow-up. The primary outcome was a multi-domain cognitive composite, and secondary outcomes were immediate/delayed memory and executive function composites. Predictors of interest were self-reported measures of physical activity, cognitive activity, adherence to a Mediterranean-style diet (MIND), and interactions with each other and age. We conducted linear mixed effects analyses within an Information-theoretic (IT) model averaging (MA) approach on a set of models including covariates and combinations of these 2- and 3-way interactions. The IT approach was selected due to the large number of interactions of interest and to avoid pitfalls of traditional model selection approaches.ResultsModel-averaged results identified no significant modifiable behavior*age interactions in relationship to the primary composite outcome. In secondary outcomes, higher MIND diet scores associated with slower decline in executive function. Men showed faster decline than women on delayed memory, independent of health behaviors. There were no other significant interactions among any other health behaviors and cognitive trajectories.ConclusionsWhen multiple covariates and health behaviors were considered simultaneously, there were limited weak associations with cognitive decline in this age range. These results may be explained alone or in combination by three alternative explanations: 1) the range of cognitive decline is in middle age is too small to observe relationships with health behaviors, 2) the putative associations of these health behaviors on cognition may not be robust in this age range, or 3) the self-reported measures of the health behaviors may not be optimal for predicting cognitive decline. More study may be needed that incorporates sensitive measures of health behaviors, AD biomarker profiles, and/or other disease comorbidities.

2019 ◽  
Vol 50 (2) ◽  
pp. 403-413 ◽  
Author(s):  
Carlijn M. Maasakkers ◽  
◽  
Jurgen A. H. R. Claassen ◽  
Paul A. Gardiner ◽  
Marcel G. M. Olde Rikkert ◽  
...  

Abstract Background Besides physical activity as a target for dementia prevention, sedentary behaviour is hypothesized to be a potential target in its own right. The rising number of persons with dementia and lack of any effective treatment highlight the urgency to better understand these modifiable risk factors. Therefore, we aimed to investigate whether higher levels of sedentary behaviour are associated with reduced global cognitive functioning and slower cognitive decline in older persons without dementia. Methods We used five population cohorts from Greece, Australia, USA, Japan, and Singapore (HELIAD, PATH, SALSA, SGS, and SLAS2) from the Cohort Studies of Memory in an International Consortium. In a coordinated analysis, we assessed the relationship between sedentary behaviour and global cognitive function with the use of linear mixed growth model analysis (mean follow-up range of 2.0–8.1 years). Results Baseline datasets combined 10,450 older adults without dementia with a mean age range between cohorts of 66.7–75.1 years. After adjusting for multiple covariates, no cross-sectional association between sedentary behaviour and cognition was found in four studies. One association was detected where more sedentary behaviour was cross-sectionally linked to higher cognition levels (SLAS2, B = 0.118 (0.075; 0.160), P < 0.001). Longitudinally, there were no associations between baseline sedentary behaviour and cognitive decline (P > 0.05). Conclusions Overall, these results do not suggest an association between total sedentary time and lower global cognition in older persons without dementia at baseline or over time. We hypothesize that specific types of sedentary behaviour may differentially influence cognition which should be investigated further. For now, it is, however, too early to establish undifferentiated sedentary time as a potential effective target for minimizing cognitive decline in older adults without dementia.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 331-332
Author(s):  
Jacqueline Guzman ◽  
Yuliana Soto ◽  
David Marquez ◽  
Susan Aguinaga

Abstract Latinos have high risk of Alzheimer’s disease and related dementias (ADRD). Self-rated health (SRH) has been used to predict cognitive decline. Early detection of executive function changes may help identify those at higher risk of cognitive decline. The purpose of this study was to examine the relationship between SRH and executive function in Latinos. Latinos (N=333, 84.4% female, Mage= 64.9 ± 7.08) from the BAILA randomized controlled trial self-rated their health as 1) poor/fair, 2) good, and 3) very good/excellent. Executive function was assessed by the Trail-making B, Verbal Fluency, Stroop C & CW, and the Digit Modality tests and stratified by SRH. One-way analysis of variance showed that the effect of SRH was significant for Trails B, F(2,298)=4.01, p=.019 and Stroop CW, F(2,298)=3.07, p=.048. Tukey’s test indicated that participants who rated their health as fair/poor took longer to complete Trails B (M=196.78±83.0 seconds) compared to those who rated their health as good (M=185.25 ± 85.1 seconds) and very good/excellent (M=149.25±95.3 seconds). Stroop CW results demonstrated that those in the fair/poor health category scored lower (M=17.22±6.6) than those in good (M=19.70±8.5 words/minutes) and very good/excellent health categories (M=18.73±8.2 words/minute). In sum, the results suggest SRH is related to executive function such that lower categories of SRH are indicative of poorer executive function. SRH might be used as a proxy for executive function and as a tool that community leaders can use to identify individuals at high risk of ADRD in need of behavioral interventions.


2020 ◽  
Vol 32 (S1) ◽  
pp. 82-82

Authors:Henry Brodaty, Megan Heffernan, Gavin Andrews, Kaarin Anstey, Maria Fiatarone Singh, Louisa Jorm, Nicola Lautenschlager, Anthony Maeder, John McNeill, Perminder Sachdev, Michael Valenzuela, Maintain Your Brain Collaborative Team.Abstract:In the absence of disease modifying interventions for Alzheimer’s disease (AD) and other dementias there is an increased interest in dementia prevention. An issue for population-based lifestyle preventative approaches is scalability. An internet-based multicomponent Maintain Your Brain (MYB) randomised trial is currently underway.Invitations to participate in Maintain Your Brain were emailed or mailed to people aged 55-77 years from the 45 and Up study, a population-based cohort study of one in ten people aged 45 years and older (n = 267,000). To be enrolled into the study participants were required to have risk factors that made them eligible for at least one of the available modules. Modules were designed to address physical inactivity and health risks associated with inactivity (Physical Activity), adherence to a Mediterranean-type diet and health risks associated with poor nutrition (Nutrition), cognitive activity (Brain Training) and mental wellbeing (Peace of Mind).During recruitment 96,418 invitations were sent and 14,064 (14%) provided consent. Of those who completed baseline over 90% were eligible for at least two modules of the intervention. Overall, 6,236 (44%) were enrolled resulting in an overall recruitment rate of 6%, or 50% of those eligible at screening. The final sample was 64% female with a mean age of 64.9yrs (SD = 5.8, range 55-77 yrs) and mean years of education of 12.9yrs (SD = 3.0, range 2-22 yrs).Recruitment rates in MYB were comparable to other clinical trials targeting older people and who included online recruitment strategies. This is promising for the willingness of participants to engage with trials that use online rather than traditional in-person methods. Although the baseline withdrawal number (3%) remained stable after randomisation (4%), a further 25% of participants did not attempt any activities. These rates continued at the annual assessments when 4% withdrew, 31% completed no follow-up activities, 14% partially completed and 55% completed all.Online lifestyle interventions have capacity to reach broad segments of the 55-77 year old population, the majority of whom may benefit from support activities shown to be effective in reducing risk of cognitive decline and ultimately delay onset of dementia. The challenge with this new approach is encouraging continued engagement with the program over time.


2021 ◽  
Author(s):  
Nicolai Franzmeier ◽  
Rik Ossenkoppele ◽  
Matthias Brendel ◽  
Anna Rubinski ◽  
Ruben Smith ◽  
...  

2021 ◽  
pp. 1-14
Author(s):  
Daniel E. Gustavson ◽  
Amy J. Jak ◽  
Jeremy A. Elman ◽  
Matthew S. Panizzon ◽  
Carol E. Franz ◽  
...  

Background: Although not strongly correlated with current objective cognitive ability, subjective cognitive decline (SCD) is a risk factor for Alzheimer’s disease. Most studies focus on SCD in relation to future decline rather than objective prior decline that it purportedly measures. Objective: We evaluated whether self-report of cognitive decline—as a continuous measure—corresponds to objectively-assessed episodic memory and executive function decline across the same period. Methods: 1,170 men completed the Everyday Cognition Questionnaire (ECog) at mean age 68 assessing subjective changes in cognitive ability relative to 10 years prior. A subset had mild cognitive impairment (MCI), but MCI was diagnosed without regard to subjective decline. Participants completed up to 3 objective assessments of memory and executive function (M = 56, 62, and 68 years). Informant-reported ECogs were completed for 1,045 individuals. Analyses controlled for depression and anxiety symptoms assessed at mean age 68. Results: Participant-reported ECog scores were modestly associated with objective decline for memory (β= –0.23, 95%CI [–0.37, –0.10]) and executive function (β= –0.19, 95%CI [–0.33, –0.05]) over the same time period. However, these associations were nonsignificant after excluding MCI cases. Results were similar for informant ratings. Participant-rated ECog scores were more strongly associated with concurrent depression and anxiety symptoms, (β= 0.44, 95%CI [0.36, 0.53]). Conclusion: Continuous SCD scores are correlated with prior objective cognitive changes in non-demented individuals, though this association appears driven by individuals with current MCI. However, participants’ current depression and anxiety ratings tend to be strongly associated with their SCD ratings. Thus, what primarily drives SCD ratings remains unclear.


2021 ◽  
Author(s):  
Havisha Pedamallu ◽  
Matthew J. Ehrhardt ◽  
Julia Maki ◽  
April Idalski Carcone ◽  
Melissa M. Hudson ◽  
...  

BACKGROUND Motivational interviewing is an effective strategy to mitigate chronic disease risk through promotion of health behavior changes. However, multiple barriers impede its delivery to and uptake by patients. mHealth-based versions of motivational interviewing interventions, or technology-delivered adaptations of motivational interviewing (TAMIs), might increase reach, but their effectiveness is less well-understood. OBJECTIVE The purpose of this narrative review was to characterize the extent to which TAMIs: (1) affect behavioral outcomes, (2) have included individuals from populations that have been marginalized, and (3) have addressed socio-contextual influences on health. METHODS We identified studies indexed in PubMed that described interventions incorporating motivational interviewing techniques into a mobile or electronic health platform. Data were abstracted from eligible studies, including target population characteristics, study design and eligibility criteria, theoretical/conceptual models utilized, mHealth tool details, and effects on behavioral outcomes. RESULTS Thirty-three studies reported the use of TAMIs. Sample sizes ranged from 10 to 2,069 participants ages 13 to 70 years. Most studies (n=24) directed interventions towards individuals engaging in behaviors that increased the risk of chronic disease. Most studies oversampled (n=18) individuals from marginalized socio-demographic groups, but few were designed specifically with marginalized groups in mind (n=3). TAMIs utilized text messaging (n=7), web-based (n=19), app + text messaging (n=1), and web-based + text messaging (n=3) delivery platforms. Twenty-seven (90%) included randomized controlled trials reporting behavioral and health-related outcomes, 21 of which reported statistically significant improvements in targeted behaviors with the use of TAMIs. TAMIs improved targeted health behaviors in the remaining 3 studies. Nine of 30 (30%) assessed TAMI feasibility, acceptability, and/or satisfaction, all of which rated TAMIs highly in this regard. Among 18 studies comprised of a disproportionately high number of racial or ethnic minorities, 15 (83%) reported increased engagement in health behaviors and/or better health outcomes. CONCLUSIONS TAMIs can improve health promotion and disease management behaviors for people from a variety of socio-demographic backgrounds. Future studies are needed to determine the contribution of TAMIs on individual health outcomes, and to determine best practices for implementing TAMIs into clinical practice.


2016 ◽  
Vol 12 ◽  
pp. P774-P774
Author(s):  
Sander C.J. Verfaillie ◽  
Rosalinde E.R. Slot ◽  
Betty M. Tijms ◽  
Femke H. Bouwman ◽  
Marije Benedictus ◽  
...  

2015 ◽  
Vol 94 (3) ◽  
pp. 136
Author(s):  
João Gabriel Magalhães Dias ◽  
Pablo Rodrigo Andrade da Silva ◽  
Tânia Corrêa de Toledo Ferraz Alvez

The elderly population is growing worldwide, and therefore cognitive decline and dementia is a major problem for healthcare system. However, many elders do not develop dementia or significant cognitive impairment even though present brain lesions, such as cortical atrophy and/or lesions, leading to the concept of Cognitive Reserve (CR). The main objective of this review is to establish the recent findings of CR in elderly cognition and explore some of the cognitive markers related to CR. In order to accomplish that we carried out a search for papers published either in English or Portuguese language in the last 5 years in the Medline database using as keywords cognitive reserve, elderly and aging/ageing. We filtered 14 studies that specifically approached the neuropsychological aspects (e.g, memory, attention, orientation, executive function) and reviewed them in detail. Based on these papers regarding old-aged individuals, education appears to have several implications on CR by strengthening cognitive abilities, however does not appear to impact on cognitive decline. Besides, we realized that cognitive performance is one of the form to measure CR, even though the methods cannot be standardized, which may be the cause of some varied conclusions. Regarding CR, education was the most prevalent measure, and CR seems to have a beneficial effect on executive function and episodic memory and it seems to act by both neural reserve and neural compensation. Print exposure appears as a potential variable positively related to cognitive performance and CR.


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