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Abulseoud OA, Caparelli EC, Krell‐Roesch J, Geda YE, Ross TJ, Yang Y. Sex-difference in the association between social drinking, structural brain aging and cognitive function in older individuals free of cognitive impairment. Front Psychiatry 2024; 15:1235171. [PMID: 38651011 PMCID: PMC11033502 DOI: 10.3389/fpsyt.2024.1235171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
Background We investigated a potential sex difference in the relationship between alcohol consumption, brain age gap and cognitive function in older adults without cognitive impairment from the population-based Mayo Clinic Study of Aging. Methods Self-reported alcohol consumption was collected using the food-frequency questionnaire. A battery of cognitive testing assessed performance in four different domains: attention, memory, language, and visuospatial. Brain magnetic resonance imaging (MRI) was conducted using 3-T scanners (Signa; GE Healthcare). Brain age was estimated using the Brain-Age Regression Analysis and Computational Utility Software (BARACUS). We calculated the brain age gap as the difference between predicted brain age and chronological age. Results The sample consisted of 269 participants [55% men (n=148) and 45% women (n=121) with a mean age of 79.2 ± 4.6 and 79.5 ± 4.7 years respectively]. Women had significantly better performance compared to men in memory, (1.12 ± 0.87 vs 0.57 ± 0.89, P<0.0001) language (0.66 ± 0.8 vs 0.33 ± 0.72, P=0.0006) and attention (0.79 ± 0.87 vs 0.39 ± 0.83, P=0.0002) z-scores. Men scored higher in visuospatial skills (0.71 ± 0.91 vs 0.44 ± 0.90, P=0.016). Compared to participants who reported zero alcohol drinking (n=121), those who reported alcohol consumption over the year prior to study enrollment (n=148) scored significantly higher in all four cognitive domains [memory: F3,268 = 5.257, P=0.002, Language: F3,258 = 12.047, P<0.001, Attention: F3,260 = 22.036, P<0.001, and Visuospatial: F3,261 = 9.326, P<0.001] after correcting for age and years of education. In addition, we found a significant positive correlation between alcohol consumption and the brain age gap (P=0.03). Post hoc regression analysis for each sex with language z-score revealed a significant negative correlation between brain age gap and language z-scores in women only (P=0.008). Conclusion Among older adults who report alcohol drinking, there is a positive association between higher average daily alcohol consumption and accelerated brain aging despite the fact that drinkers had better cognitive performance compared to zero drinkers. In women only, accelerated brain aging is associated with worse performance in language cognitive domain. Older adult women seem to be vulnerable to the negative effects of alcohol on brain structure and on certain cognitive functions.
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Affiliation(s)
- Osama A. Abulseoud
- Department of Psychiatry and Psychology, Mayo Clinic, Phoenix, AZ, United States
- Department of Neuroscience, Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Phoenix, AZ, United States
| | - Elisabeth C. Caparelli
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States
| | - Janina Krell‐Roesch
- Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, MN, United States
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Yonas E. Geda
- Department of Neurology, and the Franke Barrow Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Thomas J. Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States
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Fania A, Monaco A, Amoroso N, Bellantuono L, Cazzolla Gatti R, Firza N, Lacalamita A, Pantaleo E, Tangaro S, Velichevskaya A, Bellotti R. Machine learning and XAI approaches highlight the strong connection between O 3 and N O 2 pollutants and Alzheimer's disease. Sci Rep 2024; 14:5385. [PMID: 38443419 DOI: 10.1038/s41598-024-55439-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Alzheimer's disease (AD) is the most common type of dementia with millions of affected patients worldwide. Currently, there is still no cure and AD is often diagnosed long time after onset because there is no clear diagnosis. Thus, it is essential to study the physiology and pathogenesis of AD, investigating the risk factors that could be strongly connected to the disease onset. Despite AD, like other complex diseases, is the result of the combination of several factors, there is emerging agreement that environmental pollution should play a pivotal role in the causes of disease. In this work, we implemented an Artificial Intelligence model to predict AD mortality, expressed as Standardized Mortality Ratio, at Italian provincial level over 5 years. We employed a set of publicly available variables concerning pollution, health, society and economy to feed a Random Forest algorithm. Using methods based on eXplainable Artificial Intelligence (XAI) we found that air pollution (mainly O 3 and N O 2 ) contribute the most to AD mortality prediction. These results could help to shed light on the etiology of Alzheimer's disease and to confirm the urgent need to further investigate the relationship between the environment and the disease.
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Affiliation(s)
- Alessandro Fania
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, 70125, Bari, Italy
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy
| | - Alfonso Monaco
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, 70125, Bari, Italy.
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy.
| | - Nicola Amoroso
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy
- Dipartimento di Farmacia - Scienze del Farmaco, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Loredana Bellantuono
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy
- Dipartimento di Biomedicina Traslazionale e Neuroscienze (DiBraiN), Università degli Studi di Bari Aldo Moro, 70124, Bari, Italy
| | - Roberto Cazzolla Gatti
- Department of Biological Sciences, Geological and Environmental (BiGeA), Alma Mater Studiorum - University of Bologna, 40126, Bologna, Italy
| | - Najada Firza
- Dipartimento di Economia e Finanza, Università degli Studi di Bari Aldo Moro, 70124, Bari, Italy
- Catholic University Our Lady of Good Counsel, 1031, Tirana, Albania
| | - Antonio Lacalamita
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, 70125, Bari, Italy
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy
| | - Ester Pantaleo
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, 70125, Bari, Italy
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy
| | - Sabina Tangaro
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy
- Dipartimento di Scienze del Suolo, della Pianta e degli Alimenti, Università degli Studi di Bari Aldo Moro, 70126, Bari, Italy
| | | | - Roberto Bellotti
- Dipartimento Interateneo di Fisica M. Merlin, Universitá degli Studi di Bari Aldo Moro, 70125, Bari, Italy
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Bari, 70125, Bari, Italy
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Feldberg C, Barreyro JP, Tartaglini MF, Hermida PD, Moya García L, Benetti L, Somale MV, Allegri R. Estimation of cognitive reserve and its impact on cognitive performance in older adults. Appl Neuropsychol Adult 2024; 31:117-127. [PMID: 34870538 DOI: 10.1080/23279095.2021.2002864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Cognitive reserve provides evidence in the search for answers regarding the role that lifestyle has in the protection of cognition in old age. Through a structural equations model, different things were analyzed: the relative weight of education, occupational complexity, free time activities and the intelligence quotient in cognitive reserve; and its impact on three cognitive domains: memory, language and executive functions. DESIGN A trail analysis was executed, using structural equations procedure. PARTICIPANTS 167 older participants (mean = 76.74 years, standard deviation = 6.8 years). MEASUREMENTS Participants were assessed with: Sociodemographic Questionnaire, Occupational Activity Agency Questionnaire, Social Participation Questionnaire and Neuropsychological Evaluation Battery for: memory, language and executive functions. RESULTS The cognitive reserve factor is well represented by the measures included, with values between .43 and .86, and shows a direct effect on language (β = .52, p < .001), executive functions (β = .77, p <.001), and memory (β = .36, p = .003). CONCLUSIONS In conclusion, lifestyle factors, such as education, occupational complexity, leisure time activities and intelligence quotient have an impact on the conformation of cognitive reserve and performance in some psychological processes.
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Affiliation(s)
- Carolina Feldberg
- National Scientific and Technical, Research Council- INEBA, CONICET-INEBA, Buenos Aires, Argentina
| | - Juan Pablo Barreyro
- National Scientific and Technical, Research Council- University of Buenos Aires, CONICET- University of Buenos Aires, Buenos Aires, Argentina
| | | | - Paula Daniela Hermida
- National Scientific and Technical, Research Council in the Investigations Institute IAT IMET-UBACONICET, Buenos Aires, Argentina
| | - Lydia Moya García
- Cognitive Neurology Service of the Buenos Aires Neuroscience Institute, INEBA Buenos Aires, Buenos Aires, Argentina
| | - Laureana Benetti
- Cognitive Neurology Service of the Buenos Aires Neuroscience Institute, INEBA Buenos Aires, Buenos Aires, Argentina
| | - María Verónica Somale
- Cognitive Neurology Service of the Buenos Aires Neuroscience Institute, INEBA Buenos Aires, Buenos Aires, Argentina
| | - Ricardo Allegri
- Cognitive Neurology Service of the FLENI Foundation, Foundation for Childhood Neurological Disorders, Cognitive Neurology, Neuropsychology and Neuropsychiatry Section (CONICET-FLENI), Buenos Aires, Argentine
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Pucci V, La Face A, Gasteiger-Klicpera B, Mondini S. Cognitive reserve proxies for individuals with intellectual developmental disability: A scoping review. J Appl Res Intellect Disabil 2024; 37:e13204. [PMID: 38361365 DOI: 10.1111/jar.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/18/2023] [Accepted: 01/09/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Cognitive reserve (CR) has not been studied in people with Intellectual Developmental Disability, a population with a high incidence of dementia. Commonly adopted CR proxies should be adapted to reflect more specifically the experiences of people with Intellectual Developmental Disability. METHOD This scoping review intended to identify CR proxies relevant to people with this condition. RESULTS Some of these were the same already detected in a population without intellectual disabilities (education, occupation, physical activity, leisure, community and social activities); others were found to be specifically relevant for this population: type of schooling, parental educational level, environmental stimulation and living place. CONCLUSIONS These proxies need to be considered in studies on CR and Intellectual Developmental Disability and in clinical practice. Research on the protective effect of CR aims to encourage policies promoting lifestyle-based educational and preventive interventions and overcome participation barriers for people with Intellectual Developmental Disability.
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Affiliation(s)
- Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padova, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padova, Italy
| | - Annalisa La Face
- Inclusive Education Unit, Institute of Education Research and Teacher Education, University of Graz, Graz, Austria
| | - Barbara Gasteiger-Klicpera
- Inclusive Education Unit, Institute of Education Research and Teacher Education, University of Graz, Graz, Austria
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padova, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padova, Italy
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Manrique-Gutiérrez G, Rodríguez-Cayetano Q, Samudio-Cruz MA, Carrillo-Mora P. The role of cognitive reserve in traumatic brain injury: a systematic review of observational studies. Brain Inj 2024; 38:45-60. [PMID: 38219070 DOI: 10.1080/02699052.2024.2304876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVE Evaluate the role of cognitive reserve (CR) on cognitive and physical sequelae in traumatic brain injury (TBI). METHODS A comprehensive search strategy was conducted in four databases in English and Spanish in the last 12 years (2011-2023). Inclusion criteria: original cross-sectional and longitudinal studies whose main or secondary objective was to evaluate the effect of CR in adult patients with TBI. PRISMA guidelines were used to report the search and selection method and STROBE checklist was used to evaluate the quality of studies. RESULTS Eighteen observational studies were included in this review. Multiple sources of variability were observed: number of patients, time of evolution, severity of the TBI, type of CR proxy, cognitive assessment instrument, etc. However, the most commonly used indicators of CR were premorbid IQ and educational attainment. A positive and consistent association between CR and performance on cognitive tests after injury was found. CONCLUSIONS CR has a consistent positive effect on cognition and on some other aspects of recovery in traumatic brain injury. In future studies, it will be necessary to promote the use of CR indices based on various indicators and explore the effects of CR on other aspects related to the recovery of brain trauma.
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Affiliation(s)
- Gabriel Manrique-Gutiérrez
- PECEM (Plan de Estudios Combinados en Medicina), Facultad de Medicina, Universidad Nacional Autónoma de México, México City, México
| | | | - María Alejandra Samudio-Cruz
- Division de Neurociencias Clinicas, Instituto Nacional de Rehabilitación "Luis Guillerimo Ibarra Ibarra", México City, México
| | - Paul Carrillo-Mora
- Division de Neurociencias Clinicas, Instituto Nacional de Rehabilitación "Luis Guillerimo Ibarra Ibarra", México City, México
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Pinto JO, Peixoto B, Dores AR, Barbosa F. Measures of cognitive reserve: An umbrella review. Clin Neuropsychol 2024; 38:42-115. [PMID: 37073431 DOI: 10.1080/13854046.2023.2200978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Abstract
Objective: Recently, there has been a growing interest in operationalizing and measuring cognitive reserve (CR) for clinical and research purposes. This umbrella review aims to summarize the existing systematic and meta-analytic reviews about measures of CR. Method: A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the guidelines of Aromataris et al. (2015) to identify the systematic reviews and meta-analysis involving the assessment of CR. The methodological quality of the papers included in this umbrella review was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) and Specialist Unit for Review Evidence (SURE). Results: Thirty-one reviews were identified, sixteen of which were systematic reviews, and fifteen were meta-analyses. Most of the reviews had a critically low quality, according to AMSTAR-2. The reviews included between two and 135 studies. Most of the papers focused on older adults, mainly those with dementia. CR was measured using one to six proxies, but most considered each proxy separately. The most assessed proxies of CR were education on its own, combined with occupation and/or engagement in activities or combined with parental education, bilingualism, and engagement in activities when four CR proxies were studied. Most of the studies included in higher quality reviews focused on three proxies, with education and engagement in activities being the most evaluated using CR questionnaires. Conclusion: Despite the growing interest in measuring CR, its operationalization did not improve since the last umbrella review in this field.
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Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- CESPU, University Institute of Health Sciences, Gandra, Portugal
| | - Bruno Peixoto
- CESPU, University Institute of Health Sciences, Gandra, Portugal
- NeuroGen - Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Mora MG, Suchy Y. Know thyself: Executive functioning and sex predict self-appraisal of functional abilities in community-dwelling older adults. Clin Neuropsychol 2023; 37:1686-1709. [PMID: 36779583 DOI: 10.1080/13854046.2023.2167738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/06/2023] [Indexed: 02/14/2023]
Abstract
Objective: The capacity for accurate self-appraisals of age-related changes in cognitive and functional abilities is integral to the maintenance of independence in later life, yet there is little understanding of the factors that place nondemented older adults at risk for poor self-awareness. This study examined the potential contributions of executive functioning (EF), crystallized intelligence (IQ-Cr), and sex in predicting congruence between performance and self-appraisals of instrumental activities of daily living (IADL) in a group of community-dwelling older adults. Method: A group of 150 nondemented, community-dwelling older adults (White and majority highly educated) completed measures of EF and IQ-Cr. Participants also completed five timed IADL tasks and self-appraised their performance relative to others of similar age. Results: Sex [F(1,148) = 7.75, p = .006, ηp2 = .05] and EF [(F(1,147) = 5.30, p = .02, ηp2 = .04)], but not IQ-Cr, predicted the relationship between performance and self-appraisals, such that those with lower EF and those of male sex overestimated their performance more than those with higher EF and females. Conclusions: Findings indicate that having average to below average EF abilities and being of male sex are risk factors for less accurate self-report of IADL abilities and as such might represent important considerations when assessing IADL abilities via self-report among largely independent, community-dwelling older adults.
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Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Mühlbäck A, Mana J, Wallner M, Frank W, Lindenberg KS, Hoffmann R, Klempířová O, Klempíř J, Landwehrmeyer GB, Bezdicek O. Establishing normative data for the evaluation of cognitive performance in Huntington's disease considering the impact of gender, age, language, and education. J Neurol 2023; 270:4903-4913. [PMID: 37347292 PMCID: PMC10511566 DOI: 10.1007/s00415-023-11823-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND A declining cognitive performance is a hallmark of Huntington's disease (HD). The neuropsychological battery of the Unified HD Rating Scale (UHDRS'99) is commonly used for assessing cognition. However, there is a need to identify and minimize the impact of confounding factors, such as language, gender, age, and education level on cognitive decline. OBJECTIVES Aim is to provide appropriate, normative data to allow clinicians to identify disease-associated cognitive decline in diverse HD populations by compensating for the impact of confounding factors METHODS: Sample data, N = 3267 (60.5% females; mean age of 46.9 years (SD = 14.61, range 18-86) of healthy controls were used to create a normative dataset. For each neuropsychological test, a Bayesian generalized additive model with age, education, gender, and language as predictors was constructed to appropriately stratify the normative dataset. RESULTS With advancing age, there was a non-linear decline in cognitive performance. In addition, performance was dependent on educational levels and language in all tests. Gender had a more limited impact. Standardized scores have been calculated to ease the interpretation of an individual's test outcome. A web-based online tool has been created to provide free access to normative data. CONCLUSION For defined neuropsychological tests, the impact of gender, age, education, and language as factors confounding disease-associated cognitive decline can be minimized at the level of a single patient examination.
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Affiliation(s)
- Alžbeta Mühlbäck
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081, Ulm, Germany.
- Huntington Center South, kbo-Isar-Amper-Klinikum, Taufkirchen, Germany.
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.
| | - Josef Mana
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | | | - Wiebke Frank
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081, Ulm, Germany
| | - Katrin S Lindenberg
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081, Ulm, Germany
| | - Rainer Hoffmann
- Huntington Center South, kbo-Isar-Amper-Klinikum, Taufkirchen, Germany
| | - Olga Klempířová
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Jiří Klempíř
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | | | - Ondrej Bezdicek
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
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Howard KA, Massimo L, Griffin SF, Gagnon RJ, Zhang L, Rennert L. Systematic examination of methodological inconsistency in operationalizing cognitive reserve and its impact on identifying predictors of late-life cognition. BMC Geriatr 2023; 23:547. [PMID: 37684556 PMCID: PMC10492336 DOI: 10.1186/s12877-023-04263-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Cognitive reserve (CR) is the ability to maintain cognitive performance despite brain pathology. CR is built through lifecourse experiences (e.g., education) and is a key construct in promoting healthy aging. However, the operationalization of CR and its estimated association with late-life cognition varies. The purpose of this study was to systematically examine the operationalization of CR and the relationship between its operationalization and late-life cognition. METHODS We performed a comprehensive review of experiences (proxies) used to operationalize CR. The review informed quantitative analyses using data from 1366 participants of the Memory and Aging Project to examine 1) relationships between proxies and 2) the relationship between operationalization and late-life cognition. We also conducted a factor analysis with all identified CR experiences to create a composite lifecourse CR score. Generalized linear mixed models examined the relationship between operationalizations and global cognition, with secondary outcomes of five domains of cognition to examine consistency. RESULTS Based on a review of 753 articles, we found the majority (92.3%) of the 28 commonly used proxies have weak to no correlation between one another. There was substantial variability in the association between operationalizations and late-life global cognition (median effect size: 0.99, IQR: 0.34 to 1.39). There was not strong consistency in the association between CR operationalizations and the five cognitive domains (mean consistency: 56.1%). The average estimate for the 28 operationalizations was 0.91 (SE = 0.48), compared to 2.48 (SE = 0.40) for the lifecourse score and it was associated with all five domains of cognition. CONCLUSIONS Inconsistent methodology is theorized as a major limitation of CR research and barrier to identification of impactful experiences for healthy cognitive aging. Based on the weak associations, it is not surprising that the relationship between CR and late-life cognition is dependent on the experience used to operationalize CR. Scores using multiple experiences across the lifecourse may help overcome such limitations. Adherence to a lifecourse approach and collaborative movement towards a consensus operationalization of CR are imperative shifts in the study of CR that can better inform research on risk factors related to cognitive decline and ultimately aid in the promotion of healthy aging.
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Affiliation(s)
- Kerry A Howard
- Department of Public Health Sciences, Clemson University, Clemson, SC, 29634, USA.
- Center for Public Health Modeling and Response, Clemson University, Clemson, SC, 29634, USA.
| | - Lauren Massimo
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, Clemson, SC, 29634, USA
| | - Ryan J Gagnon
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Lu Zhang
- Department of Public Health Sciences, Clemson University, Clemson, SC, 29634, USA
| | - Lior Rennert
- Department of Public Health Sciences, Clemson University, Clemson, SC, 29634, USA.
- Center for Public Health Modeling and Response, Clemson University, Clemson, SC, 29634, USA.
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Guerrini S, Hunter EM, Papagno C, MacPherson SE. Cognitive reserve and emotion recognition in the context of normal aging. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2023; 30:759-777. [PMID: 35634692 DOI: 10.1080/13825585.2022.2079603] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
The Cognitive Reserve (CR) hypothesis accounts for individual differences in vulnerability to age- or pathological-related brain changes. It suggests lifetime influences (e.g., education) increase the effectiveness of cognitive processing in later life. While evidence suggests CR proxies predict cognitive performance in older age, it is less clear whether CR proxies attenuate age-related decline on social cognitive tasks. This study investigated the effect of CR proxies on unimodal and cross-modal emotion identification. Sixty-six older adults aged 60-78 years were assessed on CR proxies (Cognitive Reserve Index Questionnaire, NART), unimodal(faces only, voices only), and cross-modal (faces and voices combined) emotion recognition and executive function (Stroop Test). No CR proxy predicted performance on emotion recognition. However, NART IQ predicted performance on the Stroop test; higher NART IQ was associated with better performance. The current study suggests CR proxies do not predict performance on social cognition tests but do predict performance on cognitive tasks.
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Affiliation(s)
- Sofia Guerrini
- Dipartimento di Psicologia, Università degli studi di Milano-Bicocca, Milano, Italy
| | | | - Costanza Papagno
- CeRiN, Centro di Riabilitazione Neurocognitiva, CIMeC, Università di Trento, Rovereto, Italy
| | - Sarah E MacPherson
- Human Cognitive Neuroscience, Department of Psychology, University of Edinburgh, Edinburgh, UK
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Maffezzini S, Pucci V, Riccardi A, Montemurro S, Puthenparampil M, Perini P, Rinaldi F, Gallo P, Arcara G, Mondini S. Clinical Profiles in Multiple Sclerosis: Cognitive Reserve and Motor Impairment along Disease Duration. Behav Sci (Basel) 2023; 13:708. [PMID: 37753986 PMCID: PMC10525733 DOI: 10.3390/bs13090708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
(i) Background: Cognitive impairment in people with multiple sclerosis (MS) has been studied in relation to certain clinical variables (e.g., motor disability and disease duration) and lifestyle factors such as cognitive reserve (CR). However, only very few studies have considered the interaction of clinical variables and cognitive reserve in preserving the integrity of the neuropsychological profile. In this paper, we hypothesised that a higher level of CR might predict good cognitive efficiency by modulating the clinical outcome of the disease. (ii) Methods: A sample of 100 participants with MS (age range 30-74), was recruited and assessed remotely with a questionnaire to measure CR and a cognitive screening test. Data were analysed through generalized additive models. (iii) Results: We found that the model analysing the interaction between CR and disease duration, and between CR and motor disability, was able to explain a significant percentage of cognitive performance. In particular, higher levels of CR predicted a better cognitive performance despite a long disease duration, unless the motor disability was severe. (iv) Conclusion: This study highlights the crucial role of CR in modulating cognitive efficiency in people with MS.
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Affiliation(s)
- Sabrina Maffezzini
- Multiple Sclerosis Centre, University-Hospital of Padua, 35128 Padova, Italy; (S.M.); (A.R.); (M.P.); (P.P.); (F.R.); (P.G.)
| | - Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, 35128 Padova, Italy;
- Human Inspired Technology Centre (HIT), University of Padua, 35122 Padova, Italy
| | - Alice Riccardi
- Multiple Sclerosis Centre, University-Hospital of Padua, 35128 Padova, Italy; (S.M.); (A.R.); (M.P.); (P.P.); (F.R.); (P.G.)
| | | | - Marco Puthenparampil
- Multiple Sclerosis Centre, University-Hospital of Padua, 35128 Padova, Italy; (S.M.); (A.R.); (M.P.); (P.P.); (F.R.); (P.G.)
- Department of Neuroscience, University of Padua, 35128 Padova, Italy
| | - Paola Perini
- Multiple Sclerosis Centre, University-Hospital of Padua, 35128 Padova, Italy; (S.M.); (A.R.); (M.P.); (P.P.); (F.R.); (P.G.)
| | - Francesca Rinaldi
- Multiple Sclerosis Centre, University-Hospital of Padua, 35128 Padova, Italy; (S.M.); (A.R.); (M.P.); (P.P.); (F.R.); (P.G.)
| | - Paolo Gallo
- Multiple Sclerosis Centre, University-Hospital of Padua, 35128 Padova, Italy; (S.M.); (A.R.); (M.P.); (P.P.); (F.R.); (P.G.)
- Department of Neuroscience, University of Padua, 35128 Padova, Italy
| | - Giorgio Arcara
- IRCCS San Camillo Hospital, 30126 Venice, Italy; (S.M.); (G.A.)
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, 35128 Padova, Italy;
- Human Inspired Technology Centre (HIT), University of Padua, 35122 Padova, Italy
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12
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Wu Z, Pandigama DH, Wrigglesworth J, Owen A, Woods RL, Chong TTJ, Orchard SG, Shah RC, Sheets KM, McNeil JJ, Murray AM, Ryan J. Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. JAMA Netw Open 2023; 6:e2323690. [PMID: 37450299 PMCID: PMC10349343 DOI: 10.1001/jamanetworkopen.2023.23690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/31/2023] [Indexed: 07/18/2023] Open
Abstract
Importance Lifestyles enriched with socially and mentally stimulating activities in older age may help build cognitive reserve and reduce dementia risk. Objective To investigate the association of leisure activities and social networks with dementia risk among older individuals. Design, Setting, and Participants This longitudinal prospective cohort study used population-based data from the ASPREE Longitudinal Study of Older Persons (ALSOP) for March 1, 2010, to November 30, 2020. Community-dwelling individuals in Australia aged 70 years or older who were generally healthy and without major cognitive impairment at enrollment were recruited to the ALSOP study between March 1, 2010, and December 31, 2014. Data were analyzed from December 1, 2022, to March 31, 2023. Exposures A total of 19 measures of leisure activities and social networks assessed at baseline were classified using exploratory factor analysis. Main Outcomes and Measures Dementia was adjudicated by an international expert panel according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Cox proportional hazards regression examined dementia risk over 10 years, adjusting for education, socioeconomic status, and a range of health-related factors. Results This study included 10 318 participants. Their median age was 73.8 (IQR, 71.6-77.2) years at baseline, more than half (52.6%) were women, and most self-identified as White (98.0%). In adusted analyses, more frequent engagement in adult literacy activities (eg, writing letters or journaling, using a computer, and taking education classes) and in active mental activities (eg, playing games, cards, or chess and doing crosswords or puzzles) was associated with an 11.0% (adjusted hazard ratio [AHR], 0.89 [95% CI, 0.85-0.93]) and a 9.0% (AHR, 0.91 [95% CI, 0.87-0.95]) lower risk of dementia, respectively. To a lesser extent, engagement in creative artistic activities (craftwork, woodwork, or metalwork and painting or drawing) (AHR, 0.93 [95% CI, 0.88-0.99]) and in passive mental activities (reading books, newspapers, or magazines; watching television; and listening to music or the radio) (AHR, 0.93 [95% CI, 0.86-0.99]) was also associated with reduced dementia risk. In contrast, interpersonal networks, social activities, and external outings were not associated with dementia risk in this sample. Conclusions and Relevance These results suggest that engagement in adult literacy, creative art, and active and passive mental activities may help reduce dementia risk in late life. In addition, these findings may guide policies for geriatric care and interventions targeting dementia prevention for older adults.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Danushika H. Pandigama
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Monash School of Medicine, Monash University, Melbourne, Australia
| | - Jo Wrigglesworth
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Trevor T.-J. Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
- Department of Clinical Neurosciences, St Vincent’s Hospital, Melbourne, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Raj C. Shah
- Department of Family and Preventive Medicine, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Kerry M. Sheets
- Division of Geriatric and Palliative Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis, Minnesota
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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13
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Arora M, Pozzato I, McBain C, Tran Y, Sandalic D, Myles D, Middleton JW, Craig A. Cognitive Reserve and Its Association with Cognitive and Mental Health Status following an Acute Spinal Cord Injury. J Clin Med 2023; 12:4258. [PMID: 37445291 DOI: 10.3390/jcm12134258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/14/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a common secondary condition associated with spinal cord injury (SCI). Cognitive reserve (CR) is believed to protect against cognitive decline and can be assessed by premorbid intelligence (pmIQ). Despite the potential utility of pmIQ as a complementary metric in the evaluation of MCI in SCI, this approach has been infrequently employed. The purpose of this study was to examine the association between MCI and pmIQ in adults with SCI with the aim of exploring the potential value of pmIQ as a marker of CR in this population. METHODS Cognitive function was assessed on three occasions in adults with SCI over a 12-month period post-injury, and pmIQ was assessed once at baseline. Demographic and mental health measures were also collected, and logistic regression was conducted to determine the strength of association between pmIQ and MCI while adjusting for factors such as mental health and age. RESULTS The regression analysis revealed that at the time of admission to SCI rehabilitation, the MCI assessed by a valid neurocognitive screen was strongly associated with pmIQ. That is, if a person has MCI, there was 5.4 greater odds (p < 0.01) that they will have poor pmIQ compared to a person without MCI after adjustment for age and mental health. CONCLUSIONS The assessment of CR is an important area that should be considered to improve the process of diagnosing MCI in adults with an acute SCI and potentially facilitate earlier intervention to slow or prevent cognitive decline.
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Affiliation(s)
- Mohit Arora
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Ilaria Pozzato
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Candice McBain
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2113, Australia
| | - Danielle Sandalic
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Daniel Myles
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - James Walter Middleton
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Ashley Craig
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
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14
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Cuéllar-García MF, Dager-Berecochea I, Villegas-Iparrea AP, Molina-Escalante Z, Villalobos-Gallegos L, Toledo-Fernández A. Big Five personality factors predict self-rated cognitive reserve: a two-wave online study in a Mexican sample. Cogn Neuropsychiatry 2023; 28:102-115. [PMID: 36695101 DOI: 10.1080/13546805.2023.2168530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Introduction: One of the main contributors to cognitive reserve (CR) is the involvement in cognitively stimulating activities (CSAs), including education, work, leisure, social and physical activities. Personality traits are plausible determinants of CR, influencing the tendency to engage in CSAs. The goal of this study was to evaluate the association between personality and CR, operationalised as self-rated involvement in CSAs, in a sample of individuals aged 18-50 or more. Method: We collected two-wave non-probabilistic online data throughout Mexico. The instruments were the Big Five Inventory-2 for the baseline, its extra-short form for the follow-up and the Self-Rating of Cognitive Reserve (SRCR). Confirmatory factor analyses (CFAs) were performed to test the unifactorial structure of the SRCR, and multiple regressions were conducted with personality factors as predictors of CR. Results: For the baseline, 2025 participants were recruited, and 610 for the follow-up, most of them female and aged 18-40. CFAs showed excellent goodness-of-fit, and the regression analyses proved Negative Emotionality and Extraversion to be the main predictors of CR. Conclusions: Our study highlights the need to identify personality profiles at high risk of underdevelopment of CR in ages where it is still feasible to promote engagement in CSAs.
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Affiliation(s)
| | | | | | | | - Luis Villalobos-Gallegos
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California-Tijuana, Tijuana, Mexico
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15
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Covey TJ, Shucard JL, Wang X, Gregory MA, Shucard DW. Cognitive skill learning in multiple sclerosis: A meaningful component of the neuropsychological profile. Brain Cogn 2023; 166:105959. [PMID: 36842286 DOI: 10.1016/j.bandc.2023.105959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/27/2023]
Abstract
Cognitive skill learning (CSL) refers to the capacity to improve performance on specific cognitive operations through repeated practice. We hypothesized that high CSL aptitude may promote accumulation of cognitive reserve, and resiliency to cognitive decline, in people with Multiple Sclerosis (MS). Using an adaptive working memory training paradigm, we obtained CSL aptitude indices (amount of improvement on the training task over time) in MS patients for a single session of practice (25-30 min), and longer-term practice (twenty sessions). Neuropsychological performance was assessed with the Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and the Raven's Advanced Progressive Matrices (RAPM). CSL aptitude measures were positively correlated with neuropsychological performance, and had high diagnostic accuracy for classifying cognitive impairment in MS, defined as 1.5 SD below the demographics-corrected normative mean of the SDMT. Positive relationships between CSL aptitude measures and neuropsychological performance tended to be more pronounced for individuals with high estimated cognitive reserve, suggesting that high CSL aptitude is a a factor that promotes the protective effects of cognitive reserve. Furthermore, regression analyses indicated that CSL aptitude is separable from baseline cognitive capacity. The findings suggest that CSL aptitude impacts the neuropsychological profile in MS, and may be a factor underlying variance in cognitive resiliency.
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Affiliation(s)
- Thomas J Covey
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States; Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States.
| | - Janet L Shucard
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States; Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States
| | - Xuedi Wang
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States; Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States
| | - Madeline A Gregory
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States; Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States
| | - David W Shucard
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States; Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, United States
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16
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Gyllenhammar M, Rennie A, Padilla DF, Wallert J, Rydström A, Wahlund LO, Eriksdotter M, Westman E, Ekman U. The Association Between Temporal Atrophy and Episodic Memory Is Moderated by Education in a Multi-Center Memory Clinic Sample. J Alzheimers Dis 2023; 92:605-614. [PMID: 36776050 PMCID: PMC10041436 DOI: 10.3233/jad-220741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Cognitive reserve (CR) is hypothesized to partially explain the discrepancy between Alzheimer's disease related brain pathology and cognitive performance. Educational attainment is often used as a proxy for CR. OBJECTIVE To examine the association of years of education and the relationship between atrophy in the medial temporal lobe and episodic memory, in a cross-sectional ecological multi-center memory clinic cohort. METHODS Included patients (n = 702) had undergone memory clinic examination and were diagnosed with subjective cognitive impairment (n = 99), mild cognitive impairment (n = 471), or dementia (n = 132). Total years of education were used as a moderating variable and neuropathology was operationalized as visual ratings of medial temporal lobe atrophy (MTA) on magnetic resonance imaging and computer tomography images. Weighted least squares regression and multiple regression were used to analyze moderation and the effect of education separately by diagnostic group. A composite score of two episodic memory tests constituted the dependent variable. RESULTS After controlling for age and gender the interaction term between MTA and years of education was significant indicating moderation. In particular, the regression model showed that at low levels of MTA, high education individuals had better episodic memory performance. However, at higher MTA levels, high education individuals had the lowest episodic memory performance. Education had a significant positive effect on episodic memory in SCI and MCI, but not dementia. CONCLUSION These results extend the findings of education moderating the effect of MTA on cognition to a naturalistic memory clinic setting. Implications of the findings for theories on CR are discussed.
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Affiliation(s)
- Måns Gyllenhammar
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Rennie
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Ferreira Padilla
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - John Wallert
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anders Rydström
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Eric Westman
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience: King's College London, London, UK
| | - Urban Ekman
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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17
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Kristinsson S, Busby N, Rorden C, Newman-Norlund R, den Ouden DB, Magnusdottir S, Hjaltason H, Thors H, Hillis AE, Kjartansson O, Bonilha L, Fridriksson J. Brain age predicts long-term recovery in post-stroke aphasia. Brain Commun 2022; 4:fcac252. [PMID: 36267328 PMCID: PMC9576153 DOI: 10.1093/braincomms/fcac252] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/25/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
The association between age and language recovery in stroke remains unclear. Here, we used neuroimaging data to estimate brain age, a measure of structural integrity, and examined the extent to which brain age at stroke onset is associated with (i) cross-sectional language performance, and (ii) longitudinal recovery of language function, beyond chronological age alone. A total of 49 participants (age: 65.2 ± 12.2 years, 25 female) underwent routine clinical neuroimaging (T1) and a bedside evaluation of language performance (Bedside Evaluation Screening Test-2) at onset of left hemisphere stroke. Brain age was estimated from enantiomorphically reconstructed brain scans using a machine learning algorithm trained on a large sample of healthy adults. A subsample of 30 participants returned for follow-up language assessments at least 2 years after stroke onset. To account for variability in age at stroke, we calculated proportional brain age difference, i.e. the proportional difference between brain age and chronological age. Multiple regression models were constructed to test the effects of proportional brain age difference on language outcomes. Lesion volume and chronological age were included as covariates in all models. Accelerated brain age compared with age was associated with worse overall aphasia severity (F(1, 48) = 5.65, P = 0.022), naming (F(1, 48) = 5.13, P = 0.028), and speech repetition (F(1, 48) = 8.49, P = 0.006) at stroke onset. Follow-up assessments were carried out ≥2 years after onset; decelerated brain age relative to age was significantly associated with reduced overall aphasia severity (F(1, 26) = 5.45, P = 0.028) and marginally failed to reach statistical significance for auditory comprehension (F(1, 26) = 2.87, P = 0.103). Proportional brain age difference was not found to be associated with changes in naming (F(1, 26) = 0.23, P = 0.880) and speech repetition (F(1, 26) = 0.00, P = 0.978). Chronological age was only associated with naming performance at stroke onset (F(1, 48) = 4.18, P = 0.047). These results indicate that brain age as estimated based on routine clinical brain scans may be a strong biomarker for language function and recovery after stroke.
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Affiliation(s)
- Sigfus Kristinsson
- Correspondence to: Sigfus Kristinsson, PhD Center for the Study of Aphasia Recovery University of South Carolina, 915 Greene Street Columbia, SC 29209, USA E-mail:
| | - Natalie Busby
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA
| | - Christopher Rorden
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Roger Newman-Norlund
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Dirk B den Ouden
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Communication Sciences and Disorders, Columbia, SC 29208, USA
| | | | - Haukur Hjaltason
- Department of Medicine, University of Iceland, Reykjavik 00107, Iceland,Department of Neurology, Landspitali University Hospital, Reykjavik 00101, Iceland
| | - Helga Thors
- Department of Medicine, University of Iceland, Reykjavik 00107, Iceland
| | - Argye E Hillis
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MA 21218, USA
| | - Olafur Kjartansson
- Department of Neurology, Landspitali University Hospital, Reykjavik 00101, Iceland
| | - Leonardo Bonilha
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Julius Fridriksson
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Communication Sciences and Disorders, Columbia, SC 29208, USA
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18
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Ferrari-Díaz M, Bravo-Chávez RI, Silva-Pereyra J, Fernández T, García-Peña C, Rodríguez-Camacho M. Verbal intelligence and leisure activities are associated with cognitive performance and resting-state electroencephalogram. Front Aging Neurosci 2022; 14:921518. [PMID: 36268192 PMCID: PMC9577299 DOI: 10.3389/fnagi.2022.921518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022] Open
Abstract
Cognitive reserve (CR) is the adaptability of cognitive processes that helps to explain differences in the susceptibility of cognitive or daily functions to resist the onslaught of brain-related injury or the normal aging process. The underlying brain mechanisms of CR studied through electroencephalogram (EEG) are scarcely reported. To our knowledge, few studies have considered a combination of exclusively dynamic proxy measures of CR. We evaluated the association of CR with cognition and resting-state EEG in older adults using three of the most frequently used dynamic proxy measures of CR: verbal intelligence, leisure activities, and physical activities. Multiple linear regression analyses with the CR proxies as independent variables and cognitive performance and the absolute power (AP) on six resting-state EEG components (beta, alpha1, alpha2, gamma, theta, and delta) as outcomes were performed. Eighty-eight healthy older adults aged 60–77 (58 female) were selected from previous study data. Verbal intelligence was a significant positive predictor of perceptual organization, working memory, processing speed, executive functions, and central delta power. Leisure activities were a significant positive predictor of posterior alpha2 power. The dynamic proxy variables of CR are differently associated with cognitive performance and resting-state EEG. Implementing leisure activities and tasks to increase vocabulary may promote better cognitive performance through compensation or neural efficiency mechanisms.
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Affiliation(s)
- Martina Ferrari-Díaz
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
| | - Ricardo Iván Bravo-Chávez
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
| | - Juan Silva-Pereyra
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
- *Correspondence: Juan Silva-Pereyra,
| | - Thalía Fernández
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Juriquilla, Mexico
| | - Carmen García-Peña
- Departamento de Investigación, Instituto Nacional de Geriatría, Ciudad de México, Mexico
| | - Mario Rodríguez-Camacho
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
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19
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Martin P, Gondo Y, Lee G, Woodard JL, Miller LS, Poon LW. Cognitive Reserve and Cognitive Functioning among Oldest Old Adults: Findings from the Georgia Centenarian Study. Exp Aging Res 2022; 49:334-346. [PMID: 35929967 PMCID: PMC9899291 DOI: 10.1080/0361073x.2022.2106717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Living a long life does not guarantee the maintenance of optimal cognitive functioning; however, similar to older adults in general, cognitive reserve may also protect oldest-old adults from cognitive decline. The purpose of this study was to assess cognitive reserve among centenarians and octogenarians and to evaluate a process model of cognitive reserve. METHODS A total of 321 centenarians and octogenarians from the Georgia Centenarian Study were included in this study. Cognitive reserve components included level of education, occupational responsibility, current social engagement, past engaged lifestyle, and activity. Cognitive functioning was measured with the Mini-Mental Status Examination. RESULTS Structural equation modeling was computed, and the overall model fit well, χ2 (df = 3) = 5.02, p = .17; CFI = .99, RMSEA = .05. Education is directly and indirectly related to cognitive functioning through occupational responsibility and past engaged lifestyle. Current social engagement is related to cognitive functioning directly and indirectly through current activities. The four direct predictors (i.e., education, current social engagement, current activity, and past engaged lifestyle) explained 35% of the variance in cognitive functioning. CONCLUSION The results provide important information for cognitive reserve theories with implications for interventions that build cognitive reserve.
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Omar AKAE, Dahesh SMA, Ellakwa DES, Gomaa MK, Abdulsamad B, Hanafy R, Al Metwally HG, Mohammad RNEM, Badawy SS, El Saleh RM, Abdelhafiz ME, Gouda AM, Seada SAS, Amr MM, Asar Y, Alamrawy RG. Cognitive impairment in health care workers recovering from COVID-19 infection: a cross-sectional comparative study. Middle East Curr Psychiatry 2022; 29:79. [PMCID: PMC9573797 DOI: 10.1186/s43045-022-00245-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/05/2022] [Indexed: 06/01/2023] Open
Abstract
Background The COVID-19 outbreak has infected people all over the world where many clinics are being constructed to diagnose and treat lingering symptoms or long COVID. Neurological and long-term cognitive consequences are very worrisome. Many of COVID-19’s neurological symptoms are likely the result of the body’s extensive immunological response to infection rather than the virus attacking the brain or nervous system directly. At the same time, the extent and type of COVID-19’s cognitive consequences are unknown. The goal of this study was to assess the cognitive functions of healthcare workers 2 weeks to 3 months after COVID-19 infection. Ninety-two healthcare workers participated in the study; 32 were post-COVID-19 cases, and 60 were healthy people (the comparison group). The cognitive functions of the participants were assessed using the Addenbrooke’s Cognitive Examination (ACE-III) test, which evaluated attention, memory, language, and visuospatial skills, as well as the Arabic version of the Patient Health Questionnaire Anxiety GAD-7 and Depression Assessments PHQ-9. Results The study revealed that there was a highly significant direct correlation between post-infection with COVID-19 and scores of both anxiety and depression and an inverse correlation in the case of attention and memory. On the other hand, there is no statistical effect of post-COVID-19 on verbal fluency, language scores, and visio-spatial abilities. Using multiple linear regression, there was a powerful significant decrease effect of post-COVID-19 on memory scores controlling both anxiety and depression degrees (Beta = − 0.745, P < 0.001). Also, there was a strong negative correlation post-COVID-19 on attention scores controlling both anxiety and depression degrees (Beta = − 0.745, P < 0.001). Conclusions The study showed a strong negative effect of post-COVID-19 on the attention and memory of patients. Furthermore, both anxiety and depression scores increased significantly among the post-COVID-19 patients.
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Affiliation(s)
| | - Salwa M. A. Dahesh
- Research Institute of Medical Entomology, General Organization for Teaching Hospitals and Institutes, Ministry of Health and Population, Cairo, Egypt
| | - Doha El-Sayed Ellakwa
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | | | | | - Rana Hanafy
- Ministry of Health and Population, Cairo, Egypt
| | | | | | | | | | | | | | | | | | - Yomna Asar
- Mamoura Psychiatric Hospital, General Secretariat of Mental Health and Addiction Treatment, Ministry of Health and Population, Alexandria, Egypt
- Neuroscience Research Master Candidate, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Roa Gamal Alamrawy
- Mamoura Psychiatric Hospital, General Secretariat of Mental Health and Addiction Treatment, Ministry of Health and Population, Alexandria, Egypt
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21
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Kim J, Kim MS. An Overview of Cognitive Reserve in Aging Based on Keyword Network Analysis. INQUIRY 2022; 59:469580221139374. [DOI: 10.1177/00469580221139374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Many studies have reported that Cognitive reserve is a critical mechanism affecting cognitive statuses, such as dementia. The purposes of this study were to identify the knowledge structure and the research trend on cognitive reserve by conducting keyword analysis on research papers ranging from the earliest to the most recent studies done on the topic and to suggest directions for future research. The Web of Science (WOS) database was used to search for articles on cognitive reserve in aging from 2001 to 2020. NetMiner version 4 (cyram, KOREA), a social network analysis program, was used for keyword network analysis. Data analysis showed keywords that could be categorized as cognitive reserve related keywords (cognitive reserve related concepts, cognitive reserve related factor, cognitive reserve diagnosis and measurement, cognitive reserve outcomes) and cognitive reserve research keywords (research subject/disease, research method, intervention, research field). Through trend analysis, we found that various keywords appeared, indicating that the research has gradually developed conceptually and methodically. Based on these findings, future CR studies require the development of multimodal interface-based tools by applying modern digital technology that can be used to more accurately diagnose and monitor CR; remotely, in real time. In addition, to improve CR, it is suggested that the development of cognitive stimulation interventions utilizing VR which fuses AI based interaction technology with the subjects. Finally, CR could develop further through a cooperation of multidisciplinary professionals such as psychology, medicine and nursing.
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Affiliation(s)
- Jihyun Kim
- Sahmyook University, Seoul, Republic of Korea
| | - Mi So Kim
- Shinhan University, Gyeonggi-do, Republic of Korea
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22
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Zijlmans JL, Lamballais S, Vernooij MW, Ikram MA, Luik AI. Sociodemographic, Lifestyle, Physical, and Psychosocial Determinants of Cognitive Reserve. J Alzheimers Dis 2021; 85:701-713. [PMID: 34864674 PMCID: PMC8842775 DOI: 10.3233/jad-215122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive reserve aims to explain individual differences in the susceptibility to the functional impact of dementia in the presence of equal amount of neuropathological damage. It is thought to be shaped by a combination of innate individual differences and lifetime exposures. Which determinants are associated with cognitive reserve remains unknown. OBJECTIVE The objective of this study was to investigate the associations of sociodemographic, lifestyle, physical, and psychosocial determinants with cognitive reserve, and potential sex differences. METHODS This cross-sectional study included 4,309 participants from the Rotterdam Study (mean age 63.9±10.7) between 2006-2016. Participants completed five cognitive tests and a brain MRI-scan. Cognitive reserve was defined as a latent variable that captures variance common across five cognitive tests, while adjusting for demographic and MRI-inferred neuropathological factors. The associations of potential determinants and cognitive reserve, adjusted for relevant confounders, were assessed with structural equation models. RESULTS Current smoking (adjusted mean difference: -0.31, 95%confidence interval -0.42; -0.19), diabetes mellitus (-0.25, -0.40; -0.10) and depressive symptoms (-0.07/SD, -0.12; -0.03) were associated with a lower cognitive reserve whereas alcohol use (0.07/SD, 0.03; 0.12) was associated with higher cognitive reserve. Only smoking was associated with cognitive reserve in both men and women. Employment, alcohol use, diabetes, history of cancer, COPD, and depressive symptoms were only associated with cognitive reserve in women. CONCLUSION Our study found that current smoking, diabetes mellitus, and depressive symptoms were associated with a lower cognitive reserve, whereas more alcohol use was associated with a higher cognitive reserve, but with clear differences between men and women.
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Affiliation(s)
- Jendé L Zijlmans
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Sander Lamballais
- Department of Clinical Genetics, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.,Department of Radiology and nuclear medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
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23
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Takasugi T, Tsuji T, Hanazato M, Miyaguni Y, Ojima T, Kondo K. Community-level educational attainment and dementia: a 6-year longitudinal multilevel study in Japan. BMC Geriatr 2021; 21:661. [PMID: 34814847 PMCID: PMC8609807 DOI: 10.1186/s12877-021-02615-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As the understanding of the association between community-level education and dementia is insufficient, this study examined the contextual association of community-level prevalence of low educational attainment on the risk of dementia incidence. With this study, we further explored the potential differences in the aforementioned associations for urban and non-urban areas. METHODS We analyzed 6 years of prospective cohort data from the Japan Gerontological Evaluation Study, beginning with the baseline data collected between 2010 and 2012, for 51,186 physically and cognitively independent individuals aged ≥65 years (23,785 men and 27,401 women) from 346 communities in 16 municipalities across 7 prefectures. We assessed dementia incidence using available data from the long-term care insurance system in Japan. We dichotomized education years as ≤9 and ≥ 10 years and aggregated individual-level educational attainment as a community-level independent variable. Model 1 covariates were age and sex. Income, residential years, disease, alcohol, smoking, social isolation, and population density were added in Model 2. We conducted multiple imputation to address the missing data. We performed a two-level (community and individual) survival analysis to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS The results indicate that the cumulative incidence of dementia during the follow-up period was 10.6%. The mean proportion with educational attainment of ≤9 years was 40.8% (range: 5.1-87.3%). Low community-level educational attainment was significantly associated with higher dementia incidence (HR: 1.04; 95% CI: 1.01-1.07), estimated by 10 percentage points of low educational attainment after adjusting for individual-level educational years and covariates. While the association was significant in non-urban areas (HR: 1.07; 1.02-1.13), there was no association in urban areas (HR: 1.03; 0.99-1.06). CONCLUSIONS Older people living in communities with low educational attainment among their age demographic develop dementia more often compared with those living in areas with high educational attainment after adjusting for individual-level educational attainment and covariates; the association was pronounced in non-urban areas. Securing education for adolescents as a life course and population approach could thus be crucial in preventing dementia later in life among older people living in non-urban areas.
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Affiliation(s)
- Tomo Takasugi
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-Ward, Tokyo, 112-0012, Japan
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-Ward, Chiba City, Chiba, 263-8522, Japan.,Design Research Institute, Chiba University, 1-19-1 Bunka, Sumida-ku, Tokyo, 131-0044, Japan
| | - Yasuhiro Miyaguni
- Faculty of Social Welfare, Nihon Fukushi University, Okuda, Mihama-cho, Chita-gun, Aichi, 470-3295, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu-City, Aichi, 474-8511, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-Ward, Chiba City, Chiba, 263-8522, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu-City, Aichi, 474-8511, Japan
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24
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Brodtmann A, Werden E, Khlif MS, Bird LJ, Egorova N, Veldsman M, Pardoe H, Jackson G, Bradshaw J, Darby D, Cumming T, Churilov L, Donnan G. Neurodegeneration Over 3 Years Following Ischaemic Stroke: Findings From the Cognition and Neocortical Volume After Stroke Study. Front Neurol 2021; 12:754204. [PMID: 34744989 PMCID: PMC8570373 DOI: 10.3389/fneur.2021.754204] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/27/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Stroke survivors are at high risk of dementia, associated with increasing age and vascular burden and with pre-existing cognitive impairment, older age. Brain atrophy patterns are recognised as signatures of neurodegenerative conditions, but the natural history of brain atrophy after stroke remains poorly described. We sought to determine whether stroke survivors who were cognitively normal at time of stroke had greater total brain (TBV) and hippocampal volume (HV) loss over 3 years than controls. We examined whether stroke survivors who were cognitively impaired (CI) at 3 months following their stroke had greater brain volume loss than cognitively normal (CN) stroke participants over the next 3 years. Methods: Cognition And Neocortical Volume After Stroke (CANVAS) study is a multi-centre cohort study of first-ever or recurrent adult ischaemic stroke participants compared to age- and sex-matched community controls. Participants were followed with MRI and cognitive assessments over 3 years and were free of a history of cognitive impairment or decline at inclusion. Our primary outcome measure was TBV change between 3 months and 3 years; secondary outcomes were TBV and HV change comparing CI and CN participants. We investigated associations between group status and brain volume change using a baseline-volume adjusted linear regression model with robust standard error. Results: Ninety-three stroke (26 women, 66.7 ± 12 years) and 39 control participants (15 women, 68.7 ± 7 years) were available at 3 years. TBV loss in stroke patients was greater than controls: stroke mean (M) = 20.3 cm3 ± SD 14.8 cm3; controls M = 14.2 cm3 ± SD 13.2 cm3; [adjusted mean difference 7.88 95%CI (2.84, 12.91) p-value = 0.002]. TBV decline was greater in those stroke participants who were cognitively impaired (M = 30.7 cm3; SD = 14.2 cm3) at 3 months (M = 19.6 cm3; SD = 13.8 cm3); [adjusted mean difference 10.42; 95%CI (3.04, 17.80), p-value = 0.006]. No statistically significant differences in HV change were observed. Conclusions: Ischaemic stroke survivors exhibit greater neurodegeneration compared to stroke-free controls. Brain atrophy is greater in stroke participants who were cognitively impaired early after their stroke. Early cognitive impairment was associated greater subsequent atrophy, reflecting the combined impacts of stroke and vascular brain burden. Atrophy rates could serve as a useful biomarker for trials testing interventions to reduce post-stroke secondary neurodegeneration. Clinical Trail Registration:http://www.clinicaltrials.gov, identifier: NCT02205424.
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Affiliation(s)
- Amy Brodtmann
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dementia Research Centre, Florey Institute and University of Melbourne, Parkville, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Mohamed Salah Khlif
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Laura J Bird
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Natalia Egorova
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dementia Research Centre, Florey Institute and University of Melbourne, Parkville, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Michele Veldsman
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Heath Pardoe
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
| | - Graeme Jackson
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Jennifer Bradshaw
- Department of Clinical Neuropsychology, Austin Health, Heidelberg, VIC, Australia
| | - David Darby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dementia Research Centre, Florey Institute and University of Melbourne, Parkville, VIC, Australia
| | - Toby Cumming
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Leonid Churilov
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Geoffrey Donnan
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
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25
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Cotrena C, Branco LD, Ponsoni A, Shansis FM, Fonseca RP. Cognitive reserve may outperform age, mood and psychiatric comorbidities as a predictor of executive functioning in bipolar disorder and healthy adults. J Clin Exp Neuropsychol 2021; 43:611-622. [PMID: 34730064 DOI: 10.1080/13803395.2021.1981251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Cognitive reserve plays a protective role against executive dysfunction in healthy adults and individuals with psychiatric illnesses such as bipolar disorder. However, the magnitude of the influence of cognitive reserve on specific executive functions (EFs), and its impact relative to variables such as depressive symptoms, age and psychiatric comorbidities, is unexplored. This study aimed to quantify the influence of cognitive reserve on specific EFs, and compare its impact with that of depressive symptoms, age and psychiatric comorbidities, in separate models for patients with bipolar disorder and healthy adults. METHOD This was a cross-sectional study of 121 adults with no mood disorders and 109 with bipolar disorder, all of whom underwent a comprehensive psychiatric assessment and evaluation of the EFs. Cognitive reserve was measured using years of education, IQ and reading and writing habits. The association between EFs and predictors (cognitive reserve, depressive symptoms, age and psychiatric comorbidities) was evaluated through structural equation modeling. Four models were constructed for each group independently (bipolar disorder and control), one each for working memory, verbal fluency, inhibition and flexibility, due to group differences in age and cognitive reserve. RESULTS Working memory, inhibition and flexibility were most significantly predicted by cognitive reserve and age. Verbal fluency was only predicted by cognitive reserve. Comorbidities and depressive symptoms were not significant in any of the models. Cognitive reserve had a positive influence on all EFs in models for patients with bipolar disorder and models for control participants. Age had a negative impact on three of the four EFs tested. CONCLUSION Fostering cognitive reserve through continued education and cognitively stimulating leisure activities may be an effective intervention for executive dysfunction in patients and non-patients alike. In some cases, the effects of these interventions may outweigh the negative cognitive impact of aging, depressive symptoms and psychiatric conditions.
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Affiliation(s)
- Charles Cotrena
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS)
| | - Laura Damiani Branco
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS)
| | - André Ponsoni
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS)
| | | | - Rochele Paz Fonseca
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS)
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26
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Li X, Song R, Qi X, Xu H, Yang W, Kivipelto M, Bennett DA, Xu W. Influence of Cognitive Reserve on Cognitive Trajectories: Role of Brain Pathologies. Neurology 2021; 97:e1695-e1706. [PMID: 34493618 PMCID: PMC8605617 DOI: 10.1212/wnl.0000000000012728] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence on the association of cognitive reserve (CR) with the cognitive trajectories is limited. We aimed to examine the influence of CR indicator on domain-specific cognitive trajectories taking brain pathologies into account. METHODS Within the Rush Memory and Aging Project, 1,697 participants without dementia (mean age 79.6 years) were followed up to 21 years. CR indicator encompassing education, early-life, mid-life, and late-life cognitive activities and late-life social activity was ascertained at baseline and categorized as tertiles (lowest, middle, and highest). Global cognition, episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed were assessed annually with 19 tests, from which composite scores were derived. During the follow-up, 648 participants died and underwent autopsies to evaluate brain pathologies. Data were analyzed using linear mixed-effect models. RESULTS Among the participants, the score of the CR indicator ranged from -8.00 to 5.74 (mean 0.00 ± 2.23). In multi-adjusted mixed-effect models, compared to the lowest CR, the highest was related to a slower decline in global cognition (β = 0.028, 95% confidence interval [CI] 0.012-0.043), episodic memory (β = 0.028, 95% CI 0.010-0.047), and working memory (β = 0.019, 95% CI 0.005-0.033) during the follow-up. In brain pathologic data analysis, the association of the highest CR with cognitive function changes remained significant among participants with high Alzheimer disease pathology or gross infarcts. DISCUSSION High CR indicator is associated with preserved global cognitive function, episodic memory, and working memory, even in the presence of brain pathologies. Our findings highlight the important role of high CR accumulation in the prevention of cognitive decline.
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Affiliation(s)
- Xuerui Li
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL.
| | - Ruixue Song
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Xiuying Qi
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Hui Xu
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL.
| | - Wenzhe Yang
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Miia Kivipelto
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - David A Bennett
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Weili Xu
- From the Department of Epidemiology and Biostatistics (X.L., R.S., X.Q., W.Y., W.X.), School of Public Health, Tianjin Medical University; Tianjin Key Laboratory of Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.); Center for International Collaborative Research on Environment, Nutrition and Public Health (X.L., R.S., X.Q., W.Y., W.X.), Tianjin; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine (R.S.), Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan; Big Data and Engineering Research Center (H.X.), Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China; Division of Clinical Geriatrics, Center for Alzheimer Research (M.K.), and Aging Research Center (W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Aging (M.K.), Karolinska University Hospital, Stockholm, Sweden; Ageing and Epidemiology (AGE) Research Unit (M.K.), School of Public Health, Imperial College London, UK; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL.
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García-Moreno JA, Cañadas-Pérez F, García-García J, Roldan-Tapia MD. Cognitive Reserve and Anxiety Interactions Play a Fundamental Role in the Response to the Stress. Front Psychol 2021; 12:673596. [PMID: 34539485 PMCID: PMC8446200 DOI: 10.3389/fpsyg.2021.673596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 08/03/2021] [Indexed: 12/21/2022] Open
Abstract
The aims of the present study were to assess the possible interaction between Cognitive Reserve (CR) and State Anxiety (SA) on adrenocortical and physiological responses in coping situations. Forty healthy, middle-aged men completed the Cognitive Reserve Scale and the State-Trait Anxiety Inventory. We used an Observational Fear Conditioning (OFC) paradigm in order to assess emotional learning and to induce stress. Electrodermal activity (EDA) and salivary cortisol concentrations were measured throughout the conditions. Our results indicate that those who indicated having higher state anxiety showed a lower capacity for learning the contingency, along with presenting higher salivary cortisol peak response following the observational fear-conditioning paradigm. The most prominent finding was the interaction between cognitive reserve and state anxiety on cortisol response to the post observational fear-conditioning paradigm. Thus, those who showed a high anxiety-state and, at the same time, a high cognitive reserve did not present an increased salivary cortisol response following the observational fear-conditioning paradigm. Given these results, we postulate that the state anxiety reported by participants, reflects emotional activation that hinders the attention needed to process and associate emotional stimuli. However, cognitive reserve has an indirect relation with conditioning, enabling better emotional learning. In this context, cognitive reserve demonstrated a protective effect on hormonal response in coping situations, when reported anxiety or emotional activation were high. These findings suggest that cognitive reserve could be used as a tool to deal with the effects of stressors in life situations, limiting development of the allostatic load.
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Affiliation(s)
- Jose A García-Moreno
- CERNEP Research Center, University of Almeria, Almería, Spain.,CEINSAUAL Research Center, University of Almeria, Almería, Spain
| | - Fernando Cañadas-Pérez
- CERNEP Research Center, University of Almeria, Almería, Spain.,CEINSAUAL Research Center, University of Almeria, Almería, Spain
| | | | - María D Roldan-Tapia
- CERNEP Research Center, University of Almeria, Almería, Spain.,CEINSAUAL Research Center, University of Almeria, Almería, Spain
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28
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Bocancea DI, van Loenhoud AC, Groot C, Barkhof F, van der Flier WM, Ossenkoppele R. Measuring Resilience and Resistance in Aging and Alzheimer Disease Using Residual Methods: A Systematic Review and Meta-analysis. Neurology 2021; 97:474-488. [PMID: 34266918 PMCID: PMC8448552 DOI: 10.1212/wnl.0000000000012499] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/14/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE There is a lack of consensus on how to optimally define and measure resistance and resilience in brain and cognitive aging. Residual methods use residuals from regression analysis to quantify the capacity to avoid (resistance) or cope (resilience) "better or worse than expected" given a certain level of risk or cerebral damage. We reviewed the rapidly growing literature on residual methods in the context of aging and Alzheimer disease (AD) and performed meta-analyses to investigate associations of residual method-based resilience and resistance measures with longitudinal cognitive and clinical outcomes. METHODS A systematic literature search of PubMed and Web of Science databases (consulted until March 2020) and subsequent screening led to 54 studies fulfilling eligibility criteria, including 10 studies suitable for the meta-analyses. RESULTS We identified articles using residual methods aimed at quantifying resistance (n = 33), cognitive resilience (n = 23), and brain resilience (n = 2). Critical examination of the literature revealed that there is considerable methodologic variability in how the residual measures were derived and validated. Despite methodologic differences across studies, meta-analytic assessments showed significant associations of levels of resistance (hazard ratio [HR] [95% confidence interval (CI)] 1.12 [1.07-1.17]; p < 0.0001) and levels of resilience (HR [95% CI] 0.46 [0.32-0.68]; p < 0.001) with risk of progression to dementia/AD. Resilience was also associated with rate of cognitive decline (β [95% CI] 0.05 [0.01-0.08]; p < 0.01). DISCUSSION This review and meta-analysis supports the usefulness of residual methods as appropriate measures of resilience and resistance, as they capture clinically meaningful information in aging and AD. More rigorous methodologic standardization is needed to increase comparability across studies and, ultimately, application in clinical practice.
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Affiliation(s)
- Diana I Bocancea
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Anna C van Loenhoud
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Colin Groot
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Frederik Barkhof
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Wiesje M van der Flier
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Rik Ossenkoppele
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
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Vujic A, Mowszowski L, Meares S, Duffy S, Batchelor J, Naismith SL. Engagement in cognitively stimulating activities in individuals with Mild Cognitive Impairment: relationships with neuropsychological domains and hippocampal volume. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2021; 29:1000-1021. [PMID: 34330189 DOI: 10.1080/13825585.2021.1955822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Late-life participation in cognitively stimulating activities is thought to contribute to an individual's cognitive reserve and thus protect against cognitive decline, yet its association with clinical markers of neurodegeneration is not well established. To investigate, we developed a 13-item self-report "cognitively stimulating activities" questionnaire (CSA-Q), which was completed by a community sample of 269 older adults (>50 years) at risk of dementia. Participants met criteria for Mild Cognitive Impairment (MCI) and were classified as amnestic (aMCI; n = 93) or non-amnestic (naMCI; n = 176). Weighted CSA-Q dimensions were calculated for activity intensity, mental engagement and social engagement via a panel of 23 inter-raters. The CSA-Q mean and its dimensions were examined in relation to: (a) demographics (age, sex), (b) cognitive reserve proxies (years of education, premorbid IQ), (c) neuropsychological markers across cognitive domains of executive function, processing speed, learning, and memory storage, and (d) neuroimaging markers (left and right hippocampal volume). Analyses were conducted for all MCI, as well as for aMCI and naMCI sub-types. The CSA-Q was found to have concurrent validity with cognitive reserve proxies. Among all MCI, the CSA-Q dimensions of intensity and mental engagement had moderate associations with left hippocampal volume, but not with neuropsychological performance. For naMCI, the CSA-Q had moderate associations with left hippocampal volume, and small associations with aspects of executive functioning and processing speed. No equivalent associations emerged for the aMCI subtype. Our findings show that the CSA-Q may be particularly useful for older adults with non-amnestic cognitive deficits.
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Affiliation(s)
- Adam Vujic
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Department of Science, School of Psychology, University of Sydney, Sydney, Australia
| | - Susanne Meares
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Shantel Duffy
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Charles Perkins Centre, University of Sydney, Australia.,Faculty of Health Sciences, Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Jennifer Batchelor
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Department of Science, School of Psychology, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Australia
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Wright LM, De Marco M, Venneri A. A Graph Theory Approach to Clarifying Aging and Disease Related Changes in Cognitive Networks. Front Aging Neurosci 2021; 13:676618. [PMID: 34322008 PMCID: PMC8311855 DOI: 10.3389/fnagi.2021.676618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/04/2021] [Indexed: 01/12/2023] Open
Abstract
In accordance with the physiological networks that underlie it, human cognition is characterized by both the segregation and interdependence of a number of cognitive domains. Cognition itself, therefore, can be conceptualized as a network of functions. A network approach to cognition has previously revealed topological differences in cognitive profiles between healthy and disease populations. The present study, therefore, used graph theory to determine variation in cognitive profiles across healthy aging and cognitive impairment. A comprehensive neuropsychological test battery was administered to 415 participants. This included three groups of healthy adults aged 18-39 (n = 75), 40-64 (n = 75), and 65 and over (n = 70) and three patient groups with either amnestic (n = 75) or non-amnestic (n = 60) mild cognitive impairment or Alzheimer's type dementia (n = 60). For each group, cognitive networks were created reflective of test-to-test covariance, in which nodes represented cognitive tests and edges reflected statistical inter-nodal significance (p < 0.05). Network metrics were derived using the Brain Connectivity Toolbox. Network-wide clustering, local efficiency and global efficiency of nodes showed linear differences across the stages of aging, being significantly higher among older adults when compared with younger groups. Among patients, these metrics were significantly higher again when compared with healthy older controls. Conversely, average betweenness centralities were highest in middle-aged participants and lower among older adults and patients. In particular, compared with controls, patients demonstrated a distinct lack of centrality in the domains of semantic processing and abstract reasoning. Network composition in the amnestic mild cognitive impairment group was similar to the network of Alzheimer's dementia patients. Using graph theoretical methods, this study demonstrates that the composition of cognitive networks may be measurably altered by the aging process and differentially impacted by pathological cognitive impairment. Network alterations characteristic of Alzheimer's disease in particular may occur early and be distinct from alterations associated with differing types of cognitive impairment. A shift in centrality between domains may be particularly relevant in identifying cognitive profiles indicative of underlying disease. Such techniques may contribute to the future development of more sophisticated diagnostic tools for neurodegenerative disease.
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Affiliation(s)
- Laura M Wright
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
| | - Matteo De Marco
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom.,Department of Life Sciences, Brunel University London, London, United Kingdom
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Boyle R, Knight SP, De Looze C, Carey D, Scarlett S, Stern Y, Robertson IH, Kenny RA, Whelan R. Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults. Alzheimers Res Ther 2021; 13:128. [PMID: 34253231 PMCID: PMC8276413 DOI: 10.1186/s13195-021-00870-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/28/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cognitive reserve is most commonly measured using socio-behavioural proxy variables. These variables are easy to collect, have a straightforward interpretation, and are widely associated with reduced risk of dementia and cognitive decline in epidemiological studies. However, the specific proxies vary across studies and have rarely been assessed in complete models of cognitive reserve (i.e. alongside both a measure of cognitive outcome and a measure of brain structure). Complete models can test independent associations between proxies and cognitive function in addition to the moderation effect of proxies on the brain-cognition relationship. Consequently, there is insufficient empirical evidence guiding the choice of proxy measures of cognitive reserve and poor comparability across studies. METHOD In a cross-sectional study, we assessed the validity of 5 common proxies (education, occupational complexity, verbal intelligence, leisure activities, and exercise) and all possible combinations of these proxies in 2 separate community-dwelling older adult cohorts: The Irish Longitudinal Study on Ageing (TILDA; N = 313, mean age = 68.9 years, range = 54-88) and the Cognitive Reserve/Reference Ability Neural Network Study (CR/RANN; N = 234, mean age = 64.49 years, range = 50-80). Fifteen models were created with 3 brain structure variables (grey matter volume, hippocampal volume, and mean cortical thickness) and 5 cognitive variables (verbal fluency, processing speed, executive function, episodic memory, and global cognition). RESULTS No moderation effects were observed. There were robust positive associations with cognitive function, independent of brain structure, for 2 individual proxies (verbal intelligence and education) and 16 composites (i.e. combinations of proxies). Verbal intelligence was statistically significant in all models. Education was significant only in models with executive function as the cognitive outcome variable. Three robust composites were observed in more than two-thirds of brain-cognition models: the composites of (1) occupational complexity and verbal intelligence, (2) education and verbal intelligence, and (3) education, occupational complexity, and verbal intelligence. However, no composite had larger average effects nor was more robust than verbal intelligence alone. CONCLUSION These results support the use of verbal intelligence as a proxy measure of CR in cross-sectional studies of cognitively healthy older adults.
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Affiliation(s)
- R Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - S P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - C De Looze
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - D Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - S Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Y Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York City, USA
| | - I H Robertson
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - R Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
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Feinkohl I, Kozma P, Borchers F, van Montfort SJT, Kruppa J, Winterer G, Spies C, Pischon T. Contribution of IQ in young adulthood to the associations of education and occupation with cognitive ability in older age. BMC Geriatr 2021; 21:346. [PMID: 34090365 PMCID: PMC8180039 DOI: 10.1186/s12877-021-02290-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Studies suggest that a higher education and occupation are each associated with a higher late-life cognitive ability, but their inter-relationships in their association with cognitive ability and the contribution of peak IQ in young adulthood (‘pre-morbid IQ’) often remain unclear. Methods Cross-sectional analysis of 623 participants aged ≥65 years of the BioCog study. Education was coded according to the International Standard Classification of Education (ISCED; range 1 to 6). Occupation was coded as ‘semi/unskilled’, ‘skilled manual’, ‘skilled non-manual’, ‘managerial’, ‘professional’. A summary score of global ability (‘g’) was constructed from six cognitive tests. Pre-morbid IQ was estimated from vocabulary. The Geriatric Depression Scale assessed symptoms of depression. Age- and sex-adjusted analyses of covariance were performed. Results Education (partial eta2 0.076; p < 0.001) and occupation (partial eta2 = 0.037; p < 0.001) were each significantly associated with g. For education, the association was attenuated but remained statistically significant when pre-morbid IQ was controlled for (partial eta2 0.036; p < 0.001) and was unchanged with additional adjustment for depression (partial eta2 0.037; p < 0.001). For occupation, the association with g was no longer significant when pre-morbid IQ (partial eta2 = 0.015; p = 0.06) and depression (partial eta2 = 0.011; p = 0.18) were entered as covariates in separate steps. When education and occupation were entered concurrently into the fully adjusted model, only education was independently associated with g (partial eta2 0.030; p < 0.001; occupation, p = 0.93). Conclusion While a higher education and a higher occupation were each associated with a higher late-life cognitive ability, only for education some unique contribution to cognitive ability remained over and above its relationship with pre-morbid IQ, depression, and occupation. Further research is needed to address whether a longer time spent in education may promote late-life cognitive ability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02290-y.
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Affiliation(s)
- Insa Feinkohl
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle Str. 10, 13092, Berlin, Germany.
| | - Petra Kozma
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedrich Borchers
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Jochen Kruppa
- Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georg Winterer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Spies
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle Str. 10, 13092, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany.,Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Core Facility Biobank, Berlin, Germany
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Stebbins RC, Noppert GA, Yang YC, Dowd JB, Simanek A, Aiello AE. Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study. Am J Epidemiol 2021; 190:786-797. [PMID: 33094810 DOI: 10.1093/aje/kwaa238] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/12/2020] [Accepted: 10/20/2020] [Indexed: 12/26/2022] Open
Abstract
Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect-measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (-0.56 points (95% confidence interval: -1.63, 0.52) and -0.89 points (95% confidence interval: -2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among persons with fewer educational resources.
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Petersen JD, Wehberg S, Packness A, Svensson NH, Hyldig N, Raunsgaard S, Andersen MK, Ryg J, Mercer SW, Søndergaard J, Waldorff FB. Association of Socioeconomic Status With Dementia Diagnosis Among Older Adults in Denmark. JAMA Netw Open 2021; 4:e2110432. [PMID: 34003271 PMCID: PMC8132141 DOI: 10.1001/jamanetworkopen.2021.10432] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Low socioeconomic status (SES) has been identified as a risk factor for the development of dementia. However, few studies have focused on the association between SES and dementia diagnostic evaluation on a population level. OBJECTIVE To investigate whether household income (HHI) is associated with dementia diagnosis and cognitive severity at the time of diagnosis. DESIGN, SETTING, AND PARTICIPANTS This population- and register-based cross-sectional study analyzed health, social, and economic data obtained from various Danish national registers. The study population comprised individuals who received a first-time referral for a diagnostic evaluation for dementia to the secondary health care sector of Denmark between January 1, 2017, and December 17, 2018. Dementia-related health data were retrieved from the Danish Quality Database for Dementia. Data analysis was conducted from October 2019 to December 2020. EXPOSURES Annual HHI (used as a proxy for SES) for 2015 and 2016 was obtained from Statistics Denmark and categorized into upper, middle, and lower tertiles within 5-year interval age groups. MAIN OUTCOMES AND MEASURES Dementia diagnoses (Alzheimer disease, vascular dementia, mixed dementia, dementia with Lewy bodies, Parkinson disease dementia, or other) and cognitive stages at diagnosis (cognitively intact; mild cognitive impairment but not dementia; or mild, moderate, or severe dementia) were retrieved from the database. Univariable and multivariable logistic and linear regressions adjusted for age group, sex, region of residence, household type, period (2017 and 2018), medication type, and medical conditions were analyzed for a possible association between HHI and receipt of dementia diagnosis. RESULTS Among the 10 191 individuals (mean [SD] age, 75 [10] years; 5476 women [53.7%]) included in the study, 8844 (86.8%) were diagnosed with dementia. Individuals with HHI in the upper tertile compared with those with lower-tertile HHI were less likely to receive a dementia diagnosis after referral (odds ratio, 0.65; 95% CI, 0.55-0.78) and, if diagnosed with dementia, had less severe cognitive stage (β, -0.16; 95% CI, -0.21 to -0.10). Individuals with middle-tertile HHI did not significantly differ from those with lower-tertile HHI in terms of dementia diagnosis (odds ratio, 0.92; 95% CI, 0.77-1.09) and cognitive stage at diagnosis (β, 0.01; 95% CI, -0.04 to 0.06). CONCLUSIONS AND RELEVANCE The results of this study revealed a social inequality in dementia diagnostic evaluation: in Denmark, people with higher income seem to receive an earlier diagnosis. Public health strategies should target people with lower SES for earlier dementia detection and intervention.
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Affiliation(s)
- Jindong Ding Petersen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sonja Wehberg
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Aake Packness
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | - Nanna Herning Svensson
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Nana Hyldig
- OPEN (Open Patient Data Explorative Network), Odense University Hospital, Region of Southern Denmark, Odense, Denmark
| | - Søren Raunsgaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Merethe Kirstine Andersen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Ryg
- Geriatric Research Unit, Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Stewart W. Mercer
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Frans Boch Waldorff
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Section of General Practice, Research Unit of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Abstract
BACKGROUND In the current climate of an ageing population, it is imperative to identify preventive measures for dementia. AIMS We implemented a multifaceted index of cognitive reserve markers and investigated dementia incidence over 15 years of follow-up in a representative sample of the English population. METHOD Data were 12 280 participants aged ≥50 years from the English Longitudinal Study of Ageing, free from dementia at their baseline assessments during wave 1 (2002-2003), 3 (2006-2007) or 4 (2008-2009), and followed up until wave 8 (2016-2017). The Cognitive Reserve Index was constructed as a composite measure of education, occupation and leisure activities, using a standardised questionnaire. Cox proportional hazards regression models were used to estimate the hazard ratios of dementia in relation to cognitive reserve levels (low, medium and high) and its components (education, occupation and leisure activities). RESULTS During the follow-up period, 602 participants aged 56-99 years developed dementia. Higher levels of cognitive reserve (hazard ratio 0.65, 95% CI 0.48-0.89, P = 0.008) were associated with a lower risk of dementia. An individual analysis of its components showed that higher levels of education (hazard ratio 0.56, 95% CI 0.36-0.88, P = 0.012), occupation (hazard ratio 0.72, 95% CI 0.56-0.91, P = 0.008) and leisure activities (hazard ratio 0.74, 95% CI 0.56-0.99, P = 0.047) were predictive of a reduced dementia risk, with the first two components particularly protective in younger participants (<85 years). CONCLUSIONS This study showed a reduced risk of dementia for individuals with a higher level of cognitive reserve, represented by higher education, complex occupations and multifaceted level of leisure activities.
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Balzarotti S, Biassoni F, Confalonieri F, Meinero CA, Ciceri MR. Cognitive Reserve and Driving-Related Cognitive Abilities in a Sample of Oldest Old Drivers Undergoing Assessment of Fitness to Drive. J Appl Gerontol 2021; 40:1758-1767. [PMID: 33645249 DOI: 10.1177/0733464821994703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examines the relationship between age, cognitive reserve (CR), and driving-related cognitive abilities in a sample of oldest old drivers undergoing evaluation of fitness to drive. Structural equation modeling was used to investigate the associations between age, CR, and performances to a standardized set of cognitive tests assessing fitness to drive. Education and work complexity were used as proxy measures of CR. The results showed both measures of CR, but not age, were significantly associated with higher general intelligence. Education also predicted higher decision speed, and decision speed partly mediated the effect of education on general intelligence. These findings suggest that over age of 80 years old, CR was a better predictor of driving-related cognitive abilities than age. Education was associated with better performance across different cognitive domains including processing speed.
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Alvares Pereira G, Silva Nunes MV, Alzola P, Contador I. Cognitive reserve and brain maintenance in aging and dementia: An integrative review. Appl Neuropsychol Adult 2021; 29:1615-1625. [PMID: 33492168 DOI: 10.1080/23279095.2021.1872079] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This research is an integrative review of scientific evidence differentiating between cognitive reserve (CR) and brain maintenance concepts. Thus, we have examined how CR socio-behavioral proxies (i.e. education, occupational attainment, and leisure activities) may help to cope with age-related cognitive decline and negative consequences of brain pathology. We also analyze lifestyle factors associated with brain maintenance or the relative absence of change in neural resources over time. Medline and Web of Science databases were used for the bibliographic search in the last 20 years. Observational cohort studies were selected to analyze the effect of different CR proxies on cognitive decline, including dementia incidence, whereas studies employing functional neuroimaging (fMRI) were used to display the existence of compensation mechanisms. Besides, structural MRI studies were used to test the association between lifestyle factors and neural changes. Our findings suggest that education, leisure activities, and occupational activity are protective factors against cognitive decline and dementia. Moreover, functional neuroimaging studies have verified the existence of brain networks that may underlie CR. Therefore, CR may be expressed either through a more efficient utilization (neural reserve) of brain networks or the recruitment of additional brain regions (compensation). Finally, lifestyle factors such as abstaining from smoking, lower alcohol consumption, and physical activity contributed to brain maintenance and were associated with the preservation of cognitive function. Advances in multimodal neuroimaging studies, preferably longitudinal design, will allow a better understanding of the neural mechanisms associated with the prevention of cognitive decline and preservation of neural resources in aging.
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Affiliation(s)
| | - Maria Vânia Silva Nunes
- Health Sciences Institute, Portuguese Catholic University, Lisbon, Portugal.,Interdisciplinary Health Research Center, Lisbon, Portugal
| | - Patricia Alzola
- Department of Basic Psychology, Psychobiology and Methodology, University of Salamanca, Salamanca, Spain
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology, University of Salamanca, Salamanca, Spain
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Gómez-Ramírez J, Ávila-Villanueva M, Fernández-Blázquez MÁ. Selecting the most important self-assessed features for predicting conversion to mild cognitive impairment with random forest and permutation-based methods. Sci Rep 2020; 10:20630. [PMID: 33244011 DOI: 10.1038/s41598-020-77296-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 11/09/2020] [Indexed: 12/11/2022] Open
Abstract
Alzheimer's Disease is a complex, multifactorial, and comorbid condition. The asymptomatic behavior in the early stages makes the identification of the disease onset particularly challenging. Mild cognitive impairment (MCI) is an intermediary stage between the expected decline of normal aging and the pathological decline associated with dementia. The identification of risk factors for MCI is thus sorely needed. Self-reported personal information such as age, education, income level, sleep, diet, physical exercise, etc. is called to play a key role not only in the early identification of MCI but also in the design of personalized interventions and the promotion of patients empowerment. In this study, we leverage a large longitudinal study on healthy aging in Spain, to identify the most important self-reported features for future conversion to MCI. Using machine learning (random forest) and permutation-based methods we select the set of most important self-reported variables for MCI conversion which includes among others, subjective cognitive decline, educational level, working experience, social life, and diet. Subjective cognitive decline stands as the most important feature for future conversion to MCI across different feature selection techniques.
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de Godoy LL, Alves CAPF, Saavedra JSM, Studart-Neto A, Nitrini R, da Costa Leite C, Bisdas S. Understanding brain resilience in superagers: a systematic review. Neuroradiology 2020; 63:663-683. [PMID: 32995945 DOI: 10.1007/s00234-020-02562-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/16/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Superagers are older adults presenting excellent memory performance that may reflect resilience to the conventional pathways of aging. Our contribution aims to shape the evidence body of the known distinctive biomarkers of superagers and their connections with the Brain and Cognitive Reserve and Brain Maintenance concepts. METHODS We performed a systematic literature search in PubMed and ScienceDirect with no limit on publication date for studies that evaluated potential biomarkers in superagers classified by validated neuropsychological tests. Methodological quality was assessed using the QUADAS-2 tool. RESULTS Twenty-one studies were included, the majority in neuroimaging, followed by histological, genetic, cognition, and a single one on blood plasma analysis. Superagers exhibited specific regions of cortical preservation, rather than global cortical maintenance, standing out the anterior cingulate and hippocampus regions. Both superagers and controls showed similar levels of amyloid deposition. Moreover, the functional oscillation patterns in superagers resembled those described in young adults. Most of the quality assessment for the included studies showed medium risks of bias. CONCLUSION This systematic review supports selective cortical preservation in superagers, comprehending regions of the default mode, and salience networks, overlapped by stronger functional connectivity. In this context, the anterior cingulate cortex is highlighted as an imaging and histologic signature of these subjects. Besides, the biomarkers included pointed out that the Brain and Cognitive Reserve and Brain Maintenance concepts are independent and complementary in the superagers' setting.
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Affiliation(s)
- Laiz Laura de Godoy
- The National Hospital of Neurology and Neurosurgery, University College London, London, UK. .,Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
| | | | | | - Adalberto Studart-Neto
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Ricardo Nitrini
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Claudia da Costa Leite
- Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Sotirios Bisdas
- The National Hospital of Neurology and Neurosurgery, University College London, London, UK
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40
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Paplikar A, Ballal D, Varghese F, Sireesha J, Dwivedi R, Rajan A, Mekala S, Arshad F, Kaul S, Alladi S. Assessment of Lifestyle Experiences across Lifespan and Cognitive Ageing in the Indian Context. Psychology and Developing Societies 2020. [DOI: 10.1177/0971333620937512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With rising numbers of elderly and dementia in developing societies, there is a need to understand factors protective against dementia. Evidence suggests that lifetime cognitive activities including education, occupation, and complex leisure activities contribute to cognitive reserve. However, these factors are understudied in India. This paper describes the validation of the Lifetime of Experiences Questionnaire (LEQ), a comprehensive measure of complex lifetime activities, to the Indian cultural context. It also examines the relationship between lifetime experiences and cognition among 52 healthy elderly and 30 dementia patients. High inter-rater (κ=0.923, p < 0.001), test-retest (ρ: 0.905 to 0.986) reliability, and internal consistency were found for LEQ-total (0.992) and sub-scores. Literate dementia patients (25) scored significantly lower mid-life (27.5 vs. 23.3), late-life (28.5 vs. 22.5) and total LEQ (83.5 vs. 20.9) scores than literate healthy group (37). LEQ scores positively correlated with global cognition, and domains of attention and memory on the Addenbrooke’s Cognitive Examination, in healthy and dementia groups. Moreover, LEQ scores correlated positively with age at onset of dementia and negatively with clinical dementia rating (CDR) scores. Our study demonstrates that lifetime activities, especially mid-life experiences, play a protective role in development of late-life dementia, and need to be advocated to preserve late-life cognition.
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Affiliation(s)
- Avanthi Paplikar
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Divya Ballal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Feba Varghese
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jala Sireesha
- Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Ramya Dwivedi
- Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Amulya Rajan
- Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Shailaja Mekala
- Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Subhash Kaul
- Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Langer K, O'Shea DM, De Wit L, DeFeis B, Mejia A, Amofa P, Chandler M, Locke DEC, Fields J, Phatak V, Dean PM, Smith G. Self-Efficacy Mediates the Association Between Physical Function and Perceived Quality of Life in Individuals with Mild Cognitive Impairment. J Alzheimers Dis 2020; 68:1511-1519. [PMID: 30909227 DOI: 10.3233/jad-181020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Research has shown that individuals with mild cognitive impairment (MCI) value quality of life (QoL) above and beyond cognitive function or other potential outcomes in MCI. There is evidence supporting the negative impact of poor physical function on QoL ratings. OBJECTIVE The study explored whether a modified measure of self-efficacy for managing MCI and education mediated and/or moderated the relationship between physical function and QoL in persons with MCI. METHODS Baseline data from 200 participants with MCI were obtained from a larger study assessing the effectiveness of a behavioral intervention. Physical function was assessed by the Short Physical Performance Battery. QoL was assessed with the Quality of Life in Alzheimer's Disease scale. Memory-related self-efficacy was assessed using a modified 9-item version of the Chronic Disease Self-Efficacy Scales. Mediation and moderation analyses tested the hypotheses that self-efficacy and education alter the association between physical function and QoL in individuals with MCI. All analyses were adjusted for age, cognitive severity, and sex. RESULTS Self-efficacy for managing MCI was a significant mediator of the association between physical function and perceived QoL. Individuals with better physical function reported higher self-efficacy which was associated with higher QoL ratings. CONCLUSIONS Greater self-efficacy for managing MCI mediated the negative association between physical function and quality of life in this exploratory study. Interventions aimed at enhancing memory self-efficacy in MCI may improve perceived QoL, even in the presence of poor physical function. Future research is needed to investigate this further.
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Affiliation(s)
- Kailey Langer
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Deirdre M O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Brittany DeFeis
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea Mejia
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Priscilla Amofa
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Melanie Chandler
- Division of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Dona E C Locke
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Julie Fields
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, USA
| | - Vaishali Phatak
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Pamela M Dean
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Stephan BCM, Siervo M, Brayne C. How can population‐based studies best be utilized to reduce the global impact of dementia? Recommendations for researchers, funders, and policymakers. Alzheimers Dement 2020; 16:1448-1456. [DOI: 10.1002/alz.12127] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/22/2020] [Accepted: 05/06/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Blossom C. M. Stephan
- Institute of Mental Health Division of Psychiatry and Applied Psychology School of Medicine University of Nottingham Innovation Park Nottingham UK
| | - Mario Siervo
- School of Life Sciences Queen's Medical Centre The University of Nottingham Medical School Nottingham UK
| | - Carol Brayne
- Department of Public Health and Primary Care Cambridge Institute of Public Health University of Cambridge Cambridge UK
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Chen L, Lu B. Cognitive reserve regulates the association between hearing difficulties and incident cognitive impairment evidence from a longitudinal study in China. Int Psychogeriatr 2020; 32:635-43. [PMID: 31744571 DOI: 10.1017/S1041610219001662] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive reserve (CR) can prevent the risk of incident cognitive impairment in the elderly. However, the moderator effects of CR on the link between hearing difficulties (HDs) and the risk of incident cognitive impairment are not well understood. METHODS This cohort study obtained data from the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014. The baseline samples included 6309 participants aged 65 years and older at baseline. Cognitive impairment was assessed using the Chinese version of the Mini Mental State Examination. A composite measure of CR was calculated based on education, occupational complexity, and leisure activities of the participants. The marginal structural model was utilized to investigate whether CR moderates the association between HD and incident cognitive impairment. Odds ratios (ORs) and accompanying 95% confidence intervals (CIs) were calculated. RESULTS Of the 6309 participants at baseline, 1936 (30.7%) developed cognitive impairment during the 6-year follow-up period and 2562 (40.6%) reported HD. The risk of incident cognitive impairment was 1.90-fold (95% CI 1.69-2.14) for participants developing HD compared to those without. Those with middle CR had lower OR (0.72, 95% CI 0.62-0.82) that further decreased to 0.58 (95% CI 0.49-0.69) for those with high CR. Participants with HD with low CR showed the highest OR (4.32, 95% CI 3.42-5.47). In addition, individuals with HD with low education levels or low complex occupations had the highest risk of incident cognitive impairment. CONCLUSIONS CR moderates the negative association between HD and cognitive function. Education and occupation complexity may be more sensitive proxies for CR.
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Abstract
Objectives: Dementia related cognitive impairment, as forgetting recent memories, brings several emotional challenges to patients and their families. This paper reports a case of a non-collaborative high-education level patient. who recurrently refused a set of conventional cognitive stimulation exercises, as he also was in refusal of his cognitive impairment. The aim of this report is to show the benefits of a personalized cognitive stimulation (PCS) program.Methods: A24-sessions PCS program was conceived within a person-centered care approach and in active co-creation between the therapist and the patient.Results: The results evidence the patient's increasing therapeutic engagement in the proposed activities, along with mild cognitive improvement. This procedure also promoted a diagnosis acceptance and the patient's mood stabilization. Two illustrative materials used in this tailored intervention are available as supplemental material.Conclusions: Cognitive stimulating programs benefit from tailoring and personalization. Personalization indeed helped the patient feeling engaged and increased his participation in the activities. Furthermore, his mood stabilized, and the patient accepted his cognitive impairments. Thus, PCS is a way of reaching person-centered care.Clinical implications: PCS may be used to improve patient's engagement in the stimulating activities. Also, PCS promoted the dementia diagnosis acceptance..
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Affiliation(s)
| | - Oscar Ribeiro
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.,Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
| | - Humbertina Maia
- Psychogeriatrics Service, Hospital de Magalhães Lemos, Porto, Portugal
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Peña-González P, Mondragón-Maya A, Silva-Pereyra J, Roa-Rojas P. Cognitive Reserve and Executive Functions in Adults with Type 2 Diabetes. J Diabetes Res 2020; 2020:7941543. [PMID: 33083496 PMCID: PMC7557905 DOI: 10.1155/2020/7941543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/22/2020] [Accepted: 08/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adults with type two diabetes mellitus (DM2) show cognitive deficits within the executive function domain. The detrimental effects of DM2 over executive function (EF) performance may be mediated by factors such as cognitive reserve (CR). CR mediates cognitive performance by delaying the appearance of clinical symptoms from subjacent brain pathology or attenuating the severity of such symptoms. Our main goal was to study the effects of CR on executive functions of adults with DM2. METHODS Data from a total of 1,034 adults were included (362 women, 672 men). Subjects were categorized into four groups: subjects with DM2 and high CR (n = 235), control subjects with high CR (n = 265), subjects with DM2 and low CR (n = 298), and control subjects with low CR (n = 236). CR was quantified through 3 proxies: education, occupational complexity, and leisure activities. Executive functions were evaluated through visual scanning, verbal fluency, and backwards counting tasks. First, a series of four one-way ANOVAs was performed where group was included as a between-subject factor and executive function as a dependent variable. Second, a hierarchical multiple regression analysis was conducted to assess the weight of each CR proxy on EF performance. RESULTS CR level significantly affected all executive function scores independently of the diabetes status. Hierarchical regression analyses indicated that years of education accounted for most of the variance in the model for executive function performance. In this study, we found that there is a significant effect of CR on executive function performance of DM2 subjects and education is the most important CR proxy.
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Affiliation(s)
| | - Alejandra Mondragón-Maya
- Carrera de Psicología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, Mexico
| | - Juan Silva-Pereyra
- Proyecto de Neurociencias, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, Mexico
| | - Paloma Roa-Rojas
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico
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Lessov-Schlaggar CN, Del Rosario OL, Morris JC, Ances BM, Schlaggar BL, Constantino JN. Adaptation of the Clinical Dementia Rating Scale for adults with Down syndrome. J Neurodev Disord 2019; 11:39. [PMID: 31842726 DOI: 10.1186/s11689-019-9300-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 11/25/2019] [Indexed: 12/14/2022] Open
Abstract
Background Adults with Down syndrome (DS) are at increased risk for Alzheimer disease dementia, and there is a pressing need for the development of assessment instruments that differentiate chronic cognitive impairment, acute neuropsychiatric symptomatology, and dementia in this population of patients. Methods We adapted a widely used instrument, the Clinical Dementia Rating (CDR) Scale, which is a component of the Uniform Data Set used by all federally funded Alzheimer Disease Centers for use in adults with DS, and tested the instrument among 34 DS patients recruited from the community. The participants were assessed using two versions of the modified CDR—a caregiver questionnaire and an in-person interview involving both the caregiver and the DS adult. Assessment also included the Dementia Scale for Down Syndrome (DSDS) and the Raven’s Progressive Matrices to estimate IQ. Results Both modified questionnaire and interview instruments captured a range of cognitive impairments, a majority of which were found to be chronic when accounting for premorbid function. Two individuals in the sample were strongly suspected to have early dementia, both of whom had elevated scores on the modified CDR instruments. Among individuals rated as having no dementia based on the DSDS, about half showed subthreshold impairments on the modified CDR instruments; there was substantial agreement between caregiver questionnaire screening and in-person interview of caregivers and DS adults. Conclusions The modified questionnaire and interview instruments capture a range of impairment in DS adults, including subthreshold symptomatology, and the instruments provide complementary information relevant to the ascertainment of dementia in DS. Decline was seen across all cognitive domains and was generally positively related to age and negatively related to IQ. Most importantly, adjusting instrument scores for chronic, premorbid impairment drastically shifted the distribution toward lower (no impairment) scores.
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Menardi A, Pascual-Leone A, Fried PJ, Santarnecchi E. The Role of Cognitive Reserve in Alzheimer's Disease and Aging: A Multi-Modal Imaging Review. J Alzheimers Dis 2019; 66:1341-1362. [PMID: 30507572 DOI: 10.3233/jad-180549] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Comforts in modern society have generally been associated with longer survival rates, enabling individuals to reach advanced age as never before in history. With the increase in longevity, however, the incidence of neurodegenerative diseases, especially Alzheimer's disease, has also doubled. Nevertheless, most of the observed variance, in terms of time of clinical diagnosis and progression, often remains striking. Only recently, differences in the social, educational and occupational background of the individual, as proxies of cognitive reserve (CR), have been hypothesized to play a role in accounting for such discrepancies. CR is a well-established concept in literature; lots of studies have been conducted in trying to better understand its underlying neural substrates and associated biomarkers, resulting in an incredible amount of data being produced. Here, we aimed to summarize recent relevant published work addressing the issue, gathering evidence for the existence of a common path across research efforts that might ease future investigations by providing a general perspective on the actual state of the arts. An innovative model is hereby proposed, addressing the role of CR across structural and functional evidences, as well as the potential implementation of non-invasive brain stimulation techniques in the causal validation of such theoretical frame.
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Affiliation(s)
- Arianna Menardi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Emiliano Santarnecchi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Takasugi T, Tsuji T, Nagamine Y, Miyaguni Y, Kondo K. Socio-economic status and dementia onset among older Japanese: A 6-year prospective cohort study from the Japan Gerontological Evaluation Study. Int J Geriatr Psychiatry 2019; 34:1642-1650. [PMID: 31328308 DOI: 10.1002/gps.5177] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/17/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Lower socio-economic status (SES) may be associated with dementia later in life, but there is inconsistent evidence supporting this claim. We aim to examine the association between three SESs (education, job, and income indicators) and dementia onset in older adults. METHODS Study design was a 6-year prospective cohort study. Participants included a total of 52 063 community-dwelling adults aged 65 years or older without long-term care needs from the Japan Gerontological Evaluation Study. Outcome variable was dementia onset. Explanatory variables were educational years, the longest job held, and equivalised household income. We performed Cox proportional hazard analysis by gender with multiple imputation. RESULTS During the follow-up period, 10.5% of participants acquired dementia. The adjusted risks of dementia incidence of the participants with less than 6 years of education were 1.34 times (95% confidence interval [CI], 1.04-1.73) in men and 1.21 (1.00-1.45) times in women higher than those with more than 13 years of education. Females with less than 1.99 million yen (hazard ratio = 0.83, 0.72-0.96) of equivalised income were less likely to acquire dementia than those with four million yen or higher. CONCLUSIONS Educational attainment had a robust impact on dementia onset compared with the other SES factors in both genders of older Japanese people. Securing an education for children could be crucial to prevent dementia later in life. The longest job held was less likely to be risks of dementia incidence, compared with the other two factors.
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Affiliation(s)
- Tomo Takasugi
- Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.,Business R&D Department, Risk Management Business Unit, Sompo Risk Management Inc, Tokyo, Japan
| | - Taishi Tsuji
- Department of Social Preventive Medical Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yuiko Nagamine
- Department of Social Preventive Medical Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yasuhiro Miyaguni
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Toledo-Fernández A, Marín-Navarrete R, Villalobos-Gallegos L, Salvador-Cruz J, Benjet C, Roncero C. Testing whether cognitive reserve as measured by self-rating of stimulating activities moderates the association of polysubstance use and neurocognitive disorder. Cogn Neuropsychiatry 2019; 24:421-433. [PMID: 31554497 DOI: 10.1080/13546805.2019.1670631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Introduction: The objectives were to identify a latent factor of cognitive reserve (CR) assessed by self-rating of cognitively stimulating activities, to analyze the association between this factor and educational attainment, and to test whether CR moderates the association between polysubstance use and neurocognitive disorder (NCD). Methods: Cross-sectional data of 753 participants was collected in Mexico City. A questionnaire for self-rating of stimulating activities (work/education, leisure, physical, social, usual- and current environments) was designed. Confirmatory factor analysis was performed to test unifactoriality. This CR factor was then used within a structural equation model of moderation between recent- and years of substance use and indicators of NCD (Montreal Cognitive Assessment and an interview for subjective cognitive deficits). Results: We found acceptable goodness-of-fit values for the unifactorial model, but no association of this factor with educational attainment, nor with recent- and years of substance use (suggesting independence of CR and severity of neuropathology). We did not find a moderation effect of CR between substance use and indicators of NCD; CR was negatively associated with subjective cognitive deficits only. Conclusions: Moderation effect of self-rated CR should be further tested using direct measures of substance-induced neuropathology. Measurement of self-rated CR may complement self-reported cognitive examination.
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Affiliation(s)
- Aldebarán Toledo-Fernández
- Clinical Trials Unit on Addiction and Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz (INPRFM), Mexico City, Mexico
| | - Rodrigo Marín-Navarrete
- Clinical Trials Unit on Addiction and Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz (INPRFM), Mexico City, Mexico
| | - Luis Villalobos-Gallegos
- School of Medicine and Psychology, Autonomous University of Baja California-Tijuana, Tijuana, Mexico
| | - Judith Salvador-Cruz
- Department of Neuropsychology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Corina Benjet
- Division of Epidemiological and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
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Abstract
Socioeconomic conditions in childhood predict cognitive functioning in later life. It is unclear whether poor childhood socioeconomic status (SES) also predicts the acceleration of cognitive decline. One proposed pathway is via cardiometabolic risk, which has been linked to both childhood SES and earlier onset of cognitive impairment. Using data from the Health and Retirement Study, we examine the impact of childhood SES on cognitive trajectories over six years and test whether it operates through increased cardiometabolic risk and adult SES. We find that higher childhood SES leads to slower cognitive decline, partially due to lower levels of cardiometabolic risk. However, these pathways operate entirely through adult socioeconomic attainment. The results have important implications for future trends in cognitive population health within the context of growing social inequality and reduced social mobility.
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Affiliation(s)
- Katsuya Oi
- Northern Arizona University, Flagstaff, AZ, USA
| | - Steven Haas
- Pennsylvania State University, Tempe, AZ, USA
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