scholarly journals Early-but Not Late-Onset Hypertension Is Related to Midlife Cognitive Function

Hypertension ◽  
2021 ◽  
Vol 77 (3) ◽  
pp. 972-979
Author(s):  
Karri Suvila ◽  
Joao A.C. Lima ◽  
Yuichiro Yano ◽  
Zaldy S. Tan ◽  
Susan Cheng ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Early Onset ◽  
Cognitive Assessment ◽  
Late Onset ◽  
Montreal Cognitive Assessment ◽  
Digit Symbol Substitution Test ◽  
Digit Symbol ◽  
Symbol Substitution

Hypertension is related to increased risk of cognitive decline in a highly age-dependent manner. However, conflicting evidence exists on the relation between age of hypertension onset and cognition. Our goal was to investigate the association between early- versus late-onset hypertension and midlife cognitive performance in 2946 CARDIA study (Coronary Artery Risk Development in Young Adults) participants (mean age 55±4, 57% women). The participants underwent 9 repeat examinations, including blood pressure measurements, between 1985 to 1986 and 2015 to 2016. The participants underwent brain magnetic resonance imaging and completed Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, Stroop interference test, and the Montreal Cognitive Assessment to evaluate cognitive function at the year 30 exam. We assessed the relation between age of hypertension onset and cognitive function using linear regression models adjusted for cognitive decline risk factors, including systolic blood pressure. We observed that individuals with early-onset hypertension (onset at <35 years) had 0.24±0.09, 0.22±0.10, 0.27±0.09, and 0.19±0.07 lower standardized Z-scores in Digit Symbol Substitution Test, Stroop test, Montreal Cognitive Assessment, and a composite cognitive score than participants without hypertension ( P <0.05 for all). In contrast, hypertension onset at ≥35 years was not associated with cognitive function ( P  >0.05 for all). In a subgroup of 559 participants, neither early- nor late-onset hypertension was related to macrostructural brain alterations ( P  >0.05 for all). Our results indicate that early-onset hypertension is a potent risk factor for midlife cognitive impairment. Thus, age of hypertension onset assessment in clinical practice could improve risk stratification of cognitive decline in patients with hypertension.

scholarly journals Discriminant Validity of the WAIS-R Digit Symbol Substitution Test in Subjective Cognitive Decline, Mild Cognitive Impairment (Amnestic Subtype) and Alzheimer’s Disease Dementia (ADD) in Greece

2021 ◽  
Vol 11 (7) ◽  
pp. 881
Author(s):  
Marianna Tsatali ◽  
Eleni Poptsi ◽  
Despina Moraitou ◽  
Christina Agogiatou ◽  
Evaggelia Bakoglidou ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Subjective Cognitive Decline ◽  
Digit Symbol Substitution Test ◽  
Digit Symbol ◽  
Digit Symbol Substitution ◽  
Symbol Substitution ◽  
Alzheimer’S Disease Dementia

Objective: The aim of the current study was to estimate the discriminant potential and validity of the Digit Symbol Substitution Test (DSST) of the WAIS-R in the Greek elderly population meeting criteria for subjective cognitive decline (SCD), mild cognitive impairment (aMCI; amnestic subtype), or Alzheimer’s disease dementia (ADD). Method: Four hundred eighty-eight community-dwelling older adults, visitors of the Day Center of Alzheimer Hellas, participated in the study. Two hundred forty-three of them met the criteria for ADD, one hundred eighty-two for aMCI and sixty-three for SCD. Results: Path analysis indicated that the DSST score is affected by age group, educational level, and diagnostic category, but is not affected by gender. The ROC curve analysis showed that the DSST sum score could perfectly differentiate SCD from ADD patients, whereas test’s discriminant potential between aMCI and dementia ADD’s subtype was satisfactory. However, DSST was unable to separate the SCD from the aMCI group. Conclusion: It appears that the DSST is unable to separate the SCD from aMCI population. Therefore, the test in question may be insensitive to incipient cognitive decline. On the contrary, the discriminant potential of the DSST as regards SCD and ADD is excellent, while discrimination between aMCI and ADD is good.

scholarly journals Longitudinal Associations of Midlife Accelerometer Determined Sedentary Behavior and Physical Activity With Cognitive Function: The CARDIA Study

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Kara M. Whitaker ◽  
Dong Zhang ◽  
Kelley Pettee Gabriel ◽  
Monica Ahrens ◽  
Barbara Sternfeld ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Function ◽  
Verbal Learning ◽  
Digit Symbol Substitution Test ◽  
Digit Symbol ◽  
Auditory Verbal Learning Test ◽  
Digit Symbol Substitution ◽  
Auditory Verbal Learning ◽  
Symbol Substitution ◽  
Learning Test

Background To determine if accelerometer measured sedentary behavior (SED), light‐intensity physical activity (LPA), and moderate‐to‐vigorous–intensity physical activity (MVPA) in midlife is prospectively associated with cognitive function. Methods and Results Participants were 1970 adults enrolled in the CARDIA (Coronary Artery Risk Development in Young Adults) study who wore an accelerometer in 2005 to 2006 (ages 38–50 years) and had cognitive function assessments completed 5 and/or 10 years later. SED, LPA, and MVPA were measured by an ActiGraph 7164 accelerometer. Cognitive function tests included the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, and Stroop Test. Compositional isotemporal substitution analysis examined associations of SED, LPA, and MVPA with repeated measures of the cognitive function standardized scores. In men, statistical reallocation of 30 minutes of LPA with 30 minutes of MVPA resulted in an estimated difference of SD 0.07 (95% CI, 0.01–0.14), SD 0.09 (95% CI, 0.02–0.17), and SD −0.11 (95% CI, −0.19 to −0.04) in the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, and Stroop scores, respectively, indicating better performance. Associations were similar when reallocating time in SED with MVPA, but results were less robust. Reallocation of time in SED with LPA resulted in an estimated difference of SD −0.05 (95% CI, −0.06 to −0.03), SD −0.03 (95% CI, −0.05 to −0.01), and SD 0.05 (95% CI, 0.03– 0.07) in the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, and Stroop scores, respectively, indicating worse performance. Associations were largely nonsignificant among women. Conclusions Our findings support the idea that for men, higher‐intensity activities (MVPA) may be necessary in midlife to observe beneficial associations with cognition.

scholarly journals White Blood Cell Count Mediates the Association Between Periodontal Inflammation and Cognitive Performance Measured by Digit Symbol Substitution Test Among Older U.S. Adults

2020 ◽  
Author(s):  
An Li ◽  
Yuntao Chen ◽  
Luc W M van der Sluis ◽  
Annemarie A Schuller ◽  
Geerten-Has Tjakkes
Keyword(s):  
Cognitive Function ◽  
Blood Cell ◽  
White Blood Cell ◽  
Inflammatory Factors ◽  
Digit Symbol Substitution Test ◽  
Digit Symbol ◽  
Periodontal Health ◽  
Periodontal Inflammation ◽  
Symbol Substitution ◽  
Wbc Count

Abstract Background Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function. Methods We conducted a cross-sectional analysis of 766 participants aged ≥ 60 years and who had completed periodontal and cognitive examinations in the National Health and Nutrition Examination Survey (NHANES) 2001–2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen. Results Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = −0.091; 95% confidence interval [CI] = −0.174 to −0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = −0.059; 95% CI = −0.087 to −0.031) and mediated 20.3% of the total association. Conclusion Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.

Abstract 007: Treadmill Duration Predicts Cognitive Function

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Na Zhu ◽  
David R Jacobs ◽  
Pamela J Schreiner ◽  
R. Nick Bryan ◽  
Lenore J Launer ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Verbal Learning ◽  
Stroop Test ◽  
Test Duration ◽  
Digit Symbol Substitution Test ◽  
Digit Symbol ◽  
Digit Symbol Substitution ◽  
Auditory Verbal Learning ◽  
Diabetes Status ◽  
Symbol Substitution

Evidence is scarce for an association between treadmill performance and cognitive function in healthy young and middle-aged adults. We assessed the hypothesis that duration on treadmill predicts cognitive function 25 years later. Participants were from the population-based Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-center study of black and white men and women aged 18-30 at recruitment in 1985-86 (year 0). The main independent variable of interest was baseline symptom-limited maximal treadmill test duration as a measure of treadmill performance potential, including its major subcomponent cardiorespiratory fitness (CRF/TPP). Cognitive functions measured were verbal memory (with the Rey auditory-verbal learning (AVLT)), psychomotor speed (Digit Symbol Substitution Test (DSST)) and executive function (modified Stroop interference test, where lower is better). We analyzed 2444 participants who had y0 treadmill testing and y25 cognitive testing. For each additional SD of treadmill duration (2.8 minutes), the DSST was 2.4 digits correctly substituted higher, the AVLT was 0.36 words recalled higher, and the Stroop test time 1.7 seconds less, after accounting for race, sex, age, highest attained education level and center of clinic visit( Table ). Further adjustment for dietary pattern, physical activity, smoking, BMI, alcohol consumption, glomerular filtration rate, blood pressure, cholesterol and diabetes status yielded similar trends for these cognitive function tests. In conclusion, CRF/TPP predicts cognitive function 25 years later independently of other factors among apparently healthy adults. Prospective estimation of cognitive function by treadmill duration at baseline in minimally and fully adjusted model (see text for details), N=2444. Year 25 Digit Symbol Substitution Test: Digits correctly substituted mean±SD: 70.1±15.9 Year 25 Rey Auditory-Verbal Learning Test: Words correctly recalled mean±SD: 8.3±3.3 Year 25 Stroop Test : Seconds to correctly name colors mean±SD: 43.9±12.8 Slope * SE P Slope * SE P Slope * SE P Year 0 treadmill duration (SD) mean±SD: 10.0±2.8 minutes Minimally adjusted 2.4 0.36 <.0001 0.36 0.08 <.0001 -1.7 0.31 <.0001 Fully adjusted 2.3 0.45 <.0001 0.39 0.08 <.0001 -1.2 0.39 0.001 * “Slope” is the difference in the indicated cognitive function per SD (2.8 minutes) of treadmill duration.

Effect of Hypertension Duration and Blood Pressure Control During Early Adulthood on Cognitive Function in Middle Age

2021 ◽  
pp. 1-11
Author(s):  
Haobin Zhou ◽  
Zongyuan Zhu ◽  
Changsong Liu ◽  
Yujia Bai ◽  
Qiong Zhan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Function ◽  
Verbal Memory ◽  
Cognitive Assessment ◽  
Verbal Learning ◽  
Early Adulthood ◽  
Pressure Control ◽  
Stroop Test ◽  
Digit Symbol Substitution Test ◽  
Learning Test

Background: Elevated blood pressure (BP) is a risk factor for cognitive impairment. Objective: We aim to explore the association between the duration of hypertension in early adulthood, with cognitive function in midlife. Furthermore, we investigate whether this asssociation is altered among participants with controlled BP. Methods: This prospective study included 2,718 adults aged 18–30 years without hypertension at baseline who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Duration of hypertension was calculated based on repeat measurements of BP performed at 2, 5, 7, 10, 15, 20, and 25 years after baseline. Cognitive function was assessed at Year-25 using the Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), and Stroop test. Results: After multivariable adjustment, a longer hypertension duration was associated with worse verbal memory (RAVLT, p trend = 0.002) but not with processing speed (DSST, p trend = 0.112) and executive function (Stroop test, p trend = 0.975). Among subgroups of participants with controlled (BP < 140/90 mmHg) and uncontrolled (SBP≥140 mmHg or DBP≥90 mmHg) BP at the time of cognitive assessment (i.e., Year-25 BP), longer duration of hypertension was associated with worse verbal memory. Similar results were observed in subgroups with controlled and uncontrolled average BP prior to cognitive assessment. Conclusion: Longer duration of hypertension during early adulthood is associated with worse verbal memory in midlife regardless of current or long-term BP control status. The potential risk of hypertension associated cognitive decline should not be overlooked in individuals with a long duration of hypertension, even if BP levels are controlled.

Cannabidiol Ameliorates Cognitive Function via Regulation of IL-33 and TREM2 Upregulation in a Murine Model of Alzheimer’s Disease

2021 ◽  
pp. 1-5
Author(s):  
Hesam Khodadadi ◽  
Évila Lopes Salles ◽  
Abbas Jarrahi ◽  
Vincenzo Costigliola ◽  
MB Khan ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Murine Model ◽  
Early Onset ◽  
Behavioral Tests ◽  
Translational Model ◽  
Therapeutic Modalities ◽  
Model Of Alzheimer’S Disease ◽  
5Xfad Mice ◽  
Motor Outcomes

There is a dire need for due innovative therapeutic modalities to improve outcomes of AD patients. In this study, we tested whether cannabidiol (CBD) improves outcomes in a translational model of familial AD and to investigate if CBD regulates interleukin (IL)-33 and triggering receptor expressed on myeloid cells 2 (TREM2), which are associated with improved cognitive function. CBD was administered to 5xFAD mice, which recapitulate early onset, familial AD. Behavioral tests and immunoassays were used to evaluate cognitive and motor outcomes. Our findings suggest that CBD treatment enhanced IL-33 and TREM2 expression, ameliorated the symptoms of AD, and retarded cognitive decline.

scholarly journals The Association between the Montreal Cognitive Assessment and Functional Activity Questionnaire in the Systolic Blood Pressure Intervention Trial (SPRINT)

2018 ◽  
Vol 34 (6) ◽  
pp. 814-824
Author(s):  
Carolyn H Still ◽  
Nicholas M Pajewski ◽  
Gordon J Chelune ◽  
Stephen R Rapp ◽  
Kaycee M Sink ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Function ◽  
Systolic Blood Pressure ◽  
Functional Activity ◽  
Cognitive Assessment ◽  
Intervention Trial ◽  
Functional Difficulties ◽  
Global Cognitive Function ◽  
Functional Activity Questionnaire ◽  
Activity Questionnaire

Abstract Objective To examine the association of global cognitive function assessed via the Montreal Cognitive Assessment (MoCA) and deficiencies in instrumental activities of daily living (IADL) on the Functional Activity Questionnaire (FAQ) in hypertensive older adults in the Systolic Blood Pressure Intervention Trial (SPRINT). Methods In cross-sectional analysis, 9,296 SPRINT participants completed the MoCA at baseline. The FAQ was obtained from 2,705 informants for SPRINT participants scoring <21 or <22 on the MoCA, depending on education. FAQ severity ranged from no dysfunction (Score = 0) to moderate/severe dysfunction (Score = 5+). Results Participants who triggered FAQ administration were older, less educated, and more likely to be Black or Hispanic (p < 0.001). Sixty-one percent (n = 1,661) of participants’ informants reported no functional difficulties in IADLs. An informant report, however, of any difficulty on the FAQ was associated with lower MoCA scores after controlling for age, sex, race/ethnicity, and education (p < 0.05). Partial proportional odds regression indicates that participants scoring lower on the MoCA (in the 10th to <25th, fifth to <10th, and <fifth percentiles) had higher adjusted odds of their informant indicating dysfunction on the FAQ, relative to participants scoring at or above the 25th percentile on the MoCA (p < 0.001). Conclusions While lower global cognitive function was strongly associated with IADL deficits on FAQ, informants indicated no functional difficulties for the majority of SPRINT participants, despite low MoCA scores. These findings can help with designing future studies which aim to detect mild cognitive impairment and/or dementia in large, community-dwelling populations.

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