scholarly journals Educational attainment and trajectories of cognitive decline during four decades—The Glostrup 1914 cohort

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255449
Author(s):  
Kristine Harrsen ◽  
Kaare Christensen ◽  
Rikke Lund ◽  
Erik Lykke Mortensen
Keyword(s):  
Cognitive Decline ◽  
Full Scale ◽  
Community Dwelling ◽  
Clinical Test ◽  
Adult Intelligence Scale ◽  
Verbal Iq ◽  
Age Related ◽  
Formal School ◽  
Verbal Performance

Background The potential association between level of education and age-related cognitive decline remains an open question, partly because of a lack of studies including large subsamples with low education and follow-up intervals covering a substantial part of the adult lifespan. Objectives To examine cognitive decline assessed by a comprehensive clinical test of intelligence over a 35-year period of follow-up from ages 50 to 85 and to analyze the effect of education on trajectories of cognitive decline, including the effects of selective attrition. Methods A longitudinal cohort study with a 35-year follow-up of community dwelling members of the Glostrup 1914 cohort. The study sample comprised 697 men and women at the 50-year baseline assessment and additional participants recruited at later follow-ups. Verbal, Performance, and Full Scale IQs were assessed using the Wechsler Adult Intelligence Scale at ages 50, 60, 70, 80, and 85. To be able to track cognitive changes between successive WAIS assessments, all IQs were based on the Danish 50-year norms. Information on school education was self-reported. The association between education and cognitive decline over time was examined in growth curve models. Selective attrition was investigated in subsamples of participants who dropped out at early or later follow-ups. Results The trajectories for Verbal, Performance, and Full Scale IQ showed higher initial cognitive performance, but also revealed steeper decline among participants with a formal school exam compared to participants without a formal exam. Verbal IQ showed the largest difference in level between the two educational groups, whereas the interaction between education and age was stronger for Performance IQ than for Verbal IQ. In spite of the difference in trajectories, higher mean IQ was observed among participants with a formal school exam compared to those without across all ages, including the 85-year follow-up. Further analyses revealed that early dropout was associated with steeper decline, but that this effect was unrelated to education. Conclusion Comprehensive cognitive assessment over a 35-year period suggests that higher education is associated with steeper decline in IQ, but also higher mean IQ at all follow-ups. These findings are unlikely to reflect regression towards the mean, other characteristics of the employed test battery or associations between educational level and study dropout.

scholarly journals Arterial Stiffness Predicts Cognitive Decline in Japanese Community-dwelling Elderly Subjects: A One-year Follow-up Study

2015 ◽  
Vol 22 (6) ◽  
pp. 637-644 ◽  
Author(s):  
Taiki Yukutake ◽  
Minoru Yamada ◽  
Naoto Fukutani ◽  
Shu Nishiguchi ◽  
Hiroki Kayama ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Elderly Subjects ◽  
Follow Up Study ◽  
One Year

scholarly journals Playing Analog Games Is Associated With Reduced Declines in Cognitive Function: A 68-Year Longitudinal Cohort Study

2019 ◽  
Vol 75 (3) ◽  
pp. 474-482 ◽  
Author(s):  
Drew M Altschul ◽  
Ian J Deary
Keyword(s):  
Cohort Study ◽  
Cognitive Function ◽  
Social Class ◽  
Cognitive Decline ◽  
Early Life ◽  
Community Dwelling ◽  
Activity Levels ◽  
Health Issues ◽  
Cognitive Speed

Abstract Objectives Playing analog games may be associated with better cognitive function but, to date, these studies have not had extensive longitudinal follow-up. Our goal was to examine the association between playing games and change in cognitive function from age 11 to age 70, and from age 70 to 79. Method Participants were 1,091 nonclinical, independent, community-dwelling individuals all born in 1936 and residing in Scotland. General cognitive function was assessed at ages 11 and 70, and hierarchical domains were assessed at ages 70, 73, 76, and 79 using a comprehensive cognitive battery of 14 tests. Games playing behaviors were assessed at ages 70 and 76. All models controlled for early life cognitive function, education, social class, sex, activity levels, and health issues. All analyses were preregistered. Results Higher frequency of playing games was associated with higher cognitive function at age 70, controlling for age 11 cognitive function, and the majority of this association could not be explained by control variables. Playing more games was also associated with less general cognitive decline from age 70 to age 79, and in particularly, less decline in memory ability. Increased games playing between 70 and 76 was associated with less decline in cognitive speed. Discussion Playing games were associated with less relative cognitive decline from age 11 to age 70, and less cognitive decline from age 70 to 79. Controlling for age 11 cognitive function and other confounders, these findings suggest that playing more games is linked to reduced lifetime decline in cognitive function.

Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

2020 ◽  
pp. 1-11 ◽  
Author(s):  
N. Gillies ◽  
D. Cameron-Smith ◽  
S. Pundir ◽  
C. R. Wall ◽  
A. M. Milan
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Community Dwelling ◽  
B Vitamins ◽  
Cross Sectional ◽  
Longitudinal Changes ◽  
Dietary Adequacy ◽  
Metabolism Regulation ◽  
Age Related

Abstract Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

scholarly journals Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy

2020 ◽  
Vol 10 (12) ◽  
pp. 178
Author(s):  
Heifa Ounalli ◽  
David Mamo ◽  
Ines Testoni ◽  
Martino Belvederi Murri ◽  
Rosangela Caruso ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Early Stage ◽  
Psychosocial Interventions ◽  
The Elderly ◽  
Community Dwelling ◽  
Anticipatory Grief ◽  
Dignity Therapy ◽  
Existential Distress ◽  
Age Related

Demographic changes have placed age-related mental health disorders at the forefront of public health challenges over the next three decades worldwide. Within the context of cognitive impairment and neurocognitive disorders among elderly people, the fragmentation of the self is associated with existential suffering, loss of meaning and dignity for the patient, as well as with a significant burden for the caregiver. Psychosocial interventions are part of a person-centered approach to cognitive impairment (including early stage dementia and dementia). Dignity therapy (DT) is a therapeutic intervention that has been shown to be effective in reducing existential distress, mood, and anxiety symptoms and improving dignity in persons with cancer and other terminal conditions in palliative care settings. The aims of this paper were: (i) To briefly summarize key issues and challenges related to care in gerontology considering specifically frail elderly/elderly with cognitive decline and their caregivers; and (ii) to provide a narrative review of the recent knowledge and evidence on DT in the elderly population with cognitive impairment. We searched the electronic data base (CINAHL, SCOPUS, PSycInfo, and PubMed studies) for studies regarding the application of DT in the elderly. Additionally, given the caregiver’s role as a custodian of diachronic unity of the cared-for and the need to help caregivers to cope with their own existential distress and anticipatory grief, we also propose a DT-dyadic approach addressing the needs of the family as a whole.

scholarly journals Personality-Related Determinants of Subtle Cognitive Decline in Old Age: A Population-Based Study

2016 ◽  
Vol 6 (1) ◽  
pp. 120-132 ◽  
Author(s):  
Cristelle Rodriguez ◽  
Emiliano Albanese ◽  
Alan Pegna ◽  
Simona Toma ◽  
Marine Ackermann ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Protective Factor ◽  
Brain Aging ◽  
Population Based ◽  
Community Dwelling ◽  
Personality Factors ◽  
Healthy Controls ◽  
Logistic Regression Models ◽  
Healthy Elderly

Background/Aims: Recent studies of cases with mild cognitive impairment (MCI) suggested that besides Alzheimer disease (AD)-related biomarkers, some personality dimensions are associated with progression to AD. To date, there are no studies addressing the psychological determinants of subtle cognitive decline in healthy elderly controls. Methods: 488 community-dwelling healthy controls were assessed with a detailed neuropsychological battery at baseline and an 18-month follow-up. Personality factors and facets were investigated at baseline using the NEO-Personality Inventory-Revised (NEO-PI-R). Upon follow-up, there were 264 stable controls (sCON) and 224 deteriorating controls (dCON). Their personality data were compared to those of the 102 MCI cases using one-way analysis of variance and logistic regression models. Results: Significantly higher scores of Openness factor (as well as Aesthetics, Ideas and Values facets) were found in sCON than in both dCON and MCI cases. The three groups did not differ in the other NEO-PI-R factor and facet scores. Openess factor (and the same facets) was associated with cognitive preservation in healthy controls (OR: 0.72, 95% CI: 0.59, 0.87). Lower scores in the same factor and facets conferred higher risk to have MCI (OR: 0.61, 95% CI: 0.46, 0.79). Conclusion: Higher openness to new experiences and thoughts may be a protective factor against early cognitive decline in brain aging.

scholarly journals Association Between Urate-Lowering Therapies and Cognitive Decline in Community-Dwelling Older Adults: A Post-Hoc Analysis of the MAPT Study.

2021 ◽  
Author(s):  
Luc MOLET-BENHAMOU ◽  
Kelly VIRECOULON GIUDICI ◽  
Philipe BARRETO ◽  
Yves ROLLAND
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Composite Score ◽  
Cognitive Score ◽  
Using Data ◽  
Community Dwelling Older Adults

Abstract Introduction Long-term use of urate-lowering therapies (ULT) may reduce inflammaging and thus prevent cognitive decline during aging. This article examined the association between long-term use of ULT and cognitive decline among community-dwelling older adults with spontaneous memory complaints. Material and methods We performed a secondary observational analysis using data of 1,673 participants ≥ 70 years old from the Multidomain Alzheimer Preventive Trial (MAPT Study), a randomized controlled trial assessing the effect of a multidomain intervention, the administration of polyunsaturated fatty acids (PUFA), both, or placebo on cognitive decline. We compared cognitive decline during the 5-year follow-up between three groups according to ULT use: participants treated with ULT during at least 75% of the study period (PT ≥ 75; n = 51), less than 75% (PT < 75; n = 31), and non-treated participants (PNT; n = 1,591). Cognitive function (measured by a composite score) was assessed at baseline, 6 months and every year for 5 years. Linear mixed models were performed and adjusted for age, sex, body mass index (BMI), diagnosis of arterial hypertension or diabetes, baseline composite cognitive score, and MAPT intervention groups. Results After the 5-year follow-up, only non-treated participants presented a significant decline in the cognitive composite score (mean change − 0.173, 95%CI -0.212 to -0.135; p < 0.0001). However, there were no differences in change of the composite cognitive score between groups (adjusted between-group difference for PNT vs. PT < 75: 0.089, 95%CI -0.160 to 0.338, p = 0.484; PNT vs. PT ≥ 75: 0.174, 95%CI -0.042 to 0.391, p = 0.115). Conclusion Use of ULT was not associated with reduced cognitive decline over a 5-year follow-up among community-dwelling older adults at risk of dementia.

scholarly journals The Importance of Stroke as a Risk Factor of Cognitive Decline in Community Dwelling Older and Oldest peoples : The SONIC Study

2020 ◽  
Author(s):  
Werayuth Srithum ◽  
Mai Kabayama ◽  
Yasuyuki Gondo ◽  
Yukie Masui ◽  
Yuya Akagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Protective Factors ◽  
Cognitive Decline ◽  
Educational Level ◽  
Community Dwelling ◽  
Multiple Logistic Regression ◽  
History Of

Abstract Background: Cognitive impairment is a major health concern among older and oldest people.Moreover, stroke is a relevant contributor for cognitive decline and development of dementia. The study of cognitive decline focused on stroke as the important risk factor by recruiting older and oldest is still lagging behind. Therefore, the aim of this study was to investigate the importance of stroke as a risk factor of cognitive decline during three years in community dwelling older and oldest people. Methods: This study was longitudinal study with a 3-year follow-up in Japan. The participants were 1,333community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, long-term care (LTC) service used, and residential area). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up. Results: The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up. Conclusions: The cognitive decline after the 3-year follow-up was influenced by the history of stroke and advanced age, while greater MoCA-J score at the baseline was positively associated with subsequent 3 years cognitive decline. The protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

scholarly journals Higher Serum Brain-Derived Neurotrophic Factor Levels Are Associated With a Lower Risk of Cognitive Decline: A 2-Year Follow Up Study in Community-Dwelling Older Adults

2021 ◽  
Vol 15 ◽  
Author(s):  
Yoshinori Fujiwara ◽  
Kazushige Ihara ◽  
Mitsugu Hachisu ◽  
Hiroyuki Suzuki ◽  
Hisashi Kawai ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Neurotrophic Factor ◽  
Lower Risk ◽  
Community Dwelling ◽  
Baseline Serum ◽  
Bottom Quartile ◽  
Community Dwelling Older Adults ◽  
Serum Bdnf

ObjectiveTo assess the relationship of serum brain-derived neurotrophic factor (BDNF) levels with the subsequent short-term decline in cognitive functioning in community-dwelling older adults.DesignTwo-year prospective, observational study.Setting and ParticipantsThe study included 405 adults aged 65–84 years, initially free of a dementia diagnosis who were living in Tokyo, Japan.MethodsParticipants underwent health assessments at baseline (2011) and follow-up (2013). Serum BDNF levels and scores from the Montreal Cognitive Assessment-Japanese version (MoCA-J) were systematically measured. Logistic regression was used to estimate the odds of cognitive decline between baseline and follow-up assessments in the full MoCA-J scale (operationally defined as a decrease of two or more points), as well as in MoCA-J subscales (decline of one or more points in a specific subscale), as a function of serum BDNF level, adjusting for baseline demographics, prevalent chronic diseases, and baseline cognitive scores.ResultsAmong individuals who performed worse on the full MoCA-J at baseline (i.e., scores in the bottom quartile [≤21], which is consistent with a mild cognitive impairment status), but not among those who performed better (top 3 quartiles), those with highest baseline serum BDNF levels (top quartile) had lower odds of subsequent decline in the full MoCA-J scale than those with lowest (bottom quartile); i.e., odds ratio (OR): 0.10 (95% confidence interval [CI]: 0.02–0.62; p = 0.013). Regarding MoCA-J subscales, adjusted odds of decline in the executive function subscale, but not in the other five subscales, were substantially low among those with highest baseline serum BDNF levels (top quartile), as compared to those with the lowest (bottom quartile), i.e., OR: 0.27 (95% CI:0.13–0.60; p &lt; 0.001).Conclusion and ImplicationsHigher serum BDNF levels were associated with a lower risk of decline in cognitive function in a sample of community-dwelling older Japanese adults. Risk varied across cognitive subdomains and according to baseline cognition. This warrants further research to evaluate the added-value of serum BDNF in health promotion initiatives directed toward cognitive decline prevention in community-dwelling older adults.

scholarly journals Association between Stroke and Cognitive Decline in Community Dwelling Older and Oldest People: The SONIC Study

2019 ◽  
Author(s):  
Werayuth Srithum ◽  
Mai Kabayama ◽  
Yasuyuki Gondo ◽  
Yukie Masui ◽  
Yuya Akagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Protective Factors ◽  
Cognitive Decline ◽  
Educational Level ◽  
Cognitive Assessment ◽  
Community Dwelling ◽  
Multiple Logistic Regression ◽  
History Of

Abstract Background Increasing in the older people and a decline in mortality after stroke, the rate of post-stroke cognitive decline has increased. The relationship between risk factors and post-stroke cognitive decline in dwelling old and oldest people who living in the community especially with asymptomatic stroke have to be elucidated. Therefore, the aim of this study is to investigate the association between stroke and cognitive decline during three years in community dwelling older and oldest people.Methods This study was longitudinal study with a 3-year follow-up in urban and rural areas of Japan. The participants were 1,333 community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, and long-term care (LTC) service used). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was used for cognitive assessment, and a decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up.Results Rates of cognitive decline increased in advanced ages, equaling 33.3, 39.4, and 66.7% in those aged 70, 80, and 90 years old, respectively. The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up.Conclusions The cognitive decline after the 3-year follow-up was influenced by the history of stroke, advanced age, and greater MoCA-J score at the baseline, but protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

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