Association of Physical Activity and APOE Genotype With Longitudinal Cognitive Change in Early PD

Objective:To determine whether greater physical activity could modify the negative association of APOE ε4 with longitudinal cognitive changes in early Parkinson’s disease (PD) and to uncover the disease-specific mechanism for explaining such benefits of physical activity.Methods:We used data from the Parkinson’s Progression Markers Initiative cohort. Because self-reported physical activity, measured by the Physical Activity Scale of the Elderly, was initiated at 2 years after enrollment, this longitudinal analysis was based on assessments performed at years 2, 3, and 4. Cognitive function was measured annually with the Montreal Cognitive Assessment (MoCA). Dopamine transporter (DAT) imaging was performed at years 2 and 4. We assessed the interactive associations between physical activity and the APOE ε4 allele on the longitudinal changes in MoCA scores and striatal DAT activities.Results:A total of 173 early PD patients (age 63.3±10.0 years; 27% APOE ε4 carriers) were included. The APOE ε4 allele showed a steeper rate of cognitive decline than the non-APOE ε4 allele (estimate -1.33; 95% CI, -2.12 to -0.47; p=0.002). However, there was a significant interaction between physical activity and APOE ε4, such that higher physical activity was related to slower APOE ε4-related cognitive decline (estimate 0.007; 95% CI, 0.003 to 0.011; p=0.001). No significant interaction was found between physical activity and the APOE ε4 allele regarding the change in striatal DAT activities.Conclusion:Increased physical activity attenuated APOE ε4-related vulnerability to early cognitive decline in PD patients. This protective effect did not appear to be mediated by striatal dopaminergic function.Classification of evidence:This study provides Class II evidence that increased physical activity was associated with decreased APOE ε4-related early cognitive decline in PD patients.

Download Full-text

Use of Magnetic Resonance Imaging to Identify Mild Cognitive Impairment: Who Should Be Imaged?

CNS Spectrums ◽

10.1017/s1092852900026997 ◽

2008 ◽

Vol 13 (S16) ◽

pp. 18-20 ◽

Cited By ~ 3

Author(s):

Liana G. Apostolova

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Clinical Care ◽

Neuropsychological Testing ◽

The Elderly ◽

Cognitive Change ◽

Normal Aging ◽

Cognitive Changes ◽

New Information

Problems with memory are a very common complaint in the elderly and are not synonymous with dementia. Some degree of cognitive decline, manifested as greater difficulty in learning and retrieving new information for instance, develops with normal aging. Thus many older patients do not perform at the same level they did when they were younger but they do perform well when compared to their peers. For many, cognitive change ends at this stage and they proceed to lead normal, healthy, dementia-free lives.The cohort that has cognitive changes beyond what is expected in normal aging but does not yet meet criteria for dementia concerns clinicians greatly as many of these patients eventually become demented. These patients usually go through a latent stage in which neurodegenerative pathology silently spreads in the brain. Once there is enough pathological burden, cognitive decline beyond what is expected for normal aging can be detected by formal neuropsychological testing. Frequently such patients go through a state called mild cognitive impairment (MCI). In this state patients are still functionally intact and live independently, but show cognitive impairment relative to the age- and education-adjusted norms.The MCI state in itself is a prominent risk factor for developing dementia. Most patients with amnestic MCI develop Alzheimer’s disease (AD) dementia over time. At six years, as many as 80% progress to AD. Thus, MCI is a very important topic of research and an increasingly important topic of clinical care.

Download Full-text

Relation between cognitive disorders and type of physical activity: Results of the FréLE cohort

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.883 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Dupré ◽

N Barth ◽

A El Moutawakkil ◽

F Béland ◽

F Roche ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Decline ◽

Proportional Hazards ◽

Cognitive Disorders ◽

The Elderly ◽

Cognitive Status ◽

Global Test ◽

Professional Activities ◽

Beneficial Effects ◽

The Impact

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.

Download Full-text

Spousal Loss and Cognitive Functioning: Do Pre-Loss Marital Quality and Gender Matter?

Innovation in Aging ◽

10.1093/geroni/igaa057.1178 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 366-366

Author(s):

Joohong Min ◽

Jieun Song

Keyword(s):

Cognitive Decline ◽

Cognitive Functioning ◽

Marital Quality ◽

The United States ◽

Cognitive Change ◽

Life Transitions ◽

Cognitive Changes ◽

Spousal Loss ◽

And Gender ◽

The Impact

Abstract Prior research has found that the risk of cognitive decline increases after the death of a spouse. In general, the impact of life transitions is contingent on contextual factors such as socio-demographic characteristics or relationship quality. However, there is limited research on how marital quality before spousal loss and gender influence the association between spousal loss and cognitive change. The current study examines the effects of spousal loss on change in cognitive functioning as well as the moderating effects of pre-loss marital quality and gender. Data from two waves of the Midlife in the United States (MIDUS) study were analyzed (MIDUS2: 2004-05, MIDUS3: 2013-14). The analytic sample consists of two groups: (1) 179 bereaved adults who were age 54 or older at MIDUS2 (M = 65.2, SD = 9.5) and whose spouses died between MIDUS2 and MIDUS3, and (2) 179 non-bereaved adults, matched with the bereaved group on age and gender, who did not experience spousal loss between the two waves. Cognitive function was assessed via BTACT (Brief Telephone Adult Cognition Test) at both waves. Regression results show that both pre-loss marital quality and gender significantly moderate the association between spousal loss and change in cognitive functioning. Specifically, relative to their counterparts, men and those who reported better marital relationships prior to spousal death had a greater risk of cognitive decline after a spouse’s death. The findings suggest the significance of pre-loss marital quality and gender for cognitive changes in widowhood and have implications for the development of efficient interventions

Download Full-text

Physical activity, socialization and reading in the elderly over the age of seventy: What is the relation with cognitive decline? Evidence from “The Treviso Longeva (TRELONG) study”

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2008.02.006 ◽

2009 ◽

Vol 48 (3) ◽

pp. 284-286 ◽

Cited By ~ 22

Author(s):

M. Gallucci ◽

P. Antuono ◽

F. Ongaro ◽

P.L. Forloni ◽

D. Albani ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Decline ◽

The Elderly

Download Full-text

Is hospitalization a risk factor for cognitive decline in older age adults?

International Psychogeriatrics ◽

10.1017/s1041610220001763 ◽

2020 ◽

pp. 1-18

Author(s):

Lucia Chinnappa-Quinn ◽

Steve Robert Makkar ◽

Michael Bennett ◽

Ben C. P. Lam ◽

Jessica W. Lo ◽

...

Keyword(s):

Cognitive Decline ◽

Meta Analysis ◽

Severity Of Illness ◽

The Elderly ◽

Preliminary Evidence ◽

Older Age ◽

Future Research ◽

Cognitive Changes ◽

Newcastle Ottawa Scale ◽

Meta Analyses

ABSTRACT Objectives: Many studies document cognitive decline following specific types of acute illness hospitalizations (AIH) such as surgery, critical care, or those complicated by delirium. However, cognitive decline may be a complication following all types of AIH. This systematic review will summarize longitudinal observational studies documenting cognitive changes following AIH in the majority admitted population and conduct meta-analysis (MA) to assess the quantitative effect of AIH on post-hospitalization cognitive decline (PHCD). Methods: We followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Selection criteria were defined to identify studies of older age adults exposed to AIH with cognitive measures. 6566 titles were screened. 46 reports were reviewed qualitatively, of which seven contributed data to the MA. Risk of bias was assessed using the Newcastle–Ottawa Scale. Results: The qualitative review suggested increased cognitive decline following AIH, but several reports were particularly vulnerable to bias. Domain-specific outcomes following AIH included declines in memory and processing speed. Increasing age and the severity of illness were the most consistent risk factors for PHCD. PHCD was supported by MA of seven eligible studies with 41,453 participants (Cohen’s d = −0.25, 95% CI [−0.02, −0.49] I2 35%). Conclusions: There is preliminary evidence that AIH exposure accelerates or triggers cognitive decline in the elderly patient. PHCD reported in specific contexts could be subsets of a larger phenomenon and caused by overlapping mechanisms. Future research must clarify the trajectory, clinical significance, and etiology of PHCD: a priority in the face of an aging population with increasing rates of both cognitive impairment and hospitalization.

Download Full-text

PARASYMPATHETIC INFLUENCE ON COGNITIVE AGING IS MODERATED BY SYMPATHETIC ACTIVITY, ESPECIALLY IN EARLY MIDLIFE

Innovation in Aging ◽

10.1093/geroni/igz038.355 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S94-S94 ◽

Cited By ~ 1

Author(s):

Erik L Knight ◽

Ryan Giuliano ◽

Sean Shank ◽

Megan Clarke ◽

David M Almeida

Keyword(s):

Nervous System ◽

Cognitive Decline ◽

Cognitive Aging ◽

Parasympathetic Nervous System ◽

Cognitive Change ◽

Interactive Effects ◽

Cognitive Test ◽

Cognitive Changes ◽

Beneficial Effects ◽

Age Related

Abstract The two branches of the autonomic nervous system (ANS) have been individually linked to age-related changes in cognitive functioning: The parasympathetic nervous system (PNS) is thought to support healthy cognitive aging, whereas the sympathetic nervous system (SNS) has been linked to heightened cognitive decline. Despite these separate findings and despite the integrative nature of the ANS, little work has examined the two branches simultaneously to better understand their interactive effects on age-related cognitive changes. We examined cognitive change in two waves of the MIDUS cognitive project and indexed PNS and SNS activity from heart rate variability and epinephrine levels (respectively) from the MIDUS biomarker project (n = 764, 56% female, mean age = 54.1 years). Our findings indicate that higher PNS levels attenuate cognitive decline, but only among individuals with low SNS levels; at higher SNS levels, the beneficial effects of the PNS are blocked. Further, lower PNS levels can be somewhat compensated for by increased SNS levels. This pattern was most robust among individuals transitioning to mid-life (i.e., 35-40 years old at the initial cognitive test). These results suggest that interventions targeting the ANS as a modifiable factor in cognitive aging should consider both ANS branch’s effects simultaneously, particularly in the early stages of midlife.

Download Full-text

Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample

Psychological Medicine ◽

10.1017/s0033291796003923 ◽

1997 ◽

Vol 27 (1) ◽

pp. 91-98 ◽

Cited By ~ 128

Author(s):

A. F. JORM ◽

H. CHRISTENSEN ◽

A. E. KORTEN ◽

A. S. HENDERSON ◽

P. A. JACOMB ◽

...

Keyword(s):

Longitudinal Study ◽

Cognitive Decline ◽

Mini Mental State Examination ◽

Community Sample ◽

Cognitive Change ◽

Cognitive Disorder ◽

Anxiety And Depression ◽

Cognitive Complaints ◽

Cognitive Changes ◽

State Examination

Data from a two-wave longitudinal study of an elderly community sample were used to assess whether cognitive complaints either predict subsequent cognitive decline or reflect past cognitive decline. Cognitive complaints and cognitive functioning were assessed on two occasions three and a half years apart. Cognitive complaints at Wave 1 were found not to predict future cognitive change on the Mini-Mental State Examination, an episodic memory test or a test of mental speed. Similarly, cognitive complaints at Wave 2 were unrelated to past cognitive changes on these tests after statistically controlling for the effects of anxiety and depression. Furthermore, cognitive complaints did not predict either mortality (after controlling for anxiety and depression) or future dementia. These results are evidence against the inclusion of cognitive complaints in diagnostic criteria for proposed disorders such as age-associated memory impairment, mild cognitive disorder and ageing-associated cognitive decline.

Download Full-text

The Impact of Amyloid-β or Tau on Cognitive Change in the Presence of Severe Cerebrovascular Disease

Journal of Alzheimer s Disease ◽

10.3233/jad-200680 ◽

2020 ◽

Vol 78 (2) ◽

pp. 573-585

Author(s):

Hyemin Jang ◽

Hee Jin Kim ◽

Yeong Sim Choe ◽

Soo-Jong Kim ◽

Seongbeom Park ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Interaction Effect ◽

Significant Interaction ◽

Amyloid Β ◽

Cognitive Change ◽

Significant Interaction Effect ◽

The Impact

Background: As Alzheimer’s disease (AD) and cerebral small vessel disease (CSVD) commonly coexist, the interaction between two has been of the considerable interest. Objective: We determined whether the association of Aβ and tau with cognitive decline differs by the presence of significant CSVD. Methods: We included 60 subcortical vascular cognitive impairment (SVCI) from Samsung Medical Center and 82 Alzheimer’s disease-related cognitive impairment (ADCI) from ADNI, who underwent Aβ (florbetaben or florbetapir) and tau (flortaucipir, FTP) PET imaging. They were retrospectively assessed for 5.0±3.9 and 5.6±1.9 years with Clinical Dementia Rating-sum of boxes (CDR-SB)/Mini-Mental State Examination (MMSE). Mixed effects models were used to investigate the interaction between Aβ/tau and group on CDR-SB/MMSE changes. Results: The frequency of Aβ positivity (45% versus 54.9%, p = 0.556) and mean global FTP SUVR (1.17±0.21 versus 1.16±0.17, p = 0.702) were not different between the two groups. We found a significant interaction effect of Aβ positivity and SVCI group on CDR-SB increase/MMSE decrease (p = 0.013/p < 0.001), and a significant interaction effect of global FTP uptake and SVCI group on CDR-SB increase/MMSE decrease (p < 0.001 and p = 0.030). Finally, the interaction effects of regional tau and group were prominent in the Braak III/IV (p = 0.001) and V/VI (p = 0.003) not in Braak I/II region (p = 0.398). Conclusion: The association between Aβ/tau and cognitive decline is stronger in SVCI than in ADCI. Therefore, our findings suggested that Aβ positivity or tau burden (particularly in the Braak III/IV or V/VI regions) and CSVD might synergistically affect cognitive decline.

Download Full-text