Reversal of Cognitive Aging through Enhancement of Cardiac Output

Mapping Intimacies ◽

10.5772/intechopen.95947 ◽

2021 ◽

Author(s):

Kenneth J. McLeod

Keyword(s):

Cardiac Output ◽

Cognitive Impairment ◽

Cause Of Death ◽

Soleus Muscle ◽

Muscle Activity ◽

Cognitive Aging ◽

Cerebral Perfusion ◽

Dementia Care ◽

Achievable Goal ◽

The U.S

Cognitive aging is a progressive condition leading to dementia, a condition which is now the sixth leading cause of death in the U.S., as well as being among the most expensive healthcare conditions to manage. With over 5 million affected in the U.S. alone, the annual costs to the Medicare/Medicaid system exceeds $200 billion, and with the rising age of the population, annual costs of dementia care are expected to exceed $500 billion by 2040. As there is no cure for dementia, a consensus has formed that a more pragmatic goal of research should be developing interventions capable of slowing or preventing cognitive aging. We propose that this is a readily achievable goal. Cognitive impairment is closely linked to cerebral perfusion, and cerebral perfusion is a function of cardiac output. In turn, cardiac output is completely dependent on venous return, which in the upright human, relies on adequate soleus muscle activity. As modern adults rarely squat, which is necessary for maintaining the soleus muscle, soleus insufficiency develops early in adulthood in most people. However, soleus muscle insufficiency can be reversed, resulting in improved cardiac output, cerebral perfusion, and the prevention of cognitive aging.

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Cognitive Aging in the United States and Mexico

Innovation in Aging ◽

10.1093/geroni/igaa057.1903 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 573-574

Author(s):

Sunshine Rote ◽

Jacqueline Angel ◽

Fernando Torres-Gil

Keyword(s):

Cognitive Impairment ◽

Cognitive Aging ◽

Care Service ◽

Cost Effective ◽

The United States ◽

Clear Understanding ◽

Service Needs ◽

Healthy Immigrant Effect ◽

Term Care ◽

The U.S

Abstract The Latino population is rapidly aging, with the number of adults 65 and older expected to increase by more than six times to 17.5 million by 2050. Mexico’s population is also aging and will increase by 227 percent over the next 25 years. We focus on the consequences of rising longevity and increasing numbers of older Latinos living with dementia both in the U.S. and in Mexico. Providing cost-effective and appropriate services to aging Latinos with dementia will require a clear understanding of the intra-diversity among this group in different social and national circumstances. The purpose of this symposium is the understand how migration between and within countries and other social and health factors (e.g., diabetes) impact risk for cognitive impairment and dementia using three national datasets: the HRS, MHAS, and HEPESE. Four paper presentations and one discussant will examine several thematic issues as they relate to cognitive aging for Latinos, including: (1) cross-national estimates of dementia prevalence in Mexico and the U.S.; (2) the healthy immigrant effect and health convergence hypothesis for cognitive impairment for Latinos in the U.S. and Mexico; and (3) implications of these trends for long-term care service needs for Latinos living with dementia in the U.S. and Mexico. The resulting discussion will provide new empirical and theoretical insights on the determinants of cognitive aging for this population. It will also inform debates and aid in implementing innovative strategies and solutions to mitigate risk for impairment and improve dementia care for older Latinos.

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Physical activity and cognitive function in older persons

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2016/8 ◽

2016 ◽

Vol 64 (2) ◽

Keyword(s):

Physical Activity ◽

Cognitive Impairment ◽

Cognitive Function ◽

Executive Functions ◽

Cognitive Aging ◽

Clinical Studies ◽

Older Persons ◽

Positive Effects ◽

Critical Challenge

Strategies to improve cognitive aging are highly needed. Among those, promotion of exercise and physical activity appears as one of the most attractive and beneficial intervention. Indeed, results from basic and clinical studies suggest that exercise and physical activity have positive effects on cognition in older persons without cognitive impairment, as well as in those with dementia. Despite inconsistent results, aerobic exercise appears to have the strongest potential to enhance cognition. However, even limited periods of walking (45 minutes, three times a week, over a 6-month period) have also been shown to enhance cognition, particularly executive functions. Changing long-term lifestyle habits in these older persons remains a critical challenge and attractive programs susceptible to gain adherence are needed to succeed in achieving improved cognitive aging.

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Intradialytic Cerebral Hypoperfusion as Mechanism for Cognitive Impairment in Patients on Hemodialysis

Journal of the American Society of Nephrology ◽

10.1681/asn.2019050461 ◽

2019 ◽

Vol 30 (11) ◽

pp. 2052-2058 ◽

Cited By ~ 7

Author(s):

Dawn F. Wolfgram

Keyword(s):

Cognitive Impairment ◽

Cerebral Perfusion ◽

Ischemic Injury ◽

Hemodialysis Patients ◽

Cognitive Outcomes ◽

Cerebral Injury ◽

Cerebral Hypoperfusion ◽

Increased Risk ◽

Cerebral Ischemic Injury ◽

Cerebral Ischemic

The high frequency of cognitive impairment in individuals on hemodialysis is well characterized. In-center hemodialysis patients are disproportionately affected by cognitive impairment compared with other dialysis populations, identifying hemodialysis itself as a possible factor. The pathophysiology of cognitive impairment has multiple components, but vascular-mediated cerebral injury appears to contribute based on studies demonstrating increased cerebral ischemic lesions and atrophy in brain imaging of patients on hemodialysis. Patients on hemodialysis may be at increased risk for cerebral ischemic injury disease due to vasculopathy associated with ESKD and from their comorbid diseases, such as hypertension and diabetes. This review focuses on the intradialytic cerebral hypoperfusion that can occur during routine hemodialysis due to the circulatory stress of hemodialysis. This includes a review of current methods used to monitor intradialytic cerebral perfusion and the structural and functional cognitive outcomes that have been associated with changes in intradialytic cerebral perfusion. Monitoring of intradialytic cerebral perfusion may become clinically relevant as nephrologists try to avoid the cognitive complications seen with hemodialysis. Identifying the appropriate methods to assess risk for cerebral ischemic injury and the relationship of intradialytic cerebral hypoperfusion to cognitive outcomes will help inform the decision to use intradialytic cerebral perfusion monitoring in the clinical setting as part of a strategy to prevent cognitive decline.

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EEG Measures of Value-Directed Strategic Processing in Older Adults With and Without Mild Cognitive Impairment

Innovation in Aging ◽

10.1093/geroni/igaa057.937 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 292-293

Author(s):

Lydia Nguyen ◽

Shraddha Shende ◽

Daniel Llano ◽

Raksha Mudar

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Aging ◽

Spectral Power ◽

Group Differences ◽

Cognitive Resources ◽

Alpha Power ◽

Strategic Processing ◽

Unique Word

Abstract Value-directed strategic processing is important for daily functioning. It allows selective processing of important information and inhibition of irrelevant information. This ability is relatively preserved in normal cognitive aging, but it is unclear if mild cognitive impairment (MCI) affects strategic processing and its underlying neurophysiological mechanisms. The current study examined behavioral and EEG spectral power differences between 16 cognitively normal older adults (CNOA; mean age: 74.5 ± 4.0 years) and 16 individuals with MCI (mean age: 77.1 ± 4.3 years) linked to a value-directed strategic processing task. The task used five unique word lists where words were assigned high- or low-value based on letter case and were presented sequentially while EEG was recorded. Participants were instructed to recall as many words as possible after each list to maximize their score. Results revealed no group differences in recall of low-value words, but individuals with MCI recalled significantly fewer high-value words and total number of words relative to CNOA. Group differences were observed in theta and alpha bands for low-value words, with greater synchronized theta power for CNOA than MCI and greater desynchronized alpha power for MCI than CNOA. Collectively, these findings demonstrate that more effortful neural processing of low-value words in the MCI group, relative to the CNOA group, allowed them to match their behavioral performance to the CNOA group. Individuals with MCI appear to utilize more cognitive resources to inhibit low-value information and might show memory-related benefits if taught strategies to focus on high-value information processing.

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Preliminary Results of MyCog, a Brief Assessment for the Detection of Cognitive Impairment in Primary Care

Innovation in Aging ◽

10.1093/geroni/igaa057.833 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 259-260

Author(s):

Laura Curtis ◽

Lauren Opsasnick ◽

Julia Yoshino Benavente ◽

Cindy Nowinski ◽

Rachel O’Conor ◽

...

Keyword(s):

Primary Care ◽

Cognitive Impairment ◽

Cognitive Aging ◽

False Positive ◽

False Positive Rate ◽

False Negative ◽

False Negative Rate ◽

Self Report ◽

Card Sorting ◽

Primary Care Settings

Abstract Early detection of Cognitive impairment (CI) is imperative to identify potentially treatable underlying conditions or provide supportive services when due to progressive conditions such as Alzheimer’s Disease. While primary care settings are ideal for identifying CI, it frequently goes undetected. We developed ‘MyCog’, a brief technology-enabled, 2-step assessment to detect CI and dementia in primary care settings. We piloted MyCog in 80 participants 65 and older recruited from an ongoing cognitive aging study. Cases were identified either by a documented diagnosis of dementia or mild cognitive impairment (MCI) or based on a comprehensive cognitive battery. Administered via an iPad, Step 1 consists of a single self-report item indicating concern about memory or other thinking problems and Step 2 includes two cognitive assessments from the NIH Toolbox: Picture Sequence Memory (PSM) and Dimensional Change Card Sorting (DCCS). 39%(31/80) participants were considered cognitively impaired. Those who expressed concern in Step 1 (n=52, 66%) resulted in a 37% false positive and 3% false negative rate. With the addition of the PSM and DCCS assessments in Step 2, the paradigm demonstrated 91% sensitivity, 75% specificity and an area under the ROC curve (AUC)=0.82. Steps 1 and 2 had an average administration time of <7 minutes. We continue to optimize MyCog by 1) examining additional items for Step 1 to reduce the false positive rate and 2) creating a self-administered version to optimize use in clinical settings. With further validation, MyCog offers a practical, scalable paradigm for the routine detection of cognitive impairment and dementia.

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Social and Behavioral Factors, Oral Health, and Dental Care Utilization

Innovation in Aging ◽

10.1093/geroni/igaa057.2899 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 799-800

Author(s):

Bei Wu ◽

Stephen Shuman ◽

Elisa Ghezzi

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Oral Health ◽

Health Outcomes ◽

Dental Care ◽

Care Utilization ◽

Behavioral Factors ◽

Dental Care Utilization ◽

The Impact ◽

The U.S

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

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Syncope, cerebral perfusion, and oxygenation

Journal of Applied Physiology ◽

10.1152/japplphysiol.00260.2002 ◽

2003 ◽

Vol 94 (3) ◽

pp. 833-848 ◽

Cited By ~ 240

Author(s):

Johannes J. Van Lieshout ◽

Wouter Wieling ◽

John M. Karemaker ◽

Niels H. Secher

Keyword(s):

Cardiac Output ◽

Cerebral Perfusion ◽

Near Infrared ◽

Vasovagal Syncope ◽

Low Frequencies ◽

Healthy Humans ◽

Standing Up ◽

Arterial Inflow ◽

Cerebral Blood Velocity ◽

Critical Reduction

During standing, both the position of the cerebral circulation and the reductions in mean arterial pressure (MAP) and cardiac output challenge cerebral autoregulatory (CA) mechanisms. Syncope is most often associated with the upright position and can be provoked by any condition that jeopardizes cerebral blood flow (CBF) and regional cerebral tissue oxygenation (cO2Hb). Reflex (vasovagal) responses, cardiac arrhythmias, and autonomic failure are common causes. An important defense against a critical reduction in the central blood volume is that of muscle activity (“the muscle pump”), and if it is not applied even normal humans faint. Continuous tracking of CBF by transcranial Doppler-determined cerebral blood velocity ( Vmean) and near-infrared spectroscopy-determined cO2Hb contribute to understanding the cerebrovascular adjustments to postural stress; e.g., MAP does not necessarily reflect the cerebrovascular phenomena associated with (pre)syncope. CA may be interpreted as a frequency-dependent phenomenon with attenuated transfer of oscillations in MAP to Vmeanat low frequencies. The clinical implication is that CA does not respond to rapid changes in MAP; e.g., there is a transient fall in Vmeanon standing up and therefore a feeling of lightheadedness that even healthy humans sometimes experience. In subjects with recurrent vasovagal syncope, dynamic CA seems not different from that of healthy controls even during the last minutes before the syncope. Redistribution of cardiac output may affect cerebral perfusion by increased cerebral vascular resistance, supporting the view that cerebral perfusion depends on arterial inflow pressure provided that there is a sufficient cardiac output.

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A brain stress test: Cerebral perfusion during memory encoding in mild cognitive impairment

NeuroImage Clinical ◽

10.1016/j.nicl.2016.03.002 ◽

2016 ◽

Vol 11 ◽

pp. 388-397 ◽

Cited By ~ 17

Author(s):

Long Xie ◽

Sudipto Dolui ◽

Sandhitsu R. Das ◽

Grace E. Stockbower ◽

Molly Daffner ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cerebral Perfusion ◽

Stress Test ◽

Memory Encoding

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Infant fatality patterns in shared sleep: keys to intervention strategies?

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181321651174 ◽

2021 ◽

Vol 65 (1) ◽

pp. 1322-1326

Author(s):

Dorothy Ann Drago ◽

Carol Pollack-Nelson ◽

Sarah Beth Newens

Keyword(s):

Cause Of Death ◽

Potential Risk ◽

Intervention Strategies ◽

Consumer Product Safety Commission ◽

Time Period ◽

Reduction Strategies ◽

Sleep Environment ◽

Risk Reduction Strategies ◽

The U.S ◽

Age And Sex

This study examines infant fatalities that occurred while sharing a sleep surface. Fatality data reported to the U.S. Consumer Product Safety Commission (CPSC) during the time period January, 2013 through December, 2017 and involving infants through age 10 months were reviewed. 1,587 Cases were analyzed on the following variables: infant age and sex; sleep environment by product; cause of death; fatality pattern; and breastfeeding, where it was mentioned. 97% Of deaths were due to some form of asphyxia. Adult beds were associated with 78% of shared sleep fatalities, and the primary fatality pattern was overlay (35.4%)/probable overlay (8.8%). Infants <3 months made up 65% of fatalities. The data reflect that bedsharing continues, despite AAP guidelines to the contrary, and that overlay is the primary hazard pattern to be addressed. This paper discusses potential risk reduction strategies that may reduce the potential for overlay fatalities.

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