Modifiable Factors Associated with Reversion from Mild Cognitive Impairment to Cognitively Normal Status: A Prospective Cohort Study

Abstract Background Previous studies found that about 24% of the mild cognitive impairment (MCI) patients reverse to cognitively normal (CN) status. However, it is unclear which modifiable factors are associated with this reversion. Method We conducted a prospective community-based cohort study based on 2002-2018 Chinese Longitudinal Health Longevity Survey (CLHLS). Of 35,474 older adults from 22 provinces in China in the 5 waves of CLHLS, 7,422 eligible participants with MCI were included. Multivariable Cox regression with least absolute shrinkage and selection operator (LASSO) penalty for variable selection was adopted to investigate the associations between reversion to CN and potential modifiable dietary/lifestyle, cardiometabolic, and psychological factors. Results Our analysis included 7,422 MCI participants [average age: 90.0 (SD 9.5) years]. Among these participants, 1,604 (21.6%) reversed from MCI to CN with a mean (SD) follow-up of 2.9 (1.8) years. Several dietary/lifestyle factors, including daily consumption of fresh fruits (Hazard Ratio [HR]: 1.28, 95% CI: 1.15 to 1.42; P༜.001), engagement in reading (HR: 1.24, 95% CI: 1.00 to 1.54; P =.047), housework (HR: 1.21, 95% CI: 1.08 to 1.35; P =.001), and mah-jong or other card games (HR: 1.23, 95% CI: 1.08 to 1.39; P =.001), were positively associated with possibility of reversion. Cigarette smoking (HR: 0.92, 95% CI: 0.84 to 1.00; P= .041) and duration of alcohol drinking (HR: 0.97, 95% CI: 0.94 to 0.99; P = .012) were negatively associated with possibility of reversion. None of the modifiable cardiometabolic and psychological factors was found to be significantly associated with reversion to CN. Difference was identified among different age and gender group. Conclusion This study identified several dietary/lifestyle factors associated with MCI reversion that may transfer into large-scale dementia prevention practices.

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Modifiable Lifestyle Factors Associated with Cognitive Recovery from MCI: A 12-Year Longitudinal Study

Innovation in Aging ◽

10.1093/geroni/igab046.2647 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 713-714

Author(s):

Bingyu Li

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cox Regression ◽

Lifestyle Factors ◽

Daily Consumption ◽

Cognitive Recovery ◽

Cox Regression Analysis ◽

Factors Associated ◽

Healthy Longevity ◽

Modifiable Lifestyle Factors

Abstract Introduction Many studies have investigated the risk factors associated with progression from mild cognitive impairment (MCI) to cognitive impairment, while it is unclear which lifestyle factors are associated with cognitive recovery among those who have mild cognitive impairment. Methods The study includes 7,422 participants above 65 years old with MCI from The Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cox regression analysis was adopted to investigate the association between cognitive recovery and selected lifestyle factors. LASSO was applied to select the variables. Results Daily consumption of fresh fruits is associated with higher possibility of cognitive recovery (HR: 1.28, 95% CI: 1.15-1.42) while daily consumption of meat show opposite influence (HR: 0.90, 95% CI: 0.80-0.99). Smoking (HR: 0.99, 95% CI: 0.98-1.00) and alcohol consumption (HR: 1.00, 95% CI: 0.99-1.00) are both negatively associated with cognitive recovery. Daily engagement in reading (HR: 1.24, 95% CI: 1.00-1.54), housework (HR: 1.21, 95% CI: 1.08-1.35) as well as mahjong and other card games (HR: 1.23, 95% CI: 1.08-1.39) are associated with higher possibility of cognitive recovery. Conclusion This study has identified important modifiable lifestyle factors associated with natural cognitive recovery from MCI. The findings have considerable implications for dementia prevention.

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Modifiable factors associated with recovery of mild cognitive impairment patients: Evidence from the Chinese Longitudinal Healthy Longevity Survey

Alzheimer s & Dementia ◽

10.1002/alz.057401 ◽

2021 ◽

Vol 17 (S10) ◽

Author(s):

Bingyu Li ◽

Ziyi Zhao ◽

Chang Wei ◽

Feng Sha

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Factors Associated ◽

Healthy Longevity ◽

Modifiable Factors

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Lifestyles and Cognition

Integrative Journal of Medical Sciences ◽

10.15342/ijms.2021.399 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shashi Agarwal

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Physical Inactivity ◽

Lifestyle Factors ◽

Poor Diet ◽

Age Related ◽

Modifiable Factors ◽

Age Related Cognitive Decline

Cognitive decline is a growing medical concern. It includes age-related cognitive decline, mild cognitive impairment, and dementia. Dementia results in considerable dysfunction in life and is associated with an increase in mortality. Since there is no cure at this time, attention is being increasingly directed towards prevention. Lifestyle factors, such as smoking, alcoholism, physical inactivity, poor diet, improper sleep, and loneliness are repeatedly being recognized as modifiable factors that can reduce cognitive decline. This manuscript briefly reviews the lifestyle-cognition relationship.

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One-year Outcome of Shanghai Mild Cognitive Impairment Cohort Study

Current Alzheimer Research ◽

10.2174/1567205016666181128151144 ◽

2019 ◽

Vol 16 (2) ◽

pp. 156-165 ◽

Cited By ~ 3

Author(s):

Bin Zhou ◽

Qianhua Zhao ◽

Shinsuke Kojima ◽

Ding Ding ◽

Satoshi Higashide ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cohort Study ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Detection ◽

Neuropsychological Test ◽

Clinical Trial Design ◽

Disease Assessment ◽

Factors Associated

Background & Objective: The purpose of this study is to identify the risk factors associated with the conversion from Mild Cognitive Impairment (MCI) to Alzheimer’s Disease (AD) dementia for the early detection of AD.Methods:The study comprised a prospective cohort study that included 400 MCI subjects with annual follow-ups for 3 years.Results:During the first 12 months’ follow-up, 42 subjects converted to Alzheimer’s dementia (21 probable AD and 21 possible AD), two subjects converted to other types of dementia and 56 subjects lost follow. The factors associated with a greater risk of conversion from MCI to AD included gender, whole brain volume, and right hippocampal volume (rt. HV), as well as scores on the Revised Chinese version of the Alzheimer’s Disease Assessment Scale-Cognitive subscale 13 (ADAS-Cog-C), Clock Drawing Test (CDT), Symbol Digit Modalities Test (SDMT), and Rey-Osterrieth Complex Figure Test (ROCFT). The risk classification of the combined ADAS-Cog-C and Alzheimer Cognitive Composite (ACC) score with the rt. HV and left Entorhinal Cortex Volume (lt. ECV) showed a conversion difference among the groups.Conclusion:Early detection of AD and potential selection for clinical trial design should utilize the rt. HV, as well as neuropsychological test scores, including those of the ADAS-Cog-C and ACC.

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Faculty Opinions recommendation of Surgery and brain atrophy in cognitively normal elderly subjects and subjects diagnosed with mild cognitive impairment.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13988983.15768119 ◽

2012 ◽

Author(s):

Luzius A Steiner ◽

Christoph Burkhart

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Brain Atrophy ◽

Elderly Subjects ◽

Cognitively Normal

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Lower functional hippocampal redundancy in mild cognitive impairment

Translational Psychiatry ◽

10.1038/s41398-020-01166-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Stephanie Langella ◽

◽

Muhammad Usman Sadiq ◽

Peter J. Mucha ◽

Kelly S. Giovanello ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Resting State ◽

Memory Performance ◽

Potential Mechanism ◽

Network Efficiency ◽

Cognitively Normal ◽

Normal Individuals ◽

The Relationship

AbstractWith an increasing prevalence of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in response to an aging population, it is critical to identify and understand neuroprotective mechanisms against cognitive decline. One potential mechanism is redundancy: the existence of duplicate elements within a system that provide alternative functionality in case of failure. As the hippocampus is one of the earliest sites affected by AD pathology, we hypothesized that functional hippocampal redundancy is protective against cognitive decline. We compared hippocampal functional redundancy derived from resting-state functional MRI networks in cognitively normal older adults, with individuals with early and late MCI, as well as the relationship between redundancy and cognition. Posterior hippocampal redundancy was reduced between cognitively normal and MCI groups, plateauing across early and late MCI. Higher hippocampal redundancy was related to better memory performance only for cognitively normal individuals. Critically, functional hippocampal redundancy did not come at the expense of network efficiency. Our results provide support that hippocampal redundancy protects against cognitive decline in aging.

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Financial Capacity and Regional Cerebral Tau in Cognitively Normal Older Adults, Mild Cognitive Impairment, and Alzheimer’s Disease Dementia

Journal of Alzheimer s Disease ◽

10.3233/jad-201122 ◽

2020 ◽

pp. 1-10

Author(s):

Christopher Gonzalez ◽

Nicole S. Tommasi ◽

Danielle Briggs ◽

Michael J. Properzi ◽

Rebecca E. Amariglio ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Stage ◽

Cognitively Normal ◽

Financial Capacity ◽

Posterior Cingulate ◽

Dorsolateral Prefrontal

Background: Financial capacity is often one of the first instrumental activities of daily living to be affected in cognitively normal (CN) older adults who later progress to amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. Objective: The objective of this study was to investigate the association between financial capacity and regional cerebral tau. Methods: Cross-sectional financial capacity was assessed using the Financial Capacity Instrument –Short Form (FCI-SF) in 410 CN, 199 MCI, and 61 AD dementia participants who underwent flortaucipir tau positron emission tomography from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Linear regression models with backward elimination were used with FCI-SF total score as the dependent variable and regional tau and tau-amyloid interaction as predictors of interest in separate analyses. Education, age sex, Rey Auditory Verbal Learning Test Total Learning, and Trail Making Test B were used as covariates. Results: Significant associations were found between FCI-SF and tau regions (entorhinal: p < 0.001; inferior temporal: p < 0.001; dorsolateral prefrontal: p = 0.01; posterior cingulate: p = 0.03; precuneus: p < 0.001; and supramarginal gyrus: p = 0.005) across all participants. For the tau-amyloid interaction, significant associations were found in four regions (amyloid and dorsolateral prefrontal tau interaction: p = 0.005; amyloid and posterior cingulate tau interaction: p = 0.005; amyloid and precuneus tau interaction: p < 0.001; and amyloid and supramarginal tau interaction: p = 0.002). Conclusion: Greater regional tau burden was modestly associated with financial capacity impairment in early-stage AD. Extending this work with longitudinal analyses will further illustrate the utility of such assessments in detecting clinically meaningful decline, which may aid clinical trials of early-stage AD.

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