scholarly journals Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition: Analysis of the PURE and CAHHM Studies

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012765
Author(s):  
Romella Durrani ◽  
Matthias G. Friedrich ◽  
Karleen M. Schulze ◽  
Philip Awadalla ◽  
Kumar Balasubramanian ◽  
...  

Objective:To determine whether cognitive reserve attenuates the association of vascular brain injury with cognition.Methods:Cross-sectional data were analyzed from two harmonized studies: the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and the Prospective Urban and Rural Epidemiology (PURE) study. Markers of cognitive reserve were education, involvement in social activities, marital status, height, and leisure physical activity, which were combined into a composite score. Vascular brain injury was defined asnon-lacunar brain infarcts or high white matter hyperintensity (WMH) burden on MRI. Cognition was assessed using the Montreal Cognitive Assessment Tool (MoCA) and the Digit Symbol Substitution Test (DSST).Results:There were 10,450 participants age 35-81. Mean age was 58.8 years (range 35 to 81) and 55.8% were female. Education, moderate leisure physical activity, being in a marital partnership, being taller, and participating in social groups were each independently associated with higher cognition, as was the composite cognitive reserve score. Vascular brain injury was associated with lower cognition (beta-0.35 [95% CI -0.53 to -0.17] for MoCA and beta -2.19 [95% CI-3.22 to -1.15] for DSST)-but the association was not modified by the composite cognitive reserve variable (interaction p=0.59 for MoCA and p=0.72 for DSST).Conclusions:Both vascular brain injury and markers of cognitive reserve are associated with cognition. However, the effects were independent such that the adverse effects of covert vascular brain injury were not attenuated by higher cognitive reserve. To improve cognitive brain health, interventions to both prevent cerebrovascular disease and promote positive lifestyles are needed.

2018 ◽  
Vol 122 (1) ◽  
pp. 108-116 ◽  
Author(s):  
Paul D. Loprinzi ◽  
Emily Frith

There is irrefutable evidence that regular participation in physical activity is favorably associated with numerous positive health outcomes, including cognitive function. Emerging work suggests that perceived physical activity, independent of actual physical activity behavior, is inversely associated with mortality risk. In this study, we evaluate whether perceived physical activity, independent of actual physical activity, is associated with cognitive function, a robust indicator of mortality risk. Data from the cross-sectional 1999–2002 National Health and Nutrition Examination Survey were employed ( N = 2352; 60+ years of age). Actual physical activity was assessed via a validated survey. Perceived physical activity was assessed using the following question: “Compared with others of the same age, would you say that you are: more active, less active, or about the same?” Cognitive function was assessed from the Digit Symbol Substitution Test. When examined in separate models, both actual and perceived physical activity were positively and statistically significantly associated with cognitive function. However, when considered in the same model, actual physical activity was no longer statistically significantly associated with cognitive function, but perceived physical activity was. Perceived physical activity, independent of actual physical activity, is independently associated with cognitive function. If these findings are replicated, future work should consider evaluating perceived physical activity when examining the effects of actual physical activity behavior on cognitive function.


2021 ◽  
Author(s):  
Samira Arbabi Jam ◽  
Shahab Rezaeian ◽  
Farid Najafi ◽  
Behroz Hamze ◽  
Ebrahim Shakiba ◽  
...  

Abstract Background: Dietary factors and inflammation are associated with most non-communicable diseases (NCDs). The Dietary Inflammatory Index (DII) is a developed validated assessment tool. This study was conducted to assessed association of DII with the hypertension and type 2 diabetes mellitus (T2DM). Methods: This cross-sectional analysis was performed on 9,811 participants of 35 to 65 years of the base-line phase data of Ravansar Non-Communicable Diseases (RaNCD) cohort study. The DII was calculated using 31 parameters food of food frequency questionnaire (FFQ). The estimates were performed using univariable and multivariable logistic regression.Results: The mean DII scores in healthy participants was -2.32± 1.60, in participant with T2DM, hypertension and both were -2.23± 1.59, -2.45± 1.60 and -2.25± 1.60, respectively (P= 0.011). Pre-inflammatory diet was significantly higher in male compared to female (P<0.001). In the most pro-inflammatory diet was significantly higher BMI (body mass index), triglyceride, energy intake, smokers; and was significantly lower socio-economic status (SES), physical activity and HDL-C compared to the most anti-inflammatory diet. Participants with T2DM, hypertension and comorbidity had a significantly higher mean of anthropometry indices (P<0.001) and lipid profile compared to healthy subjects (P<0.001). After adjustment for age, sex and physical activity, the odds of T2DM in the fourth quartile of DII was 1.48 (95% CI: 1.19, 1.85) times higher compared to the first quartile of DII. Conclusions: Pro-inflammatory diet was weak associations with hypertension. Pro-inflammatory diet was significant associations with increasing T2DM and its related risk factors. Modification of diet and lifestyle is suggested to reduce inflammation.


2020 ◽  
Vol 73 (suppl 6) ◽  
Author(s):  
Thainá Ferreira de Toledo Piza ◽  
Paula Parisi Hodniki ◽  
Sinval Avelino dos Santos ◽  
Maria Teresa da Costa Gonçalves Torquato ◽  
Adrielen Aparecida Silva Calixto ◽  
...  

ABSTRACT Objectives: to analyze the leisure physical activity of people with and without chronic non-communicable diseases by the single health system of the city of Ribeirão Preto – São Paulo. Methods: observational cross-sectional study, data were collected by means of interviews in a sample for convenience and random of adults. Results: there were 719 people, where 70.1% had chronic non-communicable diseases, being 68.1% inactive. Physical inactivity presents a similar distribution between the groups with and without disease and a national average in leisure physical activity. Conclusions: these data are aimed at health services that do not encourage physical and auditory leisure activities, such as multiprofessional activities in the health area.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Nicole Hoffmann ◽  
Megan E Petrov

Introduction: Hypertension is associated with increased risk for cognitive decline. Lifestyle behaviors such as moderate physical activity (MPA) and adequate sleep duration may mitigate this decline, though limited research exists. The aim of the study was to examine the joint association of MPA and sleep duration on cognitive function by hypertension status. Methods: Adults (n=2976, ≥60yrs) from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) were assessed for their habitual sleep duration (<7, 7-8.9, ≥9hr) , self-reported participation in regular MPA (yes/no), reported physician-diagnosed hypertension (yes/no), and cognitive function (Digit Symbol Substitution Test [DSST]; Animal Fluency test). Weighted linear regression analyses were conducted to assess joint association of sleep duration and MPA on cognitive function, and test the modifying effect of hypertension status (alpha level set at 0.1) after adjustment for demographics. Results: See Table. There were significant main effects for combined MPA and sleep duration on DSST (Wald F (5,28)=5.33, p =.001) and Animal Fluency (Wald F (5,28)=2.58, p =.05). Participants who did not engage in MPA regardless of sleep duration had significantly worse cognitive function compared to participants who engaged in MPA and obtained 7-8.9hr sleep. There was a significant interaction between MPA-sleep duration groups and hypertension status on DSST (Wald F (5,28)=2.42, p =.06), but not on Animal Fluency. Stratified analyses indicated among individuals with hypertension the buffering effect of MPA regardless of sleep duration was maintained, but not for individuals without hypertension. Conclusions: In a sample of adults, regular MPA predicted better cognitive outcomes regardless of sleep duration. Among individuals with hypertension regular MPA regardless of sleep duration was significantly associated with better executive function, but no such association was found among individuals without hypertension.


2019 ◽  
Vol 75 (9) ◽  
pp. 1609-1617 ◽  
Author(s):  
Nienke Legdeur ◽  
Betty M Tijms ◽  
Elles Konijnenberg ◽  
Anouk den Braber ◽  
Mara ten Kate ◽  
...  

Abstract The prevalence of brain pathologies increases with age and cognitive and physical functions worsen over the lifetime. It is unclear whether these processes show a similar increase with age. We studied the association of markers for brain pathology cognitive and physical functions with age in 288 cognitively normal individuals aged 60–102 years selected from the cross-sectional EMIF-AD PreclinAD and 90+ Study at the Amsterdam UMC. An abnormal score was consistent with a score below the 5th percentile in the 60- to 70-year-old individuals. Prevalence of abnormal scores was estimated using Generalized Estimating Equations (GEE) models. The prevalence of abnormal handgrip strength, the Digit Symbol Substitution Test, and hippocampal volume showed the fastest increase with age and abnormal MMSE score, muscle mass, and amyloid aggregation the lowest. The increase in prevalence of abnormal markers was partly dependent on sex, level of education, and amyloid aggregation. We did not find a consistent pattern in which markers of brain pathology cognitive and physical processes became abnormal with age.


2014 ◽  
Vol 26 (2) ◽  
pp. 138-146 ◽  
Author(s):  
Naiman A. Khan ◽  
Charles H. Hillman

Physical inactivity has been shown to increase the risk for several chronic diseases across the lifespan. However, the impact of physical activity and aerobic fitness on childhood cognitive and brain health has only recently gained attention. The purposes of this article are to: 1) highlight the recent emphasis for increasing physical activity and aerobic fitness in children’s lives for cognitive and brain health; 2) present aspects of brain development and cognitive function that are susceptible to physical activity intervention; 3) review neuroimaging studies examining the cross-sectional and experimental relationships between aerobic fitness and executive control function; and 4) make recommendations for future research. Given that the human brain is not fully developed until the third decade of life, preadolescence is characterized by changes in brain structure and function underlying aspects of cognition including executive control and relational memory. Achieving adequate physical activity and maintaining aerobic fitness in childhood may be a critical guideline to follow for physical as well as cognitive and brain health.


2021 ◽  
Vol 12 ◽  
Author(s):  
María Paz García-Portilla ◽  
Leticia García-Álvarez ◽  
Leticia González-Blanco ◽  
Francesco Dal Santo ◽  
Teresa Bobes-Bascarán ◽  
...  

Introduction: Interest in the idea of recovery for certain patients with schizophrenia has been growing over the last decade. Improving symptomatology and functioning is crucial for achieving this. Our study aims to identify those factors that substantially contribute to real-world functioning in these patients.Methods: We carried out a cross-sectional study in stable outpatients with schizophrenia on maintenance antipsychotic monotherapy. Patients: We studied 144 outpatients with schizophrenia (DSM-IV-TR criteria) meeting the following criteria: (1) 18–65 years of age; (2) being clinically stable for at least the previous three months; (3) on maintenance antipsychotic monotherapy (prescriptions ≤ 10 mg olanzapine, ≤200 mg quetiapine, or ≤100 mg levomepromazine as hypnotics were also allowed); and (4) written informed consent. Assessment: We collected information on demographic and clinical variables by using an ad hoc questionnaire. For psychopathology, we employed the Spanish versions of the following psychometric instruments: the Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS-Sp), and the Calgary Depression Scale (CDS). In addition, cognitive domains were assessed using the Verbal Fluency Test (VFT), the Digit Symbol Substitution Test (DSST), and the Trail Making Test, parts A and B (TMT-A and TMT-B). Finally, we employed the Spanish versions of the University of California San Diego Performance-based Skills Assessment (Sp-UPSA) and the Personal and Social Performance (PSP) for assessing functional capacity and real-world functioning, respectively. Statistical analysis: A forward stepwise regression was conducted by entering those variables significantly associated with PSP total score into the univariate analyses (Student's t-test, ANOVA with Duncan's post-hoc test, or bivariate Pearson correlation).Results: A total of 144 patients; mean age 40 years, 64% males, mean length of illness 12.4 years, PSP total score 54.3. The final model was a significant predictor of real-world functioning [F(7, 131) = 36.371, p &lt; 0.001] and explained 66.0% of the variance. Variables retained in the model: BNSS-Sp abulia, asociality, and blunted affect, PANSS general psychopathology, Sp-UPSA transportation, TMT-B, and heart rate.Conclusion: Our model will contribute to a more efficient and personalized daily clinical practice by assigning specific interventions to each patient based on specific impaired factors in order to improve functioning.


2020 ◽  
Vol 9 (6) ◽  
pp. e98963321
Author(s):  
Adriana de Oliveira Lameira Veríssimo ◽  
Juniel Pereira Honorato ◽  
Silvio Douglas Medeiros Costa ◽  
João Victor Moura Garcia ◽  
Isis Jaspe Reis da Silva ◽  
...  

Heart failure is characterized as the lack of blood pumping capacity performed by the heart, which is considered a public health problem worldwide. Due to HF, the individual can develop clinical aspects that impact cognitive function and, consequently, self-care. Therefore, this study aimed to investigate cognitive changes and self-care in patients affected by HF and compare it with the cognitive and self-care changes of healthy participants. This is a quantitative, epidemiological, cross-sectional case-control study carried out at an institution in the city of Belém, Pará, Brazil. The following tests were used for data collection: Montreal Cognitive Assessment, Digit Symbol Substitution Test, European Heart Failure Self-care Behavior Scale (EHFScBS). Data were tabulated in Microsoft Excel 2010 and statistically treated by Epi Info version 3.5.2 with a 5% significance level and considering a 95% confidence interval in all analyzes. It was observed that patients with HF have slightly better self-care compared to patients without HF with scores obtained by EHFScBS equal to 29.7 ± 6.9 and 31.8 ± 8.2, respectively. Additionally, patients with HF showed impairments in the three cognitive domains, and women with HF demonstrated greater cognitive impairment compared to the other participants. The present study provides data to help build new approaches to interventions by the multidisciplinary team to promote better self-care and avoid cognitive impairments in patients with HF.


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