1
|
Loaiza VM. An overview of the hallmarks of cognitive aging. Curr Opin Psychol 2024; 56:101784. [PMID: 38198908 DOI: 10.1016/j.copsyc.2023.101784] [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: 11/17/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024]
Abstract
Although the notion of cognitive aging is commonly associated with decline in popular culture, a wealth of scientific literature shows that cognitive aging is more aptly characterized as multidirectional, such that trajectories of cognitive changes include areas of stability and growth (e.g., general knowledge) in addition to decline (e.g., episodic long-term memory). This article overviews these multidirectional trajectories, the heterogeneous factors that moderate the rate of change across individual trajectories, and the extensive literature that has investigated the most important factors, such as working memory, that constrain cognition across the adult lifespan. In light of the multidirectional nature of cognitive change, increasing research has considered methods to leverage the often-overlooked benefits of getting older to ameliorate cognitive deficits.
Collapse
Affiliation(s)
- Vanessa M Loaiza
- University of Sheffield, Department of Psychology, 219 Portobello, Sheffield, S1 4DP, United Kingdom.
| |
Collapse
|
2
|
Hsu JH, Liu CC, Chen IW, Wu JY, Huang PY, Liu TH, Hung KC. Efficacy of the visual cognitive assessment test for mild cognitive impairment/mild dementia diagnosis: a meta-analysis. Front Public Health 2023; 11:1293710. [PMID: 38026272 PMCID: PMC10644725 DOI: 10.3389/fpubh.2023.1293710] [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: 09/13/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is an intermediate stage between normal ageing and dementia. The early identification of MCI is important for timely intervention. The visual cognitive assessment test (VCAT) is a brief language-neutral screening tool for detecting MCI/mild dementia. This meta-analysis evaluated the diagnostic efficacy of the VCAT for MCI/mild dementia. Methods Medline, Embase, Google Scholar, and Cochrane Library were searched from their inception until August 2023 to identify studies using VCAT to diagnose MCI/mild dementia. The primary outcome was to assess the diagnostic accuracy of the VCAT for detecting MCI/mild dementia through area under the receiver operating characteristic curve (AU-ROC) analysis. The secondary outcome was to explore the correlation between VCAT scores and MCI/mild dementia presence by comparing scores among patients with and without MCI/mild dementia. Pooled sensitivity, specificity, and area under the curve (AUC) were calculated. Results Five studies with 1,446 older adults (mean age 64-68.3 years) were included. The percentage of participants with MCI/mild dementia versus controls ranged from 16.5% to 87% across studies. All studies were conducted in Asian populations, mostly Chinese, in Singapore and Malaysia. The pooled sensitivity was 80% [95% confidence interval (CI) 68%-88%] and the specificity was 75% (95% CI 68%-80%). The AU-ROCC was 0.77 (95% CI 0.73-0.81). Patients with MCI/mild dementia had lower VCAT scores than the controls (mean difference -6.85 points, p < 0.00001). Conclusion VCAT demonstrated acceptable diagnostic accuracy in distinguishing MCI/mild dementia in cognitively normal older adults. As a language-neutral and culturally unbiased tool, the VCAT shows promise in detecting MCI/mild dementia. Further studies in non-Asian populations are required. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42023453453.
Collapse
Affiliation(s)
- Jui-Hung Hsu
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chien-Cheng Liu
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ting-Hui Liu
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| |
Collapse
|
3
|
Mathys H, Peng Z, Boix CA, Victor MB, Leary N, Babu S, Abdelhady G, Jiang X, Ng AP, Ghafari K, Kunisky AK, Mantero J, Galani K, Lohia VN, Fortier GE, Lotfi Y, Ivey J, Brown HP, Patel PR, Chakraborty N, Beaudway JI, Imhoff EJ, Keeler CF, McChesney MM, Patel HH, Patel SP, Thai MT, Bennett DA, Kellis M, Tsai LH. Single-cell atlas reveals correlates of high cognitive function, dementia, and resilience to Alzheimer's disease pathology. Cell 2023; 186:4365-4385.e27. [PMID: 37774677 PMCID: PMC10601493 DOI: 10.1016/j.cell.2023.08.039] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/20/2023] [Accepted: 08/29/2023] [Indexed: 10/01/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia worldwide, but the molecular and cellular mechanisms underlying cognitive impairment remain poorly understood. To address this, we generated a single-cell transcriptomic atlas of the aged human prefrontal cortex covering 2.3 million cells from postmortem human brain samples of 427 individuals with varying degrees of AD pathology and cognitive impairment. Our analyses identified AD-pathology-associated alterations shared between excitatory neuron subtypes, revealed a coordinated increase of the cohesin complex and DNA damage response factors in excitatory neurons and in oligodendrocytes, and uncovered genes and pathways associated with high cognitive function, dementia, and resilience to AD pathology. Furthermore, we identified selectively vulnerable somatostatin inhibitory neuron subtypes depleted in AD, discovered two distinct groups of inhibitory neurons that were more abundant in individuals with preserved high cognitive function late in life, and uncovered a link between inhibitory neurons and resilience to AD pathology.
Collapse
Affiliation(s)
- Hansruedi Mathys
- Picower Institute for Learning and Memory, MIT, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA; University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
| | - Zhuyu Peng
- Picower Institute for Learning and Memory, MIT, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA
| | - Carles A Boix
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA 02139, USA; Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Matheus B Victor
- Picower Institute for Learning and Memory, MIT, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA
| | - Noelle Leary
- Picower Institute for Learning and Memory, MIT, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA
| | - Sudhagar Babu
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Ghada Abdelhady
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Xueqiao Jiang
- Picower Institute for Learning and Memory, MIT, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA
| | - Ayesha P Ng
- Picower Institute for Learning and Memory, MIT, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA
| | - Kimia Ghafari
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Alexander K Kunisky
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Julio Mantero
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA 02139, USA; Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Kyriaki Galani
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA 02139, USA; Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Vanshika N Lohia
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Gabrielle E Fortier
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Yasmine Lotfi
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Jason Ivey
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Hannah P Brown
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Pratham R Patel
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Nehal Chakraborty
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Jacob I Beaudway
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Elizabeth J Imhoff
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Cameron F Keeler
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Maren M McChesney
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Haishal H Patel
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Sahil P Patel
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Megan T Thai
- University of Pittsburgh Brain Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | | | - Manolis Kellis
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA 02139, USA; Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Li-Huei Tsai
- Picower Institute for Learning and Memory, MIT, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA; Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| |
Collapse
|
4
|
Buchman AS, Wang T, Oveisgharan S, Zammit AR, Agrawal S, Yu L, Bennett DA. Correlated decline of cognitive and motor phenotypes and ADRD pathologies in old age. Alzheimers Dement 2023; 19:4150-4162. [PMID: 37303291 PMCID: PMC10524791 DOI: 10.1002/alz.13347] [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: 03/15/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Examining motor and cognitive decline in separate models may underestimate their associations. METHODS In a single trivariate model, we examined the levels and rates of decline of three phenotypes, sensor-derived total daily physical activity, motor abilities, and cognition in 1007 older adults during 6 years of follow-up. In 477 decedents, we repeated the model adding fixed terms for indices of nine brain pathologies. RESULTS Simultaneous rates of decline of all three phenotypes showed the strongest correlations with shared variance of up to 50%. Brain pathologies explained about 3% of the variance of declining daily physical activity, 9% of declining motor abilities, and 42% of cognitive decline. DISCUSSION The rates of declining cognitive and motor phenotypes are strongly correlated and measures of brain pathologies account for only a small minority of their decline. Further work is needed to elucidate the biology underlying correlated cognitive and motor decline in aging adults.
Collapse
Affiliation(s)
- Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, 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
| | - Shahram Oveisgharan
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Andrea R Zammit
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Sonal Agrawal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, Illinois, USA
| | - Lei Yu
- 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
| |
Collapse
|
5
|
Nolin SA, Cowart H, Merritt S, McInerney K, Bharadwaj PK, Franchetti MK, Raichlen DA, Jessup CJ, Hishaw GA, Van Etten EJ, Trouard TP, Geldmacher DS, Wadley VG, Porges ES, Woods AJ, Cohen RA, Levin BE, Rundek T, Alexander GE, Visscher KM. Validity of the NIH toolbox cognitive battery in a healthy oldest-old 85+ sample. J Int Neuropsychol Soc 2023; 29:605-614. [PMID: 36239453 DOI: 10.1017/s1355617722000443] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the construct validity of the NIH Toolbox Cognitive Battery (NIH TB-CB) in the healthy oldest-old (85+ years old). METHOD Our sample from the McKnight Brain Aging Registry consists of 179 individuals, 85 to 99 years of age, screened for memory, neurological, and psychiatric disorders. Using previous research methods on a sample of 85 + y/o adults, we conducted confirmatory factor analyses on models of NIH TB-CB and same domain standard neuropsychological measures. We hypothesized the five-factor model (Reading, Vocabulary, Memory, Working Memory, and Executive/Speed) would have the best fit, consistent with younger populations. We assessed confirmatory and discriminant validity. We also evaluated demographic and computer use predictors of NIH TB-CB composite scores. RESULTS Findings suggest the six-factor model (Vocabulary, Reading, Memory, Working Memory, Executive, and Speed) had a better fit than alternative models. NIH TB-CB tests had good convergent and discriminant validity, though tests in the executive functioning domain had high inter-correlations with other cognitive domains. Computer use was strongly associated with higher NIH TB-CB overall and fluid cognition composite scores. CONCLUSION The NIH TB-CB is a valid assessment for the oldest-old samples, with relatively weak validity in the domain of executive functioning. Computer use's impact on composite scores could be due to the executive demands of learning to use a tablet. Strong relationships of executive function with other cognitive domains could be due to cognitive dedifferentiation. Overall, the NIH TB-CB could be useful for testing cognition in the oldest-old and the impact of aging on cognition in older populations.
Collapse
Affiliation(s)
- Sara A Nolin
- University of Alabama at Birmingham, Heersink School of Medicine, Evelyn F. McKnight Brain Institute, Birmingham, AL, USA
| | - Hannah Cowart
- University of Alabama at Birmingham, Heersink School of Medicine, Evelyn F. McKnight Brain Institute, Birmingham, AL, USA
| | - Stacy Merritt
- University of Miami, Miller School of Medicine, Evelyn F. McKnight Brain Institute, Miami, FL, USA
| | - Katalina McInerney
- University of Miami, Miller School of Medicine, Evelyn F. McKnight Brain Institute, Miami, FL, USA
| | - P K Bharadwaj
- University of Arizona, Evelyn F. McKnight Brain Institute, Tucson, AZ, USA
| | | | | | - Cortney J Jessup
- University of Arizona, Evelyn F. McKnight Brain Institute, Tucson, AZ, USA
| | - G Alex Hishaw
- University of Arizona, Evelyn F. McKnight Brain Institute, Tucson, AZ, USA
| | - Emily J Van Etten
- University of Arizona, Evelyn F. McKnight Brain Institute, Tucson, AZ, USA
| | - Theodore P Trouard
- University of Arizona, Evelyn F. McKnight Brain Institute, Tucson, AZ, USA
| | - David S Geldmacher
- University of Alabama at Birmingham, Heersink School of Medicine, Evelyn F. McKnight Brain Institute, Birmingham, AL, USA
| | - Virginia G Wadley
- University of Alabama at Birmingham, Heersink School of Medicine, Evelyn F. McKnight Brain Institute, Birmingham, AL, USA
| | - Eric S Porges
- University of Florida, Evelyn F. and William L. McKnight Brain Institute, Gainesville, FL, USA
| | - Adam J Woods
- University of Florida, Evelyn F. and William L. McKnight Brain Institute, Gainesville, FL, USA
| | - Ron A Cohen
- University of Florida, Evelyn F. and William L. McKnight Brain Institute, Gainesville, FL, USA
| | - Bonnie E Levin
- University of Miami, Miller School of Medicine, Evelyn F. McKnight Brain Institute, Miami, FL, USA
| | - Tatjana Rundek
- University of Miami, Miller School of Medicine, Evelyn F. McKnight Brain Institute, Miami, FL, USA
| | - Gene E Alexander
- University of Arizona, Evelyn F. McKnight Brain Institute, Tucson, AZ, USA
| | - Kristina M Visscher
- University of Alabama at Birmingham, Heersink School of Medicine, Evelyn F. McKnight Brain Institute, Birmingham, AL, USA
| |
Collapse
|
6
|
Nevado A, del Rio D, Pacios J, Maestú F. Neuropsychological networks in cognitively healthy older adults and dementia patients. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:903-927. [PMID: 34415217 PMCID: PMC9485389 DOI: 10.1080/13825585.2021.1965951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
Neuropsychological tests have commonly been used to determine the organization of cognitive functions by identifying latent variables. In contrast, an approach which has seldom been employed is network analysis. We characterize the network structure of a set of representative neuropsychological test scores in cognitively healthy older adults and MCI and dementia patients using network analysis. We employed the neuropsychological battery from the National Alzheimer's Coordinating Center which included healthy controls (n = 7623), mild cognitive impairment patients (n = 5981) and dementia patients (n = 2040), defined according to the Clinical Dementia Rating. The results showed that, according to several network analysis measures, the most central cognitive function is executive function followed by attention, language, and memory. At the test level, the most central test was the Trail Making Test B, which measures cognitive flexibility. Importantly, these results and most other network measures, such as the community organization and graph representation, were similar across the three diagnostic groups. Therefore, network analysis can help to establish a ranking of cognitive functions and tests based on network centrality and suggests that this organization is preserved in dementia. Central nodes might be particularly relevant both from a theoretical and clinical point of view, as they are more associated with other nodes, and their disruption is likely to have a larger effect on the overall network than peripheral nodes. The present analysis may provide a proof of principle for the application of network analysis to cognitive data.
Collapse
Affiliation(s)
- Angel Nevado
- Experimental Psychology Department, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | - David del Rio
- Experimental Psychology Department, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | - Javier Pacios
- Experimental Psychology Department, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | - Fernando Maestú
- Experimental Psychology Department, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| |
Collapse
|
7
|
Abstract
OBJECTIVE The Cognitive Abilities Screening Instrument (CASI) is a screening test of global cognitive function used in research and clinical settings. However, the CASI was developed using face validity and has not been investigated via empirical tests such as factor analyses. Thus, we aimed to develop and test a parsimonious conceptualization of the CASI rooted in cognitive aging literature reflective of crystallized and fluid abilities. DESIGN Secondary data analysis implementing confirmatory factor analyses where we tested the proposed two-factor solution, an alternate one-factor solution, and conducted a χ2 difference test to determine which model had a significantly better fit. SETTING N/A. PARTICIPANTS Data came from 3,491 men from the Kuakini Honolulu-Asia Aging Study. MEASUREMENTS The Cognitive Abilities Screening Instrument. RESULTS Findings demonstrated that both models fit the data; however, the two-factor model had a significantly better fit than the one-factor model. Criterion validity tests indicated that participant age was negatively associated with both factors and that education was positively associated with both factors. Further tests demonstrated that fluid abilities were significantly and negatively associated with a later-life dementia diagnosis. CONCLUSIONS We encourage investigators to use the two-factor model of the CASI as it could shed light on underlying cognitive processes, which may be more informative than using a global measure of cognition.
Collapse
|
8
|
Serum metabolomic biomarkers of perceptual speed in cognitively normal and mildly impaired subjects with fasting state stratification. Sci Rep 2021; 11:18964. [PMID: 34556796 PMCID: PMC8460824 DOI: 10.1038/s41598-021-98640-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
Cognitive decline is associated with both normal aging and early pathologies leading to dementia. Here we used quantitative profiling of metabolites involved in the regulation of inflammation, vascular function, neuronal function and energy metabolism, including oxylipins, endocannabinoids, bile acids, and steroid hormones to identify metabolic biomarkers of mild cognitive impairment (MCI). Serum samples (n = 212) were obtained from subjects with or without MCI opportunistically collected with incomplete fasting state information. To maximize power and stratify the analysis of metabolite associations with MCI by the fasting state, we developed an algorithm to predict subject fasting state when unknown (n = 73). In non-fasted subjects, linoleic acid and palmitoleoyl ethanolamide levels were positively associated with perceptual speed. In fasted subjects, soluble epoxide hydrolase activity and tauro-alpha-muricholic acid levels were negatively associated with perceptual speed. Other cognitive domains showed associations with bile acid metabolism, but only in the non-fasted state. Importantly, this study shows unique associations between serum metabolites and cognitive function in the fasted and non-fasted states and provides a fasting state prediction algorithm based on measurable metabolites.
Collapse
|
9
|
Chamberlain JD, Sprague BN, Ross LA. Age- and time-varying associations between subjective health and episodic memory in older adults. J Gerontol B Psychol Sci Soc Sci 2021; 77:673-682. [PMID: 34329436 DOI: 10.1093/geronb/gbab142] [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: 01/28/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE There are positive correlations between subjective health reports and episodic memory performance in older adults. However, previous studies have not evaluated the scope of such complex relationships, nor the potentially nonlinear magnitude of these correlations across age and time. We employed multiple subjective heath indices to evaluate the scope and nonlinearity of such relationships with memory performance. METHOD We utilized a cross-sectional (N = 2,783 at baseline) and longitudinal sample (N = 311) of healthy older adults aged 65 and older from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. We used time-varying effects modeling (TVEM) to assess potential differences in relationship magnitudes between memory and three subjective health subscales (general health, role physical function, and physical function, from the Short Form Health Survey; SF-36) across five years. RESULTS Episodic memory positively predicted all subjective health measures cross-sectionally and longitudinally in our sample. TVEM revealed the relationships between all subjective health measures and episodic memory were stable across age. While role physical function and physical function maintained stable relationships with episodic memory across time, general health became increasingly coupled with memory five years following baseline. DISCUSSION Together, our findings highlight stable and varying relationships between episodic memory and multiple subjective health indicators across metrics of time in older adults.
Collapse
Affiliation(s)
- Jordan D Chamberlain
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Briana N Sprague
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Lesley A Ross
- Department of Psychology, Clemson University, Clemson, SC, USA
| |
Collapse
|
10
|
Haitas N, Amiri M, Wilson M, Joanette Y, Steffener J. Age-preserved semantic memory and the CRUNCH effect manifested as differential semantic control networks: An fMRI study. PLoS One 2021; 16:e0249948. [PMID: 34129605 PMCID: PMC8205163 DOI: 10.1371/journal.pone.0249948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 03/26/2021] [Indexed: 11/18/2022] Open
Abstract
Semantic memory representations are overall well-maintained in aging whereas semantic control is thought to be more affected. To explain this phenomenon, this study aims to test the predictions of the Compensation Related Utilization of Neural Circuits Hypothesis (CRUNCH) focusing on task demands in aging as a possible framework. The CRUNCH effect would manifest itself in semantic tasks through a compensatory increase in neural activation in semantic control network regions but only up to a certain threshold of task demands. This study will compare 40 young (20-35 years old) with 40 older participants (60-75 years old) in a triad-based semantic judgment task performed in an fMRI scanner while manipulating levels of task demands (low vs. high) through semantic distance. In line with the CRUNCH predictions, differences in neurofunctional activation and behavioral performance (accuracy and response times) are expected in young vs. old participants in the low- vs. high-demand conditions manifested in semantic control Regions of Interest.
Collapse
Affiliation(s)
- Niobe Haitas
- Laboratory of Communication and Aging, Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Mahnoush Amiri
- Laboratory of Communication and Aging, Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Maximiliano Wilson
- Centre de Recherche CERVO – CIUSSS de la Capitale-Nationale et Département de Réadaptation, Université Laval, Quebec City, Quebec, Canada
| | - Yves Joanette
- Laboratory of Communication and Aging, Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Jason Steffener
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
11
|
Cognitive dedifferentiation as a function of cognitive impairment in the ADNI and MemClin cohorts. Aging (Albany NY) 2021; 13:13430-13442. [PMID: 34038387 PMCID: PMC8202862 DOI: 10.18632/aging.203108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/13/2021] [Indexed: 12/17/2022]
Abstract
The cause of cognitive dedifferentiation has been suggested as specific to late-life abnormal cognitive decline rather than a general feature of aging. This hypothesis was tested in two large cohorts with different characteristics. Individuals (n = 2710) were identified in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) research database (n = 1282) in North America, and in the naturalistic multi-site MemClin Project database (n = 1223), the latter recruiting from 9 out of 10 memory clinics in the greater Stockholm catchment area in Sweden. Comprehensive neuropsychological testing informed diagnosis of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI). Diagnosis was further collapsed into cognitive impairment (CI: MCI or dementia) vs no cognitive impairment (NCI). After matching, loadings on the first principal component were higher in the CI vs NCI group in both ADNI (53.1% versus 38.3%) and MemClin (33.3% vs 30.8%). Correlations of all paired combinations of individual tests by diagnostic group were also stronger in the CI group in both ADNI (mean inter-test r = 0.51 vs r = 0.33, p < 0.001) and MemClin (r = 0.31 vs r = 0.27, p = 0.042). Dedifferentiation was explained by cognitive impairment when controlling for age, sex, and education. This finding replicated across two separate, large cohorts of older individuals. Knowledge that the structure of human cognition becomes less diversified and more dependent on general intelligence as a function of cognitive impairment should inform clinical assessment and care for these patients as their neurodegeneration progresses.
Collapse
|
12
|
Rabipour S, Rajagopal S, Pasvanis S, Rajah MN. Generalization of memory-related brain function in asymptomatic older women with a family history of late onset Alzheimer's Disease: Results from the PREVENT-AD Cohort. Neurobiol Aging 2021; 104:42-56. [PMID: 33964608 DOI: 10.1016/j.neurobiolaging.2021.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/04/2021] [Accepted: 03/18/2021] [Indexed: 11/18/2022]
Abstract
Late-onset Alzheimer's disease (AD) disproportionately affects women compared to men. Episodic memory decline is one of the earliest and most pronounced deficits observed in AD. However, it remains unclear whether sex influences episodic memory-related brain function in cognitively intact older adults at risk of developing AD. Here we used task-based multivariate partial least squares analysis to examine sex differences in episodic memory-related brain activity and brain activity-behavior correlations in a matched sample of cognitively intact older women and men with a family history of AD from the PREVENT-AD cohort study in Montreal, Canada (Mage=63.03±3.78; Meducation=15.41±3.40). We observed sex differences in task-related brain activity and brain activity-behavior correlations during the encoding of object-location associative memories and object-only item memory, and the retrieval of object only item memories. Our findings suggest a generalization of episodic memory-related brain activation and performance in women compared to men. Follow up analyses should test for sex differences in the relationship between brain activity patterns and performance longitudinally, in association with risk factors for AD development. This article is part of the Virtual Special Issue titled COGNITIVE NEUROSCIENCE OF HEALTHY AND PATHOLOGICAL AGING. The full issue can be found on ScienceDirect at https://www.sciencedirect.com/journal/neurobiology-of-aging/special-issue/105379XPWJP.
Collapse
Affiliation(s)
- Sheida Rabipour
- Centre for Cerebral Imaging, Douglas Hospital Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Stamatoula Pasvanis
- Centre for Cerebral Imaging, Douglas Hospital Research Centre, Montreal, Canada
| | - M Natasha Rajah
- Centre for Cerebral Imaging, Douglas Hospital Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
| |
Collapse
|
13
|
Sánchez-Izquierdo M, Fernández-Ballesteros R. Cognition in Healthy Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:962. [PMID: 33499254 PMCID: PMC7908458 DOI: 10.3390/ijerph18030962] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 02/01/2023]
Abstract
The study of cognitive change across a life span, both in pathological and healthy samples, has been heavily influenced by developments in cognitive psychology as a theoretical paradigm, neuropsychology and other bio-medical fields; this alongside the increase in new longitudinal and cohort designs, complemented in the last decades by the evaluation of experimental interventions. Here, a review of aging databases was conducted, looking for the most relevant studies carried out on cognitive functioning in healthy older adults. The aim was to review not only longitudinal, cross-sectional or cohort studies, but also by intervention program evaluations. The most important studies, searching for long-term patterns of stability and change of cognitive measures across a life span and in old age, have shown a great range of inter-individual variability in cognitive functioning changes attributed to age. Furthermore, intellectual functioning in healthy individuals seems to decline rather late in life, if ever, as shown in longitudinal studies where age-related decline of cognitive functioning occurs later in life than indicated by cross-sectional studies. The longitudinal evidence and experimental trials have shown the benefits of aerobic physical exercise and an intellectually engaged lifestyle, suggesting that bio-psycho-socioenvironmental factors concurrently with age predict or determine both positive or negative change or stability in cognition in later life.
Collapse
|
14
|
Zhang Y, Natale G, Clouston S. Incidence of Mild Cognitive Impairment, Conversion to Probable Dementia, and Mortality. Am J Alzheimers Dis Other Demen 2021; 36:15333175211012235. [PMID: 34032119 PMCID: PMC8715729 DOI: 10.1177/15333175211012235] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Few studies have jointly estimated incidence of MCI, conversion to probable dementia, and mortality in a nationally representatie sample. METHODS We used data from six waves of the National Health and Aging Trends Study (2011-2016). Multivariable-adjusted multi-state survival models (MSMs) were used to model incidence upon accounting for misclassification. RESULTS A total of 6,078 eligible NHATS participants were included (average age: 77.49 ± 7.79 years; 58.42% females; 68.99% non-Hispanic white). The incidence of MCI was estimated to be 41.0 [35.5, 47.3]/1,000 person-years (PY). Participants converted to probable dementia at a high rate of 241.3 [189.6, 307.0]/1,000 PY, though a small number also reverted from MCI to cognitively normal. Education was associated with lower incidence of MCI and conversion to probable dementia, but increased mortality in those with MCI. There were also substantial racial and ethnic disparities in the incidence of MCI and dementia. CONCLUSIONS Our results underscore the relatively common incidence of and conversions between MCI and dementia in community-dwelling older Americans and uncover the beneficial impact of education to withstand cognitive impairment before death.
Collapse
Affiliation(s)
- Yun Zhang
- Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, NY, USA
| | - Ginny Natale
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, NY, USA
| | - Sean Clouston
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, NY, USA
| |
Collapse
|
15
|
Cosarderelioglu C, Nidadavolu LS, George CJ, Oh ES, Bennett DA, Walston JD, Abadir PM. Brain Renin-Angiotensin System at the Intersect of Physical and Cognitive Frailty. Front Neurosci 2020; 14:586314. [PMID: 33117127 PMCID: PMC7561440 DOI: 10.3389/fnins.2020.586314] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022] Open
Abstract
The renin–angiotensin system (RAS) was initially considered to be part of the endocrine system regulating water and electrolyte balance, systemic vascular resistance, blood pressure, and cardiovascular homeostasis. It was later discovered that intracrine and local forms of RAS exist in the brain apart from the endocrine RAS. This brain-specific RAS plays essential roles in brain homeostasis by acting mainly through four angiotensin receptor subtypes; AT1R, AT2R, MasR, and AT4R. These receptors have opposing effects; AT1R promotes vasoconstriction, proliferation, inflammation, and oxidative stress while AT2R and MasR counteract the effects of AT1R. AT4R is critical for dopamine and acetylcholine release and mediates learning and memory consolidation. Consequently, aging-associated dysregulation of the angiotensin receptor subtypes may lead to adverse clinical outcomes such as Alzheimer’s disease and frailty via excessive oxidative stress, neuroinflammation, endothelial dysfunction, microglial polarization, and alterations in neurotransmitter secretion. In this article, we review the brain RAS from this standpoint. After discussing the functions of individual brain RAS components and their intracellular and intracranial locations, we focus on the relationships among brain RAS, aging, frailty, and specific neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and vascular cognitive impairment, through oxidative stress, neuroinflammation, and vascular dysfunction. Finally, we discuss the effects of RAS-modulating drugs on the brain RAS and their use in novel treatment approaches.
Collapse
Affiliation(s)
- Caglar Cosarderelioglu
- Division of Geriatrics, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey.,Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lolita S Nidadavolu
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Claudene J George
- Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Esther S Oh
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Jeremy D Walston
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Peter M Abadir
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| |
Collapse
|
16
|
Gonzalez-Burgos L, Hernández-Cabrera JA, Westman E, Barroso J, Ferreira D. Cognitive compensatory mechanisms in normal aging: a study on verbal fluency and the contribution of other cognitive functions. Aging (Albany NY) 2020; 11:4090-4106. [PMID: 31232698 PMCID: PMC6628999 DOI: 10.18632/aging.102040] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 06/17/2019] [Indexed: 12/16/2022]
Abstract
Verbal fluency has been widely studied in cognitive aging. However, compensatory mechanisms that maintain its optimal performance with increasing age are not completely understood. Using cross-sectional data, we investigated differentiation and dedifferentiation processes in verbal fluency across the lifespan by analyzing the association between verbal fluency and numerous cognitive measures within four age groups (N=446): early middle-age (32-45 years), late middle-age (46-58 years), early elderly (59-71 years), and late elderly (72-84 years). ANCOVA was used to investigate the interaction between age and fluency modality. Random forest models were conducted to study the contribution of cognition to semantic, phonemic, and action fluency. All modalities declined with increasing age, but semantic fluency was the most vulnerable to aging. The most prominent reduction in performance was observed during the transition from middle-age to early elderly, when cognitive variables stopped contributing (differentiation), and new cognitive variables started contributing (dedifferentiation). Lexical access, processing speed, and executive functions were among the most contributing functions. We conclude that the association between age and verbal fluency is masked by age-specific influences of other cognitive functions. Differentiation and dedifferentiation processes can coexist. This study provides important data for better understanding of cognitive aging and compensatory processes.
Collapse
Affiliation(s)
- Lissett Gonzalez-Burgos
- Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Juan Andrés Hernández-Cabrera
- Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - José Barroso
- Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
| | - Daniel Ferreira
- Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
17
|
de la Fuente J, Moreno-Agostino D, de la Torre-Luque A, Prina AM, Haro JM, Caballero FF, Ayuso-Mateos JL. Development of a Combined Sensory-Cognitive Measure Based on the Common Cause Hypothesis: Heterogeneous Trajectories and Associated Risk Factors. THE GERONTOLOGIST 2020; 60:e357-e366. [PMID: 31115438 PMCID: PMC7362620 DOI: 10.1093/geront/gnz066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is a link between sensory and cognitive functioning across old age. However, there are no integrative measures for assessing common determinants of sensory-cognitive functioning. This study aims to develop a combined measure of sensory-cognitive functioning, and to identify heterogeneous trajectories and associated risk factors. RESEARCH DESIGN AND METHODS Two thousand two hundred and fifty-five individuals aged 60 years and over selected from the first six waves (2002-2012) of the English Longitudinal Study of Ageing completed a set of five self-reported visual and hearing functioning items and four cognitive items. Several health-related outcomes were also collected. RESULTS The common cause model presented longitudinal factorial invariance (Tucker-Lewis index [TLI] = 0.989; Comparative Fit Index [CFI] = 0.991; Root Mean Square Error of Approximation [RMSEA] = 0.026). A common factor explained 32%, 36%, and 26% of the visual, hearing, and cognitive difficulties, respectively. The developed sensory-cognitive measure predicted incident dementia over 10 years (area under the curve = .80; 95% confidence interval [CI] = .75, .86). A three-trajectory model was proved to fit better, according to growth mixture modeling. Low levels of education and household wealth, disability, diabetes, high blood pressure, depressive symptoms, and low levels of physical activity were risk factors associated with the classes showing trajectories with a steeper increase of sensory-cognitive difficulties. DISCUSSION AND IMPLICATIONS A time-invariant factor explains both sensory and cognitive functioning over 8 years. The sensory-cognitive measure derived from this factor showed a good performance for predicting dementia 10 years later. Several easily identifiable socioeconomic and health-related risk factors could be used as early markers of subsequent sensory-cognitive decline. Therefore, the proposed latent measure could be useful as a cost-effective indicator of sensory-cognitive functioning.
Collapse
Affiliation(s)
- Javier de la Fuente
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Dario Moreno-Agostino
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Alejandro de la Torre-Luque
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - A Matthew Prina
- Department of Health Service and Population Research, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Josep María Haro
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine, Public Health, and Microbiology, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
18
|
Cadar D, Robitaille A, Pattie A, Deary IJ, Muniz-Terrera G. The long arm of childhood intelligence on terminal decline: Evidence from the Lothian Birth Cohort 1921. Psychol Aging 2020; 35:806-817. [PMID: 32437183 DOI: 10.1037/pag0000477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study investigates the heterogeneity of cognitive trajectories at the end of life by assigning individuals into groups according to their cognitive trajectories prior to death. It also examines the role of childhood intelligence and education on these trajectories and group membership. Participants were drawn from the Lothian Birth Cohort of 1921 (LBC1921), a longitudinal study of individuals with a mean age of 79 years at study entry, and observed up to a maximum of five times to their early 90s. Growth mixture modeling was employed to identify groups of individuals with similar trajectories of global cognitive function measured with the Mini-Mental State Examination (MMSE) in relation to time to death, accounting for childhood intelligence, education, the time to death from study entry, and health conditions (hypertension, diabetes, and cardiovascular disease). Two distinct groups of individuals (classes) were identified: a smaller class (18% of the sample) of individuals whose MMSE scores dropped linearly with about 0.5 MMSE points per year closer to death and a larger group (82% of the sample) with stable MMSE across the study period. Only childhood intelligence was found to be associated with an increased probability of belonging to the stable class of cognitive functioning prior to death (odds ratio = 1.08, standard error = 0.02, p ≤ .001). These findings support a protective role of childhood intelligence, a marker of cognitive reserve, against the loss of cognitive function prior to death. Our results also suggest that terminal decline is not necessarily a normative process. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Dorina Cadar
- Department of Behavioural Science and Health, University College London
| | | | | | - Ian J Deary
- Department of Psychology, University of Edinburgh
| | | |
Collapse
|
19
|
Sprague BN, Freed SA, Phillips CB, Ross LA. A viewpoint on change point modeling for cognitive aging research: Moving from description to intervention and practice. Ageing Res Rev 2020; 58:101003. [PMID: 31881367 DOI: 10.1016/j.arr.2019.101003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 11/08/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022]
Abstract
Chronological age is a commonly-used time metric, but there may be more relevant time measures in older adulthood. This paper reviews change point modeling, a type of analysis increasingly common in cognitive aging research but with limited application in applied research. Here, we propose a new application of such models for cognitive training studies. Change point models have the potential to assess intervention outcomes such as compression of morbidity or reduced decline after an event (e.g., reduced cognitive decline after a dementia diagnosis) as well as changes in outcome trajectories across different intervention dosages (e.g., initial vs. booster training). Through change point modeling, we can better understand how interventions impact cognitive aging trajectories.
Collapse
Affiliation(s)
- Briana N Sprague
- Department of Human Development and Family Studies, The Pennsylvania State University.
| | - Sara A Freed
- Department of Human Development and Family Studies, The Pennsylvania State University
| | | | - Lesley A Ross
- Department of Human Development and Family Studies, The Pennsylvania State University
| |
Collapse
|
20
|
Hong SH, Han K, Park S, Kim SM, Kim NH, Choi KM, Baik SH, Park YG, Yoo HJ. Gamma-Glutamyl Transferase Variability and Risk of Dementia in Diabetes Mellitus: A Nationwide Population-Based Study. J Clin Endocrinol Metab 2020; 105:5709623. [PMID: 31955208 DOI: 10.1210/clinem/dgaa019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/17/2020] [Indexed: 01/09/2023]
Abstract
CONTEXT Gamma-glutamyl transferase (GGT) has been associated with oxidative stress and inflammatory reactions. Variability in various biomarkers has emerged as a new clinical indicator for diseases including neurodegenerative disorders. OBJECTIVE We investigated the association between GGT variability and dementia risk in patients with diabetes mellitus (DM). DESIGN, PARTICIPANTS, AND METHODS We used the Korean National Health Insurance Service datasets of Claims and Health Check-ups from 2004 to 2016. The risk of incident dementia (all-cause dementia, Alzheimer disease, vascular dementia) was analyzed by quartiles of GGT variability in ≥ 40-year-old DM individuals without baseline dementia. RESULTS During 6.12 years of follow-up, 37, 983 cases of dementia developed. In the fully adjusted model, the group with the highest quartile of GGT variability had a 19% increased risk of all-cause dementia when compared with the lowest quartile group (hazard ratio; 95% confidence interval): 1.19; 1.16-1.22, with a small effect size (Cohen d's = 0.14). Compared with the group with low baseline GGT level and the lowest quartiles of its variability, the group with high baseline GGT level and the highest quartile of its variability increased 27% of all-cause dementia. A 1 SD increment in the GGT variability was associated with a 3% increased risk of all-cause dementia. Subgroup analysis showed a more prominent association between increased GGT variability and dementia risk in men and < 60-year-old individuals (P for interaction ≤ .001). CONCLUSIONS In subjects with DM, high variability of GGT increased the risk of dementia independently of other factors, including baseline GGT levels.
Collapse
Affiliation(s)
- So-Hyeon Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Kyungdo Han
- Department of B iostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sanghyun Park
- Department of B iostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seon Mee Kim
- Department of Family Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Yong Gyu Park
- Department of B iostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| |
Collapse
|
21
|
Wilson RS, Yu L, Leurgans SE, Bennett DA, Boyle PA. Proportion of cognitive loss attributable to terminal decline. Neurology 2019; 94:e42-e50. [PMID: 31792096 DOI: 10.1212/wnl.0000000000008671] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/27/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To estimate the proportion of late-life cognitive loss attributable to impending death. METHODS Older persons (n = 1,071) in a longitudinal cohort study without dementia at enrollment underwent annual cognitive assessments (mean 10.6 years, SD 4.6, range 4-24) prior to death. We estimated the onset of terminal acceleration in cognitive decline and rates of decline before and after this point in change point models that allowed calculation of the percent of cognitive loss attributable to terminal decline. Outcomes were composite measures of global and specific cognitive functions. We also estimated dementia and mild cognitive impairment (MCI) incidence before and during the terminal period. RESULTS A mean of 3.7 years before death (95% credible interval [CI] -3.8 to -3.5), the rate of global cognitive decline accelerated to -0.313 unit per year (95% CI -0.337 to -0.290), a more than 7-fold increase indicative of terminal decline. The mean global cognitive score dropped 0.377 unit (SD 0.516) assuming no terminal decline and 1.192 units (SD 1.080) with terminal decline. As a result, 71% (95% bootstrapped CI 0.70, 0.73) of overall global cognitive loss was terminal. In subsequent analyses, terminal decline accounted for 70% of episodic memory loss, 65% of semantic memory loss, 57% of working memory loss, 52% of perceptual speed loss, and 53% of visuospatial loss. MCI incidence in the preterminal and terminal periods was similar, but dementia incidence was more than 6-fold higher in the terminal period than preterminal. CONCLUSION Most late-life cognitive loss is driven by terminal decline.
Collapse
Affiliation(s)
- Robert S Wilson
- From the Departments of Neurological Sciences (R.S.W., L.Y., S.E.L., D.A.B.) and Behavioral Sciences (R.S.W., P.A.B.), Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL.
| | - Lei Yu
- From the Departments of Neurological Sciences (R.S.W., L.Y., S.E.L., D.A.B.) and Behavioral Sciences (R.S.W., P.A.B.), Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - Sue E Leurgans
- From the Departments of Neurological Sciences (R.S.W., L.Y., S.E.L., D.A.B.) and Behavioral Sciences (R.S.W., P.A.B.), Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - David A Bennett
- From the Departments of Neurological Sciences (R.S.W., L.Y., S.E.L., D.A.B.) and Behavioral Sciences (R.S.W., P.A.B.), Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - Patricia A Boyle
- From the Departments of Neurological Sciences (R.S.W., L.Y., S.E.L., D.A.B.) and Behavioral Sciences (R.S.W., P.A.B.), Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| |
Collapse
|
22
|
Wilson RS, Yang J, Yu L, Leurgans SE, Capuano AW, Schneider JA, Bennett DA, Boyle PA. Postmortem neurodegenerative markers and trajectories of decline in cognitive systems. Neurology 2019; 92:e831-e840. [PMID: 30674595 DOI: 10.1212/wnl.0000000000006949] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 10/15/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To assess whether neurodegenerative pathologies are differentially related to trajectories of change in different cognitive abilities. METHODS At annual intervals for up to 21 years, 915 older participants in a longitudinal clinical-pathologic cohort study completed a battery of 15 tests from which previously established composite measures of episodic memory, semantic memory, working memory, and perceptual speed were derived. At death, they underwent a neuropathologic examination to quantify Alzheimer disease pathology, Lewy bodies, transactive response DNA-binding protein 43 (TDP-43) pathology, and hippocampal sclerosis plus multiple markers of cerebrovascular disease. Time-varying effect models were used to assess change over time in the relation of neuropathologic markers to cognitive trajectories. RESULTS Controlling for pathology, decline in perceptual speed was evident about 15 years before death; modest decline in semantic and working memory occurred later; and there was little change in episodic memory. Each neurodegenerative marker was associated with lower episodic memory function beginning about 10 to 16 years before death. As time before death decreased, Alzheimer disease pathology, Lewy bodies, and hippocampal sclerosis were associated with impairment in other cognitive domains but the association of TDP-43 pathology with cognition continued to be mainly confined to episodic memory. CONCLUSIONS The results suggest that episodic memory impairment is an early sign of multiple neurodegenerative conditions, which primarily differ in their associations with other cognitive systems.
Collapse
Affiliation(s)
- Robert S Wilson
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL.
| | - Jingyun Yang
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL
| | - Lei Yu
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL
| | - Sue E Leurgans
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL
| | - Ana W Capuano
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL
| | - Julie A Schneider
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL
| | - David A Bennett
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL
| | - Patricia A Boyle
- From the Departments of Neurological Sciences (R.S.W., J.Y., L.Y., S.E.L., A.W.C., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., P.A.B.), and Pathology (J.A.S.), Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL
| |
Collapse
|
23
|
Karr JE, Graham RB, Hofer SM, Muniz-Terrera G. When does cognitive decline begin? A systematic review of change point studies on accelerated decline in cognitive and neurological outcomes preceding mild cognitive impairment, dementia, and death. Psychol Aging 2019; 33:195-218. [PMID: 29658744 DOI: 10.1037/pag0000236] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Older adults who ultimately develop dementia experience accelerated cognitive decline long before diagnosis. A similar acceleration in cognitive decline occurs in the years before death as well. To evaluate preclinical and terminal cognitive decline, past researchers have incorporated change points in their analyses of longitudinal data, identifying point estimates of how many years prior to diagnosis or death that decline begins to accelerate. The current systematic review aimed to summarize the published literature on preclinical and terminal change points in relation to mild cognitive impairment (MCI), dementia, and death, identifying the order in which cognitive and neurological outcomes decline and factors that modify the onset and rate of decline. A systematic search protocol yielded 35 studies, describing 16 longitudinal cohorts, modeling change points for cognitive and neurological outcomes preceding MCI, dementia, or death. Change points for cognitive abilities ranged from 3-7 years prior to MCI diagnosis, 1-11 years prior to dementia diagnosis, and 3-15 years before death. No sequence of decline was observed preceding MCI or death, but the following sequence was tentatively accepted for Alzheimer's disease: verbal memory, visuospatial ability, executive functions and fluency, and last, verbal IQ. Some of the modifiers of the onset and rate of decline examined by previous researchers included gender, education, genetics, neuropathology, and personality. Change point analyses evidence accelerated decline preceding MCI, dementia, and death, but moderators of the onset and rate of decline remain ambiguous due to between-study modeling differences, and coordinated analyses may improve comparability across future studies. (PsycINFO Database Record
Collapse
|
24
|
de la Fuente J, Hjelmborg J, Wod M, de la Torre-Luque A, Caballero FF, Christensen K, Ayuso-Mateos JL. Longitudinal Associations of Sensory and Cognitive Functioning: A Structural Equation Modeling Approach. J Gerontol B Psychol Sci Soc Sci 2018; 74:1308-1316. [DOI: 10.1093/geronb/gby147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Although visual and hearing impairments have been found to be associated with cognitive decline in the old age, the mechanism underlying this relationship remains unclear. This study aimed at assessing the predictive role of visual and hearing difficulties on subsequent cognitive functioning.
Method
From the cohort of the first (2002) and fifth waves (2010) of the English Longitudinal Study of Ageing (ELSA), 3,508 individuals aged 60 and older were included in the study. Five self-reported visual and hearing functioning items were used to assess sensory functioning at baseline. Cognition was assessed 8 years later by means of four measured tests covering immediate and delayed recall, verbal fluency, and processing speed. A Multiple Indicators Multiple Causes approach was used to assess the longitudinal associations of visual and hearing functioning with cognitive difficulties. A multigroup longitudinal measurement invariance was used to estimate latent change in cognitive difficulties across groups of participants presenting either visual, hearing, or dual sensory impairment (i.e., those reporting difficulties in both visual and hearing functioning items).
Results
Visual (β = 0.140, p < .001) and hearing (β = 0.115, p < .001) difficulties predicted cognitive difficulties 8 years later. The latent increase in cognitive difficulties was steeper in people with visual impairment (d = 0.52, p < .001), hearing impairment (d = 0.50, p < .001), and dual-sensory impairment (d = 0.68, p < .001) than those non-impaired (d = 0.12, p < .001).
Discussion
Visual and hearing difficulties were identified as predictors of subsequent cognitive decline in the old age. Interventions to prevent visual and hearing difficulties may have a substantial impact to slow down subsequent age-related cognitive decline.
Collapse
Affiliation(s)
- Javier de la Fuente
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Mental Health, Madrid, Spain
| | - Jacob Hjelmborg
- Unit of Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Mette Wod
- Unit of Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Alejandro de la Torre-Luque
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Mental Health, Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine, Public Health, and Microbiology, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Kaare Christensen
- Unit of Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Mental Health, Madrid, Spain
| |
Collapse
|
25
|
Lam M, Lee J, Rapisarda A, See YM, Yang Z, Lee SA, Abdul-Rashid NA, Kraus M, Subramaniam M, Chong SA, Keefe RSE. Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis. JAMA Psychiatry 2018; 75:929-939. [PMID: 30046827 PMCID: PMC6142925 DOI: 10.1001/jamapsychiatry.2018.1668] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Cognitive deficits are a key feature of risk for psychosis. Longitudinal changes in cognitive architecture may be associated with the social and occupational functioning in young people. OBJECTIVES To examine longitudinal profiles of cognition in individuals at ultrahigh risk (UHR) for psychosis, compared with healthy controls, and to investigate the association of cognition with functioning. DESIGN, SETTING, AND PARTICIPANTS This study has a multiple-group prospective design completed in 24 months and was conducted from January 1, 2009, to November 11, 2012, as part of the Longitudinal Youth at-Risk Study conducted in Singapore. Participants either were recruited from psychiatric outpatient clinics, educational institutions, and community mental health agencies or self-referred. Follow-up assessments were performed every 6 months for 2 years or until conversion to psychosis. Individuals with medical causes for psychosis, current illicit substance use, or color blindness were excluded. Data analysis was conducted from June 2014 to May 2018. MAIN OUTCOMES AND MEASURES Neuropsychological, perceptual, and social cognitive tasks; semi-structured interviews, and the Structured Clinical Interview for DSM-IV Axis I disorders were administered every 6 months. The UHR status of nonconverters, converters, remitters, and nonremitters was monitored. Cognitive domain scores and functioning were investigated longitudinally. RESULTS In total, 384 healthy controls and 173 UHR individuals between ages 14 and 29 years were evaluated prospectively. Of the 384 healthy controls, 153 (39.8%) were female and 231 (60.2%) were male with a mean (SD) age of 21.69 (3.26) years. Of the 173 individuals at UHR for psychosis, 56 (32.4%) were female and 117 (67.6%) were male with a mean (SD) age of 21.27 (3.52) years). After 24 months of follow-up, 383 healthy controls (99.7%) and 122 individuals at UHR for psychosis (70.5%) remained. Baseline cognitive deficits were associated with psychosis conversion later (mean odds ratio [OR], 1.66; combined 95% CI, 1.08-2.83; P = .04) and nonremission of UHR status (mean OR, 1.67; combined 95% CI, 1.09-2.95; P = .04). Five cognitive components-social cognition, attention, verbal fluency, general cognitive function, and perception-were obtained from principal components analysis. Longitudinal component structure change was observed in general cognitive function (maximum vertical deviation = 0.59; χ2 = 8.03; P = .01). Group-by-time interaction on general cognitive function (F = 12.23; η2 = 0.047; P < .001) and perception (F = 8.33; η2 = 0.032; P < .001) was present. Changes in attention (F = 5.65; η2 = 0.013; P = .02) and general cognitive function (F = 7.18; η2 = 0.014; P = .01) accounted for longitudinal changes in social and occupational functioning. CONCLUSIONS AND RELEVANCE Individuals in this study who met the UHR criteria appeared to demonstrate cognitive deficits, and those whose UHR status remitted were seen to recover cognitively. Cognition appeared as poor in nonremitters and appeared to be associated with poor functional outcome. This study suggests that cognitive dimensions are sensitive to the identification of young individuals at risk for psychosis and to the longitudinal course of those at highest risk.
Collapse
Affiliation(s)
- Max Lam
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health,
Singapore, Singapore,Department of General Psychiatry 1, Institute of
Mental Health, Singapore, Singapore
| | - Attilio Rapisarda
- Research Division, Institute of Mental Health,
Singapore, Singapore,Neuroscience and Behavioural Disorders, Duke-NUS
Medical School, Singapore, Singapore
| | - Yuen Mei See
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Zixu Yang
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Sara-Ann Lee
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | | | - Michael Kraus
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, North Carolina
| | | | - Siow-Ann Chong
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Richard S. E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, North Carolina
| |
Collapse
|
26
|
Gamma-Glutamyltransferase (GGT) as a biomarker of cognitive decline at the end of life: contrasting age and time to death trajectories. Int Psychogeriatr 2018; 30:981-990. [PMID: 29108523 DOI: 10.1017/s1041610217002393] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTBackground:A recently published study suggests that Gamma-Glutamyltransferase (GGT) in midlife is related to an increased risk of dementia. In the present longitudinal study, we explore the effects of serum GGT on cognitive decline and dementia also in more advanced ages. METHODS We analyzed GGT in a sample of 452 individuals, aged 80 years and older at baseline, with the purpose to explore subsequent effects on cognitive performance. We specifically modeled GGT to cognitive change, time to death, and dementia. RESULTS Our main finding is that a higher level of GGT is associated with cognitive decline prior to death and vascular dementia in late life. These findings were evident across cognitive domains. CONCLUSIONS This is the first longitudinal study to report on significant associations in late life between GGT, cognitive performance and dementia. Further research is needed to examine the underlying mechanisms of GGT as a marker of age-related cognitive decline.
Collapse
|
27
|
Wilson RS, Capuano AW, Yu L, Yang J, Kim N, Leurgans SE, Lamar M, Schneider JA, Bennett DA, Boyle PA. Neurodegenerative disease and cognitive retest learning. Neurobiol Aging 2018; 66:122-130. [PMID: 29558667 DOI: 10.1016/j.neurobiolaging.2018.02.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 01/28/2023]
Abstract
Retest learning impacts estimates of cognitive aging, but its bases are uncertain. Here, we test the hypothesis that dementia-related neurodegeneration impairs retest learning. Older persons without cognitive impairment at enrollment (n = 567) had annual cognitive testing for a mean of 11 years, died, and had a neuropathologic examination to quantify 5 neurodegenerative pathologies. Change point models were used to divide cognitive trajectories into an early retest sensitive component and a later component less sensitive to retest. Performance on a global cognitive measure (baseline mean = 0.227, standard deviation = 0.382) increased an estimated mean of 0.142-unit per year for a mean of 1.5 years and declined an estimated mean of 0.123-unit per year thereafter. No pathologic marker was related to cognitive change before the change point; each was related to cognitive decline after the change point. Results were comparable in analyses that used specific cognitive outcomes, included 220 individuals with mild cognitive impairment at enrollment, or allowed a longer retest learning period. The findings suggest that neurodegeneration does not impact cognitive retest learning.
Collapse
Affiliation(s)
- Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Jingyun Yang
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Namhee Kim
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
28
|
Jansen WJ, Wilson RS, Visser PJ, Nag S, Schneider JA, James BD, Leurgans SE, Capuano AW, Bennett DA, Boyle PA. Age and the association of dementia-related pathology with trajectories of cognitive decline. Neurobiol Aging 2018; 61:138-145. [PMID: 29078129 PMCID: PMC5721665 DOI: 10.1016/j.neurobiolaging.2017.08.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 08/23/2017] [Accepted: 08/26/2017] [Indexed: 01/06/2023]
Abstract
The association of dementia-related pathologies with cognition is hypothesized to decrease as age advances. We examined this in 413 persons without cognitive impairment at baseline who completed annual cognitive evaluations during a mean of 10.4 years. After death, neuropathologic examinations quantified beta amyloid plaque load, neurofibrillary tangles, and transactive response DNA-binding protein 43 pathology, and identified Lewy bodies, hippocampal sclerosis, and gross and microscopic cerebral infarcts. We tested whether age at death modified associations of these neuropathologies with the nonlinear trajectory of cognitive decline using mixed-effects change point models. The rate of global cognitive decline was gradual at first and then increased approximately 10-fold in the last 3 years of life. After adjustment for all other pathologic indices, tangle density, gross infarcts, Lewy bodies, and transactive response DNA-binding protein 43 were associated with global cognitive decline. However, the deleterious association of dementia-related pathologies with cognitive decline did not systematically vary by age. This suggests that the neuropathologic mechanisms underlying late-life cognitive decline do not substantially differ across the spectrum of age.
Collapse
Affiliation(s)
- Willemijn J Jansen
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Neurology, VUmc Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Sukriti Nag
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Bryan D James
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
29
|
Wallert J, Ekman U, Westman E, Madison G. The worst performance rule with elderly in abnormal cognitive decline. INTELLIGENCE 2017. [DOI: 10.1016/j.intell.2017.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
30
|
Salthouse TA. Comparable Consistency, Coherence, and Commonality of Measures of Cognitive Functioning Across Adulthood. Assessment 2017; 26:726-736. [PMID: 28737041 DOI: 10.1177/1073191117721742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increased age is associated with lower scores in many cognitive tests, but interpretation of those results is based on the assumption that the measurement at different ages is equivalent, such that the differences reflect quantitative rather than qualitative changes. The assumption of measurement equivalence was investigated by comparing adult age differences in the relations among alternative versions of the same tests, among different tests of the same ability, and among different cognitive abilities. Results from three independent data sets revealed that only modest age differences were apparent at each level, which implies that cognitive abilities have similar measurement properties at different ages in adulthood.
Collapse
|
31
|
Boyle PA, Yang J, Yu L, Leurgans SE, Capuano AW, Schneider JA, Wilson RS, Bennett DA. Varied effects of age-related neuropathologies on the trajectory of late life cognitive decline. Brain 2017; 140:804-812. [PMID: 28082297 DOI: 10.1093/brain/aww341] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/18/2016] [Indexed: 01/27/2023] Open
Abstract
The objective of this study was to examine whether the effects of age-related neuropathologies on cognition change over time. Participants were 1096 deceased persons from two clinical-pathologic studies. All were without dementia at baseline, completed a detailed battery of cognitive tests annually over up to 21 years, died, and underwent detailed neuropathologic examinations to identify Alzheimer's disease pathology, vascular pathologies (i.e. macro- and microscopic infarcts, atherosclerosis, arteriolar sclerosis, and cerebral amyloid angiopathy), Lewy bodies, transactive response DNA-binding protein 43 (TDP-43) pathology, and hippocampal sclerosis. A time-varying effects model was used to flexibly characterize the trajectory of global cognition and assess whether the effects of demographics and each neuropathologic index on cognition changed over time. Results indicated that the mean trajectory of global cognition was characterized by gradual cognitive decline beginning ∼15 years before death and accelerated decline in the last few years. With the exception of microinfarcts and arteriolar sclerosis, all neuropathologies were associated with the cognitive trajectory. However, the nature of their associations varied. Alzheimer's disease pathology, macroscopic infarcts, Lewy bodies, TDP-43 pathology, and hippocampal sclerosis were associated with progressive cognitive decline, with their deleterious effects increasing over time. By contrast, atherosclerosis and cerebral amyloid angiopathy pathology were associated with a lower level of cognition but their effects were relatively stable over time. These results suggest that age-related neuropathologies are differentially related to late life cognitive trajectories. Whereas some contribute to progressive cognitive deterioration, others lower the level of cognition but exert relatively stable effects over time.
Collapse
Affiliation(s)
- Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Jingyun Yang
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
32
|
Wilson RS, Bennett DA. How Does Psychosocial Behavior Contribute to Cognitive Health in Old Age? Brain Sci 2017; 7:brainsci7060056. [PMID: 28545247 PMCID: PMC5483629 DOI: 10.3390/brainsci7060056] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 11/16/2022] Open
Abstract
With the aging of the U.S. population, the number of cognitively disabled persons is expected to substantially increase in coming decades, underscoring the urgent need for effective interventions. Here, we review the current evidence linking psychosocial factors to late-life cognitive loss and consider the study design needed to illuminate the biologic bases of the associations. We then examine an ongoing study that includes several of the key design elements, the Rush Memory and Aging Project. In this longitudinal clinical-pathological cohort study, indicators of personality, social connectedness, and psychological well-being were shown to predict late-life cognitive outcomes. Participants who died underwent a uniform neuropathologic examination to quantify common dementia-related pathologies. Some psychosocial indicators were associated with cerebral infarction; some indicators modified the association of neurodegenerative pathologies with cognitive loss; and the association of some indicators with cognitive outcomes appears to be independent of the pathologies traditionally associated with late-life dementia. These findings suggest that psychosocial behavior influences late-life cognitive health through multiple neurobiologic mechanisms. A better understanding of these mechanisms may lead to novel strategies for preserving cognitive health in old age.
Collapse
Affiliation(s)
- Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
| |
Collapse
|
33
|
Wilson RS, Rajan KB, Barnes LL, Jansen W, Amofa P, Weuve J, Evans DA. Terminal decline of episodic memory and perceptual speed in a biracial population. AGING NEUROPSYCHOLOGY AND COGNITION 2017; 25:378-389. [PMID: 28332920 PMCID: PMC5928786 DOI: 10.1080/13825585.2017.1306020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We compared trajectories of terminal cognitive decline in older Black (n = 3372) and White (n = 1756) persons from a defined population who completed tests of episodic memory and perceptual speed at 3-year intervals for up to 18 years. During a mean of 9.9 years of observation, 1608 Black persons and 902 White persons died. Preterminal decline of episodic memory did not differ by race. Terminal episodic memory decline began earlier in Black persons (mean of 4.3 years before death) than in White persons (mean = 3.9 years) and progressed more slowly. By contrast, terminal decline of perceptual speed began earlier in White persons (mean = 5.0 years) than in Black persons (mean = 4.5 years). Rate of perceptual speed decline was more rapid in White persons than in Black persons in both the preterminal and terminal periods. The results indicate that terminal cognitive decline occurs in Black persons but suggest that the rate of cognitive decline during the terminal period is less rapid in Black persons than in White persons.
Collapse
Affiliation(s)
- Robert S Wilson
- a Rush Alzheimer's Disease Center, Department of Neurological Sciences, Department of Behavioral Sciences , Rush University Medical Center , Chicago , IL , USA
| | - Kumar B Rajan
- b Rush Institute for Healthy Aging, Department of Internal Medicine , Rush University Medical Center , Chicago , IL , USA
| | - Lisa L Barnes
- a Rush Alzheimer's Disease Center, Department of Neurological Sciences, Department of Behavioral Sciences , Rush University Medical Center , Chicago , IL , USA
| | - Willemijn Jansen
- c Department of Psychiatry & Neuropsychology , Maastricht University , Maastricht , the Netherlands
| | - Priscilla Amofa
- d Rush Alzheimer's Disease Center , Rush University Medical Center , Chicago , IL , USA
| | - Jennifer Weuve
- e Department of Epidemiology, School of Public Health , Boston University , Boston , MA , USA
| | - Denis A Evans
- b Rush Institute for Healthy Aging, Department of Internal Medicine , Rush University Medical Center , Chicago , IL , USA
| |
Collapse
|
34
|
Davis DHJ, Muniz-Terrera G, Keage HAD, Stephan BCM, Fleming J, Ince PG, Matthews FE, Cunningham C, Ely EW, MacLullich AMJ, Brayne C. Association of Delirium With Cognitive Decline in Late Life: A Neuropathologic Study of 3 Population-Based Cohort Studies. JAMA Psychiatry 2017; 74:244-251. [PMID: 28114436 PMCID: PMC6037291 DOI: 10.1001/jamapsychiatry.2016.3423] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Delirium is associated with accelerated cognitive decline. The pathologic substrates of this association are not yet known, that is, whether they are the same as those associated with dementia, are independent, or are interrelated. OBJECTIVE To examine whether the accelerated cognitive decline observed after delirium is independent of the pathologic processes of classic dementia. DESIGN, SETTING, AND PARTICIPANTS Harmonized data from 987 individual brain donors from 3 observational cohort studies with population-based sampling (Vantaa 85+, Cambridge City Over-75s Cohort, Cognitive Function and Ageing Study) performed from January 1, 1985, through December 31, 2011, with a median follow-up of 5.2 years until death, were used in this study. Neuropathologic assessments were performed with investigators masked to clinical data. Data analysis was performed from January 1, 2012, through December 31, 2013. Clinical characteristics of brain donors were not different from the rest of the cohort. Outcome ascertainment was complete given that the participants were brain donors. EXPOSURES Delirium (never vs ever) and pathologic burden of neurofibrillary tangles, amyloid plaques, vascular lesions, and Lewy bodies. Effects modeled using random-effects linear regression and interactions between delirium and pathologic burden were assessed. OUTCOMES Change in Mini-Mental State Examination (MMSE) scores during the 6 years before death. RESULTS There were 987 participants (290 from Vantaa 85+, 241 from the Cambridge City Over-75s Cohort, and 456 from the Cognitive Function and Ageing Study) with neuropathologic data; mean (SD) age at death was 90 (6.4) years, including 682 women (69%). The mean MMSE score 6 years before death was 24.7 points. The 279 individuals with delirium (75% women) had worse initial scores (-2.8 points; 95% CI, -4.5 to -1.0; P < .001). Cognitive decline attributable to delirium was -0.37 MMSE points per year (95% CI, -0.60 to -0.13; P < .001). Decline attributable to the pathologic processes of dementia was -0.39 MMSE points per year (95% CI, -0.57 to -0.22; P < .001). However, the combination of delirium and the pathologic processes of dementia resulted in the greatest decline, in which the interaction contributed an additional -0.16 MMSE points per year (95% CI, -0.29 to -0.03; P = .01). The multiplicative nature of these variables resulted in individuals with delirium and the pathologic processes of dementia declining 0.72 MMSE points per year faster than age-, sex-, and educational level-matched controls. CONCLUSIONS AND RELEVANCE Delirium in the presence of the pathologic processes of dementia is associated with accelerated cognitive decline beyond that expected for delirium or the pathologic process itself. These findings suggest that additional unmeasured pathologic processes specifically relate to delirium. Age-related cognitive decline has many contributors, and these findings at the population level support a role for delirium acting independently and multiplicatively to the pathologic processes of classic dementia.
Collapse
Affiliation(s)
- Daniel H J Davis
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England2Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, England
| | | | - Hannah A D Keage
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia
| | | | - Jane Fleming
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Paul G Ince
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, England
| | - Fiona E Matthews
- Institute of Health and Society, Newcastle University, Newcastle, England
| | - Colm Cunningham
- School of Biochemistry and Immunology, Trinity College, Dublin, Ireland
| | - E Wesley Ely
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee9Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center, Nashville
| | | | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| |
Collapse
|
35
|
Cordovilla-Guardia S, Vilar-López R, Lardelli-Claret P, Navas J, Guerrero-López F, Fernández-Mondéjar E. Ingreso en cuidados intensivos por un traumatismo relacionado con el consumo de alcohol o drogas, un «momento propicio de enseñanza» para el inicio del cambio. ENFERMERIA INTENSIVA 2017; 28:4-12. [DOI: 10.1016/j.enfi.2016.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 12/18/2016] [Accepted: 12/22/2016] [Indexed: 01/24/2023]
|
36
|
Yaffe K, Peltz CB, Ewing SK, McCulloch CE, Cummings SR, Cauley JA, Hillier TA, Ensrud KE. Long-term Cognitive Trajectories and Mortality in Older Women. J Gerontol A Biol Sci Med Sci 2016; 71:1074-80. [PMID: 26843186 PMCID: PMC4945886 DOI: 10.1093/gerona/glw003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 01/05/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few studies have examined whether change in cognition is linked to mortality. This study examined the relationship between cognitive trajectories in older age and risk of death. METHODS We studied community-dwelling, nondemented women aged 65+ (mean age = 71) enrolled in a prospective study of aging and followed up to 25 years. A modified Mini-Mental State Examination (mMMSE) and Trail Making Task Part B (TMTB) were administered at multiple visits during follow-up. We examined the association between cognitive trajectories (analyzed by quintiles) from baseline to age 80 (n = 7,477 for mMMSE and n = 6,503 for TMTB) and all-cause mortality after age 80 using Cox regression models, both unadjusted and adjusted for education, physical activity, alcohol, depression score, current smoking and history of hypertension and diabetes. Cause of death was determined from death certificates, classified as cardiovascular, cancer and other. RESULTS Women with greater rate of decline were older, less educated, less physically active, had higher depression score and were more likely to have a history of hypertension and diabetes (all p < .01). Participants with the greatest decline (quintile 1) had an increased risk of death (mMMSE hazard ratio [HR] = 1.28; TMTB HR = 1.43] and those with the least decline (quintile 5) had a decreased risk of death (mMMSE HR = 0.73; TMTB HR = 0.61) compared with intermediate decliners (quintiles 2-4). Cognitive trajectories were associated with cardiovascular mortality and other causes of death, but not cancer deaths. CONCLUSIONS Our study suggests that greater decline in general cognition or executive function is associated with higher rates of mortality in oldest-old women.
Collapse
Affiliation(s)
- Kristine Yaffe
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco. Department of Mental Health, San Francisco VA Medical Center, California
| | - Carrie B Peltz
- Department of Mental Health, San Francisco VA Medical Center, California. NCIRE-The Veterans Health Research Institute, San Francisco, California.
| | - Susan K Ewing
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco
| | - Charles E McCulloch
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco
| | - Steve R Cummings
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Teresa A Hillier
- Kaiser Permanente Center for Health Research Northwest/Hawaii, Portland, Oregon
| | - Kristine E Ensrud
- School of Public Health, University of Minnesota, Minneapolis. Department of Medicine, Minneapolis VA Health Care System, Minnesota
| |
Collapse
|
37
|
Roberts KL, Allen HA. Perception and Cognition in the Ageing Brain: A Brief Review of the Short- and Long-Term Links between Perceptual and Cognitive Decline. Front Aging Neurosci 2016; 8:39. [PMID: 26973514 PMCID: PMC4772631 DOI: 10.3389/fnagi.2016.00039] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/15/2016] [Indexed: 11/13/2022] Open
Abstract
Ageing is associated with declines in both perception and cognition. We review evidence for an interaction between perceptual and cognitive decline in old age. Impoverished perceptual input can increase the cognitive difficulty of tasks, while changes to cognitive strategies can compensate, to some extent, for impaired perception. While there is strong evidence from cross-sectional studies for a link between sensory acuity and cognitive performance in old age, there is not yet compelling evidence from longitudinal studies to suggest that poor perception causes cognitive decline, nor to demonstrate that correcting sensory impairment can improve cognition in the longer term. Most studies have focused on relatively simple measures of sensory (visual and auditory) acuity, but more complex measures of suprathreshold perceptual processes, such as temporal processing, can show a stronger link with cognition. The reviewed evidence underlines the importance of fully accounting for perceptual deficits when investigating cognitive decline in old age.
Collapse
Affiliation(s)
| | - Harriet A Allen
- School of Psychology, University of Nottingham Nottingham, UK
| |
Collapse
|
38
|
Abstract
The aim of this study was to compare patterns of cognitive decline in older Latinos and non-Latinos. At annual intervals for a mean of 5.7 years, older Latino (n=104) and non-Latino (n=104) persons of equivalent age, education, and race completed a battery of 17 cognitive tests from which previously established composite measures of episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability were derived. In analyses adjusted for age, sex, and education, performance declined over time in each cognitive domain, but there were no ethnic group differences in initial level of function or annual rate of decline. There was evidence of retest learning following the baseline evaluation, but neither the magnitude nor duration of the effect was related to Latino ethnicity, and eliminating the first two evaluations, during which much of retest learning occurred, did not affect ethnic group comparisons. Compared to the non-Latino group, the Latino group had more diabetes (38.5% vs. 25.0; χ2[1]=4.4; p=.037), fewer histories of smoking (24.0% vs. 39.4%, χ2[1]=5.7; p=.017), and lower childhood household socioeconomic level (-0.410 vs. -0.045, t[185.0]=3.1; p=.002), but controlling for these factors did not affect results. Trajectories of cognitive aging in different abilities are similar in Latino and non-Latino individuals of equivalent age, education, and race. (JINS, 2016, 22, 58-65).
Collapse
|
39
|
I forgot when I lost my grip-strong associations between cognition and grip strength in level of performance and change across time in relation to impending death. Neurobiol Aging 2015; 38:68-72. [PMID: 26827644 DOI: 10.1016/j.neurobiolaging.2015.11.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 11/18/2015] [Accepted: 11/19/2015] [Indexed: 11/21/2022]
Abstract
An association between level of cognitive function and grip strength is well established, whereas evidence for longitudinal associations of change in the 2 functions is still unclear. We examined associations between cognition and grip strength in levels of performance and in longitudinal change in late life in a population-based sample, aged ≥80 years at baseline, followed until death. The sample consisted of 449 nondemented individuals drawn from the OCTO-Twin Study. A test battery assessing 6 cognitive domains and grip strength was administered at 5 occasions with measurements intervals of 2 years. We fitted time to death bivariate growth curve models, adjusted for age, education, and sex which resulted in associations between grip strength and cognition in both levels of performance (across all cognitive domains) and rates of change (in 4 of 6 domains). These results show that cognition and grip strength change conjointly in later life and that the association between cognition and grip strength is stronger before death than earlier in life.
Collapse
|
40
|
Garcia-Ramos C, Lin JJ, Prabhakaran V, Hermann BP. Developmental Reorganization of the Cognitive Network in Pediatric Epilepsy. PLoS One 2015; 10:e0141186. [PMID: 26505900 PMCID: PMC4624435 DOI: 10.1371/journal.pone.0141186] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/06/2015] [Indexed: 11/19/2022] Open
Abstract
Traditional approaches to understanding cognition in children with epilepsy (CWE) involve cross-sectional or prospective examination of diverse test measures, an approach that does not inform the interrelationship between different abilities or how interrelationships evolve prospectively. Here we utilize graph theory techniques to interrogate the development of cognitive landmarks in CWE and healthy controls (HC) using the two-year percentage change across 20 tests. Additionally, we characterize the development of cognition using traditional analyses, showing that CWE perform worse at baseline, develop in parallel with HC, statically maintaining cognitive differences two years later. Graph analyses, however, showed CWE to exhibit both lower integration and segregation in development of their cognitive networks compared to HC. In conclusion, graph analyses of neuropsychological data capture a dynamic and changing complexity in the interrelationships among diverse cognitive skills, maturation of the cognitive network over time, and the nature of differences between normally developing children and CWE.
Collapse
Affiliation(s)
- Camille Garcia-Ramos
- Department of Medical Physics, University of Wisconsin-Madison, Madison WI, United States of America
- * E-mail:
| | - Jack J. Lin
- Department of Neurology, University of California, Irvine, Irvine CA, United States of America
| | - Vivek Prabhakaran
- Department of Medical Physics, University of Wisconsin-Madison, Madison WI, United States of America
- Department of Radiology, University of Wisconsin-Madison, Madison WI, United States of America
| | - Bruce P. Hermann
- Department of Neurology, University of Wisconsin-Madison, Madison WI, United States of America
| |
Collapse
|
41
|
Wilson RS, Capuano AW, Sytsma J, Bennett DA, Barnes LL. Cognitive aging in older Black and White persons. Psychol Aging 2015; 30:279-85. [PMID: 25961876 DOI: 10.1037/pag0000024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
During a mean of 5.2 years of annual follow-up, older Black (n = 647) and White (n = 647) persons of equivalent age and education completed a battery of 17 cognitive tests from which composite measures of 5 abilities were derived. Baseline level of each ability was lower in the Black subgroup. Decline in episodic and working memory was not related to race. Decline in semantic memory, perceptual speed, and visuospatial ability was slower in Black persons than White persons, and in semantic memory and perceptual speed this effect was stronger in older than younger participants. Racial differences persisted after adjustment for retest effects. The results suggest subtle cognitive aging differences between Black persons and White persons.
Collapse
Affiliation(s)
- Robert S Wilson
- Department of Neurological Sciences, Rush Alzheimer's Disease Center, Rush University Medical Center
| | - Ana W Capuano
- Department of Neurological Sciences, Rush Alzheimer's Disease Center, Rush University Medical Center
| | - Joel Sytsma
- Rush Alzheimer's Disease Center, Rush University Medical Center
| | - David A Bennett
- Department of Neurological Sciences, Rush Alzheimer's Disease Center, Rush University Medical Center
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush Alzheimer's Disease Center, Rush University Medical Center
| |
Collapse
|
42
|
Wilson RS, Boyle PA, Yu L, Segawa E, Sytsma J, Bennett DA. Conscientiousness, dementia related pathology, and trajectories of cognitive aging. Psychol Aging 2015; 30:74-82. [PMID: 25664558 DOI: 10.1037/pag0000013] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The study aim was to determine the contribution of dementia related pathologies to the association of conscientiousness with late-life cognitive health. At enrollment in 2 longitudinal clinical-pathologic cohort studies, 309 older individuals without cognitive impairment completed a standard conscientiousness measure. Annually thereafter, they completed a battery of 17 cognitive tests. On death, they underwent a uniform neuropathologic examination from which measures of neurofibrillary tangles, Lewy bodies, chronic gross cerebral infarction, and hippocampal sclerosis were derived. The relation of conscientiousness and the neuropathologic markers to cognitive decline was assessed in mixed-effects change point models to accommodate nonlinear cognitive decline. During a mean of 10.7 years of follow-up, annual decline on a composite measure of global cognition (baseline M = 0.082, SD = 0.499) was gradual (estimated M = -0.036, 95% CI [-0.046, -0.025]) until a mean of 3.2 years before death (95% CI [-3.6, -2.8]) when it accelerated to a mean annual loss of 0.369 unit (95% CI [-0.426, -0.317]), a tenfold increase. Higher conscientiousness (baseline M = 33.6, SD = 5.1) was associated with slower terminal decline (estimate = 0.064, 95% CI [0.024, 0.103]) but not preterminal decline (estimate = 0.005, 95% CI [-0.003, 0.013]). After adjustment for neuropathologic burden, conscientiousness was still related to terminal decline (estimate = 0.057, 95% CI [0.019, 0.094]) and accounted for 4% of the variance in terminal slopes. In addition, the association of neocortical Lewy bodies with terminal cognitive decline was attenuated in those with higher conscientiousness. The results suggest that higher conscientiousness is protective of late-life cognitive health.
Collapse
Affiliation(s)
- Robert S Wilson
- Rush Alzheimer's Disease Center, Department of Neurological Sciences, Department of Behavioral Sciences, Rush University Medical Center
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Department of Behavioral Sciences, Rush University Medical Center
| | - Lei Yu
- Rush Alzheimer's Disease Center, Department of Neurological Sciences, Rush University Medical Center
| | - Eisuke Segawa
- Department of Preventive Medicine, Rush University Medical Center
| | - Joel Sytsma
- Rush Alzheimer's Disease Center, Rush University Medical Center
| | - David A Bennett
- Rush Alzheimer's Disease Center, Department of Neurological Sciences, Rush University Medical Center
| |
Collapse
|
43
|
Praetorius M, Thorvaldsson V, Johansson B, Hassing LB. Gender Differences in Cognitive Performance in Old Age. GEROPSYCH-THE JOURNAL OF GERONTOPSYCHOLOGY AND GERIATRIC PSYCHIATRY 2014. [DOI: 10.1024/1662-9647/a000111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective: To examine gender differences in level and change of cognitive performance in the oldest old while accounting for gender differences in longevity. Method: 574 individuals, aged 80 years and older, from the OCTO Twin Study. Five cognitive domains were administered at five occasions at 2-year intervals. Results: There were no cognitive differences between men and women, with the exception that men showed a steeper rate of decline in semantic memory. This effect was driven by men who had developed dementia and declined at a faster rate than women. Conclusion: Our results support previous findings showing minor to nonexisting gender differences in cognition among nondemented individuals in very old age when taking gender differences in longevity into account.
Collapse
Affiliation(s)
| | | | - Boo Johansson
- Department of Psychology, University of Gothenburg, Sweden
| | | |
Collapse
|
44
|
Praetorius M, Thorvaldsson V, Hassing LB, Johansson B. Substantial effects of apolipoprotein E ε4 on memory decline in very old age: longitudinal findings from a population-based sample. Neurobiol Aging 2013; 34:2734-9. [DOI: 10.1016/j.neurobiolaging.2013.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 06/04/2013] [Accepted: 06/08/2013] [Indexed: 11/26/2022]
|
45
|
Wilson RS, Yu L, Trojanowski JQ, Chen EY, Boyle PA, Bennett DA, Schneider JA. TDP-43 pathology, cognitive decline, and dementia in old age. JAMA Neurol 2013; 70:1418-24. [PMID: 24080705 PMCID: PMC3830649 DOI: 10.1001/jamaneurol.2013.3961] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Cognitive decline is a leading cause of disability and death in old age but its neurobiological bases are not well understood. OBJECTIVE To test the hypothesis that transactive response DNA-binding protein 43 (TDP-43) is related to late-life cognitive decline. DESIGN, SETTING, AND PARTICIPANTS Longitudinal clinical-pathologic cohort study involving more than 40 Catholic groups across the United States. A total of 130 older Catholic nuns, priests, and monks underwent annual clinical evaluations, including detailed cognitive testing, for a mean of 10.1 years prior to death. On neuropathologic examination, we collected semiquantitative measures of TDP-43 pathology, density of neuronal neurofibrillary tangles, area occupied by amyloid-beta plaques, and the presence of alpha-synuclein Lewy bodies from multiple brain regions. Gross and microscopic cerebral infarcts and hippocampal sclerosis were also identified. MAIN OUTCOMES AND MEASURES Annual rate of change in a previously established composite measure of global cognition during a mean of 10.1 years of annual observation before death. RESULTS Transactive response DNA-binding protein 43 pathology, ranging from sparse to severe, was identified in 46% of participants and was associated with amyloid plaques, tangles, and hippocampal sclerosis but not neocortical Lewy bodies or cerebral infarcts. After controlling for amyloid plaques, tangles, and hippocampal sclerosis, TDP-43 pathology was associated with more rapid cognitive decline and accounted for nearly as much of the variability in rates of global cognitive decline as did tangles. Transactive response DNA-binding protein 43 pathology had a distinct cognitive profile that differed from other neuropathologic processes (related to decline in episodic and working memory but not in other cognitive domains), and it was elevated in those who developed dementia but not in those with mild cognitive impairment. CONCLUSION AND RELEVANCE The results suggest that TDP-43 is an important brain pathology underlying cognitive decline and dementia in old age.
Collapse
Affiliation(s)
- Robert S. Wilson
- Rush Alzheimer’s Disease Center (RSW, LY, E-YC, PAB, DAB, JAS) and Departments of Neurological Sciences (RSW, LY, DAB, JAS), Behavioral Sciences (RSW, PAB), and Pathology (JAS), Rush University Medical Center, Chicago, IL; Institute on Aging (JQT), Center for Neurodegenerative Disease Research (JQT), and Department of Pathology and Laboratory Medicine (JQT), University of Pennsylvania, Philadelphia, PA
| | - Lei Yu
- Rush Alzheimer’s Disease Center (RSW, LY, E-YC, PAB, DAB, JAS) and Departments of Neurological Sciences (RSW, LY, DAB, JAS), Behavioral Sciences (RSW, PAB), and Pathology (JAS), Rush University Medical Center, Chicago, IL; Institute on Aging (JQT), Center for Neurodegenerative Disease Research (JQT), and Department of Pathology and Laboratory Medicine (JQT), University of Pennsylvania, Philadelphia, PA
| | - John Q. Trojanowski
- Rush Alzheimer’s Disease Center (RSW, LY, E-YC, PAB, DAB, JAS) and Departments of Neurological Sciences (RSW, LY, DAB, JAS), Behavioral Sciences (RSW, PAB), and Pathology (JAS), Rush University Medical Center, Chicago, IL; Institute on Aging (JQT), Center for Neurodegenerative Disease Research (JQT), and Department of Pathology and Laboratory Medicine (JQT), University of Pennsylvania, Philadelphia, PA
| | - Er-Yun Chen
- Rush Alzheimer’s Disease Center (RSW, LY, E-YC, PAB, DAB, JAS) and Departments of Neurological Sciences (RSW, LY, DAB, JAS), Behavioral Sciences (RSW, PAB), and Pathology (JAS), Rush University Medical Center, Chicago, IL; Institute on Aging (JQT), Center for Neurodegenerative Disease Research (JQT), and Department of Pathology and Laboratory Medicine (JQT), University of Pennsylvania, Philadelphia, PA
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center (RSW, LY, E-YC, PAB, DAB, JAS) and Departments of Neurological Sciences (RSW, LY, DAB, JAS), Behavioral Sciences (RSW, PAB), and Pathology (JAS), Rush University Medical Center, Chicago, IL; Institute on Aging (JQT), Center for Neurodegenerative Disease Research (JQT), and Department of Pathology and Laboratory Medicine (JQT), University of Pennsylvania, Philadelphia, PA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center (RSW, LY, E-YC, PAB, DAB, JAS) and Departments of Neurological Sciences (RSW, LY, DAB, JAS), Behavioral Sciences (RSW, PAB), and Pathology (JAS), Rush University Medical Center, Chicago, IL; Institute on Aging (JQT), Center for Neurodegenerative Disease Research (JQT), and Department of Pathology and Laboratory Medicine (JQT), University of Pennsylvania, Philadelphia, PA
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center (RSW, LY, E-YC, PAB, DAB, JAS) and Departments of Neurological Sciences (RSW, LY, DAB, JAS), Behavioral Sciences (RSW, PAB), and Pathology (JAS), Rush University Medical Center, Chicago, IL; Institute on Aging (JQT), Center for Neurodegenerative Disease Research (JQT), and Department of Pathology and Laboratory Medicine (JQT), University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
46
|
Boyle PA, Yu L, Wilson RS, Schneider JA, Bennett DA. Relation of neuropathology with cognitive decline among older persons without dementia. Front Aging Neurosci 2013; 5:50. [PMID: 24058343 PMCID: PMC3766823 DOI: 10.3389/fnagi.2013.00050] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/23/2013] [Indexed: 12/21/2022] Open
Abstract
Objective: Although it is now widely accepted that dementia has a long preclinical phase during which neuropathology accumulates and cognition declines, little is known about the relation of neuropathology with the longitudinal rate of change in cognition among older persons without dementia. We quantified the burden of the neuropathologies of the three most common causes of dementia [i.e., Alzheimer’s disease (AD), cerebrovascular disease (CVD), and Lewy body disease (LBD)] and examined their relation with cognitive decline in a large cohort of persons without dementia proximate to death. Methods: A total of 467 deceased participants without dementia from two longitudinal clinical-pathologic studies, Rush Memory and Aging Project and Religious Orders Study, completed a mean of 7 annual evaluations including 17 cognitive tests. Neuropathologic examinations provided quantitative measures of AD (i.e., amyloid load, tangle density), CVD (i.e., macroscopic infarcts, microinfarcts), and neocortical Lewy bodies. Random coefficient models were used to examine the relation of the neuropathologies with rates of global cognitive decline as well as decline in four specific cognitive systems. Results: At autopsy, 82% of persons without dementia had amyloid, 100% had tangles, 29% had macroscopic infarcts, 25% had microinfarcts, and 6% had neocortical Lewy bodies. Global cognition declined a mean of 0.034 unit per year (SE = 0.003, p < 0.001). In separate analyses, amyloid, tangles (p-values <0.001) and neocortical Lewy bodies (p = 0.015) were associated with an increased rate of global cognitive decline; macroscopic infarcts and microinfarcts were not. Further, when analyzed simultaneously, amyloid, tangles, and neocortical Lewy bodies remained associated with global cognitive decline (p-values <0.024). Finally, measures of AD were associated with decline in three of four systems, including episodic memory (i.e., tangles), semantic memory (i.e., amyloid and tangles), and working memory (i.e., amyloid). Lewy bodies also were associated with decline in three of four systems (i.e., semantic memory, working memory, and perceptual speed). Interpretation: The neuropathologies of the common causes of dementia, particularly AD and neocortical LBD, are associated with decline in multiple cognitive abilities among older persons without dementia.
Collapse
Affiliation(s)
- Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago, IL, USA ; Department of Behavioral Sciences, Rush University Medical Center Chicago, IL, USA
| | | | | | | | | |
Collapse
|
47
|
Gerstorf D, Ram N. Inquiry into terminal decline: five objectives for future study. THE GERONTOLOGIST 2013; 53:727-37. [PMID: 23704220 DOI: 10.1093/geront/gnt046] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Notions of terminal decline propose that late-life change is primarily driven by processes closely tied to pathology and mortality rather than chronological age. We use the rationales of longitudinal research as outlined by Baltes and Nesselroade (Baltes, P., & Nesselroade, J. [1979]. History and rationale of longitudinal research. In J. R. Nesselroade & P. Baltes (Eds.), Longitudinal research in the study of behavior and development [pp. 1-39]. San Diego, CA: Academic Press) as a framework for organizing research on terminal decline. In doing so, we note that there are relatively robust descriptions of terminal decline across a variety of different domains, as well as the extent of interindividual differences in the levels of function, rates of change, and timing of terminal decline (research rationales 1 and 2). However, there is much more to learn about the interrelations among change in different domains, the underlying mechanisms of change, and the factors that contribute to interindividual differences in change (research rationales 3-5). Needed are new study designs and analytical models that better address the structural, temporal, and causal interrelations that contribute to and protect against terminal decline.
Collapse
Affiliation(s)
- Denis Gerstorf
- Address correspondence to Denis Gerstorf, Institute of Psychology, Humboldt University Berlin, Rudower Chaussee 18, 12489 Berlin, Germany. E-mail:
| | | |
Collapse
|
48
|
Wilson RS, Boyle PA, Segawa E, Yu L, Begeny CT, Anagnos SE, Bennett DA. The influence of cognitive decline on well-being in old age. Psychol Aging 2013; 28:304-13. [PMID: 23421323 DOI: 10.1037/a0031196] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study addressed the hypothesis that late life cognitive decline leads to loss of well-being. Participants are older persons from the Rush Memory and Aging Project. Beginning in 2001, they underwent annual clinical evaluations that included detailed cognitive performance testing and a 10-item self-report measure of purpose in life, an aspect of well-being. Initial analyses involved 1,049 individuals who were without dementia at baseline and followed a mean of 5.0 years. The intercepts and slopes of global cognition and purpose were positively correlated, and level of cognition at a given evaluation predicted level of purpose at the subsequent evaluation, consistent with the study hypothesis. Purpose also predicted subsequent cognition. These findings persisted in analyses that excluded mild cognitive impairment or controlled for time varying levels of depressive symptoms or disability. To see whether cognitive decline's correlation with purpose differed from its correlation with other aspects of well-being, we conducted additional analyses on a subgroup of 560 persons without dementia who completed a multidimensional measure of well-being once between 2008 and 2011. More rapid cognitive decline in the period preceding well-being assessment (M = 5.5 years, SD = 2.8) was associated with lower level of nearly all aspects of well-being (5 of 6 measures), but the extent of the association varied across well-being dimensions and was stronger for purpose than for self-acceptance and autonomy. The results support the hypothesis that cognitive aging leads to diminished well-being, particularly aspects such as purpose in life that involve behavioral regulation.
Collapse
Affiliation(s)
- Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
| | | | | | | | | | | | | |
Collapse
|
49
|
Wilson RS, Segawa E, Boyle PA, Anagnos SE, Hizel LP, Bennett DA. The natural history of cognitive decline in Alzheimer's disease. Psychol Aging 2012; 27:1008-17. [PMID: 22946521 DOI: 10.1037/a0029857] [Citation(s) in RCA: 242] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The study aim was to describe the temporal course of cognitive decline in Alzheimer's disease (AD). We selected 226 persons from 2 longitudinal clinical-pathological studies who were cognitively healthy at baseline, followed at least 4 years (M = 10.2, SD = 3.5), and clinically diagnosed with AD at some point during follow-up. Each evaluation included a battery of 17 cognitive tests from which a previously established composite measure of global cognition was derived. In those who died, a uniform neuropathologic examination established the pathological diagnoses of Alzheimer's disease and other common conditions that impair cognition. Mixed-effects models with 2 change points were used to assess trajectories of cognitive decline. In the main analysis, there was no change in cognitive function until a mean of 7.5 years before dementia was diagnosed (95% confidence interval [CI]: -8.3, -6.7). The global cognitive measure declined a mean of 0.087-unit per year (95% CI: -0.099, -0.073) until a mean of 2.0 years before the diagnosis (95% CI: -2.2, -1.7) when it increased more than 4-fold to a mean loss of 0.370-unit per year (95% CI: -0.417, -0.334). Of 126 individuals who died and underwent autopsy, 101 (80%) met pathologic criteria for AD, of whom 67 had at least one other pathologic condition. Pathologic measures of AD and cerebral infarction were not strongly related to cognitive trajectories. The results indicate that cognitive decline in AD begins many years before dementia is diagnosed and accelerates during the course of the disease.
Collapse
|
50
|
Bennett DA, Schneider JA, Arvanitakis Z, Wilson RS. Overview and findings from the religious orders study. Curr Alzheimer Res 2012; 9:628-45. [PMID: 22471860 PMCID: PMC3409291 DOI: 10.2174/156720512801322573] [Citation(s) in RCA: 466] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 12/27/2011] [Accepted: 01/12/2012] [Indexed: 12/22/2022]
Abstract
UNLABELLED The Religious Orders Study is a longitudinal clinical-pathologic cohort study of aging and Alzheimer's disease (AD). In this manuscript, we summarize the study methods including the study design and describe the clinical evaluation, assessment of risk factors, collection of ante-mortem biological specimens, brain autopsy and collection of selected postmortem data. THE RESULTS (1) review the relation of neuropathologic indices to clinical diagnoses and cognition proximate to death; (2) examine the relation of risk factors to clinical outcomes; (3) examine the relation of risk factors to measures of neuropathology; and (4) summarize additional study findings. We then discuss and contextualize the study findings.
Collapse
Affiliation(s)
- David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina, Suite 1028, Chicago, IL 60612, USA.
| | | | | | | |
Collapse
|