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Wunderle V, Kuzu TD, Tscherpel C, Fink GR, Grefkes C, Weiss PH. Age- and sex-related changes in motor functions: a comprehensive assessment and component analysis. Front Aging Neurosci 2024; 16:1368052. [PMID: 38813530 PMCID: PMC11133706 DOI: 10.3389/fnagi.2024.1368052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/23/2024] [Indexed: 05/31/2024] Open
Abstract
Age-related motor impairments often cause caregiver dependency or even hospitalization. However, comprehensive investigations of the different motor abilities and the changes thereof across the adult lifespan remain sparse. We, therefore, extensively assessed essential basic and complex motor functions in 444 healthy adults covering a wide age range (range 21 to 88 years). Basic motor functions, here defined as simple isolated single or repetitive movements in one direction, were assessed by means of maximum grip strength (GS) and maximum finger-tapping frequency (FTF). Complex motor functions, comprising composite sequential movements involving both proximal and distal joints/muscle groups, were evaluated with the Action Research Arm Test (ARAT), the Jebsen-Taylor Hand Function Test (JTT), and the Purdue Pegboard Test. Men achieved higher scores than women concerning GS and FTF, whereas women stacked more pins per time than men during the Purdue Pegboard Test. There was no significant sex effect regarding JTT. We observed a significant but task-specific reduction of basic and complex motor performance scores across the adult lifespan. Linear regression analyses significantly predicted the participants' ages based on motor performance scores (R2 = 0.502). Of note, the ratio between the left- and right-hand performance remained stable across ages for all tests. Principal Component Analysis (PCA) revealed three motor components across all tests that represented dexterity, force, and speed. These components were consistently present in young (21-40 years), middle-aged (41-60 years), and older (61-88 years) adults, as well as in women and men. Based on the three motor components, K-means clustering analysis differentiated high- and low-performing participants across the adult life span. The rich motor data set of 444 healthy participants revealed age- and sex-dependent changes in essential basic and complex motor functions. Notably, the comprehensive assessment allowed for generating robust motor components across the adult lifespan. Our data may serve as a reference for future studies of healthy subjects and patients with motor deficits. Moreover, these findings emphasize the importance of comprehensively assessing different motor functions, including dexterity, force, and speed, to characterize human motor abilities and their age-related decline.
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Affiliation(s)
- Veronika Wunderle
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Taylan D. Kuzu
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Caroline Tscherpel
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Department of Neurology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gereon R. Fink
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Christian Grefkes
- Department of Neurology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Peter H. Weiss
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
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Yang Z, Hotterbeex P, Marent PJ, Cerin E, Thomis M, van Uffelen J. Physical activity, sedentary behaviour, and cognitive function among older adults: A bibliometric analysis from 2004 to 2024. Ageing Res Rev 2024; 97:102283. [PMID: 38552882 DOI: 10.1016/j.arr.2024.102283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/20/2024]
Abstract
Because of population ageing, there will be a vast increase in the prevalence of cognitive decline and dementia. Physical activity and sedentary behaviour have been identified as modifiable lifestyle behaviours associated with these cognitive conditions. Therefore, the aim of this bibliometric analysis is to reveal the knowledge structure of the field of physical activity, sedentary behaviour, and cognitive function among older adults from 2004 to 2024, and to predict emerging research trends. A total of 1290 publications were retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer were applied to conduct performance analysis, science mapping, and enrichment. T. Liu-Ambrose was the most prolific author (39 publications), and the University of British Columbia was the most prolific institution (48 publications). The USA, China, and Canada were the three most productive countries with 392, 174, and 136 publications respectively. Two research trends revealed the knowledge structure of this field, including the shift from evaluating the effectiveness of interventions on cognitive function to evaluating the effectiveness of interventions on other health-related outcomes, as well as an expansion of research on the role of physical activity and sedentary behaviour in the context of healthy ageing. Sleep, sedentary behaviour, and virtual reality may be emerging research trends and may predict directions for future research. Collectively, this bibliometric analysis provides a one-step overview of the knowledge structure in this field for researchers and other stakeholders, as well as a reference for future research.
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Affiliation(s)
- Zhen Yang
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Pauline Hotterbeex
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Leuven Brain Institute, KU Leuven, Leuven, Belgium; Department of Movement and Sports Sciences, Ghent University Research Centre for Aging Young, Ghent University, Ghent, Belgium
| | - Pieter-Jan Marent
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Department of Movement and Sports Sciences, Ghent University Research Centre for Aging Young, Ghent University, Ghent, Belgium
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Martine Thomis
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Jannique van Uffelen
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Leuven Brain Institute, KU Leuven, Leuven, Belgium.
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3
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Novotný JS, Srt L, Stokin GB. Emotion regulation shows an age- and sex-specific moderating effect on the relationship between chronic stress and cognitive performance. Sci Rep 2024; 14:3028. [PMID: 38321166 PMCID: PMC10847168 DOI: 10.1038/s41598-024-52756-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Despite the extensive knowledge about the effects of chronic stress on cognition, the underlying mechanisms remain unclear. We conducted a cross-sectional moderation analysis on a population-based sample of 596 adults to examine the age- and sex-specific role of emotion regulation (ER) in the relationship between chronic stress and cognitive performance using validated self-report questionnaires. While women showed no direct or moderated relationship between stress and cognition, men displayed a distinct age-related pattern where stress was negatively associated with poorer cognitive performance at older ages, and the onset of this relationship was detected earlier in men with ER problems. These results showed that suppression of emotions and lack of executive control of ER amplify the negative consequences of chronic stress and suggest that there are sex-specific differences in the decline of ability to cope with long-term exposure to stressors.
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Affiliation(s)
- Jan S Novotný
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 1333/5, 779 00, Olomouc, Czech Republic
| | - Luka Srt
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Gorazd B Stokin
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 1333/5, 779 00, Olomouc, Czech Republic.
- Department of Neurology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
- Translational Neuroscience and Aging Program, Center for Translational Medicine, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czech Republic.
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Ikram MA, Kieboom BCT, Brouwer WP, Brusselle G, Chaker L, Ghanbari M, Goedegebure A, Ikram MK, Kavousi M, de Knegt RJ, Luik AI, van Meurs J, Pardo LM, Rivadeneira F, van Rooij FJA, Vernooij MW, Voortman T, Terzikhan N. The Rotterdam Study. Design update and major findings between 2020 and 2024. Eur J Epidemiol 2024; 39:183-206. [PMID: 38324224 DOI: 10.1007/s10654-023-01094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
The Rotterdam Study is a population-based cohort study, started in 1990 in the district of Ommoord in the city of Rotterdam, the Netherlands, with the aim to describe the prevalence and incidence, unravel the etiology, and identify targets for prediction, prevention or intervention of multifactorial diseases in mid-life and elderly. The study currently includes 17,931 participants (overall response rate 65%), aged 40 years and over, who are examined in-person every 3 to 5 years in a dedicated research facility, and who are followed-up continuously through automated linkage with health care providers, both regionally and nationally. Research within the Rotterdam Study is carried out along two axes. First, research lines are oriented around diseases and clinical conditions, which are reflective of medical specializations. Second, cross-cutting research lines transverse these clinical demarcations allowing for inter- and multidisciplinary research. These research lines generally reflect subdomains within epidemiology. This paper describes recent methodological updates and main findings from each of these research lines. Also, future perspective for coming years highlighted.
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Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Willem Pieter Brouwer
- Department of Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Guy Brusselle
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Pulmonology, University Hospital Ghent, Ghent, Belgium
| | - Layal Chaker
- Department of Epidemiology, and Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head & Neck Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, and Department of Neurology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Rob J de Knegt
- Department of Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Joyce van Meurs
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Fernando Rivadeneira
- Department of Medicine, and Department of Oral & Maxillofacial Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, and Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Natalie Terzikhan
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
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5
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Hao W, Shan YF, Kimura T, Ukawa S, Ohira H, Okabayashi S, Wakai K, Ando M, Tamakoshi A. Dual decline in subjective gait speed and domain-specific cognition is associated with higher risk of incident dementia in older Japanese adults: A 15-year age-specific cohort study. Arch Gerontol Geriatr 2024; 117:105254. [PMID: 37952420 DOI: 10.1016/j.archger.2023.105254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Dual decline in gait speed and cognition has been found to have higher dementia risk than no decline or pure decline. However, evidence from the Asian population is lacking. Therefore, we aimed to investigate the association of dual decline from age 65 to 70 years with late-life dementia in older Japanese adults with different personal characteristics. METHODS Data were collected from an age-specific cohort study conducted in 482 Japanese 65-year-old adults. We investigated participant demographics, medical histories, lifestyles, subjective gait speed, and cognition at both 64/65 and 70/71 years old, and confirmed dementia until age of 85 years. Cox proportion hazard models were used to estimate the risk of dementia, with adjustments for covariates, and death was treated as a competing risk. RESULTS After a mean follow-up period of 12.5-years, 111 participants developed dementia. Older adults with dual decline are more likely to have hyperlipidemia, diabetes, and smoking habits. And we found that dual decline in gait speed and domain-specific cognition was associated with a higher risk of dementia compared with no decline in most cognitive tests, with the highest risk observed for gait speed combined with memory (sub-distribution hazard ratio:3.89, 95 %, confidence intervals: [1.68-9.01]). However, significant differences only existed in men after stratification by sex. CONCLUSIONS A dual decline in subjective gait speed and cognition may serve as a robust predictor of dementia over a decade prior to its onset, particularly in men. These findings highlighted the importance of screening for dual decline at an early age.
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Affiliation(s)
- Wen Hao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yi-Fan Shan
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shigekazu Ukawa
- Department of Social Welfare Science and Clinical Psychology, Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka, Japan
| | - Hideki Ohira
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | - Satoe Okabayashi
- Agency for Health, Safety and Environment, Kyoto University, Kyoto, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
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6
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Fekete M, Lehoczki A, Tarantini S, Fazekas-Pongor V, Csípő T, Csizmadia Z, Varga JT. Improving Cognitive Function with Nutritional Supplements in Aging: A Comprehensive Narrative Review of Clinical Studies Investigating the Effects of Vitamins, Minerals, Antioxidants, and Other Dietary Supplements. Nutrients 2023; 15:5116. [PMID: 38140375 PMCID: PMC10746024 DOI: 10.3390/nu15245116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Cognitive impairment and dementia are burgeoning public health concerns, especially given the increasing longevity of the global population. These conditions not only affect the quality of life of individuals and their families, but also pose significant economic burdens on healthcare systems. In this context, our comprehensive narrative review critically examines the role of nutritional supplements in mitigating cognitive decline. Amidst growing interest in non-pharmacological interventions for cognitive enhancement, this review delves into the efficacy of vitamins, minerals, antioxidants, and other dietary supplements. Through a systematic evaluation of randomized controlled trials, observational studies, and meta-analysis, this review focuses on outcomes such as memory enhancement, attention improvement, executive function support, and neuroprotection. The findings suggest a complex interplay between nutritional supplementation and cognitive health, with some supplements showing promising results and others displaying limited or context-dependent effectiveness. The review highlights the importance of dosage, bioavailability, and individual differences in response to supplementation. Additionally, it addresses safety concerns and potential interactions with conventional treatments. By providing a clear overview of current scientific knowledge, this review aims to guide healthcare professionals and researchers in making informed decisions about the use of nutritional supplements for cognitive health.
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Affiliation(s)
- Mónika Fekete
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
| | - Andrea Lehoczki
- National Institute for Haematology and Infectious Diseases, Department of Haematology and Stem Cell Transplantation, South Pest Central Hospital, 1097 Budapest, Hungary;
| | - Stefano Tarantini
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Health Promotion Sciences, College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Peggy and Charles Stephenson Oklahoma Cancer Center, Oklahoma City, OK 73104, USA
| | - Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
| | - Tamás Csípő
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (S.T.)
| | - Zoltán Csizmadia
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
| | - János Tamás Varga
- Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
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7
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Lin RSY, Su JJ, Kim S, Wong AKC, Chan TW, Lee SHC. Psychometric properties of the Chinese version of the Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction scale (MCLHB-DRR) in Chinese community-dwelling older adults. Geriatr Nurs 2023; 54:237-245. [PMID: 37847938 DOI: 10.1016/j.gerinurse.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To assess the psychometric properties of Chinese version of Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR) scale in Chinese community-dwelling older adults. METHODS A convenience sample of 150 Chinese adults aged ≥50 was recruited from local community facilities. Reliability of MCLHB-DRR was evaluated using internal consistency and test-retest reliability over two weeks. Content validity and construct validity were assessed. Translation process followed Brislin's translation model. RESULTS After excluding two items with poor loadings, the confirmatory factor analysis revealed a good model fit (χ2/df=2.14; CFI=0.91; IFI=0.91; RMSEA=0.087). The scale exhibited good internal consistency (Cronbach's alpha = 0.865), as well as acceptable test-retest reliability (ICC=0.730). CONCLUSIONS The Chinese MCLHB-DRR showed satisfactory psychometric properties, providing valuable insights for promoting dementia risk reduction in Chinese population, considering cultural nuances that shape motivations and knowledge of lifestyle changes.
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Affiliation(s)
- Rose Sin Yi Lin
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, 255 Crittenden Blvd, Rochester, New York, 14620, USA
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Sarang Kim
- Australian Institute of Health and Welfare, 26 Thynne Street, Bruce, ACT, Australia
| | | | - Tsz Wing Chan
- Pamela Youde Nethersole Eastern Hospital, Main Block, Lok Man Rd, Chai Wan, Hong Kong
| | - Sonia Ho Ching Lee
- The Hong Kong Society for Rehabilitation, Units R9-R12, Podium, Wo Che Plaza, Wo Che Estate, Shatin, NT
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8
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Whitman ET, Knodt AR, Elliott ML, Abraham WC, Cheyne K, Hogan S, Ireland D, Keenan R, Leung JH, Melzer TR, Poulton R, Purdy SC, Ramrakha S, Thorne PR, Caspi A, Moffitt TE, Hariri AR. Functional topography of the neocortex predicts covariation in complex cognitive and basic motor abilities. Cereb Cortex 2023; 33:8218-8231. [PMID: 37015900 PMCID: PMC10321095 DOI: 10.1093/cercor/bhad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 04/06/2023] Open
Abstract
Although higher-order cognitive and lower-order sensorimotor abilities are generally regarded as distinct and studied separately, there is evidence that they not only covary but also that this covariation increases across the lifespan. This pattern has been leveraged in clinical settings where a simple assessment of sensory or motor ability (e.g. hearing, gait speed) can forecast age-related cognitive decline and risk for dementia. However, the brain mechanisms underlying cognitive, sensory, and motor covariation are largely unknown. Here, we examined whether such covariation in midlife reflects variability in common versus distinct neocortical networks using individualized maps of functional topography derived from BOLD fMRI data collected in 769 45-year-old members of a population-representative cohort. Analyses revealed that variability in basic motor but not hearing ability reflected individual differences in the functional topography of neocortical networks typically supporting cognitive ability. These patterns suggest that covariation in motor and cognitive abilities in midlife reflects convergence of function in higher-order neocortical networks and that gait speed may not be simply a measure of physical function but rather an integrative index of nervous system health.
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Affiliation(s)
- Ethan T Whitman
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27710, USA
| | - Annchen R Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27710, USA
| | - Maxwell L Elliott
- Department of Psychology, Center for Brain Science, Harvard University, Cambridge, MA 02138, USA
| | | | - Kirsten Cheyne
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - Sean Hogan
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - David Ireland
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - Ross Keenan
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, Auckland 1010, New Zealand
- Christchurch Radiology Group, Christchurch 8014, New Zealand
| | - Joan H Leung
- School of Psychology, University of Auckland, Auckland 1142, New Zealand
- Eisdell Moore Centre, University of Auckland, Auckland 1142, New Zealand
| | - Tracy R Melzer
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, Auckland 1010, New Zealand
- Department of Medicine, University of Otago, Christchurch 9016, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - Suzanne C Purdy
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, Auckland 1010, New Zealand
- School of Psychology, University of Auckland, Auckland 1142, New Zealand
- Eisdell Moore Centre, University of Auckland, Auckland 1142, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - Peter R Thorne
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, Auckland 1010, New Zealand
- Eisdell Moore Centre, University of Auckland, Auckland 1142, New Zealand
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27710, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC 27710, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London SE5 8AF, UK
- PROMENTA, Department of Psychology, University of Oslo, NO-0316 Oslo, Norway
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27710, USA
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27710, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC 27710, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London SE5 8AF, UK
- PROMENTA, Department of Psychology, University of Oslo, NO-0316 Oslo, Norway
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27710, USA
| | - Ahmad R Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27710, USA
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9
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Wang Y, Owen A, Franks A, Ackerman I, Fitzgerald SM, Liew S, Woods RL, Wluka AE, McNeil JJ, Cicuttini FM. Functional outcomes following knee replacement in community-dwelling older adults. BMC Geriatr 2023; 23:261. [PMID: 37131170 PMCID: PMC10152584 DOI: 10.1186/s12877-023-03925-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/24/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Knee replacements are increasingly performed in older adults but uncertainty remains regarding their benefits in the context of age-related decline in physical function and other comorbidities. This study aimed to examine (1) the effect of knee replacement on functional outcomes in the context of age-related decline in physical function and (2) the factors associated with minimal important improvement in physical function after knee replacement in community-dwelling older adults aged ≥ 70 years. METHODS This cohort study was performed within the ASPREE trial, with 889 participants undergoing knee replacement during the trial and 858 age- and sex-matched controls without knee or hip replacement identified from 16,703 Australian participants aged ≥ 70 years. Health-related quality of life was assessed annually using the SF-12, including its physical and mental component summary (PCS and MCS). Gait speed was measured biennially. Multiple linear regression and analysis of covariance were used to adjust for potential confounders. RESULTS Participants with knee replacement had significantly lower pre- and post-replacement PCS scores and gait speed compared with age- and sex-matched controls. Participants with knee replacement had significant improvement in PCS score following knee replacement (mean change 3.6, 95% CI 2.9-4.3) while PCS score remaining unchanged in age- and sex-matched controls (-0.02, 95% CI -0.6 to 0.6) during follow-up period. The greatest improvements were observed for bodily pain and physical function. Following knee replacement, 53% of participants experienced minimal important improvement in PCS score (increased by ≥ 2.7), while 24% experienced worsened PCS score (reduced by > 2.7). Participants experiencing improved PCS score postoperatively had significantly lower PCS and higher MCS scores pre-surgery. CONCLUSIONS Although community-based older adults experienced a significant improvement in PCS scores after knee replacement, their postoperative physical functional status remained significantly lower than age- and sex-matched controls. The degree of preoperative physical function impairment was a strong predictor of functional improvement, suggesting that this could be an important consideration when identifying older people most likely to benefit from knee replacement surgery.
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Affiliation(s)
- Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Angus Franks
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Ilana Ackerman
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Sharyn M Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | | | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Anita E Wluka
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
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10
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Handing EP, Jiao Y, Aichele S. Age-Related Trajectories of General Fluid Cognition and Functional Decline in the Health and Retirement Study: A Bivariate Latent Growth Analysis. J Intell 2023; 11:65. [PMID: 37103250 PMCID: PMC10144147 DOI: 10.3390/jintelligence11040065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
There have been few studies on associations between age-related declines in fluid cognition and functional ability in population-representative samples of middle-aged and older adults. We used a two-stage process (longitudinal factor analysis followed by structural growth modeling) to estimate bivariate trajectories of age-related changes in general fluid cognition (numeracy, category fluency, executive functioning, and recall memory) and functional limitation (difficulties in daily activities, instrumental activities, and mobility). Data came from the Health and Retirement Study (Waves 2010-2016; N = 14,489; ages 50-85 years). Cognitive ability declined on average by -0.05 SD between ages 50-70 years, then -0.28 SD from 70-85 years. Functional limitation increased on average by +0.22 SD between ages 50-70 years, then +0.68 SD from 70-85 years. Significant individual variation in cognitive and functional changes was observed across age windows. Importantly, cognitive decline in middle age (pre-age 70 years) was strongly correlated with increasing functional limitation (r = -.49, p < .001). After middle age, cognition declined independently of change in functional limitation. To our knowledge, this is the first study to estimate age-related changes in fluid cognitive measures introduced in the HRS between 2010-2016.
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Affiliation(s)
| | - Yuqin Jiao
- Department of Human Development and Family Studies, Fort Collins, CO 80523, USA
| | - Stephen Aichele
- Department of Human Development and Family Studies, Fort Collins, CO 80523, USA
- Colorado School of Public Health, Fort Collins, CO 80523, USA
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11
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Depestele S, van Dun K, Verstraelen S, Van Hoornweder S, Meesen R. Midfrontal Theta and Cognitive Control During Interlimb Coordination Across the Adult Lifespan. J Mot Behav 2023; 55:278-288. [PMID: 36863697 DOI: 10.1080/00222895.2023.2183178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Interlimb coordination is required for adequate execution of most daily life activities. Yet, aging negatively affects interlimb coordination, impacting the quality of life in older people. Therefore, disentangling the underlying age-related neural mechanisms is of utmost importance. Here, we investigated neurophysiological processes of an interlimb reaction time task, including both simple and complex coordination modes. Midfrontal theta power, measured using electroencephalography (EEG), was analyzed as a marker for cognitive control. In total, 82 healthy adults participated, with 27 younger, 26 middle-aged, and 29 older adults. On a behavioral level, reaction time increased across the adult lifespan, and error rate was higher in older adults. Notably, aging disproportionately affected reaction times in the complex coordination modes, with larger reaction time increases from simple to complex movements than in younger adults, starting already at middle age. On the neurophysiological level, EEG showed that only younger adults had significantly increased levels of midfrontal theta power during complex relative to simple coordination modes, while no significant differences were found between simple and complex movements in middle-aged and older adults. The absence of this theta power upregulation with regard to movement complexity with increasing age might reflect a premature saturation of the available mental resources.
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Affiliation(s)
- Siel Depestele
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Agoralaan, UHasselt-Hasselt University, Diepenbeek, Belgium
| | - Kim van Dun
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Agoralaan, UHasselt-Hasselt University, Diepenbeek, Belgium
| | - Stefanie Verstraelen
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Agoralaan, UHasselt-Hasselt University, Diepenbeek, Belgium
| | - Sybren Van Hoornweder
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Agoralaan, UHasselt-Hasselt University, Diepenbeek, Belgium
| | - Raf Meesen
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Agoralaan, UHasselt-Hasselt University, Diepenbeek, Belgium
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12
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Depestele S, van Dun K, Verstraelen S, Ross V, Van Hoornweder S, Brijs K, Brijs T, Getzmann S, Meesen R. Age-related changes in midfrontal theta activity during steering control: A driving simulator study. Neurobiol Aging 2023; 123:145-153. [PMID: 36572595 DOI: 10.1016/j.neurobiolaging.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 12/07/2022]
Abstract
Motor control, a ubiquitous part of driving, requires increased cognitive controlled processing in older adults relative to younger adults. However, the influence of aging on motor-related neural mechanisms in the context of driving has rarely been studied. The present study aimed to identify age-related changes in cognitive control and attention allocation during a simulated steering task, using electroencephalography. Midfrontal theta, a marker for cognitive control, and posterior alpha power, a marker for attention allocation, were measured in a total of 26 young, 25 middle-aged, and 28 older adults. By adapting driving speed, the difficulty level of this steering task was individualized for each participant. Results show age-related changes in midfrontal theta power, but not in posterior alpha power, despite similar steering accuracy across age groups. Specifically, only younger and, to a lesser extent, middle-aged adults exhibited increased theta power while driving through more demanding curved segments relative to straight segments. In contrast, theta power upregulation was absent in older adults, suggesting a saturation of cognitive resources while driving, possibly due to a limitation in resource capacity, or less automatic motor-related neural processing.
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Affiliation(s)
- Siel Depestele
- UHasselt-Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium.
| | - Kim van Dun
- UHasselt-Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium
| | - Stefanie Verstraelen
- UHasselt-Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium
| | - Veerle Ross
- UHasselt-Hasselt University, School of Transportation Sciences, Transportation Research Institute (IMOB), Hasselt, Belgium
| | - Sybren Van Hoornweder
- UHasselt-Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium
| | - Kris Brijs
- UHasselt-Hasselt University, School of Transportation Sciences, Transportation Research Institute (IMOB), Hasselt, Belgium
| | - Tom Brijs
- UHasselt-Hasselt University, School of Transportation Sciences, Transportation Research Institute (IMOB), Hasselt, Belgium
| | - Stephan Getzmann
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), TU Dortmund University, Dortmund, Germany
| | - Raf Meesen
- UHasselt-Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium
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13
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de Crom TO, Ginos BN, Oudin A, Ikram MK, Voortman T, Ikram MA. Air Pollution and the Risk of Dementia: The Rotterdam Study. J Alzheimers Dis 2023; 91:603-613. [PMID: 36463450 PMCID: PMC9912721 DOI: 10.3233/jad-220804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Exposure to air pollution has been suggested to increase the risk of dementia, but studies on this link often lack a detailed screening for dementia and data on important confounders. OBJECTIVE To determine the association of exposure to air pollution with the risk of dementia and cognitive decline in the population-based Rotterdam Study. METHODS Between 2009 and 2010, we determined air pollutant concentrations at participants residential addresses using land use regression models. Determined air pollutants include particulate matter <10μm (PM10) and <2.5μm (PM2.5), a proxy of elemental carbon (PM2.5 absorbance), nitrogen oxide (NOx), and nitrogen dioxide (NO2). As the individual air pollutant levels were highly correlated (r = 0.71-0.98), we computed a general marker covering all air pollutants based on a principal component analysis. We followed participants up for dementia until 2018 and determined cognitive performance during two subsequent examination rounds. Using Cox and linear mixed models, we related air pollution to dementia and cognitive decline. RESULTS Of the 7,511 non-demented participants at baseline, 545 developed dementia during a median follow-up of 7 years. The general marker of all air pollutants was not associated with the risk of dementia (hazard ratio [95% confidence interval]: 1.04 [0.95-1.15]), neither were the individual air pollutants. Also, the general marker of all air pollutants or the individual air pollutant levels were not associated with cognitive decline. CONCLUSION In this study, we found no clear evidence for an association between exposure to air pollution and the risk of dementia or cognitive decline.
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Affiliation(s)
- Tosca O.E. de Crom
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Bigina N.R. Ginos
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Anna Oudin
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - M. Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands,Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands,Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands,Correspondence to: M. Arfan Ikram, Department of Epidemiology, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail:
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14
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Whitman ET, Knodt AR, Elliott ML, Abraham WC, Cheyne K, Hogan S, Ireland D, Keenan R, Lueng JH, Melzer TR, Poulton R, Purdy SC, Ramrakha S, Thorne PR, Caspi A, Moffitt TE, Hariri AR. Functional Topography of the Neocortex Predicts Covariation in Complex Cognitive and Basic Motor Abilities. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.09.523297. [PMID: 36711683 PMCID: PMC9881949 DOI: 10.1101/2023.01.09.523297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Although higher-order cognitive and lower-order sensorimotor abilities are generally regarded as distinct and studied separately, there is evidence that they not only covary but also that this covariation increases across the lifespan. This pattern has been leveraged in clinical settings where a simple assessment of sensory or motor ability (e.g., hearing, gait speed) can forecast age-related cognitive decline and risk for dementia. However, the brain mechanisms underlying cognitive, sensory, and motor covariation are largely unknown. Here, we examined whether such covariation in midlife reflects variability in common versus distinct neocortical networks using individualized maps of functional topography derived from BOLD fMRI data collected in 769 45-year old members of a population-representative cohort. Analyses revealed that variability in basic motor but not hearing ability reflected individual differences in the functional topography of neocortical networks typically supporting cognitive ability. These patterns suggest that covariation in motor and cognitive abilities in midlife reflects convergence of function in higher-order neocortical networks and that gait speed may not be simply a measure of physical function but rather an integrative index of nervous system health.
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Affiliation(s)
- Ethan T. Whitman
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Annchen R. Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Maxwell L. Elliott
- Department of Psychology, Center for Brain Science, Harvard University, Cambridge, MA, USA
| | | | - Kirsten Cheyne
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Sean Hogan
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - David Ireland
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Ross Keenan
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, New Zealand
- Christchurch Radiology Group, Christchurch, New Zealand
| | - Joan H. Lueng
- School of Psychology, University of Auckland, New Zealand
- Eisdell Moore Centre, University of Auckland, New Zealand
| | - Tracy R. Melzer
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Suzanne C. Purdy
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, New Zealand
- School of Psychology, University of Auckland, New Zealand
- Eisdell Moore Centre, University of Auckland, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Peter R. Thorne
- Brain Research New Zealand-Rangahau Roro Aotearoa, Centre of Research Excellence, Universities of Auckland and Otago, New Zealand
- Eisdell Moore Centre, University of Auckland, New Zealand
- School of Population Health, University of Auckland, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
- PROMENTA, Department of Psychology, University of Oslo, Norway
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
- PROMENTA, Department of Psychology, University of Oslo, Norway
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Ahmad R. Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
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15
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Ji X, Gao H, Sun D, Zhuang J, Fang Y, Wang K, Ahmadizar F. Trajectories of Cognition and Daily Functioning Before and After Incident Diabetes. Diabetes Care 2023; 46:75-82. [PMID: 36378879 DOI: 10.2337/dc22-1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The temporal pattern of cognitive and functional change before and after incident diabetes remains unknown. RESEARCH DESIGN AND METHODS Data from wave 2 to wave 9 (2004-2018) of the English Longitudinal Study of Ageing were used. Global cognition (assessed by orientation, memory, and executive function) and daily functioning (calculated as the sum of impaired basic and instrumental activities of daily living) were measured in each wave. Incident diabetes was defined as glycated hemoglobin A1c ≥6.5% (47.5 mmol/mol), self-reported doctor diagnosis of diabetes, or glucose-lowering medication use during follow-up. RESULTS Among the 6,342 participants (mean age 65.0 years, 57.8% women) included, 576 participants (9.1%) with incident diabetes were identified during a median follow-up of 13.3 years. The annual rates of change in global cognition (β = -0.035 SD/year; 95% CI -0.054 to -0.015), orientation (-0.031 SD/year; -0.060 to -0.002), memory (-0.016 SD/year; -0.029 to -0.003), and executive function (-0.027 SD/year; -0.042 to -0.013) were accelerated after diabetes diagnosis compared with before the event. The postdiabetes annual changes in daily functioning (0.093 points/year; 95% CI 0.056-0.131) were also accelerated compared with the prediabetes diagnosis. However, the rate of cognitive and functional decline before the diabetes diagnosis in participants with future incident diabetes was similar to the rate in participants without diabetes. Also, no significant acute change was observed during its onset. CONCLUSIONS Incident diabetes is associated with accelerated cognitive and functional decline after, but not before, the event. We suggest careful monitoring for cognitive and physical dysfunction after a diabetes diagnosis.
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Affiliation(s)
- Xiaoli Ji
- Department of Occupational Disease, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui Gao
- Changning Center for Disease Control and Prevention, Shanghai, China
| | - Daoyuan Sun
- Department of Occupational Disease, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianlin Zhuang
- Changning Center for Disease Control and Prevention, Shanghai, China
| | - Yuan Fang
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Kan Wang
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Fariba Ahmadizar
- Department of Data Science and Biostatistics, Julius Global Health, University Medical Center Utrecht, Utrecht, the Netherlands
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16
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Malik J, Maciaszek J. Effect of the Juggling-Based Motor Learning Physical Activity on Well-Being in Elderly: A Pre-Post Study with a Special Training Protocol. Healthcare (Basel) 2022; 10:healthcare10122442. [PMID: 36553966 PMCID: PMC9778107 DOI: 10.3390/healthcare10122442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Background: The importance of physical activity for the elderly is undeniable. Specific forms of exercise that are able to engage practitioners, both cognitively and physically, may provide more positive consequences for health and quality of life. Juggling is one of these activities that has both of these characteristics. Methods: Twenty elderly people (70.55 ± 4.91) were included in a juggling-based motor learning protocol for twelve training units during one month of exercising. An evaluation of the proposed exercises (five-point Likert scale) and a subjective assessment of well-being (WHO-5) were conducted during the protocol. Results: All participants learned to perform a three-ball flash cascade. Exercises were rated as very attractive (4.85 ± 0.31) by the practitioners, and a statistically significant improvement in well-being in participants was shown (p < 0.01; d = 0.76). Additionally, in the participating group, the number of people at risk of depression decreased significantly after the intervention with juggling classes (p < 0.01; g = 0.5). Conclusions: The proposed protocol could be an interesting physical activity for the elderly. It can be assumed that this activity, especially when performed in a group form, can improve the well-being of participants in a short period of time.
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17
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Paulsen AJ, Schubert CR, Pinto AA, Chappell RJ, Chen Y, Cruickshanks KJ, Engelman CD, Ferrucci L, Hancock LM, Johnson SC, Merten N. Associations of sensory and motor function with blood-based biomarkers of neurodegeneration and Alzheimer's disease in midlife. Neurobiol Aging 2022; 120:177-188. [PMID: 36209638 PMCID: PMC9613601 DOI: 10.1016/j.neurobiolaging.2022.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 10/15/2022]
Abstract
Pathological biomarkers of dementia and Alzheimer's disease (AD) change decades before clinical symptoms. Common sensory and motor changes in aging adults may be early markers of neurodegeneration. We investigated if midlife sensory and motor functions in Beaver Dam Offspring Study (BOSS) participants (N = 1529) were associated with longitudinal changes in blood-based biomarkers of neurodegeneration (neurofilament light chain (NfL); total tau (TTau)) and AD (amyloid beta (Aβ)). Mixed-effects models with baseline sensory and motor function as determinants and 10-year biomarker change as outcome were used. Participants with hearing impairment and worse motor function (among women) showed faster increases in NfL level over time (0.8% per year; 0.3% per year, respectively). There were no significant associations with TTau or Aβ. We found consistent relationships between worse baseline hearing and motor function with a faster increase in neurodegeneration, specifically serum NfL level. Future studies with longer follow-up should determine if sensory and motor changes are more reflective of general neurodegeneration than AD-specific pathology and whether sensory and motor tests may be useful screening tools for neurodegeneration risk.
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Affiliation(s)
- Adam J Paulsen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
| | - Carla R Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Alex A Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Richard J Chappell
- Department of Biostatistics and Medical Informatics and Department of Statistics, University of Wisconsin, Madison, WI, USA
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA; Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Luigi Ferrucci
- Longitudinal Study Section, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Laura M Hancock
- Department of Neurology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Sterling C Johnson
- Alzheimer's Disease Research Center and Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA; Geriatric Research Education and Clinical Center of the William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Natascha Merten
- Department of Geriatrics and Adult Development, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
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18
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Siokas V, Liampas I, Lyketsos CG, Dardiotis E. Association between Motor Signs and Cognitive Performance in Cognitively Unimpaired Older Adults: A Cross-Sectional Study Using the NACC Database. Brain Sci 2022; 12:1365. [PMID: 36291299 PMCID: PMC9599814 DOI: 10.3390/brainsci12101365] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
Aiming to examine whether specific motor signs are associated with worse performance in specific cognitive domains among cognitively unimpaired (CU) individuals, we performed a cross-sectional analysis of data from the baseline evaluations of older, CU participants from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set. In total, 8149 CU (≥60 years) participants were included. Of these, 905 individuals scored ≥ 2 on at least one of the motor domains of the Unified Parkinson's Disease Rating Scale part III (UPDRSIII). Cognitively impaired individuals, participants with psychiatric disorders and/or under treatment with antipsychotic, anxiolytic, sedative or hypnotic agents were excluded. Nine motor signs were examined: hypophonia, masked facies, resting tremor, action/postural tremor, rigidity, bradykinesia, impaired chair rise, impaired posture/gait and postural instability. Their association with performance on episodic memory, semantic memory, language, attention, processing speed or executive function was assessed using crude and adjusted linear regression models. Individuals with impaired chair rise had worse episodic memory, semantic memory, processing speed and executive function, while those with bradykinesia had worse language, processing speed and executive function. Sensitivity analyses, by excluding participants with cerebrovascular disease or PD, or other Parkinsonism, produced similar results with the exception of the relationship between bradykinesia and language performance.
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Affiliation(s)
- Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece
| | - Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece
| | - Constantine G. Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, Greece
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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19
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Wang Y, Owen A, Franks A, Ackerman I, Fitzgerald SM, Liew S, Woods RL, Wluka AE, McNeil JJ, Cicuttini FM. Functional Outcomes Following Hip Replacement in Community-Dwelling Older Adults. J Clin Med 2022; 11:jcm11175117. [PMID: 36079051 PMCID: PMC9457152 DOI: 10.3390/jcm11175117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/16/2022] [Accepted: 08/27/2022] [Indexed: 11/17/2022] Open
Abstract
Uncertainty remains regarding the benefit of hip replacement in older adults in the context of age-related decline in physical function. This study aimed to examine the effect of hip replacement on functional outcomes and identify factors associated with clinically important improvement in physical function postoperatively in community-dwelling older adults. This cohort study was performed within the ASPREE trial, with 698 participants receiving hip replacement and 677 age- and sex-matched controls without knee or hip replacement during the trial drawn from 16,703 Australian participants aged ≥70 years. Health status (physical and mental component summary [PCS and MCS]) was assessed annually using the SF-12. Participants receiving hip replacement had significantly lower pre- and post-replacement PCS scores compared with controls (p < 0.0001). There was significant improvement in PCS score following hip replacement (mean change 4.9, 95%CI 4.0−5.7) but no change in controls (0.01, 95%CI −0.7−0.7). Following hip replacement, 46.7% of participants experienced clinically important improvement in PCS score, while 15.5% experienced worsened PCS score. Participants experiencing improved postoperative PCS score had significantly lower PCS and higher MCS scores preoperatively. The degree of preoperative physical function impairment was a significant indicator of older people most likely to benefit from hip replacement surgery.
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Affiliation(s)
- Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Angus Franks
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Ilana Ackerman
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Sharyn M. Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Susan Liew
- Alfred Hospital, Melbourne 3004, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Anita E. Wluka
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Flavia M. Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Correspondence: ; Tel.: +61-39-9030158
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20
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Han C, An J, Chan P. Effects of cognitive ageing trajectories on multiple adverse outcomes among Chinese community-dwelling elderly population. BMC Geriatr 2022; 22:692. [PMID: 35996087 PMCID: PMC9396872 DOI: 10.1186/s12877-022-03387-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether cognitive ageing trajectory is related to common functional deficits independent of initial cognitive function remains inconclusive. We aimed to explore the adverse health effect and potential predictive factors of distinct cognitive trajectories among Chinese older adults. METHODS Three thousand five hundred eighty-one community-dwelling older adults who completed three consecutive cognitive function examinations with the Mini-Mental State Examination (MMSE) over 5 years and were without cognitive impairment at enrollment were included. A group-based trajectory model was used to estimate cognitive ageing trajectories. Multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) were computed with logistic regression models to identify potential baseline determinants and health effect of cognitive trajectories on various adverse outcomes. RESULTS Two distinct cognitive ageing trajectories were identified with about 5.3% of the study participants ascribed to the rapidly decreasing group. Subjects with rapidly decreasing cognition showed significantly higher odds (OR, 95%CI) of experiencing frailty (4.04, 2.77-5.86), falls (2.01, 1.05-3.70), balance impairment (4.20, 2.75-6.38), high fall risk (5.66, 2.67-11.77) based on the Tinetti total score, disability in activities of daily living (1.76, 1.19-2.56), disability in instrumental activities of daily living (1.52, 1.05-2.19), and motor cognitive risk syndrome (2.24, 1.23-3.98) compared with their steadily decreasing counterparts. Individuals with older age, low education level, no marriage, high score of rapid eye movement behavior disorders, poor physical and cognitive function at baseline were more predisposed to an accelerated cognitive decline. CONCLUSIONS Faster cognitive decline was independently associated with higher risk of multiple adverse events. Our findings put more emphasis on a routine and constant surveillance of cognitive function among community-dwelling older adults.
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Affiliation(s)
- Chao Han
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jing An
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Piu Chan
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China. .,Department of Neurobiology, Neurology and Geriatrics, Beijing Institute of Geriatrics, Clinical Center for Parkinson's Disease, Key Laboratories for Neurodegenerative Diseases of the Ministry of Education; Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Advanced Innovative Center for Human Brain Protection, Xuanwu Hospital of Capital Medical University, 45 Changchun Road, Beijing, 100053, China.
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21
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Wu B, Toseef MU, Stickel AM, González HM, Tarraf W. Associations Between Midlife Functional Limitations and Self-Reported Health and Cognitive Status: Results from the 1998-2016 Health and Retirement Study. J Alzheimers Dis 2022; 85:1621-1637. [PMID: 34958028 PMCID: PMC9116387 DOI: 10.3233/jad-215192] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Life-course approaches to identify and help improve modifiable risk factors, particularly in midlife, may mitigate cognitive aging. OBJECTIVE We examined how midlife self-rated physical functioning and health may predict cognitive health in older age. METHODS We used data from the Health and Retirement Study (1998-2016; unweighted-N = 4,685). We used survey multinomial logistic regression and latent growth curve models to examine how midlife (age 50-64 years) activities of daily living (ADL), physical function, and self-reported health affect cognitive trajectories and cognitive impairment not dementia (CIND) and dementia status 18 years later. Then, we tested for sex and racial/ethnic modifications. RESULTS After covariates-adjustment, worse instrumental ADL (IADL) functioning, mobility, and self-reported health were associated with both CIND and dementia. Hispanics were more likely to meet criteria for dementia than non-Hispanic Whites given increasing IADL impairment. CONCLUSION Midlife health, activities limitations, and difficulties with mobility are predictive of dementia in later life. Hispanics may be more susceptible to dementia in the presence of midlife IADLs. Assessing midlife physical function and general health with brief questionnaires may be useful for predicting cognitive impairment and dementia in later life.
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Affiliation(s)
- Benson Wu
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Mohammad Usama Toseef
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI
| | - Ariana M. Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Wassim Tarraf
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI
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22
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Hartley P, Monaghan A, Donoghue OA, Kenny RA, Romero-Ortuno R. Exploring bi-directional temporal associations between timed-up-and-go and cognitive domains in the Irish longitudinal study on ageing (TILDA). Arch Gerontol Geriatr 2021; 99:104611. [PMID: 34998129 DOI: 10.1016/j.archger.2021.104611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The bi-directional longitudinal associations between mobility and cognition in older adults are poorly understood. Our objective was to study the temporal associations between timed-up-and-go (TUG) and five cognitive function domains: global cognition, processing speed, verbal fluency, executive function, and sustained attention. METHODS We designed two longitudinal samples: A (for cognition as predictor of mobility), and B (for mobility as predictor of cognition). To examine the associations between the five cognitive domains at wave 1 and change in TUG times up to wave 5 (eight years), five linear mixed-effect models were fitted. To examine the associations between TUG times at wave 1 and change in the five cognitive domains between waves 1 and 3 (four years), five linear-regression models were fitted. RESULTS After removing participants with missing data, sample A numbered 4913 participants (mean age 62), and sample B 3675 (mean age 61). Baseline cognitive domains were all significant predictors of future change in TUG times. Baseline TUG time was also a significant predictor of future change in all five cognitive domains. In both cases, poorer performance at baseline predicted greater future loss of function. CONCLUSION There was evidence of bi-directional temporal relationships between cognition and mobility. In both directions, the effect of the explanatory variable was small, though cognition as predictor of future mobility may have greater clinical relevance than vice versa. Our findings underscore the importance for clinicians of considering the bi-directional associations between cognition and mobility when observing subtle changes in either, especially as impairments emerge.
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Affiliation(s)
- Peter Hartley
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland; Department of Public Health and Primary Care, University of Cambridge, United Kingdom.
| | - Ann Monaghan
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Orna A Donoghue
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Ireland
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23
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Mooldijk SS, Licher S, Vernooij MW, Ikram MK, Ikram MA. Seasonality of cognitive function in the general population: the Rotterdam Study. GeroScience 2021; 44:281-291. [PMID: 34750718 PMCID: PMC8810929 DOI: 10.1007/s11357-021-00485-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022] Open
Abstract
Seasonal variation in cognitive function and underlying cerebral hemodynamics in humans has been suggested, but not consistently shown in previous studies. We assessed cognitive function in 10,276 participants from the population-based Rotterdam Study, aged 45 years and older without dementia, at baseline and at subsequent visits between 1999 and 2016. Seasonality of five cognitive test scores and of a summary measure of global cognition were determined, as well as of brain perfusion. Using linkage with medical records, we also examined whether a seasonal variation was present in clinical diagnoses of dementia. We found a seasonal variation of global cognition (0.05 standard deviations [95% confidence interval: 0.02–0.08]), the Stroop reading task, the Purdue Pegboard test, and of the delayed world learning test, with the best performance in summer months. In line with these findings, there were fewer dementia diagnoses of dementia in spring and summer than in winter and fall. We found no seasonal variation in brain perfusion. These findings support seasonality of cognition, albeit not explained by brain perfusion.
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Affiliation(s)
- Sanne S Mooldijk
- Department of Epidemiology, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Silvan Licher
- Department of Epidemiology, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
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Harrsen K, Christensen K, Lund R, Mortensen EL. Educational attainment and trajectories of cognitive decline during four decades-The Glostrup 1914 cohort. PLoS One 2021; 16:e0255449. [PMID: 34339478 PMCID: PMC8328320 DOI: 10.1371/journal.pone.0255449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background The potential association between level of education and age-related cognitive decline remains an open question, partly because of a lack of studies including large subsamples with low education and follow-up intervals covering a substantial part of the adult lifespan. Objectives To examine cognitive decline assessed by a comprehensive clinical test of intelligence over a 35-year period of follow-up from ages 50 to 85 and to analyze the effect of education on trajectories of cognitive decline, including the effects of selective attrition. Methods A longitudinal cohort study with a 35-year follow-up of community dwelling members of the Glostrup 1914 cohort. The study sample comprised 697 men and women at the 50-year baseline assessment and additional participants recruited at later follow-ups. Verbal, Performance, and Full Scale IQs were assessed using the Wechsler Adult Intelligence Scale at ages 50, 60, 70, 80, and 85. To be able to track cognitive changes between successive WAIS assessments, all IQs were based on the Danish 50-year norms. Information on school education was self-reported. The association between education and cognitive decline over time was examined in growth curve models. Selective attrition was investigated in subsamples of participants who dropped out at early or later follow-ups. Results The trajectories for Verbal, Performance, and Full Scale IQ showed higher initial cognitive performance, but also revealed steeper decline among participants with a formal school exam compared to participants without a formal exam. Verbal IQ showed the largest difference in level between the two educational groups, whereas the interaction between education and age was stronger for Performance IQ than for Verbal IQ. In spite of the difference in trajectories, higher mean IQ was observed among participants with a formal school exam compared to those without across all ages, including the 85-year follow-up. Further analyses revealed that early dropout was associated with steeper decline, but that this effect was unrelated to education. Conclusion Comprehensive cognitive assessment over a 35-year period suggests that higher education is associated with steeper decline in IQ, but also higher mean IQ at all follow-ups. These findings are unlikely to reflect regression towards the mean, other characteristics of the employed test battery or associations between educational level and study dropout.
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Affiliation(s)
- Kristine Harrsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Rikke Lund
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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