scholarly journals Patterns and risk factors of cognitive decline among community-dwelling Korean older adults: The Korean Longitudinal Study of Aging (2006–2016)

2020 ◽  
Author(s):  
Jinhee Shin ◽  
Eunhee Cho

Abstract Background Dementia prevalence is increasing worldwide, and thus, the global impact of cognitive impairment and dementia has become a priority public health issue. This study aimed to assess the patterns of and risk factors for cognitive decline over time in community-dwelling Korean adults aged ≥ 65 years. Methods Older adults with normal cognitive function at baseline in 2006 were evaluated, and changes in their cognitive function were followed over time. The data were obtained from the 2006–2016 Korean Longitudinal Study of Aging. Cognitive function in 2016 was classified based on the Korean-Mini-Mental State Examination score as normal, mild dementia, and moderate and severe dementia. The t-test, ANOVA, and linear mixed models were used to analyse the patterns and risk factors f cognitive decline over time. Results Of the 1,262 participants examined, 752 maintained normal cognitive function, 267 older adults showed a change from normal cognitive function to mild dementia, and 243 older adults showed a decline from normal cognitive function to moderate and severe dementia between 2006 and 2016. There were significant differences in cognitive function over time among the three groups, and these were influenced by age, gender, education level, religion, activities of daily living, instrumental activities of daily living, regular exercise, number of meetings with friends, and depression. The differences have gradually increased over 10 years. Conclusions This study identified the patterns of cognitive decline over time and important factors related to cognitive decline. Individualised interventions such as improving physical function through regular exercise, increasing social activity, and managing depression by early detection and treatment may contribute to maintain cognitive function.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 598-598
Author(s):  
Ruixue Zhaoyang ◽  
Stacey Scott ◽  
Eric Cerino ◽  
Martin Sliwinski

Abstract Social relationships play an important role in cognitive health and aging. However, it is unclear how older adult’s cognitive function affects their everyday social interactions, especially for those with mild cognitive impairment (MCI). This study examined whether older adults with intact cognition vs. MCI differed in their daily social interactions. Community-dwelling older adults from the Einstein Aging Study (N=244, 70-91 yrs) reported their social interactions five times daily for 14 consecutive days using smartphones. Compared to those with normal cognitive function, older adults with MCI reported less frequent positive social interactions (p=0.012) and in-person social activities (p=0.006) on a daily basis. These two groups, however, did not show significant differences in their social relationships assessed by a conventional global questionnaire. The results support that, relative to global social relationships, daily social interactions are more sensitive, ecologically valid social markers that can facilitate the early detection of MCI.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.


Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 567
Author(s):  
Akio Goda ◽  
Shin Murata ◽  
Hideki Nakano ◽  
Koji Nonaka ◽  
Hiroaki Iwase ◽  
...  

Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population.


2012 ◽  
Vol 25 (2) ◽  
pp. 275-285 ◽  
Author(s):  
Feng Lin ◽  
Ding-Geng Chen ◽  
David E. Vance ◽  
Karlene K. Ball ◽  
Mark Mapstone

ABSTRACTBackground: The present study examined the prospective relationships between subjective fatigue, cognitive function, and everyday functioning.Methods: A cohort study with secondary data analysis was conducted using data from 2,781 community-dwelling older adults without dementia who were enrolled to participate in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized intervention trial. Measures included demographic and health information at baseline, and annual assessments of subjective fatigue, cognitive function (i.e. speed of processing, memory, and reasoning), and everyday functioning (i.e. everyday speed and everyday problem-solving) over five years.Results: Four distinct classes of subjective fatigue were identified using growth mixture modeling: one group complaining fatigue “some of the time” at baseline but “most of the time” at five-year follow-up (increased fatigue), one complaining fatigue “a good bit of the time” constantly over time (persistent fatigue), one complaining fatigue “most of the time” at baseline but “some of the time” at five-year follow-up (decreased fatigue), and the fourth complaining fatigue “some of the time” constantly over time (persistent energy). All domains of cognitive function and everyday functioning declined significantly over five years; and the decline rates, but not the baseline levels, differed by the latent class of subjective fatigue. Except for the decreased fatigue class, there were different degrees of significant associations between the decline rates of subjective fatigue and all domains of cognitive function and everyday functioning in other classes of subjective fatigue.Conclusion: Future interventions should address subjective fatigue when managing cognitive and functional abilities in community-dwelling older adults.


2019 ◽  
Vol 15 (3) ◽  
pp. e1-e10 ◽  
Author(s):  
Seonho Kim ◽  
Dallong Han ◽  
Jongeun Lee

Background and ObjectiveSocietal aging and increasing average life expectancy have led to a significant increase in the population of individuals aged 75 years or above. Hence, it is becoming more meaningful and appropriate for researchers to divide those above the age of 65 years into various subgroups, such as young-old and old-old. Based on this division, we investigated the prevalence and correlates of impairments in activities of daily living (ADLs) among community-dwelling older adults (young-old vs. old-old) in South Korea. Material and MethodsThis was a cross-sectional study. We used the data of 4,368 older adults (≥65 years old) from the 2012 Korean Longitudinal Study of Aging. ADL impairment was assessed using a modified version of the Katz Index of Independence in Activities of Daily Living. ResultsThe prevalence of ADL impairment was greater in old-old participants (12.7%) than in young-old ones (3.0%). ADL impairment was significantly associated with gender, perceived health status, regular exercise, cognitive function, and depressive symptoms in young-old individuals. By contrast, in old-old individuals, the significant predictors were residential area, socioeconomic status, perceived health status, regular exercise, cognitive function, and depressive symptoms. Among both age subgroups, cognitive function was the strongest predictive factor of ADL impairment. Conclusion We found clear age differences in the prevalence and correlates of ADL impairment in older Koreans. Such age differences should be considered when studying and developing interventions for ADL impairment in older adults.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 173-174
Author(s):  
Fereshteh Mehrabi ◽  
François Béland

Abstract Social isolation and frailty are global public health issues that may lead to poor health outcomes. We tested the two following hypotheses: 1) changes in social isolation and frailty are associated with adverse health outcomes over two years, 2) the associations between social isolation and health vary across different levels of frailty. We estimated a series of latent growth models to test our hypotheses using data from the FRéLE longitudinal study among 1643 Canadian community-dwelling older adults aged 65 years and over. Missing data were handled by pattern mixture models with the assumption of missing not at random. We measured social isolation through social participation, social networks, and social support from different social ties. We assessed frailty using Fried’s criteria. Our results revealed that higher frailty at baseline was associated with a higher rate of comorbidity, depression, and cognitive decline over two years. Less social participation at baseline was associated with comorbidity, depression, and changes in cognitive decline. Less social support from friends, children, partner, and family at baseline was associated with comorbidity, cognitive decline, and changes in depression. Fewer contacts with grandchildren were related to cognitive decline over time. The associations of receiving less support from partner with depression and participating less in social activities with comorbidity, depression, and cognitive decline were higher among frail or prefrail than robust older adults over time. This longitudinal study suggests that intimate connectedness and social participation may ameliorate health status in frail older populations, highlighting the importance of age-friendly city policies.


2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Juan Luis Sanchez-Sanchez ◽  
Kelly V. Giudici ◽  
Sophie Guyonnet ◽  
Julien Delrieu ◽  
Yan Li ◽  
...  

Abstract Background Monocyte Chemoattractant Protein-1 (MCP-1), a glial-derived chemokine, mediates neuroinflammation and may regulate memory outcomes among older adults. We aimed to explore the associations of plasma MCP-1 levels (alone and in combination with β-amyloid deposition—Aβ42/40) with overall and domain-specific cognitive evolution among older adults. Methods Secondary analyses including 1097 subjects (mean age = 75.3 years ± 4.4; 63.8% women) from the Multidomain Alzheimer Preventive Trial (MAPT). MCP-1 (higher is worse) and Aβ42/40 (lower is worse) were measured in plasma collected at year 1. MCP-1 in continuous and as a dichotomy (values in the highest quartile (MCP-1+)) were used, as well as a dichotomy of Aβ42/40. Outcomes were measured annually over 4 years and included the following: cognitive composite z-score (CCS), the Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) sum of boxes (overall cognitive function); composite executive function z-score, composite attention z-score, Free and Cued Selective Reminding Test (FCSRT - memory). Results Plasma MCP-1 as a continuous variable was associated with the worsening of episodic memory over 4 years of follow-up, specifically in measures of free and cued delayed recall. MCP-1+ was associated with worse evolution in the CCS (4-year between-group difference: β = −0.14, 95%CI = −0.26, −0.02) and the CDR sum of boxes (2-year: β = 0.19, 95%CI = 0.06, 0.32). In domain-specific analyses, MCP-1+ was associated with declines in the FCSRT delayed recall sub-domains. In the presence of low Aβ42/40, MCP-1+ was not associated with greater declines in cognitive functions. The interaction with continuous biomarker values Aβ42/40× MCP-1 × time was significant in models with CDR sum of boxes and FCSRT DTR as dependent variables. Conclusions Baseline plasma MCP-1 levels were associated with longitudinal declines in overall cognitive and episodic memory performance in older adults over a 4-year follow-up. How plasma MCP-1 interacts with Aβ42/40 to determine cognitive decline at different stages of cognitive decline/dementia should be clarified by further research. The MCP-1 association on cognitive decline was strongest in those with amyloid plaques, as measured by blood plasma Aβ42/40.


2020 ◽  
Vol 77 (2) ◽  
pp. 781-794 ◽  
Author(s):  
Chenbo Zhang ◽  
Jianfeng Luo ◽  
Changzheng Yuan ◽  
Ding Ding

Background: Previous studies have indicated that B vitamin deficiencies are an essential cause of neurological pathology. There is a need to provide evidence of the benefit of B vitamins for the prevention of cognitive decline in community-dwelling older adults. Objective: To examine the association between intake and plasma levels of vitamins B12, B6, and folate and cognitive function in older populations through a systematic review and meta-analysis. Methods: Medline (PubMed), EMBASE, and Cochrane databases were used to search the literature though August 8, 2019. We included observational population-based studies evaluating the association between concentrations or intake levels of vitamins B6, B12, or folate and cognition in older adults aged ≥45 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale. Odds ratios (ORs) and hazard ratios (HRs) were analyzed by the random-effects model. Sensitivity analyses were conducted by excluding the studies with significant heterogeneity. Results: Twenty-one observational studies with sample sizes ranging from 155–7030 were included in the meta-analysis. Higher levels of vitamin B12 (OR = 0.77, 95% CI = 0.61–0.97) and folate concentration (OR = 0.68, 95% CI = 0.51–0.90) were associated with better cognition in cross-sectional studies, but not in sensitivity analyses or prospective studies. High vitamin B6 concentrations showed no significant benefit on cognition and dementia risk. Prospective studies did not provide substantial evidence for the relationship. Conclusion: The results from our meta-analysis suggest that vitamins B12, B6, and folate may not be modifiable risk factors for slowing cognitive decline among community-dwelling older individuals.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Gail A Laughlin ◽  
Linda K McEvoy ◽  
Elizabeth Barrett-Connor ◽  
Lori B Daniels ◽  
Joachim H Ix

Objectives: The contribution of vascular disease to neurocognitive decline is now widely recognized. Fetuin-A is an abundant plasma protein known to predict vascular disease. Prior studies have shown that fetuin-A levels are lower in patients with Alzheimer’s disease in direct proportion to the severity of cognitive impairment; however, their association with normal cognitive aging is unknown. We evaluated the association of serum fetuin-A levels with cognitive function in relatively high-functioning, community-dwelling older adults from the Rancho Bernardo Study. Methods: This is a population-based study of 1382 older adults (median age 75) who had plasma fetuin-A levels and cognitive function evaluated in 1992-96; 855 had repeat cognitive function assessment a median of 4 years later. Results: Adjusting for age, sex, education, and depression, higher levels of fetuin-A were associated with better baseline performance on the Mini-Mental Status Exam (MMSE) (P=0.012) and a tendency for better Trails Making B scores (P=0.066). In longitudinal analyses, the likelihood of a major decline (highest decile of change) in Trails B was 29% lower (P=0.010) for each SD higher baseline fetuin-A level; odds of major decline in MMSE was 42% lower (P=0.005) per SD higher fetuin-A for individuals with no known CVD, but were not related to fetuin-A in those with CVD (P=0.33). Fetuin-A was not related to Category Fluency performance. Results did not vary by sex and were not explained by numerous vascular risk factors and comorbidities. Conclusions: Higher plasma fetuin-A concentrations are associated with better performance on tests of global cognitive function and executive function and with reduced likelihood of major decline in these cognitive abilities over a 4-year period. These observations are consistent with the hypothesis that higher fetuin-A protects against cognitive decline in relatively high functioning older adults, although this may be less apparent in those with established vascular disease. Fetuin-A may serve as a biological link between vascular disease and normal age-related cognitive decline.


Sign in / Sign up

Export Citation Format

Share Document