Serum Immunoglobulins and Cognitive Status in the Elderly: 1. A Population Study

1980 ◽  
Vol 136 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Donna Cohen ◽  
Carl Eisdorfer

SummaryFifty-seven cognitively impaired elderly had significantly elevated serum IgG (P $0.005) and IgA (P $0.01) levels and similar IgM levels, compared to a population of 65 elderly matched for age and sex, who did not manifest cognitive impairment. These findings are compatible with a current hypothesis that immunological factors may be important in the cognitive disorders observed with increasing frequency among the aged.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Dupré ◽  
N Barth ◽  
A El Moutawakkil ◽  
F Béland ◽  
F Roche ◽  
...  

Abstract Background Few previous cohorts have studied the different type of physical activities and the degree of cognitive decline. The objective of this work was to analyze the leisure, domestic and professional activities with mild and moderate cognitive disorders in older people living in community. Methods The study used data from the longitudinal and observational study, FrèLE (FRagility: Longitudinal Study of Expressions). The collected data included: socio-demographic variables, lifestyle, and health status (frailty, comorbidities, cognitive status, depression). Cognitive decline was assessed by using: MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment). MoCA was used with two cut-offs (26 and 17) so as to define mild and moderate cognitive disorders Physical activity was assessed by the PASE (Physical Activity Scale for the Elderly), structured in three sections: leisure, domestic and professional activities. Spline and proportional hazards regression models (Cox) were used to estimate the risk of cognitive disorders. Results At baseline, 1623 participants were included and the prevalence of cognitive disorders was 6.9% (MMSE) and 7.2% (MoCA), mild cognitive disorders was 71.3%. The mean age was 77 years, and 52% of the participants were women. After a 2 years long follow-up, we found 6.9% (MMSE) and 6% (MoCA) cognitive disorders on participants. Analyses showed that domestic activities were associated to cognitive decline (HR = 0.52 [0.28-0.94] for MMSE and HR = 0.48 [0.28-0.80] for MoCA). No association were found with leisure and professional activities, and no spline were significant with mild cognitive disorders. Conclusions Analysis showed a relationship between cognitive disorders and type of physical activity, thanks to the use of specific questionnaire of elderly and two global test of cognition. These findings will contribute to the debate on the beneficial effects of physical activity on cognition. Key messages This work allowed to compare two test of cognition and their link with physical activity. It contributes to the debate on the beneficial effects of physical activity on cognition. The work allowed us to see the effect of the different types of physical activity and the impact of the statistical method on the results.


2021 ◽  
Vol 25 (2) ◽  
pp. 19-27
Author(s):  
Tatiana Andreevna Bogdanova ◽  
Anna V. Turusheva ◽  
Elena V. Frolova ◽  
Dmitriy L. Logunov

BACKGROUND: Cognitive impairment is one of the most common geriatric syndromes that occur in the elderly. Dementia is a severe cognitive disorder that results in the professional, social, and functional impairment and gradual loss of independence. However, in most cases, the stage of dementia is preceded by a long period of non-dementia cognitive impairment. In this regard, one of the priorities of public health is to identify potentially reversible forms of dementia and cognitive impairment in the early stages. AIM: To assess demographic characteristics, co-morbidities and factors that are associated with cognitive impairment in adults aged 65 years and over and to determine the prevalence of cognitive disorders in aging population. MATERIALS AND METHODS: cross-sectional study included all patients aged 65 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 in Saint Petersburg. Measurements: the Montreal cognitive assessment test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, blood pressure measurement, a medication review and blood tests (complete blood count, lipids, hormones, glucose, ALT, AST and creatinine). RESULTS: The prevalence of mild cognitive impairment was 62.9 % (95 % CI 56-70), severe cognitive impairment 8.2 %. We detected that hypertension, stroke, sleep disorders, subjective memory complaints and symptoms of depression were identified as factors associated with CI after adjustment for covariates. Hypertension and depression were related with cognitive impairment (p 0.05). Also patients with depression scored worse in global cognition and attention function (p 0.05). Patients with diabetes had association with a decrease in abstraction function (p = 0.02). Low hemoglobin levels were related with poor global cognition and memory impairment (p 0.01). Beta-blocker use was significantly associated with poor global cognition and memory impairment (p 0.01). CONCLUSIONS: We found that elders have a high prevalence of cognitive disorders. We also demonstrated association between co-morbidities and factors as hypertension, anemia, diabetes, depression and administration of beta-blockers with poor cognitive performance in the elderly.


2010 ◽  
Vol 138 (5-6) ◽  
pp. 319-322 ◽  
Author(s):  
Emilija Dubljanin-Raspopovic ◽  
Dragana Matanovic ◽  
Marko Bumbasirevic

Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE) at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM) at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission). Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01). Absolute functional gain, however, was higher in 1) cognitively intact compared to cognitively impaired patients (p<0.01), and 2) cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01). No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05). Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best achievable outcome to be reached.


2020 ◽  
Vol 11 ◽  
Author(s):  
André J. Esgalhado ◽  
Débora Reste-Ferreira ◽  
Stephanie E. Albino ◽  
Adriana Sousa ◽  
Ana Paula Amaral ◽  
...  

There is increasing evidence that in humans the adaptive immunological system can influence cognitive functions of the brain. We have undertaken a comprehensive immunological analysis of lymphocyte and monocyte populations as well as of HLA molecules expression in a cohort of elderly volunteers (age range, 64–101) differing in their cognitive status. Hereby, we report on the identification of a novel signature in cognitively impaired elderly characterized by: (1) elevated percentages of CD8+ T effector-memory cells expressing high levels of the CD45RA phosphate receptor (Temrahi); (2) high percentages of CD8+ T cells expressing high levels of the CD8β chain (CD8βhi); (3) augmented production of IFNγ by in vitro activated CD4+ T cells. Noteworthy, CD3+CD8+ Temrahi and CD3+CD8βhi cells were associated with impaired cognition. Cytomegalovirus seroprevalence showed that all volunteers studied but one were CMV positive. Finally, we show that some of these phenotypic and functional features are associated with an increased frequency of the HLA-B8 serotype, which belongs to the ancestral haplotype HLA-A1, Cw7, B8, DR3, DQ2, among cognitively impaired volunteers. To our knowledge, this is the first proof in humans linking the amount of cell surface CD45RA and CD8β chain expressed by CD8+ Temra cells, and the amount of IFNγ produced by in vitro activated CD4+ T cells, with impaired cognitive function in the elderly.


2019 ◽  
Vol 75 (7) ◽  
pp. 1386-1392
Author(s):  
Brian Downer ◽  
Sadaf Milani ◽  
Rebeca Wong

Abstract Background Many older adults become physically and cognitively impaired. However, it is unclear whether unimpaired older adults are more likely to become physically or cognitively impaired first and if this sequence impacts mortality risk. Methods Data came from the Mexican Health and Aging Study. The sample included 1,283 participants aged ≥60 years who were physically and cognitively unimpaired in 2001. Multinomial logistic regression was used to estimate probabilities of being unimpaired, cognitively impaired only, physically impaired only, or cognitively-physically impaired in 2003. Proportional hazard models were used to estimate mortality risk through 2015 according to physical and cognitive status in 2003. Results The probabilities for being unimpaired, physically impaired only, cognitively impaired only, and cognitively-physically impaired in 2003 were 0.45, 0.22, 0.19, and 0.13, respectively. Older age, female sex, and arthritis were associated with significantly greater probability of becoming physically impaired only than cognitively impaired only in 2003. Cognitive impairment only (hazard ratio [HR] = 1.42, 95% confidence interval [CI] = 1.09–1.85) in 2003 but not physical impairment only (HR = 1.22, 95% CI = 0.94–1.58) was associated with greater mortality than being unimpaired in 2003. Cognitively-physically impaired participants had higher mortality risk than participants who were physically (HR = 1.58, 95% CI = 1.18–2.12) or cognitively (HR = 1.36, 95% CI = 1.01–1.84) impaired only. Discussion The likelihood of becoming only physically or cognitively impaired over 2 years varies by demographic and health characteristics. The mortality risk for unimpaired older adults who become cognitively impaired only is similar to those who become physically impaired only. Research should determine if the sequence of cognitive and physical impairments is associated with other outcomes.


2014 ◽  
Vol 27 (2) ◽  
pp. 279-288 ◽  
Author(s):  
Sophie Pilleron ◽  
Jean-Pierre Clément ◽  
Bébène Ndamba-Bandzouzi ◽  
Pascal Mbelesso ◽  
Jean-François Dartigues ◽  
...  

ABSTRACTBackground:To date, no studies have examined the relationship between cognitive disorders and personality disorders. Our aim was to investigate the association between dependent personality disorder (DPD) and cognitive disorders in Central Africa.Methods:Between 2011 and 2012, a cross-sectional multicenter population-based study was carried out in rural and urban areas of the Central African Republic (CAR) and the Republic of Congo (ROC). Participants aged ≥65 years were interviewed using the Community Screening Interview for Dementia (CSI-D). Elderly people who performed poorly (CSI-D cognitive tests score or COGSCORE ≤ 24.5/30) were clinically assessed by neurologists and underwent further psychometric testing. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition and Petersen criteria were required for the diagnosis of dementia and mild cognitive impairment (MCI) respectively. DPD was assessed using the Personality Diagnostic Questionnaire-4+. Socio-demographic, vascular, and psychological factors were also documented. Multivariate multinomial logistic regression models were used to estimate the associations.Results:Of the 2,002 participants screened, 860 and 912 had data for cognitive status and DPD in CAR and ROC respectively. In fully adjusted models, DPD was significantly associated with MCI in ROC (Odds Ratio (OR) = 2.2, 95% CI: 1.0–4.7) and CAR (OR = 2.1, 95% CI: 1.1–4.0) and with dementia only in ROC (OR = 4.8, 95% CI: 2.0–11.7).Conclusions:DPD was associated with cognitive disorders among elderly people in Central Africa. This association should be confirmed in other contexts. This study paves the way for research on the association between personality and cognitive impairment in Africa.


2016 ◽  
Vol 6 (9) ◽  
pp. 578 ◽  
Author(s):  
Komal Chauhan ◽  
Aditika Agarwal

Background: The Neurodegenerative diseases are increasingly affecting the elderly with a severe impact on their brain health. There is a wide gap in supplementation based studies for increasing the cognition levels of the geriatric population especially in the developing countries like India, which are at extreme risk of developing neurological disorders. Vitamin B12 herein has caught much attention lately for improving the cognitive status. Literature has linked the possibility of alleviating neurological disorders in the elderly with effective vitamin B12 management. Abundant animal and human models have proved that supplementation of vitamin B12 is beneficial for the restoration of cognitive functions. Objective: To supplement vitamin B12 deficient mild cognitively impaired geriatric patients with injectable doses of vitamin B12 followed by impact evaluation. Methods: Screening of the mild cognitively impaired patients was carried out using the Mini-Mental State Examination and Yamaguchi Fox Pigeon Imitation test. Baseline information was elicited from the patients residing in urban Vadodara (a district in the state of Gujarat), India. This included socio-demographic, medical and drug history, anthropometric and physical activity pattern as well as biochemical parameters comprising of serum vitamin B12 and glycated haemoglobin profile. A sub-sample of 60 patients with mild cognitive impairment (MCI) demonstrating severe vitamin B12 deficiency were conveniently enrolled for injectable doses of Vitamin B12 in the dosage of 1,000 μg every day for one week, followed by 1,000 μg every week for 4 weeks & finishing with 1,000 μg for the remaining 4 months. Post six months intervention all the parameters were elicited. Results: Vitamin B12 supplementation resulted in a significant (p<0.001) improvement in the MMSE scores of the patients with a rise of 9.63% in the total patients. Gender-wise division also highlighted a significant increase (p<0.001) in the scores by 6.79% and 12.46% in overall males and females and a 10.20% and 8.24% rise for young-old (60-69 yrs) and old- old (70-85 yrs) categories, respectively. As a result, 27 patients progressed towards the category from the MCI state being assessed by MMSE scores. In the same manner, YGFPIT too demonstrated a 38% increase in normal with 35% males, 42% females, 41% young–old and 31% old-old moving to normal status. Thus, a total number of 28 patients progressed to the normal condition as per YGFPIT.Conclusion: Hence, vitamin B12 supplementation was found significantly effective in placing the serum vitamin B12 of MCI patients from the deficiency state to sufficient levels and in turn increased their performance in MMSE and YFPIT scores. Keywords: Mild Cognitive Impairment, vitamin B12, geriatrics, cognition


2018 ◽  
Vol 33 (8) ◽  
pp. 1040-1045 ◽  
Author(s):  
Hannah E Wadsworth ◽  
Kaltra Dhima ◽  
Kyle B Womack ◽  
John Hart ◽  
Myron F Weiner ◽  
...  

Abstract Objective The feasibility and reliability of neuropsychological assessment at a distance have been demonstrated, but the validity of this testing medium has not been adequately demonstrated. The purpose of this study was to determine the ability of video teleconferencing administration of neuropsychological measures (teleneuropsychology) in discriminating cognitively impaired from non-impaired groups of older adults. It was predicted that measures administered via video teleconference would distinguish groups and that the magnitude of differences between impaired and non-impaired groups would be similar to group differences achieved in traditional administration. Methods The sample consisted of 197 older subjects, separated into two groups, with and without cognitive impairment. The cognitive impairment group included 78 individuals with clinical diagnoses of mild cognitive impairment or Alzheimer’s disease. All participants completed counterbalanced neuropsychological testing using alternate test forms in both a teleneuropsychology and a traditional face-to-face (FTF) administration condition. Tests were selected based upon their common use in dementia evaluations, brevity, and assessment of multiple cognitive domains. Results from FTF and teleneuropsychology test conditions were compared using individual repeated measures ANCOVA, controlling for age, education, gender, and depression scores. Results All ANCOVA models revealed significant main effects of group and a non-significant interaction between group and administration condition. All ANCOVA models revealed non-significant main effects for administration condition, except category fluency. Conclusions Results derived from teleneuropsychologically administered tests can distinguish between cognitively impaired and non-impaired individuals similar to traditional FTF assessment. This adds to the growing teleneuropsychology literature by supporting the validity of remote assessments in aging populations.


2020 ◽  
pp. 10.1212/CPJ.0000000000000829
Author(s):  
Gayatri Devi ◽  
Darren R. Gitelman ◽  
Daniel Press ◽  
Kirk R. Daffner

Aging physicians are at a higher risk of cognitive impairment, undermining patient safety and unraveling physicians' careers. Neurologists, occupational health physicians, and psychiatrists will participate in both health system policy decisions and individual patient evaluations. We address cognitive impairment in aging physicians and attendant risks and benefits. If significant cognitive impairment is found after an appropriate evaluation, precautions to confidentially support physicians' practicing safely for as long as possible should be instituted. Understanding that there is heterogeneity and variability in the course of cognitive disorders is crucial to supporting cognitively impaired, practicing physicians. Physicians who are no longer able to practice clinically have other meaningful options.


1996 ◽  
Vol 26 (4) ◽  
pp. 829-835 ◽  
Author(s):  
D. Clarke ◽  
K. Morgan ◽  
J. Lilley ◽  
T. Arie ◽  
R. Jones ◽  
...  

SynopsisSurvivors from a nationally representative sample of elderly people originally screened in 1985 were reassessed in 1989 and again in 1993. On each occasion respondents were rated as cognitively impaired, borderline impaired or unimpaired (using a brief information/orientation scale), with the validity of these ratings assessed in subsequent clinical interviews. Where follow-up screening was not possible, information was derived from death certificates and hospital case-notes. Over 8 years (1985–93) the overall incidence rate per person–year at risk was 1·58%, giving age-specific rates of 0·72, 1·32, 1·63, 3·46, 2·55 and 1·41% for the age groups 65–69, 70–74, 75–79, 80–84, 85–89 and ≥ 90 respectively. Of 43 individuals classified at screening as borderline impaired in 1985 and 1989, 19 were diagnosed as demented at clinical interviews conducted within 16 weeks of screening. Four-year follow-ups among the remaining 24 showed that 15 had died, while 6 showed a worsened cognitive status. Controlling for both age and sex, aggregated 4-year mortality was significantly higher among those defined at screening in 1985 and 1989 as either impaired or borderline, when compared with the unimpaired.


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