Predictors of Cognitive Decline in 85-Year-Old Patients Without Cognitive Impairment at Baseline

2013 ◽  
Vol 28 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Francesc Formiga ◽  
Assumpta Ferrer ◽  
David Chivite ◽  
Jesus Alburquerque ◽  
Claudia Olmedo ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Mini Mental State Examination ◽  
Oldest Old ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Multiple Logistic Regression ◽  
Community Based ◽  
Old Patients ◽  
State Examination

Background/Rationale: To determine how many 85-year-old community-dwelling patients with good cognitive performance at baseline maintain this level at 2-year follow-up. Methods: We realized a longitudinal community-based study including 169 inhabitants. Patients who maintained scores >23 on the Spanish version of the Mini-Mental State Examination (MEC) were compared with the rest. Results: A total of 144 individuals (85.2%) were found maintaining a MEC score >23. Under the combined criteria 110 (65%) presented no new cognitive decline. Multiple logistic regression analysis showed that maintaining a MEC score >23 was significantly associated with having a higher MEC score at baseline ( P < .001, odds ratio 1.280, 95% confidence interval 1.104-1.484). Conclusion: Most oldest-old patients with good cognitive function at baseline maintain this level at 2-year follow-up.

Medical Complications Predict Cognitive Decline in Nondemented Hip Fracture Patients—Results of a Prospective Observational Study

2018 ◽  
Vol 31 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Juliana Hack ◽  
Daphne Eschbach ◽  
Rene Aigner ◽  
Ludwig Oberkircher ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Influencing Factors ◽  
Hip Fractures ◽  
Mental State ◽  
Mini Mental State Examination ◽  
University Hospital ◽  
Medical Complications ◽  
Consecutive Series ◽  
State Examination

Objective: The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. Methods: A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Results: Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. Conclusions: In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.

scholarly journals The Importance of Stroke as a Risk Factor of Cognitive Decline in Community Dwelling Older and Oldest peoples : The SONIC Study

2020 ◽  
Author(s):  
Werayuth Srithum ◽  
Mai Kabayama ◽  
Yasuyuki Gondo ◽  
Yukie Masui ◽  
Yuya Akagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Protective Factors ◽  
Cognitive Decline ◽  
Educational Level ◽  
Community Dwelling ◽  
Multiple Logistic Regression ◽  
History Of

Abstract Background: Cognitive impairment is a major health concern among older and oldest people.Moreover, stroke is a relevant contributor for cognitive decline and development of dementia. The study of cognitive decline focused on stroke as the important risk factor by recruiting older and oldest is still lagging behind. Therefore, the aim of this study was to investigate the importance of stroke as a risk factor of cognitive decline during three years in community dwelling older and oldest people. Methods: This study was longitudinal study with a 3-year follow-up in Japan. The participants were 1,333community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, long-term care (LTC) service used, and residential area). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up. Results: The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up. Conclusions: The cognitive decline after the 3-year follow-up was influenced by the history of stroke and advanced age, while greater MoCA-J score at the baseline was positively associated with subsequent 3 years cognitive decline. The protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

scholarly journals Association between Stroke and Cognitive Decline in Community Dwelling Older and Oldest People: The SONIC Study

2019 ◽  
Author(s):  
Werayuth Srithum ◽  
Mai Kabayama ◽  
Yasuyuki Gondo ◽  
Yukie Masui ◽  
Yuya Akagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Protective Factors ◽  
Cognitive Decline ◽  
Educational Level ◽  
Cognitive Assessment ◽  
Community Dwelling ◽  
Multiple Logistic Regression ◽  
History Of

Abstract Background Increasing in the older people and a decline in mortality after stroke, the rate of post-stroke cognitive decline has increased. The relationship between risk factors and post-stroke cognitive decline in dwelling old and oldest people who living in the community especially with asymptomatic stroke have to be elucidated. Therefore, the aim of this study is to investigate the association between stroke and cognitive decline during three years in community dwelling older and oldest people.Methods This study was longitudinal study with a 3-year follow-up in urban and rural areas of Japan. The participants were 1,333 community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, and long-term care (LTC) service used). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was used for cognitive assessment, and a decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up.Results Rates of cognitive decline increased in advanced ages, equaling 33.3, 39.4, and 66.7% in those aged 70, 80, and 90 years old, respectively. The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up.Conclusions The cognitive decline after the 3-year follow-up was influenced by the history of stroke, advanced age, and greater MoCA-J score at the baseline, but protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

scholarly journals Associations between Commonly Used Characteristics in Frailty Assessment and Mental State in Frail Elderly People

Proceedings ◽  
2018 ◽  
Vol 2 (19) ◽  
pp. 1247 ◽  
Author(s):  
Iván González ◽  
Rocío Garrido ◽  
Fco Navarro ◽  
Jesús Fontecha ◽  
Ramón Hervás ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Decline ◽  
Elderly People ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Multiple Logistic Regression ◽  
Frail Elders ◽  
Frailty Assessment ◽  
The Impact ◽  
State Examination

This paper presents a cross-sectional study to analyze the impact on cognitive decline of a set of characteristics used for frailty assessment in elderly people. Considered characteristics come from several dimensions, including anthropometric, biological, nutritional, functional and mobility. Cognitive functioning is estimated by the Mini-Mental State Examination test. Additionally, mobility dimension is assessed from two perspectives: one based on direct observation of ambulation through subjective gait analyses; and the other performing explicit gait trials by using the instrumentation provided. In order to accomplish the purpose of this research, a multiple logistic regression analysis is carried out. Variables are grouped according to popular and/or standardized categories adopted in other clinical studies. Mini-Mental State Examination represents the dependent variable, while the characteristics for frailty assessment make up the set of explanatory variables. The multiple logistic regression is performed using a sample of 81 frail elders from two nursing homes in Spain. The results obtained indicate that frail elders aged 90 years of older, with moderate dependence in daily functioning, moderate risk of falls and with a stride interval gait variability greater than 6% were most likely to suffer cognitive decline, representing what is called cognitive frails.

The effect of education and occupational complexity on rate of cognitive decline in Alzheimer's patients

2006 ◽  
Vol 12 (1) ◽  
pp. 147-152 ◽  
Author(s):  
ROSS ANDEL ◽  
CHERYL VIGEN ◽  
WENDY J. MACK ◽  
LINDA J. CLARK ◽  
MARGARET GATZ
Keyword(s):  
Cognitive Decline ◽  
Cognitive Reserve ◽  
Mini Mental State Examination ◽  
Mixed Effects Models ◽  
Average Lifetime ◽  
High Complexity ◽  
Clinical Onset ◽  
Occupational Complexity ◽  
State Examination

We explored the effect of education and occupational complexity on the rate of cognitive decline (as measured by the Mini-Mental State Examination) in 171 patients with a confirmed Alzheimer's disease (AD) diagnosis. Complexity was measured as substantive complexity of work and complexity of work with data, people, and things. Average lifetime occupational complexity was calculated based on years at each occupation. Participants were followed for an average of 2.5 years and 3.7 visits. In multivariate mixed-effects models, high education, high substantive complexity, and high complexity of work with data and people predicted faster rates of cognitive decline, controlling for age, gender, native language, dementia severity, and entry into the analyses at initial versus follow-up testing. These results provide support for the concept of cognitive reserve according to which greater reserve may postpone clinical onset of AD but also accelerate cognitive decline after the onset. (JINS, 2006, 12, 147–152.)

scholarly journals Short daytime napping reduces the risk of cognitive decline in community-dwelling older adults: a 5-year longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kaori Kitamura ◽  
Yumi Watanabe ◽  
Kazutoshi Nakamura ◽  
Chikako Takano ◽  
Naomi Hayashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Beneficial Effects ◽  
Daytime Nap ◽  
Study Participants

Abstract Background Beneficial effects of napping on cognition have been suggested in cross-sectional studies. This study aimed to clarify longitudinal associations between cognitive decline and sleep characteristics, particularly daytime napping, over a 5-year period in older adults. Methods Study participants were 389 community-dwelling individuals aged ≥65 years living in Ojiya City, Niigata, Japan. Baseline and follow-up examinations were conducted in 2011–2013 and 2016–2018, respectively. Trained nurses visited and interviewed participants to collect the following information at baseline and follow-up: demographic characteristics, disease history, lifestyle habits including bedtime, sleeping hours, and daytime nap duration, and cognitive function. The assessment of cognitive function was performed using the revised Hasegawa’s dementia scale (HDS-R), with cognitive decline defined as a change in the HDS-R of ≤ − 3 over 5 years. Odds ratios (ORs) for cognitive decline were calculated using multiple logistic regression analysis. Results Mean age of participants was 74.6 years (SD 6.4), and the cumulative incidence of cognitive decline was 106/389 (27.3%). The adjusted OR for 1–29 min daytime napping was significantly lower compared to that for no napping (OR = 0.47, 95%CI: 0.23–0.96). Earlier bedtime was associated with cognitive decline (adjusted P for trend = 0.0480). Conclusion Short daytime napping (< 30 min) reduces the risk of cognitive decline over 5 years for community-dwelling older people. A future study will be necessary to confirm the effect of short napping on the reduction of risk for clinically diagnosed dementia.

scholarly journals Longitudinal cognitive screening study in community-dwelling individuals

2010 ◽  
Vol 4 (3) ◽  
pp. 214-221 ◽  
Author(s):  
Carolina P.M. Pereira ◽  
Florindo Stella ◽  
Salma S.S. Hernandez ◽  
Larissa P. Andrade ◽  
Camila V.L. Texeira ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Functional Decline ◽  
Community Dwelling ◽  
Cognitive Screening ◽  
Cognitive Changes ◽  
Functional Activities ◽  
Screening Study ◽  
State Examination ◽  
Spearman’S Correlation

Abstract Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process. Longitudinal studies can provide a better understanding of this progression. Objectives: To evaluate the cognitive and functional evolution of community-dwelling individuals without dementia through a three-year longitudinal study. Methods: 168 individuals were evaluated in 2006. Three years later in 2009, 73 of these subjects were reevaluated as regards cognition and functionality using the Mini Mental State Examination (MMSE), Brief Cognitive Battery (BCB) and the Pfeffer Functional Activities Questionnaire. The statistical analysis included descriptive measurements, the Wilcoxon's test for intra-group comparison, and the Spearman's correlation coefficient test for comparing cognitive and functionality scores. Results: After three years, the Wilcoxon's test showed a discreet yet significant cognitive decline (MMSE: -0.7 points; p=0.02; Z= -2.29; and global score on the BCB: +3.6 points; p=0.02; Z= -2.29), in addition to functional decline (Pfeffer: +0.7 points; p= 0.001; Z= -3.38). Conclusions: After three years of follow-up we observed a discreet yet significant functional and cognitive decline in the subjects. Longitudinal cognitive screening represents an important strategy in the early identification of changes from normal conditions to a dementia process.

scholarly journals Anxiety symptoms and risk of cognitive decline in older community-dwelling men

2017 ◽  
Vol 29 (7) ◽  
pp. 1137-1145 ◽  
Author(s):  
Ahmed M. Kassem ◽  
Mary Ganguli ◽  
Kristine Yaffe ◽  
Joseph T. Hanlon ◽  
Oscar L. Lopez ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Mini Mental State Examination ◽  
Older Men ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Poor Sleep ◽  
Neurodegenerative Process ◽  
Global Cognition ◽  
B Test ◽  
State Examination

ABSTRACTBackground:Previous research regarding anxiety as a predictor of future cognitive decline in older adults is limited and inconsistent. We examined the independent relationship between anxiety symptoms and subsequent cognitive decline.Methods:We included 2,818 community-dwelling older men (mean age = 76.1, SD ±5.3 years) who were followed on an average for 3.4 years. We assessed anxiety symptoms at baseline using the Goldberg Anxiety Scale (GAS; range = 0–9). We assessed cognitive function at baseline and at two subsequent visits using the Modified Mini-Mental State Examination (3MS; global cognition) and the Trails B test (executive function).Results:At baseline, there were 690 (24%) men with mild anxiety symptoms (GAS 1–4) and 226 (8%) men with moderate/severe symptoms (GAS 5–9). Men with anxiety symptoms were more likely to have depressed mood, poor sleep, more chronic medical conditions, and more impairment in activities of daily living compared to those with no anxiety symptoms. Compared to those with no anxiety symptoms at baseline, men with any anxiety symptoms were more likely to have substantial worsening in Trails B completion time (OR = 1.56, 95% CI 1.19, 2.05). The association was attenuated after adjusting for potential confounders, including depression and poor sleep, but remained significant (OR = 1.40, 95% CI 1.04, 1.88).Conclusion:In cognitively healthy older men, mild anxiety symptoms may potentially predict future decline in executive functioning. Anxiety is likely a manifestation of an underlying neurodegenerative process rather than a cause.

scholarly journals Short Daytime Napping Reduces the Risk of Cognitive Decline in Community-Dwelling Elderly Individuals: a 5-Year Longitudinal Study

2021 ◽  
Author(s):  
Kaori Kitamura ◽  
Yumi Watanabe ◽  
Kazutoshi Nakamura ◽  
Chikako Takano ◽  
Naomi Hayashi ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Elderly Individuals ◽  
Beneficial Effects ◽  
Community Dwelling Older People ◽  
Study Participants

Abstract Background: Beneficial effects of napping on cognition have been suggested in cross-sectional studies. This study aimed to clarify longitudinal associations between cognitive decline and sleep characteristics, particularly daytime napping, over a 5-year period in older adults. Methods: Study participants were 389 community-dwelling individuals aged ≥65 years living in Ojiya City, Niigata, Japan. Baseline and follow-up examinations were conducted in 2011-2013 and 2016-2018, respectively. Trained nurses visited and interviewed participants to collect the following information: demographic characteristics, disease history, lifestyle habits including sleep and daytime napping, and cognitive function at baseline; and cognitive function at follow-up. The assessment of cognitive function was performed using the revised Hasegawa’s dementia scale (HDS-R), with cognitive decline defined as a 5-year change in HDS-R of ≤–3. Odds ratios (ORs) for cognitive decline were calculated using multiple logistic regression analysis.Results: Mean age of participants was 74.6 years (SD 6.4), and the cumulative incidence of cognitive decline was 106/389 (27.3%). The multivariable-adjusted OR for 1-29 min daytime napping was significantly lower compared to that for no napping (OR=0.47, 95%CI: 0.23-0.96). Bedtime was inversely associated with cognitive decline (multivariable-adjusted P for trend=0.0480).Conclusion: Short daytime napping (<30 min) reduces the risk of 5-year cognitive decline in community-dwelling older people. A future study will be necessary to confirm the effect of short napping on the reduction of risk for clinically diagnosed dementia.

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