1062Effectiveness of recruitment and retention strategies in a population based prospective LoCARPoN AIIMS cohort study

Background In Indian population, recruitment and retention of elderly population for any study is challenging due to different demographic variations and ageing effects. In LoCARPoN (Longitudinal Cognition and Aging Research in the Population of National Capital Region) Cohort study which is first study in India to identify the risk factors for stroke or major cognitive disorders among elderly different multiple strategies were adopted for recruitment and retention of healthy participants aged 50 years and above . Methods The study was conducted in urban population in Delhi, India. The strategies adopted for recruitment and retention of participants for 3 years including follow up is done by following multiple principles viz, participants centric, resource management, system functionality, approachable facilities and other reinforcement tactics. Results Among 18294 households, 9817 households were found to be eligible to participate in the study. Out of that 7383 houses were approachable others refused (2434) at first stage. By following the strategies which incorporates participants’ satisfaction, efficient system functionality and reliable information a total of 12250 eligible participants in 7383 houses were contacted, out of them 8858 (72.3%) were consented to visit medical sites . Out of he Consented individuals 7505 (61.3 %) visited medical site. Conclusions The multiple strategies used were very effective for recruitment and retention of cohort participants Key messages Multiple strategies concerning study participants needs flexible and approachable techniques helps in recruitment and retention in any longitudinal cohort studies.

Cross-sectional association between objective cognitive performance and perceived age-related gains and losses in cognition

ABSTRACT Objectives: Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training. Design: Cross-sectional observational study. Participants: The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age. Measurements: We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH). Results: Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training. Conclusions: Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables – alongside psychological variables – related to perceived cognitive losses.

Mitochondrial Functioning and the Relations among Health, Cognition, and Aging: Where Cell Biology Meets Cognitive Science

Cognitive scientists have determined that there is a set of mechanisms common to all sensory, perceptual, and cognitive abilities and correlated with age- and disease-related declines in cognition. These mechanisms also contribute to the development and functional coherence of the large-scale brain networks that support complex forms of cognition. At the same time, these brain and cognitive patterns are correlated with myriad health outcomes, indicating that at least some of the underlying mechanisms are common to all biological systems. Mitochondrial functions, including cellular energy production and control of oxidative stress, among others, are well situated to explain the relations among the brain, cognition, and health. Here, I provide an overview of the relations among cognitive abilities, associated brain networks, and the importance of mitochondrial energy production for their functioning. These are then linked to the relations between cognition, health, and aging. The discussion closes with implications for better integrating research in cognitive science and cell biology in the context of developing more sensitive measures of age- and disease-related declines in cognition.

EFFICACY OF COGNITIVE TRAINING FOCUSED ON DIFFERENT MEMORY SUBSYSTEMS FOR COMMUNITY DWELLING ELDERLY INDIVIDUALS

Background: With the aging process, some memory subsystems as the episodic and working memory change. Cognitive training has been suggested for prevention of cognitive decline but previous studies have conflicting results. Objective: To verify the efficacy of two types of multidimensional cognitive training programs, one focusing on internal strategies to boost episodic memory (EMT) and another based on activities targeting speed processing and working memory (WMT). Methods: One hundred thirty six community dwelling older adults (aged 60 or over and living independently) took part in the study, 76 undertook EMT, 30 undertook WMT and 30 participated in a control program that focused on autobiographical memory (AMT). Training occurred during 8 weekly group sessions of 1,5h. All groups participated in lectures about cognition and aging during the training. They received activities to practice at home. A neuropsychological battery was applied before and after the interventions. Results: ANOVA of repeated measures pointed to significant higher scores in global cognition (ACER), their memory subtest, and in recall score of categorized noun pictures. The interaction showed that the episodic group improved more than the others in the recall of pictures (interaction between group and task p <0,01). Conclusion: The results demonstrated immediate gains after training in specific episodic memory trained skills.

Cognitive Decline and Financial Well-Being: Evidence From the Cognitive Economics Study

Maintaining financial well-being is important for older adults, as they are generally decumulating wealth at this stage of life. We use survey data from the Cognitive Economics Study (CogEcon, 2008-2017) and Cognition and Aging in the USA Study (CogUSA, 2007-2014) to investigate the impact of cognitive decline on financial well-being of older adults in the United States. In our sample (N = 976), with an average starting age of 65 years old, we use linear regression, then add results including a control function approach to correct our estimates for sample selection and attrition. In particular, those who have poor health outcomes (including death) disproportionately attrit from the study and may bias the results of a naïve regression. The naïve regression results yield no relationship between cognition and financial well-being; however, after controlling for attrition, we find that a decline in crystallized intelligence is associated with a decrease in financial well-being, and changes in fluid intelligence are not associated with changes in financial well-being.

Health considerations for transgender women and remaining unknowns: a narrative review

Transgender (trans) women (TW) were assigned male at birth but have a female gender identity or gender expression. The literature on management and health outcomes of TW has grown recently with more publication of research. This has coincided with increasing awareness of gender diversity as communities around the world identify and address health disparities among trans people. In this narrative review, we aim to comprehensively summarize health considerations for TW and identify TW-related research areas that will provide answers to remaining unknowns surrounding TW’s health. We cover up-to-date information on: (1) feminizing gender-affirming hormone therapy (GAHT); (2) benefits associated with GAHT, particularly quality of life, mental health, breast development and bone health; (3) potential risks associated with GAHT, including cardiovascular disease and infertility; and (4) other health considerations like HIV/AIDS, breast cancer, other tumours, voice therapy, dermatology, the brain and cognition, and aging. Although equally deserving of mention, feminizing gender-affirming surgery, paediatric and adolescent populations, and gender nonbinary individuals are beyond the scope of this review. While much of the data we discuss come from Europe, the creation of a United States transgender cohort has already contributed important retrospective data that are also summarized here. Much remains to be determined regarding health considerations for TW. Patients and providers will benefit from larger and longer prospective studies involving TW, particularly regarding the effects of aging, race and ethnicity, type of hormonal treatment (e.g. different oestrogens, anti-androgens) and routes of administration (e.g. oral, parenteral, transdermal) on all the topics we address.