scholarly journals Association of parathyroid hormone with 20-year cognitive decline

Neurology ◽  
2017 ◽  
Vol 89 (9) ◽  
pp. 918-926 ◽  
Author(s):  
Samuel M. Kim ◽  
Di Zhao ◽  
Andrea L.C. Schneider ◽  
Sai Krishna Korada ◽  
Pamela L. Lutsey ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Large Population ◽  
Population Based ◽  
Cognitive Testing ◽  
Word Recall ◽  
Cross Sectional ◽  
Significant Difference

Objective:We hypothesized that elevated parathyroid hormone (PTH) levels will be independently associated with 20-year cognitive decline in a large population-based cohort.Methods:We studied 12,964 middle-aged white and black ARIC participants without a history of prior stroke who, in 1990–1992 (baseline), had serum PTH levels measured and cognitive function testing, with repeat cognitive testing performed at up to 2 follow-up visits. Cognitive testing included the Delayed Word Recall, the Digit Symbol Substitution, and the Word Fluency tests, which were summed as a globalZscore. Using mixed-effects models, we compared the relative decline in individual and global cognitive scores between each of the top 3 quartiles of PTH levels to the reference bottom quartile. We adjusted for demographic variables, education, vascular risk factors, and levels of calcium, phosphate, and vitamin D. We imputed missing covariate and follow-up cognitive data to account for attrition.Results:The mean (SD) age of our cohort was 57 (6) years, 57% were women, and 24% were black. There was no cross-sectional association of elevated PTH with cognitive globalZscore at baseline (p> 0.05). Over a median of 20.7 years, participants in each PTH quartile showed a decline in cognitive function. However, there was no significant difference in cognitive decline between each of the top 3 quartiles and the lowest reference quartile (p> 0.05). In a subset, there was also no association of higher mid-life PTH levels with late-life prevalent adjudicated dementia (p> 0.05).Conclusions:Our work does not support an independent influence of PTH on cognitive decline in this population-based cohort study.

Abstract P217: Parathyroid Hormone is Not Independently Associated With Cognitive Decline: 20 Year Follow-up From the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Samuel M Kim ◽  
Di Zhao ◽  
Andrea L Schneider ◽  
Sai Krishna Korada ◽  
Pamela L Lutsey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Parathyroid Hormone ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Population Based ◽  
Word Recall ◽  
Z Score ◽  
Cerebral Disease ◽  
Vitamin D Levels

Background: Little is known about the role of parathyroid hormone (PTH) in cognitive decline. Elevated PTH may contribute to cognitive impairment and dementia by mechanisms of endothelial dysfunction, increased vascular stiffness, hypertension, and atherosclerosis, as well as via small vessel cerebral disease. We hypothesized that elevated PTH levels will be independently associated with 20-year cognitive decline in a large population-based cohort study. Methods: We studied 12,964 middle-aged white and black ARIC participants without history of prior stroke who had serum PTH levels and cognitive function testing measured in 1990-92 (baseline) and repeat cognitive testing at up to 2 follow-up visits in 1996-98 and 2011-13. The cognitive tests included the Delayed Word Recall, Digit Symbol Substitution, and Word Fluency tests, which were summed as a global z score. Using mixed-effects models, we compared the relative decline in global cognitive score between each of the top three quartiles of PTH levels to the reference bottom quartile. Time since baseline was modeled by using a linear spline with a knot at 6 years. We adjusted for demographic variables, education, vascular risk factors, and calcium, phosphorous, and vitamin D levels. We imputed missing covariates and follow-up cognitive data using multiple imputation by chained equations (MICE) methods to account for attrition during study follow-up. Results: The mean (SD) age of our cohort was 57(6) years, 57% were women, and 24% black race. There was no cross-sectional association of elevated PTH with cognitive global Z score at baseline (all p>0.05). Over a median of 20.7 years, participants in each PTH quartile showed decline in cognitive function ( Table Part A ). However, cognitive decline was not steeper in participants with PTH levels in the higher quartiles than participants with the lowest PTH levels (all p>0.05). [ Table Part B ]. Conclusions: Our work does not support an independent influence of PTH on cognitive decline in this biracial population-based cohort study.

Internet-based cognitive testing in multiple sclerosis

2007 ◽  
Vol 13 (8) ◽  
pp. 1011-1019 ◽  
Author(s):  
M. Younes ◽  
J. Hill ◽  
J. Quinless ◽  
M. Kilduff ◽  
B. Peng ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Verbal Memory ◽  
Stability Index ◽  
Cross Sectional Study ◽  
Cognitive Testing ◽  
The Internet ◽  
Cross Sectional ◽  
Multiple Sclerosis Patients

Cognitive impairment in multiple sclerosis is difficult to study because of the heterogeneity and variability of this disease. The gold standard for measurement of cognitive function in multiple sclerosis is a full battery of neurocognitive tests, which is time consuming and expensive. Some cognitive tests like the PASAT, a measure of working verbal memory and processing speed, have been proposed for screening and follow-up of cognitive function in clinical trials. We studied whether we could measure cognitive function in multiple sclerosis over the Internet. For this we used the Cognitive Stability Index (CSI)™, developed for persons with known or suspected primary central nervous system illness. The CSI was compared with formal neurocognitive testing (NPsych) and the PASAT in a cross-sectional study of 40 consecutive multiple sclerosis patients with subjective cognitive complaints. NPsych revealed that only 18 of the 40 patients (46%) were cognitively impaired. Although both the CSI and the PASAT were equalivalent in their specificity (86%), the CSI was significantly more sensitive than the PASAT (83% versus 28%). We conclude that the CSI, because of its availability over the Internet, has great potential as a tool for screening and follow up of cognitive function in multiple sclerosis. Multiple Sclerosis 2007; 13: 1011—1019. http://msj.sagepub.com

scholarly journals Apathy and cognitive and functional decline in community-dwelling older adults: results from the Baltimore ECA longitudinal study

2010 ◽  
Vol 22 (5) ◽  
pp. 819-829 ◽  
Author(s):  
Diana E. Clarke ◽  
Jean Y. Ko ◽  
Constantine Lyketsos ◽  
George W. Rebok ◽  
William W. Eaton
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
General Health Questionnaire ◽  
Functional Decline ◽  
Population Based ◽  
Community Dwelling ◽  
Public Health Importance ◽  
Cross Sectional ◽  
Prevalence Estimates

ABSTRACTBackground: Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer's disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and/or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults.Methods: Data on 1,136 community-dwelling adults aged 50 years and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Logistic regression, t-tests, χ2 and Generalized Estimating Equations were used to accomplish the study's objectives.Results: The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower Mini-mental State Examination (MMSE) scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR = 2.74; 95%CI = 1.35, 5.57) function at 1-year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were twice as likely to have functional decline. Incidence of apathy at 1-year follow up and 13-year follow-up was 22.6% and 29.4%, respectively.Conclusions: These results underline the public health importance of apathy and the need for further population-based studies in this area.

scholarly journals Cognitive reserve as a moderator of the negative association between mood and cognition: evidence from a population-representative cohort

2017 ◽  
Vol 48 (1) ◽  
pp. 61-71 ◽  
Author(s):  
C. Opdebeeck ◽  
F. E. Matthews ◽  
Y-T. Wu ◽  
R. T. Woods ◽  
C. Brayne ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Reserve ◽  
Large Population ◽  
Population Based ◽  
Cross Sectional Study ◽  
Negative Association ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
The Individual ◽  
Mood And Cognition

BackgroundCognitive reserve (CR) has been associated with better cognitive function and lower risk of depression in older people, yet it remains unclear whether CR moderates the association between mood and cognition. This study aimed to investigate whether a comprehensive indicator of CR, including education, occupation and engagement in cognitive and social activities, acts as a moderator of this association.MethodsThis was a cross-sectional study utilising baseline data from the Cognitive Function and Ageing Study II (CFAS II), a large population-based cohort of people aged 65+ in England. Complete data on the measures of CR, mood and cognition were available for 6565 dementia-free individuals. Linear regression models were used to investigate the potential modifying effect of CR on the association between cognition and mood with adjustment for age, sex and missing data.ResultsLevels of CR did moderate the negative association between mood and cognition; the difference in cognition between those with and without a clinical level mood disorder was significantly smaller in the middle (−2.28; 95% confidence interval (CI) −3.65 to −0.90) and higher (−1.30; 95% CI −2.46 to −0.15) CR groups compared with the lower CR group (−4.01; 95% CI −5.53 to −2.49). The individual components of CR did not significantly moderate the negative association between mood and cognition.ConclusionThese results demonstrate that CR, indexed by a composite score based on multiple indicators, can moderate the negative association between lowered mood and cognition, emphasising the importance of continuing to build CR across the lifespan in order to maintain cognitive health.

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.

Longitudinal assessment of cancer-related cognitive impairment (CRCI) up to six-months post-chemotherapy with multiple cognitive testing methods in 943 breast cancer (BC) patients and controls.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10014-10014 ◽  
Author(s):  
Michelle Christine Janelsins ◽  
Charles E. Heckler ◽  
Luke Joseph Peppone ◽  
Supriya Gupta Mohile ◽  
Karen Michelle Mustian ◽  
...  
Keyword(s):  
Visual Processing ◽  
Mixed Model ◽  
Word Association ◽  
Cognitive Testing ◽  
Longitudinal Change ◽  
Word Recall ◽  
Significant Group ◽  
Significant Difference ◽  
Group Time

10014 Background: Large nationwide studies are needed to assess CRCI. Methods: NCORPs recruited BC patients and age-matched non-cancer controls. Computerized ((CANTAB Delayed Match to Sample (DMS), Rapid Visual Processing (RVP), Verbal Recognition Memory (VRM)), paper-based ((Controlled Oral Word Association (COWA), and Trail Making Test (TMT)) , and phone-based (category fluency, word recall, backward counting and digits backward) cognitive assessments of memory, attention, and executive function at pre-chemotherapy, post-chemotherapy, and 6 months follow-up (or time-equivalent for controls) were completed. Longitudinal mixed model (LMM)s included group, time, time*group, and adjusted for age, education, reading, anxiety, and depression. Results: 580 BC patients (mean age = 54) and 363 controls (mean age = 53) were assessed. In all LMMs, there was a significant group*time interaction depicting lower scores in patients compared to controls (p < 0.005) except for TMT (p = 0.09). For longitudinal change on the DMS memory test (primary aim), we observed no significant difference between groups from pre- to post-chemotherapy but did observe a significant difference from pre-chemotherapy to follow-up (p = 0.017) where patients significantly declined (p = 0.005) and controls did not change. We observed similar results for RVP. For VRM, there was a significant pre- to post-chemotherapy group difference (p = 0.003). For COWA, patients significantly declined and controls significantly improved reflecting a significant between group difference (p < 0.001) from pre- to post-chemotherapy. For TMT, both groups significantly improved with patients improving less than controls reflected by a significant between group difference (p = 0.04) that remained a trend at follow-up (p = 0.06). On all phone tests, there was a significant between group effect from both pre- to post-chemotherapy and at follow-up with patients doing less well than controls (all p < 0.001). Conclusions: This nationwide study shows CRCI in BC patients persists in multiple cognitive domains up to 6 months post-chemotherapy compared to controls. Clinical trial information: NCT01382082.

scholarly journals Exploring the bidirectional associations between loneliness and cognitive functioning over 10 years: the English longitudinal study of ageing

2019 ◽  
Vol 48 (6) ◽  
pp. 1937-1948 ◽  
Author(s):  
Jiamin Yin ◽  
Camille Lassale ◽  
Andrew Steptoe ◽  
Dorina Cadar
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Fluency ◽  
Word Recall ◽  
Reverse Causality ◽  
Linear Slope ◽  
Rate Of Decline ◽  
English Longitudinal Study

Abstract Background As the population ages, cognitive decline and dementia have become major health concerns in the UK. Loneliness has been linked to cognitive decline, but the reverse causality of this association remains unclear. This study aims to examine whether there is a bidirectional relationship between loneliness and cognitive function in older English adults (age 50 years and over) over a 10-year follow-up. Methods Data came from a nationally representative sample of 5885 participants in the English Longitudinal Study of Ageing (ELSA), free of stroke or dementia and followed every 2 years up to wave 7 (2014–15). At each wave, cognitive function was measured with word recall and verbal fluency tests, and loneliness was measured with the abridged version of the revised UCLA Loneliness Scale. Bivariate dual change score models were used to assess the multivariate associations between loneliness and cognitive function, used interchangeably as exposures and outcomes. Results Greater loneliness at baseline was associated with poorer memory [β intercept = −0.03, standard error (SE) = 0.01, P  =  0.016] and verbal fluency (β intercept = −0.01, SE  =  001, P =  0.027) at baseline, and with a stronger linear rate of decline in both memory (β linear slope = −0.07, SE  =  001, P  ≤ 0.001) and verbal fluency (β linear slope = −0.09, SE  =  0.03, P =  0.003) over a 10-year follow-up period, although the performance on verbal fluency did not change substantially on average over this period. We also found that higher baseline memory, but not verbal fluency, predicted a slower change in loneliness (β linear slope = −0.01, SE  =  001, P =  0.004) and that a linear decline in memory was associated with an acceleration in loneliness (β quadratic slope = −0.02, SE  =  001, P  ≤ 0.001) during follow-up. Conclusions Higher loneliness is associated with poorer cognitive function at baseline and contributes to a worsening in memory and verbal fluency over a decade. These factors seem, however, to be partially intertwined, since baseline memory and its rate of decline also contribute to an increase in loneliness over time.

scholarly journals Pet ownership and cognitive decline in older people

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Nicola Veronese ◽  
Lee Smith ◽  
Vania Noventa ◽  
Guillermo F. López-Sánchez ◽  
Jacopo Demurtas ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Fluency ◽  
Later Life ◽  
Positive Influence ◽  
Pet Ownership ◽  
Cross Sectional ◽  
Positive Effects ◽  
Significant Difference ◽  
Dog Owners

Animals can have a positive influence on human health. However, it is not yet known whether pet ownership can prevent cognitive decline. Therefore, we aimed to investigate cross-sectional and prospective associations between pet ownership and cognitive function in a large, representative sample of older adults. Data were from the English Longitudinal Study of Ageing (ELSA) using data collected in wave 5 and six years later in wave 8. Pet ownership was categorized as no pet, dog, cat or other pet. Cognitive function was assessed using tests of verbal fluency (assessed by asking how many different animals the participants could name in 60 seconds) and memory (sum of immediate and delayed verbal recall). Multiple linear regression, adjusted for potential confounders, was used to test the associations between pet ownership and cognitive function. A total of 8291 people (mean age: 66.72 years) were included. In cross-sectional analyses, dog owners had better verbal fluency than individuals with no pet, but there was no significant difference between cat or other pet owners and those with no pet. In prospective analyses, dog owners had a significantly larger decline in recall than those with no pet, whilst cat owners had a significantly smaller decline in verbal fluency. These results provide some evidence to suggest that pet ownership may have positive effects on cognition in later life. However, benefits of pet ownership were not unilaterally observed across different types of pet and measures of cognitive function suggesting that further research is required.

Preserved cognition and reduced age-related cognitive decline during treatment with angiotensin II receptor blockers: A 20-year follow-up study

2017 ◽  
Vol 41 (S1) ◽  
pp. S372-S372 ◽  
Author(s):  
D. Wincewicz ◽  
T. Tolmunen ◽  
A.K. Brem ◽  
J. Kauhanen ◽  
S. Lehto
Keyword(s):  
Angiotensin Ii ◽  
Cognitive Decline ◽  
Population Based ◽  
Angiotensin Ii Receptor ◽  
Cross Sectional ◽  
Age Related ◽  
Receptor Blockers ◽  
Age Related Cognitive Decline ◽  
The Brain

IntroductionModulators of the brain renin-angiotensin system (RAS) have been shown to improve cognitive functioning in several animal models of neuropsychiatric disorders. Moreover, the brain RAS has been considered a new target for the treatment of Alzheimer's disease (AD). However, there are no population-based follow-up studies supporting this hypothesis.ObjectivesCross-sectional and prospective relationships between cognitive decline and ARB treatment were examined in the population-based Kuopio Ischemic Heart Disease Risk Factor Study.AimsTo evaluate procognitive/antidementia capacity of orally delivered angiotensin II receptor blockers (ARB).MethodsThe study was conducted on a sample of 1774 subjects (920 females, 854 males; age range at baseline: 42–61 years) from Eastern Finland. An established cutoff score of at least 2-point decrease in the Mini Mental State Examination over a 9-year follow-up was used to detect age-related cognitive decline in the cross-sectional setting. In the prospective setting, a hospital discharge diagnosis of dementia/AD was used as outcome variable. Cross-sectional relationships were determined with logistic regression and prospective analyses were conducted with the Cox proportional hazards model (both adjusted for relevant background variables).ResultsCross-sectional analysis displayed a decrease of the odds of cognitive decline (n = 87; 4.9% of participants) in those with ARB treatment; OR = 0.445, 95% CI: 0.22–0.90, P = 0.024. Furthermore, in the prospective setting, the risk of dementia/AD diagnosis (n = 149; 8.4% of participants) was significantly reduced in ARB treated participants; HR = 0.621, 95% CI: 0.40–0.98, P = 0.038.ConclusionsARB treatment is associated with a decreased risk for age-related cognitive decline and dementia/AD manifestation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Patient perceptions and preferences of biologic therapies in SLE

2019 ◽  
Vol 6 (1) ◽  
pp. e000322 ◽  
Author(s):  
S Sam Lim ◽  
Hong Kan ◽  
Bonnie F Pobiner ◽  
Gaobin Bao ◽  
Cristina Drenkard
Keyword(s):  
Ad Hoc ◽  
Large Population ◽  
Population Based ◽  
Cross Sectional Study ◽  
Patient Perceptions ◽  
Biologic Therapies ◽  
Full Spectrum ◽  
Cross Sectional ◽  
Significant Difference ◽  
Blacks And Whites

ObjectiveTo evaluate patient perceptions of biologic therapies from a large, population-based cohort of patients with SLE with significant numbers of blacks and whites and across the full spectrum of socioeconomic strata and disease severity.MethodsThis was a cross-sectional study of validated patients with SLE enrolled in the Georgians Organized Against Lupus Cohort between September 2014 and August 2015. The survey instrument was developed ad hoc by the authors and contained an introduction on biologics.ResultsA total of 676 participants were on average 48.4 years old with 15.9 years of disease; 93.2% were female and 80.6% were black; 34.2% had private health insurance and 9.8% had no insurance; and 26.8% and 27.5% had Medicare or Medicaid, respectively. Of all respondents, 30.8% had heard of biologics, with a significant difference between blacks and whites (25.2% vs 53.4%, respectively). There were no significant differences, however, between blacks and whites with respect to ever having been on biologics (7.6% and 11.5%, respectively) or where they got their information about biologics. Out of 202 individuals who had heard of biologics, 102 (51.3%) were familiar with potential benefits or side effects, and most (n=129, 66.5%) had a neutral perception to risks associated with biologic use. There was no perception of biologics working differently between races/ethnicities. More (n=76, 62.8%) blacks preferred intravenous over subcutaneous modalities compared with whites (n=12, 37.5%) but were not as willing to pay as much out of pocket for it. Individuals with Medicare were significantly more likely to have been on biologics.ConclusionsThere are important similarities and differences between blacks and whites with lupus with respect to their perceptions of biologic therapies and their impact. There are opportunities to increase patient exposure to information about biologics and improve their understanding in order for them to make the best informed decision possible.

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