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Zhi S, Zhang S, Yang D, Sun J, Gao S, Song D, Ma D, Fang S, Zhong Q, Wu Y, Sun J. Cross-cultural adaptation and validation of the Australian National University Alzheimer Disease Risk Index (ANU-ADRI) for Chinese community-dwelling residents: A cross-sectional Study. Geriatr Nurs 2024; 58:225-231. [PMID: 38838404 DOI: 10.1016/j.gerinurse.2024.05.031] [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: 02/05/2024] [Revised: 05/19/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To cross-culturally adapt the Australian National University Alzheimer Disease Risk Index (ANU-ADRI) and verify the reliability and validity of its cognitive activity domain. METHODS According to Beaton's guidelines, the ANU-ADRI was were translated into Chinese. The psychometric properties of ANU-ADRI its cognitive activity was conducted among community-dwelling residents (n = 442) in Changchun, Harbin and Hegang from December 2021 to July 2023. RESULTS The Chinese version of the ANU-ADRI had good content validity and face validity. Exploratory factor analysis of cognitive activity revealed a 3-factor structure, with a cumulative variance contribution rate of 64.124 %. Confirmatory factor analysis revealed a good model fit (x2/df = 1.664, RMSEA = 0.055, RMR = 0.090, GFI = 0.942, CFI = 0.919, IFI = 0.921, TLI = 0.902, and NFI = 0.824). The internal consistency (Cronbach's α = 0.807) and test-retest reliability (ICC = 0.787) were considered satisfactory. CONCLUSION The ANU-ADRI showed acceptable reliability and validity for assessing risk factors for Alzheimer's disease among middle-aged and elderly community-dwelling residents.
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Affiliation(s)
- Shengze Zhi
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Shuang Zhang
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | | | - Juanjuan Sun
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Shizheng Gao
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Dongpo Song
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Dongfei Ma
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Shuyan Fang
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Qiqing Zhong
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Yifan Wu
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China
| | - Jiao Sun
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin, PR China.
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Gaynor AM, Gazes Y, Haynes CR, Babukutty RS, Habeck C, Stern Y, Gu Y. Childhood engagement in cognitively stimulating activities moderates relationships between brain structure and cognitive function in adulthood. Neurobiol Aging 2024; 138:36-44. [PMID: 38522385 DOI: 10.1016/j.neurobiolaging.2024.02.010] [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: 06/30/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024]
Abstract
Greater engagement in cognitively stimulating activities (CSA) during adulthood has been shown to protect against neurocognitive decline, but no studies have investigated whether CSA during childhood protects against effects of brain changes on cognition later in life. The current study tested the moderating role of childhood CSA in the relationships between brain structure and cognitive performance during adulthood. At baseline (N=250) and 5-year follow-up (N=204) healthy adults aged 20-80 underwent MRI to assess four structural brain measures and completed neuropsychological tests to measure three cognitive domains. Participants were categorized into low and high childhood CSA based on self-report questionnaires. Results of multivariable linear regressions analyzing interactions between CSA, brain structure, and cognition showed that higher childhood CSA was associated with a weaker relationship between cortical thickness and memory at baseline, and attenuated the effects of change in cortical thickness and brain volume on decline in processing speed over time. These findings suggest higher CSA during childhood may mitigate the effects of brain structure changes on cognitive function later in life.
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Affiliation(s)
- Alexandra M Gaynor
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Montclair State University, Department of Psychology, Montclair, NJ, United States
| | - Yunglin Gazes
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Caleb R Haynes
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States
| | - Reshma S Babukutty
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States
| | - Christian Habeck
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Yaakov Stern
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Yian Gu
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States; Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, United States.
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de Vries LE, Huitinga I, Kessels HW, Swaab DF, Verhaagen J. The concept of resilience to Alzheimer's Disease: current definitions and cellular and molecular mechanisms. Mol Neurodegener 2024; 19:33. [PMID: 38589893 PMCID: PMC11003087 DOI: 10.1186/s13024-024-00719-7] [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: 08/23/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024] Open
Abstract
Some individuals are able to maintain their cognitive abilities despite the presence of significant Alzheimer's Disease (AD) neuropathological changes. This discrepancy between cognition and pathology has been labeled as resilience and has evolved into a widely debated concept. External factors such as cognitive stimulation are associated with resilience to AD, but the exact cellular and molecular underpinnings are not completely understood. In this review, we discuss the current definitions used in the field, highlight the translational approaches used to investigate resilience to AD and summarize the underlying cellular and molecular substrates of resilience that have been derived from human and animal studies, which have received more and more attention in the last few years. From these studies the picture emerges that resilient individuals are different from AD patients in terms of specific pathological species and their cellular reaction to AD pathology, which possibly helps to maintain cognition up to a certain tipping point. Studying these rare resilient individuals can be of great importance as it could pave the way to novel therapeutic avenues for AD.
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Affiliation(s)
- Luuk E de Vries
- Department of Neuroregeneration, Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands.
| | - Inge Huitinga
- Department of Neuroimmunology, Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands
| | - Helmut W Kessels
- Swammerdam Institute for Life Sciences, Amsterdam Neuroscience, University of Amsterdam, 1098 XH, Amsterdam, the Netherlands
| | - Dick F Swaab
- Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, Netherlands
| | - Joost Verhaagen
- Department of Neuroregeneration, Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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Sandrini M, Manenti R, Gobbi E, Pagnoni I, Geviti A, Alaimo C, Campana E, Binetti G, Cotelli M. Cognitive reserve predicts episodic memory enhancement induced by transcranial direct current stimulation in healthy older adults. Sci Rep 2024; 14:4879. [PMID: 38418583 PMCID: PMC10902403 DOI: 10.1038/s41598-024-53507-0] [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: 04/27/2023] [Accepted: 02/01/2024] [Indexed: 03/01/2024] Open
Abstract
Episodic memory shows the largest degree of age-related decline. Anodal transcranial Direct Current Stimulation (tDCS) can enhance episodic memory in aging but there is also evidence of response variability even when using identical stimulation parameters. To explore which inter-individual factors (i.e. age, education, encoding performance, cognitive reserve, tDCS group and timing of tDCS application) may directly and/or indirectly modulate verbal memory recall, we used data from our previous tDCS studies that showed enhanced episodic memory recall in 80 healthy older adults. In these studies we used the same paradigm and stimulation parameters but tDCS was applied during different memory stages. Memory recall was tested 48 hours and 30 days after encoding. Univariate regression models showed that tDCS group (Anodal vs. Sham) predicted memory recall, indicating higher scores in the Anodal group than in the Sham group. Encoding performance predicted memory recall in both tDCS groups. Multiple regression models revealed that cognitive reserve, measured with a life experience questionnaire, predicted memory recall only for the Anodal group. Higher cognitive reserve was linked to better memory recall. Accounting for individual differences in cognitive reserve at baseline helps to explain tDCS responsiveness. This knowledge may contribute to optimize its use in older adults.
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Affiliation(s)
- Marco Sandrini
- School of Psychology, University of Roehampton, London, UK
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Andrea Geviti
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Li X, Xu W. A change in social participation affects cognitive function in middle-aged and older Chinese adults: analysis of a Chinese longitudinal study on aging (2011-2018). Front Public Health 2024; 12:1295433. [PMID: 38371232 PMCID: PMC10869472 DOI: 10.3389/fpubh.2024.1295433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024] Open
Abstract
Background One of the biggest challenges facing older adults is cognitive decline and social participation has always been considered a protective factor. However, it is not clear whether social participation predicts cognitive function in this population, rather than depressive symptoms, self-reported health, and activities of daily life, with sufficient capacity to detect unique effects. Methods This study included adults aged 45 and above in China (N = 5,258) who participated in a large national older adult health survey and provided data from 2011, 2013, 2015, and 2018. The unique associations between the predictors of social participation and cognitive function over time and context were evaluated in the Latent Growth Model (LGM). Results Among the 5,258 participants in our study, an overall cognitive decline was observed. Social participation predicts two dimensions of cognitive function, with a degree of impact comparable to depressive symptoms, self-reported health, and activities of daily life. Among them, social participation exhibits a noteworthy prognostic impact on episodic memory during the same period. The regression coefficient is approximately 0.1 (p < 0.05) after controlling other mixed variables (depressive symptoms, self-reported health, and activities of daily life). In contrast, social participation is also a significant predictor of mental intactness in the same period, with a regression coefficient of 0.06 (p < 0.05), even if all mixed variables are controlled. Conclusion Over time, the correlation strength of social participation is comparable to other recognized cognitive function prediction indicators, indicating that promoting social participation among middle-aged and older Chinese adults is a meaningful way to improve cognitive function degradation, which has important policy and practical significance.
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Affiliation(s)
- Xuyang Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Wenyan Xu
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Tomaszewski Farias S, Fox J, Dulaney H, Chan M, Namboodiri S, Harvey DJ, Weakley A, Rahman S, Luna C, Beech BF, Campbell L, Schmitter-Edgecombe M. Memory support training and lifestyle modifications to promote healthy aging in persons at risk for Alzheimer's disease: a digital application supported intervention (Brain Boosters). BMC Geriatr 2023; 23:881. [PMID: 38129775 PMCID: PMC10740219 DOI: 10.1186/s12877-023-04574-x] [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: 06/19/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Evidence-based interventions to protect against cognitive decline among older adults at risk for Alzheimer's disease and related dementias (ADRD) are urgently needed. Rehabilitation approaches to support memory and behavioral/lifestyle interventions are recognized as promising strategies for preserving or improving cognitive health, although few previous interventions have combined both approaches. This paper describes the protocol of the Brain Boosters intervention, which synergistically combines training in compensatory and healthy lifestyle behaviors and supports implementation and tracking of new behaviors with a digital application. METHODS The study utilizes a single-site, single-blinded, randomized controlled design to compare a structured lifestyle and compensatory aid intervention to an education-only self-guided intervention. We plan to enroll 225 community-dwelling adults (25% from underrepresented groups) aged 65 + who endorse subjective cognitive decline (SCD) and low baseline levels of healthy lifestyle behaviors. Both interventions will be administered in group format, consisting of 15 two-hour classes that occur weekly for ten weeks and taper to bi-monthly and monthly, for an intervention duration of 6 months. Participants in both interventions will receive education about a variety of memory support strategies and healthy lifestyle behaviors, focusing on physical and cognitive activity and stress management. The structured intervention will also receive support in adopting new behaviors and tracking set goals aided by the Electronic Memory and Management Aid (EMMA) digital application. Primary outcomes include global cognition (composite of memory, attention, and executive function tests) and everyday function (Everyday Cognition Questionnaire). Data will be collected at baseline and outcome visits, at approximately 6, 12, and 18 months. Qualitative interviews, self-report surveys (e.g., indicators of self-determination, health literacy) and EMMA data metrics will also be used to identify what components of the intervention are most effective and for whom they work. DISCUSSION Successful project completion will provide valuable information about how individuals with SCD respond to a compensation and preventative lifestyle intervention assisted by a digital application, including an understanding of factors that may impact outcomes, treatment uptake, and adherence. The work will also inform development, scaling, and personalization of future interventions that can delay disability in individuals at risk for ADRD. TRIAL REGISTRATION ClinicalTrials.gov. (NCT05027789, posted 8/30/2021).
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Affiliation(s)
| | - J Fox
- Department of Neurology, University of California, Davis, Sacramento, USA
| | - H Dulaney
- Department of Neurology, University of California, Davis, Sacramento, USA
| | - M Chan
- Department of Neurology, University of California, Davis, Sacramento, USA
| | - S Namboodiri
- Department of Neurology, University of California, Davis, Sacramento, USA
| | - D J Harvey
- Department of Biostatistics, University of California, Davis, Davis, USA
| | - A Weakley
- Department of Neurology, University of California, Davis, Sacramento, USA
| | - S Rahman
- Department of Psychology, Washington State University, Pullman, USA
| | - C Luna
- Department of Psychology, Washington State University, Pullman, USA
| | - B F Beech
- Department of Psychology, Washington State University, Pullman, USA
| | - L Campbell
- Department of Neurology, University of California, Davis, Sacramento, USA
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Snow C, Guadagni V, Eskes GA, Poulin MJ, Longman RS. Internal consistency and reliability of the lifetime and modified current cognitive activity questionnaires and their association with cognitive performance: a six-year follow up of the Brain in Motion study. J Clin Exp Neuropsychol 2023; 45:579-596. [PMID: 38146770 DOI: 10.1080/13803395.2023.2272979] [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: 11/22/2022] [Accepted: 09/11/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Cognitive activity questionnaires could provide insight into neurocognitive reserve. The Lifetime Cognitive Activities Questionnaire (LCAQ) assesses cognitive activities at four stages of life. The Modified Current Cognitive Activities Questionnaire (CCAQ) assesses current cognitive activities. We examined the construct validity, internal consistency, test-retest reliability, and stability of these questionnaires throughout the Brain in Motion (BIM) study and their relationship with cognitive performance. METHODS The LCAQ, Montreal Cognitive Assessment (MoCA), and neuropsychological battery were administered at the initial pre-intervention and six-year follow-up. The CCAQ was administered at five timepoints. Construct validity of the CCAQ/LCAQ was assessed using proxies of cognitive engagement (educational attainment and the North American Adult Reading Test [NAART]). Cronbach alpha analysis determined internal consistency. LCAQ reliability was established by comparing the pre-intervention and six-year follow-up. CCAQ reliability was determined by comparing both pre-intervention assessments, correlations throughout BIM determined stability. A multiple linear regression investigated the associations between cognitive engagement and cognitive domains derived from a principal component analysis. RESULTS MoCA scores at the initial pre-intervention (27.49 ± 1.46) and six-year follow up (26.53 ± 2.08). The LCAQ and CCAQ correlated with educational attainment and the NAART. The LCAQ (n = 266) produced an alpha of 0.90 (20 items). The CCAQ (n = 261) resulted in an alpha of 0.71 (25 items). LCAQ scores (n = 94) at the initial pre-intervention and six-year follow-up were correlated. CCAQ (n = 94) scores at the initial pre-intervention correlated with scores at all five other timepoints. The multiple linear regression revealed associations between the CCAQ and verbal memory/attention. The NAART was associated with processing speed, concept formation, and verbal memory/attention. CONCLUSIONS In the absence of cognitive decline, these questionnaires exhibit significant construct validity, internal consistency, test-retest reliability, and the CCAQ displayed stability. The NAART and CCAQ were associated with neuropsychological performance. Our findings support future use of these questionnaires and exemplify the neuroprotective role of cognitive engagement.
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Affiliation(s)
- Connor Snow
- Department of Physiology and Pharmacology Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Veronica Guadagni
- Department of Physiology and Pharmacology Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Gail A Eskes
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Canada
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, Halifax, Canada
| | - Marc J Poulin
- Department of Physiology and Pharmacology Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - R Stewart Longman
- Psychology Service, Alberta Health Service, Foothills Medical Centre, Calgary, Canada
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Canada
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Duffner LA, DeJong NR, Jansen JFA, Backes WH, de Vugt M, Deckers K, Köhler S. Associations between social health factors, cognitive activity and neurostructural markers for brain health - A systematic literature review and meta-analysis. Ageing Res Rev 2023; 89:101986. [PMID: 37356551 DOI: 10.1016/j.arr.2023.101986] [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: 10/25/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
Social health factors (e.g., social activities or social support) and cognitive activity engagement have been associated with dementia risk, but their neural substrates have not been well established. This systematic review and meta-analysis summarizes the available evidence regarding the association between these factors and cerebral macro- and micro-structure. A comprehensive literature search was conducted in various databases, following predefined criteria. Heterogeneity, risk of publication bias and overall certainty of evidence were assessed using standardized scales and, whenever appropriate, random effects meta-analysis was conducted. Of 6715 identified articles, 43 were included. Overall, consistency of findings was low and methodological heterogeneity high for all outcomes. However, in some studies cognitive and social activities were positively associated with total brain, global and cortical grey matter and hippocampal volume as well as white matter microstructural integrity. Furthermore, structural social network characteristics (e.g., social network size) were associated with regional grey matter volumes, while functional social network characteristics (e.g., social support) were additionally associated with total brain volume. Meta-analyses revealed small but significant partial correlations between cognitive and social activities and hippocampal (three studies; n = 892; rz =0.07) and white matter hyperintensity volume (three studies; n = 2934; rz =-0.04). More prospective studies are needed to assess temporal associations.
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Affiliation(s)
- Lukas A Duffner
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Nathan R DeJong
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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Krasnova A, Tom SE, Valeri L, Crane PK, Bennett DA. Direct Effect of Life-Course Socioeconomic Status on Late-Life Cognition and Cognitive Decline in the Rush Memory and Aging Project. Am J Epidemiol 2023; 192:882-894. [PMID: 36757185 PMCID: PMC10505419 DOI: 10.1093/aje/kwad033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 11/29/2022] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
The role of socioeconomic status (SES) across the life course in late-life cognition is unclear. We tested the hypotheses that: 1) High SES in childhood, young adulthood, midlife, and late life have independent causal effects on higher cognition level and slower cognitive decline; 2) Compared with stable low SES (referent), stable high SES has the largest estimated effect for higher cognition level and slower decline among life-course SES combinations. The Rush Memory and Aging Project enrolled 1,940 dementia-free older adults in northeastern Illinois (1997-2018). We used inverse probability-weighted marginal structural models to estimate the joint and independent effect of each life-course SES on global and domain-specific cognition. A total of 1,746 participants had, on average, 6 years of follow-up. High SES at each life-course stage starting in young adulthood had a protective estimated effect on global and domain-specific cognition intercepts. Compared with consistently low SES, consistently high SES (β = 0.64, 95% confidence interval: 0.48, 0.93) and high SES beyond childhood (β = 0.64, 95% confidence interval: 0.47, 0.83) had the largest benefit for global cognition intercepts. None of the life-course SES measures influenced rate of global or domain-specific decline. Additional understanding of life-course SES components influencing cognitive level is warranted.
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Affiliation(s)
- Anna Krasnova
- Correspondence to Anna Krasnova, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY 10032 (e-mail: )
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Krueger KR, Desai P, Beck T, Wilson RS, Evans D, Rajan KB. Cognitive Activity Is Associated with Cognitive Function over Time in a Diverse Group of Older Adults, Independent of Baseline Biomarkers. Neuroepidemiology 2023; 57:229-237. [PMID: 37263261 PMCID: PMC10997141 DOI: 10.1159/000531208] [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: 03/02/2023] [Accepted: 05/15/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND More frequent engagement in cognitive activity is associated with better cognitive function in older adults, but the mechanism of action is not fully understood. Debate remains whether increased cognitive activity provides a meaningful benefit for cognitive health or if decreased cognitive activity represents a prodrome of cognitive impairment. Neurological biomarkers provide a novel way to examine this relationship in the context of cognitive aging. METHODS We examined the association of self-reported cognitive activity, cognitive function, and concentrations of three biomarkers in community-dwelling participants of a longitudinal, population-based study. Cognitive activity was measured at baseline by asking participants to rate the frequency of 7 activities: (1) viewing television, (2) listening to the radio, (3) visiting a museum, (4) playing games, such as cards, checkers, crosswords, or other puzzles or games, (5) reading books, (6) reading magazines, and (7) reading newspapers. Cognitive function was measured with a battery of four tests (Mini-Mental State Examination, Digit Symbol Test, and the immediate and delayed recall of the East Boston Test) averaged into a composite score. At baseline, we evaluated the concentration of total tau (tau), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). RESULTS The study sample comprised 1,168 older participants, primarily non-Hispanic Blacks (60%) and women (63%). At baseline, they were an average of 77 years old with 12.6 years of education. Mixed-effects models showed that cognitive activity was associated with better cognitive functioning at baseline and over time. These relationships remained after each biomarker was added to the model. Over an average of 6.4 years of follow-up, cognitive activity was associated with cognitive decline in the model with tau (estimate = 0.0123; p value = 0.03) and was mildly attenuated in the models with NfL (estimate = 0.0110; p value = 0.06) and GFAP (estimate = 0.0111; p value = 0.06). Biomarkers did not modify the association between cognitive activity and cognitive function over time. CONCLUSION The benefits of cognitive activity on cognition appear to be independent of biomarkers: tau, NfL, and GFAP, measured at baseline. More frequent cognitive activity may benefit the cognitive health of older adults with a wide range of potential disease risk and presentations.
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Affiliation(s)
- Kristin R. Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, (IL) 60612, United States of America
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, (IL) 60612, United States of America
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, (IL) 60612, United States of America
| | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, (IL) 60612, United States of America
| | - Denis Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, (IL) 60612, United States of America
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, (IL) 60612, United States of America
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11
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Ilchibaeva T, Tsybko A, Lipnitskaya M, Eremin D, Milutinovich K, Naumenko V, Popova N. Brain-Derived Neurotrophic Factor (BDNF) in Mechanisms of Autistic-like Behavior in BTBR Mice: Crosstalk with the Dopaminergic Brain System. Biomedicines 2023; 11:biomedicines11051482. [PMID: 37239153 DOI: 10.3390/biomedicines11051482] [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: 04/25/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Disturbances in neuroplasticity undoubtedly play an important role in the development of autism spectrum disorders (ASDs). Brain neurotransmitters and brain-derived neurotrophic factor (BDNF) are known as crucial players in cerebral and behavioral plasticity. Such an important neurotransmitter as dopamine (DA) is involved in the behavioral inflexibility of ASD. Additionally, much evidence from human and animal studies implicates BDNF in ASD pathogenesis. Nonetheless, crosstalk between BDNF and the DA system has not been studied in the context of an autistic-like phenotype. For this reason, the aim of our study was to compare the effects of either the acute intracerebroventricular administration of a recombinant BDNF protein or hippocampal adeno-associated-virus-mediated BDNF overexpression on autistic-like behavior and expression of key DA-related and BDNF-related genes in BTBR mice (a widely recognized model of autism). The BDNF administration failed to affect autistic-like behavior but downregulated Comt mRNA in the frontal cortex and hippocampus; however, COMT protein downregulation in the hippocampus and upregulation in the striatum were insignificant. BDNF administration also reduced the receptor TrkB level in the frontal cortex and midbrain and the BDNF/proBDNF ratio in the striatum. In contrast, hippocampal BDNF overexpression significantly diminished stereotypical behavior and anxiety; these alterations were accompanied only by higher hippocampal DA receptor D1 mRNA levels. The results indicate an important role of BDNF in mechanisms underlying anxiety and repetitive behavior in ASDs and implicates BDNF-DA crosstalk in the autistic-like phenotype of BTBR mice.
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Affiliation(s)
- Tatiana Ilchibaeva
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Prospekt Akad. Lavrentyeva 10, 630090 Novosibirsk, Russia
| | - Anton Tsybko
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Prospekt Akad. Lavrentyeva 10, 630090 Novosibirsk, Russia
| | - Marina Lipnitskaya
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Prospekt Akad. Lavrentyeva 10, 630090 Novosibirsk, Russia
| | - Dmitry Eremin
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Prospekt Akad. Lavrentyeva 10, 630090 Novosibirsk, Russia
| | - Kseniya Milutinovich
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Prospekt Akad. Lavrentyeva 10, 630090 Novosibirsk, Russia
| | - Vladimir Naumenko
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Prospekt Akad. Lavrentyeva 10, 630090 Novosibirsk, Russia
| | - Nina Popova
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Prospekt Akad. Lavrentyeva 10, 630090 Novosibirsk, Russia
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12
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Ai M, Morris TP, Zhang J, de la Colina AN, Tremblay-Mercier J, Villeneuve S, Whitfield-Gabrieli S, Kramer AF, Geddes MR. Resting-state MRI functional connectivity as a neural correlate of multidomain lifestyle adherence in older adults at risk for Alzheimer's disease. Sci Rep 2023; 13:7487. [PMID: 37160915 PMCID: PMC10170147 DOI: 10.1038/s41598-023-32714-1] [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: 12/30/2022] [Accepted: 03/30/2023] [Indexed: 05/11/2023] Open
Abstract
Prior research has demonstrated the importance of a healthy lifestyle to protect brain health and diminish dementia risk in later life. While a multidomain lifestyle provides an ecological perspective to voluntary engagement, its association with brain health is still under-investigated. Therefore, understanding the neural mechanisms underlying multidomain lifestyle engagement, particularly in older adults at risk for Alzheimer's disease (AD), gives valuable insights into providing lifestyle advice and intervention for those in need. The current study included 139 healthy older adults with familial risk for AD from the Prevent-AD longitudinal aging cohort. Self-reported exercise engagement, cognitive activity engagement, healthy diet adherence, and social activity engagement were included to examine potential phenotypes of an individual's lifestyle adherence. Two adherence profiles were discovered using data-driven clustering methodology [i.e., Adherence to healthy lifestyle (AL) group and Non-adherence to healthy lifestyle group]. Resting-state functional connectivity matrices and grey matter brain features obtained from magnetic resonance imaging were used to classify the two groups using a support vector machine (SVM). The SVM classifier was 75% accurate in separating groups. The features that show consistently high importance to the classification model were functional connectivity mainly between nodes located in different prior-defined functional networks. Most nodes were located in the default mode network, dorsal attention network, and visual network. Our results provide preliminary evidence of neurobiological characteristics underlying multidomain healthy lifestyle choices.
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Affiliation(s)
- Meishan Ai
- Department of Psychology, Northeastern University, Boston, MA, USA.
| | - Timothy P Morris
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Jiahe Zhang
- Department of Psychology, Northeastern University, Boston, MA, USA
| | | | - Jennifer Tremblay-Mercier
- STOP-AD Centre, Centre for Studies on Prevention of Alzheimer's Disease, Montreal, QC, Canada
- Douglas Mental Health University Institute Research Centre, Affiliated with, McGill University, Montreal, QC, Canada
| | - Sylvia Villeneuve
- STOP-AD Centre, Centre for Studies on Prevention of Alzheimer's Disease, Montreal, QC, Canada
- Douglas Mental Health University Institute Research Centre, Affiliated with, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Arthur F Kramer
- Department of Psychology, Northeastern University, Boston, MA, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, Urbana-Champaign, IL, USA
| | - Maiya R Geddes
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- STOP-AD Centre, Centre for Studies on Prevention of Alzheimer's Disease, Montreal, QC, Canada
- Montreal Neurological Institute, Montreal, QC, Canada
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13
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Lamar M, Glover CM, Capuano AW, Wilson RS, Fleischman DA, Bennett DA, Marquez DX. Stability and change in acculturation-related characteristics in older Latinos: Implications for culturally compatible ADRD research. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12380. [PMID: 37051589 PMCID: PMC10083703 DOI: 10.1002/trc2.12380] [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] [Received: 08/30/2022] [Revised: 02/16/2023] [Accepted: 03/01/2023] [Indexed: 04/14/2023]
Abstract
Introduction Acculturation-related characteristics, that is, factors directly connected to culture and familial relationships, are associated with engaged research participation within Latino communities. Despite this, little empirical data exists on whether acculturation changes over time in older Latinos, which has potential implications for Alzheimer's disease and related dementias (ADRD) research study design including longer duration clinical trial implementation. Methods Self-identified Latinos (n = 222; mean age = 71, 76% female) participating in one of three ongoing longitudinal community-based cohort studies of aging who reported their nativity outside of the United States/District of Columbia (US/DC) contributed, on average, 4.0 ± 1.2 years of annually collected data. This included acculturation-related characteristics of total, language-, and social-based scores from the Short Acculturation Scale for Hispanics (SASH) and total and domain-specific scores from an abbreviated Sabogal Familism questionnaire. We used ordinal mixed effects models and linear mixed effects models (as appropriate) to assess change in acculturation metrics after adjusting for age, sex, education, income, and duration of time in the US/DC. Results Although none of the SASH metrics changed over time (P-values ≥ 0.25), all Familism metrics declined over time (P-values ≤ 0.044). Additionally, select participant-based characteristics including years of education were significantly (and differentially) associated with level of, but not change in, acculturation-related outcomes. Discussion Results suggest that specific acculturation-related factors (i.e., familism) change over time in older Latinos, and participant-based characteristics associated with baseline levels of (but not change in) acculturation more generally. Thus, acculturation-related characteristics are not all static, trait-like qualities but rather a multi-faceted, and at times evolving, construct. Considering this dynamic phenotyping is important when contextualizing older Latinos' lived experience, and when designing, adapting, and conducting ADRD clinical trials and other health-related interventions.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Crystal M. Glover
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Ana W. Capuano
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Robert S. Wilson
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Debra A. Fleischman
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - David A. Bennett
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - David X. Marquez
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Kinesiology and NutritionUniversity of Illinois ChicagoChicagoIllinoisUSA
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14
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Crawford JL, English T, Braver TS. Cognitive Effort-Based Decision-Making Across Experimental and Daily Life Indices in Younger and Older Adults. J Gerontol B Psychol Sci Soc Sci 2023; 78:40-50. [PMID: 36242777 PMCID: PMC9890909 DOI: 10.1093/geronb/gbac167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The study investigated whether cognitive effort decision-making measured via a neuroeconomic paradigm that manipulated framing (gain vs. loss outcomes), could predict daily life engagement in mentally demanding activities in both younger and older adults. METHOD Younger and older adult participants (N = 310) completed the Cognitive Effort Discounting paradigm (Cog-ED), under both gain and loss conditions, to provide an experimental index of cognitive effort costs for each participant in each framing condition. A subset of participants (N = 230) also completed a 7-day Ecological Momentary Assessment (EMA) protocol measuring engagement in mentally demanding daily life activities. RESULTS In a large, online sample, we replicated a robust increase in cognitive effort costs among older, relative to younger, adults. Additionally, costs were found to be reduced in the loss relative to gain frame, although these effects were only reliable at high levels of task difficulty and were not moderated by age. Critically, participants who had lower effort costs in the gain frame tended to report engaging in more mentally demanding daily life activities, but the opposite pattern was observed in the loss frame. Further analyses demonstrated the specificity of reward-related cognitive motivation in predicting daily life mentally demanding activities. DISCUSSION Together, these results suggest that cognitive effort costs, as measured through behavioral choice patterns in a neuroeconomic decision-making task, can be used to predict and explain engagement in mentally demanding activities during daily life among both older and younger adults.
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Affiliation(s)
- Jennifer L Crawford
- Department of Psychological and Brain Sciences, Washington University, St Louis, Missouri, USA
| | - Tammy English
- Department of Psychological and Brain Sciences, Washington University, St Louis, Missouri, USA
| | - Todd S Braver
- Department of Psychological and Brain Sciences, Washington University, St Louis, Missouri, USA
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15
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Weziak-Bialowolska D, Bialowolski P, Sacco PL. Mind-stimulating leisure activities: Prospective associations with health, wellbeing, and longevity. Front Public Health 2023; 11:1117822. [PMID: 36875413 PMCID: PMC9982162 DOI: 10.3389/fpubh.2023.1117822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/20/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction This study examines prospective associations within a 6-year perspective between three mind-stimulating leisure activities (relaxed and solitary: reading; serious and solitary: doing number and word games; serious and social: playing cards and games) and 21 outcomes in (1) physical health, (2) wellbeing, (3) daily life functioning, (4) cognitive impairment, and (5) longevity domains. Methods Data were obtained from 19,821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Temporal associations were obtained using generalized estimating equations. All models were controlled for prior sociodemographic, personality, lifestyle factors, health behaviors, and pre-baseline leisure activity values and all outcome variables. The Bonferroni correction was used to correct for multiple testing. E-values were calculated to examine the sensitivity of the associations to unmeasured confounding. Secondary analyses (1) under the complete case scenario, (2) after excluding respondents with health conditions, and (3) using a limited set of covariates were conducted to provide evidence for the robustness of the results. Results The relaxed solitary activity of reading almost daily was prospectively associated with a lower risk of depression, experiencing pain, daily functioning limitations, cognitive impairment, lower loneliness scores, and more favorable wellbeing outcomes. Engaging in serious solitary leisure activities almost daily was prospectively associated with a lower risk of depression, feeling full of energy, and a lower risk of death by any cause. Occasionally engaging in these activities was prospectively associated with greater optimism and a lower risk of cognitive impairment. Engaging in serious social activities was prospectively associated with greater happiness, lower scores on the loneliness scale, a lower risk of Alzheimer's disease, and an increased risk of cancer. Additionally, occasionally engaging in serious social activities was associated with greater optimism and lower risk of depression, pain, and mobility limitations. These associations were independent of demographics, socioeconomic status, personality, history of diseases, and prior lifestyle. The sensitivity analyses provided substantial evidence for the robustness of these associations. Discussion Mind-engaging leisure activities can be considered a health and wellbeing resource. Practitioners may consider them tools that help middle-aged and older adults maintain their health and quality of life.
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Affiliation(s)
- Dorota Weziak-Bialowolska
- Centre for Evaluation and Analysis of Public Policies, Faculty of Philosophy, Jagiellonian University, Cracow, Poland.,Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
| | - Piotr Bialowolski
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States.,Department of Economics, Kozminski University, Warsaw, Poland
| | - Pier Luigi Sacco
- Dipartimento di Scienze Filosofiche, Pedagogiche ed Economico-Quantitative, University of Chieti-Pescara, Pescara, Italy.,metaLAB (at) Harvard, Harvard University, Cambridge, MA, United States.,Consiglio Nazionale delle Ricerche - L'Istituto di Scienze del Patrimonio Culturale, Naples, Italy
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16
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Li X, Zhang J, Hou R, Zheng M, Singh M, Li H, Li C, Zhang X, Yang X, Wu L, Wang Y, Zheng D. Bidirectional associations of intellectual and social activities with cognitive function among middle-aged and elderly adults in China. J Affect Disord 2022; 319:83-89. [PMID: 36116603 DOI: 10.1016/j.jad.2022.09.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies evaluating the association between leisure activities and cognitive function produced conflicting results. Different types of leisure activities may have different effects on cognition, and very few studies have explored their bidirectional associations. Our study aimed to explore whether intellectual and social activities had bidirectional associations with cognitive function among the middle-aged and elderly adults in China. METHODS Data was derived from the China Health and Retirement Longitudinal Study. The data in this study were based on 11,549 participants aged 45 or older whose intellectual and social activities and cognitive function were assessed at baseline. Cross-lagged panel model was used to examine the temporal relationship of intellectual and social activities with cognitive function. RESULTS Totally, 5624 participants completed the third follow-up in 2018. The results showed that the better the cognitive function they had at baseline, the more intellectual activities they were engage in (β = 0.044, P < 0.001) and vice versa (β = 0.042, P = 0.001). Additionally, better cognitive function at baseline was significantly associated with more engagement in social activities (β = 0.028, P = 0.030); in contrast, higher engagement in social activities at baseline was not related to better cognitive function (β = -0.008, P = 0.523). LIMITATIONS Engagement in social and intellectual activities was assessed via questionnaire. CONCLUSIONS Our findings indicated that there was a bidirectional relationship between intellectual activities and cognitive function. However, participation in social activities did not slow down the decline in cognitive function. Participating in intellectual activities, compared to social activities, is especially beneficial for cognitive function.
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Affiliation(s)
- Xiaochun Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jiajia Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Rui Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Manqi Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Manjot Singh
- Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, University of Western Australia, Crawley, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Haibin Li
- Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Xiaoyu Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Xinghua Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Lijuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
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Kim JW, Byun MS, Yi D, Lee JH, Sung K, Han D, Byeon G, Kim MJ, Jung JH, Chang YY, Jung G, Lee JY, Lee YS, Kim YK, Kang KM, Sohn CH, Lee DY. Association of low meal frequency with decreased in vivo Alzheimer's pathology. iScience 2022; 25:105422. [PMID: 36388975 PMCID: PMC9646955 DOI: 10.1016/j.isci.2022.105422] [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: 05/04/2022] [Revised: 09/11/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Little is known about the association between meal frequency and Alzheimer's disease (AD) in humans. We tested the hypothesis that low meal frequency (LMF) is associated with reduced in vivo AD pathology in human brain, and additionally investigated the mediation of serum ghrelin, a hunger-related hormone, for the association. A total of 411 non-demented older adults were systematically interviewed to identify their dietary patterns including meal frequency and underwent multi-modal neuroimaging for cerebral beta-amyloid (Aβ) and tau deposition, glucose metabolism, and cerebrovascular injury. LMF (less than three meals a day) was significantly associated with lower Aβ deposition compared to high meal frequency (HMF). In addition, both LMF and reduced Aβ deposition were significantly related to elevated serum ghrelin. Our findings suggest that LMF may be related to the lower risk of AD through reduced brain amyloid deposition. Additionally, ghrelin appears mediate the association between LMF and lower amyloid deposition.
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Affiliation(s)
- Jee Wook Kim
- Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong, Gyeonggi 18450, Republic of Korea
- Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Gangwon 24252, Republic of Korea
| | - Min Soo Byun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Dahyun Yi
- Medical Research Center Seoul National University, Institute of Human Behavioral Medicine, Seoul 03080, Republic of Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Kiyoung Sung
- Department of Psychiatry, Eulji University Nowon Eulji Medical Center, Seoul 01830, Republic of Korea
| | - Dongkyun Han
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Gihwan Byeon
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon 24289, Republic of Korea
| | - Min Jung Kim
- Department of Psychiatry, Eulji University Nowon Eulji Medical Center, Seoul 01830, Republic of Korea
| | - Joon Hyung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Yoon Young Chang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Gijung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jun-Young Lee
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
| | - Yun-Sang Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
| | - Koung Mi Kang
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Medical Research Center Seoul National University, Institute of Human Behavioral Medicine, Seoul 03080, Republic of Korea
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Accelerometer-Assessed Physical Activity and Cognitive Performance among European Adults Aged 50+: The Mediating Effects of Social Contacts and Depressive Symptoms. Healthcare (Basel) 2022; 10:healthcare10112279. [DOI: 10.3390/healthcare10112279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cognitive decline is a major public health concern worldwide and it is vital to identify and better understand effective population-based means to improve cognitive performance in old age. The current study set out to examine the links between accelerometer-based physical activity with cognitive performance in later life, as well the indirect pathways through one’s social network contacts and depression. Method: We used data from 855 participants aged 50 and above who took part in a cross-sectional accelerometer study as part of the Survey of Ageing, Retirement and Health (SHARE). Cognitive function was measured as an average score of fluency, immediate and delayed recall tests, social contacts were the average contact frequency with members of the social support network, and depression was the Euro-D summary score of depressive symptoms. A multiple mediation analysis was conducted to test the direct and indirect associations between total physical activity (intensity gradient) and cognitive function, as well as the mediation of this association by social contacts and depressive symptoms. Results: Intensity of physical activity was directly related to better cognitive performance (B = 0.170, p = 0.007). The association was partially mediated by social contacts (B = 0.022, 95% CI 0.005, 0.046) and depressive symptoms (B = 0.009, 95% CI 0.009, 0.025), such that total physical activity was linked to cognitive health via more frequent contacts with network members and low depressive symptoms. Conclusions: Practitioners might consider encouraging a physically active lifestyle that involves social interactions to support better cognitive aging and mental health.
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Wagner M, Wilson RS, Leurgans SE, Boyle PA, Bennett DA, Grodstein F, Capuano AW. Quantifying longitudinal cognitive resilience to Alzheimer's disease and other neuropathologies. Alzheimers Dement 2022; 18:2252-2261. [PMID: 35102704 PMCID: PMC10119432 DOI: 10.1002/alz.12576] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Cognitive resilience (CR) has been defined as the continuum of better (or worse) than expected cognition, given the degree of neuropathology. To quantify this concept, existing approaches focus on either cognitive level at a single time point or slopes of cognitive decline. METHODS In a prospective study of 1215 participants, we created a continuous measure of CR defined as the mean of differences between estimated person-specific and marginal cognitive levels over time, after accounting for neuropathologies. RESULTS Neuroticism and depressive symptoms were associated with all CR measures (P-values < .012); as expected, cognitive activity and education were only associated with the cognitive-level approaches (P-values < .0002). However, compared with the existing CR measures focusing on a single measure or slopes of cognition, our new measure yielded stronger relations with risk factors. DISCUSSION Defining CR based on the longitudinal differences between person-specific and marginal cognitive levels is a novel and complementary way to quantify CR.
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Affiliation(s)
- Maude Wagner
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Ana W. Capuano
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
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Li X, Xia J, Li Y, Xu K, Chen K, Zhang J, Li H, Zhang Z. Risk scores of incident mild cognitive impairment in a Beijing community-based older cohort. Front Aging Neurosci 2022; 14:976126. [PMID: 36262884 PMCID: PMC9574183 DOI: 10.3389/fnagi.2022.976126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: It is very important to identify individuals who are at greatest risk for mild cognitive impairment (MCI) to potentially mitigate or minimize risk factors early in its course. We created a practical MCI risk scoring system and provided individualized estimates of MCI risk. Methods: Using data from 9,000 older adults recruited for the Beijing Ageing Brain Rejuvenation Initiative, we investigated the association of the baseline demographic, medical history, lifestyle and cognitive data with MCI status based on logistic modeling and established risk score (RS) models 1 and 2 for MCI. We evaluated model performance by computing the area under the receiver operating characteristic (ROC) curve (AUC). Finally, RS model 3 was further confirmed and improved based on longitudinal outcome data from the progression of MCI in a sub-cohort who had an average 3-year follow-up. Results: A total of 1,174 subjects (19.8%) were diagnosed with MCI at baseline, and 72 (7.8%) of 849 developed MCI in the follow-up. The AUC values of RS models 1 and 2 were between 0.64 and 0.70 based on baseline age, education, cerebrovascular disease, intelligence and physical activities. Adding baseline memory and language performance, the AUC of RS model 3 more accurately predicted MCI conversion (AUC = 0.785). Conclusion: A combination of risk factors is predictive of the likelihood of MCI. Identifying the RSs may be useful to clinicians as they evaluate their patients and to researchers as they design trials to study possible early non-pharmaceutical interventions to reduce the risk of MCI and dementia.
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Affiliation(s)
- Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Jianan Xia
- BABRI Centre, Beijing Normal University, Beijing, China
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Yumeng Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Kai Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Kewei Chen
- BABRI Centre, Beijing Normal University, Beijing, China
- Banner Alzheimer’s Institute, Phoenix, AZ, United States
| | - Junying Zhang
- BABRI Centre, Beijing Normal University, Beijing, China
- Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, China
| | - He Li
- BABRI Centre, Beijing Normal University, Beijing, China
- Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
- *Correspondence: Zhanjun Zhang
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21
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Qiu Y, Sha L, Zhang X, Li G, Zhu W, Xu Q. Induction of A Disintegrin and Metalloproteinase with Thrombospondin motifs 1 by a rare variant or cognitive activities reduces hippocampal amyloid-β and consequent Alzheimer’s disease risk. Front Aging Neurosci 2022; 14:896522. [PMID: 36016856 PMCID: PMC9395645 DOI: 10.3389/fnagi.2022.896522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/15/2022] [Indexed: 11/30/2022] Open
Abstract
Amyloid-β (Aβ) derived from amyloid precursor protein (APP) hydrolysis is acknowledged as the predominant hallmark of Alzheimer’s disease (AD) that especially correlates to genetics and daily activities. In 2019, meta-analysis of AD has discovered five new risk loci among which A Disintegrin and Metalloproteinase with Thrombospondin motifs 1 (ADAMTS1) has been further suggested in 2021 and 2022. To verify the association, we re-sequenced ADAMTS1 of clinical AD samples and subsequently identified a novel rare variant c.–2067A > C with watchable relevance (whereas the P-value was not significant after adjustment). Dual-luciferase assay showed that the variant sharply stimulated ADAMTS1 expression. In addition, ADAMTS1 was also clearly induced by pentylenetetrazol-ignited neuronal activity and enriched environment (EE). Inspired by the above findings, we investigated ADAMTS1’s role in APP metabolism in vitro and in vivo. Results showed that ADAMTS1 participated in APP hydrolysis and consequently decreased Aβ generation through inhibiting β-secretase-mediated cleavage. In addition, we also verified that the hippocampal amyloid load of AD mouse model was alleviated by the introduction of ADAMTS1, and thus spatial cognition was restored as well. This study revealed the contribution of ADAMTS1 to the connection of genetic and acquired factors with APP metabolism, and its potential in reducing hippocampal amyloid and consequent risk of AD.
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Affiliation(s)
- Yunjie Qiu
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
| | - Longze Sha
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
- Neuroscience Center, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiuneng Zhang
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
| | - Guanjun Li
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
| | - Wanwan Zhu
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
- Neuroscience Center, Chinese Academy of Medical Sciences, Beijing, China
| | - Qi Xu
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
- Neuroscience Center, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Qi Xu,
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22
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Sheffler P, Kürüm E, Sheen AM, Ditta AS, Ferguson L, Bravo D, Rebok GW, Strickland-Hughes CM, Wu R. Growth Mindset Predicts Cognitive Gains in an Older Adult Multi-Skill Learning Intervention. Int J Aging Hum Dev 2022; 96:501-526. [PMID: 35726166 PMCID: PMC10052424 DOI: 10.1177/00914150221106095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Growth mindset (belief in the malleability of intelligence) is a unique predictor of young learners' increased motivation and learning, and may have broader implications for cognitive functioning. Its role in learning in older adulthood is unclear. As part of a larger longitudinal study, we examined growth mindset and cognitive functioning in older adults engaged in a 3-month multi-skill learning intervention that included growth mindset discussions. Before, during, and after the intervention, participants reported on their growth mindset beliefs and completed a cognitive battery. Study 1 indicated that intervention participants, but not control participants, increased their growth mindset during the intervention. Study 2 replicated these results and found that older adults with higher preexisting growth mindsets showed larger cognitive gains at posttest compared to those with lower preexisting growth mindsets. Our findings highlight the potential role of growth mindset in supporting positive learning cycles for cognitive gains in older adulthood.
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Affiliation(s)
- Pamela Sheffler
- Department of Psychology, 8790University of California, Riverside, CA, USA
| | - Esra Kürüm
- Department of Statistics, University of California, Riverside, CA, USA
| | - Angelica M Sheen
- Department of Cognitive Sciences, 8788University of California, Irvine, CA, USA
| | - Annie S Ditta
- Department of Psychology, 8790University of California, Riverside, CA, USA
| | - Leah Ferguson
- Department of Psychology, 8790University of California, Riverside, CA, USA
| | - Diamond Bravo
- Department of Psychology, 8790University of California, Riverside, CA, USA
| | - George W Rebok
- Bloomberg School of Public Health and Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Rachel Wu
- Department of Psychology, 8790University of California, Riverside, CA, USA
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23
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Dhana K, Franco OH, Ritz EM, Ford CN, Desai P, Krueger KR, Holland TM, Dhana A, Liu X, Aggarwal NT, Evans DA, Rajan KB. Healthy lifestyle and life expectancy with and without Alzheimer's dementia: population based cohort study. BMJ 2022; 377:e068390. [PMID: 35418416 PMCID: PMC9006322 DOI: 10.1136/bmj-2021-068390] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine the impact of lifestyle factors on life expectancy lived with and without Alzheimer's dementia. DESIGN Prospective cohort study. SETTING The Chicago Health and Aging Project, a population based cohort study in the United States. PARTICIPANTS 2449 men and women aged 65 years and older. MAIN EXPOSURE A healthy lifestyle score was developed based on five modifiable lifestyle factors: a diet for brain health (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay-MIND diet score in upper 40% of cohort distribution), late life cognitive activities (composite score in upper 40%), moderate or vigorous physical activity (≥150 min/week), no smoking, and light to moderate alcohol consumption (women 1-15 g/day; men 1-30 g/day). MAIN OUTCOME Life expectancy with and without Alzheimer's dementia in women and men. RESULTS Women aged 65 with four or five healthy factors had a life expectancy of 24.2 years (95% confidence interval 22.8 to 25.5) and lived 3.1 years longer than women aged 65 with zero or one healthy factor (life expectancy 21.1 years, 19.5 to 22.4). Of the total life expectancy at age 65, women with four or five healthy factors spent 10.8% (2.6 years, 2.0 to 3.3) of their remaining years with Alzheimer's dementia, whereas women with zero or one healthy factor spent 19.3% (4.1 years, 3.2 to 5.1) with the disease. Life expectancy for women aged 65 without Alzheimer's dementia and four or five healthy factors was 21.5 years (20.0 to 22.7), and for those with zero or one healthy factor it was 17.0 years (15.5 to 18.3). Men aged 65 with four or five healthy factors had a total life expectancy of 23.1 years (21.4 to 25.6), which is 5.7 years longer than men aged 65 with zero or one healthy factor (life expectancy 17.4 years, 15.8 to 20.1). Of the total life expectancy at age 65, men with four or five healthy factors spent 6.1% (1.4 years, 0.3 to 2.0) of their remaining years with Alzheimer's dementia, and those with zero or one healthy factor spent 12.0% (2.1 years, 0.2 to 3.0) with the disease. Life expectancy for men aged 65 without Alzheimer's dementia and four or five healthy factors was 21.7 years (19.7 to 24.9), and for those with zero or one healthy factor life expectancy was 15.3 years (13.4 to 19.1). CONCLUSION A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer's dementia. The life expectancy estimates might help health professionals, policy makers, and stakeholders to plan future healthcare services, costs, and needs.
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Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Oscar H Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ethan M Ritz
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Christopher N Ford
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Thomas M Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Neelum T Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
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Grodstein F, Wang T, Leurgans SE, Wilson RS, Bennett DA. Modifiable psychosocial risk factors and delayed onset of dementia in older populations: analysis of two prospective US cohorts. BMJ Open 2022; 12:e059317. [PMID: 35379643 PMCID: PMC8981290 DOI: 10.1136/bmjopen-2021-059317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Preventing Alzheimer's dementia (AD) fundamentally equates to delaying onset. Thus, we quantified associations of modifiable, psychosocial risk factors to years of delayed onset of dementia. DESIGN Two prospective cohorts (n=2860) with negative and positive psychosocial factors measured at baseline (depressive symptoms, neuroticism, cognitive activity). SETTING AND PARTICIPANTS Religious Orders Study of older priests, nuns and brothers across the USA, initiated in 1994; Rush Memory and Aging Project, of older persons in Chicago area, initiated in 1997. OUTCOME MEASURE We conducted annual neurological and neuropsychological assessments to identify AD (n=785 incident cases). We compared age at diagnosis of AD across psychosocial risk factor groups, controlling for confounders, using accelerated failure time models. RESULTS We found strong relations of three or more depressive symptoms with age at AD diagnosis; estimated mean age at diagnosis was 86.9 years with significant symptoms versus 92.1 years with no symptoms (p=0.001). In addition, neuroticism was inversely related to age at AD diagnosis; estimated mean age at diagnosis was 88.8 years for the highest neuroticism tertile and 93.1 years in the lowest tertile (p<0.001). Participants with higher cognitive activity (such as reading books) had later AD diagnosis; estimated mean age at diagnosis was 89.2 years for the lowest cognitive activity group and 92.6 years for the highest activity group (p<0.001). CONCLUSIONS Higher depressive symptoms were associated with 5-year acceleration in AD; higher neuroticism with 4-year acceleration and higher cognitive activity with a 3.5-year delay. To translate findings, prior health services research in the USA indicates delaying dementia 5 years could add 3 years of life and reduce individual costs of care >$60 000. These results provide a rigorous, easily translatable metric for communicating and evaluating the potential public health impact of psychosocial and experiential interventions.
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Affiliation(s)
- Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Tianhao Wang
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Cognitive reserve proxies, Alzheimer pathologies, and cognition. Neurobiol Aging 2022; 110:88-95. [PMID: 34879329 PMCID: PMC9234822 DOI: 10.1016/j.neurobiolaging.2021.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/09/2021] [Accepted: 10/10/2021] [Indexed: 02/03/2023]
Abstract
This study aimed to explore the moderating effects of the frequently used cognitive reserve (CR) proxies [i.e., education, premorbid intelligence quotient (pIQ), occupational complexity (OC), and lifetime cognitive activity (LCA)] on the relationships between various in vivo Alzheimer's disease (AD) pathologies and cognition. In total, 351 [268 cognitively unimpaired (CU), 83 cognitive impaired (CI)] older adults underwent multi-modal brain imaging to measure AD pathologies and cognitive assessments, and information on CR proxies was obtained. For overall participants, only education moderated the relationship between Aβ deposition and cognition. Education, pIQ, and LCA, but not OC, showed moderating effect on the relationship between AD-signature cerebral hypometabolism and cognition. In contrast, only OC had a moderating effect on the relationship between cortical atrophy of the AD-signature regions and cognition. Such moderation effects of the CR proxies were similarly observed in CI individuals, but most of them were not in CU individuals. The findings suggest that the proposed CR proxies have different moderating effects on the relationships between specific AD pathologies and cognition.
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26
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Wilson RS. Author Response: Cognitive Activity and Onset Age of Incident Alzheimer Disease Dementia. Neurology 2022. [DOI: 10.1212/wnl.0000000000013133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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27
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Stieger M, Liu Y, Graham EK, DeFrancisco J, Lachman ME. Personality Change Profiles and Changes in Cognition Among Middle-Aged and Older Adults. JOURNAL OF RESEARCH IN PERSONALITY 2021; 95. [PMID: 34949898 DOI: 10.1016/j.jrp.2021.104157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research on the relationship between personality traits and cognitive abilities has primarily used cross-sectional designs and considered personality traits individually in relation to cognitive dimensions. This study (N = 2,652) examined the relationship between Big Five personality change profiles and change in cognitive factors, episodic memory and executive functioning. Latent profile analysis was used to capture patterns of change across the Big Five traits. Three profiles of personality change were defined: Decreasers, Maintainers, and Increasers. The Decreasers declined more in episodic memory compared to the Increasers and Maintainers. Also, the Decreasers declined more in executive functioning compared to the Increasers, but not the Maintainers. The findings advance our understanding of the links between patterns of personality change and cognitive aging.
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Li X, Song R, Qi X, Xu H, Yang W, Kivipelto M, Bennett DA, Xu W. Influence of Cognitive Reserve on Cognitive Trajectories: Role of Brain Pathologies. Neurology 2021; 97:e1695-e1706. [PMID: 34493618 PMCID: PMC8605617 DOI: 10.1212/wnl.0000000000012728] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence on the association of cognitive reserve (CR) with the cognitive trajectories is limited. We aimed to examine the influence of CR indicator on domain-specific cognitive trajectories taking brain pathologies into account. METHODS Within the Rush Memory and Aging Project, 1,697 participants without dementia (mean age 79.6 years) were followed up to 21 years. CR indicator encompassing education, early-life, mid-life, and late-life cognitive activities and late-life social activity was ascertained at baseline and categorized as tertiles (lowest, middle, and highest). Global cognition, episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed were assessed annually with 19 tests, from which composite scores were derived. During the follow-up, 648 participants died and underwent autopsies to evaluate brain pathologies. Data were analyzed using linear mixed-effect models. RESULTS Among the participants, the score of the CR indicator ranged from -8.00 to 5.74 (mean 0.00 ± 2.23). In multi-adjusted mixed-effect models, compared to the lowest CR, the highest was related to a slower decline in global cognition (β = 0.028, 95% confidence interval [CI] 0.012-0.043), episodic memory (β = 0.028, 95% CI 0.010-0.047), and working memory (β = 0.019, 95% CI 0.005-0.033) during the follow-up. In brain pathologic data analysis, the association of the highest CR with cognitive function changes remained significant among participants with high Alzheimer disease pathology or gross infarcts. DISCUSSION High CR indicator is associated with preserved global cognitive function, episodic memory, and working memory, even in the presence of brain pathologies. Our findings highlight the important role of high CR accumulation in the prevention of cognitive decline.
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Affiliation(s)
- Xuerui Li
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL.
| | - Ruixue Song
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Xiuying Qi
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Hui Xu
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL.
| | - Wenzhe Yang
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Miia Kivipelto
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - David A Bennett
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Weili Xu
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL.
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Bennett DA. Reducing Your Risk of Alzheimer's Dementia: Building a Better Brain as We Age. Arch Clin Neuropsychol 2021; 36:1257-1265. [PMID: 34651647 PMCID: PMC8517621 DOI: 10.1093/arclin/acab052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/14/2022] Open
Abstract
Alzheimer' dementia is a large and growing public health problem. Of utmost importance for limiting the impact of the disease on society is the prevention of dementia, that is, delay onset either by years whereby death ensues prior to dementia onset. The Religious Orders Study and the Rush Memory and Aging Project are two harmonized cohort studies of aging and dementia that include organ donation at death. Ongoing since 1994 and 1997, respectively, we published on the association of numerous experiential, psychological, and medical risk factors for dementia, many of which are potentially modifiable. Here, selected findings are reviewed based on a presentation at the 2020 National Academy of Neuropsychology given virtually in Chicago in October of 2020.
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Affiliation(s)
- David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA,Corresponding author at: Rush Alzheimer’s Disease Center; 1750 W. Harrison Street, Suite 1000; Chicago, IL 60612, USA. E-mail address:
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Zhang Y, Fu S, Ding D, Lutz MW, Zeng Y, Yao Y. Leisure Activities, APOE ε4, and Cognitive Decline: A Longitudinal Cohort Study. Front Aging Neurosci 2021; 13:736201. [PMID: 34616288 PMCID: PMC8488387 DOI: 10.3389/fnagi.2021.736201] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/20/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Both leisure activities and the ε4 allele of the apolipoprotein E (APOE ε4) have been shown to affect cognitive health. We aimed to determine whether engagement in leisure activities protects against APOE ε4-related cognitive decline. Methods: We used the cohort data from the Chinese Longitudinal Healthy Longevity Survey. A total of 3,017 participants (mean age of 77.0 years, SD = 9.0; 49.3% female) from 23 provinces of China were recruited in 2008 and were reinterviewed in 2014. We assessed cognitive function using the Mini-Mental State Examination (MMSE). We calculated cognitive decline using subtraction of the MMSE score of each participant in 2008 and 2014. We genotyped a number of APOE ε4 alleles for each participant at baseline and determined the Index of Leisure Activities (ILAs) by summing up the frequency of nine types of typical activities in productive, social, and physical domains. We used ordinal logistic regression models to estimate the effects of leisure activities, APOE ε4, and their interaction on cognitive decline, statistically adjusted for a range of potential confounders. Results: There were significant associations between APOE ε4 and faster cognitive decline, independent of potential confounders, and between leisure activities and mitigated cognitive decline. The odds ratios were 1.25 (95% CI: 1.03, 1.53) and 0.93 (95% CI: 0.89, 0.97), respectively. We found significant interactions of APOE ε4 with leisure activities with a P-value of 0.018. We also observed interactive effects of subtypes of leisure activities: participants who regularly engaged in productive activities were more likely to reduce the risk of APOE ε4-related cognitive decline. Conclusion: Our findings provide support for the indication that participating in leisure activities reduces the risk of APOE ε4-related cognitive decline.
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Affiliation(s)
- Yun Zhang
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Michael W Lutz
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States
| | - Yi Zeng
- Center for Healthy Aging and Development Studies at National School of Development, Peking University, Beijing, China.,Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, United States
| | - Yao Yao
- Center for Healthy Aging and Development Studies at National School of Development, Peking University, Beijing, China.,Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, United States.,China Center for Health Development Studies, Peking University, Beijing, China
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31
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Staging of Dementia Severity With the Hong Kong Version of the Montreal Cognitive Assessment (HK-MoCA)'s. Alzheimer Dis Assoc Disord 2021; 34:333-338. [PMID: 32701514 DOI: 10.1097/wad.0000000000000399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) has been used to screen for dementia, but it has not been validated to delineate the stages of Alzheimer disease (AD). This study aimed to determine the cut-off score ranges for mild, moderate, and severe AD. METHODS The HK-MoCA score was matched against the Clinical Dementia Rating on 155 patients with AD. Investigators performing the HK-MoCA and Clinical Dementia Rating were blinded to each other. Receiver-operating characteristic analysis was used to determine the cut-off scores between different stages of AD (mild, moderate, and severe stage). A secondary analysis with adjustments for age and education received were also performed. RESULT The cut-off score in HK-MoCA was ≤4 for those with severe AD (sensitivity 84.4%, specificity 91.9%, area under curve=0.92, P<0.001) and 5 to 9 for those with moderate AD (sensitivity 86.3%, specificity of 93.3%, area under curve=0.953, P<0.001). With adjustments for age and education, the cut-off score for moderate AD was adjusted to 5 to 8, whereas the cut-off score for severe AD remained unchanged. CONCLUSIONS The severity of AD could be delineated using the HK-MoCA for the Cantonese-speaking population in Hong Kong, and the effect of education on the cut-off score needs further investigation.
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Wilson RS, Wang T, Yu L, Grodstein F, Bennett DA, Boyle PA. Cognitive Activity and Onset Age of Incident Alzheimer Disease Dementia. Neurology 2021; 97:e922-e929. [PMID: 34261788 PMCID: PMC8408511 DOI: 10.1212/wnl.0000000000012388] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/27/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the hypothesis that higher level of cognitive activity predicts older age at dementia onset in Alzheimer disease (AD) dementia. METHODS As part of a longitudinal cohort study, 1,903 older persons without dementia at enrollment reported their frequency of participation in cognitively stimulating activities. They had annual clinical evaluations to diagnose dementia and AD, and the deceased underwent neuropathologic examination. In analyses, we assessed the relation of baseline cognitive activity to age at diagnosis of incident AD dementia and to postmortem markers of AD and other dementias. RESULTS During a mean of 6.8 years of follow-up, 457 individuals were diagnosed with incident AD at a mean age of 88.6 (SD 6.4, range 64.1-106.5) years. In an extended accelerated failure time model, higher level of baseline cognitive activity (mean 3.2, SD 0.7) was associated with older age at AD dementia onset (estimate 0.026; 95% confidence interval 0.013-0.039). Low cognitive activity (score 2.1, 10th percentile) was associated with a mean onset age of 88.6 years compared to a mean onset age of 93.6 years associated with high cognitive activity (score 4.0, 90th percentile). Results were comparable in subsequent analyses that adjusted for potentially confounding factors. In 695 participants who died and underwent a neuropathologic examination, cognitive activity was unrelated to postmortem markers of AD and other dementias. CONCLUSION A cognitively active lifestyle in old age may delay the onset of dementia in AD by as much as 5 years.
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Affiliation(s)
- Robert S Wilson
- From the Rush Alzheimer's Disease Center (R.S.W., T.W., L.Y., F.G., D.A.B., P.A.B.), Department of Neurological Sciences (R.S.W., T.W., L.Y., F.G., D.A.B.), and Department of Psychiatry and Behavioral Sciences (R.S.W., P.A.B.), Rush University Medical Center, Chicago, IL.
| | - Tianhao Wang
- From the Rush Alzheimer's Disease Center (R.S.W., T.W., L.Y., F.G., D.A.B., P.A.B.), Department of Neurological Sciences (R.S.W., T.W., L.Y., F.G., D.A.B.), and Department of Psychiatry and Behavioral Sciences (R.S.W., P.A.B.), Rush University Medical Center, Chicago, IL
| | - Lei Yu
- From the Rush Alzheimer's Disease Center (R.S.W., T.W., L.Y., F.G., D.A.B., P.A.B.), Department of Neurological Sciences (R.S.W., T.W., L.Y., F.G., D.A.B.), and Department of Psychiatry and Behavioral Sciences (R.S.W., P.A.B.), Rush University Medical Center, Chicago, IL
| | - Francine Grodstein
- From the Rush Alzheimer's Disease Center (R.S.W., T.W., L.Y., F.G., D.A.B., P.A.B.), Department of Neurological Sciences (R.S.W., T.W., L.Y., F.G., D.A.B.), and Department of Psychiatry and Behavioral Sciences (R.S.W., P.A.B.), Rush University Medical Center, Chicago, IL
| | - David A Bennett
- From the Rush Alzheimer's Disease Center (R.S.W., T.W., L.Y., F.G., D.A.B., P.A.B.), Department of Neurological Sciences (R.S.W., T.W., L.Y., F.G., D.A.B.), and Department of Psychiatry and Behavioral Sciences (R.S.W., P.A.B.), Rush University Medical Center, Chicago, IL
| | - Patricia A Boyle
- From the Rush Alzheimer's Disease Center (R.S.W., T.W., L.Y., F.G., D.A.B., P.A.B.), Department of Neurological Sciences (R.S.W., T.W., L.Y., F.G., D.A.B.), and Department of Psychiatry and Behavioral Sciences (R.S.W., P.A.B.), Rush University Medical Center, Chicago, IL
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Moored KD, Bandeen-Roche K, Snitz BE, DeKosky ST, Williamson JD, Fitzpatrick AL, Carlson MC. Risk of Dementia Differs across Lifestyle Engagement Subgroups: A Latent Class and Time to Event Analysis in Community-Dwelling Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 77:872-884. [PMID: 34387336 PMCID: PMC9071387 DOI: 10.1093/geronb/gbab152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Better understanding of the lifestyle activities shared among older adult subgroups may inform further health-behavioral interventions that can be deployed at the group or community level. We applied latent class analysis to characterize qualitatively distinct lifestyle engagement groups, examined their differential risk of incident dementia, and compared their predictive utility to traditional activity frequency and variety scores. METHOD Participants were from the Ginkgo Evaluation of Memory Study (N=3,068, Mean age=78.5). Lifestyle activities were measured at baseline using the Lifestyle Activity Questionnaire. All-cause dementia was screened every six months and cases were clinically adjudicated. Median follow-up was 6 years. Time to dementia was assessed using discrete-time proportional hazards models, adjusted for demographic and health covariates. RESULTS Latent classes provided slightly poorer case discrimination than the frequency scores but identified distinct qualitative subgroups. In the four-class model, the Variety (22%) and Intellectual (18%) lifestyle groups had high engagement in intellectual activities, whereas the Variety and Social groups (32%) had high engagement in formal social activities. Compared to the Least Active group (28%), the Variety (HR=.67, 95% CI:(.48,.93)) and Intellectual (HR=.65, 95% CI:(.45,.93)) groups had significantly lower risk of incident dementia, but only among those without prevalent MCI. DISCUSSION Older adults highly engaged in intellectual activities, but not necessarily social activities, had the lowest risk of incident dementia. Activity frequency scores provided only slightly better case discrimination than activity variety scores and latent classes. Latent classes of older adults differed by their amount and types of activities, which may inform intervention design.
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Affiliation(s)
- Kyle D Moored
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven T DeKosky
- Department of Neurology, University of Florida College of Medicine, Gainesville, Florida
| | - Jeff D Williamson
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, Washington
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Dhana K, Barnes LL, Liu X, Agarwal P, Desai P, Krueger KR, Holland TM, Halloway S, Aggarwal NT, Evans DA, Rajan KB. Genetic risk, adherence to a healthy lifestyle, and cognitive decline in African Americans and European Americans. Alzheimers Dement 2021; 18:572-580. [PMID: 34310036 DOI: 10.1002/alz.12435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION We investigated the role of genetic risk and adherence to lifestyle factors on cognitive decline in African Americans and European Americans. METHODS Using data from the Chicago Health and Aging Project (1993-2012; n = 3874), we defined the genetic risk based on presence of apolipoprotein E (APOE) ε 4 allele and determined a healthy lifestyle using a scoring of five factors: non-smoking, exercising, being cognitively active, having a high-quality diet, and limiting alcohol use. We used linear mixed-effects models to estimate cognitive decline by genetic risk and lifestyle score. RESULTS APOE ε 4 allele was associated with faster cognitive decline in both races. However, within APOE ε 4 carriers, adherence to a healthy lifestyle (eg., 4 to 5 healthy factors) was associated with a slower cognitive decline by 0.023 (95% confidence interval [CI] 0.004, 0.042) units/year in African Americans and 0.044 (95% CI 0.008, 0.080) units/year in European Americans. DISCUSSION A healthy lifestyle was associated with a slower cognitive decline in African and European Americans.
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Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Thomas M Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Shannon Halloway
- Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Neelum T Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
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Dintica CS, Haaksma ML, Olofsson JK, Bennett DA, Xu W. Joint trajectories of episodic memory and odor identification in older adults: patterns and predictors. Aging (Albany NY) 2021; 13:17080-17096. [PMID: 34232918 PMCID: PMC8312450 DOI: 10.18632/aging.203280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/23/2021] [Indexed: 11/29/2022]
Abstract
Emerging evidence suggests that olfactory function is closely linked to memory function. The aims of this study were to assess whether olfactory and episodic memory functions follow similar age-related decline trajectories, to identify different patterns of decline, as well as predictors of the patterns. 1023 participants from the Memory and Aging Project were followed for up to 8 years with annual episodic memory and odor identification assessments. Trajectories were modelled using growth mixture models. Multivariate logistic regression was used to identify pattern predictors. Three patterns of joint trajectories were identified; Class 1- stable average performance in both functions (n=690, 67.4%); Class 2- stable average episodic memory and declining odor identification (n=231, 22.6%); and Class 3- decline in both functions (n= 102, 10.0%). Class predictors included age, sex, APOE ε4 status, cognitive activity level and BMI. Participants in Class 3 were most likely to develop dementia. Episodic memory and olfactory function show similar trajectories in aging. Such classification can contribute to a better understanding of the factors related to cognitive decline and dementia.
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Affiliation(s)
- Christina S. Dintica
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Miriam L. Haaksma
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jonas K. Olofsson
- Gösta Ekman Laboratory, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China
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Dhana K, Aggarwal NT, Rajan KB, Barnes LL, Evans DA, Morris MC. Impact of the Apolipoprotein E ε4 Allele on the Relationship Between Healthy Lifestyle and Cognitive Decline: A Population-Based Study. Am J Epidemiol 2021; 190:1225-1233. [PMID: 33585904 DOI: 10.1093/aje/kwab033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Adherence to a healthy lifestyle-characterized by abstaining from smoking, being physically and cognitively active, having a high-quality diet, and limiting alcohol use-is associated with slower cognitive decline in older adults, but whether this relationship extends to persons with a genetic predisposition (e.g., carriers of the ε4 allele of the apolipoprotein E gene (APOE*E4)) remains uncertain. Using data from a population-based study, the Chicago Health and Aging Project (Chicago, Illinois), we followed 3,886 individuals who underwent regular clinical and cognitive assessments from 1993 to 2012. Of 3,886 older adults, 1,269 (32.7%) were APOE*E4 carriers. Compared with noncarriers, APOE*E4 carriers had faster cognitive decline (β = -0.027 units/year, 95% confidence interval (CI): -0.032, -0.023). In contrast, persons with 2-3 and 4-5 healthy lifestyle factors had slower cognitive decline (β = 0.008 units/year (95% CI: 0.002, 0.014) and β = 0.019 units/year (95% CI: 0.011, 0.026), respectively) compared with those with 0-1 factor. In analyses stratified by APOE*E4 status, adherence to a healthy lifestyle (e.g., 4-5 factors vs. 0-1 factors) was associated with a slower rate of cognitive decline in both APOE*E4 carriers (β = 0.029, 95% CI: 0.013, 0.045) and noncarriers (β = 0.013, 95% CI: 0.005, 0.022). These results underscore the impact of a healthy lifestyle on cognition, particularly among persons with a genetic predisposition, who are more vulnerable to cognitive decline as they age.
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Soldan A, Pettigrew C, Zhu Y, Wang MC, Bilgel M, Hou X, Lu H, Miller MI, Albert M. Association of Lifestyle Activities with Functional Brain Connectivity and Relationship to Cognitive Decline among Older Adults. Cereb Cortex 2021; 31:5637-5651. [PMID: 34184058 DOI: 10.1093/cercor/bhab187] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/05/2023] Open
Abstract
This study examines the relationship of engagement in different lifestyle activities to connectivity in large-scale functional brain networks, and whether network connectivity modifies cognitive decline, independent of brain amyloid levels. Participants (N = 153, mean age = 69 years, including N = 126 with amyloid imaging) were cognitively normal when they completed resting-state functional magnetic resonance imaging, a lifestyle activity questionnaire, and cognitive testing. They were followed with annual cognitive tests up to 5 years (mean = 3.3 years). Linear regressions showed positive relationships between cognitive activity engagement and connectivity within the dorsal attention network, and between physical activity levels and connectivity within the default-mode, limbic, and frontoparietal control networks, and global within-network connectivity. Additionally, higher cognitive and physical activity levels were independently associated with higher network modularity, a measure of functional network specialization. These associations were largely independent of APOE4 genotype, amyloid burden, global brain atrophy, vascular risk, and level of cognitive reserve. Moreover, higher connectivity in the dorsal attention, default-mode, and limbic networks, and greater global connectivity and modularity were associated with reduced cognitive decline, independent of APOE4 genotype and amyloid burden. These findings suggest that changes in functional brain connectivity may be one mechanism by which lifestyle activity engagement reduces cognitive decline.
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Affiliation(s)
- Anja Soldan
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Corinne Pettigrew
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Yuxin Zhu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Mei-Cheng Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD 21224, USA
| | - Xirui Hou
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Michael I Miller
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Marilyn Albert
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Oveisgharan S, Wilson RS, Yu L, Schneider JA, Bennett DA. Association of Early-Life Cognitive Enrichment With Alzheimer Disease Pathological Changes and Cognitive Decline. JAMA Neurol 2021; 77:1217-1224. [PMID: 32597941 DOI: 10.1001/jamaneurol.2020.1941] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Indicators of early-life cognitive enrichment (ELCE) have been associated with slower cognitive decline and decreased dementia in late life. However, the mechanisms underlying this association have not been elucidated. Objective To examine the association of ELCE with late-life Alzheimer disease (AD) and other common dementia-related pathological changes. Design, Setting, and Participants This clinical-pathological community-based cohort study, the Rush Memory and Aging Project, followed up participants before death for a mean (SD) of 7.0 (3.8) years with annual cognitive and clinical assessments. From January 1, 1997, through June 30, 2019, 2044 participants enrolled, of whom 1018 died. Postmortem data were leveraged from 813 participants. Data were analyzed from April 12, 2019, to February 20, 2020. Exposures Four indicators of ELCE (early-life socioeconomic status, availability of cognitive resources at 12 years of age, frequency of participation in cognitively stimulating activities, and early-life foreign language instruction) were obtained by self-report at the study baseline, from which a composite measure of ELCE was derived. Main Outcomes and Measures A continuous global AD pathology score derived from counts of diffuse plaques, neuritic plaques, and neurofibrillary tangles. Results The 813 participants included in the analysis had a mean (SD) age of 90.1 (6.3) years at the time of death, and 562 (69%) were women. In a linear regression model controlled for age at death, sex, and educational level, a higher level of ELCE was associated with a lower global AD pathology score (estimate, -0.057; standard error, 0.022; P = .01). However, ELCE was not associated with any other dementia-related pathological changes. In addition, a higher level of ELCE was associated with less cognitive decline (mean [SD], -0.13 [0.19] units per year; range, -1.74 to 0.85). An indirect effect through AD pathological changes constituted 20% of the association between ELCE and the rate of late-life cognitive decline, and 80% was a direct association. Conclusions and Relevance These findings suggest that ELCE was associated with better late-life cognitive health, in part through an association with fewer AD pathological changes.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.,Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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Effectiveness of a chess-training program for improving cognition, mood, and quality of life in older adults: A pilot study. Geriatr Nurs 2021; 42:894-900. [PMID: 34098442 DOI: 10.1016/j.gerinurse.2021.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Regular practice of a cognitively stimulating activity, such as chess, can help maintain a healthy cognitive, social, and psychological state during the aging process. OBJECTIVE To evaluate the effects of a chess-training program on cognitive status, mood, and quality of life (QoL) in a sample of institutionalized and semi-institutionalized older adults. METHOD A nonrandomized, controlled pilot study with repeated measures (pre- and post-intervention) was conducted. RESULTS Analyses revealed a positive impact of the chess program on general cognitive status (p < 0.001) and promising evidence (p < 0.043) of an impact on attention, processing speed, and executive functions. The participants in the intervention group also showed significant improvement in QoL scores (p < 0.021). CONCLUSIONS A 12-week chess-training protocol with two 60-minute sessions per week improved cognition and QoL in a sample of institutionalized and semi-institutionalized older adults. Further research with larger samples is needed to explore its effects in depth.
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Stimulation cognitive chez les personnes âgées : effets d’une méthode de stimulation cognitive par les jeux sur les fonctions cognitives et l’estime de soi. PSYCHOLOGIE FRANCAISE 2021. [DOI: 10.1016/j.psfr.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Liu X, Ruan Y, Huang L, Guo Y, Sun S, Chen H, Gao J, Shi Y, Xiao Q. Cognitive leisure activity and all-cause mortality in older adults: a 4-year community-based cohort. BMC Geriatr 2021; 21:236. [PMID: 33836660 PMCID: PMC8033664 DOI: 10.1186/s12877-021-02180-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 03/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a negative correlation between cognitive leisure activity and cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported. OBJECTIVES This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based older people cohort in China. METHODS The current study sample comprised 4003 community residents aged ≥60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Time-Dependent Cox Regression Model and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality. RESULTS During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8, 26.7, 6.1 and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54-0.97, P = 0.028). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥80 y, cognitively impaired, and not diagnosed with cancer (P < 0.05). CONCLUSION Cognitive leisure activity was positively associated with reduced risk of death from all cause among the older people in major city of China, which helped promote a comprehensive understanding of health characteristics at advanced ages.
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Affiliation(s)
- Xin Liu
- School of Public Health, Fudan University, Shanghai, 200032, China.,Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Ye Ruan
- Shanghai municipal Center for Disease Control and Prevention, 1380 west Zhongshan Road, Shanghai, 200336, China.,National Clinical Research Center for aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Limei Huang
- Songjiang Center of Disease Prevention and Control, Shanghai, 201620, China
| | - Yanfei Guo
- Songjiang Center of Disease Prevention and Control, Shanghai, 201620, China
| | - Shuangyuan Sun
- Songjiang Center of Disease Prevention and Control, Shanghai, 201620, China
| | - Hao Chen
- School of Public Health, Fudan University, Shanghai, 200032, China.,Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, 200032, China.,Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Yan Shi
- Shanghai municipal Center for Disease Control and Prevention, 1380 west Zhongshan Road, Shanghai, 200336, China. .,National Clinical Research Center for aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
| | - Qianyi Xiao
- School of Public Health, Fudan University, Shanghai, 200032, China. .,Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China.
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Shin SH, Park S, Wright C, D'astous VA, Kim G. The Role of Polygenic Score and Cognitive Activity in Cognitive Functioning Among Older Adults. THE GERONTOLOGIST 2021; 61:319-329. [PMID: 32564085 DOI: 10.1093/geront/gnaa073] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study explored whether the intensity of cognitive activities could moderate the relationship between a genetic predisposition for developing Alzheimer's disease (AD) and cognitive functioning among older adults in the United States. Furthermore, we examined whether the same moderating effects were dependent on different measures of cognition. RESEARCH DESIGN AND METHODS We used a data set from the 2000-2014 waves of the Health and Retirement Study and the Consumption and Activities Mail Survey. Our sample included 3,793 individuals aged 50 or older. We used the polygenic score (PGS) for AD as a genetic trait for cognitive functioning. Reading, listening to music, using a computer, playing cards/games/solving puzzles, singing/playing musical instruments, and creating art and crafts were included as cognitive activities, and TV viewing as passive activities. We used total cognition, fluid intelligence, and crystallized intelligence as proxies for cognitive functioning. Growth-curve models were conducted. RESULTS After controlling for covariates, we found that reading books, using a computer, and playing cards/games/solving puzzles had a positive effect on cognitive functioning. An additional hour spent reading books moderated the negative effect of AD PGS on cognition. The measure of fluid, when compared with crystallized intelligence, appeared to drive these results. DISCUSSION AND IMPLICATIONS Reading could be a protective factor against cognitive decline among older adults who are genetically predisposed to developing AD. Implications for individuals, caregivers, clinicians, and policymakers are suggested. Furthermore, the onset of AD in those at greater genetic risk may be delayed with this intervention.
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Affiliation(s)
- Su Hyun Shin
- Department of Family and Consumer Studies, University of Utah, Salt Lake City
| | - Soohyun Park
- Department of Psychology, University of Alabama, Tuscaloosa
| | - Cheryl Wright
- Department of Family and Consumer Studies, University of Utah, Salt Lake City
| | | | - Giyeon Kim
- Department of Psychology, Chung-Ang University, Seoul, South Korea
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Armstrong NM, Tom SE, Harrati A, Casaletto K, Pa J, Arce Rentería M, Gu Y, Rajan KB, Schupf N, Fieo R, Weuve J, Simonsick EM, Manly JJ, Stern Y, Zahodne LB. Longitudinal Relationship of Leisure Activity Engagement with Cognitive Performance among Non-Demented, Community-Dwelling Older Adults. THE GERONTOLOGIST 2021; 62:352-363. [PMID: 33784376 DOI: 10.1093/geront/gnab046] [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: 12/11/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Leisure activity engagement (LAE) may reduce the risk of incident dementia. However, cognitive performance may predict LAE change. We evaluated the temporal ordering of overall and subtypes of LAE (intellectual, physical, and social) and cognitive performance (global, language, memory, and visuospatial function) among non-demented older adults. RESEARCH DESIGN AND METHODS The Washington Heights-Inwood Columbia Aging Project concurrently administered a survey measure of 13 leisure activities and a neuropsychological battery every 18-24 months for up to 14 years to 5,384 racially and ethnically diverse participants. We used parallel process conditional latent growth curve models to examine temporal ordering in the overall sample and within baseline diagnostic groups (MCI vs. cognitively normal). RESULTS Levels and changes of overall and subtypes of LAE were positively correlated with cognitive performance in the overall sample and within each diagnostic group. In the overall sample, higher initial memory was associated with slower declines in social LAE (Estimate=0.019, 95% Confidence Interval, CI: 0.001, 0.037). Among MCI, higher initial physical LAE was associated with slower declines in memory (Estimate=0.034, 95% CI: 0.001, 0.067), but higher initial intellectual LAE was related to steeper declines in visuospatial function (Estimate=-0.028, 95% CI: -0.052, -0.004). Among cognitively normal, higher initial memory was associated with slower declines in intellectual LAE (Estimate=0.012, 95% CI: 0.002, 0.022). DISCUSSION AND IMPLICATIONS Dynamic interplay of LAE with cognitive performance was observed across diagnostic groups. Levels of LAE subtypes could be more predictive of change in certain cognitive domains within older adults with MCI.
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Affiliation(s)
- Nicole M Armstrong
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Sarah E Tom
- Department of Neurology and the Department of Epidemiology, Columbia University Medical Center, New York, New York, USA
| | - Amal Harrati
- Department of Primary Care and Population Health, Stanford University Medical School, Stanford, California, USA
| | - Kaitlin Casaletto
- Memory and Aging Center, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Miguel Arce Rentería
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Yian Gu
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Kumar B Rajan
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California, USA
| | - Nicole Schupf
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Robert Fieo
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.,US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Jennifer J Manly
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Laura B Zahodne
- Department of Psychology and Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Wittich W, Pichora-Fuller MK, Johnson A, Joubert S, Kehayia E, Bachir V, Aubin G, Jaiswal A, Phillips N. Effect of Reading Rehabilitation for Age-Related Macular Degeneration on Cognitive Functioning: Protocol for a Nonrandomized Pre-Post Intervention Study. JMIR Res Protoc 2021; 10:e19931. [PMID: 33704074 PMCID: PMC7995070 DOI: 10.2196/19931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/24/2020] [Accepted: 02/24/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Age-related vision impairments and dementia both become more prevalent with increasing age. Research into the mechanisms of these conditions has proposed that some of their causes (eg, macular degeneration/glaucoma and Alzheimer's disease) could be symptoms of an underlying common cause. Research into sensory-cognitive aging has provided data that sensory decline may be linked to the progression of dementia through reduced sensory stimulation. While hearing loss rehabilitation may have a beneficial effect on cognitive functioning, there are no data available on whether low vision rehabilitation, specifically for reading, could have a beneficial effect on cognitive health. OBJECTIVE The research questions are: (1) Does low vision rehabilitation reduce reading effort? (2) If so, does reduced reading effort increase reading activity, and (3) If so, does increased reading activity improve cognitive functioning? The primary objective is to evaluate cognition before, as well as at 6 months and 12 months after, 3 weeks of low vision reading rehabilitation using magnification in individuals with age-related macular degeneration, with or without coexisting hearing impairments. We hypothesize that improvements postrehab will be observed at 6 months and maintained at 12 months for participants with vision loss and less so for those with dual sensory loss. The secondary objective is to correlate participant characteristics with all cognitive outcomes to identify which may play an important role in reading rehabilitation. METHODS We employ a quasiexperimental approach (nonrandomized, pre-post intervention study). A 3x3 design (3 groups x 3 time points) allows us to examine whether cognitive performance will change before and after 6 months and 12 months of a low vision reading intervention, when comparing 75 low vision and 75 dual sensory impaired (vision & hearing) participants to 75 age-matched healthy controls. The study includes outcome measures of vision (eg, reading acuity and speed), cognition (eg, short-term and long-term memory, processing speed), participant descriptors, demographics, and clinical data (eg, speech perception in noise, mental health). RESULTS The study has received approval, and recruitment began on April 24, 2019. As of March 4, 2021, 38 low vision and 7 control participants have been enrolled. Lockdown forced a pause in recruitment, which will recommence once the COVID-19 crisis has reached a point where face-to-face data collection with older adults becomes feasible again. CONCLUSIONS Evidence of protective effects caused by reading rehabilitation will have a considerable impact on the vision rehabilitation community and their clients as well as all professionals involved in the care of older adults with or without dementia. If we demonstrate that reading rehabilitation has a beneficial effect on cognition, the demand for rehabilitation services will increase, potentially preventing cognitive decline across groups of older adults at risk of developing macular degeneration. TRIAL REGISTRATION ClinicalTrials.gov NCT04276610; Unique Protocol ID: CRIR-1284-1217; https://clinicaltrials.gov/ct2/show/NCT04276610. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19931.
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Affiliation(s)
- Walter Wittich
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Concordia University, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | - Aaron Johnson
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Sven Joubert
- Department of Psychology, Université de Montréal, Montreal, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Eva Kehayia
- Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Vanessa Bachir
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada
| | - Gabrielle Aubin
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Atul Jaiswal
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada
| | - Natalie Phillips
- Department of Psychology, Concordia University, Montreal, QC, Canada
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Wu R, Zhao J, Cheung C, Natsuaki M, Rebok G, Strickland-Hughes C. Learning as an Important Privilege: A Life Span Perspective with Implications for Successful Aging. Hum Dev 2021. [DOI: 10.1159/000514554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Research has demonstrated the cognitive and mental health benefits of learning new skills and content across the life span, enhancing knowledge as well as cognitive performance. We argue that the importance of this learning – which is not available equally to all – goes beyond the cognitive and mental health benefits. Learning is important for not only the maintenance, but also enhancement of functional independence in a dynamic environment, such as changes induced by the COVID-19 pandemic and technological advances. Learning difficult skills and content is a privilege because the opportunities for learning are neither guaranteed nor universal, and it requires personal and social engagement, time, motivation, and societal support. This paper highlights the importance of considering learning new skills and content as an <i>important privilege</i> across the life span and argues that this privilege becomes increasingly exclusionary as individuals age, when social and infrastructural support for learning decreases. We highlight research on the potential positive and negative impacts of retirement, when accessibility to learning opportunities may vary, and research on learning barriers due to low expectations and limited resources from poverty. We conclude that addressing barriers to lifelong learning would advance theories on life span cognitive development and raise the bar for successful aging. In doing so, our society might imagine and achieve previously unrealized gains in life span cognitive development, through late adulthood.
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Integrating Three Characteristics of Executive Function in Non-Demented Aging: Trajectories, Classification, and Biomarker Predictors. J Int Neuropsychol Soc 2021; 27:158-171. [PMID: 32772936 PMCID: PMC7873176 DOI: 10.1017/s1355617720000703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE With longitudinal executive function (EF) data from the Victoria Longitudinal Study, we investigated three research goals pertaining to key characteristics of EF in non-demented aging: (a) examining variability in EF longitudinal trajectories, (b) establishing trajectory classes, and (c) identifying biomarker predictors discriminating these classes. METHOD We used a trajectory analyses sample (n = 781; M age = 71.42) for the first and second goals and a prediction analyses sample (n = 570; M age = 70.10) for the third goal. Eight neuropsychological EF measures were used as indicators of three EF dimensions: inhibition, updating, and shifting. Data-driven classification analyses were applied to the full trajectory distribution. Machine learning prediction analyses tested 15 predictors from genetic, functional, lifestyle, mobility, and demographic risk domains. RESULTS First, we observed: (a) significant variability in EF trajectories over a 40-year band of aging and (b) significantly variable patterns of EF decline. Second, a four-class EF trajectory model was observed, characterized with classes differentiated by an algorithm of level and slope information. Third, the highest group class was discriminated from lowest by several prediction factors: more education, more novel cognitive activity, lower pulse pressure, younger age, faster gait, lower body mass index, and better balance. CONCLUSION First, with longitudinal variability in EF aging, the data-driven approach showed that long-term trajectories can be differentiated into separable classes. Second, prediction analyses discriminated class membership by a combination of multiple biomarkers from demographic, lifestyle, functional, and mobility domains of risk for brain and cognitive aging decline.
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Glover CM, Yu L, Stewart CC, Wilson RS, Bennett DA, Boyle PA. The Association of Late Life Cognitive Activity with Healthcare and Financial Decision-Making in Community-Dwelling, Nondemented Older Adults. Am J Geriatr Psychiatry 2021; 29:117-125. [PMID: 32646635 PMCID: PMC7738416 DOI: 10.1016/j.jagp.2020.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to test the hypothesis that late life cognitive activity is associated with decision-making in older adults and to examine whether this association varies by level of cognitive function. DESIGN This study employed a cross-sectional design. SETTING All data were collected in participants' community-based residences. PARTICIPANTS Participants were 1,084 older adults (mean age = 81.05 years, standard deviation = 7.53) without dementia (median Mini-Mental State Examination score = 29, interquartile range = 27.86-30.00). MEASUREMENTS Participants completed assessments of late life cognitive activity, cognitive function, and decision-making. We used linear regression models to examine the associations of late life cognitive activity and cognitive function with decision-making. RESULTS In a regression model adjusted for age, gender, and education, more frequent late life cognitive activity was associated with better decision-making, as was higher cognitive function. Furthermore, in an additional model that included the interaction of late life cognitive activity and cognitive function, the interaction was significant, such that late life cognitive activity was most strongly associated with decision-making among participants with lower levels of cognitive function. CONCLUSION Frequent engagement in late life cognitive activity may help maintain decision-making among older persons, particularly among those with lower levels of cognitive function.
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Affiliation(s)
- Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center (CMG, LY, RSW, DAB, PAB), Chicago, IL; Department of Psychiatry and Behavioral Sciences, Rush Medical College (CMG, RSW, PAB), Chicago, IL; Department of Neurological Sciences, Rush Medical College (CMG, LY, RSW, DAB), Chicago, IL.
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center (CMG, LY, RSW, DAB, PAB), Chicago, IL; Department of Neurological Sciences, Rush Medical College (CMG, LY, RSW, DAB), Chicago, IL
| | - Christopher C Stewart
- Department of Neurology, Indiana University School of Medicine (CCS), Indianapolis, IN
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center (CMG, LY, RSW, DAB, PAB), Chicago, IL; Department of Psychiatry and Behavioral Sciences, Rush Medical College (CMG, RSW, PAB), Chicago, IL; Department of Neurological Sciences, Rush Medical College (CMG, LY, RSW, DAB), Chicago, IL
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center (CMG, LY, RSW, DAB, PAB), Chicago, IL; Department of Neurological Sciences, Rush Medical College (CMG, LY, RSW, DAB), Chicago, IL
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center (CMG, LY, RSW, DAB, PAB), Chicago, IL; Department of Psychiatry and Behavioral Sciences, Rush Medical College (CMG, RSW, PAB), Chicago, IL
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Kim DE, Roberts TJ, Moon C. Relationships among types of activity engagement and insomnia symptoms among older adults. BMC Geriatr 2021; 21:87. [PMID: 33516192 PMCID: PMC7847011 DOI: 10.1186/s12877-021-02042-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/20/2021] [Indexed: 01/18/2023] Open
Abstract
Background An increasing awareness exists that lack of activity engagement is associated with insomnia symptoms. However, the majority of studies have focused on the association between a single type of activity engagement and insomnia symptoms. Methods This is a cross-sectional study using secondary data from the Health and Retirement Study examining the relationships among different types of activity engagement and insomnia symptoms among older adults. The sample for this study included 3321 older adults who responded to survey modules on activity engagement and insomnia symptoms in 2016. Activity engagement was measured using items for three types of activities (i.e., social, cognitive, and physical) validated in this study. Insomnia symptoms were measured using four items (i.e., difficulty of falling asleep, waking up during the night, waking up too early, and feeling rested). Independent t-tests were conducted to identify the differences in insomnia symptoms according to activity engagement level. Regressions were conducted to examine the associations among three types of activity engagement and insomnia symptoms after adjusting for covariates such as demographics, chronic disease, activities of daily living difficulty, cognitive function, sleep disorder, loneliness, and caregiving. Results The respondents in the high-level social, cognitive, and physical activity engagement groups were found to show fewer insomnia symptoms. Furthermore, higher social (β = − 0.04, p = 0.040) and cognitive (β = − 0.06, p = 0.007) activity engagements were associated with fewer insomnia symptoms even after adjusting for other types of activity engagement and all covariates. Conclusions This study suggests that older adults with higher social and cognitive activity engagements may be likely to have fewer insomnia symptoms. Based on these results, future research is needed to develop multi-component intervention programs that can encourage older adults to engage in these activities. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02042-y.
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Affiliation(s)
- Da Eun Kim
- College of Nursing and Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea.
| | - Tonya J Roberts
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Chooza Moon
- College of Nursing, University of Iowa, Iowa City, IA, USA
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Hanscom M, Loane DJ, Aubretch T, Leser J, Molesworth K, Hedgekar N, Ritzel RM, Abulwerdi G, Shea-Donohue T, Faden AI. Acute colitis during chronic experimental traumatic brain injury in mice induces dysautonomia and persistent extraintestinal, systemic, and CNS inflammation with exacerbated neurological deficits. J Neuroinflammation 2021; 18:24. [PMID: 33461596 PMCID: PMC7814749 DOI: 10.1186/s12974-020-02067-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Disruptions of brain-gut axis have been implicated in the progression of a variety of gastrointestinal (GI) disorders and central nervous system (CNS) diseases and injuries, including traumatic brain injury (TBI). TBI is a chronic disease process characterized by persistent secondary injury processes which can be exacerbated by subsequent challenges. Enteric pathogen infection during chronic TBI worsened cortical lesion volume; however, the pathophysiological mechanisms underlying the damaging effects of enteric challenge during chronic TBI remain unknown. This preclinical study examined the effect of intestinal inflammation during chronic TBI on associated neurobehavioral and neuropathological outcomes, systemic inflammation, and dysautonomia. METHODS Dextran sodium sulfate (DSS) was administered to adult male C57BL/6NCrl mice 28 days following craniotomy (Sham) or TBI for 7 days to induce intestinal inflammation, followed by a return to normal drinking water for an additional 7 to 28 days for recovery; uninjured animals (Naïve) served as an additional control group. Behavioral testing was carried out prior to, during, and following DSS administration to assess changes in motor and cognitive function, social behavior, and mood. Electrocardiography was performed to examine autonomic balance. Brains were collected for histological and molecular analyses of injury lesion, neurodegeneration, and neuroinflammation. Blood, colons, spleens, mesenteric lymph nodes (mLNs), and thymus were collected for morphometric analyses and/or immune characterization by flow cytometry. RESULTS Intestinal inflammation 28 days after craniotomy or TBI persistently induced, or exacerbated, respectively, deficits in fine motor coordination, cognition, social behavior, and anxiety-like behavior. Behavioral changes were associated with an induction, or exacerbation, of hippocampal neuronal cell loss and microglial activation in Sham and TBI mice administered DSS, respectively. Acute DSS administration resulted in a sustained systemic immune response with increases in myeloid cells in blood and spleen, as well as myeloid cells and lymphocytes in mesenteric lymph nodes. Dysautonomia was also induced in Sham and TBI mice administered DSS, with increased sympathetic tone beginning during DSS administration and persisting through the first recovery week. CONCLUSION Intestinal inflammation during chronic experimental TBI causes a sustained systemic immune response and altered autonomic balance that are associated with microglial activation, increased neurodegeneration, and persistent neurological deficits.
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Affiliation(s)
- Marie Hanscom
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA.
| | - David J Loane
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Taryn Aubretch
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
| | - Jenna Leser
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
| | - Kara Molesworth
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
| | - Nivedita Hedgekar
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
| | - Rodney M Ritzel
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
| | - Gelareh Abulwerdi
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
| | - Terez Shea-Donohue
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alan I Faden
- Department of Anesthesiology and Shock, Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF #6-016, Baltimore, MD, 21201, USA
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Iizuka A, Suzuki H, Ogawa S, Takahashi T, Murayama S, Kobayashi M, Fujiwara Y. Association between the frequency of daily intellectual activities and cognitive domains: A cross-sectional study in older adults with complaints of forgetfulness. Brain Behav 2021; 11:e01923. [PMID: 33145970 PMCID: PMC7821585 DOI: 10.1002/brb3.1923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/23/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Frequent engagement in intellectual activities has been shown to reduce the risk of developing dementia. The present study sought to examine the association between the frequency of daily intellectual activities and cognitive domains in older adults with complaints of forgetfulness. METHODS A cross-sectional study was conducted as a part of regional health examination in Tokyo from 2014 to 2016. A total of 436 participants were asked the frequency of intellectual activities in four categories: 1) reading, 2) writing, 3) using technology, and 4) watching TV and listening to the radio. The Japanese version of the Montreal Cognitive Assessment (MoCA-J) scale was used for the cognitive assessments. The relationships between MoCA-J scores and each intellectual activity were explored. RESULTS Binominal logistic regression analysis revealed that the frequencies of reading, writing, and using technology were significantly related to the language and attention, language, and memory domains, respectively, even after adjusting for demographic characteristics. CONCLUSIONS The results suggested that the frequency of daily intellectual activities differed depending on the activity type, and each activity was related to a specific cognitive domain.
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Affiliation(s)
- Ai Iizuka
- Research Team for Social Participation and Community HealthTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Hiroyuki Suzuki
- Research Team for Social Participation and Community HealthTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Susumu Ogawa
- Research Team for Social Participation and Community HealthTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Tomoya Takahashi
- Research Team for Social Participation and Community HealthTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Sachiko Murayama
- Research Team for Social Participation and Community HealthTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Momoko Kobayashi
- Research Team for Social Participation and Community HealthTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community HealthTokyo Metropolitan Institute of GerontologyTokyoJapan
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