Combined Memory and Executive Function Tests Can Screen Mild Cognitive Impairment and Converters to Dementia in a Community: The Osaki-Tajiri Project

Background: Older adults with Mild Cognitive Impairment (MCI) are at higher risk of falls and injuries, but the underlying mechanism is poorly understood. Inappropriate anticipatory postural adjustments to overcome balance perturbations are affected by cognitive decline. However, it is unknown whether anticipatory gait control to avoid an obstacle is affected in MCI. Objective: Using the dual-task paradigm, we aim to assess whether gait control is affected during obstacle negotiation challenges in older adults with MCI. Methods: Seventy-nine participants (mean age = 72.0 ± 2.7 years; women = 30.3%) from the “Gait and Brain Study” were included in this study (controls = 27; MCI = 52). In order to assess the anticipatory control behaviour for obstacle negotiation, a 6-m electronic walkway embedded with sensors recorded foot prints to measure gait speed and step length variability, during early (3 steps before the late phase) and late (3 steps before the obstacle) pre-crossing phases of an ad hoc obstacle, set at 15% of participant’s height. Participants walked under single- and dual-task gait (counting backwards by 1’s from 100 while walking) conditions. Three-way mixed repeated-measures analysis of variance models examined differences in gait performance between groups when transitioning between pre-crossing phases towards an obstacle during single- and dual-task conditions. Analyses were adjusted for age, sex, years of education, lower limb function, fear of falling, medical status, depressive symptoms, baseline gait speed and executive function. Results: A significant three-way interaction among groups, pre-crossing phases and task showed that participants with MCI attenuated the gait deceleration (p = 0.02) and performed fewer step length adjustments (p = 0.03) when approaching the obstacle compared with controls while dual-tasking. These interactions were attenuated when executive function performance was added as a covariate in the adjusted statistical model. Conclusion: Older adults with MCI attenuate the anticipatory gait adjustments needed to avoid an obstacle when dual-tasking. Deficits in higher-order cognitive processing may limit obstacle negotiation capabilities in MCI populations, being a potential falls risk factor.

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Working Memory and Executive Function Decline across Normal Aging, Mild Cognitive Impairment, and Alzheimer’s Disease

BioMed Research International ◽

10.1155/2015/748212 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 137

Author(s):

Anna-Mariya Kirova ◽

Rebecca B. Bays ◽

Sarita Lagalwar

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Working Memory ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Executive Dysfunction ◽

Normal Aging ◽

Future Research ◽

Neurological Differences

Alzheimer’s disease (AD) is a progressive neurodegenerative disease marked by deficits in episodic memory, working memory (WM), and executive function. Examples of executive dysfunction in AD include poor selective and divided attention, failed inhibition of interfering stimuli, and poor manipulation skills. Although episodic deficits during disease progression have been widely studied and are the benchmark of a probable AD diagnosis, more recent research has investigated WM and executive function decline during mild cognitive impairment (MCI), also referred to as the preclinical stage of AD. MCI is a critical period during which cognitive restructuring and neuroplasticity such as compensation still occur; therefore, cognitive therapies could have a beneficial effect on decreasing the likelihood of AD progression during MCI. Monitoring performance on working memory and executive function tasks to track cognitive function may signal progression from normal cognition to MCI to AD. The present review tracks WM decline through normal aging, MCI, and AD to highlight the behavioral and neurological differences that distinguish these three stages in an effort to guide future research on MCI diagnosis, cognitive therapy, and AD prevention.

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P495: The relationship between executive function and falls risk in people with mild cognitive impairment (MCI) and early stage dementia

European Geriatric Medicine ◽

10.1016/s1878-7649(14)70660-6 ◽

2014 ◽

Vol 5 ◽

pp. S239

Author(s):

V. Van der Wardt ◽

P. Logan ◽

T. Masud ◽

R. Harwood

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Early Stage ◽

Falls Risk ◽

The Relationship

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Home‐based evaluation of executive function (Home‐MET) for older adults with mild cognitive impairment

Alzheimer s & Dementia ◽

10.1002/alz.041368 ◽

2020 ◽

Vol 16 (S6) ◽

Author(s):

Frank Ho‐yin Lai

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Home Based

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Effectiveness of Combined Cognitive and Physical Interventions to Enhance Functioning in Older Adults With Mild Cognitive Impairment: A Systematic Review of Randomized Controlled Trials

The Gerontologist ◽

10.1093/geront/gnz149 ◽

2019 ◽

Vol 60 (8) ◽

pp. e633-e642 ◽

Cited By ~ 8

Author(s):

Chenchen Yang ◽

Ami Moore ◽

Elias Mpofu ◽

Diana Dorstyn ◽

Qiwei Li ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Randomized Controlled Trials ◽

Processing Speed ◽

Controlled Trials ◽

Positive Effects ◽

Randomized Controlled

Abstract Background and Objectives Cognitive training delivered in conjunction with physical activity, may help to optimize aging and delay or prevent dementia in individuals with mild cognitive impairment (MCI). However, their efficacy is less well studied compared to pharmaceutical treatments. This systematic review synthesizes the emerging evidence on combined cognitive-physical interventions for enhancing functioning in older adults with MCI, with implications for practice and research. Research Design and Methods We searched the PubMed, PsycINFO, Ageline, Medline, Web of Science and ProQuest databases, and hand-searched articles published between July 2013 and November 2018. Only randomized controlled trials which incorporated cognitive and physical components targeted to individuals with MCI over the age of 50 were eligible. Our search yielded 10 eligible, independent articles. Results Intervention participants with MCI self-reported, or demonstrated, improved functioning across a range of cognitive (global cognitive function, executive function, processing speed, memory, attention, mood, emotion, motivation, brain cortex, orientation), and physical (gait, balance, mobility) outcomes. Interventions which combined cognitive-physical training were comparable to those which isolated these same elements, in terms of their effects on executive function, processing speed, attention, mood, and cardiorespiratory fitness. Discussion and Implications There is preliminary evidence to support the positive effects of multicomponent interventions to improve cognitive-motor abilities in older adults at risk of developing dementia. The strength of this research evidence is, however, limited. Longitudinal studies are needed to determine whether these effects are maintained over time. The optimal intervention intensity and length also need to be established.

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Playing Mahjong for 12 Weeks Improved Executive Function in Elderly People With Mild Cognitive Impairment: A Study of Implications for TBI-Induced Cognitive Deficits

Frontiers in Neurology ◽

10.3389/fneur.2020.00178 ◽

2020 ◽

Vol 11 ◽

Cited By ~ 1

Author(s):

Han Zhang ◽

Yi Peng ◽

Chunliu Li ◽

Hong Lan ◽

Guoqiang Xing ◽

...

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Elderly People ◽

Cognitive Deficits

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Exercise Increases the Dynamics of Diurnal Cortisol Secretion and Executive Function in People With Amnestic Mild Cognitive Impairment

Journal of Aging and Physical Activity ◽

10.1123/japa.2014-0006 ◽

2015 ◽

Vol 23 (4) ◽

pp. 550-558 ◽

Cited By ~ 16

Author(s):

Juan Tortosa-Martínez ◽

Angela Clow ◽

Nuria Caus-Pertegaz ◽

Gloria González-Caballero ◽

Immaculada Abellán-Miralles ◽

...

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Exercise Intervention ◽

Exercise Program ◽

Cortisol Concentration ◽

Control Group ◽

Cortisol Secretion ◽

Before And After ◽

Exercise Induced

Regular physical activity is protective against, and beneficial for, mild cognitive impairment (MCI), dementia, and Alzheimer’s disease. The mechanisms underlying these benefits remain unknown although it has been suggested that exercise-induced changes in the circadian pattern of cortisol secretion may be implicated. Fitness, salivary cortisol levels (0 and 30 min postawakening, midday, 5 p.m., and 9 p.m.), and cognitive function were determined in a group of amnestic MCI patients (n = 39) before and after a three-month exercise program (n = 19) or usual care (n = 20). At baseline, fitness measures were positively correlated with peak levels of cortisol and a greater fall in cortisol concentration from peak levels to midday. The exercise intervention successfully increased fitness and resulted in a greater fall in cortisol concentration from peak to midday, compared with the control group. The exercise intervention enhanced indices of executive function, although memory, mood, and functionality were not affected.

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