Informant-Reported Cognitive Decline and Activity Engagement across Four Years in a Community Sample

Background: Subtle age-related cognitive decline may be associated with the capacity to remain engaged in mental, physical, and social activities. Informant reports of cognitive decline potentially provide additional information to psychometric tests on change in everyday cognitive function relevant to activity engagement. Objective: To investigate relations between decline in everyday cognitive function as assessed by informant report and activity engagement in community-dwelling older adults. Methods: A sample of cognitively normal older adults was drawn from the 2 latest waves of the PATH Through Life Study (n = 1,391; mean age 74.5 ± 1.5, 48.4% female). PATH is a 16-year longitudinal cohort study set in the Canberra/Queanbeyan district, Australia. Assessments were carried out at baseline, and at 3 subsequent time-points 4 years apart. At wave-4, the IQCODE, an informant measure of 4-year cognitive decline was provided by a spouse, family member, or friend of each participant. Activity engagement was assessed by the abbreviated RIASEC Mental Activity List, self-reported frequency and duration of physical activity (Whitehall Questionnaire) and the Lubben Social Network Scale that assessed interaction with family/friends. Participants provided demographic information, self-reported health status (SF-12), and responses to the Goldberg Depression Scale. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test (CVLT) were used to measure objective 4-year cognitive change. Those with MMSE score of ≤27 were excluded. Results: IQCODE score predicted disengagement from mental activities over 4 years in cognitively healthy adults (β = -0.056, standard error [SE] = 0.019, p = 0.004). This association was robust to covariate control and change on the SDMT which was also significantly related to mental activity disengagement. In models adjusted for change scores on the SDMT and the CVLT, the IQCODE was associated with less physical (β = -0.692, SE = 0.24, p = 0.004) and social engagement (β -0.046, SE = 0.021, p = 0.032), but relationships were attenuated with the inclusion of covariates. Conclusion: Informant-reported cognitive decline in a non-clinical sample was linked to activities that support cognitive health. Associations were robust to adjustment for cognitive change scores. Utilising informant reports prior to the manifestation of clinically relevant decline may identify those who would benefit most from personalised activity interventions.

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Hearing loss and cognitive function among Chinese older adults: The role of participation in leisure activities

10.21203/rs.2.20305/v2 ◽

2020 ◽

Author(s):

Jiamin Gao ◽

Nicole M. Armstrong ◽

Jennifer A. Deal ◽

Frank R. Lin ◽

Ping He

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Decline ◽

Fixed Effects ◽

Leisure Activities ◽

Leisure Activity ◽

Cognitive Change ◽

Activity Engagement

Abstract Background Hearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess whether having hearing loss were associated with cognitive decline and engagement in leisure activities modified this association among Chinese elderly. Methods Using data from the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011-2014, 9,710 individuals aged 65 years old or above with self-reported measures of hearing status and global cognition, as measured by the Modified Mini Mental Examination (MMSE), were included in this study. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and by sex. Results People with self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference on the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive function decline with 8% [-1.22, -0.39] increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognition. Actively participating in leisure activities modified the relationship between hearing loss and cognitive decline in males, while leisure activity engagement did not modify any associations among females. Conclusion Hearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.

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Hearing loss and cognitive function among Chinese older adults: The role of participation in leisure activities

10.21203/rs.2.20305/v1 ◽

2020 ◽

Author(s):

Jiamin Gao ◽

Nicole M. Armstrong ◽

Jennifer A. Deal ◽

Frank R. Lin ◽

Ping He

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Decline ◽

Fixed Effects ◽

Leisure Activities ◽

Leisure Activity ◽

Cognitive Change ◽

Activity Engagement

Abstract BackgroundHearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess whether having hearing loss were associated with cognitive decline and engagement in leisure activities modified this association among Chinese elderly.MethodsUsing data from the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011-2014, 9,710 individuals aged 65 years old or above with self-reported measures of hearing status and global cognition, as measured by the Modified Mini Mental Examination (MMSE), were included in this study. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and by sex.ResultsPeople with self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference on the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive function decline with 8% [-1.22, -0.39] increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognition. Actively participating in leisure activities modified the relationship between hearing loss and cognitive decline in males, while leisure activity engagement did not modify any associations among females.ConclusionHearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.

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

Circulation ◽

10.1161/circ.131.suppl_1.22 ◽

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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The Relationship between Subjective Cognitive Decline and Health Literacy in Healthy Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare8040567 ◽

2020 ◽

Vol 8 (4) ◽

pp. 567

Author(s):

Akio Goda ◽

Shin Murata ◽

Hideki Nakano ◽

Koji Nonaka ◽

Hiroaki Iwase ◽

...

Keyword(s):

Older Adults ◽

Health Literacy ◽

Cognitive Function ◽

Cognitive Decline ◽

Depression Scale ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Healthy Community ◽

Community Dwelling Older Adults ◽

The Relationship

Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population.

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Plasma MCP-1 and changes on cognitive function in community-dwelling older adults

Alzheimer s Research & Therapy ◽

10.1186/s13195-021-00940-2 ◽

2022 ◽

Vol 14 (1) ◽

Author(s):

Juan Luis Sanchez-Sanchez ◽

Kelly V. Giudici ◽

Sophie Guyonnet ◽

Julien Delrieu ◽

Yan Li ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Episodic Memory ◽

Cognitive Decline ◽

Continuous Variable ◽

Community Dwelling ◽

Clinical Dementia Rating ◽

Delayed Recall ◽

Domain Specific

Abstract Background Monocyte Chemoattractant Protein-1 (MCP-1), a glial-derived chemokine, mediates neuroinflammation and may regulate memory outcomes among older adults. We aimed to explore the associations of plasma MCP-1 levels (alone and in combination with β-amyloid deposition—Aβ42/40) with overall and domain-specific cognitive evolution among older adults. Methods Secondary analyses including 1097 subjects (mean age = 75.3 years ± 4.4; 63.8% women) from the Multidomain Alzheimer Preventive Trial (MAPT). MCP-1 (higher is worse) and Aβ42/40 (lower is worse) were measured in plasma collected at year 1. MCP-1 in continuous and as a dichotomy (values in the highest quartile (MCP-1+)) were used, as well as a dichotomy of Aβ42/40. Outcomes were measured annually over 4 years and included the following: cognitive composite z-score (CCS), the Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) sum of boxes (overall cognitive function); composite executive function z-score, composite attention z-score, Free and Cued Selective Reminding Test (FCSRT - memory). Results Plasma MCP-1 as a continuous variable was associated with the worsening of episodic memory over 4 years of follow-up, specifically in measures of free and cued delayed recall. MCP-1+ was associated with worse evolution in the CCS (4-year between-group difference: β = −0.14, 95%CI = −0.26, −0.02) and the CDR sum of boxes (2-year: β = 0.19, 95%CI = 0.06, 0.32). In domain-specific analyses, MCP-1+ was associated with declines in the FCSRT delayed recall sub-domains. In the presence of low Aβ42/40, MCP-1+ was not associated with greater declines in cognitive functions. The interaction with continuous biomarker values Aβ42/40× MCP-1 × time was significant in models with CDR sum of boxes and FCSRT DTR as dependent variables. Conclusions Baseline plasma MCP-1 levels were associated with longitudinal declines in overall cognitive and episodic memory performance in older adults over a 4-year follow-up. How plasma MCP-1 interacts with Aβ42/40 to determine cognitive decline at different stages of cognitive decline/dementia should be clarified by further research. The MCP-1 association on cognitive decline was strongest in those with amyloid plaques, as measured by blood plasma Aβ42/40.

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Importance of Activity Engagement and Neighborhood to Cognitive Function Among Older Chinese Americans

Research on Aging ◽

10.1177/0164027520917064 ◽

2020 ◽

Vol 42 (7-8) ◽

pp. 226-235

Author(s):

Fengyan Tang ◽

Wei Zhang ◽

Iris Chi ◽

Mengting Li ◽

Xin Qi Dong

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Chinese Americans ◽

Cognitive Change ◽

Future Research ◽

Social Activities ◽

Activity Engagement ◽

Chinese Older Adults ◽

Neighborhood Cohesion ◽

Positive Effects

This study investigates the differential associations of activity engagement and perceived neighborhood characteristics (i.e., cohesion, disorder, sense of community) with cognitive measures. Using data of 2,713 Chinese older adults in Chicago, who completed two interviews between 2011 and 2015, we identified three activity domains: reading, social, and games. In general, engagement in more reading and social activities was associated with better baseline cognitive function, but the positive effects tapered off over time in some cases. Neighborhood cohesion had both direct and indirect effects on cognitive function. Engagement in social activities mediated the neighborhood cohesion effects, that is, living in a cohesive neighborhood promoted social activities and consequently benefited cognitive function. Findings speak to the importance of activity engagement and neighborhood cohesion for cognition among the U.S. Chinese older adults. Future research is needed to investigate the longitudinal relationships of activity engagement and environmental factors with cognitive change.

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Egg Consumption and Multi-Domain Cognitive Function in a Representative Sample of Older U.S. Adults (P14-004-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz052.p14-004-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Nicholas Bishop ◽

Krystle Zuniga ◽

Bailey Noon

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Performance ◽

Representative Sample ◽

Cognitive Change ◽

Community Dwelling ◽

Cognitive Health ◽

Egg Consumption ◽

Whole Egg

Abstract Objectives Existing research supports a positive relationship between egg intake and cognitive function in older populations, though the impact of whole egg consumption on multi-domain cognitive function and cognitive decline in representative samples of older adults has not been described. We examined the association between egg consumption, cognitive performance, and cognitive change in a representative sample of U.S. adults age 65 and older. Methods We drew observations from the 2012 and 2014 Health and Retirement Study (HRS) and the recently released 2013 Health Care and Nutrition Study (HCNS). The analytic sample contained 3835 respondents, representing a weighted population of 37,806,082 community-dwelling U.S. adults age 65 and older in 2013. Path analytic models were estimated to identify the association between egg consumption groups (none, ≤1 serving per week, 2–6 servings per week, ≥7 servings per week) and cognitive performance across domains of working memory, executive function, and global mental status. First-order autoregressive models were used to assess change in cognition over the two-year observational period. Results Though bivariate analyses suggested that moderate egg consumers had the best cognitive performance at baseline, egg consumption was not associated with cognitive performance or cognitive change when adjusting models for covariates known to have a robust association with cognitive health such as race/ethnicity, education, and physical activity. Follow-up analyses suggested that overall dietary intake was not meaningfully related to egg consumption, though intake of specific nutrients contained in eggs such as cholesterol and choline generally increased with greater egg consumption. Conclusions These results suggest that egg consumption does not benefit, nor is detrimental to, the cognitive health of older adults. Further studies of whole egg consumption and cognitive performance would benefit from controlled experimental settings, extended follow-up periods to measure cognitive change, and assessment of both community-dwelling and institutionalized older adults. Funding Sources This research was supported by funding from the American Egg Board/Egg Nutrition Center.

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104 Sociodemographic, Cognitive & Physical Function Characteristics among Older Adult Fallers with and without Cognitive Frailty: Preliminary Results

Age and Ageing ◽

10.1093/ageing/afz164.104 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Resshaya Murukesu ◽

Devinder Kaur Ajit Singh ◽

Suzana Shahar ◽

Ponnusamy Subramaniam

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Physical Function ◽

Older Adult ◽

Verbal Learning ◽

Community Dwelling ◽

Step Test ◽

Medical Attention ◽

Categorical Variables ◽

Cognitive Frailty

Abstract Introduction Older adults with frailty and cognitive impairment are more susceptible to falls. The risk factor of falls and faller profiles among older adults in general has been established. However, information regarding potential risk factors and faller patterns among older adults with cognitive frailty is limited. Objective To examine the sociodemographic, cognitive and physical function characteristics of fallers with and without cognitive frailty. Methods A total of 133 community dwelling older adults aged 60 years and above were screened at three older adult activity centres in Kuala Lumpur. Sociodemographic details were obtained via interview. Cognitive Frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Cognitive function was assessed using the Mini Mental State Examination (MMSE), Digit Span (DS) test and Ray Auditory Verbal Learning Test (RAVLT). The Senior Fitness test was used to asses physical function. Characteristics of falls were documented using a self-administered questionnaire. Data was descriptively analysed; independent T-test was used for continuous variables and chi-square test was used for categorical variables. Results Prevalence of falls was 21.1% (n=28). Within fallers, 42.9% (n=12) were cognitively frail and 57.1% (n=16) were not. Fallers with cognitive frailty were significantly older (mean age = 72.31±5.29) (p<0.001), had lower MMSE scores (p<0.01), lower 2 Minute Step test scores (p<0.001) and lower Lawton Instrumental Activities of Daily Living scores (p<0.05). Descriptively, fallers with cognitive frailty were mostly recurrent fallers (67%), sustained falls outdoors due to ‘slip and fall’ and majority sought medical attention after the fall(s). Conclusion Fallers with cognitive frailty were older and had lower physical and cognitive function as compared to those without. There is a need to further understand the relationship between falls and cognitive frailty in order to provide holistic fall prevention and management strategies. Acknowledgement of grant UKM(DCP-2017-002/2) and Ministry of Higher Education(LRGS/BU/2012/UKM-UKM/K/01).

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Vitamin B12, B6, or Folate and Cognitive Function in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

Journal of Alzheimer s Disease ◽

10.3233/jad-200534 ◽

2020 ◽

Vol 77 (2) ◽

pp. 781-794 ◽

Cited By ~ 1

Author(s):

Chenbo Zhang ◽

Jianfeng Luo ◽

Changzheng Yuan ◽

Ding Ding

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Vitamin B12 ◽

Prospective Studies ◽

Meta Analysis ◽

Community Dwelling ◽

Sensitivity Analyses ◽

Community Dwelling Older Adults

Background: Previous studies have indicated that B vitamin deficiencies are an essential cause of neurological pathology. There is a need to provide evidence of the benefit of B vitamins for the prevention of cognitive decline in community-dwelling older adults. Objective: To examine the association between intake and plasma levels of vitamins B12, B6, and folate and cognitive function in older populations through a systematic review and meta-analysis. Methods: Medline (PubMed), EMBASE, and Cochrane databases were used to search the literature though August 8, 2019. We included observational population-based studies evaluating the association between concentrations or intake levels of vitamins B6, B12, or folate and cognition in older adults aged ≥45 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale. Odds ratios (ORs) and hazard ratios (HRs) were analyzed by the random-effects model. Sensitivity analyses were conducted by excluding the studies with significant heterogeneity. Results: Twenty-one observational studies with sample sizes ranging from 155–7030 were included in the meta-analysis. Higher levels of vitamin B12 (OR = 0.77, 95% CI = 0.61–0.97) and folate concentration (OR = 0.68, 95% CI = 0.51–0.90) were associated with better cognition in cross-sectional studies, but not in sensitivity analyses or prospective studies. High vitamin B6 concentrations showed no significant benefit on cognition and dementia risk. Prospective studies did not provide substantial evidence for the relationship. Conclusion: The results from our meta-analysis suggest that vitamins B12, B6, and folate may not be modifiable risk factors for slowing cognitive decline among community-dwelling older individuals.

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Abstract MP88: Fetuin-A, a Vascular Biomarker of Cognitive Decline in Older Adults

Circulation ◽

10.1161/circ.129.suppl_1.mp88 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Gail A Laughlin ◽

Linda K McEvoy ◽

Elizabeth Barrett-Connor ◽

Lori B Daniels ◽

Joachim H Ix

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Vascular Disease ◽

Sex Education ◽

Cognitive Aging ◽

Community Dwelling ◽

Fetuin A ◽

High Functioning ◽

Age Related

Objectives: The contribution of vascular disease to neurocognitive decline is now widely recognized. Fetuin-A is an abundant plasma protein known to predict vascular disease. Prior studies have shown that fetuin-A levels are lower in patients with Alzheimer’s disease in direct proportion to the severity of cognitive impairment; however, their association with normal cognitive aging is unknown. We evaluated the association of serum fetuin-A levels with cognitive function in relatively high-functioning, community-dwelling older adults from the Rancho Bernardo Study. Methods: This is a population-based study of 1382 older adults (median age 75) who had plasma fetuin-A levels and cognitive function evaluated in 1992-96; 855 had repeat cognitive function assessment a median of 4 years later. Results: Adjusting for age, sex, education, and depression, higher levels of fetuin-A were associated with better baseline performance on the Mini-Mental Status Exam (MMSE) (P=0.012) and a tendency for better Trails Making B scores (P=0.066). In longitudinal analyses, the likelihood of a major decline (highest decile of change) in Trails B was 29% lower (P=0.010) for each SD higher baseline fetuin-A level; odds of major decline in MMSE was 42% lower (P=0.005) per SD higher fetuin-A for individuals with no known CVD, but were not related to fetuin-A in those with CVD (P=0.33). Fetuin-A was not related to Category Fluency performance. Results did not vary by sex and were not explained by numerous vascular risk factors and comorbidities. Conclusions: Higher plasma fetuin-A concentrations are associated with better performance on tests of global cognitive function and executive function and with reduced likelihood of major decline in these cognitive abilities over a 4-year period. These observations are consistent with the hypothesis that higher fetuin-A protects against cognitive decline in relatively high functioning older adults, although this may be less apparent in those with established vascular disease. Fetuin-A may serve as a biological link between vascular disease and normal age-related cognitive decline.

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