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

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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Blood pressure variability is related to faster cognitive decline in ischemic stroke patients: PICASSO subanalysis

Scientific Reports ◽

10.1038/s41598-021-83945-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yerim Kim ◽

Jae-Sung Lim ◽

Mi Sun Oh ◽

Kyung-Ho Yu ◽

Ji Sung Lee ◽

...

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Cognitive Function ◽

Cognitive Decline ◽

Repeated Measures ◽

Blood Pressure Variability ◽

Cognitive Test ◽

Multiple Variables ◽

Over Time

AbstractBlood pressure variability (BPV) is associated with higher cardiovascular morbidity risks; however, its association with cognitive decline remains unclear. We investigated whether higher BPV is associated with faster declines in cognitive function in ischemic stroke (IS) patients. Cognitive function was evaluated between April 2010 and August 2015 using the Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment in 1,240 Korean PICASSO participants. Patients for whom baseline and follow-up cognitive test results and at least five valid BP readings were available were included. A restricted maximum likelihood–based Mixed Model for Repeated Measures was used to compare changes in cognitive function over time. Among a total of 746 participants (64.6 ± 10.8 years; 35.9% female). Baseline mean-MMSE score was 24.9 ± 4.7. The median number of BP readings was 11. During a mean follow-up of 2.6 years, mean baseline and last follow-up MMSE scores were 25.4 ± 4.8 vs. 27.8 ± 4.4 (the lowest BPV group) and 23.9 ± 5.2 vs. 23.2 ± 5.9 (the highest BPV group). After adjusting for multiple variables, higher BPV was independently associated with faster cognitive decline over time. However, no significant intergroup difference in cognitive changes associated with mean systolic BP was observed. Further research is needed to elucidate how BPV might affect cognitive function.

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ASSOCIATION BETWEEN BLOOD PRESSURE AND COGNITIVE FUNCTION OF COMMUNITY-DWELLING OLDEST OLD IN OKINAWA, JAPAN

Innovation in Aging ◽

10.1093/geroni/igz038.2391 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S643-S643

Author(s):

Yukihiro Namihira ◽

Takashi Tokashiki ◽

Akio Ishida ◽

Yusuke Ohya ◽

Hiroko H Dodge

Keyword(s):

Blood Pressure ◽

Cognitive Function ◽

Arterial Stiffness ◽

Cognitive Decline ◽

Pulse Pressure ◽

Cognitive Aging ◽

Oldest Old ◽

Community Dwelling ◽

Vascular Stiffness ◽

High Cognitive Function

Abstract Background: Adults 80 years and older are the fastest-growing segment of the Japanese population and face a high risk of cognitive decline. There are some evidences connecting hypertension to cognitive decline. In mid-life hypertension is known to have influence the cognitive decline in older age. However, a few study have examined the association between hypertension or vascular stiffness and cognitive function among elderly over 80 years old. We analyzed the associations between vascular stiffness and cognitive function among relatively healthy community-dwelling non-demented oldest old. Method: Data came from the Keys to Optimal Cognitive Aging (KOCOA) study; an ongoing cohort of relatively healthy volunteers aged over 80 years old, living in Okinawa, Japan. In 2017, 105 non-demented (Clinical Dementia Rating < 1) subjects completed three kinds of examination for vascular function (75 % female, mean age (SD) 84.0 (3.0)). We categorized subjects into low and high cognitive function groups using Montreal Cognitive Assessment (MoCA) (25/26 as a cutpoint). Logistic regression models were used to examine the association between cognitive and vascular functions. Results: Narrower pulse pressure, an indicator of lower arterial stiffness, was associated with better cognitive function among subjects, after adjusting for gender, age, and education (p≦0.05), although systolic and diastolic blood pressure were not. Conclusion: Our findings suggest that narrower pulse pressure is related with cognitive preservation. The present study supports the hypothesis that lower arterial stiffness is related with better cognitive function even among the oldest old.

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Relationship Between Dietary Lutein and Cognition in an Older Adult Population (P14-030-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz052.p14-030-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Krystle Zuniga ◽

Alexandria Turner ◽

Nicholas Bishop

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Older Adult ◽

Verbal Memory ◽

Adult Population ◽

Panel Study ◽

Community Dwelling ◽

Leafy Vegetables ◽

Cognitive Domain ◽

Word Recall

Abstract Objectives The dietary carotenoid lutein accumulates in the brain, and lutein supplementation has been demonstrated to improve cognitive function in older adults. The purpose of the study was to examine the association between dietary lutein intake and cognitive function in a recent and representative sample of the older adult U.S. population. Additionally, we aimed to identify the major contributors to dietary lutein intake in older adults. Methods Observations were drawn from the 2012 Health and Retirement Study (HRS), a nationally-representative panel study of older U.S. adults, and the 2013 Health Care and Nutrition Study (HCNS), which assessed dietary intake via food frequency questionnaire in a subsample of HRS respondents. The analytic sample included 7045 respondents age 50 and older. Cognitive function was evaluated on the cognitive domain of episodic verbal memory, assessed using immediate word recall (IWR) and delayed word recall (DWR). Quartiles of lutein intake were calculated then used to compare IWR and DWR scores in 2012. Descriptive statistics and bivariate comparisons were adjusted for the complex survey design of the HRS and HCNS with results representative of community-dwelling older Americans in 2013. Results The average age of the sample was 65.6 ± 10.3 years old. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, eggs, fruit and other vegetables were significant predictors of dietary lutein intake. Lutein intake was significantly different between quartiles (P < 0.001) with lutein intakes of 720 ± 231 ug/day (Q1), 1468 ± 229 ug/day (Q2), 2394 ± 324 ug/day (Q3), and 5632 ± 3029 ug/day (Q4). Quartiles 3 and 4 had significantly higher IWR and DWR scores than quartiles 1 and 2 (P < 0.001). Conclusions Older adults may benefit from higher lutein intake through consumption of various vegetables, fruits, and eggs, as lutein may specifically protect episodic memory. Further research is needed to identify the mechanism of lutein's cognitive benefits. Funding Sources American Egg Board/Egg Nutrition Center.

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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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Blood-Based Oxidative Stress Markers and Cognitive Performance in Early Old Age: The HAPIEE Study

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000450702 ◽

2016 ◽

Vol 42 (5-6) ◽

pp. 297-309 ◽

Cited By ~ 6

Author(s):

Pia Horvat ◽

Ruzena Kubinova ◽

Andrzej Pajak ◽

Abdonas Tamosiunas ◽

Ben Schöttker ◽

...

Keyword(s):

Oxidative Stress ◽

Older Adults ◽

Cognitive Function ◽

Old Age ◽

Verbal Fluency ◽

Community Dwelling ◽

Cognitive Test ◽

Oxidative Stress Markers ◽

Stress Markers ◽

Early Old Age

Background/Aims: Oxidative stress is involved in Alzheimer disease pathology, but its impact on cognitive function in community-dwelling older adults remains unknown. We estimated associations between serum oxidative stress markers and cognitive function in early old age. Methods: Subjects aged 45-69 years recruited in urban centers in Central and Eastern Europe had memory, verbal fluency, and processing speed assessed at baseline (2002-2005) and 3 years later. Derivatives of reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP), and total thiol levels (TTLs) were measured at baseline in a subsample. Linear regression was used to estimate associations of biomarkers with cognitive test scores cross-sectionally (n = 4,304) and prospectively (n = 2,882). Results: Increased d-ROM levels were inversely associated with global cognition and verbal fluency cross-sectionally and in prospective analysis; observed effects corresponded to 3-4 years' higher age. TTL was inconsistently associated with memory. BAP was not related to cognitive function. Conclusion: This study found modest evidence for a relationship between serum d-ROMs and cognitive function in a population sample of older adults.

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Dual-task gait speed and mobility are positively associated with declarative memory

Innovation in Aging ◽

10.1093/geroni/igab046.3175 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 879-879

Author(s):

Michelle Gray ◽

Sally Paulson ◽

Joshua Gills ◽

Erica Madero ◽

Jennifer Myers ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Physical Function ◽

Sex Education ◽

Dual Task ◽

Declarative Memory ◽

Peak Velocity ◽

Paired Comparison ◽

Community Dwelling ◽

Cognitive Testing

Abstract In the US, it is not recommended to perform routine screening assessments for cognitive function or impairment among older adults, due to the lack of effective pharmacological treatments. These common practices result in delayed identification and treatments for slowing cognitive decline progression. Thus, the purpose of the present investigation was to determine the ability to predict cognition from common measures of physical function. Seventy-five community-dwelling older adults (80.7±5.4 years) completed physical function and cognitive assessments. Physical function was assessed using the Short Physical Performance Battery (SPPB), peak velocity during a power sit-to-stand task, and dual-task walking test. Cognition (declarative memory) was assessed using a validated Visual Paired Comparison test. 38% of the variance in cognition was accounted for by the predictor variables (age, sex, education, SPPB, dual-task, peak velocity). Significant predictors included dual-task walking (p = .03), SPPB (p = .02), and education (p = .02). For each 1 second faster during the dual-task performance, cognition increased by 4 percentile units. Likewise, each 1 unit increase in SPPB resulted in an increase of 4 percentile points in cognition. The results indicate more than a third of the variance in declarative memory can be predicted by commonly assessed measures of physical function. This information is useful when identifying older adults that may have cognitive impairment before overt signs are realized. With the lack of recommended cognitive testing, using physical function declines to identify possible cognitive decline is promising. These results are preliminary in nature and longitudinal determination is warranted.

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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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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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Dietary Sodium/Potassium Intake Does Not Affect Cognitive Function or Brain Imaging Indices

American Journal of Nephrology ◽

10.1159/000486580 ◽

2018 ◽

Vol 47 (1) ◽

pp. 57-65 ◽

Cited By ~ 7

Author(s):

Kristen L. Nowak ◽

Linda Fried ◽

Anna Jovanovich ◽

Joachim Ix ◽

Kristine Yaffe ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Sodium Intake ◽

Brain Mri ◽

Community Dwelling ◽

Dietary Sodium ◽

Potassium Intake ◽

Community Dwelling Older Adults ◽

Structural Brain

Background: Dietary sodium may influence cognitive function through its effects on cerebrovascular function and cerebral blood flow. Methods: The aim of this study was to evaluate the association of dietary sodium intake with cognitive decline in community-dwelling older adults. We also evaluated the associations of dietary potassium and sodium:potassium intake with cognitive decline, and associations of these nutrients with micro- and macro-structural brain magnetic resonance imaging (MRI) indices. In all, 1,194 participants in the Health Aging and Body Composition study with measurements of dietary sodium intake (food frequency questionnaire [FFQ]) and change in the modified Mini Mental State Exam (3MS) were included. Results: The age of participants was 74 ± 3 years with a mean dietary sodium intake of 2,677 ± 1,060 mg/day. During follow-up (6.9 ± 0.1 years), 340 (28%) had a clinically significant decline in 3MS score (≥1.5 SD of mean decline). After adjustment, dietary sodium intake was not associated with odds of cognitive decline (OR 0.96, 95% CI 0.50–1.84 per doubling of sodium). Similarly, potassium was not associated with cognitive decline; however, higher sodium:potassium intake was associated with increased odds of cognitive decline (OR 2.02 [95% CI 1.01–4.03] per unit increase). Neither sodium or potassium alone nor sodium:potassium were associated with micro- or macro-structural brain MRI indices. These results are limited by the use of FFQ. Conclusions: In community-dwelling older adults, higher sodium:potassium, but not sodium or potassium intake alone, was associated with decline in cognitive function, with no associations observed with micro- and macro-structural brain MRI indices. These findings do not support reduction dietary sodium/increased potassium intake to prevent cognitive decline with aging.

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