Abstract P409: Thyroid Function and Cognitive Decline in Middle-aged and Older Adults: The Elsa-Brasil Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Claudia Szlejf ◽  
Claudia K Suemoto ◽  
Carolina Janovsky ◽  
Paulo A LOTUFO ◽  
Isabela M Bensenor
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Word Recall ◽  
Adult Health ◽  
Middle Aged ◽  
Second Wave

Introduction: The role of subtle thyroid alterations on cognitive decline is controversial. We aimed to investigate the association of thyrotropin (TSH) and free thyroxine (FT4) with baseline performance on cognitive tests and with cognitive decline in middle-aged and older adults without overt thyroid disease. Methods: This is a longitudinal analysis of the Brazilian Longitudinal Study of Adult Health baseline and second wave, after 4 years of follow-up. We included participants aged ≥ 55 years without over thyroid disease, prevalent stroke and use of drugs that could affect thyroid function and cognition. TSH and FT4 were assessed at baseline. Cognition was evaluated at baseline and at the second wave using delayed word recall test (DWR), semantic verbal fluency test (SVF), and trail making test version B (TMT). Baseline and longitudinal associations of TSH tertiles and FT4 tertiles with cognitive performance were investigated with generalized estimating equations, adjusted for sociodemographic characteristics, lifestyle, cardiovascular risk factors, and depression. Results: The baseline mean age of the 4675 participants was 62.4 ± 5.8 years, 52.3% women (2445 out of 4675). At baseline, TSH levels were not associated with cognitive performance in any test, although the highest FT4 tertile was associated with poorer performance on DWR (β = -0.087, 95% CI = -0.155; -0.019) and SVF (β = -0.076, 95%CI = -0.143; -0.010) after adjustment. Additionally, the lowest FT4 tertile was associated with poorer performance on SVF (β = -0.090, 95%CI = -0.152; -0.028). Cognitive performance did not change after 4 years of follow-up and there was no effect of time on the association of thyroid hormone levels with cognitive performance. Conclusion: At baseline, FT4 levels were associated with worse cognitive performance in a relatively young sample. Neither baseline FT4 nor TSH were associated with cognitive decline after 4 years.

Normative Data for the ELSA-Brasil Neuropsychological Assessment and Operationalized Criterion for Cognitive Impairment for Middle-Aged and Older Adults

2020 ◽  
pp. 1-11
Author(s):  
Laiss Bertola ◽  
Isabela M. Benseñor ◽  
Alessandra C. Goulart ◽  
Andre R. Brunoni ◽  
Paulo Caramelli ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Depressive Episode ◽  
Normative Data ◽  
Accurate Diagnosis ◽  
Adult Health ◽  
Middle Aged ◽  
Primary Care Settings

Abstract Objectives: Normative data should consider sociodemographic diversity for the accurate diagnosis of cognitive impairment. This study aims to provide normative data for a brief neuropsychological battery and present diagnostic criteria for cognitive impairment that could be used in primary care settings. Methods: We selected 9618 Brazilian middle-aged and older adults after detailed exclusion criteria to avoid subtle cognitive impairment. We analyzed age, sex, and education influence on cognitive performance. To verify the evidence of criterion validity, we compared the cognitive performance of subjects with and without a depressive episode. Additionally, we verified the percentage of spurious scores under three different cutoffs. Results: Age and education had the greatest impact on cognition. Normative scores were provided according to age and education groups. Participants with a depressive episode performed poorer than control subjects. The clinical cutoff of at least two scores below the 7th percentile revealed the adequate percentage of spurious and possible clinical performance. Conclusions: The Longitudinal Study on Adult Health (ELSA-Brasil) provided normative data based on a unique selected set of cognitively normal subjects. Normative groups were selected based on age and education, and the battery was sensitive to the presence of a depressive episode. We suggested clinical cutoffs for the tests in this battery that could be used in primary care settings to improve the accurate diagnosis of cognitive impairment.

Cognitive Performance Trajectories Before and After Sleep Treatment Initiation in Middle-Aged and Older Adults: Results from the Health and Retirement Study

2021 ◽  
Author(s):  
Christopher N Kaufmann ◽  
Mark W Bondi ◽  
Wesley K Thompson ◽  
Adam P Spira ◽  
Sonia Ancoli-Israel ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Sleep Disturbance ◽  
Cognitive Performance ◽  
Treatment Initiation ◽  
Health And Retirement Study ◽  
Middle Aged ◽  
Before And After ◽  
Sleep Treatment ◽  
Retirement Study

Abstract BACKGROUND Sleep disturbances are associated with risk of cognitive decline but it is not clear if treating disturbed sleep mitigates decline. We examined differences in cognitive trajectories before and after sleep treatment initiation. METHODS Data came from the 2006-2014 Health and Retirement Study. At each of five waves, participants were administered cognitive assessments and scores were summed. Participants also reported if, in prior two weeks, they had taken medications or used other treatments to improve sleep. Our sample (N=3,957) included individuals who at HRS 2006 were >50 years, had no cognitive impairment, reported no sleep treatment, and indicated experiencing sleep disturbance. We identified differences between those receiving vs. not receiving treatment in subsequent waves, and among those treated (N=1,247), compared cognitive trajectories before and after treatment. RESULTS At baseline, those reporting sleep treatment at subsequent waves were more likely to be younger, female, Caucasian, to have more health conditions, to have higher BMI, and more depressive symptoms (all p’s≤0.015). Decline in cognitive performance was mitigated in periods after sleep treatment vs. periods before (B=-0.20, 95% CI=-0.25, -0.15, p<0.001; vs., B=-0.26, 95% CI=-0.32, -0.20, p<0.001), and this same trend was seen for self-initiated and doctor-recommended treatments. Trends were driven by those with higher baseline cognitive performance—those with lower performance saw cognitive declines following sleep treatment. CONCLUSIONS In middle-aged and older adults with sleep disturbance, starting sleep treatment may slow cognitive decline. Future research should assess types, combinations, and timing of treatments most effective in improving cognitive health in later life.

Longitudinal Association Between Self-Reported Sensory Impairments and Episodic Memory among Older Adults in China: A Prospective Cohort Study

2021 ◽  
pp. 089198872110064
Author(s):  
Xiaochen Ma ◽  
Jingkai Wei ◽  
Nathan Congdon ◽  
Yan Li ◽  
Lu Shi ◽  
...  
Keyword(s):  
Older Adults ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Word Recall ◽  
Sensory Impairment ◽  
Hearing Impairments ◽  
Linear Mixed Effects ◽  
Sensory Impairments ◽  
Longitudinal Association

Sensory impairments, such as visual and hearing impairments, and cognitive decline are prevalent among mid-age and older adults in China. With 4-year longitudinal data from the China Health and Retirement Longitudinal Study, we assessed the association between self-reported sensory impairments and episodic memory. Multivariate linear mixed-effects models were used to estimate the association of baseline sensory impairment in 2011-2012 with cognitive decline at 2- and 4-year follow-up visits. Among the 13,097 participants, longitudinal associations were identified between having hearing loss (β = -0.14, 95% CI: -0.22, -0.05), having both poor hearing and vision (β = -0.14, 95% CI: -0.23, -0.04) and decline in immediate word recall over 4 years, compared to those without self-reported sensory impairment. In addition, these associations were more significant among those aged 60 and older and among women. Further research is needed to investigate these associations in the longer term, providing evidence to support interventions that can prevent or delay sensory impairments and preserve cognitive functions in older adults.

Effects of Morning Blue-Green 500 nm Light Therapy on Cognition and Biomarkers in Middle-Aged and Older Adults with Subjective Cognitive Decline and Mild Cognitive Impairment: Study Protocol for a Randomized Controlled Trial

2021 ◽  
pp. 1-16
Author(s):  
Ziqi Wang ◽  
Yige Zhang ◽  
Li Dong ◽  
Zihao Zheng ◽  
Dayong Zhong ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Controlled Trial ◽  
Light Therapy ◽  
Physiological Parameters ◽  
Subjective Cognitive Decline ◽  
Middle Aged

Background: Given that there is no specific drug to treat Alzheimer’s disease, non-pharmacologic interventions in people with subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) are one of the most important treatment strategies. Objective: To clarify the efficacy of blue-green (500 nm) light therapy on sleep, mood, and physiological parameters in patients with SCD and aMCI is an interesting avenue to explore. Methods: This is a monocentric, randomized, and controlled trial that will last for 4 weeks. We will recruit 150 individuals aged 45 years or older from memory clinics and divide them into 5 groups: SCD treatment (n = 30), SCD control (n = 30), aMCI treatment (n = 30), aMCI control (n = 30), and a group of healthy adult subjects (n = 30) as a normal control (NC). Results: The primary outcome is the change in subjective and objective cognitive performance between baseline and postintervention visits (4 weeks after baseline). Secondary outcomes include changes in performance assessing from baseline, postintervention to follow-up (3 months after the intervention), as well as sleep, mood, and physiological parameters (including blood, urine, electrophysiology, and neuroimaging biomarkers). Conclusion: This study aims to provide evidence of the impact of light therapy on subjective and objective cognitive performance in middle-aged and older adults with SCD or aMCI. In addition, we will identify possible neurophysiological mechanisms of action underlying light therapy. Overall, this trial will contribute to the establishment of light therapy in the prevention of Alzheimer’s disease.

Effect of Physical Inactivity on Cognitive Performance after 2.5 Years of Follow-Up

GeroPsych ◽  
2010 ◽  
Vol 23 (1) ◽  
pp. 7-15 ◽  
Author(s):  
M.C. Aichberger ◽  
M.A. Busch ◽  
F.M. Reischies ◽  
A. Ströhle ◽  
A. Heinz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Verbal Fluency ◽  
Physical Inactivity ◽  
Physical Activities ◽  
Word Recall ◽  
Random Effects Models ◽  
Somatic Comorbidities

Objective: To examine the association between physical activity and cognitive performance in a longitudinal study. Methods: We analyzed data from 17.333 noninstitutionalized persons aged 50 years or older in 11 European countries who participated in Wave 1 (2004/2005) and Wave 2 (2006/2007) of the Survey of Heath, Ageing, and Retirement in Europe (SHARE). Physical activity at baseline was measured as self-reported frequency of sports or activities requiring vigorous activity, and frequency of activities demanding a moderate level of activity. Cognitive function was measured at baseline and after a mean of 2.5 years of follow-up by delayed word recall and verbal fluency tests. The effects of physical activity at baseline on cognitive performance at follow-up were assessed in hierarchical multilevel random effects models adjusted for sociodemographic variables (age, education), somatic comorbidities, functional impairment (basic and instrumental activities of daily living, maximum grip strength), depressive symptoms, and body mass index. Results: After adjusting for potential confounders, we found physical inactivity (neither moderate nor vigorous) to be associated with a higher rate of cognitive decline over a mean follow-up of 2.5 years (β = –1.79 (SE = 0.17) for verbal fluency; β = –0.35 (SE = 0.04) for delayed word recall). Further analyses showed that vigorous activities more than once a week were especially related to change in cognition over time. Conclusion: Engagement in moderate and vigorous physical activities protects against cognitive decline in older age. Participation in physical activities may be of particular importance when other risk factors for cognitive decline are present.

scholarly journals The Association Between Obesity and Long-Term Cognitive Performance in Middle-Aged and Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 379-380
Author(s):  
Andrew Fiscella ◽  
Ross Andel
Keyword(s):  
United States ◽  
Older Adults ◽  
Executive Function ◽  
Cognitive Performance ◽  
Oldest Old ◽  
The United States ◽  
Normal Weight ◽  
Middle Aged ◽  
Global Cognition

Abstract Obesity is a growing epidemic in the United States and has been associated with negative health outcomes such as cardiovascular disease and diabetes. However, an obesity paradox has emerged which suggests that the effects of obesity may vary by age, with older adults potentially seeing a protective effect of obesity. This study examined the effects of overweight and obese status on cognitive performance at baseline and follow-up. It was hypothesized that obese middle-aged adults would perform worse than normal weight peers, but that reverse would be observed in older adults. Data from 701 participants in the Midlife in the United States study were included. Body mass index (BMI) and waist circumference were employed as measures of obesity. Z-scores for executive function, memory, and global cognition were used to quantify cognitive performance. While obese participants tended to perform worse on average than normal weight individuals there were no significant differences in performance between obese and normal weight participants in global cognition (p=.134), executive function (p=.164), or episodic memory (p=.708). Additionally, age did not moderate this relationship. However, there was a significant effect of education on all three domains. When stratified by education, participants with some college or higher, had a significant time*obesity*age interaction (F[3,328]=3.016, p<.05). For the oldest-old participants, executive function scores were higher for obese participants at follow-up compared to normal weight participants, but not at baseline. These findings suggest that level of education may serve as a form of cognitive reserve which compensates for deficits due to obesity.

Abstract 01: Diabetes is a Risk Factor for 20-year Cognitive Decline

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Andreea M Rawlings ◽  
A. Richey Sharrett ◽  
Josef Coresh ◽  
Marilyn Albert ◽  
David J Couper ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Cognitive Performance ◽  
Word Recall ◽  
Older Individuals ◽  
Word Fluency ◽  
Chronic Hyperglycemia ◽  
Symbol Substitution ◽  
Rapid Cognitive Decline ◽  
Diagnosed Diabetes

Introduction: Most studies examining the association between diabetes and cognitive decline have been among older individuals and/or have had limited follow-up. We undertook this study to examine the association of diabetes in mid-life with long-term change in cognitive function in a community-based population of blacks and whites. Hypothesis: We hypothesized that diabetes and chronic hyperglycemia - as measured by HbA1c at baseline - would be associated with 20-year cognitive decline. Methods: We used generalized estimating equations to examine the association of diabetes at baseline (1990-1992, aged 48-67 years) with 20-year change in cognitive performance among 13015 (24% black; 55% female; 1205 with diabetes) ARIC participants. Delayed Word Recall, Digit Symbol Substitution, and Word Fluency were used to assess cognitive performance, and were summarized using a global Z score. Self-reported diagnosis or diabetes medication use at baseline was used to assess diabetes and HbA1c was categorized using clinical cutpoints. Models were adjusted for demographic and clinical variables. Results: Diagnosed diabetes was associated with significantly more cognitive decline compared to persons without diabetes (Z = -0.17, 95% CI: -0.26, -0.07) (Figure). This represents 19% faster decline compared to persons without diabetes. We also observed a significant trend in decline among clinical categories of HbA1c, even below the threshold for diagnosis of diabetes. Results were similar in race-stratified analyses. In addition, among white participants poorly controlled diabetes (HbA1c>7) had significantly more decline compared to persons whose diabetes was controlled (Z = -0.24 (95% CI: -0.46, -0.02)). Conclusions: Diabetes in middle-age was associated with substantially more rapid cognitive decline across 20 years of follow-up. Our results also suggest that pre-diabetes and poor control of diabetes lead to greater cognitive decline.

scholarly journals Cognitive Performance in Older Adults With Subjective Cognitive Decline

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 291-291
Author(s):  
Vanessa Taler ◽  
Cassandra Morrison ◽  
Christine Sheppard
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Subsequent Development ◽  
Word Recall ◽  
Subjective Cognitive Decline ◽  
Semantic Features ◽  
Lower Performance ◽  
Word Finding

Abstract Subjective cognitive decline (SCD) refers to a perceived decline in cognitive function in the absence of neuropsychological deficits. Older adults with SCD are at increased of subsequent development of mild cognitive impairment or dementia. We had 224 adults aged 65+ complete questionnaires assessing their subjective appraisal of their cognitive function, including questions about word-finding difficulty, memory, and attention/concentration. Participants also completed the Montreal Cognitive Assessment (MoCA). All participants exhibited cognitive performance that was within normal limits for age and education. In total, 29.5% of participants reported word-finding difficulties, 16.5% reported difficulties with remembering things, and 8.5% reported difficulties with attention/concentration. We found that (1) self-reported word-finding difficulties were associated with lower performance on delayed word recall, and (2) self-reported difficulties in concentration/attention or memory were associated with lower performance on the abstraction subtask in the MoCA. No other MoCA subtasks were associated with self-reported cognitive function. A subset of the participants (n=69) also completed a battery of tasks assessing semantic function, including picture naming, associative matching tasks, identification of semantic features, and semantic questions. Again, self-reported word-finding difficulty predicted lower performance on semantic tasks. These results suggest that older adults may be aware of changes in their cognitive performance prior to objective neuropsychological impairment. Moreover, their awareness appears to be domain-specific: self-reported language difficulty is associated with lower performance on language-based tasks, while self-reported difficulty in memory, attention, or concentration is associated with lower performance on an abstraction task.

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.

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