Abstract W P156: Arterial Stiffness in Older Adults With and Without Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Ada Tang ◽  
Daria Shkredova ◽  
Derek W Stouth ◽  
Maureen J MacDonald ◽  
Jennifer J Heisz

Introduction: Silent cerebrovascular infarcts resulting from vascular disease can manifest as a decline in cognitive function. These silent events are also associated with increased risk of clinically overt stroke. Arterial stiffness is a marker that represents atherosclerotic progression and is a predictor of cardiovascular events and mortality. This study examined the relationship between arterial stiffness and cognitive impairment between adults aged 50-80 years old with and without stroke. Hypothesis: We hypothesized that elevated arterial stiffness would be observed in individuals with stroke, and also be associated with increased cognitive impairment across all participants. Methods: Cognition was assessed using the Montreal Cognitive Assessment (MoCA). Arterial stiffness was quantified using carotid-femoral pulse wave velocity (cfPWV, in m/s), calculated as cfPWV=D/Δt, where D was the distance measured between arterial sites and Δt was the pulse transit time. Higher values represent increased stiffness, and values >10 m/s are associated with increased risk for cardiovascular events. Results: Twenty-five participants were assessed: 11 participants 4.7±2.4 years post-stroke and 14 older adults without stroke. The non-stroke group was older (73.1±3.9 vs. 65.2±9.4 years, P=0.009), while the stroke group had lower MoCA scores (21.2±3.2 vs. 24.4±2.8, P=0.01). There were no between-group differences in cfPWV (stroke 9.4 m/s vs. older adults 9.9 m/s, P=0.49), when controlling for age and MoCA scores. In backward regression analysis, age explained 21% of the variance of cfPWV (P=0.03), while MoCA was not a contributor. Conclusions: In conclusion, these results suggest that age is a significant correlate of arterial stiffness, regardless of the presence of stroke or cognitive impairment. Ongoing work will examine whether stroke history also contributes to arterial stiffness when groups are matched for age.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 292-293
Author(s):  
Lydia Nguyen ◽  
Shraddha Shende ◽  
Daniel Llano ◽  
Raksha Mudar

Abstract Value-directed strategic processing is important for daily functioning. It allows selective processing of important information and inhibition of irrelevant information. This ability is relatively preserved in normal cognitive aging, but it is unclear if mild cognitive impairment (MCI) affects strategic processing and its underlying neurophysiological mechanisms. The current study examined behavioral and EEG spectral power differences between 16 cognitively normal older adults (CNOA; mean age: 74.5 ± 4.0 years) and 16 individuals with MCI (mean age: 77.1 ± 4.3 years) linked to a value-directed strategic processing task. The task used five unique word lists where words were assigned high- or low-value based on letter case and were presented sequentially while EEG was recorded. Participants were instructed to recall as many words as possible after each list to maximize their score. Results revealed no group differences in recall of low-value words, but individuals with MCI recalled significantly fewer high-value words and total number of words relative to CNOA. Group differences were observed in theta and alpha bands for low-value words, with greater synchronized theta power for CNOA than MCI and greater desynchronized alpha power for MCI than CNOA. Collectively, these findings demonstrate that more effortful neural processing of low-value words in the MCI group, relative to the CNOA group, allowed them to match their behavioral performance to the CNOA group. Individuals with MCI appear to utilize more cognitive resources to inhibit low-value information and might show memory-related benefits if taught strategies to focus on high-value information processing.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.


Author(s):  
Yuko Yamaguchi ◽  
Marta Zampino ◽  
Toshiko Tanaka ◽  
Stefania Bandinelli ◽  
Yusuke Osawa ◽  
...  

Abstract Background Anemia is common in older adults and associated with greater morbidity and mortality. The causes of anemia in older adults have not been completely characterized. Although elevated circulating growth and differentiation factor 15 (GDF-15) has been associated with anemia in older adults, it is not known whether elevated GDF-15 predicts the development of anemia. Methods We examined the relationship between plasma GDF-15 concentrations at baseline in 708 non-anemic adults, aged 60 years and older, with incident anemia during 15 years of follow-up among participants in the Invecchiare in Chianti (InCHIANTI) Study. Results During follow-up, 179 (25.3%) participants developed anemia. The proportion of participants who developed anemia from the lowest to highest quartile of plasma GDF-15 was 12.9%, 20.1%, 21.2%, and 45.8%, respectively. Adults in the highest quartile of plasma GDF-15 had an increased risk of developing anemia (Hazards Ratio 1.15, 95% Confidence Interval 1.09, 1.21, P<.0001) compared to those in the lower three quartiles in a multivariable Cox proportional hazards model adjusting for age, sex, serum iron, soluble transferrin receptor, ferritin, vitamin B12, congestive heart failure, diabetes mellitus, and cancer. Conclusions Circulating GDF-15 is an independent predictor for the development of anemia in older adults.


2021 ◽  
Vol 11 (1) ◽  
pp. 68
Author(s):  
Sara G. Aguilar-Navarro ◽  
Itzel I. Gonzalez-Aparicio ◽  
José Alberto Avila-Funes ◽  
Teresa Juárez-Cedillo ◽  
Teresa Tusié-Luna ◽  
...  

Mild cognitive impairment (MCI) (amnestic or non-amnestic) has different clinical and neuropsychological characteristics, and its evolution is heterogeneous. Cardiovascular risk factors (CVRF), such as hypertension, diabetes, or dyslipidemia, and the presence of the Apolipoprotein E ε4 (ApoE ε4) polymorphism have been associated with an increased risk of developing Alzheimer’s disease (AD) and other dementias but the relationship is inconsistent worldwide. We aimed to establish the association between the ApoE ε4 carrier status and CVRF on MCI subtypes (amnestic and non-amnestic) in Mexican older adults. Cross-sectional study including 137 older adults (n = 63 with normal cognition (NC), n = 24 with amnesic, and n = 50 with non-amnesic MCI). Multinomial logistic regression models were performed in order to determine the association between ApoE ε4 polymorphism carrier and CVRF on amnestic and non-amnestic-MCI. ApoE ε4 carrier status was present in 28.8% participants. The models showed that ApoE ε4 carrier status was not associated neither aMCI nor naMCI condition. The interaction term ApoE ε4 × CVRF was not statistically significant for both types of MCI. However, CVRF were associated with both types of MCI and the association remained statistically significant after adjustment by sex, age, and education level. The carrier status of the ApoE genotype does not contribute to this risk.


2021 ◽  
pp. 108482232110304
Author(s):  
Grace F. Wittenberg ◽  
Michelle A. McKay ◽  
Melissa O’Connor

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.


2020 ◽  
pp. 1-11
Author(s):  
Yang Jiang ◽  
Juan Li ◽  
Frederick A. Schmitt ◽  
Gregory A. Jicha ◽  
Nancy B. Munro ◽  
...  

Background: Early prognosis of high-risk older adults for amnestic mild cognitive impairment (aMCI), using noninvasive and sensitive neuromarkers, is key for early prevention of Alzheimer’s disease. We have developed individualized measures in electrophysiological brain signals during working memory that distinguish patients with aMCI from age-matched cognitively intact older individuals. Objective: Here we test longitudinally the prognosis of the baseline neuromarkers for aMCI risk. We hypothesized that the older individuals diagnosed with incident aMCI already have aMCI-like brain signatures years before diagnosis. Methods: Electroencephalogram (EEG) and memory performance were recorded during a working memory task at baseline. The individualized baseline neuromarkers, annual cognitive status, and longitudinal changes in memory recall scores up to 10 years were analyzed. Results: Seven of the 19 cognitively normal older adults were diagnosed with incident aMCI for a median 5.2 years later. The seven converters’ frontal brainwaves were statistically identical to those patients with diagnosed aMCI (n = 14) at baseline. Importantly, the converters’ baseline memory-related brainwaves (reduced mean frontal responses to memory targets) were significantly different from those who remained normal. Furthermore, differentiation pattern of left frontal memory-related responses (targets versus nontargets) was associated with an increased risk hazard of aMCI (HR = 1.47, 95% CI 1.03, 2.08). Conclusion: The memory-related neuromarkers detect MCI-like brain signatures about five years before diagnosis. The individualized frontal neuromarkers index increased MCI risk at baseline. These noninvasive neuromarkers during our Bluegrass memory task have great potential to be used repeatedly for individualized prognosis of MCI risk and progression before clinical diagnosis.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S367-S367
Author(s):  
Ryan S Falck ◽  
John R Best ◽  
Jennifer C Davis ◽  
Patrick Chan ◽  
Daniel Backhouse ◽  
...  

Abstract Poor sleep is common among older adults with Mild Cognitive Impairment (MCI) and may contribute to their increased risk for dementia. Chronotherapy is a set of intervention strategies which can improve sleep quality by strengthening the entrainment of the biological clock to the solar light-dark cycle, and includes strategies such as: 1) bright light therapy (BLT); 2) physical activity (PA); and 3) good sleep hygiene. Thus, in this 24-week randomized controlled trial (RCT; NCT02926157), we aimed to examine the efficacy of a multimodal, personalized chronotherapy intervention to improve sleep quality among older adults with MCI. Ninety-six older adults (65+ years) with MCI were randomized to either: 1) a multimodal personalized chronotherapy group (INT); or 2) a waitlist-plus-education control group (CON). Participants allocated to the INT received four once-weekly, general sleep hygiene education classes, followed by 20 weeks of 1) individually-timed BLT; and 2) bi-weekly, individually-tailored PA counselling in conjunction with receiving a consumer-available PA tracker (Fitbit® FlexTM). We found a significant group x time interaction for objectively measured sleep fragmentation (5.01; p< 0.01) and also for Pittsburgh Sleep Quality Index (PSQI) score (p= 0.03), such that the INT: 1) maintained sleep fragmentation while CON worsened at 12 weeks (p< 0.01); and 2) had improved PSQI score compared to CON at both 12 weeks (p< 0.01) and 24 weeks (p= 0.04). Our results provide novel evidence that a multimodal personalized chronotherapy approach may promote both objective and subjective aspects of sleep quality in older adults with MCI.


2020 ◽  
Vol 21 (2) ◽  
pp. 89-107
Author(s):  
Reona Chiba ◽  
Yuki Ohashi ◽  
Akiko Ozaki

Purpose Several epidemiological studies have reported an age-related increase in the prevalence of sleep disturbances. This study aims to investigate the relationship between sleep and sarcopenia/frailty in older adults and clarify issues that remain to be addressed in future studies. Design/methodology/approach PubMed was searched for relevant studies with the following keywords in the title: “sleep” and “sarcopenia” or “sleep” and “frailty.” A total of 15 studies published in English between 1998 and 2018 were reviewed. Findings Among the four studies that examined the relationship between sarcopenia and sleep, two reported that long or short sleep duration increased the risk of sarcopenia and this association was more pronounced in women than men. Among the seven studies examining the relationship between frailty and sleep, four reported that higher Pittsburgh Sleep Quality Index (PSQI) scores were associated with an increased risk of frailty. Practical implications Most previous studies have focused on interventions targeting a single area such as muscle strength or exercise habits, in older adults at risk for frailty. The results suggest that interventions targeting improved sleep may positively impact the maintenance of muscle strength. Originality/value The literature review revealed that too much or too little sleep increases the risk of sarcopenia in older adults. Further, sleep deprivation, greater night-time wakefulness and reduced sleep quality increase the risk of frailty. Interestingly, the risk of mortality is increased in individuals with daytime functional disorders such as excessive drowsiness or napping habits.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S77-S77
Author(s):  
Jessica S West ◽  
Scott Lynch

Abstract As the number of older adults increases, increased prevalence of cognitive and sensory impairments pose growing public health challenges. Research on the relationship between hearing impairment and cognition, however, is minimal and has yielded mixed results, with some studies finding that hearing impairment is associated with cognitive decline, and others reporting that the association is weak or non-existent. Most of this research has been conducted outside of the U.S., and the few U.S.-based longitudinal studies have relied mostly on small, non-representative samples involving short follow-up periods. Further, despite known gendered patterns in cognitive and hearing impairments, no studies to date have examined whether the relationship between the two varies by gender. Our study addresses these weaknesses in the literature by utilizing nine waves of the Health and Retirement Study (1998-2014; n=14,169), a large, nationally representative, longitudinal study that facilitates examination of long-term interrelationships between hearing and cognitive impairments. In this study, we use autoregressive latent trajectory (ALT) methods to model: 1) the relationship between hearing impairment and cognitive decline, and 2) sex differences in the relationship. ALT models enable us to determine whether hearing impairment and cognitive impairment are associated, net of their common tendency simply to co-trend with age. Results indicate that hearing and cognitive impairments are strongly interrelated processes that trend together over time. Moreover, hearing impairment has an increasing impact on cognitive impairment across age while the effect of cognitive impairment on hearing impairment levels out over time. Sex differences in these patterns are discussed.


Author(s):  
Dan Song ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Qiuhua Sun

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.


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