Effect of food insecurity on the cognitive problems among elderly in India

Background Food Insecurity (FI) is a crucial social determinant of health, independent of other socioeconomic factors, as inadequate food resources create a threat to physical and mental health especially among older person. The present study explores the associations between FI and cognitive ability among the aged population in India. Methods To measure the cognitive functioning we have used two proxies, word recall and computational problem. Descriptive analysis and multivariable logistic regression was used to understand the prevalence of word recall and computational problem by food security and some selected sociodemographic parameters. All the results were reported at 95% confidence interval. Results We have used the data from the first wave of longitudinal ageing study of India (LASI), with a sample of 31,464 older persons 60 years and above. The study identified that 17 and 5% of the older population in India experiencing computational and word recall problem, respectively. It was found that respondents from food secure households were 14% less likely to have word recall problems [AOR:0.86, 95% CI:0.31–0.98], and 55% likely to have computational problems [AOR:0.45, 95% CI:0.29–0.70]. We also found poor cognitive functioning among those experiencing disability, severe ADL, and IADL. Further, factors such as age, education, marital status, working status, health related factors were the major contributors to the cognitive functioning in older adults. Conclusion This study suggest that food insecurity is associated with a lower level of cognition among the elderly in India, which highlight the need of food policy and interventional strategies to address food insecurity, especially among the individuals belonging to lower wealth quintiles. Furthermore, increasing the coverage of food distribution may also help to decrease the burden of disease for the at most risk population. Also, there is a need for specific programs and policies that improve the availability of nutritious food among elderly.

Sense of Purpose in Life Promotes Resilience to Memory Deficits Related to Depressive Symptomatology

Individuals higher in depressive symptoms commonly present with neuropsychological deficits including poorer memory performance. Sense of purpose in life, a component of psychological well-being, has been shown to promote resilience to cognitive impairment in older adulthood, but it is unclear whether it may also protect against cognitive deficits associated with higher depressive symptoms. This study examined whether purpose in life moderated the effect of depressive symptoms on cognitive functioning in a large longitudinal study of 4599 American older adults (Mage = 74.33 years, range = 65–104 years, 56.84% female) across a 12-year follow-up period. Depressive symptomatology was assessed at each wave using the 8-item Center for Epidemiologic Studies Depression Scale. Multilevel models assessed the influence of depressive symptoms and the interaction with sense of purpose in life on changes in word recall and mental status. Higher depressive symptoms were associated with poorer recall at baseline, but not rate of change over time. A negative interaction was observed between sense of purpose in life and depressive symptoms such that individuals higher in purpose experienced a less negative impact of depressive symptoms on word recall. No significant interaction of sense of purpose and depressive symptoms was observed on mental status. Having a sense of purpose in life may help protect older adults from memory deficits associated with higher depressive symptoms. The present findings underscore the potential for sense of purpose to promote cognitive reserve in older adulthood, allowing individuals to maintain cognitive performance in the face of accruing neuropsychological challenges.

WLS-ILIAD: New Longitudinal Resource for Cognitive and Dementia Data

One of the distinctive strengths of WLS is the availability of Henmon-Nelson IQ scores on all participants while in high school, followed by prospective collection of data through cognitive batteries of varying size and sophistication. Launched in 1993, the initial longitudinal cognitive testing included 8 abstract reasoning items followed by the administration of larger cognitive batteries in 2004 and 2011 comprised of a 10-item word recall test, digit ordering task, phonemic and category fluency, as well as repeated and new items from the WAIS-R similarities task first administered in the 1993 survey. In 2018, with R01 funding from NIA, the scope of cognitive testing expanded significantly and includes administration of a phone-based cognitive screening measure, and a comprehensive in-person neuropsychological assessment for individuals identified at risk for dementia targeting a range of cognitive domains, including memory, language, attention, visuospatial abilities, and executive functioning.

Telephone-Based Word List Recall and Hearing Ability

Certain consonant sounds called fricatives (e.g, “s” and “f”) are difficult to hear over the telephone; phones exclude high-frequency sounds that affect their intelligibility. This may be problematic for older adults responding to phone-based memory tests. Many older adults have some degree of hearing loss, and older men have it more in the high-frequency range. Hearing loss, in combination with phone bandwidth restrictions, may reduce older adults’ recall of fricative words. Participants (n=3,612, mean age=64.2, 60% women) in the 1998 wave of the Health and Retirement study (HRS) completed a word list immediate recall task over the phone. List 4 recall was examined because it was evenly split (5 each) between words with and without fricative consonant sounds. Subjective ratings of hearing and health, age, depression, and education were also measured. A Wilcoxon signed-rank test showed participants recalled fewer fricative (M=2.8) than nonfricative (M=3.0) words, Z=-8.47, p<.001. An ordinal regression for fricative word recall indicated a sex by hearing interaction; males with worse hearing were less likely to recall more fricative words, OR=.94, 95% CI [.88, 1.01], p=.076, after controlling for age, education, health, and depression. An ordinal regression for nonfricative word recall did not show a main effect for hearing or a hearing by sex interaction. For both models, age, education, and health were related to recall. Consonant sounds may influence phone-based word recall, particularly for older men. Attention should be paid to word selection when designing phone-based cognitive tests in order to avoid memory impairment overestimation.

Sleep Quality and Cognitive Decline: A Cross-Country Comparison Between England and China

Too little or too much sleep is associated with accelerated cognitive decline in older adults. However, sleep duration does not capture other sleep problems prevalent in older adults, such as difficulties with falling or staying asleep. Less is known about the impact of sleep quality on cognitive ageing, and if this relationship differs between England and China. Therefore, the aim of this study is to examine the relationship of self-reported sleep quality with cognitive performance and rate of change over 6-7 years follow-up in two nationally-representative samples of English and Chinese older adults. The primary outcome was a memory score (range 0-20), which was assessed using immediate and delayed 10-word recall tests in both cohorts. The results of bivariate descriptive analyses at baseline suggest there may be an inverted U-shaped association between sleep quality and memory in English older adults, and a positive dose-response association in Chinese older adults.

Low Cognitive Performance Increases The Risk Of Hospital-Associated Complications In Older Adults

Considering the limited evidence regarding the factors that contribute to long-term consequences after hospitalization of older people, we analysed the relationship between cognitive performance and hospital-associated complications (HAC). One thousand, three hundred Individuals aged 60 and older (mean age 82.3, 53.3% female), not assigned to palliative care and admitted in medical and surgical wards from a private hospital, were followed up from admission to 30 days after discharge. HAS was evaluated using a multicomponent measure that combines 12 hospital-associated complications (delirium, functional decline, falls, pressure injuries, bronchoaspiration, non-planned ICU transfer, physical restraints, hospital stay > 30 days, death, long-term care transfer, and readmission). Cognitive performance was assessed using the "10-point cognitive screener (10-CS)", which combines temporal orientation, category fluency, and word recall evaluation. Results Overall, 464 (35.7%) participants had one or more HAC during their admission. Patients with HAC showed lower 10-CS scores than those with in HAC (p <0.001). Adjusting for sociodemographic data, medication, chronic diseases, delirium screening, functional performance, each 10-CS point decreased the HAC changes by 19.2% (odds ratio = 0.808; 95% CI = 0.660 – 0.990). Conclusion These findings show that low cognitive performance was significantly associated with the risk of developing HAC during hospitalization and within 30 days after discharge. That evidence forms the critical foundation for the next steps towards validating the accuracy of these models in predicting vulnerability to HAC and developing screening tools to be used at the point of care.

Caregiver Burden Is Associated With Dementia Patient Cognitive Performance in NHATS

Informal caregivers of dementia patients engage in multicomponent care that is often stressful. In heart failure patients, caregiver burden has been associated with occurrence of cardiovascular events. However, little is known about how caregiver burden affects patient cognition in dementia care dyads. Using data from the National Health and Aging Trends Study and National Study of Caregiving, we examined the association between caregiver burden, assessed on 38 aspects of caring, and patient cognition, assessed with the immediate and delay word recall, Clock Drawing, and self-rated memory. In fully adjusted models at round 7 (2017) higher caregiver burden was cross-sectionally associated with lower immediate (B=-0.02, 95% CI -0.03, -0.01) and delayed (B=-0.03, 95% CI -0.04, -0.02) word recall. Longitudinally, across rounds 7-9 (2017-2019) higher burden was associated with lower patient Clock Draw score (B=-0.01, 95% CI -0.03, -0.001). These findings have implications for economic assistance and interventions in dementia care dyad.

Effects of exploring a novel environment on memory across the lifespan

Exploration is a crucial aspect of mammalian behavior, and new environments provide unique opportunities to learn. Exploration of a novel environment has been shown to promote memory formation in healthy adults, even for unrelated events. Studies in animals have suggested that such novelty-induced memory boosts are mediated by hippocampal dopamine. The dopaminergic system is known to develop and deteriorate over the lifespan, but so far, the effects of novelty on memory across the lifespan have not yet been investigated. In the current study, we used novel and previously familiarized virtual environments to pinpoint the effects of spatial novelty on declarative memory in humans across the lifespan. After exploring a novel or familiar environment, participants were presented a list of words, and either performed a semantic task (deep encoding) or judged whether the first letter of the shown word was open or closed (shallow encoding). Incidental memory was quantified in a surprise test. Our sample (n = 439) included children, adolescents, younger adults, and older adults. Results showed that participants in the deep encoding condition remembered more words than those in the shallow condition, but novelty did not influence this effect. Interestingly, however, children, adolescents and younger adults benefitted from exploring a novel compared to a familiar environment as evidenced by better word recall, while these effects were absent in older adults. Our findings suggest that the beneficial effects of novelty on memory follow the deterioration of pathways in the brain involved in novelty-related processing across the lifespan.

Type 2 diabetes and cognitive functions in patients with chronic cerebrovascular diseases

Background. Type 2 diabetes (Т2DM) both directly and indirectly impacts the development of morphological and functional changes of the central nervous system. Aim. The study was to determine clinical and neurophysiological patterns of cognitive impairment (CI) in patients with chronic cerebrovascular diseases (CCD) and Т2DM. Materials and methods. We examined 132 patients with CCD. First group included 58 patients without Т2DM aged 64.5 [58; 72], second group 74 patients with CCD and Т2DM 63 [57; 70]. Clinical, neurological, neuropsychological, neurophysiological (cognitive evoked potentials (EP) and neurovisualisation (brain MRI) examination was carried out to all patients. Results. Somatic and neurological characteristics of the patients were similar in both groups with the exception of more distinct metabolic changes in Т2DM patients. Neurovisualisation study of the brain MRI in Т2DM patients revealed more distinct changes in the form of white matter hyperintensity and subarachnoidal spaces enlargement. Neuropsychological examination in patients revealed the reduction of intellectual flexibility, constructive praxis disruption, optical spatial dysfunction and deteoration of delayed word recall. Significant disorders in the way of overall cognitive impairment, lobar dysfunction and impaired verbal associative productivity, proved by statistically lower amplitude and higher latency of P300 EP peak were noted in Т2DM patients. Correlation links were detected: for P300 amplitude and direct and inverse number listing test (r=0.366 and r=0.520; p=0.006 and p0.001 respectively); P300 latency and HbA1c (r=0.32; р0.05) in group 2 and glucose levels in both groups (r=0.30; p0.05); inverse relationship of latency with control functions evaluation (r=-0.34; p=0.008). Conclusion. CCD especially with Т2DM manifests with neurocognitive imbalance, including control functions disruption and are accompanied by neurophysiological and neurovisualistion changes.

Effect of Food Insecurity On The Cognitive Problems Among Elderly In India

Background: Food Insecurity (FI) is a crucial social determinant of health, independent of other socioeconomic factors, as inadequate food resources create a threat to physical and mental health especially among older person. The present study explores the associations between FI and cognitive ability among the aged population in India. Methods: We have used the data from the first wave of longitudinal ageing study of India (LASI), with a sample of 31,464 older persons 60 years and above. To measure the cognitive functioning we have used two proxies, word recall and computational problem. Descriptive analysis and multivariable logistic regression was used to understand the prevalence of word recall and computational problem by food security and some selected sociodemographic parameters. All the results were reported at 95% confidence interval. Results: The study identified that 17% and 5% of the older population in India experiencing computational and word recall problem, respectively. It was found that respondents from food secure households were 14 percent less likely to have word recall problems [AOR:0.86, 95% CI:0.31-0.98], and 55 percent likely to have computational problems [AOR:0.45, 95% CI:0.29-0.70]. We also found poor cognitive functioning among those experiencing disability, severe ADL, and IADL. Further, factors such as age, education, marital status, working status, health related factors were the major contributors to the cognitive functioning in older adults. Conclusion: This study suggest that food insecurity is associated with a lower level of cognition among the elderly in India, which highlight the need of food policy and interventional strategies to address food insecurity, especially among the individuals belonging to lower wealth quintiles. Furthermore, increasing the coverage of food distribution may also help to decrease the burden of disease for the at most risk population. Also, there is a need for specific programs and policies that improve the availability of nutritious food among elderly.