Renal dysfunction is associated with decline of cognitive function in community-dwelling older adults: Korean frailty and aging cohort study

Abstract Background Cognitive decline is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly population. We conducted this study to clarify the relationship between renal dysfunction and decline of cognitive function in community-dwelling elderly population. Methods A cross-sectional analysis was performed using data from the Korean Frailty and Aging Cohort Study, a nationwide cohort study. Total 2847 (1333 men, 1514 women) eligible participants were enrolled for this study. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Global cognitive function was assessed with the Mini-mental State Examination-Korean version. Other domains of cognitive function were tested with the Consortium to Establish a Registry for Alzheimer’s disease and the Frontal Assessment Battery. Results The mean age of all participants was 76.0 ± 3.9 years and eGFR (all in mL/min/1.73 m2) was 77.5 ± 14.3. And the mean eGFR was 91.7 ± 3.2 in quartile 1, 84.9 ± 1.8 in quartile 2, 76.1 ± 3.7 in quartile 3, and 57.2 ± 10.8 in quartile 4. In baseline characteristics, participants with lower eGFR tend to have lower cognitive function scores than participant with higher eGFR. In linear regression analysis, eGFR was correlated with the word list memory (β = 0.53, P = 0.005), word list recall (β = 0.86, P < 0.001), and word list recognition (β = 0.43, P = 0.030) after adjustment of confounding variables. Moreover, after multivariate adjustment the association with cognitive impairment in quartile 2 was stronger (adjusted OR: 1.535, 95% CI: 1.111–2.120, P = 0.009), and the ORs of cognitive impairment were 1.501 (95% CI: 1.084–2.079, P = 0.014) in quartile 3 and 1.423 (95% CI: 1.022–1.983, P = 0.037) in quartile 4. Conclusion In older adults, the immediate, recent memory, and recognition domains were significantly related to renal function. Also, the mild renal dysfunction was independently associated with impairment of global cognitive function. These results suggest that the early stages of renal dysfunction could be an effective target to prevent worsening of cognitive impairment. Therefore, regular monitoring and early detection of mild renal dysfunction in elderly population might be needed.

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P0798ASSOCIATION BETWEEN RENAL DYSFUNCTION AND GENERAL COGNITIVE FUNCTION IN COMMUNITY DWELLING OLDER ADULTS: KOREAN FRAILTY AND AGING COHORT STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0798 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Jiyoon Kong ◽

Jin Sug Kim ◽

Min Hye Kang ◽

Shin Yeong Kang ◽

Ri Ra ◽

...

Keyword(s):

Older Adults ◽

Renal Function ◽

Cohort Study ◽

Cognitive Impairment ◽

Cognitive Function ◽

Renal Dysfunction ◽

The Elderly ◽

Community Dwelling ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Background and Aims Cognitive impairment is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly. We conducted this study to clarify the relationship between the renal function and cognitive impairment in community dwelling older adults in Korea. Method A cross-sectional analysis was performed on the data of the Korean Frailty and Aging Cohort Study (KFACS), a nationwide cohort study that began in 2016. Of the 3014 participants assessed in the first and second year, 2847 participants (1333 men, 1514 women) who completed baseline assessments were enrolled. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Renal function of the participants was classified into four groups by eGFR quartile. General cognitive function was accessed with mini-mental state exam in the Korean version (MMSE-KC). Participants who had MMSE-KC score less than 1.5 standard deviation by age, gender, and education level were regarded as the cognitive impairment. Multivariate logistic regression model was used to examine the relationship between renal function and cognitive impairment. In addition, we investigated to find the point of eGFR interval at which the odds ratio begins to increase. Results The mean eGFR in quartile 1 was 91.7 ± 3.22 ml/min/1.73m2, and 84.9 ± 1.81 in quartile 2, 76.1 ± 3.66 in quartile 3, and 57.2 ± 10.75 in quartile 4. In baseline characteristics, participants with lower eGFR had lower MMSE-KC scores. And the prevalence of cognitive impairment was 10.8% in quartile 1, 15.9% in quartile 2, 15.2% in quartile 3, 14.9% in quartile 4. After multivariate adjustment, the odds ratio (OR) of cognitive impairment in quartile 2 [adjusted OR: 1.569, 95% confidence intervals (CI): 1.141 - 2.158, p = 0.006] compared with quartile 1. And the odd ratios of cognitive impairment were 1.539 (95% CI: 1.113 - 2.127, p = 0.009) in quartile 3, 1.475 (95% CI: 1.062 - 2.049, p = 0.020) in quartile 4 compared with quartile 1, respectively. Among the participants with eGFR above 60 ml/min/1.73m2, the renal function was grouped by 5 ml/min/1.73m2 interval. The risk of cognitive impairment started to increase from eGFR between 80 and 85 ml/min/1.73m2 (adjusted OR: 1.667, 95% CI: 1.128 - 2.463, p = 0.010). Conclusion Renal dysfunction was associated with lower global cognitive function in older adults. And the risk of cognitive impairment increased from quartile 2, especially, eGFR between 80 and 85 ml/min/1.73m2 in this population. These results suggest that mild decline of kidney function is also a risk factor of cognitive decline in the elderly.

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Calf Circumference as a Screening Tool for Cognitive Frailty in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)

Journal of Clinical Medicine ◽

10.3390/jcm7100332 ◽

2018 ◽

Vol 7 (10) ◽

pp. 332 ◽

Cited By ~ 4

Author(s):

Miji Kim ◽

Min Jeong ◽

Jinho Yoo ◽

Da Song ◽

Chang Won

Keyword(s):

Older Adults ◽

Cohort Study ◽

Cognitive Impairment ◽

Cognitive Function ◽

Frailty Index ◽

Community Dwelling ◽

Calf Circumference ◽

Cross Sectional ◽

Cognitive Frailty ◽

Community Dwelling Older Adults

The aim of this study was to examine calf circumference in relation to cognitive frailty in community-dwelling older adults. Cross-sectional analysis was performed on the first-year baseline data of 1559 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. The final analysis included 1221 adults who were non-dependent in terms of instrumental activities of daily living, who underwent frailty and cognitive function assessments. Physical frailty was defined using the Fried Frailty Index. Cognitive impairment was defined as a score 1.5 standard deviations below the age-, sex- and education-matched norms on any of four cognitive-function tests. The prevalence of cognitive frailty was 2.8% for men and 3.8% for women. After adjusting for potential confounders, in comparison to the “physically robust without cognitive impairment” group, the estimates of increased odds ratios (ORs) for low calf circumference (<32 cm) were much greater in the prefrail with cognitive impairment (OR 4.62, 95% confidence interval (CI): 2.02–10.61) and frail with cognitive impairment (OR 10.94, 95% CI: 2.87–41.68) groups in men but not in women. Low calf circumference was strongly related to cognitive frailty in men only, suggesting calf circumference can be used as an indicator of these outcomes.

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Do Communication Patterns Affect the Association between Cognitive Impairment and Hearing Loss among Older Adults in Vietnam?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041603 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1603

Author(s):

Tran Dai Tri Han ◽

Keiko Nakamura ◽

Kaoruko Seino ◽

Vo Nu Hong Duc ◽

Thang Van Vo

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Cognitive Impairment ◽

Cognitive Function ◽

Vision Loss ◽

Community Dwelling ◽

Cross Sectional ◽

Ordinal Logistic Regression Analysis ◽

Communication Devices ◽

Community Dwelling Older Adults

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.

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The Role of Daily Social Interactions in Detecting Mild Cognitive Impairment

Innovation in Aging ◽

10.1093/geroni/igaa057.2013 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 598-598

Author(s):

Ruixue Zhaoyang ◽

Stacey Scott ◽

Eric Cerino ◽

Martin Sliwinski

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Social Interactions ◽

Social Relationships ◽

Daily Basis ◽

Community Dwelling ◽

Normal Cognitive Function ◽

Social Markers

Abstract Social relationships play an important role in cognitive health and aging. However, it is unclear how older adult’s cognitive function affects their everyday social interactions, especially for those with mild cognitive impairment (MCI). This study examined whether older adults with intact cognition vs. MCI differed in their daily social interactions. Community-dwelling older adults from the Einstein Aging Study (N=244, 70-91 yrs) reported their social interactions five times daily for 14 consecutive days using smartphones. Compared to those with normal cognitive function, older adults with MCI reported less frequent positive social interactions (p=0.012) and in-person social activities (p=0.006) on a daily basis. These two groups, however, did not show significant differences in their social relationships assessed by a conventional global questionnaire. The results support that, relative to global social relationships, daily social interactions are more sensitive, ecologically valid social markers that can facilitate the early detection of MCI.

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Exploring Cognitively Loaded Physical Activity Compared With Control to Improve Global Cognitive Function in Older Community-Dwelling Adults With Mild Cognitive Impairment: Systematic Review With Meta-Analysis

American Journal of Lifestyle Medicine ◽

10.1177/1559827619876887 ◽

2019 ◽

pp. 155982761987688

Author(s):

Kristina Zawaly ◽

Richard Fortier ◽

Stephen Buetow ◽

Lynette Tippett ◽

Ngaire Kerse

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Meta Analysis ◽

Community Dwelling ◽

Controlled Trials ◽

Global Cognitive Function ◽

Global Cognition

Objective. A systematic review with a meta-analysis explored effects of cognitively loaded physical activity interventions on global cognition in community-dwelling older adults (≥65 years of age) experiencing mild cognitive impairment (MCI), compared to any control. Methods. A literature search was conducted in 4 databases (MEDLINE [OvidSP], PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials [Wiley]) from inception until January 30, 2018. The meta-analysis was conducted with Review Manager 5.3. Results. Six randomized controlled trials (RCTs) with 547 participants were identified. The interventions ranged from 4 to 52 weeks. Baseline and initial follow-up assessments were used. The primary pooled analysis of all RCTs demonstrated a nonsignificant trivial effect (standardized mean difference [SMD] 0.07, 95% confidence interval [CI] −0.44 to 0.58) favoring the intervention. In pooled subanalysis of 4 RCTs (n = 405) using the same global cognition measure (Mini-Mental State Examination) and duration of intervention >12 weeks, the intervention group achieved a small but significant improvement for global cognition (SMD 0.45, 95% CI 0.14 to 0.75). Conclusion. When all the RCTs were pooled, the effect of cognitively loaded physical activity intervention on global cognitive function in older adults with MCI remained unclear. The subgroup analysis provides translation evidence for future RCT study designs.

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AEROBIC TRAINING, THE DEFAULT MODE NETWORK, AND COGNITION IN OLDER ADULTS WITH MILD VASCULAR COGNITIVE IMPAIRMENT

Innovation in Aging ◽

10.1093/geroni/igz038.213 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S55-S55

Author(s):

Rachel A Crockett ◽

Chun Liang Hsu ◽

Cindy Barha ◽

Ging-Yuek Robin Hsiung ◽

Teresa Liu-Ambrose

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Functional Connectivity ◽

Default Mode Network ◽

Resting State ◽

Aerobic Training ◽

Vascular Cognitive Impairment ◽

Default Mode ◽

Global Cognitive Function

Abstract Aerobic training has been shown to be effective at improving cognitive and brain outcomes in older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI). However, uncertainty remains regarding the underlying neurobiological mechanisms by which exercise elicits these improvements in cognition. Increased aberrant functional connectivity of the default mode network has been highlighted as a factor contributing to cognitive decline in older adults with cognitive impairment. Greater connectivity of the DMN at rest is associated with poorer performance on attention-demanding tasks, indicative of a lack of ability to deactivate the network on task. Our previous work on a randomized controlled trial of participants with mild SIVCI, demonstrated that 6-months of thrice weekly aerobic training led to improved global cognitive function, as measured by Alzheimer’s disease Assessment Scale-Cognitive subscale (ADAS-Cog), compared with a health education program. Thus, we conducted secondary analyses to investigate whether these changes in global cognitive function were associated with changes in resting state DMN connectivity. A subsample of 21 participants underwent a resting state functional magnetic resonance imaging (fMRI) scan before and after trial completion. Change in resting state DMN connectivity was found to significantly predict change in ADAS-Cog score (β = -.442, p=.038) after controlling for age, intervention group, and baseline functional capacity (R2=.467, F(4,16)= 3.507, p=.031). These findings suggest that functional connectivity of the DMN may underlie changes in global cognitive function. Furthermore, aerobic exercise is a promising intervention by which to elicit these changes in older adults with mild SIVCI.

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Association of Gait With Global and Domain-specific Cognitive Function Among Community-dwelling Older Adults: A Cross-sectional Study

10.21203/rs.3.rs-439336/v1 ◽

2021 ◽

Author(s):

WEN HAO ◽

Wenjing Zhao ◽

Takashi Kimura ◽

Shigekazu Ukawa ◽

Ken Kadoya ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cross Sectional Study ◽

Community Dwelling ◽

Initial Contact ◽

Sectional Study ◽

Cross Sectional ◽

Domain Specific ◽

Global Cognitive Function ◽

Gait Parameters

Abstract Background: Gait is associated with cognitive function and is a trait marker of dementia; however, research on gait and cognitive function usually concentrates on several individual gait parameters. This study used wearable sensors to measure gait parameters in different aspects and comprehensively explored the association of gait with global cognitive function and domain-specific cognitive function.Methods: The data of this cross-sectional study were obtained from 236 community-dwelling Japanese older adults (125 men and 111 women) aged 70–81 years. Gait was measured by asking participants to walk a 6-meter course and back using the Physilog® sensors (GaiUp®, Switzerland). Global cognitive function and cognitive domains were evaluated by face-to-face interviews using the Japanese version of the Montreal Cognitive Assessment. Twenty gait parameters were summarized as independent gait factors using factor analysis. A generalized linear model and linear regression model were used to explore the relationship of gait with global cognitive function and domain-specific cognitive function adjusted for several confounding factors.Results: Factor analysis yielded four gait factors: general cycle, initial contact, propulsion, and mid-swing. Among them, general cycle factor was significantly associated with global cognitive function (β=-0.565, [-0.967, -0.163]), executive function (P=0.012), and memory (P=0.045); initial contact was associated with executive function (P=0.019).Conclusion: Better gait was related to better cognitive function, especially the general cycle, which was correlated with both global and domain-specific cognitive function. The predictive value should be examined in future cohort studies.

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Effects of physical exercise on cognitively impaired older adults: a meta-analysis of randomized control trials

10.21203/rs.3.rs-15634/v1 ◽

2020 ◽

Author(s):

Lenka Sontakova ◽

Alzbeta Bartova ◽

Klara Dadova ◽

Iva Holmerova ◽

Michal Steffl

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Physical Exercise ◽

Cognitive Functions ◽

Cognitive Impairments ◽

Meta Analysis ◽

Randomized Control Trials ◽

Global Cognitive Function ◽

Randomized Control

Abstract Objectives: The main aim of this meta-analysis was to compare the effects of different physical activities on cognitive functions in older adults divided according to cognitive impairment levels. Methods: We searched Web of Science, Scopus, and PubMed for randomized control trials (RCT). A standardized mean difference (SMD) of the pre-post intervention score of global cognitive function tests were calculated by the random model in the Cochrane meta-analyses for people with cognitive impairment generally and across three levels - mild, mild to moderate, and moderate to severe cognitive impairment separately. Additionally, an unstandardized coefficient beta (B) was calculated in generalized linear models to estimate the effects of exercise, cognitive impairment severity, age, female ratio, length of intervention, and time of exercise a week on the global cognitive function. Results: Data from 26 studies involving 1,137 participants from intervention groups and 1,187 participants from control groups were analyzed. Physical exercise had a positive effect on cognitive functions in people across all levels of cognitive impairments SMD (95 % confidence interval [CI]) = 1.19 (0.77 - 1.62); however, heterogeneity was considerably high I 2 = 95%. Aerobic (B = 8.881) and resistance exercise (B = 4.464) was significantly associated with better results in global cognitive functions when compared to active control. A higher number of female participants cin intervention groups had a statistically significant effect on the global cognitive function (B = 0.229). onclusions: Physical exercise was associated with cognitive function improvement in older people with cognitive impairments. Aerobic exercise was more strongly associated than resistance exercise to combat cognitive decline. Keywords: Physical activity, Dementia, Aging, Meta-analysis, Aerobic exercise, Cognitive function

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Tea consumption and measures of attention and psychomotor speed in the very old: the Newcastle 85+ longitudinal study

BMC Nutrition ◽

10.1186/s40795-020-00361-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Edward Jonathan Okello ◽

Nuno Mendonça ◽

Blossom Stephan ◽

Graciela Muniz-Terrera ◽

Keith Wesnes ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Function ◽

Sustained Attention ◽

Community Dwelling ◽

Tea Consumption ◽

Psychomotor Speed ◽

Very Old ◽

Old Adults ◽

Global Cognitive Function ◽

Over Time

Abstract Background A number of studies have indicated a beneficial effect of tea consumption on the reduction of risk of cognitive impairment and dementia in older aged populations. However, there is a paucity of data on these associations in the very old, defined as individuals aged 85 years and over. We investigated the relationship between tea consumption in the very old and measures of global cognitive function, memory, attention and psychomotor speed. Method Longitudinal (5-years), population-based cohort study of individuals aged 85+ years in the North East of England, United Kingdom. Participants were community-dwelling and institutionalized men and women recruited through general medical practices (n = 676). Baseline tea consumption and longitudinal measures of global and domain specific (memory, speed and attention) cognitive function were assessed. Linear mixed models, controlling for demographic (e.g. age, sex and education) and health variables were used to determine whether tea consumption was protective against cognitive decline. Results Tea consumption was not associated with cognitive function at baseline on any measure (unadjusted and adjusted analyses). In the linear mixed effects models adjusted for age, sex, education and disease co-morbidity, higher tea consumption was associated with significantly better attention (focused and sustained attention), and psychomotor speed (complex tasks only) over five-years follow-up. However, there was no association between tea consumption and global cognitive function, memory or performance on simple speed tasks over time. Conclusions In this cohort study of non-demented very old adults we found that higher (vs. lower) tea consumption was associated with better performance over time on measures of focused and sustained attention and some psychomotor speed tasks. No associations with global cognition, memory or easy speed tasks (simple Reaction Time or Word Recognition) were detected. The results have implications for the development of possible diet-based interventions focused on improving cognitive function in the very old age group. These findings need to be confirmed in a sufficiently powered and well-designed RCT with non-demented very old adults.

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Social Networks, Community Engagement, and Cognitive Impairment among Community-Dwelling Chinese Older Adults

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000502090 ◽

2019 ◽

Vol 9 (3) ◽

pp. 330-337

Author(s):

Jinlei Li ◽

Zijuan Wang ◽

Zhiwei Lian ◽

Zhikai Zhu ◽

Yuanli Liu

Keyword(s):

Older Adults ◽

Social Networks ◽

Cognitive Impairment ◽

Social Network ◽

Cognitive Function ◽

Community Engagement ◽

Community Dwelling ◽

Chinese Older Adults ◽

Network Characteristics ◽

Community Activities

Aims: To examine the association of social networks and community engagement with cognitive impairment among community-dwelling Chinese older adults. Methods: From November 2017 to May 2018, we selected 1,115 elderly individuals from 3 Chinese communities (Beijing, Hefei, and Lanzhou) using a random-cluster sampling method, and recorded data on demographics, social network characteristics, community activities, and cognitive function. The odds ratios (ORs) of these associations were adjusted for potential confounders in logistic regression models. Results: The prevalence of cognitive impairment was 25.7% (n = 287). An adequate social network (OR 0.55; 95% confidence interval [CI] 0.33–0.91) and enough social support from friends (OR 0.43; 95% CI 0.29–0.62) were negatively associated with cognitive impairment. Family support was not significantly associated with cognitive impairment (OR 0.64; 95% CI 0.34–1.21). Taking part in elderly group travel, communication with others using WeChat, and community activities such as Tai Chi and walking together were negatively associated with cognitive impairment. Conclusion: Social network characteristics and community engagement were found to be related to cognitive function among community-dwelling Chinese elderly adults.

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