MADRID+90 study on factors associated with longevity: Study design and preliminary data

The progressive aging of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy aging and which with the emergence of age-related diseases, especially Alzheimer’s type dementia. The project “Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid” (MADRID+90) brings together a multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological aging, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of rapidly aging societies.

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Factors associated with longevity: design and preliminary data of the MADRID+90 study

10.31234/osf.io/s9a84 ◽

2020 ◽

Author(s):

Miguel Ángel Fernández-Blázquez ◽

Teodoro Del Ser ◽

Belén Frades-Payo ◽

Marina Ávila-Villanueva ◽

Meritxell Valentí-Soler ◽

...

Keyword(s):

Cognitive Status ◽

Cognitive Testing ◽

Economic Consequences ◽

Strong Increase ◽

Second Phase ◽

Factors Associated ◽

Age Related ◽

New Policies ◽

The Impact ◽

The City

The progressive ageing of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy ageing and which with the emergence of age-related diseases, especially Alzheimer's type dementia. The project “Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid” (MADRID+90) brings together a powerful multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological ageing, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of the ageing phenomenon.

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A-03 The Brain–Body Connection in Aging Neurological Populations: Examining the Impact of Exercise and Sedentary Behavior on Brain Structure and Cognitive Functioning in Older Adults with Multiple Sclerosis

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa067.03 ◽

2020 ◽

Vol 35 (6) ◽

pp. 776-776

Author(s):

C Roman ◽

P Arnett

Keyword(s):

Multiple Sclerosis ◽

Older Adults ◽

Graph Theory ◽

Sedentary Behavior ◽

Healthy Aging ◽

Moderate Activity ◽

Subcortical Structures ◽

Negative Effects ◽

Age Related ◽

The Impact

Abstract Objective Advancements in treatments for multiple sclerosis (MS) have led to an increase in the number of older adults living with the disease. Exercise has been shown to be remarkably beneficial for “healthy aging,” while sedentary behavior has proved to have more deleterious effects. Despite evidence for the impact of these factors, their influence on older adults with MS is largely unknown. The current study utilizes volumetric measures and graph theory to investigate the relationship between physical activity/sedentary behavior, structural brain indices, and cognition in older adults with MS. Method Twenty-seven older adults (55+) with MS were scanned during a structural MRI protocol and cognitively evaluated using the Multiple Sclerosis Functional Composite and Symbol Digit Modalities Test. Graph theory metrics were calculated to examine white matter network properties. FreeSurfer was used to calculate volumes for subcortical structures. Exercise was quantified as the ‘days per week engaged in moderate activity,’ while sedentary behavior was measured as ‘hours per day sitting.’ Results Multiple regression interaction analyses were conducted. Results showed an exercise by age interaction, such that exercise protected against the negative effects of age on thalamic volume and assortivity. Hours sitting per day was shown to add to the negative effects of aging on structural networks even after controlling for exercise. Lastly, exercise was observed to be protective against age-related cognitive decline in this sample. Conclusions This is one of the first studies to examine exercise/sedentariness and brain indices in older adults with MS, pointing to possible brain altering and protective interventions for this group.

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Abstract W P80: Predictors of Cognitive Status in Post-Aneurysm Surgery Patients

Stroke ◽

10.1161/str.46.suppl_1.wp80 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Andrea Holcombe ◽

James Torner ◽

Steven Anderson ◽

Emine Bayman ◽

Michael Todd ◽

...

Keyword(s):

Risk Factors ◽

Subarachnoid Hemorrhage ◽

Surgical Treatment ◽

Cognitive Status ◽

Cognitive Testing ◽

World Federation ◽

Aneurysm Surgery ◽

Cognitive Changes ◽

Factors Associated ◽

Post Surgery

Introduction: Patients who undergo surgical treatment for ruptured intracranial aneurysms may have a different risk profile for a spectrum of cognitive impairment based upon characteristics at presentation of their subarachnoid hemorrhage. Methods: The Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) is a multi-center, prospective, randomized clinical trial investigation of whether induced hypothermia during surgical treatment for subarachnoid hemorrhage resulted in improved outcomes. Cognitive status was defined by raw Mini-Mental Status Examination (MMSE) cutoff scores. A normal cognition was defined as a MMSE score of 28 or greater. Mildly impaired patients were defined as a score of 24-27, and severely impaired patients were defined as those with a score of less than 24. Age was analyzed by five-year age groups, with the exception of patients 30 or younger and patients 75 and older. Ordinal logistic regression was utilized to determine the final predictors. Results: Of the 1,000 patients who were followed for cognitive testing, 61 died and 21 were medically untestable. Five patients refused testing and tests were not administered to 30 patients. A total of 883 patients completed the MMSE at 3 months post-surgery. Based on the raw MMSE scores, the median score for the severely impaired patients was 20 (IQR: 16-22), 26 (IQR: 25-27) for mildly impaired patients, and 29 (IQR: 29-30) for cognitively normal patients. Gender, and race were found to be statistically significant (p<.05) predictors after controlling for age and education. Baseline Rankin Score and the occurrence of a leakage or rupture during surgery were also predictive of cognitive status. The World Federation of Neurosurgical Societies Score, the Fisher’s SAH Score, and aneurysm size and location were not found to be statistically significant. Conclusion: Patients with surgical treatment for subarachnoid hemorrhage share several demographic risk factors associated with cognitive changes in the general public, but have additional neurological risk factors associated with SAH and aneurysm procedures.

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Potentially modifiable factors associated with agitation and aggression in Alzheimer’s disease: results of the ICTUS study

International Psychogeriatrics ◽

10.1017/s1041610218001990 ◽

2019 ◽

Vol 31 (10) ◽

pp. 1509-1516 ◽

Cited By ~ 2

Author(s):

Adelaide de Mauleon ◽

Maria Soto ◽

Pierre Jean Ousset ◽

Fati Nourhashemi ◽

Benoit Lepage ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Affective Disorder ◽

Positive Impact ◽

Neuropsychiatric Symptoms ◽

Cognitive Status ◽

Community Dwelling ◽

Factors Associated ◽

Modifiable Factors ◽

The Impact

ABSTRACTObjectives:To study potentially modifiable factors associated with the severity of agitation or aggression (A/A) symptoms among Alzheimer’s disease (AD) patients.Design:Data from the Impact of Cholinergic Treatment Use (ICTUS) study, European longitudinal prospective observational study.Setting:Community dwelling outpatients included in 29 European memory clinics.Participants:1375 participants with probable AD (Mini-Mental State Examination score of 10–26) with an informal caregiver.Measurements:At baseline and twice yearly over the two-year follow-up, patients underwent comprehensive clinical and neuropsychological assessments: sociodemographic data, cognitive status, functional impairment, and assessment of neuropsychiatric symptoms based on Neuro-Psychiatric Inventory (NPI). The ZARIT scale assessed the caregiver’s burden. The variable of interest was the severity of the item of A/A of the NPI. To study factors associated to the severity of A/A symptoms six months later, a multivariate mixed regression model was used.Results:Frequency of A/A symptom varied from 30% to 34% at each visit. Two factors were found to be independently associated with the severity of A/A: (1) the presence of affective disorder (anxiety, depression, and/or irritability) that increased the severity of the A/A by 0.89 point (coefficient:0.89; 95% Confidence Interval (CI) = [0.48,1.30], p < 0.001), and (2) a severe caregiver burden that increased the severity of the A/A by 1.08 point (coefficient:1.08; 95% CI = [0.69,1.47], p < 0.001).Conclusion:Research should evaluate whether the identification and treatment of an affective disorder along with the evaluation and optimal management of the caregiver would have a positive impact on the course of A/A in mild to moderate AD patients.

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Preventive Interventions for the Second Half of Life: A Systematic Review

American Journal of Health Promotion ◽

10.1177/0890117117712355 ◽

2017 ◽

Vol 32 (4) ◽

pp. 1122-1139 ◽

Cited By ~ 1

Author(s):

Cother Hajat ◽

Adriana Selwyn ◽

Mark Harris ◽

Derek Yach

Keyword(s):

Systematic Review ◽

Healthy Aging ◽

Data Extraction ◽

Evidence Base ◽

Noncommunicable Diseases ◽

Level Of Evidence ◽

Summary Table ◽

Age Related ◽

Meta Analyses ◽

The Impact

Objective: Recent improvements in life expectancy globally require intensified focus on noncommunicable diseases and age-related conditions. The purpose of this article is to inform the development of age-specific prevention guidelines for adults aged 50 and above, which are currently lacking. Data Source: PubMed, Cochrane database, and Google Scholar and explicit outreach to experts in the field. Study Inclusion and Exclusion Criteria: Meta-analyses, intervention-based, and prospective cohort studies that reported all-cause mortality, disease-specific mortality, or morbidity in adults were included. Data Extraction: A systematic review was undertaken in 2015 using search terms of a combination of <risk factor> and “intervention,” “mortality,” “reduction,” “improvement,” “death,” and “morbidity.” Data Synthesis: Interventions were categorized according to the Center for Evidence-Based Medicine Level of Evidence framework. Results: A summary table reports for each intervention the impact, strength of evidence, initiation, duration, and details of the intervention. Age-decade-specific preventive recommendations have been proposed relating to physical activity, diet, tobacco and alcohol use, medication adherence, screening and vaccination, and mental and cognitive health. Conclusion: Clear recommendations have been made according to the existing evidence base, but further research investment is needed to fill the many gaps. Further, personalized approaches to healthy aging complemented by population-wide approaches and broader cross-sector partnerships will help to ensure greater longevity is an opportunity, rather than a burden, for society.

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THE INTERRELATIONSHIP BETWEEN INSULIN-LIKE GROWTH FACTOR 1, APOLIPOPROTEIN E Ε4, LIFESTYLE FACTORS, AND THE AGING BODY AND BRAIN

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2020.11 ◽

2020 ◽

pp. 1-9

Author(s):

S.A. Galle ◽

I.K. Geraedts ◽

J.B. Deijen ◽

M.V. Milders ◽

M.L. Drent

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Growth Factor ◽

Apolipoprotein E ◽

Cognitive Functioning ◽

Brain Function ◽

Healthy Aging ◽

Insulin Like Growth Factor ◽

Age Related ◽

The Impact

Aging is associated with a decrease in body and brain function and with a decline in insulin-like growth factor 1 levels. The observed associations between alterations in insulin-like growth factor 1 levels and cognitive functioning and Mild Cognitive Impairment suggest that altered insulin-like growth factor 1 signaling may accompany Alzheimer’s disease or is involved in the pathogenesis of the disease. Recent animal research has suggested a possible association between insulin-like growth factor 1 levels and the Apolipoprotein E ε4 allele, a genetic predisposition to Alzheimer’s disease. It is therefore hypothesized that a reduction in insulin-like growth factor 1 signaling may moderate the vulnerability to Alzheimer’s disease of human Apolipoprotein E ε4 carriers. We address the impact of age-related decline of insulin-like growth factor 1 levels on physical and brain function in healthy aging and Alzheimer’s disease and discuss the links between insulin-like growth factor 1 and the Apolipoprotein E ε4 polymorphism. Furthermore, we discuss lifestyle interventions that may increase insulin-like growth factor 1 serum levels, including physical activity and adherence to a protein rich diet and the possible benefits to the physical fitness and cognitive functioning of the aging population.

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The Impact of Anemia on Mortality, Cognition and Function in a Racially Diverse Community-Dwelling Elderly Population.

Blood ◽

10.1182/blood.v104.11.1627.1627 ◽

2004 ◽

Vol 104 (11) ◽

pp. 1627-1627

Author(s):

Susan Denny ◽

Maragatha Kuchibhatla ◽

Harvey Jay Cohen

Keyword(s):

Disease Status ◽

The Elderly ◽

Epidemiologic Studies ◽

Cognitive Status ◽

Community Dwelling ◽

Mild Anemia ◽

Age Related ◽

Definition Of ◽

And Function ◽

The Impact

Abstract The WHO definition of anemia, Hgb<12g/dL (W) and <13g/dL (M) is largely based on studies in younger populations. As our population is aging it is important to explore the impact of varying Hgb levels on mortality and function in representative populations of older persons. The Duke Established Populations for Epidemiologic Studies for the Elderly (EPESE) is a random household sample, over sampled for African Americans (AA), initiated in 1986. In 1992 we obtained Hgb levels for 1744 subjects age >71 and evaluated functional and cognitive status at baseline and 4 years later, and mortality for 8 years. Using WHO criteria, the prevalence of anemia was 24%. It was age related; 17% (65–74), 25% (75–79), 32% (>80) p<.0001, but not gender related. There was a strong racial difference, 33.6% AA, 13.8% Caucasians (p=<.0001) with an odds ratio, adjusted for age, education, renal insufficiency and comorbidity of 3.0 (95%CI 2.3 – 3.9) Baseline functional status was worse in anemic subjects (p<.0001) but cognition was not (p=.06). The risk ratio for 8 year mortality was 1.7 (95% CI 1.5, 2.0) for anemic subjects (p=.0001). This did not differ by gender nor, despite the increased prevalence, by race (RR AA: caucasian = 0.85; 95% CI 0.6–1.2). Assessing survival by Hgb level, a nonlinear relationship was seen, with highest % survival between 13–14 g/dL for women (p<.0001) and 14–15g/dL for men (p=.09). Using the WHO standard as reference, controlling for baseline characteristics, women with Hgb 10–11 g/dL had higher mortality (RR 2.1, 95% CI. 1.5 –3.1) but with 11–12 g/dL did not. Similarly men with Hgb 10–11 g/dL had increased mortality (RR2.0, 95% CI 1.1, 3.7). In women there was a progressively greater decline in function at 4 years with each decrement of Hgb level from 16 to 10g/dL, but not in men. Both women and men with mild anemia (11–12 g/dL and 10–11g/dL respectively) had greater decreases in cognition than those at higher levels (p=.01). Thus in an elderly community based population, anemia is significantly more common in AA independent of disease status, and is independently associated with increased mortality over eight years for both races and genders, and with declines in function and cognition most prominently in women. Further investigation of the etiology of these relationships is warranted.

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Alterations in Diffusion Measures of White Matter Integrity Associated with Healthy Aging

The Journals of Gerontology Series A ◽

10.1093/gerona/glz289 ◽

2019 ◽

Author(s):

Ciara J Molloy ◽

Sinead Nugent ◽

Arun L W Bokde

Keyword(s):

White Matter ◽

Healthy Aging ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

B Value ◽

White Matter Hyperintensity ◽

Normal Appearing White Matter ◽

Age Related ◽

Aging Adults ◽

The Impact

Abstract This study aimed to characterize age-related white matter changes by evaluating patterns of overlap between the linear association of age with fractional anisotropy (FA) with mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Specifically, we assessed patterns of overlap between diffusion measures of normal appearing white matter by covarying for white matter hyperintensity (WMH) load, as WMHs are thought to increase with age and impact diffusion measures. Seventy-nine healthy adults aged between 18 and 75 years took part in the study. Diffusion tensor imaging (DTI) data were based on 61 directions acquired with a b-value of 2,000. We found five main patterns of overlap: FA alone (15.95%); FA and RD (31.90%); FA and AD (12.99%); FA, RD, and AD (27.93%); and FA, RD, and MD (8.79%). We showed that cognitively healthy aging adults had low WMH load, which subsequently had minimal effect on diffusion measures. We discuss how patterns of overlap may reflect underlying biological changes observed with aging such as loss of myelination, axonal damage, as well as mild microstructural and chronic white matter impairments. This study contributes to understanding the underlying causes of degeneration in specific regions of the brain and highlights the importance of considering the impact of WMHs in aging studies of white matter.

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Limbic-predominant age-related TDP-43 encephalopathy, ADNC pathology, and cognitive decline in aging

Neurology ◽

10.1212/wnl.0000000000010454 ◽

2020 ◽

Vol 95 (14) ◽

pp. e1951-e1962

Author(s):

Alifiya Kapasi ◽

Lei Yu ◽

Patricia A. Boyle ◽

Lisa L. Barnes ◽

David A. Bennett ◽

...

Keyword(s):

Alzheimer Disease ◽

Cognitive Decline ◽

Late Life ◽

Cognitive Testing ◽

Mixed Effect ◽

Mixed Effect Models ◽

Age Related ◽

Global Cognition ◽

Rate Of Decline ◽

The Impact

ObjectiveTo examine the impact of 3 pathologic groups, pure limbic-predominant age-related transactive response DNA-binding protein 43 encephalopathy (LATE) neuropathologic changes (NC), pure Alzheimer disease neuropathologic change (ADNC), and mixed ADNC with LATE-NC, on late-life cognitive decline.MethodsData came from 1,356 community-based older persons who completed detailed annual cognitive testing and systematic neuropathologic examination at autopsy to identify LATE-NC, ADNC, and other age-related pathologies. Persons were categorized into (0) a group without a pathologic diagnosis of LATE or ADNC (n = 378), (1) LATE-NC without ADNC (n = 91), (2) ADNC without LATE-NC (n = 535), and (3) mixed ADNC with LATE-NC (n = 352). We used mixed-effect models to examine the group associations with rate of decline in global cognition and 5 cognitive domains and then examined whether age modified associations.ResultsCompared to those without LATE-NC or ADNC, those with pure LATE-NC had a faster decline in global cognition (p = 0.025) and episodic memory (p = 0.002); however, compared to persons with pure ADNC, those with pure LATE-NC showed a slower decline. Those with mixed ADNC with LATE-NC showed the fastest decline compared to those with either pathology alone. Persons ≥90 years of age with mixed ADNC with LATE-NC had slower cognitive decline compared to those ≤89 years of age.ConclusionPersons with pure LATE-NC follow a slower trajectory compared to those with pure ADNC. Those with mixed LATE/ADNC have a steeper decline than individuals with either pathology alone. In addition, age may modify the effect of pathology on cognitive decline. These findings have important implications for the development of biomarkers and prognosis for late-life cognitive decline.Classification of evidenceThis study provides Class I evidence that LATE-NC and Alzheimer disease pathologic changes are associated with different trajectories of late-life cognitive decline.

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Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Practices of Sports Medicine Professionals

Journal of Athletic Training ◽

10.4085/1062-6050-44.6.639 ◽

2009 ◽

Vol 44 (6) ◽

pp. 639-644 ◽

Cited By ~ 82

Author(s):

Tracey Covassin ◽

Robert J. Elbin ◽

Jennifer L. Stiller-Ostrowski ◽

Anthony P. Kontos

Keyword(s):

Sports Medicine ◽

Online Survey ◽

Cognitive Status ◽

Cognitive Testing ◽

Return To Play ◽

Soccer Players ◽

Neurocognitive Testing ◽

Certified Athletic Trainers ◽

Baseline Testing ◽

The Impact

Abstract Context: Computerized neurocognitive testing is becoming popular among clinicians evaluating sport-related concussions across all levels of sport. Baseline neurocognitive testing has been recommended to provide more accurate representation of the preconcussion cognitive status of individual athletes. However, little is known about the use of baseline neurocognitive testing in concussion assessment and management. Objective: To examine implementation and practice trends of sports medicine professionals using baseline neurocognitive testing at the high school and collegiate levels. Design: Quantitative survey research. Setting: Online survey. Patients or Other Participants: Certified athletic trainers (ATs) from approximately 1209 US institutions listed on the ImPACT Web site were recruited. A total of 399 ATs completed the survey, for a response return rate of 32.7%. Main Outcome Measure(s): Survey questions addressed educational level, years of certification, employment setting, percentage of athletes baseline tested, and accuracy of baseline tests. Other items addressed postconcussive neurocognitive testing protocols and scenarios for return-to-play decisions based on neurocognitive testing. Results: Nearly all ATs (94.7%) administered baseline computerized neurocognitive testing to their athletes. However, only 51.9% examined these baseline tests for validity. The majority of ATs indicated that they administer baseline neurocognitive tests most frequently to football players (88.4%), followed by women's soccer players (78.8%) and men's soccer players (71.2%). Nearly all respondents (95.5%) stated that they would not return a symptomatic athlete to play if the athlete's neurocognitive scores were back to baseline. However, when asked if they would return an athlete who is symptom free but who scores below his or her baseline, 86.5% responded no, 9.8% responded yes, and 3.8% indicated that it depended on the importance of the competition. Conclusions: The use of baseline testing, baseline testing readministration, and postconcussion protocols among ATs is increasing. However, the ATs in this study reported that they relied more on symptoms than on neurocognitive test scores when making return-to-play decisions.

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