Normal cognitive aging

Sex-specific decline in prefrontal cortex mitochondrial bioenergetics in aging baboons correlates with walking speed

Mitochondria play a crucial role in brain homeostasis and changes in mitochondrial bioenergetics are linked to age-related neurodegenerative diseases, including Alzheimer's disease and Parkinson's disease. We investigated changes in the activities of the electron transport chain (ETC) complexes in normally aging baboon brains and determined how these changes relate to donor sex, morning cortisol levels, and walking speed. We assessed mitochondrial bioenergetics from archived prefrontal cortex (PFC) tissues from a large cohort (60 individuals) of well-characterized aging baboons (6.6-22.8 years, approximately equivalent to 26.4-91.2 human years). Aging was associated with a decline in mitochondrial ETC complexes in the PFC, which was more pronounced when normalized for citrate synthase activity, suggesting that the decline is predominantly driven by changes in the specific activity of individual complexes rather than global changes in mitochondrial content. When donor sex was used as a covariate, we found that ETC activity was preserved with age in females and declined in males. Males had higher activities of each individual ETC complex and greater lactate dehydrogenase activity at a given age relative to females. Circulating cortisol negatively correlated with walking speed when male and female data were combined. We also observed a robust positive predictive relationship between walking speed and respiration linked to complexes I, III, and IV in males but not in females. This data reveals a link between frailty and PFC bioenergetic function and highlights a potential molecular mechanism for sexual dimorphism in brain resilience.

Water intake, hydration status and cognitive functions in older adults - a pilot study

PURPOSE

This study aimed to assess the relationship between the hydration status and cognitive functioning of older adults. The novelty of the study was the simultaneous use of several indicators of hydration status, including plasma and urine osmolality, specific gravity and urine color, as well as the assessment of total body water content from body composition measurements, together with comprehensive cognitive assessment.

METHODS

A cross-sectional pilot study included 35 participants aged ≥ 60 years. Water intake was assessed using the 3-day food record method. Hydration status was assessed by plasma osmolality (Posm), urine osmolality (Uosm), specific gravity (USG) and color (UC), extracellular water (ECW) and percentage of total body water (%TBW). Cognitive functions were assessed using a set of standardized neuropsychological tests including: two verbal tests (Digit Span, DS and Vocabulary, VT) from the Wechsler Adult Intelligence Scale, California Verbal Learning Test (CVLT), Verbal Fluency Test (VFT), Grooved Pegboard Test (GPT) and Global Cognitive Function (GCF).

RESULTS

The %TBW was the most strongly related to cognitive processes of all the measures of hydration status. %TBW was significantly related to the performance on memory/learning based on CVLT (r = -0.55, p = 0.002), after a short delay (r = -0.59, p = 0.001) and long delay (r = -0.57, p = 0.001) and GCF (r = -0.43, p = 0.019). Marked correlations were also present between %TBW and psychomotor speed using the GPT (r = 0.41, p = 0.028). Moreover, significant relationships were obtained in cluster analyses. Cluster 2 (lower hydration status) was characterized by lower water intake and AI% (% of Adequate Intake), higher Uosm, USG, UC, ECW and %TBC than cluster 1. At the same time, it had significantly higher scores for language ability: VT (p = 0.041) and VFT (p = 0.041).

CONCLUSION

Significant relationships between some indicators of hydration status and selected cognitive domains were observed. This pilot study complements previous research on the relationship between hydration status and cognitive function in older adults, emphasizing that even small changes in hydration status assessment parameters can affect cognitive outcomes. In healthy, free-living older adults without dehydration assessed by plasma osmolality, other parameters of hydration status, such as water intake and urine parameters, influence language functions, suggesting the need to assess multiple markers simultaneously. The long-term effect of low water intake should be evaluated in a larger study group.

Characterizing the heterogeneity of neurodegenerative diseases through EEG normative modeling

Neurodegenerative diseases like Parkinson's (PD) and Alzheimer's (AD) exhibit considerable heterogeneity of functional brain features within patients, complicating diagnosis and treatment. Here, we use electroencephalography (EEG) and normative modeling to investigate neurophysiological mechanisms underpinning this heterogeneity. Resting-state EEG data from 14 clinical units included healthy adults (n = 499) and patients with PD (n = 237) and AD (n = 197), aged over 40. Spectral and source connectivity analyses provided features for normative modeling, revealing significant, frequency-dependent EEG deviations with high heterogeneity in PD and AD. Around 30% of patients exhibited spectral deviations, while ~80% showed functional source connectivity deviations. Notably, the spatial overlap of deviant features did not exceed 60% for spectral and 25% for connectivity analysis. Furthermore, patient-specific deviations correlated with clinical measures, with greater deviations linked to worse UPDRS for PD (⍴ = 0.24, p = 0.025) and MMSE for AD (⍴ = -0.26, p = 0.01). These results suggest that EEG deviations could enrich individualized clinical assessment in Precision Neurology.

Which cognitive tests are used to examine the acute effect of physical activity on cognition in healthy adults aged 50 and older? - A systematic review

OBJECTIVES

The review aims to create an overview of current evidence on the acute effect of physical activity (PA) on cognition in adults aged 50 and older, focusing on which cognitive (sub)domains, cognitive tests, and outcomes are used, and whether effects were demonstrated.

METHODS

The MEDLINE, Embase, and Cochrane Central databases were searched for articles assessing the acute effect of PA on cognition in healthy adults aged 50 and older.

RESULTS

Forty-two articles were included, using a variety of protocols. Executive functioning was the most frequently assessed cognitive domain. Overall, thirty-five different cognitive tests were administered, among which many variations and modifications were found. Furthermore, the reported outcomes varied greatly, even when using the same test. Across tests, 45.3% of the reported outcomes demonstrated an improvement in cognition shortly after PA. Time-based outcomes demonstrated an improvement more often than accuracy-based outcomes. However, because of the large variety among protocols and often insufficiently nuanced reporting, results should be interpreted carefully.

CONCLUSIONS

The acute effect of PA on executive functioning in older adults has been examined frequently, but research in other cognitive domains is limited. The variety among study protocols and test outcomes highlights the need for more rigorous research and reporting.

The Influence of Semantic Context on the Intelligibility Benefit From Speech Glimpses in Younger and Older Adults

PURPOSE

Speech is often masked by background sound that fluctuates over time. Fluctuations in masker intensity can reveal glimpses of speech that support speech intelligibility, but older adults have frequently been shown to benefit less from speech glimpses than younger adults when listening to sentences. Recent work, however, suggests that older adults may leverage speech glimpses as much, or more, when listening to naturalistic stories, potentially because of the availability of semantic context in stories. The current study directly investigated whether semantic context helps older adults benefit from speech glimpses released by a fluctuating (modulated) masker more than younger adults.

METHOD

In two experiments, we reduced and extended semantic information of sentence stimuli in modulated and unmodulated speech maskers for younger and older adults. Speech intelligibility was assessed.

RESULTS

We found that semantic context improves speech intelligibility in both younger and older adults. Both age groups also exhibit better speech intelligibility for a modulated than an unmodulated (stationary) masker, but the benefit from the speech glimpses was reduced in older compared to younger adults. Semantic context amplified the benefit gained from the speech glimpses, but there was no indication that the amplification by the semantic context led to a greater benefit in older adults. If anything, younger adults benefitted more.

CONCLUSIONS

The current results suggest that the deficit in the masking-release benefit in older adults generalizes to situations in which extended speech context is available. That previous research found a greater benefit in older than younger adults during story listening may suggest that other factors, such as thematic knowledge, motivation, or cognition, may amplify the benefit from speech glimpses under naturalistic listening conditions.

Healthy aging delays and dedifferentiates high-level visual representations

Healthy aging impacts visual information processing with consequences for subsequent high-level cognition and everyday behavior, but the underlying neural changes in visual representations remain unknown. Here, we investigate the nature of representations underlying object recognition in older compared to younger adults by tracking them in time using electroencephalography (EEG), across space using functional magnetic resonance imaging (fMRI), and by probing their behavioral relevance using similarity judgments. Applying a multivariate analysis framework to combine experimental assessments, four key findings about how brain aging impacts object recognition emerge. First, aging selectively delays the formation of object representations, profoundly changing the chronometry of visual processing. Second, the delay in the formation of object representations emerges in high-level rather than low- and mid-level ventral visual cortex, supporting the theory that brain areas developing last deteriorate first. Third, aging reduces content selectivity in the high-level ventral visual cortex, indicating age-related neural dedifferentiation as the mechanism of representational change. Finally, we demonstrate that the identified representations of the aging brain are behaviorally relevant, ascertaining ecological relevance. Together, our results reveal the impact of healthy aging on the visual brain.

Urinary Incontinence After Prostate Treatment: Special Considerations in Geriatrics

The effects of aging are important in the workup and treatment of incontinence after prostate treatment. While conservative measures should be discussed, geriatric patients can also be offered surgery, as the available treatments are safe and effective in this group. Artificial urinary sphincter implantation is appropriate in those who can operate the device, though they should be followed to ensure they can continue to use the device over time. A suburethral sling can be safe and efficacious in those with milder incontinence and is not affected by mental or physical decline.

Efficacy of cognitive training on executive functions in healthy older adults: a systematic review with meta-analysis of randomized controlled trials

OBJECTIVE

Systematically review randomized controlled trials on the efficacy of cognitive training on executive functions in healthy older people.

MEASURES

The outcome measures were related to inhibitory control, working memory, and cognitive flexibility.

RESULTS

Thirty-one trials were included in the systematic review and thirteen trials in the meta-analysis. In the overall analysis, the cognitive training enhanced inhibitory control when measured by the Stroop task (p < .001, d = 1.64) and working memory when measured by the Corsi Block task (p = .002, d = .16). A marginal significance was found for working memory in the Digit Span task - Forward (p = .06, d = .92). However, cognitive training did not enhance inhibitory control when measured by the Go/No-Go task (p = .76, d = .59), working memory when measured by the Digit Span - Backward (p = .72, d = .95) and N-Back (p = .10, d = .26) tasks, and cognitive flexibility when measured by Trail Making - Part B (p = .08, d = .27) and Semantic Fluency (p = .49, d = .06) tasks.

CONCLUSION

Mixed evidence was found for inhibitory control and working memory; cognitive flexibility showed no evidence of improvement.

Social Leisure Activities and Cognitive Functioning among Married and Unmarried Older Men and Women in Mexico

Using data from Wave 5 (2018) of the Mexican Health and Aging Study, this research examines the implications of six social leisure activities for cognition among married and unmarried men and women in Mexico, while considering their physical health and depressive symptoms. The findings reveal some marital status and gender differences and similarities. This study indicates that church attendance and volunteering might be related to poorer cognition, whereas a training course, club participation, board games, and remote communication can provide cognitive benefits. Despite poor vision, poor hearing, and functional limitations, a training course, board games, and remote communication might be associated with better cognition. Yet, in case of poor hearing and depressive symptoms, volunteering, club participation, and board games might be linked to poorer cognition. The insights from this study can help develop intervention programs for improving later-life cognitive functioning through social leisure participation, particularly among individuals with deteriorating health.

Age moderates associations between dementia worry and subjective cognition

The present study assessed whether dementia worry is associated with adults' subjective cognitive difficulties, and whether any associations are moderated by age. Participants were 477 adults aged 18-90 years. They completed standard, subjective measures of dementia worry and everyday cognitive difficulties (i.e. attention, language, verbal and visual-spatial memory, and visual-perceptual ability). Moderated regression analyses included dementia worry as a predictor of specific cognitive difficulties, and age as a moderator. Covariates included gender, trait cognitive and somatic anxiety, general aging-related anxiety, depression, stress, mental health treatment status, and health status. Greater overall dementia worry, and specifically more frequent dementia worry, were both associated with greater attentional difficulty in middle-aged and older adults, but not in young adults. Cognitions about developing dementia in reaction to memory lapses were also associated with greater cognitive difficulties across the adult lifespan for multiple cognitive domains. Results highlight a robust relationship between dementia worry and subjective attentional difficulties, especially in middle-aged and older adults. Worry frequency is also more influential with adult aging. A cognitive or meta-cognitive mechanism may underlie subjective cognitive concerns across the adult lifespan.

The Cognitive Correlates of Financial Literacy in Older Adults

OBJECTIVES

This study examined the cognitive correlates of financial literacy using a comprehensive neuropsychological battery, and whether education modifies the relationship between cognition and financial literacy.

METHODS

Sixty-six participants completed sociodemographic questionnaires, an assessment of financial literacy, and a neuropsychological assessment. Multiple linear regression models that controlled for age, sex, and education examined the main effects of cognitive measures that showed a significant bivariate association with financial literacy.

RESULTS

After correcting for multiple comparisons, the Crystallized Composite score (p = .002) and the Picture Vocabulary test (p = .002) from the NIH Toolbox, and the Multilingual Naming Test (p > .001) from the Uniform Data Set 3 were associated with financial literacy. Contrary to our hypothesis, education did not interact with cognitive measures when considering financial literacy scores.

CONCLUSIONS

Findings suggest that vocabulary knowledge and semantic memory may play an important role in financial literacy in older age.

CLINICAL IMPLICATIONS

Assessing vocabulary knowledge and semantic processes may help to identify older adults with lower financial literacy skills. Additionally, financial literacy interventions may consider targeting individuals with lower vocabulary knowledge and semantic processing skills.

Drivers and mechanisms of cognitive decline in chronic kidney disease

Cognitive impairment is highly prevalent among individuals with chronic kidney disease (CKD). Despite its high prevalence, the contributing factors and mechanisms underlying brain-kidney dysfunction in CKD remain poorly understood. However, advances in neuroscience, including novel imaging techniques and cognitive assessment methods, have begun to clarify this complex relationship. Several factors contribute directly to cognitive decline in people with CKD, including accumulation of uraemic toxins, microvascular damage, malnutrition, chronic inflammation and disruptions in key neuroprotective pathways, such as those involving Klotho and the glymphatic system. These factors are also linked to the accelerated ageing observed in people with CKD, a key contributor to cognitive decline. However, most studies on cognition in people with CKD have been cross-sectional and associative, offering limited insight into causation. Research advances, such as studies on the effect of uraemic toxins on the blood-brain barrier and the role of the endothelial glycocalyx in vascular damage, offer promising new directions. Emerging data from longitudinal cohort studies are also enhancing our understanding of these processes, with potential implications for both the treatment of CKD-related cognitive decline and the broader issue of cognitive dysfunction in ageing populations. Here, we examine key mechanisms linking CKD to cognitive decline and consider potential therapeutic interventions.

The Impact of Exercise Training on the Brain and Cognition in Type 2 Diabetes, and its Physiological Mediators: A Systematic Review

BACKGROUND

Type 2 diabetes (T2DM) affects brain structure and function, and is associated with an increased risk of dementia and mild cognitive impairment. It is known that exercise training has a beneficial effect on cognition and brain structure and function, at least in healthy people, but the impact of exercise training on these aspects remains to be fully elucidated in patients with T2DM.

OBJECTIVE

To determine the impact of exercise training on cognition and brain structure and function in T2DM, and identify the involved physiological mediators.

METHODS

This paper systematically reviews studies that evaluate the effect of exercise training on cognition in T2DM, and aims to indicate the most beneficial exercise modality for improving or preserving cognition in this patient group. In addition, the possible physiological mediators and targets involved in these improvements are narratively described in the second part of this review. Papers published up until the 14th of January 2025 were searched by means of the electronic databases PubMed, Embase, and Web of Science. Studies directly investigating the effect of any kind of exercise training on the brain or cognition in patients with T2DM, or animal models thereof, were included, with the exception of human studies assessing cognition only at one time point, and studies combining exercise training with other interventions (e.g. dietary changes, cognitive training, etc.). Study quality was assessed by means of the TESTEX tool for human studies, and the CAMARADES tool for animal studies.

RESULTS

For the systematic part of the review, 22 papers were found to be eligible. 18 out of 22 papers (81.8%) showed a significant positive effect of exercise training on cognition in T2DM, of which two studies only showed significant improvements in the minority of the cognitive tests. Four papers (18.2%) could not find a significant effect of exercise on cognition in T2DM. Resistance and endurance exercise were found to be equally effective for achieving cognitive improvement. Machine-based power training is seemingly more effective than resistance training with body weight and elastic bands to reach cognitive improvement. In addition, BDNF, lactate, leptin, adiponectin, GSK3β, GLP-1, the AMPK/SIRT1 pathway, and the PI3K/Akt pathway were identified as plausible mediators directly from studies investigating the effect of exercise training on brain structure and function in T2DM. Via these mediators, exercise training induces multiple beneficial brain changes, such as increased neuroplasticity, increased insulin sensitivity, and decreased inflammation.

CONCLUSION

Overall, exercise training beneficially affects cognition and brain structure and function in T2DM, with resistance and endurance exercise having similar effects. However, there is a need for additional studies, and more methodological consistency between different studies in order to define an exercise program optimal for improving cognition in T2DM. Furthermore, we were able to define several mediators involved in the effect of exercise training on cognition in T2DM, but further research is necessary to unravel the entire process.

Plasma Glial Fibrillary Acidic Protein and Neurofilament Light Are Elevated in Bipolar Depression: Evidence for Neuroprogression and Astrogliosis

BACKGROUND

Recent advances now allow detection of brain-specific proteins in blood, including neurofilament light chain (NfL), a marker of axonal pathology, and glial fibrillary acidic protein (GFAP), indicative of astrocytic activation. Given the evidence of astroglial pathology and neuronal dysfunction in bipolar disorder, and ongoing debates on neuroprogression, we investigated plasma NfL and GFAP levels in affected individuals.

METHODS

This study analysed plasma NfL and GFAP measured in 216 individuals using Simoa. We used bootstrapped general linear models (GLM) to compare plasma NfL and GFAP levels between people with bipolar depression (n = 120) and healthy controls (n = 96), adjusting for age, sex, and weight. We examined associations between these biomarkers and clinical variables while adjusting for multiple comparisons. For sensitivity analyses, predictors were evaluated using Bayesian model averaging (BMA).

RESULTS

Plasma GFAP (β = 0.21 [0.07, 0.35], p = 0.006) and NfL (β = 0.06 [0.01, 0.10], p = 0.028) were elevated in people with bipolar depression. Illness duration was positively associated with NfL (r = 2.97, p = 0.002), and further supported by BMA analysis (posterior inclusion probability, PIP = 0.85). Age of onset was positively associated with GFAP (r = 0.246 p = 0.041), which was also supported by BMA analysis (PIP = 0.67).

CONCLUSIONS

These findings indicate increased plasma NfL and GFAP levels in bipolar disorder. Our findings support the neuroprogression hypothesis, where prolonged illness duration contributes to neuroaxonal damage. Elevated GFAP in those with later onset suggests a role for neuroinflammation, potentially linked to increased cardiovascular and metabolic comorbidities.

Ageing with Traumatic Brain Injury: Long-Term Cognition and Wellbeing

Whether and how traumatic brain injury (TBI) impacts ageing in the decades post-injury remains a matter of debate, partly due to a lack of controlled studies. This study examined the long-term impact of TBI on cognition and wellbeing in middle-aged and older adults and explored the relationship between age, cognition, and wellbeing, compared with a non-TBI control group. Cross-sectional data from 143 participants aged ≥40 with moderate-severe TBI (6-33 years post-injury; mean age 59.64) were compared with 71 non-TBI controls (mean age 62.10) group matched on age, gender, and premorbid IQ. Individuals with significant confounding comorbidities were excluded. A battery of neuropsychological tests and wellbeing measures (emotional distress, sleep, health-related quality of life [HRQoL]) was administered. Older age and TBI were each independently associated with poorer cognition across multiple domains (p < 0.05). The relationship between verbal learning and memory impairment post-TBI differed between age groups: individuals with TBI in their 40s-60s performed significantly worse than same-aged controls on verbal story acquisition (B = 0.09, p = 0.040, 95% confidence interval [CI] [0.004, 0.17]) and recall (B = 0.12, p = 0.009, 95% CI [0.03, 0.21]), and verbal wordlist recall (B = 0.11, p = 0.007, 95% CI [0.03, 0.19]). In comparison, no significant group differences in verbal memory emerged for ages 70-90. The TBI group reported greater emotional distress (B = 3.55, p < 0.001, 95% CI [1.73, 5.37]), poorer sleep quality (B = 1.07, p = 0.016, 95% CI [0.20, 1.94]), and poorer physical HRQoL (B = -4.26, p = 0.003, 95% CI [-7.08, -1.43]) than controls at all ages. Poorer physical HRQoL was related to poorer cognition post-TBI (p < 0.05). Our results challenge the notion that TBI exacerbates ageing. Moderate-severe TBI resulted in significant long-term impairments in cognition and wellbeing, with verbal learning and memory more impaired during middle-adulthood but not older adulthood compared to controls. TBI was not associated with changes to wellbeing with ageing. Intervention for verbal memory deficits in middle-aged adults with TBI is important, along with wider long-term supports for cognition, wellbeing, and activity participation in all individuals with TBI.

Determinants of Psychomotor Slowing in Older Adults With Depressive Disorder

BACKGROUND

Psychomotor slowing in older adults with depressive disorder (DD) has been associated with a poor prognosis. Whether psychomotor slowing is associated with depression itself, age-related physical and cognitive factors, or both, is important to personalize treatments. We examined the unique contributions of different determinants of psychomotor slowing in older adults with DD.

METHODS

Baseline data of the Routine-Outcome-Monitoring for Geriatric Psychiatry and Science (ROM-GPS) study, and the Netherlands Study of Depression in Older persons (NESDO) were used to include a total of N = 521 patients (N = 143 ROM-GPS; N = 378 NESDO) aged ≥ 60 years who fulfilled DSM-criteria of a DD. Psychomotor slowing was measured multidimensionally with motor slowing (gait speed), cognitive slowing (processing speed), and subjective slowing (item-23 of Inventory-of-Depressive-Symptoms scale). Potential determinants were categorized into demographics, depression-related, physical and cognitive health, lifestyle, and psychosocial factors. Multivariate linear regression analyses were applied for each component of slowing.

RESULTS

The minority (7.3%) had slowing on all three components. Moderate correlations were found between motor and cognitive slowing, whereas no or low correlations were found between subjective slowing and either motor or cognitive slowing. Motor slowing was associated with higher age, female sex, polypharmacy, and higher body-mass-index. Cognitive slowing was associated with diminished global cognitive performance. Subjective slowing with higher depression severity and worse global cognitive performance.

CONCLUSIONS

Psychomotor slowing in older adults with DD is complex, consisting of a motor, cognitive, and subjective component, all of which have a unique phenotype. Because motor and cognitive slowing are not closely related to depression severity, it suggests that in older people with DD other age-related factors are more important determinants, which should be taken into account for optimizing treatment.

Age-defying swallowing

Swallowing disorders, which are generally underdiagnosed, affect the elderly, leading to a decreased quality of life and complications, including aspiration pneumonia and death. Understanding the neurophysiology of swallowing and the causes of its dysfunction is a fundamental tool for the prevention, early diagnosis, and treatment of dysphagia. New technologies open a wide range of possibilities for the implementation of new care protocols for this disorder.

The Detrimental Effects of Mental Fatigue on Cognitive and Physical Performance in Older Adults Are Accentuated by Age and Attenuated by Habitual Physical Activity

OBJECTIVE

Our research objectives were to evaluate the extent to which cognitive and physical performance in older adults, when fresh, and when fatigued vary with age and habitual physical activity.

METHODS

We employed experimental study designs, with between- (Study 1: age: 51-64 and 65-80 years and Study 2: habitual physical activity: active and sedentary) and within-participants factors (Study 1: test: before cognitive task and after cognitive task and Study 2: session: fatigue and control and test: before and after cognitive task). In testing sessions, participants performed exercise (6-min walk, 30-s sit stand, and 30-s arm curl) and cognitive (response inhibition and vigilance) tasks before and after a 20-min demanding cognitive task (time load dual back [TLDB] task). In Study 2, participants completed a paced breathing task (control session) as well as the TLDB (fatigue session). Ratings of mental fatigue and exercise-related perceived exertion were obtained.

RESULTS

The 20-min TLDB task elicited a state of mental fatigue. Cognitive and physical performance was worse after than before the TLDB task. These impairments in performance were moderated by age (Study 1) and habitual physical activity (Study 2).

CONCLUSION

The deleterious effects of mental fatigue on cognitive and physical performance were accentuated by aging and attenuated by habitual physical activity.

IMPLICATIONS

Cognitive and/or physical training could mitigate the negative effects of mental fatigue on performance in older adults.

Effect of Brain Computer Interface Training on Frontoparietal Network Function for Young People: A Functional Near-Infrared Spectroscopy Study

AIMS

Inattention in young people is one of the main reasons for their declining learning ability. Frontoparietal networks (FPNs) are associated with attention and executive function. Brain computer interface (BCI) training has been applied in neurorehabilitation, but there is a lack of research on its application to cognition. This study aimed to investigate the effect of BCI on the attention network in healthy young adults.

METHODS

Twenty-seven healthy people performed BCI training for 5 consecutive days. An attention network test (ANT) was performed at baseline and immediately after the fifth day of training and included simultaneous functional near-infrared spectroscopy recording.

RESULTS

BCI performance improved significantly after BCI training (p = 0.005). The efficiencies of the alerting and executive control networks were enhanced after BCI training (p = 0.032 and 0.003, respectively). The functional connectivity in the bilateral prefrontal cortices and the right posterior parietal cortex increased significantly after BCI training (p < 0.05).

CONCLUSION

Our findings suggested that repetitive BCI training could improve attention and induce lasting neuroplastic changes in FPNs. It might be a promising rehabilitative strategy for clinical populations with attention deficits. The right PPC may also be an effective target for neuromodulation in diseases with attention deficits.

Cognitive training and retest learning effects on theta and alpha power in older and young adults: A perspective on the crunch hypothesis and the STAC-R model

According to the STAC-R model, scaffolding enhancement is achievable through various interventions. Indicating forms of compensatory scaffolding, the STAC-R model refers to phenomena described in other theoretical models, such as the enhanced fronto-parietal recruitment described in the CRUNCH hypothesis. The presented study investigated whether working memory training can induce compensatory scaffolding in older adults through increased prefrontal and parietal involvement (indicated by changes in theta and alpha power). The sample comprised 90 individuals, including 45 participants from the experimental (22 older and 23 young adults) and 45 from the passive control group (21 older and 24 young adults). The age range was 60-75 years for older adults and 20-35 years for young adults. We assessed the effects of a 12-session working memory training with the use of the adaptive n-back task on theta and alpha power measured in frontal midline and central-parietal areas by EEG in older and young adults during the n-back task performance at three difficulty levels. At the behavioral level, we found a positive, significant improvement in cognitive performance in young adults from experimental group. In contrast, the positive changes in older adults were too small to prove statistically significant. At the level of neuronal activity, we observed not a training effect but a retest effect. It was revealed primarily for theta oscillations in older adults and manifested by increased theta power with higher task demands and equalization of theta power of older and younger persons in the post-test. For alpha oscillations, the retest effect was negligible, and its only manifestation observed in older adults was a reduction in the dependence of alpha power on task difficulty. The study results indicate limited potential for improving WM performance in older adults compared to young adults. The presence of the retest learning effect, instead of the training effect, proved that familiarity with the task was crucial, rather than regular training of its performance. Changes observed in older adults in theta power can be considered positive, and these results are consistent with the CRUNCH hypothesis of a compensatory role for increased executive control involvement. In turn, changes in the alpha power in the same group should be considered rather maladaptive. Nevertheless, given the overall study findings, it can be concluded that although the behavioral effects of training are stronger in young adults, the changes in neuronal activity resulting from the retest learning effect are more marked in older adults.

Longitudinal Simulated Driving Performance and Rates of Progressive Visual Field Loss in Glaucoma

Purpose

The purpose of this study was to evaluate the association between longitudinal changes in driving performance, assessed through driving simulation, and rates of progressive visual field (VF) loss in patients with glaucoma.

Methods

Ninety-five patients with glaucoma underwent Standard Automated Perimetry (SAP) and driving simulations every 6 months. Rates of VF loss were estimated by changes in mean sensitivity (MS) of the integrated binocular VF over time. Driving performance was assessed using a simulator by maintaining lane position on a winding road while responding to peripheral visual stimuli to assess divided attention. Reaction time (RT) recorded the duration between the presentation of the stimuli and the participant's response. Linear mixed models evaluated longitudinal changes in SAP MS and mean RT. Multivariable linear regression models were used to predict driving performance, adjusting for age, cognitive impairment, and driving exposure.

Results

Progressive VF loss was associated with a longitudinal increase in mean RT to the divided attention task. In the multivariable model, each 1 decibel (dB)/year faster loss of integrated binocular MS was associated with a 0.024 logarithms (ln) s/year increase in mean RT (95% confidence interval [CI] = 0.007 to 0.042, P = 0.008). Baseline MS also significantly influenced driving performance, with each 10 dB worse baseline binocular MS associated with a 0.031 ln s/year increase in mean RT (95% CI = 0.016 to 0.045, P < 0.001).

Conclusions

Faster VF progression in patients with glaucoma was associated with worsening performance on a divided attention task during driving simulation.

Translational Relevance

Patients with glaucoma who exhibit faster VF progression may be at greater risk for a decline in driving performance.

A description of processing speed, learning and memory in people with multiple sclerosis aged 55

BACKGROUND

Approximately half of people with Multiple Sclerosis (pwMS) have cognitive difficulties, including problems with executive functioning, attention, learning, memory and information processing speed. Aging is also associated with declines in cognition. It is unclear if pwMS show a more rapid cognitive decline as they age.

OBJECTIVE

To describe information processing speed, memory, and learning in an older sample, while taking into account polypharmacy and common age-related comorbidities.

METHODS

Ninety-nine people, 55 years and older, with and without MS completed the Brief International Cognitive Assessment for Multiple Sclerosis and a validated comorbidity questionnaire. Polypharmacy along with anticholinergic and sedative medication burden were also assessed.

RESULTS

When controlling for age, gender and education, older pwMS demonstrated worse performance than people without MS (pwoMS) on tests of information processing speed, learning and delayed recall (all p<.01). However, age-related cognitive decline was comparable between pwMS and pwoMS.

CONCLUSION

In this sample, pwMS demonstrated worse cognitive function than non-neurologic controls. However, the effects of advancing age on cognition appear to impact pwMS and non-neurologic controls similarly.

Cognitive maintenance in older adults in social classes: a secondary analysis of the longitudinal SHARE data

BACKGROUND

Cognitive maintenance-defined as a capacity to maintain good or excellent cognitive functioning-is a valuable ageing outcome. Socio-demographic, dementia risk and protective factors may contribute differently to it across social classes. However, these effects have not been adequately assessed yet.

OBJECTIVE

This study aims to evaluate the effects of socio-demographic, risks and protective factors on the probability of cognitive maintenance in older adults stratified by social classes.

METHODS

Participants aged 65-85 years at the baseline from the Survey on Health, Ageing and Retirement in Europe (Waves 5 (2013) and 7 (2017)) were included. Cognitive maintenance was operationalised as six or more words recalled on the 10-word delayed recall test at baseline and follow-up. Dementia-specific risks and protective factors were selected from global strategies for dementia prevention. Multilevel logistic regressions with the country of residence as a random-effect variable were constructed to compare the relative effect of contributors across social classes.

RESULTS

20 960 participants from 14 countries were included in the analysis. The pseudo-R2 was 0.24, 0.28, 0.41 and 0.32 in participants of higher, middle, lower and not known social classes. Age, number of leisure activities and country of residence were significant predictors for all social classes. Effects of gender, depression, obesity, frailty, alcohol, education, occupation and personality traits vary across social classes.

CONCLUSION

Studying contributors to cognitive maintenance separately in social classes may show possible targets of public health strategies for improving cognitive health in populations and reducing social inequalities in cognitive health.

Cognitive Training and Enrichment Modulates Neural Plasticity and Enhances Cognitive Reserve in Aging Rats

OBJECTIVES

Cognitive decline in non-pathological aging is widely prevalent among the aging population. The current study assessed the impact of cognitive training (Ct) with multiple modules targeting various facets of learning and memory and the additional influence of an enriched environment (Ct+ee) on hippocampal subfields of aging male rats.

METHODS

Male Wistar rats aged 18 months were sorted into Control, Ct, and Ct+ee groups and were exposed to the respective modules for 30 days. Spontaneous behavioral tasks to assess working memory and recognition memory were performed. The hippocampal proper (CA1, CA3) and dentate gyrus (DG) neurons were analyzed for dendrite length, arborization, and spine density. The Synaptophysin, PSD 95 and BDNF, p53 and p-tau levels in the hippocampus were quantified.

RESULTS

The Ct group and Ct+ee group performed significantly better than the control group in behavioural tasks and had improved dendrite profiles of DG and basal tree of CA1 region of hippocampus. The Ct+ee group had increased dendrite length, arborization, and spine density in CA1, CA3 and DG neurons. Ct and Ct+ee groups showed increased expression of synaptophysin, PSD95 and BDNF and decreased p53 and p-tau levels in the hippocampus.

CONCLUSION

Cognitive training modules targeting specific mnemonic functions and enriched environment with diverse cognitive stimulators had a comprehensive effect on the neuronal health augmenting the impoverished cognitive reserve in aging rats.

Individuals 45 Years and Older in Opioid Agonist Treatment: A Scoping Review

This scoping review explores the unique challenges and needs faced by ageing individuals, aged 45 and above, in opioid agonist treatment (OAT), noting the earlier onset of age-related impairments among this population. The literature search was conducted in PsycINFO, EMBASE, MEDLINE, CINAHL, and Web of Science. A total of 28 observational studies were included. Five topics were identified: health, treatment, substance use, demographic, and social aspects. Findings reveal that, while health and age-related concerns are often discussed in the literature, limited attention has been given to gender differences, social factors such as financial issues, and psychological factors, which are also critical aspects of the lives of ageing individuals undergoing OAT. This review emphasizes the importance of expanding research to address these gaps, ultimately aiming to improve their overall well-being.

Development and Validation of Telephone Cognitive Testing for Community-Dwelling Older Adults (TCTCOA) in China

With the global acceleration of population ageing, cognitive health remains critical to the well-being of older adults. This study aimed to develop and validate Telephone Cognitive Testing for Community-dwelling Older Adults (TCTCOA), a culturally and contextually tailored cognitive assessment tool designed for healthy, community-dwelling older adults in China. TCTCOA included five cognitive domains-episodic memory, working memory, processing speed, executive function, and abstract reasoning and concept formation-assessed using culturally adapted tasks. A sample of 112 community-dwelling older adults aged 60 and above participated in the study. Sixty-eight participants completed TCTCOA via telephone and face-to-face modalities, alongside the Montreal Cognitive Assessment (MoCA) for validation. Pearson's correlations, structural validity, and convergent validity were analyzed to evaluate the tool. TCTCOA demonstrated strong correlations between telephone and face-to-face modes (r = 0.72) and moderate correlations with the MoCA. Subtests showed no ceiling or floor effects, and the composite scores followed a normal distribution. The tool's structural validity was supported by factor analysis, identifying general cognitive ability and efficiency as core components. TCTCOA is a valid, reliable, and accessible telephone-based cognitive assessment tool. It is suitable for healthy older adults in community settings, offering a practical alternative to traditional face-to-face cognitive evaluations. Its design overcomes cultural, educational, and logistical barriers, making it an effective resource for cognitive health monitoring in China.

Life course socioeconomic position and cognitive aging in later life: A scoping review

BACKGROUND AND OBJECTIVES

Low socioeconomic position (SEP) throughout the life course is related to poorer cognitive health in later life, but debate ensues on the life course models for this association. To advance inquiry on the topic, we conducted a scoping review.

RESEARCH DESIGN AND METHODS

We examined the association between life course SEP and cognitive function in later life in observational studies-considering cognition both as a cross-sectional level and as a longitudinal trajectory across cognitive domains-and assessed whether the empirical evidence supported life course models. We focused on studies in the general population with cognition measured in the second half of life (45 +). Forty-two studies (21 datasets) were included representing 595,276 participants (201,375 across unique datasets) from 46 countries.

RESULTS

For cognitive level, studies consistently found associations between SEP at various stages of the life course, both in overall cognition and across specific cognitive domains. These associations were generally robust to confounding and mediating factors. For cognitive trajectory, studies showed inconclusive associations with SEP across life course and across cognitive domains. Results supported the sensitive period, pathway, and accumulation models, but not the critical period model. Results supported that education acts as a pathway (and potential mediator) in the association between early-life SEP and later-life cognition.

DISCUSSION AND IMPLICATIONS

SEP throughout the life course has a robust association with later-life cognitive level, but not decline. Early-life cognitive enrichment for young people raised in socioeconomically disadvantaged households may reduce the SEP gap in cognitive functioning during later life.

Intersection challenges for older drivers: The impact of aging on visual cognition and driving efficiency at crossroads

OBJECTIVE

To examine the effects of aging on drivers' visual cognition and driving performance under different conditions, and to explore the associations between visual cognition and driving performance in older drivers.

METHODS

A driving simulator experiment was conducted, featuring critical scenarios with varying driving tasks and traffic complexities. Different scenarios with diverse levels of traffic complexity and driving tasks were set up. Participants from two age groups were invited: 15 individuals aged 24-47 and 15 individuals over 60. Experimental data on driving behavior and visual characteristics were collected. Based on visual features, a "Perception and Cognition" evaluation system was established, and a "Vehicle Operation" evaluation system was constructed using driving behavior data. By integrating these two dimensions, the correlation between visual cognition and driving performance in older drivers was thoroughly discussed.

RESULTS

Complex traffic flow did not significantly affect cognitive load and driving performance, possibly due to drivers waiting for oncoming traffic. Left-turning drivers exhibited lower speeds, longer times, higher speed variability, and greater acceleration. Age significantly impacted visual perception and driving performance, with older drivers finding information processing more challenging but using compensatory measures like slower intersection approach speeds. However, older drivers were weaker in speed control.

CONCLUSION

The result shows a clear link between visual cognition and driving performance. It is possible to consider how to utilize these psychological abilities to identify and potentially help drivers improve driving safety.

The effect of perioperative cognitive training on postoperative delirium in older patients undergoing total hip and knee arthroplasty: a prospective randomised trial

OBJECTIVE

This study investigated whether cognitive training (CT) ameliorates postoperative delirium (POD) in older patients undergoing total hip and knee arthroplasty.

METHODS

This clinical trial was conducted from 18 February to 10 July 2023 and included individuals aged 60-79 who underwent elective total hip and knee arthroplasties with surgery durations ≤3 hours under general anaesthesia. Patients with preoperative cognitive dysfunction and dementia were excluded. The incidence of POD was compared between the CT and routine care (RC) groups as the primary outcome. Secondary outcomes included adverse events, postoperative pain within 48 hours, and POD characteristics.

RESULTS

In this study, 122 individuals were divided into two groups. The overall incidence of POD was 8.2% (10 out of 122), with no significant difference between the two groups (9.8% for CT group vs. 6.6% for RC group; P = .509). Secondary outcomes also showed no significant difference between the two groups. The training time was less, and the compliance rate was poor in the CT group (4.0%). Nonetheless, the results revealed a significant difference in POD rates among CT subgroups, and a robust correlation was identified between CT sessions lasting less than the median duration of 12 minutes and the incidence of POD (P = .043).

CONCLUSION

The incidence of POD in older patients undergoing total hip or knee arthroplasty may not be mitigated by CT. As POD was exclusively observed in patients with fewer CT sessions, it suggests that the compliance-recommended CT sessions may contribute to the POD.

Oxidative stress and chronic cerebral hypoperfusion: An overview from preclinical rodent models

Chronic cerebral hypoperfusion (CCH) is an important clinical condition characterized by a prolonged reduction in cerebral blood flow that contributes to several neurodegenerative diseases, including vascular dementia and Alzheimer's disease. A number of rodent models of CCH have been developed that mimic the human pathological conditions of reduced cerebral perfusion. These models have been instrumental in elucidating the molecular and cellular mechanisms involved in CCH-induced brain damage. Oxidative stress is induced by perturbations in cellular pathways caused by CCH, including mitochondrial dysfunction, ion pump dysfunction, and adenosine triphosphate (ATP) depletion. The deleterious stress leads to the accumulation of reactive oxygen species (ROS) and exacerbates damage to neuronal structures, significantly impairing cognitive function. Among the various therapeutic strategies being evaluated, edaravone, a potent antioxidant, is emerging as a promising drug due to its neuroprotective properties against oxidative stress. Initially approved for use in ischemic stroke, research using rodent CCH models has shown that edaravone has significant efficacy in scavenging free radicals and ameliorating oxidative stress-induced neuronal damage under CCH conditions. This mini-review summarizes the current literature on the rodent models of CCH and then discusses the therapeutic potential of edaravone to reduce neuronal and vascular damage caused by CCH-induced oxidative stress.

Determinants of physical activity adoption and maintenance in older adults: A dual process approach

BACKGROUND

Dual process models represent a useful framework for explaining physical activity (PA) in that behavior is explained by reflective (i.e., conscious, effortful) and automatic (i.e., unconscious, effortless) determinants. Yet the distinct momentary reflective and automatic determinants associated with PA adoption and maintenance are unclear.

METHODS

Older adults (N = 202; ≥60 years) wore accelerometers to measure PA (i.e., moderate to vigorous intensity PA [MVPA], step counts) and completed brief mobile phone prompts assessing general reflective (i.e., demands, deliberation, self-efficacy, self-control, stress coping, emotion regulation), behavior-specific reflective (i.e., PA intentions, self-efficacy, planning), and automatic determinants (i.e., affect, physical and social context, functional stability of one's routine) as part of three, 2-week waves of data collection spaced over one year. Multilevel modeling was used to examine the within- and between-person associations between these determinants and subsequent PA.

RESULTS

There were within- or between-person differences between general reflective, behavior specific, and automatic determinants and PA by adopter and maintainer status. General reflective determinants tended to be more predictive of step counts compared to MVPA. Within-person behavior-specific reflective determinants (i.e., intentions, self-efficacy, plans) were positively associated with PA behavior but associations tended to be more positive among PA maintainers. Automatic determinants were more predictive of the amount of PA as opposed to the likelihood of PA occurring.

CONCLUSION

Reflective and automatic determinants, as well as the levels at which these determinants operate (i.e., between vs within), need to be considered when attempting to explain and predict the adoption and maintenance of PA.

Decreased practice effects in cognitively unimpaired amyloid betapositive individuals: a multicenter, longitudinal, cohort study

INTRODUCTION

We aimed to determine whether cognitively unimpaired (CU) amyloid- beta-positive (Aβ+) individuals display decreased practice effects on serial neuropsychological testing.

METHODS

We included 209 CU participants from three research centers, 157 Aβ- controls and 52 Aβ+ individuals. Participants underwent neuropsychological assessment at baseline and annually during a 2-year follow-up. We used linear mixed-effects models to analyze cognitive change over time between the two groups, including time from baseline, amyloid status, their interaction, age, sex, and years of education as fixed effects and the intercept and time as random effects.

RESULTS

The Aβ+ group showed reduced practice effects in verbal learning (β = -1.14, SE = 0.40, p = 0.0046) and memory function (β = -0.56, SE = 0.19, p = 0.0035), as well as in language tasks (β = -0.59, SE = 0.19, p = 0.0027).

DISCUSSION

Individuals with normal cognition who are in the Alzheimer's continuum show decreased practice effects over annual neuropsychological testing. Our findings could have implications for the design and interpretation of primary prevention trials.

HIGHLIGHTS

This was a multicenter study on practice effects in asymptomatic Aβ+ individuals. We used LME models to analyze cognitive trajectories across multiple domains. Practice-effects reductions might be an indicator of subtle cognitive decline. Implications on clinical and research settings within the AD field are discussed.

The evolution of subjective cognition after meditation training in older people: a secondary analysis of the three-arm age-well randomized controlled trial

Aging is associated with cognitive changes, even in the absence of brain pathology. This study aimed to determine if meditation training, by comparison to active and passive control groups, is linked to changes in the perception of cognitive functioning in older adults. One hundred thirty-four healthy older participants from the Age-Well Randomized Clinical Trial were included: 45 followed a meditation training, 45 a non-native language training and 44 had no intervention. Subjective cognition was assessed at baseline and following the 18-month intervention period. Perception of attentional efficiency was assessed using internal and external Attentional Style Questionnaire (ASQ) subscale scores. Perception of global cognitive capacities was measured via the total score of Cognitive Difficulties Scale (CDS). Deltas ([posttest minus pretest scores]/standard deviation at pretest) were calculated for the analyses. Generalized mixed effects models controlling for age, sex, education and baseline scores revealed that meditation training decreased the vulnerability score toward external distractors measured by the ASQ compared to non-native language training. However, no between-groups differences on ASQ internal or CDS total scores were observed. Results suggest a beneficial effect of meditation practice on perceived management of external distracting information in daily life. Meditation training may cultivate the ability to focus on specific information (e.g., breath) and ignore stimulation from other kinds of stimuli (e.g., noise).

Using a nonparametric item response theory model to identify patterns of cognitive decline: The Mokken scale analysis

Cognitive decline, particularly in dementia, presents complex challenges in early detection and diagnosis. While Item Response Theory (IRT) has been instrumental in identifying patterns of cognitive impairment through psychometric tests, its parametric models often require large sample sizes and strict assumptions. This creates a need for more adaptable, less demanding analytical methods. This study aimed to evaluate the effectiveness of Mokken scale analysis (MSA), a nonparametric IRT model, in identifying hierarchical patterns of cognitive impairment from psychometric tests. Using data from 1164 adults over 60 years old, we applied MSA to the orientation subscale of ACE-III. Our analysis involved calculating scalability, monotone homogeneity, invariant item ordering (IIO) and response functions. The MSA effectively retrieved the hierarchical order of cognitive impairment patterns. Most items showed strong scalability and consistent patterns of cognitive performance. However, challenges with IIO were observed, particularly with items having adjacent difficulty parameters. The findings highlight MSA's potential as a practical alternative to parametric IRT models in cognitive impairment research. Its ability to provide valuable insights into patterns of cognitive deterioration, coupled with less stringent requirements, makes it a useful tool for clinicians and researchers.

Impact of hearing impairment on cognitive performance

OBJECTIVE

This study aims to evaluate the cognitive performance in adults with hearing loss and to identify associations between clinical characteristics of hearing loss and cognitive outcomes.

METHODS

In this cross-sectional analytical observational study, adults with hearing loss underwent the Mini-Mental State Examination (MMSE), following the collection of their clinical and audiometric data.

RESULTS

Among 134 evaluated individuals, a majority reported a progressive onset (91.04%) and bilateral nature (87.31%) of hearing loss, with moderate hearing loss being the most common (41.04%). Sensorineural hearing loss was prevalent in 76.12% of cases, with presbycusis identified as a primary etiology in 37.31%. Comorbidities were reported in 61.19% of participants, with 16.42% using benzodiazepines or antidepressants regularly. Symptoms included imbalance (33.58%), vertigo (42.54%), and tinnitus (73.88%). Notably, a sudden onset of hearing loss and imbalance complaints were linked to a higher likelihood of subnormal MMSE performance. Analysis revealed varied cognitive domain performances associated with different clinical characteristics of hearing loss.

CONCLUSION

Various aspects of hearing loss, such as bilateral and sensorineural types, and the presence of symptoms like tinnitus and vertigo, significantly influence cognitive performance. Specifically, sudden onset hearing loss and imbalance complaints are associated with poorer overall cognitive outcomes in the MMSE. These findings underscore the importance of considering the diverse impacts of hearing loss characteristics on cognitive functions.

LEVEL OF EVIDENCE

Level 4.

Age- and Sex-Specific Patterns in Adult Brain Network Segregation

The human brain is organized into several segregated associative and sensory functional networks, each responsible for various aspects of cognitive and sensory processing. These functional networks become less segregated over the adult lifespan, possibly contributing to cognitive decline that is observed during advanced age. To date, a comprehensive understanding of decreasing network segregation with age has been hampered by (1) small sample sizes, (2) lack of investigation at different spatial scales, (3) the limited age range of participants, and more importantly (4) an inadequate consideration of sex (biological females and males) differences. This study aimed to address these shortcomings. Resting-state functional magnetic resonance imaging data were collected from 357 cognitively intact participants (18.2-91.8 years; 49.9 ± 17.1 years; 27.70 ± 1.72 MoCA score, 203 [56.8%] females), and the segregation index (defined as one minus the ratio of between-network connectivity to within-network connectivity) was calculated at three spatial scales of brain networks: whole-brain network, intermediate sensory and associative networks, as well as core visual (VIS), sensorimotor (SMN), frontoparietal (FPN), ventral attention (VAN), dorsal attention (DAN), and default mode networks (DMN). Where applicable, secondary within-, between-, and pairwise connectivity analyses were also conducted to investigate the origin of any observed age and sex effects on network segregation. For any given functional metric, linear and quadratic age effects, sex effects, and respective age by sex interaction effects were assessed using backwards iterative linear regression modeling. Replicating previous work, brain networks were found to become less segregated across adulthood. Specifically, negative quadratic decreases in whole-brain network, intermediate associative network, VAN, and DMN segregation index were observed. Intermediate sensory networks, VIS, and SMN exhibited negative linear decreases in segregation index. Secondary analysis revealed that this process of age-related functional reorganization was preferential as functional connectivity was observed to increase either between anatomically adjacent associative networks (DMN-DAN, FPN-DAN) or between anterior associative and posterior sensory networks (VIS-DAN, VIS-DMN, VIS-FPN, SMN-DMN, and SMN-FPN). Inherent sex differences in network segregation index were also observed. Specifically, whole-brain, associative, DMN, VAN, and FPN segregation index was greater in females compared to males, irrespective of age. Secondary analysis found that females have reduced functional connectivity between associative networks (DAN-VAN, VAN-FPN) compared to males and independent of age. A notable linear age-related decrease in FPN SI was also only observed for females and not males. The observed findings support the notion that functional networks reorganize across the adult lifespan, becoming less segregated. This decline may reflect underlying neurocognitive aging mechanisms like neural dedifferentiation, inefficiency, and compensation. The aging trajectories and rates of decreasing network segregation, however, vary across associative and sensory networks. This study also provides preliminary evidence of inherent sex differences in network organization, where associative networks are more segregated in females than males. These inherent sex differences suggest that female functional networks may be more efficient and functionally specialized compared to males across adulthood. Given these findings, future studies should take a more focused approach to examining sex differences across the lifespan, incorporating multimodal methodologies.

Habitual caffeine intake, genetics and cognitive performance

BACKGROUND

Research on caffeine and cognitive performance remains controversial. Variations in genes associated with caffeine metabolism and response such as CYP1A2, AHR and ADORA2A may account for variable findings.

AIM

To investigate caffeine × gene interactions on cognitive performance in all key domains of cognition in healthy individuals.

METHODS

Participants completed a lifestyle and food frequency questionnaire and a cognitive test battery including validated tasks to assess the domains of social cognition, memory, attention and executive function. Genotyping was performed for AHR rs6968554, CYP1A2 rs2472297, ADORA2A rs5751876, ADA rs73598374 and APOE rs429358 and rs7412.

RESULTS

Significant gene × caffeine interactions were observed for the domains of social cognition, (F2, 123 = 5.848, p = 0.004) and executive function (F2, 109 = 3.690, p = 0.028). 'Slow' metabolisers had a higher performance in social cognition compared with 'fast' metabolisers among high-caffeine consumers (p = 0.004), while 'fast' metabolisers had a higher performance in executive function compared with 'slow' metabolisers among moderate caffeine consumers (p = 0.002).

CONCLUSIONS

The present findings suggest an association between genetic caffeine metabolism, habitual caffeine intake and cognitive function in the domains of social cognition and executive function. More research in naturalistic environments using larger cohorts is needed to confirm these findings to add to our understanding of how habitual caffeine may influence cognitive function based on individual genotype.

Associations of frailty and cognitive impairment with all-cause and cardiovascular mortality in older adults: a prospective cohort study from NHANES 2011-2014

BACKGROUND

The global aging trend exacerbates the challenge of frailty and cognitive impairment in older adults, yet their combined impact on health outcomes remains under-investigated. This study aims to explore how frailty and psychometric mild cognitive impairment (pMCI) jointly affect all-cause and cardiovascular disease (CVD) mortality.

METHODS

The cohort study we examined 2,442 participants aged ≥ 60, is the secondary analysis from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Frailty was quantified using a 49-item frailty index, while pMCI was determined by three composite cognition scores one standard deviation (SD) below the mean. The associations between frailty, pMCI, comorbidity, and mortality were assessed using weighted Cox proportional hazards models.

RESULTS

Of the participants, 31.37% were frail, 17.2% had pMCI, and 8.64% exhibited both conditions. The cohort was stratified into four groups based on frailty and pMCI status. After a median follow-up period of 6.5 years, frail individuals with pMCI had the highest all-cause (75.23 per 1,000 person-years) and CVD (32.97 per 1,000 person-years) mortality rates. Adjusted hazard ratios (HRs) for all-cause (3.06; 95% CI, 2.05-4.56) and CVD (3.8; 95% CI, 2.07-6.96) mortality were highest in frail older adults with pMCI compared to those who were non-frail without pMCI.

CONCLUSION

Our study highlights the ubiquity of frailty and cognitive impairment in older adults and underscores the heightened risk of mortality associated with their coexistence. These findings suggest the critical need for proactive screening and management of frailty and cognitive function in clinical practice to improve outcomes for the older adults.

Investigating Modifiable Factors Associated with Cognitive Decline: Insights from the UK Biobank

Objectives: Given the escalating global prevalence of age-related cognitive impairments, identifying modifiable factors is crucial for developing targeted interventions. Methods: After excluding participants with dementia and substantial missing data, 453,950 individuals from UK Biobank (UKB) were included. Cognitive decline was assessed across four cognitive domains. The top 10% exhibiting the greatest decline were categorized as the "Cognitively At-Risk Population". Eighty-three potential factors from three categories were analyzed. Univariate and multivariate Cox proportional hazards models were employed to assess the independent and joint effects of these factors on cognitive decline. Population Attributable Fractions (PAFs) were calculated to estimate the potential impact of eliminating each risk category. Results: Our findings revealed a significant impact of unfavorable medical and psychiatric histories on processing speed and visual episodic memory decline (Hazard Ratio (HR) = 1.34, 95% CI: 1.20-1.51, p = 6.06 × 10⁻7; HR = 1.50, 95% CI: 1.22-1.86, p = 1.62 × 10⁻4, respectively). Furthermore, PAF analysis indicated that physiological and biochemical markers were the most critical risk category for preventing processing speed decline (PAF = 7.03%), while social and behavioral factors exerted the greatest influence on preventing visual episodic memory decline (PAF = 9.68%). Higher education, socioeconomic status, and handgrip strength emerged as protective factors, whereas high body mass index (BMI), hypertension, and depression were detrimental. Conclusions: By identifying this high-risk group and quantifying the impact of modifiable factors, this study provides valuable insights for developing targeted interventions to delay cognitive decline and improve public health outcomes in middle-aged and older adults.

Emerging Role of Mesenchymal Stromal Cell and Exosome Therapies in Treating Cognitive Impairment

Cognitive aging, characterized by the gradual decline in cognitive functions such as memory, attention, and problem-solving, significantly impacts daily life. This decline is often accelerated by neurodegenerative diseases, particularly Alzheimer's Disease (AD) and Parkinson's Disease (PD). AD is marked by the accumulation of amyloid-beta plaques and tau tangles, whereas PD involves the degeneration of dopaminergic neurons. Both conditions lead to severe cognitive impairment, greatly diminishing the quality of life for affected individuals. Recent advancements in regenerative medicine have highlighted mesenchymal stromal cells (MSCs) and their derived exosomes as promising therapeutic options. MSCs possess regenerative, neuroprotective, and immunomodulatory properties, which can promote neurogenesis, reduce inflammation, and support neuronal health. Exosomes, nanosized vesicles derived from MSCs, provide an efficient means for delivering bioactive molecules across the blood-brain barrier, targeting the underlying pathologies of AD and PD. While these therapies hold great promise, challenges such as variability in MSC sources, optimal dosing, and effective delivery methods need to be addressed for clinical application. The development of robust protocols, along with rigorous clinical trials, is crucial for validating the safety and efficacy of MSC and exosome therapies. Future research should focus on overcoming these barriers, optimizing treatment strategies, and exploring the integration of MSC and exosome therapies with lifestyle interventions. By addressing these challenges, MSC- and exosome-based therapies could offer transformative solutions for improving outcomes and enhancing the quality of life for individuals affected by cognitive aging and neurodegenerative diseases.

Neurocognitive difficulties in trauma-exposed adults with metabolic syndrome: no influence of PTSD status or PTSD and metabolic syndrome comorbidity

BACKGROUND

Metabolic syndrome (MetS) and posttraumatic stress disorder (PTSD) often co-occur and both may compromise cognition, owing in part to common underlying mechanisms. Few studies have investigated the additive effects of these disorders on cognitive performance. Our aims were to compare cognitive performance between patients with PTSD and trauma-exposed controls (TEC) and investigate the additive effects of MetS factors on cognition.

METHODS

In this case-control study, we included 474 adult participants, 236 with PTSD and 238 TEC. Demographic, neuropsychiatric, metabolic-related, and neurocognitive assessments were undertaken and MANCOVAs performed controlling for age. Cognitive domains (immediate and delayed memory, attention, language, visuospatial performance, working memory and global cognition) were the dependent variables in the analysis. Patient status and presence/absence of MetS or MetS components were independent variables, in each model.

RESULTS

Patients with PTSD did not demonstrate worse cognitive performance than TEC on the neurocognitive domains assessed, and the presence of MetS in patients with PTSD did not alter this finding. Individuals with MetS also did not demonstrate worse cognition when compared to those without MetS. When we looked at individual MetS features, higher BMI was associated with poorer visuospatial performance, CONCLUSIONS: These findings contrast with many previous studies showing worse neurocognitive performance related to both PTSD and MetS. Further investigation is required to establish the contribution of MetS to cognitive deficits in those with PTSD. Generalisability and inferences regarding the directionality of associations are limited.

The Human Cerebello-Hippocampal Circuit Across Adulthood

Direct communication between the hippocampus and cerebellum has been shown via coactivation and synchronized neuronal oscillations in animal models. Further, this novel cerebello-hippocampal circuit may be impacted by sex steroid hormones. The cerebellum and hippocampus are dense with estradiol and progesterone receptors relative to other brain regions. Females experience up to a 90% decrease in ovarian estradiol production after the menopausal transition. Postmenopausal women show lower cerebello-cortical and intracerebellar FC compared to reproductive aged females. Sex hormones are established modulators of both memory function and synaptic organization in the hippocampus in non-human animal studies. However, investigation of the cerebello-hippocampal (CB-HP) circuit has been limited to animal studies and small homogeneous samples of young adults as it relates to spatial navigation. Here, we investigate the CB-HP circuit in 138 adult humans (53% female) from 35-86 years of age, to define its FC patterns, and investigate its associations with behavior, hormone levels, and sex differences therein. We established robust FC patterns between the CB and HP in this sample. We predicted and found negative relationships between age and CB-HP FC. As expected, estradiol levels exhibited positive relationships with CB-HP. We found lower CB-HP FC with higher levels of progesterone. We provide the first characterization of the CB-HP circuit across middle and older adulthood and demonstrate that connectivity is sensitive to sex steroid hormone levels. This work provides the first clear CB-HP circuit mapping in the human brain and serves as a foundation for future work in neurological and psychiatric diseases.

Reliability of radiomics features as imaging biomarkers for evaluating brain aging: A study based on myelin protein and diffusion tensor imaging

Radiomics has made considerable progress in neurodegenerative diseases. However, previous studies only explored the feasibility of radiomics in clinical applications. Therefore, the objective of this study was to obtain the most relevant radiomics features with the aging changes of myelin proteins and compare their diagnostic performances with the diffusion tensor imaging (DTI) parameters to identify the reliability of these features as imaging biomarkers for assessing brain aging. Thirty middle-aged and thirty old-aged mice were assigned to the training set to explore the most relevant features of myelin proteins and their diagnostic performances. Ten middle-aged and ten old-aged mice were assigned to the testing set to further validate the reproducibility of the features. T2-weighted imaging and DTI were conducted to obtain white matter radiomics features and DTI parameters. Myelin proteins, including proteolipid protein (PLP) and myelin basic protein (MBP), were examined by immunofluorescence staining in the regions of the whole brain, cortex, corpus callosum, striatum, and anterior commissure. The Pearson correlation analysis was used to observe the correlations between radiomics features and myelin proteins. The four most relevant features with the top four correlation coefficients were selected to compare their diagnostic performances with the DTI parameters, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AxD), and radial diffusivity (RD). Wavelet-HLL_glszm_ZoneEntropy, wavelet-HLL_gldm_DependenceEntropy, wavelet-LHL_glszm_ZoneEntropy, and log-sigma-2-0-mm-3D_gldm_DependenceEntropy were the four most relevant features, which had moderately significant correlations with PLP. The area under the receiver operating characteristic curves (AUC) of the four features were 0.940, 0.917, 0.831, and 0.964 in the training set, and 0.880, 0.840, 0.860, and 0.880 in the testing set. The AUCs of FA, MD, AxD, and RD were 0.864, 0.743, 0.673, and 0.778 in the training set, and 0.780, 0.710, 0.670, and 0.730 in the testing set. These results demonstrated that radiomics features of white matter displayed significant correlations with myelin proteins and their performances were comparable or even superior to DTI parameters, which ensured their reliability as non-invasive imaging biomarkers for evaluating brain aging.

Network relationship between cognitive function and quality of life in community-dwelling older adults: an observational study from Beijing

Objective

This observational study aims to comprehensively explore the network relationship and mechanism of action between cognitive function and quality of life among community-dwelling older adults aged 60 and above in Beijing.

Methods

The research encompassed a cohort of 323 older adults individuals residing in the community in Beijing. Data were collected from January to July 2024 using convenience sampling. Cognitive function was evaluated using the Chinese adaptation of the Montreal Cognitive Assessment (MoCA), while quality of life was assessed through the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF-36v2). Cognitive assessment involved seven dimensions, namely visuospatial/executive function, naming, attention, language, abstraction, delayed recall, and orientation. Concurrently, quality of life was assessed across eight dimensions: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Network analysis graphs were developed to investigate the interrelationships among variables, identify central nodes, and evaluate stability.

Results

In the network, the dimensions of social functioning, role-physical, physical functioning, general health, vitality, orientation, and language showed high centrality strength. The dimensions of physical functioning, role-physical, language, and orientation exhibited strong closeness and betweenness. There were strong associations between role-physical and social functioning, physical functioning and role-physical, and vitality and mental health. The centrality stability coefficients for strength, closeness, and betweenness were 0.672, 0.672, and 0.285, respectively.

Conclusion

The network structure was stable, indicating that dimensions such as social functioning, role-physical, and physical functioning play pivotal roles influencing cognitive function in community-dwelling older adults. Orientation and language were the most representative dimensions of cognitive function and may serve as important targets for interventions aimed at improving cognitive function and subsequently enhancing QoL. These findings provide practical guidance for community health interventions. Future research should explore causal relationships and develop scalable strategies to support aging populations.

Withania somnifera (Ashwagandha) supplementation: a review of its mechanisms, health benefits, and role in sports performance

In recent years Withania somnifera (Ashwagandha) gained a lot of interest as an adaptogen, aiding sleep, stress management and presenting health and sports-related benefits. Although clinical effects have been previously reviewed, the specific mechanism of Ashwagandha's action and its impact on different aspects of physical performance, body composition, as well as medical effects need more thorough analysis. Therefore, this narrative review delves into the available research examining the effects of Ashwagandha supplementation on such qualities as: strength, endurance, power, recovery, muscle mass, body fat, fertility, anxiety, metabolic health and aging, with additional focus on potential mechanisms underlying these effects. Moreover, we propose future perspectives based on the gaps observed in Ashwagandha research up to date.

Role of cognitive impairment in predicting the long-term risk of all-cause mortality: a 20-year prospective cohort study in China

BACKGROUND

There is limited evidence of the relationship between cognitive changes and all-cause mortality. And it has no report of population-attributable fraction (PAF) of mortality due to cognitive impairment in Chinese elderly. In light of this, we comprehensively examined the relationship between cognitive impairment and all-cause mortality after 20-year follow-up among the elderly Chinese.

METHODS

This is an epidemiological survey with a 20-year prospective cohort study design. A total of 9093 participants came from the Chinese Longitudinal Healthy Longevity Survey 1998-2018 waves. Cox proportional hazards regressions were performed to analyze the relationship between baseline cognitive impairment status, the rate of change in the MMSE scores over two years and subsequent all-cause mortality.

RESULTS

We observed a dose-response relationship between cognition and mortality. Compared to those with no impairment, elderly with mild (AHR = 1.11, 95% CI 1.05-1.18), moderate (AHR = 1.22, 95% CI 1.13-1.33) and severe (AHR = 1.30, 95% CI 1.19-1.42) cognitive impairment showed increased mortality risk. Elderly with rapid cognitive decline had 24% higher mortality risk than those with stable cognitive (AHR = 1.24, 95%CI 1.10-1.39). The PAF of mortality due to severe cognitive impairment was 3.69% (95%CI:2.36-5.25%). Impairment in the subdomain of naming foods (AHR = 1.12, 95% CI 1.04-1.21), registration (AHR = 1.18, 95% CI 1.11-1.26), attention and calculation (AHR = 1.13, 95% CI 1.07-1.21), copy figure (AHR = 1.13, 95% CI 1.06-1.20), delayed recall (AHR = 1.14, 95% CI 1.07-1.20) and language (AHR = 1.14, 95% CI 1.05-1.24) were independently associated with increased mortality risk among participants.

CONCLUSION

Baseline cognitive impairment was inversely associated with longevity among the elderly Chinese. The rapid cognitive decline increased all-cause mortality, and this risk would continue for 20 years. These findings underscore the crucial role of early detection and management of cognitive impairment in the elderly.

Health Behaviors and Executive Function in Late Adulthood: A Time-Varying Effect Modeling Analysis

OBJECTIVE

Cognitive decline in older adults is a public health issue, with modifiable factors like obesity and sleep potentially influencing this trajectory. Previous research on their relationship with executive function has shown mixed results, particularly across older adulthood.

METHODS

This study utilized time-varying effect modeling (TVEM) to assess the impact of body mass index (BMI) and sleep on executive function in older adults aged 60 to 79, using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 cycles (N = 2543). Executive function was evaluated using the Digit Symbol Substitution Test (DSST).

RESULTS

Findings indicated that while BMI did not significantly affect cognition, adequate sleep (7-8 hours) was linked to better executive function, especially in individuals aged 63 to 65.

CONCLUSION

These results highlight sleep's importance for cognitive health and suggest interventions focusing on sleep and weight management to mitigate age-related cognitive decline.

Effects of Dance-Based Aerobic Training on Frailty and Cognitive Function in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial

Background/Objectives: The purpose of this study has been to evaluate the effects of a dance-based aerobic training program on frailty, cognitive impairment, executive functions, and verbal fluency in older adults with mild cognitive impairment. Methods: Randomized clinical trial, whose sample was made up of 92 older adults, of which 47 performed rhythmic physical activity for 12 weeks. Data on frailty were collected through FRAIL, cognitive function through the Mini-Mental State Examination (MMSE), cognitive impairment through The Montreal Cognitive Assessment (MoCA), verbal fluency using the Isaac test, and executive functions with the Trail Making Test (TMT). All variables were measured before and after the intervention by an independent researcher blinded to the treatment. Results: Participants in the experimental group showed statistically significant improvements in frailty (Cohen's d = 0.60), cognitive function (Cohen's d = 0.98), cognitive impairment (Cohen's d = 1.22), verbal fluency (Cohen's d = 0.61) and executive functions (Cohen's d = 0.64). Conclusions: This study demonstrated that a 12-week dance-based aerobic training program can significantly reduce frailty and improve cognitive abilities in older adults with mild cognitive impairment. These improvements suggest that the intervention is not only effective in terms of physical health, but also in promoting mental health and general well-being.

Cognitive function and its longitudinal predictability by intensity of physical activity in Chinese middle-aged and older adults

BACKGROUND

The aging population faces several health problems, including cognitive decline that can progress to Alzheimer's disease. Regular physical activity is widely recognized for its extensive benefits, including physical and mental health improvements especially for older adults.

OBJECTIVE

This study aimed to examine the prediction of physical activity intensities on cognitive function of older adults.

METHODS

Data from 8 years prospective survey among Chinese population aged 45 years and older is used. Cognitive function was measured by word recall, orientation, numeric subtraction, and copying a picture. Physical activity was assessed with three intensity levels. General estimating equations (GEE) with unstructured correlation matrix is used to test the prediction of physical activity intensity on cognitive function.

RESULTS

Cognitive function of participants significantly declined from 9.81 at baseline to 8.81 after 8 years. Moderate-intensity physical activity for 3 days/week was strongest positive predictor of cognitive function with a betta coefficient of 0.64. Light-intensity physical activity also positively predicted cognitive function, however vigorous physical activity for more than 3 days/week negatively predicted cognitive function.

CONCLUSIONS

Cognitive function of the Chinese population is found to continuously decline after 60 years old age. Fortunately, this decline can be delayed with age-tolerable light to moderate-intensity physical activities.