Lower visual processing speed relates to greater subjective cognitive complaints in community-dwelling healthy older adults

The psychometric properties of the Four Square Step Test in older adults with mild cognitive impairment

PURPOSE

The study aimed to determine the test-retest, interrater, and minimum detectable change, concurrent and known-groups validity in older adults with mild cognitive impairment. Minimal detectable change values are the degree of change needed to exceed a measurement's error within a confidence limit.

METHODS

A total of 46 older adults with mild cognitive impairment and 34 healthy controls were included. The Four Square Step Test was used together with the Timed Up and Go Test, Berg Balance Scale, Functional Reach Test, and One-Leg Stand Test.

RESULTS

The Four Square Step Test revealed high interrater and test-retest reliability (ICC = 0.963-0.986 and 0.937-0.956, respectively). The cut-off times of 15.11 s best distinguished older adults as fallers from non-fallers with mild cognitive impairment.

CONCLUSIONS

The Four Square Step Test is a valid, reliable, applicable, and safe dynamic balance evaluation to identify subtle changes to dynamic balance in mild cognitive impairment patients.

Abnormalities of resting-state EEG microstates in older adults with cognitive frailty

This study aims to analyze the characteristics of EEG microstates across different cognitive frailty (CF) subtypes, providing insights for the prevention and early diagnosis of CF. This study included 60 eligible older adults. Their resting-state EEG microstates were analyzed using agglomerative adaptive hierarchical clustering. Microstate temporal parameters were extracted through global field power peak-based backfitting. Spearman's partial correlation analysis and linear mixed-effects models were employed to investigate the relationship between microstate temporal parameters and CF. Statistical differences were observed in transition probabilities (TPs) from microstate B to A between healthy controls (HCs) and reversible cognitive frailty (RCF) group (t = -2.076, P = 0.042). Potentially reversible cognitive frailty (PRCF) and RCF group also exhibited statistical differences in the TPs from microstate B to A (t = 3.122, P = 0.003). In the RCF group, the occurrence of microstates A and B differed significantly from microstate C (tAC = 3.455, PAC = 0.002; tBC = 3.108, PBC = 0.004). In the PRCF group, the occurrence of microstates A, B, and C differed significantly from microstate D (tAD = -3.688, PAD = 0.001; tBD = -3.334, PBD = 0.002; tCD = -4.188, PCD < 0.001). The neural networks and processing modes engaged by microstate D during executive memory tasks differ between RCF and PRCF. A decreased occurrence of microstate C and higher TPs of microstates A and B may serve as early warning signals for RCF. Conversely, an increased occurrence of microstate D and decreased TPs of microstates C and D indicate the onset of PRCF.

Interaction between visual impairment and subjective cognitive complaints on physical activity impairment in U.S. older adults: NHANES 2005-2008

BACKGROUND/AIM

To investigate the independent relationships of visual impairment (VI) and Subjective cognitive complaints (SCC) with physical function impairment (PFI) and the interaction effect between VI and SCC on PFI in American older adults.

METHODS

The data of this cross-sectional study was obtained from the 2005-2008 National Health and Examination Survey (NHANES) conducted in the United States. The VI criterion included both subjective self-reported eyesight conditions and objective visual acuity test results. The self-reported questionnaires were utilized to determine PFI and SCC. According to the survey design of NHANS, original data were weighted to produce nationally representative estimates. Both the unweighted original data and weighted estimates underwent analysis. Crude and adjusted logistic models were employed to assess the pairwise associations among VI, SCC, and PFI. To assess the interactive effect, measures such as the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S) were calculated.

RESULTS

A total of 2,710 subjects (weighted n = 38,966,687) aged 60 years or older were included. Compared with subjects without subjective visual impairment (SVI), those with SVI had a significant positive association with PFI [weighted OR (95%CI): 3.11 (2.25, 4.31)]. After multi-variable adjusting, the relationship remained significant [weighted OR (95%CI): 1.90 (1.32, 2.72)]. Similarly, those with objective visual impairment (OVI) were positively associated with the risk of PFI in the crude model [weighted OR (95%CI): 2.35 (1.53, 3.61)] and adjusted model [weighted OR (95%CI): 1.84 (1.07, 3.17)]. Moreover, we found the association of SCC with an increased risk of FPI [crude weighted OR (95%CI): 5.02 (3.40, 7.40); adjusted weighted OR (95%CI): 3.29 (2.01, 5.38)]. Ultimately, the additive interaction showed there was a significant positive interaction term between SVI and SCC on PFI, while OVI and SCC did not.

CONCLUSION

Both VI and SCC were significantly associated with PFI in elder adults. Besides, there was a significant synergistic interaction between SVI and SCC on PFI, which indicated the improvement of SVI and SCC may be beneficial for the prevention of PFI. For the elderly, especially those with multiple disabilities, comprehensive and targeted approaches are imperative to foster their overall well-being and health.

Genetic Risk for Alzheimer's Disease Alters Perceived Executive Dysfunction in Cognitively Healthy Middle-Aged and Older Adults

Background

Subjective cognitive complaints (SCC) may be an early indicator of future cognitive decline. However, findings comparing SCC and objective cognitive performance have varied, particularly in the memory domain. Even less well established is the relationship between subjective and objective complaints in non-amnestic domains, such as in executive functioning, despite evidence indicating very early changes in these domains. Moreover, particularly early changes in both amnestic and non-amnestic domains are apparent in those carrying the Apolipoprotein-E ɛ4 allele, a primary genetic risk for Alzheimer's disease (AD).

Objective

This study investigated the role of the ɛ4 allele in the consistency between subjective and objective executive functioning in 54 healthy, cognitively intact, middle-aged and older adults.

Methods

Participants (Mage = 64.07, SD = 9.27, range = 48-84; ɛ4+ = 18) completed the Frontal Systems Behavior Scale (FrSBe) Executive Dysfunction Scale (EXECDYS) to measure subjective executive functioning (SEF) and multiple executive functioning tasks, which were condensed into a single factor.

Results

After accounting for age, depression, and anxiety, objective executive functioning performance significantly predicted SEF. Importantly, ɛ4 moderated this effect. Specifically, those carrying the ɛ4 allele had significantly less accurate self-awareness of their executive functioning compared to ɛ4 non-carriers.

Conclusions

Utilizing an approach that integrates self-evaluation of executive functioning with objective neurocognitive assessment may help identify the earliest signs of impending cognitive decline, particularly in those with genetic risk for AD. Such an approach could sensitively determine those most prone to future cognitive decline prior to symptom onset, when interventions could be most effective.