scholarly journals How Does Dementia Begin to Manifest in Bipolar Disorder? A Description of Prodromal Clinical and Cognitive Changes

2021 ◽  
pp. 1-12
Author(s):  
Brandy L. Callahan ◽  
Michael McLaren-Gradinaru ◽  
Ford Burles ◽  
Giuseppe Iaria
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Data Repository ◽  
Semantic Retrieval ◽  
Cognitive Changes ◽  
Healthy Older Adults ◽  
Verbal Recall ◽  
Neurodegenerative Process ◽  
Incident Cases

Background: Older adults with bipolar disorder (BD) have increased dementia risk, but signs of dementia are difficult to detect in the context of pre-existing deficits inherent to BD. Objective: To identify the emergence of indicators of early dementia in BD. Methods: One hundred and fifty-nine non-demented adults with BD from the National Alzheimer Coordinating Center (NACC) data repository underwent annual neuropsychological assessment up to 14 years (54.0 months average follow-up). Cognitive performance was examined longitudinally with linear mixed-effects models, and yearly differences between incident dementia and controls cases were examined in the six years prior to diagnosis. Results: Forty participants (25.2%) developed dementia over the follow-up period (‘incident cases’). Alzheimer’s disease was the most common presumed etiology, though this was likely a result of sampling biases within NACC. Incident cases showed declining trajectories in memory, language, and speeded attention two years prior to dementia onset. Conclusion: In a sample of BD patients enriched for Alzheimer’s type dementia, prodromal dementia in BD can be detected up to two years before onset using the same cognitive tests used in psychiatrically-healthy older adults (i.e., measures of verbal recall and fluency). Cognition in the natural course of BD is generally stable, and impairment or marked decline on measures of verbal episodic memory or semantic retrieval may indicate an early neurodegenerative process.

scholarly journals How Does Dementia Begin to Manifest in Bipolar Disorder? A Description of Prodromal Clinical and Cognitive Changes.

2020 ◽  
Author(s):  
Brandy L. Callahan ◽  
Michael McLaren-Gradinaru ◽  
Ford Burles ◽  
Giuseppe Iaria
Keyword(s):  
Bipolar Disorder ◽  
Small Subset ◽  
Digit Symbol ◽  
Cognitive Changes ◽  
Impaired Performance ◽  
Neurodegenerative Process ◽  
Digit Symbol Substitution ◽  
Symbol Substitution ◽  
Incident Cases

Abstract BackgroundThis study aims to identify longitudinal cognitive changes that may signal early dementia in bipolar disorder.MethodsParticipants were 114 adults with bipolar disorder, all initially non-demented, who underwent annual neuropsychological assessment up to ten years (47.3 months average follow-up). A small subset (n=12) also had available structural neuroimaging data. Longitudinal features associated with future dementia status were examined with linear mixed-effects models, and yearly differences between incident dementia and controls cases were examined in the six years prior to diagnosis.ResultsTwenty-six participants (22.8%) developed dementia over the follow-up period (‘incident cases’), and the remaining 88 (77.2%) remained dementia-free (‘controls’). Alzheimer’s disease was the most common presumed etiology in the incident cases, and this aligned with findings of smaller hippocampal volumes relative to controls. The incident cases showed clearly declining trajectories in episodic memory, verbal fluency and attention. Story recall and digit symbol substitution showed the earliest decline, four and five years before diagnosis respectively. Digit symbol substitution was most accurate at distinguishing cases from controls: impaired performance (<-1.5 SD) at any time during the follow-up period was associated with 54% sensitivity and 87% specificity of future dementia.ConclusionsProdromal dementia in bipolar disorder can be detected up to five years before onset using the same cognitive tests used in psychiatrically-healthy older adults. Cognition in the natural course of bipolar disorder is generally stable, and impairment or marked decline on measures of memory, fluency or attention may indicate an early neurodegenerative process.

scholarly journals Association of Brain Natriuretic Peptide With Mortality in Exceptionally Long-Lived Families

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 211-211
Author(s):  
Allison Kuipers ◽  
Robert Boudreau ◽  
Mary Feitosa ◽  
Angeline Galvin ◽  
Bharat Thygarajan ◽  
...  
Keyword(s):  
Older Adults ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Sex Education ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Time To Event ◽  
Healthy Older Adults ◽  
Secondary Analyses

Abstract Natriuretic peptides are produced within the heart and released in response to increased chamber wall tension and heart failure (HF). N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) is a specific natriuretic peptide commonly assayed in persons at risk for HF. In these individuals, NT-proBNP is associated with future disease prognosis and mortality. However, its association with mortality among healthy older adults remains unknown. Therefore, we determined the association of NT-proBNP with all-cause mortality over a median follow-up of 10 years in 3253 individuals free from HF at baseline in the Long Life Family Study, a study of families recruited for exceptional longevity. We performed cox proportional hazards analysis (coxme in R) for time-to event (mortality), adjusted for field center, familial relatedness, age, sex, education, smoking, alcohol, physical activity, BMI, diabetes, hypertension, and cancer. In addition, we performed secondary analyses among individuals (N=2457) within the normal NT-proBNP limits at baseline (&lt;125pg/ml aged &lt;75 years; &lt;450pg/ml aged ≥75 years). Overall, individuals were aged 32-110 years (median 67 years; 44% male), had mean NT-proBNP of 318.5 pg/ml (median 91.0 pg/ml) and 1066 individuals (33%) died over the follow-up period. After adjustment, each 1 SD greater baseline NT-proBNP was associated with a 1.30-times increased hazard of mortality (95% CI: 1.24-1.36; P&lt;0.0001). Results were similar in individuals with normal baseline NT-proBNP (HR: 1.21; 95% CI: 1.11-1.32; P&lt;0.0001). These results suggest that NT-proBNP is a strong and specific biomarker for mortality in older adults independent of current health status, even in those with clinically-defined normal NT-proBNP.

scholarly journals One-Year Follow-Up of Healthy Older Adults with Electroencephalographic Risk for Neurocognitive Disorder After Neurofeedback Training

2021 ◽  
pp. 1-15
Author(s):  
Graciela C. Alatorre-Cruz ◽  
Thalía Fernández ◽  
Susana A. Castro-Chavira ◽  
Mauricio González-López ◽  
Sergio M. Sánchez-Moguel ◽  
...  
Keyword(s):  
Older Adults ◽  
Theta Activity ◽  
Control Group ◽  
Global Changes ◽  
Healthy Population ◽  
Healthy Older Adults ◽  
Cognitive Improvement ◽  
One Year ◽  
Experimental Group

Background: In healthy older adults, excess theta activity is an electroencephalographic (EEG) predictor of cognitive impairment. In a previous study, neurofeedback (NFB) treatment reinforcing reductions theta activity resulted in EEG reorganization and cognitive improvement. Objective: To explore the clinical applicability of this NFB treatment, the present study performed a 1-year follow-up to determine its lasting effects. Methods: Twenty seniors with excessive theta activity in their EEG were randomly assigned to the experimental or control group. The experimental group received an auditory reward when the theta absolute power (AP) was reduced. The control group received the reward randomly. Results: Both groups showed a significant decrease in theta activity at the training electrode. However, the EEG results showed that only the experimental group underwent global changes after treatment. These changes consisted of delta and theta decreases and beta increases. Although no changes were found in any group during the period between the posttreatment evaluation and follow-up, more pronounced theta decreases and beta increases were observed in the experimental group when the follow-up and pretreatment measures were compared. Executive functions showed a tendency to improve two months after treatment which became significant one year later. Conclusion: These results suggest that the EEG and behavioral benefits of this NFB treatment persist for at least one year, which adds up to the available evidence contributing to identifying factors that increase its efficacy level. The relevance of this study lies in its prophylactic features of addressing a clinically healthy population with EEG risk of cognitive decline.

scholarly journals Longitudinal impact and effects of booster sessions in a cognitive training program for healthy elderly

2020 ◽  
Author(s):  
Lucas Matias Felix ◽  
Marcela Mansur Alves ◽  
Mariana Teles ◽  
Laura Jamison ◽  
Hudson Golino
Keyword(s):  
Older Adults ◽  
Cognitive Training ◽  
Passive Control ◽  
Control Group ◽  
Longitudinal Impact ◽  
Healthy Older Adults ◽  
Booster Sessions ◽  
Experimental Group

This paper reports the results from a three-years follow-up study to access the long-term efficacy of a cognitive training for healthy older adults and investigates the effects of booster sessions on the cognitive performance of the participants using an innovative analytical approach from information theory. Design: semi-randomized quasi-experimental controlled design. Participants: 50 healthy older adults, (M = 73.3, SD = 7.77) were assigned into an experimental (N = 25; Mean age = 73.9; SD = 8.62) and a passive control group (N = 25; mean age = 72.9; SD = 6.97). Instruments: six subtests of WAIS and two episodic memory tasks. Procedures: the participants were assessed in four occasions: after the end of the original intervention, pre-booster sessions (three years after the original intervention), immediately after the booster sessions and three months after the booster sessions. Results: the repeated measures ANOVA showed that two gains reported in the original intervention were identified in the follow-up: Coding (F(1, 44) = 11.79, MSE = 0.77, p = .001, ηˆG2 = .084) and Picture Completion (F(1, 47) = 10.01, MSE = 0.73, p = .003, ηˆG2 = .060). After the booster sessions, all variables presented a significant interaction between group and time favorable to the experimental group (moderate to high effect sizes). To compare the level of cohesion of the cognitive variables between the groups, an entropy-based metric was used. The experimental group presented a lower level of cohesion in three of the four measurement occasions, suggesting a differential impact of the intervention with immediate and short-term effects, but without long-term effects.

scholarly journals B-38 Gamified Mobile Cognitive Tests: Preliminary Feasibility and Acceptability in Persons with Bipolar Disorder

2019 ◽  
Vol 34 (6) ◽  
pp. 984-984
Author(s):  
T Filip ◽  
S Kamarsu ◽  
D Lomas ◽  
L Eyler ◽  
C Depp ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Tests ◽  
Cognitive Changes ◽  
Average Completion Time ◽  
Temporal Relationships ◽  
Assessment Period ◽  
Changes Over Time

Abstract Objective Current measurements of cognitive functioning are time-consuming and costly, often done as point-in-time assessments. We examined the feasibility and acceptability of six newly developed smartphone-based mobile cognitive tests (MCTs), completed in the real-world, among persons with bipolar disorder (BD) and healthy controls (HC). Methods Thirteen community-dwelling participants (seven BD and six HC), aged 18-65, completed in-person neurobehavioral assessments at baseline and our MCTs three times daily for the following 14 days. The MCTs measure cognition in the following domains: reaction time, executive functions, attention, processing speed, working memory, and learning and memory. Our protocol delivered 1-2 MCTs per session, and each test was only administered once daily. Timing of the MCTs was adjusted according to individual sleep/wake schedules. Results MCT adherence was, on average, high (82.38%). The two groups did not differ in terms of adherence (p = 0.45, 95% CI = -29.51, 13.96) or average completion time (5.21 mins, SD = 1.54 min per each assessment period; t(11) = 1.12, p = .29, 95% CI = -0.91, 2.81). There was no relationship between age and adherence (r = .296, p = .326). Acceptability was measured at follow-up via a Likert-scale rating from 0 = not at all to 4 = very much; mean likeability was high (M = 3.0, SD = 1.28). Most participants noted a high willingness to complete additional MCT testing in the future. Conclusion Our preliminary findings indicate mobile cognitive testing is feasible and accepted among bipolar disorder and comparison participants. The implications of using smartphone-based MCTs are far reaching, including increased visibility of cognitive changes over time as well as examining real-time temporal relationships between cognition and other lifestyle and environmental factors.

Effects of a simple reminiscence intervention program on the reminiscence functions in older adults

2020 ◽  
pp. 1-10
Author(s):  
Encarnación Satorres ◽  
Iraida Delhom ◽  
Juan C. Meléndez
Keyword(s):  
Older Adults ◽  
Problem Solving ◽  
Intervention Program ◽  
Intervention Group ◽  
The Self ◽  
Control Group ◽  
Identity Problem ◽  
Healthy Older Adults ◽  
Positive Functions

ABSTRACT Objectives: Reminiscence promotes the acceptance of oneself and others, a sense of meaning, and the integration of the present and the past. The currently accepted classification contains eight reminiscence functions grouped in three broader functions: self-positive functions (identity, problem-solving, and death preparation); self-negative functions (bitterness revival, boredom reduction, and intimacy maintenance); and prosocial functions (conversation and teach-inform). The main objective of this study was to investigate how the eight dimensions change over time in a sample of healthy older adults after an intervention based on simple reminiscence and subsequent follow-up. Design: Participants were randomly assigned to the treatment or control group. Setting: Participants were evaluated individually before, immediately after, and 3 months after the intervention. Participants: Participants included 139 healthy older adults (71 intervention group and 68 control group). Intervention: Ten weekly sessions lasting 2 hours each were administered, based on a simple reminiscence program. Measurements: Participants were assessed with the Reminiscence Functions Scale. Results: After the intervention, in the treatment group, there was a significant increase in the self-positive functions of problem-solving and death preparation, and these effects were maintained even at the follow-up; there was a significant reduction in the self-negative functions of bitterness revival and intimacy maintenance; and there was a significant increase in the prosocial function of conversation. Conclusions: When applying an intervention based on reminiscence, it is important to evaluate how it influences these functions because this information can help us to modify the objectives of the intervention and increase its effectiveness.

Healthy Older Adults’ Sleep Predicts All-Cause Mortality at 4 to 19 Years of Follow-Up

2003 ◽  
Vol 65 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Mary Amanda Dew ◽  
Carolyn C. Hoch ◽  
Daniel J. Buysse ◽  
Timothy H. Monk ◽  
Amy E. Begley ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthy Older Adults ◽  
All Cause Mortality

scholarly journals 385. SARS-CoV-2 Infections Among Military Personnel Deployed on the USNS COMFORT to New York City During the COVID-19 Pandemic and One-Year Follow-Up

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S294-S294
Author(s):  
Elizabeth Cooper ◽  
Tida Lee ◽  
Eric Laing ◽  
Andrew Ritter ◽  
Melissa Lee ◽  
...  
Keyword(s):  
Health Care ◽  
New York ◽  
New York City ◽  
York City ◽  
Data Repository ◽  
Blood Draw ◽  
Military Health ◽  
Incident Cases ◽  
Roll Out

Abstract Background The USNS COMFORT deployed to New York City to augment the inpatient health care capacity in March 2020. The aim of this study was to determine the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among US Navy personnel upon return from deployment, and to identify incident cases of SARS-CoV-2 infection during 1 year of follow-up. Methods Crewmembers, the majority of whom were health care workers (HCW), were enrolled following deployment, in May 2020. PCR results from symptomatic crewmembers during deployment, and Day 0 and Day 14 post-deployment screening swabs conducted on all crewmembers, per military order, were abstracted. A questionnaire and serum were collected on Day 14 post-deployment. SARS-CoV-2 infection was defined as a positive SARS-CoV-2 spike glycoprotein immunoglobulin G antibody (IgG) or PCR. COVID-19 related medical encounters, PCR and antibody testing results within 1 year following deployment were abstracted from the Military Health System Data Repository (MDR). There was adequate provision of personal protective equipment (PPE) in the hospital and the COVID-19 vaccine roll-out for HCW began in December 2020. Results Of the 1200 crewmembers, 449 were enrolled and completed the questionnaire and screening swabs, and 432 (96.2%) completed the Day 14 blood draw (Table 1). The cumulative prevalence of SARS-CoV-2 infection was 3.01% (13/432; 95% CI, 1.61%–5.09%). One of 17 subjects did not complete the blood draw and was PCR positive on Day 14. 433/449 (96.4%) had a PCR performed during the follow-up period (i.e. after the Day 14 post-deployment visit until Feb 2021), for HCW screening or symptomatic illness (median number of tests: 2 [IQR: 1, 2; range: 1,6]). 25 of 433 (5.8%) were PCR positive (Fig 1). 19 (76.0%) occurred in corpsmen, 23 (92.0%) were symptomatic and none were hospitalized. One asymptomatic re-infection occurred in a crewmember who was PCR negative and IgG positive at Day 14 post-deployment. Table 1. Characteristics of the overall cohort and by SARS-CoV-2 infection Figure 1. Number of PCR tests (bar graph) and positivity rate (red line) by month in 449 USNS COMFORT crewmembers during 1-year follow-up after return from deployment Conclusion The post-deployment prevalence of SARS-CoV-2 infection was low. A high proportion of HCW underwent PCR testing during 1-year follow-up but a low incidence of infection was observed. This was likely from community transmission as nosocomial transmission was mitigated by adequate PPE and vaccine roll-out. Disclosures All Authors: No reported disclosures

Association of zinc intake with risk of impaired physical function and frailty among older adults

2022 ◽  
Author(s):  
Veronica Vega-Cabello ◽  
Francisco Félix Caballero ◽  
Alberto Lana ◽  
Lucia Arias-Fernandez ◽  
José R Banegas ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Lower Risk ◽  
Antioxidant Properties ◽  
Community Dwelling ◽  
Dietary Factors ◽  
Lower Extremity Function ◽  
Zinc Intake ◽  
Incident Cases

Abstract Background Zinc could be a target nutrient in the prevention of physical impairment and frailty in older adults due to its anti-inflammatory/antioxidant properties. However, prospective studies evaluating this inquiry are scarce. Thus, we aimed to assess the association between zinc intake and impaired lower-extremity function (ILEF) and frailty among community-dwelling older adults. Methods We examined 2,963 adults aged ≥60 years from the Seniors-ENRICA cohort. At baseline (2008–2010) and subsequent follow-up (2012), zinc intake (mg/d) was estimated with a validated computerized face-to-face diet history and adjusted for total energy intake. From 2012 to 2017, the occurrence of ILEF was ascertained with the Short Physical Performance Battery, and of frailty according to the Fried phenotype criteria. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders, including lifestyle, comorbidity, and dietary factors. Results During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared to participants in the lowest tertile of zinc intake (3.99–8.36 mg/d), those in the highest tertile (9.51–21.2 mg/d) had a lower risk of ILEF [fully-adjusted hazard ratio (95% confidence interval): 0.75 (0.58–0.97); p for trend: 0.03] and of frailty [0.63 (0.44–0.92); p for trend: 0.02]. No differences in the association were seen by strata of socio-demographic and lifestyle factors. Conclusions Higher zinc intake was prospectively associated with a lower risk of ILEF and frailty among older adults, suggesting that adequate zinc intake, that can be achieved through a healthy diet, may help preserve physical function and reduce the progression to frailty.

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